Vocal tremor subjective and quantitative evaluation in laryngeal dystonia (Lin et al., 2026)

This incidence was statistically different than for controls (0/10) and for male patients with ADLD (0/6; <i>p</i> < .001). Predominant tremor types were horizontal (52.94%, 18/34) and mixed (41.18%, 14/34). Horizontal tremor parameters did not differ significantly within the ADLD group or between the iDT and rDT groups (<i>p</i> > .05).

Mean horizontal amplitudes were epiglottis, 0.21 vocal fold widths; left/right vestibular folds, 0.14/0.12 vocal fold widths; and left/right arytenoids, 0.16/0.13 vocal fold widths. In the anteroposterior direction, only arytenoid amplitude and velocity showed intergroup differences (<i>p</i> < .05). The iDT group had smaller epiglottic and bilateral arytenoid oscillation amplitudes than the rDT group (<i>p</i> < .05).

Mean anteroposterior amplitudes were epiglottis, 0.33 vocal fold widths; left/right vestibular folds, 0.12/0.16 vocal fold widths; and left/right arytenoids, 0.17/0.22 vocal fold widths.</p><p dir="ltr"><b>Conclusions: </b>VT is a key phenotype in female ADLD patients. Video tracking enables quantitative characterization of tremor kinematics and reveals objective amplitude differences between the rDT and iDT, providing a methodological basis for objective diagnosis, subtyping, and treatment evaluation of ADLD.</p><p dir="ltr"><b>Supplemental Material S1. </b>Representative stroboscopic recording of intermittent dystonia tremor.</p><p dir="ltr"><i>Note</i>.

This video captures the characteristic intermittent, periodic laryngeal oscillations during sustained /i/ phonation in a patient with adductor laryngeal dystonia. Quantitative kinematic analysis indicated that the intermittent dystonia tremor group exhibits significantly reduced anteroposterior oscillation amplitudes of the epiglottis and bilateral arytenoids relative to the regular dystonia tremor group (<i>p</i> < .05), characterizing this subtype by its lower tremor magnitude.</p><p dir="ltr"><b>Supplemental Material S2. </b>Representative stroboscopic recording of regular dystonia tremor.</p><p dir="ltr"><i>Note. </i>This video demonstrates the continuous and rhythmic laryngeal oscillations characteristic of the regular dystonia tremor subtype in adductor laryngeal dystonia.

Kinematic measurements revealed significantly greater anteroposterior oscillation amplitudes in the epiglottis and arytenoids for the regular dystonia tremor group (<i>p</i> < .05), suggesting a potential clinical association between tremor regularity and higher oscillatory intensity in this patient cohort.</p><p dir="ltr"><b>Supplemental Material S3. </b>Connected speech of the patient with intermittent dystonia tremor.</p><p dir="ltr"><b>Supplemental Material S4. </b>Sustained vowel /a/ production of the patient with intermittent dystonia tremor.</p><p dir="ltr"><b>Supplemental Material S5. </b>Connected speech of the patient with regular dystonia tremor.</p><p dir="ltr"><b>Supplemental Material S6. </b>Sustained vowel /a/ production of the patient with regular dystonia tremor.</p><p dir="ltr">Lin, D., Zhou, L., Wang, L., Li, L., Wang, D., Chen, X., & Xu, X. (2026).

Subjective and quantitative assessment of vocal tremor in patients with adductor laryngeal dystonia. <i>Journal of Speech, Language, and Hearing Research</i>. Advance online publication. <a href="doi.org/10.1044/2026_JSLHR-25-00990" target="_blank" rel="noreferrer">doi.org/10.1044/2026_JSLHR-25-00990</a></p>