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Published on: September 11, 2017
Top-Down Modulation of Auditory-Motor Integration in Individuals with Primary Muscle Tension Dysphonia: The Role of
Sirvan Savareh Sonj1, Farhad Torabinezhad1, Arezoo Saffarian1
1Department of Speech Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Objectives:
This study investigated whether auditory working memory (AWM) training can modulate auditory-motor integration and reduce maladaptive vocal compensations in individuals with primary muscle tension dysphonia (pMTD), a voice disorder characterized by hyperfunctional laryngeal behavior in the absence of organic pathology.
Methods:
Twenty individuals with pMTD were randomly assigned to either an intervention group receiving 12 days of AWM training using a frequency pattern recognition paradigm or a control group receiving vocal hygiene education only. Vocal compensatory responses to pitch-shift stimuli (PSS) (±100 cents) were measured pre- and post-intervention using a reflexive altered auditory feedback paradigm.
Results:
The intervention group showed significant improvements in AWM capacity (paired t test: t(9) = 18.04, P < 0.001) and reduced vocal compensatory responses to both upward and downward pitch perturbations (PSS-Up: t(9) = -3.06, P = 0.014; PSS-Down: t(9) = 3.63, P = 0.006), with stronger effects for downward shifts. No significant changes were observed in the control group (PSS-Up: t(9) = 1.30, P = 0.227; PSS-Down: t(9) = -1.68, P = 0.128). Analysis of Covariance (ANCOVA) confirmed significant between-group differences in post-intervention compensation magnitudes (PSS-Up: F(2,17) = 4.86, P = 0.021; PSS-Down: F(2,17) = 7.14, P = 0.006).
Conclusions:
AWM training enhances auditory-motor integration in pMTD by reducing maladaptive vocal compensation, supporting a top-down model of vocal motor control. These findings suggest that cognitive-based interventions targeting AWM could complement traditional voice therapies by targeting central mechanisms of sensorimotor integration, offering a novel approach to improving treatment outcomes in pMTD.
