Quality of Life in Essential Vocal Tremor

Objective: Speakers with essential vocal tremor (EVT) report that their quality of life (QoL) is negatively affected by their shaky voice. However, QoL ratings have primarily been used to measure the efficacy of treatment in EVT rather than to characterize the impact of EVT on QoL. One study used the Voice Handicap Index (VHI) in EVT and showed multidimensional impairments in voice-related QoL. Although the VHI assesses a variety of QoL constructions, the Communication Participation Item Bank (CPIB) more specifically captures interference in communicative participation and may be beneficial in studying impacts of EVT. The current study aimed to measure how VHI and CPIB scores are related in speakers with EVT. Furthermore, the study aimed to interpret VHI and CPIB scores considering tremor severity and overall health from Quality of Life in Essential Tremor Questionnaire (QuEsT) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global scores.

Methods: Ten female speakers and two male speakers between the ages of 22-77 years (M = 63 years) participated in this study. All participants were diagnosed with essential tremor by a physician and had vocal tremor. During virtual Zoom study sessions, participants completed the QoL scales in random order with clinician guidance, and their responses were recorded using Qualtrics surveys.

Results: VHI scores ranged from 17-86 out of 120 (M=48.75, SD= 23.91), with higher scores indicating greater handicap. CPIB-10 scores ranged from 5-28 out of 30 (M=17.25, SD=6.8), and CPIB-46 scores ranged from 38-131 out of 140 (M=92.25, SD = 24.94), with higher scores indicating greater communicative participation. Spearman’s correlation was −0.7 (p<0.001) for VHI and CPIB-10 scores and -0.84 (p=0.011) for VHI and CPIB-46. Based on preliminary analyses, the communication dimension scores of QuEsT were positively correlated with VHI scores.

Conclusion: The average VHI scores were consistent with those previously reported for other neurologic voice disorders. VHI and CPIB-46 scores were more negatively correlated than VHI and CPIB-10, indicating that some items on the CPIB-46 may be more representative of communicative participation in EVT. QuEST and PROMIS scores will be used to explore the relationship between voice-related QoL with tremor- and health-related QoL.