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Abnormal Parasympathetic Vagal Function in Patients with Spasmodic Dysphonia

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Grant support: in part by grants AM 16816 and NS 18276 from the National Institutes of Health, a Veterans Administration Merit Review, the Perkin Foundation, the Ariel Medical Foundation, and organized research grant AA 6495-7D from the University of Texas at Dallas.

▸Requests for reprints should be addressed to Mark Feldman, M.D.; Associate Chief of Staff for Research and Development (151), Dallas Veterans Administration Medical Center; Dallas, TX 75216.

Dallas, Texas

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;100(4):491-495. doi:10.7326/0003-4819-100-4-491
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Gastric vagal function was assessed in 15 patients with spasmodic dysphonia by measuring gastric acid output in response to sham feeding. Patients secreted significantly less acid than controls (p < 0.001). Cardiac vagal function was assessed in 11 patients by measuring heart rate during deep respiration and also during and after Valsalva maneuver. Patients with spasmodic dysphonia had a significantly reduced fluctuation of heart rate during deep respiration (sinus arrhythmia). The expiratory to inspiratory R-R interval averaged 1.08 ± 0.08 (mean ± SD) in patients and 1.22 ± 0.10 in controls (p < 0.005). The ratio of tachycardia during Valsalva maneuver to bradycardia after Valsalva manuever was also lower in patients than in controls (p < 0.005). The auditory brainstem response was abnormal in 11 of 15 patients. Our results show either a central brainstem abnormality or several cranial nerve abnormalities in some patients with spasmodic dysphonia.





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