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Physiologic Correlates of Vocal Tremor Affecting Those with Essential Tremor

Award Number: R56DC016838
ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 02/12/2019
PERIOD OF PERFORMANCE END DATE: 08/31/2027

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Physiologic Correlates of Vocal Tremor Affecting Those with Essential Tremor - PROJECT SUMMARY / ABSTRACT Essential tremor (ET) is the most prevalent adult movement disorder in the world affecting approximately 5.8% of those 65 years of age or older, and approximately 4.5 % of the US population, or 15 million people. Although ET is defined and classified primarily by bilateral upper-limb action tremor for 3 years or longer, approximately 40% of those with ET develop a disabling vocal tremor (VT) (i.e., essential vocal tremor, or EVT) that substantially impairs communication and quality of life. VT remains inconsistently classified across clinical disciplines. Under current Movement Disorders Society (MDS) tremor classification criteria, VT without clinically detected limb tremor is designated as “isolated vocal tremor” (IVT), implying that the source of tremor is isolated to the larynx, the source of voice production. In contrast, otolaryngology and speech-language pathology frameworks classify tremor affecting the voice in the absence of other neurological diagnoses or associated with a formal diagnosis of ET as “essential vocal tremor” (EVT). This discrepancy reflects a critical gap in tremor classification across different disciplines. Aside from respiratory structures, speech structures within the upper airway are not readily observable during standard neurologic examinations, and VT is most often inferred from auditory-perceptual impressions or acoustic measures of voice modulation rather than direct measurement of physiologic and kinematic markers. The overall goal of this project is to evaluate whether EVT and IVT represent distinct tremor syndromes or clinical variants along the ET spectrum. Our scientific premise is supported by our completed RO1 and preliminary studies demonstrating that EVT and IVT share equivalent axial tremor distribution and physiology and differ primarily in the degree to which limb tremor is detectable and impacts daily function. Aim 1 will evaluate whether EVT and IVT exhibit equivalent tremor distribution and physiologic patterns across speech structures by systematically characterizing respiratory, laryngeal, and articulatory tremor that correspond with acoustic modulation during sustained phonation. Aim 2 will evaluate limb tremor presence and functional impact in individuals with ET without VT (ET ), EVT, and IVT using surface electromyography, accelerometry, standardized clinical assessment, and patient-reported outcomes. The expected outcomes of this project are (1) definitive evidence regarding physiologic equivalence of EVT and IVT at the level of speech structures, and (2) identification of a continuum of limb tremor amplitude and functional impact that distinguishes EVT and IVT clinically. The impact of this work will provide a unified physiologic framework integrating axial and limb tremor, leading to improved clinical evaluation, more accurate tremor classification, and better-informed therapeutic decision-making for established and emerging treatments. This project is directly relevant to the missions of the NIDCD.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $653,819 )
2026	2026	UNIVERSITY OF UTAH	201 PRESIDENTS CIR	SALT LAKE CITY	UT	84112	SALT LAKE	USA	Research Related to Deafness and Communication Disorders	000	6	8/24/2026	COMPETING CONTINUATION	$653,819
														Subtotal = $653,819

Grand Total All Awards = $653,819

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Physiologic Correlates of Vocal Tremor Affecting Those with Essential Tremor

Award Number: R56DC016838

ORGANIZATION: NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 02/12/2019

PERIOD OF PERFORMANCE END DATE: 08/31/2027

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