# Examining the Links Among Motor Symptoms in Vocal Hyperfunction, Auditory Acuity, and Auditory-Motor Function

> **NIH NIH F31** · UNIVERSITY OF WASHINGTON · 2022 · $43,638

## Abstract

Project Summary
Voice disorders are common, affecting up to 9% of the U.S. population at any given time, and the majority of
patients referred to multidisciplinary voice clinics have hyperfunctional voice disorders (HVDs; e.g., vocal fold
nodules and muscle tension dysphonia). Clinically, HVDs are characterized by vocal fatigue, dysphonia, and
dysregulated muscle activation during voicing. Yet, relatively little is understood about the pathophysiology
underlying these signs and symptoms. Elucidating the mechanisms that cause and sustain HVDs is necessary
to guide impactful treatment research. Recent studies have identified auditory-motor impairments, including
atypical auditory discrimination of voice fundamental frequency (fo) and atypical adaptive vocal learning in
response to fo auditory feedback perturbations, in a subset of individuals with HVDs. People with HVDs display
atypical voicing across multiple parameters of voice, such as intensity and voice quality, in addition to fo. It is
possible that these behaviors relate to a broad auditory-motor impairment for vocal sensorimotor control. Thus,
the proposed studies will address the specificity of auditory-motor impairment in HVDs by examining auditory
acuity and adaptive vocal learning across two important parameters for vocal sensorimotor control: fo and
intensity. In addition to understanding the extent of auditory-motor impairment in HVDs, determining the
relationship between such impairments and the clinical characteristics of these disorders is critical to guide
clinical research. To date, a direct relationship between auditory-motor impairment and dysregulated muscle
activation during voicing, a hallmark of HVDs, has not been established. Co-contraction of opposing perilaryngeal
muscles occurs when speakers increase their vocal effort, and is thought to occur during voicing in HVDs. In
studies of reaching movements, co-contraction occurs in the limbs in response to feedback perturbations in order
to stabilize movements, and decreases as participants adapt to the perturbations. Crucially, studies of limb
sensorimotor control also suggest that worse sensory acuity reduces adaptation. Thus, we propose that
perilaryngeal co-contraction may occur in response to auditory feedback perturbations in order to stabilize the
larynx, and will decrease with adaptive vocal learning. Furthermore, impaired auditory acuity in some speakers
with HVDs may be associated with both atypical adaptive vocal learning and persistent perilaryngeal co-
contraction compared to speakers without HVDs. Therefore, Aim 1 will compare adaptive vocal learning and
perilaryngeal co-contraction in response to perturbations of fo and intensity of auditory feedback in individuals
with (n = 26) and without (n = 26) HVDs. Aim 2 will evaluate the prevalence of atypical auditory acuity for vocal
fo and intensity in the same groups of speakers. In Aim 3, relationships among auditory acuity, adaptive vocal
learning, and perilaryngea...

## Key facts

- **NIH application ID:** 10534635
- **Project number:** 1F31DC020359-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Mara Kapsner-Smith
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $43,638
- **Award type:** 1
- **Project period:** 2022-06-16 → 2024-06-15

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10534635

## Citation

> US National Institutes of Health, RePORTER application 10534635, Examining the Links Among Motor Symptoms in Vocal Hyperfunction, Auditory Acuity, and Auditory-Motor Function (1F31DC020359-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10534635. Licensed CC0.

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