{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T09:03:56Z","timestamp":1784365436499,"version":"3.55.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T00:00:00Z","timestamp":1717027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Laryngeal dystonia is a task-specific focal dystonia of laryngeal muscles that impairs speech and voice production. At present, there is no cure for LD. The most common therapeutic option for patients with LD involves Botulinum neurotoxin injections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Provide empirical evidence that non-invasive vibro-tactile stimulation (VTS) of the skin over the voice box can provide symptom relief to those affected by LD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Single-group 11-week randomized controlled trial with a crossover between two dosages (20\u2009min of VTS once or 3 times per week) self-administered in-home in two 4-week blocks. Acute effects of VTS on voice and speech were assessed in-lab at weeks 1, 6 and 11. Participants were randomized to receive either 40\u2009Hz or 100\u2009Hz VTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Primary: <jats:italic>smoothed cepstral peak prominence<\/jats:italic> (CPPS) of the voice signal to quantify voice and speech abnormalities, and <jats:italic>perceived speech effort<\/jats:italic> (PSE) ranked by participants as a measure of voice effort (scale 1\u201310). Secondary: <jats:italic>number of voice breaks<\/jats:italic> during continuous speech, the <jats:italic>Consensus Auditory-Perceptual Evaluation of Voice<\/jats:italic> (CAPE-V) inventory as a measure of overall disease severity and the <jats:italic>Voice Handicap Index<\/jats:italic> 30-item self report.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty-nine people with a confirmed diagnosis of adductor-type LD (mean [SD] age, 60.3 [11.3] years; 18 women and 21 men) completed the study. A single application of VTS improved voice quality (median CPPS increase: 0.41\u2009dB, 95% CI [0.20, 0.61]) and\/or reduced voice effort (PSE) by at least 30% in up to 57% of participants across the three study visits. Effects lasted from less than 30\u2009min to several days. There was no effect of dosage and no evidence that the acute therapeutic effects of VTS increased or decreased longitudinally over the 11-week study period. Both 100 and 40\u2009Hz VTS induced measurable improvements in voice quality and speech effort. VTS induced an additional benefit to those receiving Botulinum toxin. Participants, not receiving Botulinum treatment also responded to VTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study provides the first systematic empirical evidence that the prolonged use of laryngeal VTS can induce repeatable acute improvements in voice quality and reductions of voice effort in LD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>ClinicalTrials.gov<\/jats:ext-link> ID: NCT03746509.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1403050","type":"journal-article","created":{"date-parts":[[2024,5,30]],"date-time":"2024-05-30T04:43:57Z","timestamp":1717044237000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of an 11-week vibro-tactile stimulation treatment on voice symptoms in laryngeal dystonia"],"prefix":"10.3389","volume":"15","author":[{"given":"J\u00fcrgen","family":"Konczak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya","family":"Bhaskaran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Elangovan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinseok","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George S.","family":"Goding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter 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dysphonia","volume":"148","author":"Rosow","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"458","DOI":"10.3389\/fnhum.2014.00458","article-title":"Focal dystonia and the sensory-motor integrative loop for enacting (SMILE)","volume":"8","author":"Perruchoud","year":"2014","journal-title":"Front Hum Neurosci"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1177\/000348949510401203","article-title":"Abnormalities in long latency responses to superior laryngeal nerve stimulation in adductor spasmodic dysphonia","volume":"104","author":"Ludlow","year":"1995","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"14705","DOI":"10.1523\/JNEUROSCI.0407-13.2013","article-title":"Abnormal striatal dopaminergic neurotransmission during rest and task production in spasmodic dysphonia","volume":"33","author":"Simonyan","year":"2013","journal-title":"J Neurosci"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"2749","DOI":"10.1093\/cercor\/bhq023","article-title":"Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an fMRI study","volume":"20","author":"Simonyan","year":"2010","journal-title":"Cereb Cortex"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1002\/lary.20677","article-title":"Brainstem pathology in spasmodic dysphonia","volume":"120","author":"Simonyan","year":"2010","journal-title":"Laryngoscope"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2051","DOI":"10.1111\/ejn.12977","article-title":"Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia","volume":"42","author":"Suppa","year":"2015","journal-title":"Eur J Neurosci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1136\/jnnp.59.5.493","article-title":"Changes in the balance between motor cortical excitation and inhibition in focal, task specific dystonia","volume":"59","author":"Ridding","year":"1995","journal-title":"J Neurol Neurosurgery Psychiatry"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1002\/mds.870130123","article-title":"Alterations of motor cortical inhibition in patients with dystonia","volume":"13","author":"Rona","year":"1998","journal-title":"Mov Disord"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.parkreldis.2022.08.029","article-title":"Structural and functional brain abnormalities in idiopathic cervical dystonia: a multimodal meta-analysis","volume":"103","author":"Huang","year":"2022","journal-title":"Parkinsonism Relat Disord"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1033","DOI":"10.1016\/j.clinph.2019.03.003","article-title":"Atypical somatosensory-motor cortical response during vowel vocalization in spasmodic dysphonia","volume":"130","author":"Khosravani","year":"2019","journal-title":"Clin Neurophysiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1093\/brain\/awr332","article-title":"Oscillations in sensorimotor cortex in movement disorders: an electrocorticography study","volume":"135","author":"Crowell","year":"2012","journal-title":"Brain"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1001\/jamaneurol.2015.2561","article-title":"Patterns of cortical synchronization in isolated dystonia compared with parkinson disease","volume":"72","author":"Miocinovic","year":"2015","journal-title":"JAMA Neurol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1002\/1531-8249(200004)47:4<456::AID-ANA8>3.0.CO;2-Q","article-title":"Movement-related electroencephalographic desynchronization in patients with hand cramps: evidence for motor cortical involvement in focal dystonia","volume":"47","author":"Toro","year":"2000","journal-title":"Ann Neurol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/S1474-4422(13)70213-8","article-title":"Sensory aspects of movement disorders","volume":"13","author":"Patel","year":"2014","journal-title":"Lancet Neurol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1152\/jn.1963.26.1.177","article-title":"The response to vibration of the end organs of mammalian muscle spindels","volume":"26","author":"Bianconi","year":"1963","journal-title":"J Neurophysiol"},{"key":"ref19","first-page":"31P","article-title":"The use of vibration as a selective repetitive stimulus for Ia afferent fibres","volume":"191","author":"Brown","year":"1967","journal-title":"J Physiol"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1016\/0304-3940(82)90190-2","article-title":"Response to pressure and vibration of slowly adapting cutaneous mechanoreceptors in the human foot","volume":"34","author":"Vedel","year":"1982","journal-title":"Neurosci Lett"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"1382","DOI":"10.1126\/science.175.4028.1382","article-title":"Proprioceptive illusions induced by muscle vibration: contribution by muscle spindles to perception?","volume":"175","author":"Goodwin","year":"1972","journal-title":"Science"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1093\/brain\/95.4.705","article-title":"The contribution of muscle afferents to kinaesthesia shown by vibration induced illusions of movement and by the effects of paralysing joint afferents","volume":"95","author":"Goodwin","year":"1972","journal-title":"Brain"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1016\/j.expneurol.2007.01.010","article-title":"Changes in cortical and pallidal oscillatory activity during the execution of a sensory trick in patients with cervical 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Physiol"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1679\/aohc.45.145","article-title":"Encapsulated sensory corpuscle in the mucosa of human vocal cord: an electron microscope study","volume":"45","author":"Nagai","year":"1982","journal-title":"Arch Histol Jpn"},{"key":"ref28","first-page":"341","article-title":"PRAAT, a system for doing phonetics by computer","volume":"2001","author":"Boersma","year":"2001","journal-title":"Glot International"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/j.jvoice.2014.05.005","article-title":"Quantifying the cepstral peak prominence, a measure of dysphonia","volume":"28","author":"Heman-Ackah","year":"2014","journal-title":"J Voice"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"742","DOI":"10.3109\/02699206.2010.492446","article-title":"Quantifying dysphonia severity using a spectral\/cepstral-based acoustic index: comparisons with auditory-perceptual judgements from the CAPE-V","volume":"24","author":"Awan","year":"2010","journal-title":"Clin Linguist Phon"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/j.jvoice.2011.05.001","article-title":"Vowel- and text-based cepstral analysis of chronic hoarseness","volume":"26","author":"Mors","year":"2012","journal-title":"J Voice"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1016\/j.parkreldis.2020.03.012","article-title":"Voice analysis in adductor spasmodic dysphonia: objective diagnosis and response to botulinum toxin","volume":"73","author":"Suppa","year":"2020","journal-title":"Parkinsonism Relat Disord"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.jvoice.2014.08.017","article-title":"A review of measures of vocal effort with a preliminary study on the establishment of a vocal effort measure","volume":"29","author":"Ford Baldner","year":"2015","journal-title":"J Voice"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"14","DOI":"10.1044\/1058-0360(2010\/09-0105)","article-title":"Establishing validity of the consensus auditory-perceptual evaluation of voice (CAPE-V)","volume":"20","author":"Zraick","year":"2011","journal-title":"Am J Speech Lang Pathol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1044\/1058-0360.0603.66","article-title":"The voice handicap index (VHI): development and validation","volume":"63","author":"Jacobson","year":"1997","journal-title":"Am J Speech Lang Pathol"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"251524592091188","DOI":"10.1177\/2515245920911881","article-title":"The percentile bootstrap: a primer with step-by-step instructions in R","volume":"4","author":"Rousselet","year":"2021","journal-title":"Adv Methods Pract Psychol Sci"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41598-019-54396-4","article-title":"Laryngeal 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