Kristina Simonyan, MD, PhD, Dr med, director of laryngology research at Mass Eye and Ear, has been awarded an $11.9 million P50 Clinical Research Center Grant from the National Institute on Deafness and Other Communicable Disorders (NIDCD) of the National Institute of Health (NIH) to form a new multidisciplinary center across four academic medical institutions that will be committed to conducting research on laryngeal dystonia and voice tremor, two debilitating neurological voice disorders.
The new center will include Mass Eye and Ear and Massachusetts General Hospital, both members of Mass General Brigham, University of California San Francisco (UCSF) and the University of Utah and will involve clinicians and scientists in neuroscience, otolaryngology-;head and neck surgery, speech-language pathology, neurology, neurosurgery and radiology.
Laryngeal dystonia and voice tremor are chronic, debilitating conditions that affect voice and speech production and significantly impact the quality of life of an affected individual. These conditions often lead to devastating challenges in everyday communication, both personally and professionally. There is an urgent need to better understand the causes of various clinical presentations of these disorders so we are well-powered to develop new and effective diagnostic tools and treatments for these patients."
Dr. Kristina Simonyan, Director of Laryngology Research, Mass Eye and Ear
Dr. Simonyan, who is also an associate neuroscientist at MGH Neurology and associate professor of Otolaryngology–Head and Neck Surgery at Harvard Medical School, will serve as program director of this newly-established center. Site principal investigators include: Mark Richardson MD, PhD, director of Functional Neurosurgery at MGH; Julie Barkmeier-Kraemer, PhD, clinic director for the Voice Disorders Center at the University of Utah; John Houde, PhD, director of the Speech Neuroscience Laboratory at UCSF, and Srikantan Nagarajan, PhD, director of the Biomagnetic Imaging Laboratory at USCF.
The P50 grant will also support Mass Eye and Ear physician-scientists in the Department of Otolaryngology-;Head and Neck Surgery, Phillip C. Song, MD, Matthew R. Naunheim, MD, MBA, and Nathan Jowett, MD, FRCSC and MGH Neurology physician-scientists Nutan Sharma, MD, PhD, and Laurie Ozelius, PhD.
"This is an incredible, well-earned accomplishment for Dr. Simonyan, who has distinguished herself as an international expert in laryngeal dystonia and voice tremor," said Mark A. Varvares, MD, FACS, Chief of the Departments of Otolaryngology–Head and Neck Surgery at Mass Eye and Ear and MGH. "Funding from the grant will have a global impact on patients suffering with these neurological voice disorders."
Debilitating disorders affecting speech
Laryngeal dystonia, also known as spasmodic dysphonia, is characterized by involuntary spasms in the vocal folds, resulting in patients sounding strained, strangled, or breathy when they speak. Voice tremor causes involuntary oscillations of the vocal folds and upper respiratory tract that result in a shaky, unstable quality of voice.
These diseases often co-occur, masking the clinical presentations of each other and complicating their diagnosis and subsequent treatment. The current treatment of both laryngeal dystonia and voice tremor is mostly limited to the temporary symptom relief with repeated injections of botulinum toxin into the affected muscles or the off-label use of certain oral medications.
"The current diagnostic and treatment options for patients with laryngeal dystonia and voice tremor are very limited and, in many cases, not effective, presenting a clinical challenge for both physicians and patients" said Dr. Simonyan. "Our Center will leverage the multidisciplinary expertise of its investigators and combine state-of-the art methodologies to understand the causes of these disorders for their improved diagnosis and clinical care."
Prolific dystonia researcher
Dr. Simonyan has devoted much of her career to studying the neural mechanisms of normal and disordered voice and speech production. She currently leads several projects investigating novel diagnostic algorithms and new treatments for laryngeal dystonia and voice tremor.
Among these, Dr. Simonyan recently developed a deep-learning platform called DystoniaNet that diagnoses dystonia with 98.8 percent accuracy in 0.36 seconds based on a neural biomarker. This artificial intelligence platform is the first technology of its kind to provide an objective diagnosis for different forms of dystonia.
She is also leading a phase 2/3 clinical trial at Mass Eye and Ear on a new oral drug, sodium oxybate, for the treatment of laryngeal dystonia and voice tremor. The drug mimics the effects of alcohol, which has previously been found to relieve dystonic symptoms.
Dr. Simonyan was recently awarded a separate NIH/NIDCD grant to initiate a phase 1 clinical trial with the use of brain-computer interfaces for rehabilitation of patients with laryngeal dystonia.
"This new P50 Center grant for Dr. Simonyan and her colleagues has the potential to be a transformative addition to her body of work aimed at increasing our scientific understanding of laryngeal dystonia and other neurological voice disorders," said Michael S. Gilmore, PhD, Chief Scientific Officer at Mass Eye and Ear.