title: Subjective and perceptual analysis of voice quality and relationship with neurological disfunction in multiple sclerosis patients.
abstract: OBJECTIVE
  The aim of the present study was to evaluate subjective voice changes by voice handicap index (VHI) and voice related quality of life questionnaire (VRQL) and perceptual voice changes by Grade Roughness Breathiness Asthenia Strain (GRBAS) scale and to compare these findings with expanded disability status scale (EDSS) in multiple sclerosis (MS) patients.
  
  
  METHODS
  The patient group was composed of 36 MS patients, (mean age 45.2 ± 12.9, 13 male and 23 female) and compared with 32 healthy sex and age match individuals without neurological and voice symptoms.
  
  
  RESULTS
  The mean VHI was significantly higher in patients group (15.64 to 5.43; p=0.043). Forty-four percent of MS patients (52% of female patients) report voice problems. According to the GRBAS scale, differences between two groups were significant for Grade, Roughness, Breathiness and Strain items. The mean EDSS was 2.69 ± 1.1, for a male patients 2.54 ± 1.1 and for female 2.78 ± 1.3. There was no correlation between the EDSS and the total VHI score, between the EDSS and each of the three item of VHI, between the EDSS and VRQL, nor between the EDSS and components of GRBAS scale except for EDSS and asthenia item, (r=-0.5213, p=0.011).
  
  
  CONCLUSIONS
  Significant number of MS patients experienced voice problems. We did not establish any significant correlation between the intensity of the voice disorders and EDSS, except between EDSS and asthenia item of the GRBAS scale. The patients with low EDSS may have serious voice problems and vice versa.
authors: Department of Otorhinolaryngology, General Hospital Karlovac, A. Stampara 3, 47000 Karlovac, Croatia. Electronic address: vbauermail@yahoo.com.
authors: Vladimir
authors: V
authors: Bauer
authors: Zorica
authors: Z
authors: Aleric
authors: Ervin
authors: E
authors: Jancic
authors: Bojana
authors: B
authors: Knezevic
authors: Dubravka
authors: D
authors: Prpic
authors: Anita
authors: A
authors: Kacavenda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014832:Voice Disorders / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D014833:Voice Quality; D055815:Young Adult
keywords: Life quality in multiple sclerosis; Multiple sclerosis; Subjective voice analysis; Voice handicap index; Voice quality