Psychological Correlates of Auditory-Motor Integration in Primary Muscle Tension Dysphonia: A Preliminary Study

Primary Muscle Tension Dysphonia (pMTD) is a functional voice disorder characterized by excessive laryngeal muscle tension and vocal hyperfunction, often linked to psychological factors and impaired vocal motor control. This preliminary study investigates the relationship between psychological constructs and auditory-motor integration in pMTD, focusing on vocal compensation responses to altered auditory feedback (AAF).

Twenty-one individuals with pMTD (mean age: 35.4) participated in a reflexive AAF paradigm, producing sustained vowels while receiving brief (±100 cents) pitch-shift perturbations. Vocal compensation magnitude was measured and correlated with scores from the Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) Dominance Ratio, and Voice Handicap Index (VHI). Pearson and Spearman correlations, along with multiple regression analyses, were applied.

Significant correlations were found between higher BDI-II scores and reduced compensation for upward (r = 0.314, P < 0.05) and downward (r = -0.447, P < 0.05) pitch shifts. Elevated BIS/BAS dominance ratio was associated with weaker compensation for upward (r = 0.498, P < 0.05) and downward (r = -0.442, P < 0.05) shifts. BDI-II positively correlated with BAI (r = 0.512, P < 0.05) and BIS/BAS Dominance Ratio (r = 0.390, P < 0.05). No significant correlations were observed between BAI or VHI and vocal compensation. However, multiple regression analyses did not identify significant predictors of compensation magnitude, though trends suggested possible roles for depression and BIS dominance.

These findings underscore the critical role of psychological factors, particularly depression and BIS dominance, in modulating auditory-motor integration in pMTD, contributing to its pathophysiology. The observed impairments in vocal compensation highlight the need for further research to elucidate these psychomotor mechanisms and their impact on vocal motor control, paving the way for targeted interventions.