Status:
COMPLETED
Role of Neurotransmission and Functional CNS Networks in Spasmodic Dysphonia
Lead Sponsor:
National Institute of Neurological Disorders and Stroke (NINDS)
Conditions:
Spasmodic Dysphonia
Focal Dystonia
Eligibility:
All Genders
21-80 years
Brief Summary
This study will examine how the brain controls speech in patients with spasmodic dysphonia, a voice disorder that involves involuntary spasms of muscles in the larynx (voice box), causing breaks in sp...
Detailed Description
Spasmodic dysphonia (SD) and writer s cramp (WC) are primary focal dystonias with selective impairment of voluntary control of speaking and writing, respectively. Although the pathophysiology of SD an...
Eligibility Criteria
Inclusion
- INCLUSION CRITERIA:
- Healthy research volunteers and adult patients with ADSD and WC will be eligible for the study.
- Adult patients with ADSD will have clinically documented ADSD established by voice and speech testing and fiberoptic nasolaryngoscopy.
- Patients will be required to have:
- Intermittent uncontrolled voice breaks in vowels, liquids (r \& l), semivowels (w \& y) during speech in ADSD (at least 3 voice breaks), or
- Less prominent symptoms during whisper, singing, falsetto, or shout;
- Normal voice and vocal fold movement during protective laryngeal functions and emotional phonation, such as cough, laughter, cry.
- Adult patients with WC will have clinically documented WC established by history and neurological examination.
- Controls will be healthy subjects with a negative history of laryngeal, neurological, or psychiatric problems.
- All participants will be from 21 to 80 years old and right hand dominant.
- All participants should be able to perform a sequential finger-tapping task for 40 seconds consecutively
- EXCLUSION CRITERIA:
- Subjects who are incapable of giving an informed consent.
- Pregnant or breastfeeding women until a time when they are no longer pregnant or breastfeeding.
- Subjects with past or present medical history of (a) neurological problems, such as stroke, movement disorders (other than SD and WC in the patient group), brain tumors, traumatic brain injury with loss of consciousness, ataxias, myopathies, myasthenia gravis, demyelinating diseases, alcoholism, drug dependence; (b) psychiatric problems, such as schizophrenia, major and/or bipolar depression, obsessive-compulsive disorder; (c) laryngeal problems, such as vocal fold paralysis, paresis, vocal fold nodules and polyps, carcinoma, chronic laryngitis. (d) ventricular arrhythmias, renal and hepatic insufficiency, vascular headache, or carcinoid syndrome.
- Patients who are currently taking medications known to affect GABA and dopamine receptor binding. Occasionally, patients report receiving such medication, although dopaminergic and GABA agonist/antagonists are not typically prescribed in these patients.
- Patients who received treatment with botulinum toxin injections into the laryngeal muscles within the past 3 months.
- Patients with vocal and hand tremor or muscle tension dysphonia.
- Subjects who have tattoos with contraindications to MRI, ferromagnetic objects in their bodies (e.g., implanted stimulators, surgical clips, prosthesis, artificial heart valve, etc.) that cannot be removed for the purpose of study participation.
- Subjects who received previous radiation exposure greater than 5.0 rem per year.
- WC patients who experience focal hand dystonia at rest.
- WC patients who have focal hand dystonia associated with trauma or a known neuroanatomic lesion or disease.
Exclusion
Key Trial Info
Start Date :
July 9 2008
Trial Type :
OBSERVATIONAL
Allocation :
ACTUAL
End Date :
September 21 2016
Estimated Enrollment :
37 Patients enrolled
Trial Details
Trial ID
NCT00713414
Start Date
July 9 2008
End Date
September 21 2016
Last Update
July 5 2018
Active Locations (1)
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1
National Institutes of Health Clinical Center, 9000 Rockville Pike
Bethesda, Maryland, United States, 20892