Synchrony of laryngeal muscle activity in persons with vocal tremor.

OBJECTIVE: To determine if the tremor activity in laryngeal muscles is synchronous, which would indicate a single central source of tremor. DESIGN: Six persons with vocal tremor participated in this study. Laryngeal muscle activity was recorded from 2 intrinsic and 2 extrinsic laryngeal muscles during production of a sustained \i\ sound. Correlations were computed between electromyographic activity in pairs of laryngeal muscles to measure the degree to which electromyographic activity in one muscle was synchronous with electromyographic activity in another laryngeal muscle. In addition, correlations were computed between each of the 4 laryngeal muscles and the voice signal to determine which muscle had activity that was most highly related to amplitude modulations in the voice. Multiple samples from each subject were analyzed to obtain measures of the consistency and strength of the correlations. RESULTS: In most subjects, the bursts of electromyographic activity in one muscle were not consistently related to tremor activity in other affected muscles. Half the subjects exhibited moderate to strong correlations between thyroarytenoid muscle activity and the amplitude of the voice signal. Although the thyroarytenoid and cricothyroid muscles were always active during sustained phonation, half of the subjects did not activate either the thyrohyoid or the sternothyroid muscle during this task. CONCLUSIONS: The results of this study did not support the hypothesis that essential voice tremor is generated by a single central oscillator. Differences in the presence and timing of modulations in laryngeal muscle activity, as described in this study, may reflect clinically in the variable regularity and severity of vocal tremor.

Laryngeal activity during upright vs. supine swallowing.

Previous investigations of human pharyngeal muscle activation patterns during swallowing found a relatively invariant muscle activation onset sequence in the upright position. However, different gravitational forces influence a liquid bolus when supine and could modify the central timing control of laryngeal airway protection during swallowing. The purpose of this study was to determine whether laryngeal muscle onset timing during swallowing differed between the supine and upright positions. Nine subjects performed six swallowing trials with a 2-ml water bolus in each position. Simultaneous electromyographic recordings were obtained from the submental complex (SMC) and the right and left thyroarytenoid (TA) muscles. Regardless of body position, the timing, amplitude, and duration of the TA muscles did not vary relative to the SMC. Therefore, the sequence of TA muscle activation relative to the SMC during swallowing appeared unaffected by gravitational influences.