Vocal disorders associated with stroke: a systematic review

Abstract

Introduction. The voice is essential for human beings and depends on the integrity of the neurological and anatomical structures related to phonation. Among the implications of stroke associated with the voice, vocal disorders directly affect speech intelligibility and vocal health of individuals. Objective. To present scientific evidence based on a systematic literature review (PRISMA) answering the following guiding question: What are the possible vocal disorders associated with stroke? Method. The search for articles was carried out in the databases Scielo, Lilacs, Pubmed, Scopus, Bireme and Web of Science, there was no restriction on location, period and language. For the selection of studies, the combination based on the Medical Subject Heading Terms (MeSH) was used. In addition, a search for gray literature was carried out on Google Scholar. Two studies that scored ≥6 points according to the qualitative scoring protocol proposed by Pithon et al. (2015). 181 articles with potential for inclusion were identified, two corresponding to the defined inclusion criteria and the guiding question. Results. The subjects affected by the stroke presented aspects of rough, breathy, unstable, and pasty voices, sometimes tense, in addition to slowness and instability in laryngeal motor control. There was no direct association between vocal behavior and stroke with the topography of the brain injury. Conclusion. Among the vocal disorders associated with stroke, the regular classification of spastic and flaccid dysarthria was identified, followed by vocal aspects such as roughness, breathiness, exaggerated vocal tension, instability in the emission of vowels and reduced speed.