Brain Activity in Patients With Unilateral Vocal Fold Paralysis Detected by Functional Magnetic Resonance Imaging

Asanori Kiyuna; Norimoto Kise; Munehisa Hiratsuka; Hiroyuki Maeda; Hitoshi Hirakawa; Akira Ganaha; Mikio Suzuki

doi:10.1016/j.jvoice.2020.08.008

Brain Activity in Patients With Unilateral Vocal Fold Paralysis Detected by Functional Magnetic Resonance Imaging

J Voice. 2022 Sep;36(5):738.e1-738.e9. doi: 10.1016/j.jvoice.2020.08.008. Epub 2020 Aug 30.

Authors

Asanori Kiyuna¹, Norimoto Kise¹, Munehisa Hiratsuka¹, Hiroyuki Maeda¹, Hitoshi Hirakawa¹, Akira Ganaha², Mikio Suzuki³

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan.
² Department of Otorhinolaryngology-Head and Neck Surgery, University of Miyazaki, Miyazaki, Japan.
³ Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa, Japan. Electronic address: suzuki@med.u-ryukyu.ac.jp.

PMID: 32873428
DOI: 10.1016/j.jvoice.2020.08.008

Abstract

Objectives: Understanding brain activity in response to unilateral vocal fold paralysis is essential to determine the neural compensatory mechanism underlying adaptation to voice disorders and to develop novel and improved rehabilitation programs for these disorders. We aimed to clarify brain activity during phonation (prolonged vowel, |i:|) in patients with chronic left vocal fold paralysis (LVFP) and compare with that in normal controls.

Study design: Case-control study.

Methods: This functional magnetic resonance imaging (fMRI) study of an event-related task comprised 12 individuals with LVFP of more than 6 months duration and 12 healthy controls. The experimental task alternated phonation (prolonged vowel, |i:|) and no phonation (rest) conditions. The functional images obtained were single-shot gradient-echo echo-planar imaging. The volumes were acquired parallel to the anterior-posterior commissure plane and were sensitive to BOLD contrast. Data sets were processed and statistically analyzed using Statistical Parametric Mapping 8 software. Within-group analyses were conducted by applying the one-sample t test (P < 0.001, uncorrected). A random-effects analysis was used for group comparison.

Results: The LVFP group showed significantly higher brain activity in the right premotor areas, left parietal lobule, right primary somatosensory areas, and bilateral supplementary motor area and lower brain activity in the auditory-related areas of the superior temporal gyrus. There were no significant correlations of the percent signal change on fMRI with disease duration, maximum phonation time, or age.

Conclusion: Patients with chronic unilateral vocal fold paralysis have stronger activity during voluntary phonation in various central networks. More detailed information on the central nervous system regions related to voluntary phonation from early to chronic phase is needed to understand the compensatory mechanisms in vocal fold paralysis and to establish an effective rehabilitation program. This is the first report to investigate brain activity in chronic unilateral vocal fold paralysis.

Keywords: Brain activity––Chronic phase––Functional magnetic resonance imaging––Secondary motor area––Unilateral vocal fold paralysis.

MeSH terms

Auditory Cortex*
Case-Control Studies
Humans
Magnetic Resonance Imaging
Vocal Cord Paralysis* / diagnostic imaging
Vocal Cords / diagnostic imaging