Voice disorder in patients with Fibromyalgia
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Objective: To investigate several perceptual, acoustic and aerodynamic voice evaluation parameters in Fibromyalgia patients. Methods: A total number of 30 Fibromyalgia patients had voice evaluations by means of laryngostroboscopy, acoustic analysis (jitter, shimmer, and harmonic to noise ratio), aerodynamic measurements (maximum phonation time, s/z ratio), and perceptual analysis (GRBAS and Voice Handicap Index-10 scales). Data obtained from the patients was compared to control subjects. Results: Mean intensity was found to be significantly higher in control subjects (73.70 +/- 4.73 dB) than Fibromyalgia patients (64.50 +/- 6.92 dB), (p < 0.001). There was no statistically significant difference in fundamental frequency, perturbation parameters (jitter and shimmer) and harmonic to noise ratio between groups. Maximum phonation time in control subjects (22.53 +/- 4.95 s) was found to be significantly longer than Fibromyalgia patients (16.07 +/- 4.87 s), (p < 0.001), and s/z ratio was found to be nearly equal between patients (1.00 +/- 0.24) and control subjects (0.96 +/- 0.16). On the basis of perceptual evaluation by using a GRBAS scale, the patients showed a mean score of 2.50 +/- 1.97 and the control group showed a mean score of 0.56 +/- 1.04 (p < 0.001). "Grade" and "asthenia" parameters of GRBAS scale in Fibromyalgia patients were significantly different from the parameters of control group (p < 0.001). The Voice Handicap Index-10 scales revealed a mean score of 7.90 +/- 7.58 in Fibromyalgia patients and 1.83 +/- 2.82 in control subjects (p < 0.001). Conclusion: Fibromyalgia impairs perceived voice quality either in patient self evaluated or in clinician evaluated rating scales. Furthermore, the results confirm that Fibromyalgia caused short maximum phonation time and low voice intensity. This study is the first report with regards to voice evaluation in Fibromyalgia and in order to make a generalization further researches are needed. (C) 2013 Elsevier Ireland Ltd. All rights reserved.