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Science Capsule: Spasmodic Dysphonia
Voice production and its quality influence the communicative exchange throughout the lifespan. Voice disorders are overwhelmingly underrecognized. Occupational voice disorders are estimated to affect 28 million Americans and have a significant impact on the livelihood of teachers/professors, TV and radio journalists, lawyers, and singers. The NIDCD supports basic and clinical research studies that focus on normal voice production and the prevention and treatment of voice disorders.
Spasmodic dysphonia (SD), also referred to as laryngeal dystonia, is a voice disorder that belongs to a family of neurological disorders called focal dystonias. SD can affect anyone. When a person with SD attempts to speak, the muscles in the larynx spasm involuntarily and cause the voice to break up and sound strained or breathy. It is a rare disorder, occurring in roughly one to six of every 100,000 people. The first signs of this disorder start to appear in individuals aged 30 to 50 years. More women than men are affected. Currently, there is no cure for SD, and the most common treatment is the injection of very small amounts of botulinum toxin directly into the affected muscles of the larynx. Repeat injections are necessary as the effects last only a few months. In addition, surgical procedures, like the selective laryngeal adductor denervation-reinnervation have yielded good results in people with adductor spasmodic dysphonia. Voice therapy can also be helpful, especially when a patient has developed compensation techniques.
The NIDCD currently funds research to determine the causes and pathophysiology of SD to develop new diagnostics and better treatment options. NIDCD-supported scientists are using multi-modal imaging and next-generation DNA sequencing to identify brain abnormalities and genetic risk factors for SD. By identifying genes responsible for this voice disorder, the Institute is directly addressing the need for better, more accurate detection and diagnosis in this clinical population. NIDCD-supported scientists are now pursuing two new areas for therapies and surgical interventions: locating specific brain areas involved in regulating laryngeal muscles and understanding the neural mechanisms by which they exert their control. In addition, research is also focused on determining if there are deficits in auditory and sensory feedback processing.
The NIDCD will continue to support voice disorders research, guided by recommendations from a 2013 NIDCD-sponsored workshop on voice sciences and disorders. Leading experts in the field agreed that it is essential to strengthen the pipeline of future voice scientists by creating collaborative teams to address lingering research questions. Accordingly, the NIDCD issued two Funding Opportunity Announcements (FOAs) on Advancing Research in Voice Disorders. The initiatives seek cutting-edge research proposals such as the development of biomaterials for engineering vocal fold tissue and development of ambulatory biofeedback approaches for management of patients with voice disorders. Additionally, the FOAs encourage patient outcomes research, health services research, and community-based research with special attention to the needs of individuals with low socio-economic status, disparities, rural, second language populations, and women’s health.
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