Brain Activity During Phonation in Women With Muscle Tension Dysphonia: An fMRI Study.

Objectives: The main objectives of this functional magnetic resonance imaging (fMRI) study are (1) to investigate brain activity during phonation in women with muscle tension dysphonia (MTD) in comparison with healthy controls; and (2) to explain the neurophysiological mechanism of laryngeal hyperfunction/tension during phonation in patients with MTD.

Methods: Ten women with MTD and fifteen healthy women participated in this study. The fMRI experiment was carried out using a block design paradigm. Brain activation during phonation and exhalation was analyzed using BrainVoyager software.

Results: The statistical analysis of fMRI data has demonstrated that MTD patients control phonation by use of the auditory, motor, frontal, parietal, and subcortical areas similar to phonation control by healthy people. Comparison of phonation tasks in the two groups revealed higher brain activities in the precentral gyrus, inferior, middle and superior frontal gyrus, lingual gyrus, insula, cerebellum, midbrain, and brainstem as well as lower brain activities in the cingulate gyrus, superior and middle temporal gyrus, and inferior parietal lobe in the MTD group. No differences were found between the two groups regarding exhalation control.

Conclusions: The findings in this study provide insight into phonation and exhalation control in patients with MTD. The imaging results demonstrated that in patients with MTD, altered (higher/lower) brain activities may result in laryngeal tension and vocal hyperfunction.