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Alves MDC, Mancini PC, Teixeira LC. Modifications of auditory feedback and its effects on the voice of adult subjects: a scoping review. Codas 2023; 36:e20220202. [PMID: 38126424 PMCID: PMC10750862 DOI: 10.1590/2317-1782/20232022202pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 05/29/2023] [Indexed: 12/23/2023] Open
Abstract
INTRODUCTION The auditory perception of voice and its production involve auditory feedback, kinesthetic cues and the feedforward system that produce different effects for the voice. The Lombard, Sidetone and Pitch-Shift-Reflex effects are the most studied. The mapping of scientific experiments on changes in auditory feedback for voice motor control makes it possible to examine the existing literature on the phenomenon and may contribute to voice training or therapies. PURPOSE To map experiments and research results with manipulation of auditory feedback for voice motor control in adults. METHOD Scope review following the Checklist Preferred Reporting Items for Systematic reviews and Meta-Analyses extension (PRISMA-ScR) to answer the question: "What are the investigation methods and main research findings on the manipulation of auditory feedback in voice self-monitoring of adults?". The search protocol was based on the Population, Concept, and Context (PCC) mnemonic strategy, in which the population is adult individuals, the concept is the manipulation of auditory feedback and the context is on motor voice control. Articles were searched in the databases: BVS/Virtual Health Library, MEDLINE/Medical Literature Analysis and Retrieval System online, COCHRANE, CINAHL/Cumulative Index to Nursing and Allied Health Literature, SCOPUS and WEB OF SCIENCE. RESULTS 60 articles were found, 19 on the Lombard Effect, 25 on the Pitch-shift-reflex effect, 12 on the Sidetone effect and four on the Sidetone/Lombard effect. The studies are in agreement that the insertion of a noise that masks the auditory feedback causes an increase in the individual's speech intensity and that the amplification of the auditory feedback promotes the reduction of the sound pressure level in the voice production. A reflex response to the change in pitch is observed in the auditory feedback, however, with particular characteristics in each study. CONCLUSION The material and method of the experiments are different, there are no standardizations in the tasks, the samples are varied and often reduced. The methodological diversity makes it difficult to generalize the results. The main findings of research on auditory feedback on voice motor control confirm that in the suppression of auditory feedback, the individual tends to increase the intensity of the voice. In auditory feedback amplification, the individual decreases the intensity and has greater control over the fundamental frequency, and in frequency manipulations, the individual tends to correct the manipulation. The few studies with dysphonic individuals show that they behave differently from non-dysphonic individuals.
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Affiliation(s)
- Moisés do Carmo Alves
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Patrícia Cotta Mancini
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
| | - Leticia Caldas Teixeira
- Programa de Pós-graduação em Ciências Fonoaudiológicas, Departamento de Fonoaudiologia, Faculdade de Medicina, Universidade Federal de Minas Gerais – UFMG - Belo Horizonte (MG), Brasil.
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Lee SH, Lee GS. Long-term Average Spectrum and Nasal Accelerometry in Sentences of Differing Nasality and Forward-Focused Vowel Productions Under Altered Auditory Feedback. J Voice 2022:S0892-1997(22)00228-4. [PMID: 36050247 DOI: 10.1016/j.jvoice.2022.07.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVES AND BACKGROUND To investigate whether voice focus adjustments can alter the audio-vocal feedback and consequently modulate speech/voice motor control. Speaking with a forward-focused voice was expected to enhance audio-vocal feedback and thus decrease the variability of vocal fundamental frequency (F0). MATERIALS AND METHOD Twenty-two healthy, untrained adults (10 males and 12 females) were requested to sustain vowel /a/ with their natural focus and a forward focus and to naturally read the nasal, oral, and mixed oral-nasal sentences in normal noise-masked auditory conditions. Meanwhile, a miniature accelerometer was externally attached on the noise to detect the nasal vibrations during vocalization. Audio recordings were made and analyzed using the long-term average spectrum (LTAS) and power spectral analysis of F0. RESULTS Compared with naturally-focused vowel production and oral sentences, forward-focused vowel productions and nasal sentences both showed significant increases in nasal accelerometric amplitude and the spectral power within the range of 200∼300 Hz, and significantly decreased the F0 variability below 3 Hz, which has been reported to be associated with enhanced auditory feedback in our previous research. The auditory masking not only significantly increased the low-frequency F0 variability, but also significantly decreased the ratio of the spectral power within 200∼300 Hz to the power within 300∼1000 Hz for the vowel and sentence productions. Gender differences were found in the correlations between the degree of nasal coupling and F0 stability as well as in the LTAS characteristics in response to noise. CONCLUSIONS Variations in nasal-oral acoustic coupling not only change the formant features of speech signals, but involuntarily influence the auditory feedback control of vocal fold vibrations. Speakers tend to show improved F0 stability in response to a forward-focused voice adjustment.
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Affiliation(s)
- Shao-Hsuan Lee
- Department of Audiology and Speech Language Pathology, Mackay Medical College, New Taipei City, and Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Guo-She Lee
- School of Medicine, College of Medicine, Yangming Campus, National Yang Ming Chiao Tung University, and Department of Otorhinolaryngology, Taipei City Hospital Renai Branch, Taipei, Taiwan.
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Lee SH, Torng PC, Lee GS. Contributions of Forward-Focused Voice to Audio-Vocal Feedback Measured Using Nasal Accelerometry and Power Spectral Analysis of Vocal Fundamental Frequency. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1751-1766. [PMID: 35353595 DOI: 10.1044/2022_jslhr-21-00443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The spectral powers of the modulations of vocal fundamental frequency (f o) less than 3 Hz (low-frequency power, LFP) and between 3 and 8 Hz (middle-frequency power, MFP) had been established to indicate the audio-vocal feedback status and vocal efficiency of a speaker, and a resonant voice may enhance the auditory-vocal feedback. This study aims to determine whether the auditory feedback can be augmented by a forward and resonant voice and therefore contribute to the modulations of f o variability. METHOD Vocal signals and accelerometric signals of lateral nasal cartilage were obtained from 27 healthy adults who, respectively, sustained vowels /a/ and /i/ with their habitual speaking voice and with a forward-focused voice under three auditory conditions: natural hearing (N0), high-level noise exposure (N90), and low-level noise exposure (N60). Nasal skin vibrations were measured using a nasal accelerometry to reflect voice resonance status. Vocal intensity and f o variability were also analyzed to show the auditory-vocal interactions under varied conditions of auditory feedback and voice resonance. RESULTS In both N0 and N90 conditions, forward-focused voice showed a significantly lower LFP than the speakers' habitual voice. In addition, LFP of f o would significantly increase during natural voice production as the voice feedback was greatly masked by high-intensity noise; however, with a forward-focused voice, the noise-induced variation in LFP was significantly decreased. Under N90, MFP significantly decreased during forward-focused voice production compared with that measured during natural voice production. The stability of f o modulations was not adversely affected by N60. CONCLUSION The results support the idea that vocalizing with a forward-focused voice enhance the auditory feedback of the speaker's own voice and, thus, reduce the variability of f o during sustained phonation, especially when vocalizing in the high noise condition.
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Affiliation(s)
- Shao-Hsuan Lee
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Pao-Chuan Torng
- Department of Speech Language Pathology and Audiology, National Taipei University of Nursing and Health Sciences, Taiwan
| | - Guo-She Lee
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taiwan
- Department of Otorhinolaryngology, Taipei City Hospital, Renai Branch, Taiwan
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Lee SH, Yu JF, Fang TJ, Lee GS. Vocal fold nodules: A disorder of phonation organs or auditory feedback? Clin Otolaryngol 2019; 44:975-982. [PMID: 31436035 DOI: 10.1111/coa.13417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 07/19/2019] [Accepted: 08/18/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Increasing evidence supports that auditory feedback of one's own voice closely relates to real-time adjustments of vocal control. Previous studies highlighted that the low-frequency modulations of below 3 Hz (LFM) embedded in vocal fundamental frequency (F0) showed a reflex-like response to altered auditory inputs. However, the auditory feedback control of different vocal disorders remains unclear. DESIGN A cross-sectional, case-controlled study. SETTING A tertiary medical centre. PARTICIPANTS Sustained vocalisations of vowel/a/ from adult healthy controls and patients with vocal fold nodules, vocal fold polyps and vocal fold cysts, respectively. The vocalisations were made at a comfortable pitch and at the intensity of 70 ~ 80 dBC under the following four auditory conditions: natural hearing, 90-dBC speech noise, 10-dBC enhanced feedback of self-produced voice and both the noise and voice feedback. MAIN OUTCOME MEASURES Power spectral analysis of F0 contour of sustained vowel. RESULTS Patients with vocal fold nodules presented with different audio-vocal feedback behaviour and audio-vocal response to speech noise from the other two vocal pathologies of vocal fold polyp and vocal fold cyst as well as the healthy controls (P < .001, one-way ANOVA). CONCLUSION The vocal fold nodules may be not only a vocal fold disease but also a disease caused by abnormal audio-vocal feedback. Moreover, the distinct audio-vocal feedback of vocal fold nodules could be revealed by power spectral analysis of vocal fundamental frequencies. Although further investigations are necessary, adjustments of audio-vocal feedback behaviour may provide a new insight and benefit to the treatment of vocal fold nodules in the future.
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Affiliation(s)
- Shao-Hsuan Lee
- Ph.D. Program in Biomedical Engineering, College of Engineering, Chang Gung University, Taoyuan City, Taiwan
| | - Jen-Fang Yu
- Institute of Medical Mechatronics, College of Engineering, Chang Gung University, Taoyuan City, Taiwan
| | - Tuan-Jen Fang
- Department of Otolaryngology Head and Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan City, Taiwan.,School of Medicine, Chang Gung University, Taoyuan City, Taiwan
| | - Guo-She Lee
- Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Otolaryngology, Taipei City Hospital Renai Branch, Taipei, Taiwan
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The impact of perilaryngeal vibration on the self-perception of loudness and the Lombard effect. Exp Brain Res 2018; 236:1713-1723. [PMID: 29623381 DOI: 10.1007/s00221-018-5248-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
The role of somatosensory feedback in speech and the perception of loudness was assessed in adults without speech or hearing disorders. Participants completed two tasks: loudness magnitude estimation of a short vowel and oral reading of a standard passage. Both tasks were carried out in each of three conditions: no-masking, auditory masking alone, and mixed auditory masking plus vibration of the perilaryngeal area. A Lombard effect was elicited in both masking conditions: speakers unconsciously increased vocal intensity. Perilaryngeal vibration further increased vocal intensity above what was observed for auditory masking alone. Both masking conditions affected fundamental frequency and the first formant frequency as well, but only vibration was associated with a significant change in the second formant frequency. An additional analysis of pure-tone thresholds found no difference in auditory thresholds between masking conditions. Taken together, these findings indicate that perilaryngeal vibration effectively masked somatosensory feedback, resulting in an enhanced Lombard effect (increased vocal intensity) that did not alter speakers' self-perception of loudness. This implies that the Lombard effect results from a general sensorimotor process, rather than from a specific audio-vocal mechanism, and that the conscious self-monitoring of speech intensity is not directly based on either auditory or somatosensory feedback.
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Lee SH, Fang TJ, Yu JF, Lee GS. Responses of Middle-Frequency Modulations in Vocal Fundamental Frequency to Different Vocal Intensities and Auditory Feedback. J Voice 2017; 31:536-544. [PMID: 28268129 DOI: 10.1016/j.jvoice.2017.01.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 01/27/2017] [Accepted: 01/30/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVES AND BACKGROUND Auditory feedback can make reflexive responses on sustained vocalizations. Among them, the middle-frequency power of F0 (MFP) may provide a sensitive index to access the subtle changes in different auditory feedback conditions. MATERIALS AND METHODS Phonatory airflow temperature was obtained from 20 healthy adults at two vocal intensity ranges under four auditory feedback conditions: (1) natural auditory feedback (NO); (2) binaural speech noise masking (SN); (3) bone-conducted feedback of self-generated voice (BAF); and (4) SN and BAF simultaneously. The modulations of F0 in low-frequency (0.2 Hz-3 Hz), middle-frequency (3 Hz-8 Hz), and high-frequency (8 Hz-25 Hz) bands were acquired using power spectral analysis of F0. Acoustic and aerodynamic analyses were used to acquire vocal intensity, maximum phonation time (MPT), phonatory airflow, and MFP-based vocal efficiency (MBVE). RESULTS SN and high vocal intensity decreased MFP and raised MBVE and MPT significantly. BAF showed no effect on MFP but significantly lowered MBVE. Moreover, BAF significantly increased the perception of voice feedback and the sensation of vocal effort. CONCLUSIONS Altered auditory feedback significantly changed the middle-frequency modulations of F0. MFP and MBVE could well detect these subtle responses of audio-vocal feedback.
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Affiliation(s)
- Shao-Hsuan Lee
- Ph.D. Program in Biomedical Engineering, College of Engineering, Chang-Gung University, Taoyuan City, Taiwan
| | - Tuan-Jen Fang
- Department of Otorhinolaryngology, Chang-Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Jen-Fang Yu
- Institute of Medical Mechatronics, College of Engineering, Chang-Gung University, Taoyuan City, Taiwan
| | - Guo-She Lee
- Department of Otorhinolaryngology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Otolaryngology, Taipei City Hospital Renai Branch, Taipei, Taiwan.
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Kleber B, Friberg A, Zeitouni A, Zatorre R. Experience-dependent modulation of right anterior insula and sensorimotor regions as a function of noise-masked auditory feedback in singers and nonsingers. Neuroimage 2016; 147:97-110. [PMID: 27916664 DOI: 10.1016/j.neuroimage.2016.11.059] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/11/2016] [Accepted: 11/23/2016] [Indexed: 12/20/2022] Open
Abstract
Previous studies on vocal motor production in singing suggest that the right anterior insula (AI) plays a role in experience-dependent modulation of feedback integration. Specifically, when somatosensory input was reduced via anesthesia of the vocal fold mucosa, right AI activity was down regulated in trained singers. In the current fMRI study, we examined how masking of auditory feedback affects pitch-matching accuracy and corresponding brain activity in the same participants. We found that pitch-matching accuracy was unaffected by masking in trained singers yet declined in nonsingers. The corresponding brain region with the most differential and interesting activation pattern was the right AI, which was up regulated during masking in singers but down regulated in nonsingers. Likewise, its functional connectivity with inferior parietal, frontal, and voice-relevant sensorimotor areas was increased in singers yet decreased in nonsingers. These results indicate that singers relied more on somatosensory feedback, whereas nonsingers depended more critically on auditory feedback. When comparing auditory vs somatosensory feedback involvement, the right anterior insula emerged as the only region for correcting intended vocal output by modulating what is heard or felt as a function of singing experience. We propose the right anterior insula as a key node in the brain's singing network for the integration of signals of salience across multiple sensory and cognitive domains to guide vocal behavior.
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Affiliation(s)
- Boris Kleber
- McGill University - Montreal Neurological Institute, Neuropsychology and Cognitive Neuroscience, Montreal, QC, Canada; International Laboratory for Brain, Music and Sound research (BRAMS), Montreal, QC, Canada; Institut für Medizinische Psychologie und Verhaltensneurobiologie, Universität Tübingen, Tübingen, Germany; Center for Music in the Brain, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Anders Friberg
- Speech, Music and Hearing, KTH Royal Institute of Technology, Stockholm, Sweden
| | - Anthony Zeitouni
- Department of Otolaryngology-Head and Neck Surgery, MUHC-Royal Victoria Hospital, McGill University, Montreal, QC, Canada
| | - Robert Zatorre
- McGill University - Montreal Neurological Institute, Neuropsychology and Cognitive Neuroscience, Montreal, QC, Canada; International Laboratory for Brain, Music and Sound research (BRAMS), Montreal, QC, Canada
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Lee SH, Hsiao TY, Lee GS. Audio–vocal responses of vocal fundamental frequency and formant during sustained vowel vocalizations in different noises. Hear Res 2015; 324:1-6. [DOI: 10.1016/j.heares.2015.02.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 02/24/2015] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
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Effects of hearing aid amplification on voice F0 variability in speakers with prelingual hearing loss. Hear Res 2013; 302:1-8. [PMID: 23648550 DOI: 10.1016/j.heares.2013.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 04/16/2013] [Accepted: 04/22/2013] [Indexed: 11/20/2022]
Abstract
To investigate the audio-vocal feedback responses of (F0) to hearing amplification in severe-to-profound prelingual hearing loss (SPHL) using power spectral analysis of F0 contour of sustained vowels. Sustained phonations of vowel/a/of seventeen participants with SPHL were acquired with and without hearing-aid amplifications. The vocal intensity was visually fed back to the participants to help controlling the vocal intensity at 65-75 dBA and 85-95 dBA. The F0 contour of the phonations was extracted and submitted to spectral analysis to measure the extent of F0 fluctuations at different frequency ranges. The results showed that both high vocal intensity and hearing-aid amplification significantly improved voice F0 control by reducing the low-frequency fluctuations (low-frequency power, LFP, 0.2-3 Hz) in F0 spectrum. However, the enhanced feedback from higher vocal intensity and/or hearing amplification was not adequate to reduce the LFP to the level of a normal hearing person. Moreover, we found significant and negative correlations between LFP and supra-threshold feedback intensity (phonation intensity - hearing threshold level) for the frequencies of 500-2000 Hz. Increased vocal intensity, as well as hearing-aid amplification, improved voice F0 control by reducing the LFP of F0 spectrum, and the subtle changes in voices could be well explored using spectral analysis of F0.
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Variability in Voice Fundamental Frequency of Sustained Vowels in Speakers With Sensorineural Hearing Loss. J Voice 2012; 26:24-9. [PMID: 21227645 DOI: 10.1016/j.jvoice.2010.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Accepted: 10/06/2010] [Indexed: 11/23/2022]
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