Advertisement

Laryngeal Dystonia

  • Justin M. Hintze
  • Christy L. Ludlow
  • David G. LottEmail author
Chapter
  • 50 Downloads

Abstract

Spasmodic dysphonia (SD) is a focal laryngeal dystonia characterized by irregular and uncontrollable voice breaks. SD is a rare condition and predominantly occurs in females in their middle decades of life. Limited case series have indicated possible risk factors associated with the occurrence of SD, including a personal or family history of other types of movement disorders, previous viral illnesses, extensive voice use, and stress. In general, most cases seem sporadic and only a few appear to be familial and genetically determined. Other possible pathophysiological mechanisms include sensory processing disturbances, reduced cortical inhibition, and neurophysiological increases in excitability in the primary somatosensory cortex. Some neuroanatomical abnormalities have also been found. Overall, SD is likely a complex neural network disorder rather than one single neuroanatomical defect.

Diagnosis of SD is frequently delayed due to the complexity and overlapping of symptoms. Diagnosis should ideally involve a multidisciplinary team and include a speech examination and nasolaryngoscopy. The mainstay of treatment for SD is repeated botulinum neurotoxin injections. Surgical options, including manipulation of the larynx either by denervation, myectomy of the thyroarytenoid muscle, or laryngoplasty, have shown variable effectiveness.

Keywords

Spasmodic dysphonia (SD) Voice breaks Adductor SD Abductor SD Nasolaryngoscopy Botulinum neurotoxin injections (BoNT) Genetics Spasmodic Dysphonia Attribute Inventory (SDAI) Electromyography Surgical intervention Deep brain stimulation GABA antagonists 

References

  1. 1.
    Hintze JM, Ludlow CL, Bansberg SF, Adler CH, Lott DG. Spasmodic dysphonia: a review. Part 1: pathogenic factors. Otolaryngol Head Neck Surg. 2017;157(4):551–7.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Murry T. Spasmodic dysphonia: let’s look at that again. (The G. Paul Moore Lecture, 42nd annual symposium: care of the professional voice, Philadelphia, PA, 1 Jun 2013). J Voice. 2014;28(6):694–9.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Ludlow CL, Adler CH, Berke GS, Bielamowicz SA, Blitzer A, Bressman SB, et al. Research priorities in spasmodic dysphonia. Otolaryngol Head Neck Surg. 2008;139(4):495–505.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Edgar JD, Sapienza CM, Bidus K, Ludlow CL. Acoustic measures of symptoms in abductor spasmodic dysphonia. J Voice. 2001;15(3):362–72.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Robe E, Brumlik J, Moore P. A study of spastic dysphonia. Neurologic and electroencephalographic abnormalities. Laryngoscope. 1960;70:219–45.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Castelon Konkiewitz E, Trender-Gerhard I, Kamm C, Warner T, Ben-Shlomo Y, Gasser T, et al. Service-based survey of dystonia in Munich. Neuroepidemiology. 2002;21(4):202–6.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Nutt JG, Muenter MD, Melton LJ 3rd, Aronson A, Kurland LT. Epidemiology of dystonia in Rochester, Minnesota. Adv Neurol. 1988;50:361–5.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Patel AB, Bansberg SF, Adler CH, Lott DG, Crujido L. The Mayo Clinic Arizona spasmodic dysphonia experience: a demographic analysis of 718 patients. Ann Otol Rhinol Laryngol. 2015;124(11):859–63.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. Eur J Neurol. 2010;17(Suppl 1):28–30.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Childs L, Rickert S, Murry T, Blitzer A, Sulica L. Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients. Laryngoscope. 2011;121(10):2195–8.PubMedCrossRefPubMedCentralGoogle Scholar
  11. 11.
    Schweinfurth JM, Billante M, Courey MS. Risk factors and demographics in patients with spasmodic dysphonia. Laryngoscope. 2002;112(2):220–3.PubMedCrossRefPubMedCentralGoogle Scholar
  12. 12.
    Tanner K. Epidemiologic advances in spasmodic dysphonia. Perspect Voice Voice Disord. 2012;22(3):104.  https://doi.org/10.1044/vvd22.3.104.CrossRefGoogle Scholar
  13. 13.
    Tanner K, Roy N, Merrill RM, Sauder C, Houtz DR, Smith ME. Case-control study of risk factors for spasmodic dysphonia: a comparison with other voice disorders. Laryngoscope. 2012;122(5):1082–92.PubMedCrossRefGoogle Scholar
  14. 14.
    Izdebski K, Dedo HH, Boles L. Spastic dysphonia: a patient profile of 200 cases. Am J Otolaryngol. 1984;5(1):7–14.PubMedCrossRefGoogle Scholar
  15. 15.
    Blitzer A, Jahn AF, Keidar A. Semon’s law revisited: an electromyographic analysis of laryngeal synkinesis. Ann Otol Rhinol Laryngol. 1996;105(10):764–9.PubMedCrossRefGoogle Scholar
  16. 16.
    de Gusmao CM, Fuchs T, Moses A, Multhaupt-Buell T, Song PC, Ozelius LJ, et al. Dystonia-causing mutations as a contribution to the etiology of spasmodic dysphonia. Otolaryngol Head Neck Surg. 2016;155(4):624–8.PubMedPubMedCentralCrossRefGoogle Scholar
  17. 17.
    Lohmann K, Wilcox RA, Winkler S, Ramirez A, Rakovic A, Park JS, et al. Whispering dysphonia (DYT4 dystonia) is caused by a mutation in the TUBB4 gene. Ann Neurol. 2013;73(4):537–45.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Fuchs T, Saunders-Pullman R, Masuho I, Luciano MS, Raymond D, Factor S, et al. Mutations in GNAL cause primary torsion dystonia. Nat Genet. 2013;45(1):88–92.PubMedCrossRefGoogle Scholar
  19. 19.
    Putzel GG, Fuchs T, Battistella G, Rubien-Thomas E, Frucht SJ, Blitzer A, et al. GNAL mutation in isolated laryngeal dystonia. Mov Disord. 2016;31(5):750–5.PubMedPubMedCentralCrossRefGoogle Scholar
  20. 20.
    Jinnah HA, Berardelli A, Comella C, Defazio G, Delong MR, Factor S, et al. The focal dystonias: current views and challenges for future research. Mov Disord. 2013;28(7):926–43.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Butefisch CM, Boroojerdi B, Chen R, Battaglia F, Hallett M. Task-dependent intracortical inhibition is impaired in focal hand dystonia. Mov Disord. 2005;20(5):545–51.PubMedPubMedCentralCrossRefGoogle Scholar
  22. 22.
    Samargia S, Schmidt R, Kimberley TJ. Shortened cortical silent period in adductor spasmodic dysphonia: evidence for widespread cortical excitability. Neurosci Lett. 2014;560:12–5.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Lanzaro M, Petrone R, D’Ambrosio A. Successful treatment with clozapine in a patient with neuroleptic-induced acute laryngeal dystonia. Eur Psychiatry. 2001;16(4):261–2.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Kirke DN, Frucht SJ, Simonyan K. Alcohol responsiveness in laryngeal dystonia: a survey study. J Neurol. 2015;262(6):1548–56.PubMedPubMedCentralCrossRefGoogle Scholar
  25. 25.
    Termsarasab P, Ramdhani RA, Battistella G, Rubien-Thomas E, Choy M, Farwell IM, et al. Neural correlates of abnormal sensory discrimination in laryngeal dystonia. Neuroimage Clin. 2016;10:18–26.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Antelmi E, Erro R, Rocchi L, Liguori R, Tinazzi M, Di Stasio F, et al. Neurophysiological correlates of abnormal somatosensory temporal discrimination in dystonia. Mov Disord. 2017;32:141–8.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Ludlow CL, Schulz GM, Yamashita T, Deleyiannis FW. Abnormalities in long latency responses to superior laryngeal nerve stimulation in adductor spasmodic dysphonia. Ann Otol Rhinol Laryngol. 1995;104(12):928–35.PubMedCrossRefPubMedCentralGoogle Scholar
  28. 28.
    Deleyiannis FW, Gillespie M, Bielamowicz S, Yamashita T, Ludlow CL. Laryngeal long latency response conditioning in abductor spasmodic dysphonia. Ann Otol Rhinol Laryngol. 1999;108(6):612–9.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Cohen LG, Ludlow CL, Warden M, Estegui MD, Agostino R, Sedory SE, et al. Blink reflex curves in patients with spasmodic dysphonia. Neurology. 1989;39:572–7.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Simonyan K, Ludlow CL. Abnormal activation of the primary somatosensory cortex in spasmodic dysphonia: an FMRI study. Cereb Cortex. 2010;20(11):2749–59.PubMedPubMedCentralCrossRefGoogle Scholar
  31. 31.
    Simonyan K, Tovar-Moll F, Ostuni J, Hallett M, Kalasinsky VF, Lewin-Smith MR, et al. Focal white matter changes in spasmodic dysphonia: a combined diffusion tensor imaging and neuropathological study. Brain. 2008;131(Pt 2):447–59.PubMedCrossRefGoogle Scholar
  32. 32.
    Creighton FX, Hapner E, Klein A, Rosen A, Jinnah HA, Johns MM. Diagnostic delays in spasmodic dysphonia: a call for clinician education. J Voice. 2015;29(5):592–4.PubMedPubMedCentralCrossRefGoogle Scholar
  33. 33.
    Whurr R, Lorch M. Review of differential diagnosis and management of spasmodic dysphonia. Curr Opin Otolaryngol Head Neck Surg. 2016;24(3):203–7.PubMedCrossRefGoogle Scholar
  34. 34.
    Ludlow CL, Domangue R, Sharma D, Jinnah HA, Perlmutter JS, Berke G, et al. Consensus-based attributes for identifying patients with spasmodic dysphonia and other voice disorders. JAMA Otolaryngol Head Neck Surg. 2018;144:657–65.PubMedPubMedCentralCrossRefGoogle Scholar
  35. 35.
    Roy N, Bless DM, Heisey D, Ford CN. Manual circumlaryngeal therapy for functional dysphonia: an evaluation of short- and long-term treatment outcomes. J Voice. 1997;11:321–31.PubMedCrossRefGoogle Scholar
  36. 36.
    Roy N, Ford CN, Bless DM. Muscle tension dysphonia and spasmodic dysphonia: the role of manual laryngeal tension reduction in diagnosis and management. Ann Otol Rhinol Laryngol. 1996;105:851–6.PubMedCrossRefGoogle Scholar
  37. 37.
    Roy N, Mazin A, Awan SN. Automated acoustic analysis of task dependency in adductor spasmodic dysphonia versus muscle tension dysphonia. Laryngoscope. 2014;124(3):718–24.PubMedCrossRefGoogle Scholar
  38. 38.
    Novakovic D, Waters HH, D’Elia JB, Blitzer A. Botulinum toxin treatment of adductor spasmodic dysphonia: longitudinal functional outcomes. Laryngoscope. 2011;121(3):606–12.PubMedCrossRefGoogle Scholar
  39. 39.
    Hintze JM, Ludlow CL, Bansberg SF, Adler CH, Lott DG. Spasmodic dysphonia: a review. Part 2: characterization of pathophysiology. Otolaryngol Head Neck Surg. 2017;157(4):558–64.PubMedCrossRefGoogle Scholar
  40. 40.
    Tsuji DH, Hachiya A, Dajer ME, Ishikawa CC, Takahashi MT, Montagnoli AN. Improvement of vocal pathologies diagnosis using high-speed videolaryngoscopy. Int Arch Otorhinolaryngol (New York: Thieme). 2014;18(3):294–302.CrossRefGoogle Scholar
  41. 41.
    Yang Q, Xu W, Li Y, Cheng L. Value of laryngeal electromyography in spasmodic dysphonia diagnosis and therapy. Ann Otol Rhinol Laryngol. 2015;124(7):579–83.PubMedCrossRefPubMedCentralGoogle Scholar
  42. 42.
    Van Pelt F, Ludlow CL, Smith PJ. Comparison of muscle activation patterns in adductor and abductor spasmodic dysphonia. Ann Otol Rhinol Laryngol. 1994;103:192–200.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Kraft S, Childes J, Hillel A, Schindler J. Refractory dysphonia due to isolated cricothyroid muscle dystonia. J Voice. 2016;30(4):501–5.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Ludlow CL, Naunton RF, Terada S, Anderson BJ. Successful treatment of selected cases of abductor spasmodic dysphonia using botulinum toxin injection. Otolaryngol Head Neck Surg. 1991;104(6):849–55.PubMedCrossRefPubMedCentralGoogle Scholar
  45. 45.
    Sataloff RT, Mandel S, Mann EA, Ludlow CL. Practice parameter: laryngeal electromyography (an evidence-based review). Otolaryngol Head Neck Surg. 2004;130(6):770–9.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Blitzer A, Lovelace RE, Brin MF, Fahn S, Fink ME. Electromyographic findings in focal laryngeal dystonia (spastic dysphonia). Ann Otol Rhinol Laryngol. 1985;94(6 Pt 1):591–4.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Adler CH, Bansberg SF, Krein-Jones K, Hentz JG. Safety and efficacy of botulinum toxin type B (Myobloc) in adductor spasmodic dysphonia. Mov Disord. 2004;19(9):1075–9.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Ludlow CL, Naunton RF, Sedory SE, Schulz GM, Hallett M. Effects of botulinum toxin injections on speech in adductor spasmodic dysphonia. Neurology. 1988;38(8):1220–5.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Blitzer A, Brin MF, Stewart CF. Botulinum toxin management of spasmodic dysphonia (laryngeal dystonia): a 12-year experience in more than 900 patients. Laryngoscope. 1998;108(10):1435–41.PubMedCrossRefPubMedCentralGoogle Scholar
  50. 50.
    Adams SG, Durkin LC, Irish JC, Wong DL, Hunt EJ. Effects of botulinum toxin type A injections on aerodynamic measures of spasmodic dysphonia. Laryngoscope. 1996;106(3 Pt 1):296–300.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Rojas GV, Ricz H, Tumas V, Rodrigues GR, Toscano P, Aguiar-Ricz L. Vocal parameters and self-perception in individuals with adductor spasmodic dysphonia. J Voice. 2017;31(3):391.e7–391.e18.CrossRefGoogle Scholar
  52. 52.
    Mor N, Simonyan K, Blitzer A. Central voice production and pathophysiology of spasmodic dysphonia. Laryngoscope. 2018;128(1):177–83.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Ali SO, Thomassen M, Schulz GM, Hosey LA, Varga M, Ludlow CL, et al. Alterations in CNS activity induced by botulinum toxin treatment in spasmodic dysphonia: an H215O PET study. J Speech Lang Hear Res. 2006;49(5):1127–46.PubMedCrossRefPubMedCentralGoogle Scholar
  54. 54.
    Bielamowicz S, Ludlow CL. Effects of botulinum toxin on pathophysiology in spasmodic dysphonia. Ann Otol Rhinol Laryngol. 2000;109(2):194–203.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Pastor AM, Moreno-Lopez B, De la Cruz RR, Delgado-Garcia JM. Effects of botulinum neurotoxin type A on abducens motoneurons in the cat: ultrastructural and synaptic alterations. Neuroscience. 1997;81:457–78.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Moreno-Lopez B, De la Cruz RR, Pastor AM, Delgado-Garcia JM. Effects of botulinum neurotoxin type A on abducens motoneurons in the cat: alterations of the discharge pattern. Neuroscience. 1997;81:437–55.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Moreno-Lopez B, Pastor AM, de la Cruz RR, Delgado-Garcia JM. Dose-dependent, central effects of botulinum neurotoxin type A: a pilot study in the alert behaving cat. Neurology. 1997;48(2):456–64.PubMedCrossRefGoogle Scholar
  58. 58.
    van Esch BF, Wegner I, Stegeman I, Grolman W. Effect of botulinum toxin and surgery among spasmodic dysphonia patients. Otolaryngol Head Neck Surg. 2017;156(2):238–54.PubMedCrossRefGoogle Scholar
  59. 59.
    Shoffel-Havakuk H, Rosow DE, Lava CX, Hapner ER, Johns MM III. Common practices in botulinum toxin injection for spasmodic dysphonia treatment: a national survey. Laryngoscope. 2019;129:1650–6.PubMedCrossRefGoogle Scholar
  60. 60.
    Borodic GE, Ferrante R. Effects of repeated botulinum toxin injections on orbicularis oculi muscle. J Clin Neuroophthalmol. 1992;12(2):121–7.PubMedCrossRefPubMedCentralGoogle Scholar
  61. 61.
    Young N, Blitzer A. Management of supraglottic squeeze in adductor spasmodic dysphonia: a new technique. Laryngoscope. 2007;117(11):2082–4.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Simpson CB, Lee CT, Hatcher JL, Michalek J. Botulinum toxin treatment of false vocal folds in adductor spasmodic dysphonia: functional outcomes. Laryngoscope. 2016;126(1):118–21.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Kotby MN, Kirchner JA, Kahane JC, Basiouny SE, El-Samaa M. Histo-anatomical structure of the human laryngeal ventricle. Acta Otolaryngol. 1991;111:396–402.PubMedCrossRefPubMedCentralGoogle Scholar
  64. 64.
    Dedo HH. Recurrent laryngeal nerve section for spastic dysphonia. Ann Otol Rhinol Laryngol. 1976;85(4 Pt 1):451–9.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Aronson AE, Desanto LW. Adductor spasmodic dysphonia: three years after recurrent nerve section. Laryngoscope. 1983;93:1–8.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Fritzell B, Hammarberg B, Schiratzki H, Haglund S, Knutsson E, Martensson A. Long-term results of recurrent laryngeal nerve resection for adductor spasmodic dysphonia. J Voice. 1993;7:172–8.PubMedCrossRefPubMedCentralGoogle Scholar
  67. 67.
    Netterville JL, Stone RE, Rainey C, Zealear DL, Ossoff RH. Recurrent laryngeal nerve avulsion for treatment of spastic dysphonia. Ann Otol Rhinol Laryngol. 1991;100(1):10–4.PubMedCrossRefPubMedCentralGoogle Scholar
  68. 68.
    Weed DT, Jewett BS, Rainey C, Zealear DL, Stone RE, Ossoff RH, et al. Long-term follow-up of recurrent laryngeal nerve avulsion for the treatment of spastic dysphonia. Ann Otol Rhinol Laryngol. 1996;105(8):592–601.PubMedCrossRefPubMedCentralGoogle Scholar
  69. 69.
    Tsuji DH, Takahashi MT, Imamura R, Hachiya A, Sennes LU. Endoscopic laser thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia: a pilot study on long-term outcome on voice quality. J Voice. 2012;26(5):666.e7–12.CrossRefGoogle Scholar
  70. 70.
    Gandhi S, Remacle M, Mishra P, Desai V. Vocal outcome after endoscopic thyroarytenoid myoneurectomy in patients with adductor spasmodic dysphonia. Eur Arch Otorhinolaryngol. 2014;271(12):3249–54.PubMedCrossRefGoogle Scholar
  71. 71.
    Sanuki T, Yumoto E. Long-term evaluation of type 2 thyroplasty with titanium bridges for adductor spasmodic dysphonia. Otolaryngol Head Neck Surg. 2017;157(1):80–4.PubMedCrossRefGoogle Scholar
  72. 72.
    Chan SW, Baxter M, Oates J, Yorston A. Long-term results of type II thyroplasty for adductor spasmodic dysphonia. Laryngoscope. 2004;114(9):1604–8.PubMedCrossRefGoogle Scholar
  73. 73.
    Nomoto M, Tokashiki R, Hiramatsu H, Konomi U, Motohashi R, Sakurai E, et al. The comparison of thyroarytenoid muscle myectomy and type II thyroplasty for spasmodic dysphonia. J Voice. 2015;29(4):501–6.PubMedCrossRefGoogle Scholar
  74. 74.
    Chhetri DK, Mendelsohn AH, Blumin JH, Berke GS. Long-term follow-up results of selective laryngeal adductor denervation-reinnervation surgery for adductor spasmodic dysphonia. Laryngoscope. 2006;116(4):635–42.PubMedCrossRefGoogle Scholar
  75. 75.
    DeConde AS, Long JL, Armin BB, Berke GS. Functional reinnervation of vocal folds after selective laryngeal adductor denervation-reinnervation surgery for spasmodic dysphonia. J Voice. 2012;26(5):602–3.PubMedCrossRefGoogle Scholar
  76. 76.
    Chen M, Summers RL, Goding GS, Samargia S, Ludlow CL, Prudente CN, et al. Evaluation of the cortical silent period of the laryngeal motor cortex in healthy individuals. Front Neurosci. 2017;11:88.PubMedPubMedCentralGoogle Scholar
  77. 77.
    Suppa A, Marsili L, Giovannelli F, Di Stasio F, Rocchi L, Upadhyay N, et al. Abnormal motor cortex excitability during linguistic tasks in adductor-type spasmodic dysphonia. Eur J Neurosci. 2015;42(4):2051–60.PubMedCrossRefGoogle Scholar
  78. 78.
    Payne S, Tisch S, Cole I, Brake H, Rough J, Darveniza P. The clinical spectrum of laryngeal dystonia includes dystonic cough: observations of a large series. Mov Disord. 2014;29(6):729–35.PubMedCrossRefGoogle Scholar
  79. 79.
    Peterson EA, Roy N, Awan SN, Merrill RM, Banks R, Tanner K. Toward validation of the cepstral spectral index of dysphonia (CSID) as an objective treatment outcomes measure. J Voice. 2013;27(4):401–10.PubMedCrossRefGoogle Scholar
  80. 80.
    Awan SN, Roy N. Outcomes measurement in voice disorders: application of an acoustic index of dysphonia severity. J Speech Lang Hear Res. 2009;52(2):482–99.PubMedCrossRefGoogle Scholar
  81. 81.
    Rees CJ, Blalock PD, Kemp SE, Halum SL, Koufman JA. Differentiation of adductor-type spasmodic dysphonia from muscle tension dysphonia by spectral analysis. Otolaryngol Head Neck Surg. 2007;137(4):576–81.PubMedCrossRefGoogle Scholar
  82. 82.
    Johnson DM, Hapner ER, Klein AM, Pethan M, Johns MM 3rd. Validation of a telephone screening tool for spasmodic dysphonia and vocal fold tremor. J Voice. 2014;28(6):711–5.PubMedCrossRefGoogle Scholar
  83. 83.
    Risch V, Staiger A, Ziegler W, Ott K, Scholderle T, Pelykh O, et al. How does GPi-DBS affect speech in primary dystonia? Brain Stimul. 2015;8(5):875–80.PubMedCrossRefGoogle Scholar
  84. 84.
    Yoon MS, Munz M, Sataloff RT, Spiegel JR, Heuer RJ. Vocal tremor reduction with deep brain stimulation. Stereotact Funct Neurosurg. 1999;72(2–4):241–4.PubMedCrossRefGoogle Scholar
  85. 85.
    Ho AL, Choudhri O, Sung CK, DiRenzo EE, Halpern CH. Deep brain stimulation for essential vocal tremor: a technical report. Cureus. 2015;7(3):e256.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Ho AL, Erickson-Direnzo E, Pendharkar AV, Sung CK, Halpern CH. Deep brain stimulation for vocal tremor: a comprehensive, multidisciplinary methodology. Neurosurg Focus. 2015;38(6):E6.PubMedCrossRefPubMedCentralGoogle Scholar
  87. 87.
    Poologaindran A, Ivanishvili Z, Morrison MD, Rammage LA, Sandhu MK, Polyhronopoulos NE, et al. The effect of unilateral thalamic deep brain stimulation on the vocal dysfunction in a patient with spasmodic dysphonia: interrogating cerebellar and pallidal neural circuits. J Neurosurg. 2018;128(2):575–82.PubMedCrossRefPubMedCentralGoogle Scholar
  88. 88.
    Barbe MT, Dembek TA, Becker J, Raethjen J, Hartinger M, Meister IG, et al. Individualized current-shaping reduces DBS-induced dysarthria in patients with essential tremor. Neurology. 2014;82(7):614–9.PubMedPubMedCentralCrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Justin M. Hintze
    • 1
  • Christy L. Ludlow
    • 2
  • David G. Lott
    • 1
    Email author
  1. 1.Department of Otolaryngology–Head and Neck SurgeryMayo Clinic ArizonaPhoenixUSA
  2. 2.Department of Communication Sciences and Disorders (retired)James Madison UniversityHarrisonburgUSA

Personalised recommendations