Clinical Trials Logo

Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT06402214
Other study ID # ID 6117
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date May 1, 2024
Est. completion date May 1, 2025

Study information

Verified date April 2024
Source Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Contact Maria Raffaella Marchese, MD, PhD
Phone +39-3391144556
Email raffaellamarchese@gmail.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

Adductory spasmodic dysphonia (AdSD) is a rare condition characterised by irregular and uncontrolled voice interruptions, most commonly affecting women around the age of 45. The diagnosis is clinical and usually requires evaluation by several specialists. The exact cause is not known, but a disturbance of the motor system is hypothesised, probably related to various causes such as loss of cortical inhibition or problems with sensory input. Neuroimaging studies have shown hyperactivity in various brain regions during speech production in patients with AdSD, but it is still unclear whether this hyperactivity is due to a malfunction of auditory and somatosensory feedback or an impairment of motor programming. Recent research indicates that patients with AdSD show excessive muscle activation during phonation, probably due to abnormal processing of auditory feedback. This suggests that intervention in the auditory system may offer new treatment opportunities. The proposed study aims to describe the acoustic, auditory-perceptual and subjective voice and speech changes in AdSD subjects during the Quick-Lombard Test (LT), a test that assesses vocal response under noisy conditions.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 18
Est. completion date May 1, 2025
Est. primary completion date April 30, 2025
Accepts healthy volunteers Accepts Healthy Volunteers
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria: - Native Italian-speaking patients; - Normal hearing, hearing threshold < 20 dB HL for frequencies from 0.5 to 4 KHz; - Age >18 years and <65 years; - Written informed consent. Exclusion Criteria: - Non-Italian-speaking patients. - Patients undergoing treatment for dystonia. - Previous laryngeal surgery. - Patient undergoing speech therapy. - Patient undergoing dopaminergic therapy. - Inability to sustain phonation of sufficient duration >3 seconds or to perform sufficient tests to assess vocal outcomes. - Lack of written informed consent.

Study Design


Intervention

Other:
Lombard test
In this study a single-subject enrolment session will be set up, with the presence of a dedicated physician for informed consent, the performance of a tonal audiometric examination and a clinical practice phoniatric examination for all enrolled subjects, the collection of voice recordings both before and during the Lombard Test (LT) and the administration of the rating scales both before and after the LT performance. For each subject, voice recordings will be made of the vowel /a/ sustained for at least four seconds with a comfortable tone and volume and of the speech obtained from the reading aloud and volume of normal conversation of a phonetically balanced text (The Desert) lasting about 1 minute, first in a silent condition and then in the presence of noise. Specifically, for the LT, each subject will be exposed to a free-fieldwhite noise of speech(SWN) administered through headphones. The intensity of the noise will be 70 dB SPL. Voice recordings will be made in a quiet room.

Locations

Country Name City State
Italy Fondazione Policlinico Universitario A. Gemelli IRCCS Roma

Sponsors (1)

Lead Sponsor Collaborator
Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Country where clinical trial is conducted

Italy, 

Outcome

Type Measure Description Time frame Safety issue
Primary OMNI Vocal Effort Scale It is a validated instrument for the assessment of vocal effort perceived by the patient with AdSD. The OMNI-VES is a visual analogue scale 0-10 with graphic representation of vocal effort. The OMNI-VES will be administered under silent conditions and after the LT At the time of enrollement
Primary Auditory-perceptual assessment Blinded perceptual assessment, using the Global Grading Scale - Hoarseness - Straining - Asthenia - Straining (GRBAS) 0-3 (0 = normal; 1 = mild; 2 = moderate; 3 = severe) will be performed on the recorded voice samples by two speech therapists who will not be involved in the patients' care. Each voice sample will be anonymised and randomly distributed to the assessors. At the time of enrollement
Primary Maximum Phonation Time The maximum phonatory time (TMF) will be obtained by asking the subject to sustain the vowel /a/ as long as possible in one breath. The longest of the three attempts will be calculated as TMF in seconds. The TMF will be obtained before and during LT. at the time of enrollement
Primary Average Frequency (Hz) The Average Frequency is the fundamental frequency of the voice (pitch) usually ranges from approximately 30-300 Hz, but this varies according to different speakers: typically males' pitch ranges from 50-180Hz and females from 80-250Hz, so we usually set the pitch range to a reasonable range of 50-400Hz for general usage At the time of enrollement
Primary Maximum Frequency (Hz) The Maximum Frequency (Hz) is the highest frequency recorded within the voice signal At the time of enrollement
Primary Maximum Intensity (dB SPL) The Maximum Intensity (dB SPL) parameter refers to the highest intensity of the recorded voice signal At the time of enrollement
Primary Degree of Voice Interruptions (%) Degree of Voice Interruptions (%) is useful for the evaluation of temporary vocal interruption At the time of enrollement
Primary Cepstral Peak Prominence-Smoothed (CPPS) Cepstral Peak Prominence-Smoothed (CPPS) has been defined as a spectrum of a spectrum, whereby an inverse Fast Fourier Transform of the natural log of a frequency-domain spectrum is applied, transforming the spectrum to the time domain. The cepstral peak (CP) is a representation of the most dominant peak in the cepstrum - normally the fundamental frequency (fo) in a type I signal. After its first applications to voice was established the method of normalizing the amplitude of the overall cepstrum using a linear regression line. When applied to the cepstrum, the level difference (dB) between the cepstral peak and the regression line at the same quefrency provides the cepstral peak prominence (CPP). The CPPS values obtained from speech and vowel tasks proved reliable in predicting overall grade of dysphonia as well as breathiness. At the time of enrollement
Primary Number of Voice Interruptions Number of Voice Interruptions is useful for the evaluation of temporary vocal interruption At the time of enrollement
See also
  Status Clinical Trial Phase
Recruiting NCT05158166 - DaxibotulinumtoxinA Injection for Treatment of Adductor Spasmodic Dysphonia Phase 1/Phase 2
Enrolling by invitation NCT03129087 - The Effect of Vocal Rest Versus Vocalization Following Xeomin® Injections in Spasmodic Dysphonia N/A
Completed NCT03349086 - Effects of Vocal Exercises for Spasmodic Dysphonia N/A
Completed NCT02528006 - Treatment for Adductor Spasmodic Dysphonia by Type 2 Thyroplasty Using Titanium Bridges Phase 2/Phase 3
Not yet recruiting NCT05467228 - Laryngeal Vibro-tactile Stimulation as a Non-invasive Symptomatic Treatment for Spasmodic Dysphonia Phase 2
Completed NCT05158179 - Assessment of Laryngopharyngeal Sensation in Adductor Spasmodic Dysphonia N/A