# An acoustic estimate of laryngeal tension for clinical assessment of  voice disorders

> **NIH NIH R01** · BOSTON UNIVERSITY (CHARLES RIVER CAMPUS) · 2020 · $413,329

## Abstract

Project Summary:
Voice disorders affect 3 – 9% of the U.S. population and cause devastating effects to communication, limiting
occupational and social participation. Elevated laryngeal tension is a significant factor in a range of functional
and neurological voice disorders and a crucial target of therapeutic intervention. Overall, disorders associated
with increased laryngeal tension are highly prevalent, accounting for over 65% of referrals to multidisciplinary
voice clinics. Current clinical assessment is primarily based on unreliable auditory impressions and manual
palpation, since standard acoustic measures are not specific to laryngeal tension. To address this gap, we
have proposed an acoustic estimate of laryngeal tension, relative fundamental frequency (RFF), which has
shown promise across a range of voice disorders associated with laryngeal tension. Previously, the time
required to manually estimate RFF has prevented its clinical application, but our newly developed open-source
algorithms for automated RFF estimation now allow for the large-scale, fine-grained studies required to
endorse clinical use of RFF as an objective measure of laryngeal tension. Our collaborative team of clinicians,
scientists, and engineers will utilize our new automated algorithms to systematically validate RFF as a
measure of laryngeal tension in two voice disorder populations that span age and etiology (functional vs.
neurological): vocal hyperfunction and Parkinson's disease. Aim 1 will supply concurrent validity by comparing
RFF to two objective estimates of laryngeal tension: 1) kinematic stiffness and 2) an acoustic-accelerometric
ratio based on aerodynamic efficiency. Aim 2 will assess the ability of RFF to capture clinically meaningful
changes in laryngeal tension, following expected changes in function that are both improving (post-therapy
vocal hyperfunction) and worsening (disease progression in PD). The ability of RFF to capture these changes
will be compared with that of the objective measures from Aim 1 as well as currently clinically viable measures
(standard acoustic measures and auditory-perceptual judgments). These data are essential to support the use
of RFF as a clinical outcome measure in future assessments of treatment efficacy. Finally, Aim 3 will determine
the diagnostic sensitivity and specificity of RFF in a large cohort of speakers with and without tension-related
voice disorders, allowing clinicians to meaningfully interpret RFF values of individual patients with respect to
age, sex, and diagnosis. Overall, this project will provide the first-ever examination of the clinical utility of an
acoustic measure of voice with this degree of comprehensive detail, power, and scope, feasible only within a
framework of partnership between basic and clinical researchers. Successful completion will result in a
fully validated, objective, and automated estimate of laryngeal tension. This non-invasive and inexpensive
assessment can be translated imm...

## Key facts

- **NIH application ID:** 9960490
- **Project number:** 5R01DC015570-05
- **Recipient organization:** BOSTON UNIVERSITY (CHARLES RIVER CAMPUS)
- **Principal Investigator:** Cara E. Stepp
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $413,329
- **Award type:** 5
- **Project period:** 2016-07-15 → 2021-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9960490

## Citation

> US National Institutes of Health, RePORTER application 9960490, An acoustic estimate of laryngeal tension for clinical assessment of  voice disorders (5R01DC015570-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9960490. Licensed CC0.

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