Brain and Voice Signatures in Teachers

NCT06126627 | Recruiting

• 1 other identifier: R01DC018026
• Study Type: interventional
• Target: 100
• Locations: 1 country
• Sites: 1

Brief Summary

Primary muscle tension dysphonia voice disorder with symptoms of vocal strain and vocal fatigue is common and can have a significant negative impact on quality of Life. Yet, primary muscle tension dysphonia's causes are unknown precluding precise diagnostic classification. Stress and personality are thought to play a role and thus, the project aims to determine the practical and clinical effect of stress on the control of voice and speech in the brain. Participants are female early career teachers and student teachers with symptoms of vocal fatigue, as well as control participants without vocal fatigue, who perform speech tasks on two different occasions. Neural (imaging of brain), psychobiological (saliva, personality), and voice and speech (muscle activity of voice muscles on the neck with surface sensors, audio recordings) data will compare reactivity patterns of teachers who are stressresponders with those who are nonresponders as well as control participants. The central hypothesis is that voice box stress responders have heightened emotion-motor activations involving the emotional voice production pathway, which correlate with changes in voice muscle activity in the anterior neck. The results will provide fundamentally missing data in our understanding of the role of stress in vocal complaints and will yield new insights about the neural underpinnings of primary muscle tension dysphonia. The study findings will have a significant impact on how clinicians identify so-called laryngoresponders to help them prevent voice disorders.

Conditions

Voice Disorders; Voice Fatigue

Keywords

voice disorders; vocal fatigue; occupational voice disorders; stress reactivity; vocal control; laryngeal motor cortex; teachers; speech motor control; voice motor control

Outcome Measures

Primary Outcomes (8)

• Vocal fatigue

  Raw scores, Vocal Fatigue Index, VFI Factor 1

  through study completion, an average of 1 month

• BOLD MRI area 4p

  MRI activation in regions of interest (BOLD area 4p in mean %) as a function of speech tasks with and without stress induction

  through study completion, an average of 1 month

• Salivary cortisol

  Salivary cortisol (nmol/L) to determine stressresponders and nonresponders

  through study completion, an average of 1 month

• Suprahyoid muscle activity

  Suprahyoid muscle activity (RMS)

  through study completion, an average of 1 month

• Infrahyoid muscle activity

  Infrahyoid muscle activity (RMS)

  through study completion, an average of 1 month

• Personality, Social Potency

  Personality trait Social Potency (T-scores, Multidimensional Personality Questionnaire, MPQ)

  through study completion, an average of 1 month

• Personality, Stress Reaction

  Personality trait Stress Reaction (T-scores, Multidimensional Personality Questionnaire, MPQ)

  through study completion, an average of 1 month

• Personality, social anxiety

  Personality trait social anxiety (T-scores, Liebowitz Social Anxiety Scale, LSAS-fear)

  through study completion, an average of 1 month

Secondary Outcomes (21)

• Vocal fatigue

  through study completion, an average of 1 month

• Voice quality of life

  through study completion, an average of 1 month

• Vocal tract discomfort

  through study completion, an average of 1 month

• Informal questionnaire on vocal health

  through study completion, an average of 1 month

• BOLD MRI SMA

  through study completion, an average of 1 month

Study Arms (2)

Teachers/student teachers with vocal fatigue

EXPERIMENTAL

Teachers/student teachers with vocal fatigue based on Vocal Fatigue Index (VFI, German). Pre-Screening and Screening. Experiment 1: MRI with MRI-compatible surface electrodes on the neck and audio recordings during MRI with and without stress induction. Prior to MRI, questionnaires on voice, personality, and stress and practice oft the tasks. During experiment, collection of saliva samples (before, during, and after MRI). During MRI, multiple subjective ratings of emotional state by the participants. Experiment 2 (approximately 2 weeks later): Speech tasks with surface electromyographic sensors applied to the neck with concurrent audio recordings. Prior to the experiment questionnaires on voice and practice of tasks. Subjective ratings of vocal and cognitive effort during the experiment by the participants.

Behavioral: Stress induction

Control group

ACTIVE COMPARATOR

Control participants without vocal fatigue based on Vocal Fatigue Index (VFI, German). Same experimental procedures as in arm 1.

Behavioral: Stress induction

Interventions

Stress induction BEHAVIORAL

Induction of anticipatory stress to compare voice and speech control and production with and without exposure to stress.

Control group; Teachers/student teachers with vocal fatigue

Eligibility Criteria

• Age: 21 Years - 39 Years
• Sex: female
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64)

You may qualify if:

• Teachers (max. 10 years full-time) or student teachers in good health between 21 and 39 years with symptoms of vocal fatigue.
• Control participants in good health between 21 and 39 years without symptoms of vocal fatigue.

You may not qualify if:

• Lefthandedness
• Smoking (past 5 years)
• Known changes of the vocal folds (e.g., vocal fold nodules), vocal fold paralysis, surgeries on the larynx or thryoid or current organic or neurological changes of the vocal folds or vocal function per videoendoscopy and -stroboscopy of the larynx
• History of voice therapy
• Hoarseness
• Respiratory illness, allergies (respiratory, silver), reflux or asthma at time of participation
• Hearing disorder or hearing aids
• Psychological, neurological or endocrinological disorders
• Psychotropic or steorid medications
• Body mass index \> 30
• Indications against MRI such as metail parts in or on the body (e.g., permanent dental prostheses or braces, screws, prostheses, piercings or large tattoos
• Nearsightedness \> -5 diopters, if only glasses are worn
• Claustrophobia
• Pregnancy

Sponsors & Collaborators

• University Hospital, Bonn: lead

Study Sites (1)

University Hospital Bonn

Bonn, 53127, Germany

RECRUITING

MeSH Terms

Conditions

Voice Disorders

Condition Hierarchy (Ancestors)

Laryngeal Diseases; Respiratory Tract Diseases; Otorhinolaryngologic Diseases; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Maria Dietrich, PhD

  University Hospital, Bonn

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Maria Dietrich, PhD

CONTACT

+49228287; Maria.Dietrich@ukbonn.de

Lisa Sindermann, PhD

CONTACT

+49228287; Lisa.Sindermann@ukbonn.de

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: BASIC SCIENCE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Research Associate

Study Record Dates

• First Submitted: October 19, 2023
• First Posted: November 13, 2023
• Study Start: August 1, 2023
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): July 31, 2026
• Last Updated: August 27, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share

Locations

DE (1)