Creak Derived from CAPE-V Sentences in Patients with AdLd and pMTD.
Rachel Norotsky, Kelly Zdrowak, Katherine L Marks
Creak from the six short CAPE-V sentences did not separate adductor laryngeal dystonia from primary muscle tension dysphonia (9.85% vs 9.33%).
The shorter sentences may give creak fewer chances to appear, so this does not rule it out on longer speech tasks.
Key findings
1Creak percentage from the CAPE-V sentences did not statistically predict whether a speaker had adductor laryngeal dystonia or primary muscle tension dysphonia; the overall logistic regression model was not significant.
2Mean creak was 9.85% (SD = 10.3) in the AdLD group and 9.33% (SD = 11.8) in the pMTD group, with standard deviations larger than the means themselves.
3The authors suggest the CAPE-V sentences (6–9 syllables) may provide fewer phrase boundaries and thus fewer opportunities for creak compared to the Rainbow Passage (10–30 syllables), which is where prior studies found creak to differentiate the groups.
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What it does not show
Small sample: 21 speakers per group, all from a single centre (Emory Voice Center). Retrospective design using existing clinical recordings; no randomisation or controlled recording conditions. Roughly half of the AdLD group had not yet received botulinum toxin, whereas most AdLD speakers in prior creak studies had ongoing injections — this may reduce the acoustic contrast between groups. The CAPE-V sentences are much shorter (6–9 syllables) than the Rainbow Passage (10–30 syllables) used in prior positive studies, so the null finding may be stimulus-specific rather than a true absence of a creak difference. Eight of the 21 AdLD speakers had co-occurring vocal tremor, which could influence the acoustic signal. Cross-sectional: one recording per patient, no follow-up or repeated measures.
Declared interests
The authors declare no competing financial interests or personal relationships. No external funding source is named.
The easy way to misread this
Do not read this as evidence that creak cannot differentiate AdLD from pMTD in general. The null finding is specific to the short CAPE-V sentences (6–9 syllables). Prior studies using the longer Rainbow Passage (10–30 syllables) and spontaneous speech did find a significant creak difference. The authors themselves conclude that stimulus type and sentence length likely drive the result, so a clinician who relies on creak from longer speech tasks should not discard the measure on the basis of this paper.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →