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The goal of this clinical trial is to verify the effect on the voice of transcranial direct current stimulation (tDCS) in vocally healthy non-singers. The main question it aims to answer is: What is the brain area in which tDCS promotes better vocal performance in vocally healthy individuals? Each participants received anodal tDCS applied at an intensity of 2 mA for a duration of 20 minutes for tDCS stimulations in different areas with a 7-day washout period between stimulations. Vocal assessments was conducted before and after the intervention. The targeted places were the primary motor cortex (M1), primary somatosensory cortex (S1), Cerebellum, and dorsolateral prefrontal cortex (DLPFC).
Recently, non-invasive brain stimulation (NIBS) techniques , including transcranial direct current stimulation (tDCS), have been employed to enhance vocal skills. tDCS can be used to temporarily and reversibly modulate brain functions and is an increasingly popular tool for investigating the relationships between the brain and behavior . The aim of the present study is investigate the effect of tDCS applied to different areas on the voice of vocally healthy non-singers. This is a randomized crossover clinical trial, approved by the Research Ethics Committee of the Federal University of Pernambuco, number 5,758,856. Vocally healthy people from the city of Recife and its Metropolitan Region, aged between 18 and 45 years, participated in the study.Each participant underwent four tDCS stimulations in different areas with a 7-day washout period between stimulations to study their vocal assessments before and after tDCS. The targeted places were the primary motor cortex (M1), primary somatosensory cortex (S1), Cerebellum, and dorsolateral prefrontal cortex (DLPFC). All participants were subjected to voice acessments analysis immediately before and after tDCS application in each area. Data normality will be analyzed using the Shapiro-Wilk test, rejecting the hypothesis of normal distribution when p<0.05. ANOVA will be applied to design repeated measures in case of normality and in the existence of asymmetric data, Friedmann's ANOVA will be used for repeated measures. For the comparison of values before and after application of the technique and between modes of execution of the technique (with and without non-invasive neuromodulation), tests will be applied for related and independent samples, respectively, with a significance level of 5%
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Effects on voice of M1 tDCS in healthy voice volunteers | Active Comparator | The aim of this arm is to verify the effect on the voice of anodal tDCS M1 larynx target. |
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| Effects on voice of S1 tDCS in vocally health volunteers | Active Comparator | The aim of this arm is to verify the effect on the voice of anodal tDCS S1 larynx target. |
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| Effects on voice of PFDLC tDCS in vocally health volunteers | Active Comparator | The aim of this arm is to verify the effect on the voice of anodal tDCS PFDLC target. |
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| Effects on voice of cerebellum tDCS in vocally health volunteers | Active Comparator | The aim of this arm is to verify the effect on the voice of anodal tDCS cerebellum target. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transcranial direct current stimulation | Device | Anodal tDCS will be applied at an intensity of 2mA and duration of 20 minutes. The assembly of the electrodes during the tDCS sessions will be carried out as follows: primary motor cortex, the stimulation electrode (anode) will be positioned on C5 (international EEG 10-20 system), in S1 (2cm posterior to C5), at the PFCDL (Fp3), all with the cathode positioned on the region contralateral supraorbital. For cerebellar tDCS the anode will be positioned on the inion area and the cathode on the deltoide muscle. |
| Measure | Description | Time Frame |
|---|---|---|
| Vocal range profile | Min f0 (Hz) Max f0 (Hz) Ext f0 (Hz) Ext (ST) MÃn int (dB) Max int (dB) Area (%) Min f0 (Hz) Max f0 (Hz) Ext f0 (Hz) Ext (ST) MÃn int (dB) Max int (dB) Area (%) Minimum f0 (Hz); Maximum f0 (Hz); Extension f0; Extension in St; Minimum intensity (dB); Maximum intensity (dB); Area (%) | through study completion, an average of 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| Voice | Jitter (%); Shimmer (%); Irregularity; GNE; DAI | through study completion, an average of 6 months |
| Laryngeal diadochokinesis | Change in the task of producing vowels separately, with rapid repetition of each vowel as quickly as possible for eight seconds |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| kelly Greyce SC Oliveira, PhD student | UFPE | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Laboratório de Neurociência Aplicada | Recife | Pernambuco | 50740-560 | Brazil |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32447409 | Background | Behroozmand R, Johari K, Bridwell K, Hayden C, Fahey D, den Ouden DB. Modulation of vocal pitch control through high-definition transcranial direct current stimulation of the left ventral motor cortex. Exp Brain Res. 2020 Jun;238(6):1525-1535. doi: 10.1007/s00221-020-05832-9. Epub 2020 May 23. | |
| 33555544 | Background |
| Label | URL |
|---|---|
| Immediate Effect of a Resonance Tube on the Vocal Range Profile of Choristers | View source |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Oct 29, 2022 | Jul 15, 2024 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D014832 | Voice Disorders |
| D003147 | Communication Disorders |
| ID | Term |
|---|---|
| D007818 | Laryngeal Diseases |
| D012140 | Respiratory Tract Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D009461 | Neurologic Manifestations |
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| ID | Term |
|---|---|
| D065908 | Transcranial Direct Current Stimulation |
| ID | Term |
|---|---|
| D004599 | Electric Stimulation Therapy |
| D013812 | Therapeutics |
| D003295 | Convulsive Therapy |
| D013000 | Psychiatric Somatic Therapies |
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| through study completion, an average of 6 months |
| Vocal effort | The Adapted Borg CR10 for Vocal Effort Ratings (BR) maintained a scale from 0 to 10, where 0 means "no vocal effort at all", and 10 "maximum vocal effort". First, the participants have to reproduce a note played on a virtual keyboard (3 tones below their maximum glissando frequency) and sustain the note while counting from 21 to 30, immediately afterwards, the participants answered the Adapted Borg CR10 for Vocal Effort Ratings (BR). | through study completion, an average of 6 months |
| Peng D, Lin Q, Chang Y, Jones JA, Jia G, Chen X, Liu P, Liu H. A Causal Role of the Cerebellum in Auditory Feedback Control of Vocal Production. Cerebellum. 2021 Aug;20(4):584-595. doi: 10.1007/s12311-021-01230-1. Epub 2021 Feb 8. |
| 29213226 | Background | Thair H, Holloway AL, Newport R, Smith AD. Transcranial Direct Current Stimulation (tDCS): A Beginner's Guide for Design and Implementation. Front Neurosci. 2017 Nov 22;11:641. doi: 10.3389/fnins.2017.00641. eCollection 2017. |
| 33897361 | Background | Wang B, Xiao S, Yu C, Zhou J, Fu W. Effects of Transcranial Direct Current Stimulation Combined With Physical Training on the Excitability of the Motor Cortex, Physical Performance, and Motor Learning: A Systematic Review. Front Neurosci. 2021 Apr 9;15:648354. doi: 10.3389/fnins.2021.648354. eCollection 2021. |
| 35026217 | Background | Perikova E, Blagovechtchenski E, Filippova M, Shcherbakova O, Kirsanov A, Shtyrov Y. Anodal tDCS over Broca's area improves fast mapping and explicit encoding of novel vocabulary. Neuropsychologia. 2022 Apr 15;168:108156. doi: 10.1016/j.neuropsychologia.2022.108156. Epub 2022 Jan 10. |
| 34762812 | Background | Cardoso NSV, Lucena JA, de Lira ZS, de Vasconcelos SJ, Lopes LW, Gomes AOC. Do Flexible Silicone Tubes Immersed in Water Combined With Vocalise Improve the Immediate Effect on Voice? J Speech Lang Hear Res. 2021 Dec 13;64(12):4535-4562. doi: 10.1044/2021_JSLHR-20-00629. Epub 2021 Nov 11. |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D019954 | Neurobehavioral Manifestations |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D004191 | Behavioral Disciplines and Activities |
| D004597 | Electroshock |
| D011580 | Psychological Techniques |