# Auditory-Motor Control of Voice in Individuals with Essential Vocal Tremor

> **NIH NIH R21** · UNIVERSITY OF TEXAS AT AUSTIN · 2020 · $152,600

## Abstract

Project Summary
 Essential tremor (ET) is the most prevalent movement disorder affecting nearly one in every 100 people
worldwide. Up to sixty-two percent of individuals with ET develop vocal tremor (VT), a hyperkinetic neurological
speech disorder. VT is characterized by modulation of the frequency (pitch) and amplitude (loudness) of the
voice, which results in a ‘shaky’ sounding voice and increased effort during speech production. Neurogenic
speech disorders like VT are detrimental to communication, professional productivity, and quality of life.
Unfortunately, the current approaches for medical management of VT have inconsistent effects on voice
production and often cause adverse effects. Furthermore, there is limited evidence supporting the benefit of
behavioral management for VT. The challenges in managing VT stem from a lack of understanding of the
underlying sensorimotor deficits in this population.
 Previous research on typical sensorimotor control of voice demonstrated that healthy speakers use
auditory feedback for immediate correction of pitch errors and prevention of future errors. Based on the
Directions into the Velocities of Articulators (DIVA) model, a computational model accounting for normal and
disordered speech motor control, a neural network of feedback and feedforward mechanisms drive auditory-
motor responses and ensure that any mismatch between the intended voice output and actual voice output is
corrected. When individuals with VT attempt to produce a steady pitch, their voice output is characterized by a
4-8 Hz involuntary modulation of the fundamental frequency and amplitude. It is unknown whether the
feedback and/or feedforward systems attempt to correct for these modulations and stabilize the voice output,
or if there is dysfunction of these systems that further contributes to the modulated output.
 Thus, this study aims to investigate how auditory feedback influences pitch control in individuals with VT
compared with healthy speakers. The findings of this study may improve the understanding of sensorimotor
control in VT and guide development of sensorimotor-based treatments for the disorder. Additionally, this will
be a novel application of the current models of feedforward and feedback auditory-motor control, which may
help refine these computational models and motivate future research.

## Key facts

- **NIH application ID:** 9974504
- **Project number:** 5R21DC017001-02
- **Recipient organization:** UNIVERSITY OF TEXAS AT AUSTIN
- **Principal Investigator:** Rosemary Anne Lester-Smith
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $152,600
- **Award type:** 5
- **Project period:** 2019-07-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9974504

## Citation

> US National Institutes of Health, RePORTER application 9974504, Auditory-Motor Control of Voice in Individuals with Essential Vocal Tremor (5R21DC017001-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9974504. Licensed CC0.

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