MyoVoice to Restore Natural, Hands-free Communication to Individuals With Vocal Impairments

Study Overview
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Brief Summary
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This study will evaluate the ability of MyoVoice to replace natural speech. Referred to generally as an Augmentative and Alternative Communication (AAC) device, MyoVoice uses electrical signals recorded non-invasively from speech muscles (electromyographic, or EMG, signals) to restore communication for those with vocal impairments that resulted from surgical treatment of laryngeal and oropharyngeal cancers.

Detailed Description
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Over 7.5 million people worldwide are unable to vocalize effectively. Among these individuals are cancer survivors who underwent oropharyngeal/laryngeal surgery and must rely on AAC systems such as text-to-speech applications or artificial voice prostheses as substitutes for their natural voice. Yet most of these devices struggle to convey the expressive attributes of speech (prosody), leading to poor comprehension and a lack of emotional content. The clinical trial will investigate the feasibility of MyoVoice-a novel AAC device that uses surface EMG signals to extract patterns for understanding vocabulary and expressive attributes from articulatory musculature during silently mouthed speech-to effectively restore conversational capabilities for individuals living with vocal impairments due to surgical treatment of laryngeal and oropharyngeal cancers. Patients who underwent a total laryngectomy will be asked to communicate with a conversational partner by silently mouthing words using MyoVoice. The device performance will be evaluated in terms of its ability to accurately and quickly translate articulatory muscle activity into audible speech. MyoVoice will also be compared to that of conventional electrolaryngeal speech aids (i.e., artificial larynx) to evaluate device ease-of-use, functional efficacy, and social reception.

Official Title
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EMG Voice Restoration

Conditions
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Rehabilitation of Speech and Language Disorders, Speech Disorders, Speech, Alaryngeal, Communication Aids for Disabled, Speech Perception, Speech Intelligibility

Intervention / Treatment
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* Device: MyoVoice
* Device: Electrolarynx


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Control Subjects: Primary English speaker No history of speech, language, cognitive, or hearing disorders Normal hearing (able to pass a bilateral hearing screening using a threshold of 25 dB HL at 125, 250, 500, 1000, 2000, 4000, and 8000 Hz based on the American Speech-Language-Hearing Association) Capable of signed informed consent Laryngectomy Subjects: At least 6 months S/P total laryngectomy Proficient electrolarynx (EL) speaker Primary English speaker Sufficiently available and sufficiently healthy to comply with multiple test sessions lasting 4-6 hours Capable of signed informed consent Exclusion Criteria: Control Subjects: Inability to understand spoken English or follow simple instructions History of speech, language, cognitive, or hearing disorders Inability to provide written informed consent Laryngectomy Subjects: Inability to understand spoken English or follow simple instructions Loss of adequate sEMG sensor sites for recording from muscles of articulation due to Cancer treatment Skin disorders or radiation/surgical scarring that prevent the use of medical-grade adhesive tapes for securing sensors Inability to provide written informed consent Any other medical or psychological condition that is based on the opinion of the investigators will prevent participation in the experiment (e.g., the candidate may have an illness that makes them fatigue easily or have difficulty to attend to visual cues)

Ages Eligible for Study
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Minimum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: MyoVoice Device<br>MyoVoice Device for individuals with total laryngectomy | Device: MyoVoice<br>* Person-centric AAC system comprising a user-specific set of wearable sensors for capturing articulatory muscle activity and mobile software that provides real-time audible speech outputs.<br>Device: Electrolarynx<br>* Hand-operated electromechanical device that operates as an artificial larynx to enable a person after laryngectomy to produce speech.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Word Recognition Rate | Accuracy of identifying individual words from a designated speech corpus that are automatically transcribed using the AAC device. | 1 hour | 
| Prosody Recognition Rate | Accuracy of identifying prosodic tone and break index (ToBI) categories from a designated speech corpus that are automatically classified using the AAC device. | 1 hour | 
| System Usability Scale | Ten-question Likert scale assessment giving a global view of subjective, qualitative assessments of device usability. Participants will rank each question from 1 (strongly disagree) to 5 (strongly agree) based on how much they agree with the statement they are reading. | 1 hour | 
| Test-Retest Reliability | Repeatability of word and prosody recognition rates obtained when placing and replacing the reusable, wearable sEMG sensor veneer. | 1 hour | 
| Intelligibility | The degree to which a speaker's message can be recovered by a listener, as measured via listeners orthographically transcribing words from audio samples. | 1 hour | 
| Comprehensibility | The degree to which a listener understands the meaning of a speaker's message (e.g., if the phrase is Jane loves Bob, the listener may be asked to respond to Who loves Bob?). | 1 hour | 
| Device Comfort | Perceived assessment of user comfort when wearing the MyoVoice device as captured via a Likert scale ranked from 1 (not at all comfortable) to 5 (very comfortable). | 1 hour | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MyoVoice Translation Speed | Duration in which the MyoVoice system carries out sEMG-to-speech synthesis relative to the length and content of the message being synthesized. | 1 hour | 
| Acceptability | The degree to which naïve listeners find a speech sample to be acceptable relative to attributes of pitch, rate, understandability and voice quality. | 1 hour | 
| Acoustic Identity | The accuracy in which naïve listeners select which voice sample best matches that of a presented speech sample. | 1 hour | 
| Emotional Content | Naïve listeners will complete a single multiple-choice question to qualitatively assess the perceived emotional content conveyed by each speech sample. Listeners will select a single emotion they feel BEST represents that which was conveyed by the speech sample from a list of the seven fundamental emotions of sadness, anger, happiness, disgust, surprise, fear, and neutral. | 1 hour | 
| Prosodic sEMG-Acoustic Correlation | Correlation between recognized (sEMG) and ground-truth (acoustic) prosodic tone and break indices (ToBI) measured during speaking tasks. | 1 hour |