Introduction: Adductor spasmodic dysphonia (ADSD) is characterized by involuntary laryngeal muscle spasms. Due to the lack of a quantitative evaluation method, most measurements have demonstrated difficulty in validity and reliability for diagnosing ADSD. This study aimed to establish a novel indicator for ADSD and determine its diagnostic effects. Methods: We investigated 98 voice samples from 49 patients with ADSD and 49 healthy participants. A sustained vowel was recorded by a high-definition audio recorder. Voice samples underwent regular acoustic evaluation and a novel global dimension (GD) method. GD, Jitter, Shimmer, HNR, Frequency shift, and CPPS were measured for both groups. Results: Statistical analysis revealed that the GD method effectively differentiated ADSD patients from healthy participants (p < 0.001, D′>0.8). Subsequent multiclass receiver operating characteristic analysis demonstrated that GD possessed the most significant classification accuracy (area under the curve = 0.988) compared with other acoustic parameters. Conclusion: GD was an effective metric for objective differentiation between ADSD patients and healthy participants. This metric could assist clinicians in the diagnosis of ADSD patients.

Jinnah HA, Berardelli A, Comella C, Defazio G, Delong MR, Factor S, et al. The focal dystonias: current views and challenges for future research. Mov Disord. 2013;28(7):926–43.
Ludlow CL, Domangue R, Sharma D, Jinnah HA, Perlmutter JS, Berke G, et al. Consensus-based attributes for identifying patients with spasmodic dysphonia and other voice disorders. JAMA Otolaryngol Head Neck Surg. 2018;144(8):657–65.
Blitzer A. Spasmodic dysphonia and botulinum toxin: experience from the largest treatment series. Eur J Neurol. 2010;17(Suppl 1):28–30.
Schindler A, Ottaviani F, Mozzanica F, Bachmann C, Favero E, Schettino I, et al. Cross-cultural adaptation and validation of the voice handicap index into Italian. J Voice. 2010;24(6):708–14.
Slavych BK, Zraick RI, Ruleman A. A systematic review of voice-related patient-reported outcome measures for use with adults. J Voice. 2021;S0892-1997(21)00340-4.
Hillel AD. The study of laryngeal muscle activity in normal human subjects and in patients with laryngeal dystonia using multiple fine-wire electromyography. Laryngoscope. 2001;111(4 Pt 2 Suppl 97):1–47.
Mehta DD, Hillman RE. Current role of stroboscopy in laryngeal imaging. Curr Opin Otolaryngol Head Neck Surg. 2012;20(6):429–36.
Roy N, Gouse M, Mauszycki SC, Merrill RM, Smith ME. Task specificity in adductor spasmodic dysphonia versus muscle tension dysphonia. Laryngoscope. 2005;115(2):311–6.
Eadie TL, Baylor CR. The effect of perceptual training on inexperienced listeners' judgments of dysphonic voice. J Voice. 2006;20(4):527–44.
Shrivastav R, Sapienza CM, Nandur V. Application of psychometric theory to the measurement of voice quality using rating scales. J Speech Lang Hear Res. 2005;48(2):323–35.
Adams SG, Hunt EJ, Irish JC, Charles DA, Lang AE, Durkin LC, et al. Comparison of botulinum toxin injection procedures in adductor spasmodic dysphonia. J Otolaryngol. 1995;24(6):345–51.
Troung DD, Rontal M, Rolnick M, Aronson AE, Mistura K. Double-blind controlled study of botulinum toxin in adductor spasmodic dysphonia. Laryngoscope. 1991;101(6 Pt 1):630–4.
Watts C, Nye C, Whurr R. Botulinum toxin for treating spasmodic dysphonia (laryngeal dystonia): a systematic Cochrane review. Clin Rehabil. 2006;20(2):112–22.
Wong DL, Irish JC, Adams SG, Durkin LC, Hunt EJ. Laryngeal image analysis following botulinum toxin injections in spasmodic dysphonia. J Otolaryngol. 1995;24(1):64–8.
Yanagida S, Nishizawa N, Hashimoto R, Mizoguchi K, Hatakeyama H, Homma A, et al. Reliability and validity of speech evaluation in adductor spasmodic dysphonia. J Voice. 2018;32(5):585–91.
Cannito MP, Doiuchi M, Murry T, Woodson GE. Perceptual structure of adductor spasmodic dysphonia and its acoustic correlates. J Voice. 2012;26(6):818.e5–13.
Peterson EA, Roy N, Awan SN, Merrill RM, Banks R, Tanner K. Toward validation of the Cepstral Spectral Index of Dysphonia (CSID) as an objective treatment outcomes measure. J Voice. 2013;27(4):401–10.
Sapienza CM, Walton S, Murry T. Adductor spasmodic dysphonia and muscular tension dysphonia: acoustic analysis of sustained phonation and reading. J Voice. 2000;14(4):502–20.
Carter KM, Raich R, Hero A. On local intrinsic dimension estimation and its applications. IEEE Trans Signal Process. 2010;58(2):650–63.
Awan SN, Roy N, Jiang JJ. Nonlinear dynamic analysis of disordered voice: the relationship between the correlation dimension (D2) and pre-/post-treatment change in perceived dysphonia severity. J Voice. 2010;24(3):285–93.
Esposito M, Dubbioso R, Apisa P, Allocca R, Santoro L, Cesari U. Spasmodic dysphonia follow-up with videolaryngoscopy and voice spectrography during treatment with botulinum toxin. Neurol Sci. 2015;36(9):1679–82.
Li X, Ng MK, Cong G, Ye Y, Wu Q. MR-NTD: manifold regularization nonnegative tucker decomposition for tensor data dimension reduction and representation. IEEE Trans Neural Netw Learn Syst. 2017;28(8):1787–800.
Liu B, Raj H, Klein L, Jiang JJ. Evaluating the voice type component distributions of excised larynx phonations at three subglottal pressures. J Speech Lang Hear Res. 2021;64(5):1447–56.
Chen Z, Li J, Ren Q, Ge P. Acoustic and perceptual analyses of adductor spasmodic dysphonia in Mandarin-speaking Chinese. J Voice. 2019;33(3):333–9.
Reid EW, Nobriga CV. Spasmodic dysphonia: introductory phonetic analyses. Clin Linguist Phon. 2022:1–16.
Creighton FX, Hapner E, Klein A, Rosen A, Jinnah HA, Johns MM. Diagnostic delays in spasmodic dysphonia: a call for clinician education. J Voice. 2015;29(5):592–4.
Brockmann M, Drinnan MJ, Storck C, Carding PN. Reliable jitter and shimmer measurements in voice clinics: the relevance of vowel, gender, vocal intensity, and fundamental frequency effects in a typical clinical task. J Voice. 2011;25(1):44–53.
Mendes AP, Nunes N, Ibrahim S, Coelho AC, Francisco MA. Cepstral measures in the fado voice: gender, age and phonatory tasks. J Voice. 2023;37(1):9–16.
Meynard A, Torresani B. Spectral analysis for nonstationary audio. IEEE/ACM Trans Audio Speech Lang Process. 2018;26(12):2371–80.
You do not currently have access to this content.