Analysis of voice in patients with untreated active acromegaly

Background: Voice changes are common clinical findings of acromegaly, although scanty data are available so far. Objective: To analyze features and quantify changes of voice in patients with untreated active acromegaly. Design and methods: This was a pilot case-control study. Voice was analyzed using the Multi Dimensional Voice Program software, which generates 33 parameters related to fundamental frequency (F0), micro-perturbation of F0 and amplitude, noise, tremor, voice breaks and irregularities, and diplophony. Patients: Thirteen consecutive patients (8 women, 5 men, mean age 48±9 yr) with active acromegaly, at first diagnosis, and 13 sex- and age-matched normal subjects (controls). Results: Patients with untreated active acromegaly had mean values of parameters related to F0 significantly lower than those of controls, although mostly remaining in the normal range. Most acromegalic patients had micro-perturbation of F0, as indicated by higher mean of absolute or percentage jitter values than those of controls; micro-perturbation of amplitude was a common feature of voice in most acromegalic men. Noise-related parameters were also affected by acromegaly, being higher in male acromegalic patients than in controls and acromegalic women. On the contrary, parameters related to tremors, voice breaks, voice irregularities and diplophony did not differ in acromegalic patients and controls. Conclusions: Patients with untreated active acromegaly had low-pitched voice characterized by lowering F0 and increased values related to noise, micro perturbation of frequency, and amplitude.