Journal of Voice最新文献

{"title":"Integrating Ambulatory Biofeedback Based on Harmonic Level Differences Into Vocal Hyperfunction Treatment: Two Case Studies.","authors":"Jarrad H Van Stan, Dagmar Sternad, Benjamin Kevelson, Tiffiny Hron, Daryush D Mehta, Robert E Hillman","doi":"10.1016/j.jvoice.2026.08.049","DOIUrl":"10.1016/j.jvoice.2026.08.049","url":null,"abstract":"<p><strong>Objectives: </strong>Ambulatory biofeedback has been associated with improved generalization of modified pitch or loudness from the clinic into daily life for patients with Vocal Hyperfunction (VH). Pitch and loudness are auditory perceptual constructs readily detected and modified by many patients. They also have close connections to objective acoustic measures like fundamental frequency and sound pressure level. However, these constructs are not directly related to VH's pathophysiology. In contrast, H1-H2-the difference between the first two harmonics-is directly linked to abnormal vocal fold closure dynamics and treatment improvements. But its association with constructs that the patient can perceive-like breathiness, strain, airflow, and resonance-is more nuanced than pitch and loudness. This proof-of-concept study formally tested if ambulatory biofeedback based on H1-H2 can help two patients improve generalization in voice therapy.</p><p><strong>Method: </strong>Two patients with VH wore a voice monitor in daily life before starting voice therapy and after three therapy sessions. Biofeedback was turned on in daily life only after the second therapy session. Biofeedback consisted of a 200-ms vibrotactile cue when a H1-H2 threshold was surpassed for 500-ms.</p><p><strong>Results: </strong>Neither patient generalized after session 1. For both patients, ambulatory biofeedback based on H1-H2 was associated with significantly increased generalization after session 2 compared to baseline monitoring (d = 0.8-1.6) and session 1 (d = 1.2-1.7). Only one patient retained his increased generalization when the biofeedback was turned off after session 3 compared to baseline (d = 0.9) and session 1 (d = 1.3).</p><p><strong>Conclusions: </strong>Ambulatory biofeedback based on H1-H2 improved generalization for both VH patients, however, only one patient retained improvements after turning the biofeedback off. Future work should investigate the efficacy of incorporating H1-H2, and potentially other biomarkers associated with pathophysiology into ambulatory biofeedback for patients with VH.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13674467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice Alterations Associated with Implanted Vagus Nerve Stimulation in Epilepsy: A Systematic Review and Meta-Analysis.","authors":"Aylén Chiara Fernández, Germán Gálvez-García, Adrián Pérez Del Olmo, Fernando Gordillo-León, Mauricio Barramuño-Medina, Tatiana Romero-Arias","doi":"10.1016/j.jvoice.2026.08.043","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.043","url":null,"abstract":"<p><strong>Objective: </strong>Implanted vagus nerve stimulation (VNS) is an established treatment for drug-resistant epilepsy. However, stimulation-related voice disturbances are among the most frequently reported adverse effects. This systematic review and meta-analysis synthesized available evidence regarding voice outcomes associated with implanted VNS in patients with epilepsy.</p><p><strong>Study design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines. Studies evaluating acoustic, perceptual, aerodynamic, phonatory, laryngeal, or patient-reported voice outcomes associated with implanted VNS in epilepsy were eligible. Methodological quality was assessed using Joanna Briggs Institute critical appraisal tools and ROBINS-I. Evidence certainty was evaluated using the GRADE approach. Random-effects meta-analyses were performed for outcomes reported in controlled studies.</p><p><strong>Results: </strong>Thirteen studies published between 1993 and 2024 met the inclusion criteria, comprising case reports, case series, observational studies, and two controlled comparative studies. Qualitative synthesis consistently demonstrated increased jitter and shimmer during active stimulation, reduced maximum phonation time (MPT), perceptual voice deterioration, and greater voice-related handicap. Quantitative synthesis demonstrated shorter MPT in participants with implanted VNS than in healthy controls (MD = -8.66 s, 95% CI -11.31 to -6.01; P < 0.00001). Participants with VNS also showed significantly higher scores in the functional (MD = 6.58, 95% CI 4.13-9.04; P < 0.00001) and physical (MD = 8.49, 95% CI 3.40-13.58; P = 0.001) domains of the Voice Handicap Index. Evidence certainty ranged from low to very low.</p><p><strong>Conclusions: </strong>Implanted VNS appears to be associated with alterations in voice function, including reduced phonatory efficiency, increased acoustic perturbation, and greater self-perceived vocal handicap. Although evidence certainty remains limited, the consistency of findings and meta-analytic results support clinically relevant VNS-related voice effects. Routine voice monitoring should be considered as part of the long-term clinical management of patients receiving implanted VNS for drug-resistant epilepsy.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Laryngopharyngeal Reflux Disease in Eustachian Tube Dysfunction: A Systematic Review.","authors":"Jerome R Lechien, Antonino Maniaci","doi":"10.1016/j.jvoice.2026.09.005","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.005","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the role of laryngopharyngeal reflux disease (LPRD) in the development of Eustachian tube dysfunction (ETD) and related otitis media (OM) in adults.</p><p><strong>Methods: </strong>Two independent investigators searched PubMed, Scopus, and Cochrane databases for studies reporting laryngopharyngeal reflux disease (LPRD) findings in patients with ETD or OM according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Bias analysis was conducted using Methodological Index for Non-Randomized Studies (MINORS) and the tools of the Clarity Group and Evidence Partners.</p><p><strong>Results: </strong>Twenty clinical studies (2100 patients) met inclusion criteria. LPRD prevalence ranged from 20.3 to 32.6% in ETD and 21.0 to 73.3% in OME using symptom-based approaches, increasing up to 58.0% and 77.4%, respectively, with objective diagnostic methods. Conversely, ETD was identified in 40.0-54.5% and OME in 32.1% of patients with suspected LPRD or confirmed GERD. Pepsin and trypsin were detected in up to 39.6% of middle ear effusions. Animal models supported refluxate-induced inflammation and progressive Eustachian tube impairment. Substantial diagnostic heterogeneity and low-to-moderate methodological quality (mean MINORS: 6.7±1.6) were observed.</p><p><strong>Conclusion: </strong>Available evidence suggests a probable association between LPRD, ETD, and related OM in adults, supported by converging clinical and animal data. However, methodological limitations-including reliance on symptom-based reflux diagnosis and inconsistent ETD/OME criteria-preclude definitive causal conclusions. Prospective controlled studies using HEMII-pH monitoring and standardized otologic diagnostic criteria are needed.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Music-Supported Vocal Rehabilitation in Parkinson's Disease: Effects on Voice Intensity and Speech Performance.","authors":"Yanjin Min, Wen Chang","doi":"10.1016/j.jvoice.2026.08.033","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.033","url":null,"abstract":"&lt;p&gt;&lt;p&gt;Hypokinetic dysarthria is a highly prevalent and functionally disabling communication disorder in Parkinson's disease (PD), encompassing hypophonia, imprecise articulation, and festinating speech. Music-supported vocal rehabilitation-operationalized through the Accent Method (AM), a rhythm- and breathing-based voice therapy approach grounded in hierarchical respiratory-phonatory-prosodic coordination-offers a theoretically grounded mechanism for addressing PD dysarthria by exploiting the well-documented facilitatory effect of external rhythmic auditory cueing on motor control in PD. Despite widespread clinical use of the AM in Scandinavian centers, rigorous controlled evidence for its effects on voice intensity and speech performance in PD remains limited. Prospective, parallel-group, randomized controlled trial comparing a structured, four-phase PD-adapted AM protocol with an active nonspecific control program (vocal hygiene and general breathing exercises) over 20 weeks. Ninety-two adults with idiopathic PD (Hoehn and Yahr stages 2-3) were randomized to music-supported AM rehabilitation (n = 46) or active control (n = 46). Blinded assessors evaluated outcomes at baseline and at 6, 12, and 20 weeks. Primary outcome: Voice Handicap Index-30 (VHI-30). Secondary outcomes: GRBAS perceptual dysphonia scale, sound pressure level (SPL), maximum phonation time (MPT), acoustic parameters (jitter, shimmer, fundamental frequency [F0]), speech intelligibility rated by blinded naive listeners, UPDRS speech sub-item, and PDQ-39 communication subscale. All between-group comparisons at 20 weeks favored music-supported AM rehabilitation (all P &lt; 0.001, Bonferroni corrected; adjusted α = 0.005). VHI-30 improvement: -36.8 points (AM) vs. -9.4 points (Control); between-group difference 26.8 points (95% CI: 22.2-31.4; Cohen's d = 2.47). Voice intensity (SPL) improved by +14.8 dB in the AM group versus +4.3 dB in the control group-a nearly threefold greater improvement. Speech intelligibility improved from 67.4% to 84.6% in the AM group versus 68.1% to 73.4% in the control group (+17.2%-point between-group difference), representing a movement from clinically impaired intelligibility to near-functional communicative levels. Jitter normalized from 4.12 ± 0.98% to 1.04 ± 0.31% (AM) versus 4.08 ± 0.94% to 2.96 ± 0.77% (Control), and shimmer from 10.41 ± 2.37% to 3.18 ± 0.84% versus 10.28 ± 2.29% to 6.74 ± 1.61%. Effect sizes were large to very large across all domains (Cohen's d range: 1.41-2.47). Music-supported vocal rehabilitation using the PD-adapted Accent Method yields large, consistent, and clinically meaningful improvements in voice intensity, acoustic stability, speech intelligibility, and communication-related quality of life compared with an active nonspecific control program. These findings establish the AM as an evidence-based behavioral management option for PD-associated hypokinetic dysarthria. Head-to-head comparative trials against LSVT LOUD and SP","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpretable Acoustic Domains in Smoking-Status Prediction From Sustained Phonation: A Speaker-Independent Secondary Analysis.","authors":"Yiğit Aydoğan, İsmail Cantürk","doi":"10.1016/j.jvoice.2026.08.044","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.044","url":null,"abstract":"<p><strong>Objectives: </strong>To determine whether a previously developed 208-variable smoking-status voice model could be compressed into interpretable acoustic domains without materially reducing speaker-independent discrimination, and to assess which domains remained stable across model, perturbation, and counterfactual analyses.</p><p><strong>Methods: </strong>A secondary analysis was performed on the previously reported cohort of 64 speakers (30 smokers and 34 nonsmokers), using one primary smartphone-recorded sustained /a/ phonation per speaker. The exact 208-variable prosody-spectral feature cache was grouped into 16 prespecified acoustic domains. Domain scores were constructed independently within each leave-one-speaker-out fold using training-only imputation, robust scaling, direction alignment, and median aggregation. A balanced logistic model was evaluated from raw out-of-fold scores. Full-pipeline permutation tests, demographic residualization, domain-only models, demographic-conditional domain replacement, one-speaker jackknife analysis, a secondary Explainable Boosting Machine, and empirical counterfactual searches were performed.</p><p><strong>Results: </strong>The 16-domain model achieved an area under the receiver operating characteristic curve (AUC) of 0.753 (95% confidence interval [CI], 0.624-0.864), compared with 0.769 (95% CI, 0.645-0.878) for the recovered 208-variable model; the paired difference was -0.016 (95% CI, -0.129 to 0.095). Full-pipeline permutation tests were significant under both unrestricted permutation (P = 0.00599) and permutation restricted within age-by-gender strata (P = 0.00500). Spectral centroid, formant structure, and harmonicity/noise were significant as standalone domains after Holm correction. No single conditional-replacement test remained significant after correction. Spectral centroid ranked first in 49 of 64 jackknife analyses and appeared in 57.1% of minimal plausible counterfactuals. A plausible counterfactual was found for 98.4% of speakers, with one domain sufficient for 84.4%.</p><p><strong>Conclusions: </strong>Smoking-associated voice discrimination could be represented compactly through interpretable acoustic domains. The evidence favored a distributed, partially redundant spectral and resonance pattern rather than a single indispensable biomarker. The results describe model behavior in this cohort and require external validation before clinical interpretation.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VocaSense-X Framework: Advancing Voice Medicine Through Intelligent Diagnosis and Rehabilitation.","authors":"Kunxiao Wu, Simson Reyes","doi":"10.1016/j.jvoice.2026.08.028","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.028","url":null,"abstract":"<p><p>Voice disorders are a significant clinical issue that affect millions of people worldwide and can impair their quality of life, professional functioning, and communication. Current methods of diagnosis may be based on subjective clinical examination and disjointed rehabilitation regimens, which may lack accuracy and scalability. The study introduces the VocaSense-X Framework, a comprehensive intelligent system for improving voice medicine through integrated diagnosis and rehabilitation. The framework uses multimodal signal processing, deep learning models, and adaptive feedback mechanisms to provide accurate, data-driven analysis of vocal pathologies, including dysphonia, vocal fold lesions, and neurogenic voice disorders. VocaSense-X is a model that combines a real-time acoustic feature extraction pipeline with a hybrid convolutional-recurrent neural network, achieving superior classification performance across a wide range of patient populations. The framework includes a personalized rehabilitation module that dynamically adjusts therapeutic exercises based on continuous monitoring of the voice, enabling tracking of the patient's progress over time and supporting diagnosis. The experimental analysis using benchmark voice disorder datasets demonstrates that the diagnostic performance of VocaSense-X is significantly better than that of any other comparator architecture tested under the same experimental setup, with an accuracy of > 94. Furthermore, clinician usability tests confirm the framework's usability in both clinical and teletherapy settings. The system proposed herein is designed to fill the gap between intelligent computation and clinical voice medicine, is scalable and evidence-based, and can be used for early detection and structured voice rehabilitation. The implications of VocaSense-X for otolaryngology, speech-language pathology, and digital health platforms make it a pivotal step towards AI-driven voice healthcare innovations.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Hyoid Bone Position and Self-perceived Voice Handicap in Patients Undergoing Orthodontic Treatment.","authors":"Abdul-Latif Hamdan, Nijad Zeineddine, Lana Ghzayel, Lea Azzi, Ghena Lababidi, Valerie Sarkis, Lynn Abdel Malak, Rita Jreige, Christelle Jabbour, Anthony T Macari","doi":"10.1016/j.jvoice.2026.08.051","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.051","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the correlation between the position of the hyoid bone and self-perceived voice handicap and fatigue in a cohort of non-dysphonic patients.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Methodology: </strong>After having obtained Institutional Review Board approval (BIO-2025-0307), a retrospective cephalometric study was conducted on 272 patients. Cephalometric measures included: the vertical distance from the hyoid bone to the sella turcica (Hy-S), the vertical distance from the hyoid bone to the posterior nasal spine (Hy-PNS), the linear distance from the hyoid bone to the most anterior point of the third cervical vertebra (Hy-C3), the vertical distance from the hyoid bone to the mandibular plane (Hy-MP), and the linear distance from the hyoid bone to menton (Hy-Me). The main outcome measures of the study included the Voice Handicap Index-10 (VHI-10), the Voice Fatigue Index (VFI), and the Voice-Related Quality of Life (V-RQOL) questionnaire.</p><p><strong>Results: </strong>A total of 272 patients, 179 females and 93 males, were included in this study. The mean age of the study group was 31.04 ± 12.44 years. The mean (Hy-S), (Hy-PNS) and (Hy-Me) was 104.06 ± 20.81 mm, 61.93 ± 7.69 mm, and 43.78 ± 6.21, respectively. The mean (Hy-C3) was 34.41 ± 4.37 mm. The mean (Hy-MP) was 15.73 ± 5.78 mm. The mean VHI-10 score was 1.64 ± 3.15. The mean V-RQOL score was 98.25 ± 5.45, and the mean VFI score was 2.40 ± 6.69. There were no statistically significant correlations between any of the voice outcome measures and hyoid bone measurements. Linear regression analysis showed a significant independent, weak association between Hy-C3, the VHI-10 (β = 0.211, P = 0.003) and V-RQOL scores β = -0.155, P = 0.030).</p><p><strong>Conclusion: </strong>The position of the hyoid bone carries limited clinical significance in relation to voice in non-dysphonic patients.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pre- and Post-Workday Changes in Acoustic and Aerodynamic Voice Parameters and Vocal Fatigue in Special Education Teachers.","authors":"Tuba Kaya, Melis Özperçin, Özkan Saatçioğlu, Mustafa Ersel Ay, Ahmet Sait Gülyüz","doi":"10.1016/j.jvoice.2026.08.032","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.032","url":null,"abstract":"<p><strong>Background: </strong>Teachers are among the occupational groups at the highest risk for work-related voice disorders due to prolonged and intensive voice use. Although special education teachers face unique occupational demands that may affect vocal health, research examining workday-related voice changes in this population remains limited.</p><p><strong>Objective: </strong>This study aimed to investigate pre- and post-workday changes in self-reported vocal fatigue and objective voice parameters in special education teachers.</p><p><strong>Methods: </strong>Thirty-seven special education teachers working in special education and rehabilitation centers participated in this study. Voice assessments were conducted at two time points within the same workday: at the beginning and at the end of the workday. Self-reported vocal fatigue symptoms were assessed using the Vocal Fatigue Index (VFI), and current voice quality was evaluated using a single-item self-rating scale. Acoustic parameters and Cepstral Peak Prominence (CPP) were analyzed using the Praat software. Aerodynamic measures included maximum phonation time and the s/z ratio. Pre- and post-workday differences were analyzed using paired-samples t tests or Wilcoxon signed-rank tests, with false discovery rate adjustment for multiple comparisons.</p><p><strong>Results: </strong>VFI scores changed significantly at the end of the workday, with increases in all three subscales and the total score (P < 0.05). Participants also reported significantly poorer voice quality in the end-of-day self-ratings (P < 0.05). Acoustic analyses revealed significant increases in fundamental frequency (F0) and CPP at the end of the workday (P < 0.05), although the CPP finding was less consistent after adjustment for selected confounding variables. However, no significant changes were observed in jitter, shimmer, or HNR. Aerodynamic measures did not differ significantly between the two time points. Additional analyses indicated that the observed changes were generally not modified by teaching hours, daily water intake, or smoking status.</p><p><strong>Conclusion: </strong>Special education teachers reported greater fatigue-related symptoms and physical discomfort by the end of the workday, while also reporting greater perceived improvement in symptoms with voice rest; these findings were accompanied by changes in acoustic measures, including F0 and CPP. These results highlight the importance of evaluating occupational voice use through both subjective and objective measures and emphasize the need for preventive strategies to protect vocal health in special education teachers.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Water-Resistance Therapy on Multidimensional Voice Outcomes in Older Patients with Presbyphonia.","authors":"Geun-Hyo Kim, Dong-Won Lim, Yong-Il Cheon, Sung-Chan Shin, Yeon-Woo Lee","doi":"10.1016/j.jvoice.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.09.004","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of a structured voice therapy program incorporating Water-Resistance Therapy (WRT), a Semi-Occluded Vocal Tract Exercise, on voice quality in patients with presbyphonia.</p><p><strong>Methods: </strong>A total of 61 patients who underwent WRT were enrolled. Voice outcomes were assessed using the Acoustic Voice Quality Index (AVQI), Acoustic Breathiness Index (ABI), auditory-perceptual (A-P) ratings, and Voice Handicap Index-10 (VHI-10). Depending on normality, paired t tests or Wilcoxon signed-rank tests were used to compare pre-post differences. Correlation analysis examined inter-measure relationships, and ROC curve analysis identified AVQI and ABI cutoffs associated with clinically meaningful voice improvement.</p><p><strong>Results: </strong>All parameters improved significantly with large effect sizes (Cohen's d = 1.03-1.60 for acoustic and self-reported measures; r = 0.80-0.81 for A-P ratings, P < 0.01), with over 80% of patients showing improvement. A-P ratings demonstrated high reliability (ICC = 0.78-0.86). Acoustic measures correlated strongly with A-P ratings (r = 0.76-0.82) and VHI-10 scores (r = 0.65-0.79). ROC analysis identified cutoff values of 5.3 and 5.8 for AVQI and ABI, respectively, as indicative of treatment-related improvement (AUC = 0.78 for both).</p><p><strong>Conclusion: </strong>A WRT-based treatment program produced clinically meaningful, multidimensional improvements in presbyphonia, supported by strong inter-measure correlations and comparable discriminative performance across acoustic indices in detecting treatment response. These findings support WRT-based intervention as an effective treatment for age-related voice changes.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148972174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence-Related Voice and Speech Biomarkers of Alzheimer's Disease: A Systematic Review.","authors":"Samantha Mairesse, Giovanni Briganti, Jerome R Lechien","doi":"10.1016/j.jvoice.2026.08.038","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.08.038","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI)-based voice and speech analysis is emerging as a promising, noninvasive biomarker for Alzheimer's disease (AD) and mild cognitive impairment (MCI). This study aimed to systematically review AI voice and speech models for detecting AD and MCI, and to evaluate their translational potential.</p><p><strong>Methods: </strong>Following PRISMA guidelines, two investigators searched PubMed, Scopus, and the Cochrane Library for studies reporting diagnostic and prognostic outcomes of AI voice and speech models in AD and MCI. Data were extracted from studies applying machine learning (ML) or deep learning (DL) to human speech with quantitatively reported, clinically interpretable outcomes. Methodological quality and risk of bias were formally appraised using the PROBAST and CLAIM tools.</p><p><strong>Results: </strong>Sixty-three studies were included. Of the 18,540 participants, there were 8,044 patients (mean age: 73.1 years), 9,736 controls (mean age: 67 years), and 760 with unspecified dementia diagnoses. There were 9,571 females and 8,341 males (628 unspecified). Most reported high diagnostic performance for distinguishing AD from healthy controls using prosody (n = 41), temporal (n = 38), spectral (n = 35), and linguistic (n = 21) measures, frequently achieving areas under the curve greater than 0.80. In contrast, MCI was less reliably distinguished from normal aging. AI-based speech analysis thus represents a promising and scalable digital biomarker, but the current evidence base remains heavily constrained by small, single-center datasets and a widespread lack of external validation.</p><p><strong>Conclusion: </strong>AI-driven speech analysis holds significant potential for the early detection of cognitive decline. However, its clinical translation is currently limited by methodological bias. Future validation efforts must shift toward large-scale, multicenter, longitudinal studies with standardized speech assessments.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}