Browse by Medical Category
Research at Mass General
Vocal hyperfunction (VH) is one of the most prevalent types of voice disorders and refers to chronic conditions of abuse or misuse of the vocal mechanism (larynx or voice box) due to excessive and/or unbalanced (uncoordinated) muscular forces. These voice disorders include benign vocal fold lesions on vocal cords (commonly called vocal cord nodules) and vocal deterioration in the absence of diagnosable pathology (commonly called muscle tension dysphonia).
The Vocal Hyperfunction Clinical Research Center (VHCRC) at Massachusetts General Hospital is a comprehensive, multi-institutional research program that brings together a multidisciplinary team of investigators with various specialties to study hyperfunctional voice disorders. The VHCRC is led by Robert Hillman, PhD, CCC-SLP, research director and co-director of the MGH Voice Center. The central theme of the VHCRC is that clinical management of VH can be significantly improved by attaining a better understanding of the multiple causative factors and associated disordered physiological processes associated with these disorders and then translating this knowledge into new, more effective methods for prevention, diagnosis and treatment.
The center’s scope of research in VH is unprecedented, especially in regards to the integration of many types of data (e.g., behavioral, sensorimotor, environmental, psychological/emotional and biomechanical data) on a large scale, across multiple institutions and areas of expertise.
Multiple factors are believed to cause and maintain the disorders linked to VH. The most important include behavioral, sensorimotor, environmental, psychological, emotional and biomechanical mechanisms.
VHCRC’s interdisciplinary research program will focus on understanding the fundamental relationships between these factors and the different manifestations of VH. This will be accomplished in three major research projects led by Robert Hillman, PhD, CCC-SLP, Cara Stepp, PhD, and Matías Zañartu, PhD, and a scientific core led by Daryush Mehta, PhD. They will employ an innovative combination of laboratory studies of sensorimotor and physiological mechanisms; neural network modeling of voice motor control; computational and physical modeling of phonatory mechanisms; and the use of ambulatory biosensors to investigate the potential differential impact on vocal function of daily voice use, psychological stress and environmental noise in patients with VH and well-matched normal controls. Use of ambulatory biofeedback as a treatment strategy will also be assessed.
Director, Vocal Hyperfunction Clinical Research Center
Co-Director and Research Director, Mass General Voice Center
Professor of Surgery, Harvard Medical School
Director of Research Programs, MGH Institute of Health Professions
Administrator Coordinator for Research and Speech-Language Pathology, Mass General Voice Center
Principal Investigator, Scientific Core, Vocal Hyperfunction Clinical Research Center at Mass General
Director, Voice Science and Technology Laboratory, Mass General Voice Center
Assistant Investigator, Mass General; Assistant Professor of Surgery, Harvard Medical School
Adjunct Assistant Professor, MGH Institute of Health Professions
Associate Visiting Surgeon, Mass General Voice Center
Associate Professor in Surgery, Harvard Medical School
Co-Director, Center for Laryngeal Surgery Fellowship Program
Laryngeal Surgeon, Mass General Voice Center
Manager of Acoustics Systems Engineering, Cirrus Logic
Research Engineer, Mass General Voice Center
Senior Staff, Bioengineering Systems and Technology Group, MIT Lincoln Laboratory
Statistician, Mass General Hospital
Assistant Professor in Radiology, Harvard Medical School
Biostatistician, General Clinical Research Center, Massachusetts Institute of Technology
Research Speech-Language Pathologist, Mass General Voice Center
Instructor in Surgery, Harvard Medical School
Director, Vocal Hyperfunction Clinical Research Center; Principal Investigator, Project 1
Director of the Mass General Voice Center
Eugene B. Casey Professor of Laryngeal Surgery, Harvard Medical School
MSU Foundation Professor and Department Chair, Michigan State University
Dugald C. Jackson Professor of Computer Science and Electrical Engineering, Massachusetts Institute of Technology
Research Speech Language Pathologist, Mass General Voice Center
PhD Student, MGH Institute of Health Professions
Professor of Communication Science and Disorder, University of Utah
Professor of Rehabilitation Science and Otolaryngology, University of Kentucky
Co-Director, Laryngeal and Speech Dynamics Laboratory, University of Kentucky
Professor of Biology, Electrical and Computer Engineering, and Physics, Northeastern University
Principal Investigator, Project 2, Vocal Hyperfunction Clinical Research Center at Mass General
Director, Sensorimotor Rehabilitation Engineering Lab, Boston University
Assistant Professor, Departments of Speech, Language & Hearing Sciences, Otolaryngology-Head & Neck Surgery, and Biomedical Engineering, Boston University
Professor, Department of Speech, Language & Hearing Sciences
Professor, Department of Biomedical Engineering, Boston University
Professor, Otolaryngology-Head & Neck Surgery, Boston University School of Medicine
Senior Research Scientist, Department of Speech, Language & Hearing Sciences, Sargent College, Boston University
Principal Investigator, Project 3, Vocal Hyperfunction Clinical Research Center at Mass General
Associate Professor, Department of Electronic Engineering, Universidad Técnica Federico Santa María
Assistant Professor, Department of Mechanical and Aeronautical Engineering, Clarkson University
Assistant Professor, Department of Mechanical and Mechatronics Engineering, University of Waterloo
Research Staff, Department of Electronic Engineering, Universidad Técnica Federico Santa María
PhD Student, Department of Electronic Engineering, Universidad Técnica Federico Santa María
Post-Doctoral Research Associate, Department of Electronic Engineering, Universidad Técnica Federico Santa María
MS Student, Department of Electronic Engineering, Universidad Técnica Federico Santa María
Post-Doctoral Research Associate, Advanced Center for Electrical and Electronic Engineering, Universidad Técnica Federico Santa María
Three research projects focus on investigating mechanisms that are hypothesized to play primary roles in causing and/or maintaining Vocal Hyperfunction (VH).
Principal investigator: Robert E. Hillman, PhD, CCC-SLP, Mass General
This project uses an innovative combination of ambulatory biosensors, clinical and laboratory studies, and tracking of treatment-related effects to gain new insights into behavioral (daily voice use), environmental (noise levels), emotional (psychological stress/arousal), and physiological (phonatory function) factors related to the etiology and pathophysiology of VH. Researchers will assess the assumed role of emotional stress in eliciting a differential VH response in patients with hyperfunctional voice disorders and normal controls. In a secondary analysis, the team will examine the hypothesized impact of personality and psychological predisposition (trait theory) in modulating the vocal/VH response to emotional stress by having participants complete personality inventories. A major thrust of this project will involve testing hypotheses about the differential impact of VH on the phonatory physiology (biomechanics) associated with phonotraumatic VH (e.g., nodules) and nonphonotraumatic VH (e.g., muscle tension dysphonia). This will also include investigating the potential modulating impact on VH of environmental noise levels (Lombard Effect – increasing vocal SPL) and the presence of nodules (e.g., testing hypotheses related to the need for post-surgical voice therapy to reduce persistent/residual phonotraumatic VH). Special emphasis will be placed on testing biomechanics-based hypotheses related to the role of collision forces in phonotraumatic VH. Use of ambulatory biofeedback as a treatment strategy will also be assessed.
Principal investigator: Cara E. Stepp, PhD, Boston University
This project uses classic model-driven experimental approaches from speech motor control research to test hypotheses concerning the potential role that disordered sensorimotor mechanisms play in VH. Auditory-motor integration for feedforward and feedback control are examined. These studies include the potential impact that voice therapy might have in reducing such deficits by triggering neuroplastic central nervous system changes. This project will rely on ambulatory measures that are being further refined in Project 1 to assess pre- and post-treatment changes in daily vocal function.
Principal investigator: Matías Zañartu, PhD, Universidad Técnica Federico Santa María
This project develops and uses physical and numerical modeling (including subject-specific models) to provide unique insights into the underlying biomechanical, aero-acoustic, and muscle activation mechanisms that contribute to the pathophysiology of VH, providing direct links between model outputs and real clinical data with direct application to the ambulatory assessment of vocal function. This important fundamental work closely links/integrates with Projects 1 and 2 by providing unique insights into these mechanisms that cannot be obtained with current approaches and, in the case of Project 1, extending or improving ambulatory assessment of daily vocal function for clinical evaluation and treatment (biofeedback).
Vocal Hyperfunction Clinical Research Center
Back to Top