Reflexive and volitional voice fundamental frequency responses to an anticipated feedback pitch error.

The pitch-shift reflex is a corrective voice fundamental frequency (F0) response triggered by a sudden shift or "error" in auditory feedback pitch. We investigated how anticipating a voice pitch error affects the pitch-shift reflex and volitional voice F0 responses. Adults sustained the vowel/u/at a comfortable pitch and pressed a button to deliver a 100 cent, 100 ms auditory feedback pitch shift immediately or after a random delay. Pitch shift direction was either constant (up) or randomized (up or down). Onset anticipation often resulted in an anticipatory voice F0 change, but stimulus direction predictability did not affect the responses. When pitch error onset and direction were both anticipated, some participants produced an ideomotor voice F0 change that partially imitated the error, but they produced no apparent pitch-shift reflex. Results imply that when voice pitch errors are anticipated, volitional voice F0 responses may reduce or enhance voice F0 stability.

Self-triggered functional electrical stimulation during swallowing.

Hyolaryngeal elevation is essential for airway protection during swallowing and is mainly a reflexive response to oropharyngeal sensory stimulation. Targeted intramuscular electrical stimulation can elevate the resting larynx and, if applied during swallowing, may improve airway protection in dysphagic patients with inadequate hyolaryngeal motion. To be beneficial, patients must synchronize functional electrical stimulation (FES) with their reflexive swallowing and not adapt to FES by reducing the amplitude or duration of their own muscle activity. We evaluated the ability of nine healthy adults to manually synchronize FES with hyolaryngeal muscle activity during discrete swallows, and tested for motor adaptation. Hooked-wire electrodes were placed into the mylo- and thyrohyoid muscles to record electromyographic activity from one side of the neck and deliver monopolar FES for hyolaryngeal elevation to the other side. After performing baseline swallows, volunteers were instructed to trigger FES with a thumb switch in synchrony with their swallows for a series of trials. An experimenter surreptitiously disabled the thumb switch during the final attempt, creating a foil. From the outset, volunteers synchronized FES with the onset of swallow-related thyrohyoid activity (approximately 225 ms after mylohyoid activity onset), preserving the normal sequence of muscle activation. A comparison between average baseline and foil swallows failed to show significant adaptive changes in the amplitude, duration, or relative timing of activity for either muscle, indicating that the central pattern generator for hyolaryngeal elevation is immutable with short term stimulation that augments laryngeal elevation during the reflexive, pharyngeal phase of swallowing.

Laryngeal elevation achieved by neuromuscular stimulation at rest.

During swallowing, airway protection is achieved in part by laryngeal elevation. Although multiple muscles are normally active during laryngeal elevation, neuromuscular stimulation of select muscles was evaluated to determine which single muscle or muscle pair best elevates the larynx and should be considered during future studies of neuromuscular stimulation in dysphagic patients. Hooked-wire monopolar electrodes were inserted into mylohyoid, thyrohyoid, and geniohyoid muscle regions in 15 healthy men selected for having a highly visible thyroid prominence for videotaping. During trials of single, bilateral, and combined muscle stimulations, thyroid prominence movements were video recorded, digitized, and normalized relative to elevation during a 2-ml water swallow. Individual muscle stimulation induced approximately 30% of the elevation observed during a swallow and approximately 50% of swallow velocity, whereas paired muscle stimulation resulted in approximately 50% of the elevation and approximately 80% of the velocity produced during a swallow. Paired muscle stimulation produced significantly greater elevation than single muscle stimulation and could assist with laryngeal elevation in dysphagic patients with reduced or delayed laryngeal elevation.

Early pitch-shift response is active in both steady and dynamic voice pitch control.

When air conducted auditory feedback pitch is experimentally shifted upward or downward during steady phonation, voice pitch changes in response. The first pitch change is an automatic deflection opposite in direction to the feedback shift. It appears to help stabilize voice pitch by counteracting unintended changes. But what happens during an intended pitch change? If the purpose of the first pitch-shift response is to stabilize voice pitch around a fixed target, it should be suppressed during voluntary pitch changes. Alternatively, if the pitch-shift response is a general process of voice control it should be modified during intended pitch changes to bring production in line with the desired output. Auditory feedback pitch was shifted during steady pitch and upward glissando vocalizations by thirty trained singers. Contrary to the "steady-specific" hypothesis, pitch-shift responses occurred during dynamic pitch vocalizations. Responses were comparable in direction, peak time, and slope, but had significantly longer latency and smaller magnitude than responses elicited during steady note phonation. Results indicate that the early pitch-shift response is a general component of voice control that serves to automatically bring phonation pitch into agreement with an intended target, whether that target is constant or changing in time.