Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2025 Mar 30:S0892-1997(25)00111-0.
doi: 10.1016/j.jvoice.2025.03.017. Online ahead of print.

Neuromodulation for Laryngeal Dystonia: A Systematic Review

Chang Woo Lee  1 , Marie T Krüger  2 , Harith Akram  2 , Ludvic Zrinzo  2 , Wanding Yang  3 , Nick Hamilton  4 , John S Rubin  5 , Martin A Birchall  4 , Jonathan M Fishman  5
Affiliations
Review

Neuromodulation for Laryngeal Dystonia: A Systematic Review

Chang Woo Lee et al. J Voice. .

Abstract

Objective: The aim of this study was to systematically review and evaluate neuromodulation therapies that are currently being explored/used in the treatment of laryngeal dystonia (LD).

Methods: A systematic review of the literature was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines searching Embase, Medline, and Cochrane with the cover period January 1960-August 2024. The search strategy used was (("Laryngeal Dystonia" OR "Spasmodic Dysphonia") AND ("Neuromodulation" OR "Deep Brain Stimulation")). Articles were reviewed and screened based on the set inclusion and exclusion criteria. The Joanna Briggs Institute Critical Appraisal Checklists were used to assess the risk of bias in the included studies. Patient demographics and diagnosis, neuromodulation therapy used and its details, voice outcomes, and complications were extracted from each of the studies. A narrative review was subsequently synthesized.

Results: Twelve studies met the selection criteria and were included. In total, 130 LD patients were identified with the following neuromodulation therapies being evaluated for their use in LD: vibro-tactile stimulation, laryngeal electrical stimulation, pharmacologic (sodium oxybate), repetitive transcranial magnetic stimulation, and deep brain stimulation (DBS). All included studies reported various degrees of improvement in patients' voice symptoms with the neuromodulation therapy used. No definitive conclusion could be drawn for their efficacy within the included studies consisting of six case reports, three proof-of-concept/pilot studies, and three phase I clinical trials that used a number of different voice outcome measures used to report treatment effects, and a general lack of long-term follow-up. No significant complications were reported for any of the neuromodulation therapies.

Conclusion: Most neuromodulation therapies being explored for LD are at a very early exploratory stage. Although more clinical trials are required, from the available evidence, sodium oxybate and DBS currently appear to have the most potential for translation into clinical practice.

Keywords: Laryngeal dystonia; Laryngology; Neurolaryngology; Neuromodulation; Voice.

PubMed Disclaimer

Conflict of interest statement

Declaration of Competing Interest The authors declare the following financial interests/personal relationships that may be considered as potential competing interests: Chang Woo Lee reports financial support was provided by Royal College of Surgeons of England. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

LinkOut - more resources