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Voice Quality

Anatomy and Physiology · NLM MeSH · updated 2026-10-31 · version 1

Citations verified against PubMedNot yet clinician-reviewed10 referencesApproximately 4 min read

That component of speech which gives the primary distinction to a given speaker's voice when pitch and loudness are excluded.

Table of Contents

1. Definition2. Research landscape3. Reading the evidence4. Open-access studies5. Key reviews6. References7. About this article

Definition and research guide

This page combines a MeSH definition, publication statistics and selected research abstracts. It is a starting point for reading the literature, not a medical textbook or a systematic evidence review.

Content available: 4 complete abstracts (722 words), 10 references. Full article text is not stored or reproduced here; follow the PMID, DOI or PMC links to read the original sources and their access terms.

Definition

That component of speech which gives the primary distinction to a given speaker's voice when pitch and loudness are excluded. It involves both phonatory and resonatory characteristics. Some of the descriptions of voice quality are harshness, breathiness and nasality.

Definition: NLM Medical Subject Headings (MeSH) scope note (Public domain (U.S. National Library of Medicine); attribution requested). View the MeSH record.

Also known as: Qualities, Voice; Quality, Voice; Voice Qualities.

Where it fits in the MeSH classification

Broader topics
Voice
See also
Hoarseness; Phonation

Related concepts

  • Speech
  • Voice

Research landscape

PubMed indexes 9,287 records tagged with the MeSH heading “Voice Quality” (counts retrieved 2026-10-31). 2,564 of them (27.6%) were published from 2020 onward, and the busiest period so far is 2010-2019 with 3,711 records.

Reviews account for 630 records (6.8%) and meta-analyses for 91. Randomized controlled trials number 309 (3.3%) as a share of all records on the topic.

PubMed records by publication periodthrough 1999: 1,202 records; 2000-2009: 1,810 records; 2010-2019: 3,711 records; 2020 onward: 2,564 records1,202through 19991,8102000-20093,7112010-20192,5642020 onward
Records in PubMed indexed with this heading, by publication period. Real counts from NCBI E-utilities; the final period covers only part of the current year. Volume reflects how much has been published, not how strong the evidence is.
Show the data
PeriodRecords
through 19991,202
2000-20091,810
2010-20193,711
2020 onward2,564
Share of records by publication typeReviews: 6.8 percent; Meta-analyses: 1.0 percent; Randomized controlled trials: 3.3 percentReviews6.8% (630)Meta-analyses1.0% (91)Randomized controlled trials3.3% (309)
Share of all PubMed records on this heading that carry each publication type. Types overlap with other records, so the shares do not sum to 100%.
Publication-type chart data
Publication types among 9,287 PubMed records
TypeRecordsShare
Reviews6306.8%
Meta-analyses911.0%
Randomized controlled trials3093.3%

Method: PubMed query "Voice Quality"[MeSH Terms] with publication-type and date filters, retrieved 2026-10-31.

Reading the evidence in anatomy and physiology

Anatomy describes how body structures are built and physiology describes how they normally work, so most findings here are descriptive or mechanistic rather than evidence about treatment. Much of what is known comes from dissection, imaging, tissue studies and experiments in animals, and measurements in healthy volunteers can differ from those in people with disease or at different ages. Normal ranges vary between individuals and populations. Check whether a result was measured in people or in another species, the age and health of the participants, and the method used.

Evidence from open-access studies

These open-access studies come from PubMed’s best-match results for this heading (papers whose main topic it is), ranked here by citation count, with one recent addition. Each abstract is reproduced in full under its recorded open licence so that you can read the authors’ own words. They illustrate the literature; they are not a systematic summary of it. Citation counts measure attention, not reliability or clinical benefit.

Study comparison — selected abstracts, not a systematic review
Study / authorsYearSource label / designEurope PMC citationsLicence / source
Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls
Themistocleous C, Eckerström M, Kokkinakis D
2020Research article
Design not recorded in structured metadata
59cc by
PMID 32658934 · DOI · PMC7357785
Acoustic differences between healthy and depressed people: a cross-situation study
Wang J, Zhang L, Liu T, Pan W, Hu B, Zhu T
2019Research article
Design not recorded in structured metadata
57cc by
PMID 31615470 · DOI · PMC6794822
Acoustic voice characteristics with and without wearing a facemask
Nguyen DD, McCabe P, Thomas D, Purcell A, Doble M, Novakovic D, et al.
2021Research article
Design not recorded in structured metadata
47cc by
PMID 33707509 · DOI · PMC7970997
Second-Language Acquisition and First-Language Attrition of Speech: The Production of Arabic and English Short Vowels
Kornder L, Alharbi AS, Foltz A
2026Research article
Design not recorded in structured metadata
0cc by
PMID 40785265 · DOI · PMC13195066

Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls [1]

Research article Themistocleous C, Eckerström M, Kokkinakis D · · 2020 · cited 59 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level.
Closing excerpt
The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (149 words)

Mild Cognitive Impairment (MCI) is a syndrome characterized by cognitive decline greater than expected for an individual's age and education level. This study aims to determine whether voice quality and speech fluency distinguish patients with MCI from healthy individuals to improve diagnosis of patients with MCI. We analyzed recordings of the Cookie Theft picture description task produced by 26 patients with MCI and 29 healthy controls from Sweden and calculated measures of voice quality and speech fluency. The results show that patients with MCI differ significantly from HC with respect to acoustic aspects of voice quality, namely H1-A3, cepstral peak prominence, center of gravity, and shimmer; and speech fluency, namely articulation rate and averaged speaking time. The method proposed along with the obtainability of connected speech productions can enable quick and easy analysis of speech fluency and voice quality, providing accessible and objective diagnostic markers of patients with MCI.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 32658934 · DOI · PMC7357785

Acoustic differences between healthy and depressed people: a cross-situation study [2]

Research article Wang J, Zhang L, Liu T, Pan W, Hu B, Zhu T · · 2019 · cited 57 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
BackgroundAbnormalities in vocal expression during a depressed episode have frequently been reported in people with depression, but less is known about if these abnormalities only exist in special situations.
Closing excerpt
These findings support that depressed people's voices include both situation-specific and cross-situational patterns of acoustic features.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (251 words)

BackgroundAbnormalities in vocal expression during a depressed episode have frequently been reported in people with depression, but less is known about if these abnormalities only exist in special situations. In addition, the impacts of irrelevant demographic variables on voice were uncontrolled in previous studies. Therefore, this study compares the vocal differences between depressed and healthy people under various situations with irrelevant variables being regarded as covariates.MethodsTo examine whether the vocal abnormalities in people with depression only exist in special situations, this study compared the vocal differences between healthy people and patients with unipolar depression in 12 situations (speech scenarios). Positive, negative and neutral voice expressions between depressed and healthy people were compared in four tasks. Multiple analysis of covariance (MANCOVA) was used for evaluating the main effects of variable group (depressed vs. healthy) on acoustic features. The significances of acoustic features were evaluated by both statistical significance and magnitude of effect size.ResultsThe results of multivariate analysis of covariance showed that significant differences between the two groups were observed in all 12 speech scenarios. Although significant acoustic features were not the same in different scenarios, we found that three acoustic features (loudness, MFCC5 and MFCC7) were consistently different between people with and without depression with large effect magnitude.ConclusionsVocal differences between depressed and healthy people exist in 12 scenarios. Acoustic features including loudness, MFCC5 and MFCC7 have potentials to be indicators for identifying depression via voice analysis. These findings support that depressed people's voices include both situation-specific and cross-situational patterns of acoustic features.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 31615470 · DOI · PMC6794822

Acoustic voice characteristics with and without wearing a facemask [3]

Research article Nguyen DD, McCabe P, Thomas D, Purcell A, Doble M, Novakovic D, et al. · · 2021 · cited 47 times (Europe PMC)

Abstract reading summary — source excerpts
Opening excerpt
Facemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood.
Closing excerpt
These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (196 words)

Facemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood. In the present study, we compared acoustic voice measures in recordings of sixteen adults producing standardised vocal tasks with and without wearing either a surgical mask or a KN95 mask. Data were analysed for mean spectral levels at 0-1 kHz and 1-8 kHz regions, an energy ratio between 0-1 and 1-8 kHz (LH1000), harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), and vocal intensity. In connected speech there was significant attenuation of mean spectral level at 1-8 kHz region and there was no significant change in this measure at 0-1 kHz. Mean spectral levels of vowel did not change significantly in mask-wearing conditions. LH1000 for connected speech significantly increased whilst wearing either a surgical mask or KN95 mask but no significant change in this measure was found for vowel. HNR was higher in the mask-wearing conditions than the no-mask condition. CPPS and vocal intensity did not change in mask-wearing conditions. These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 33707509 · DOI · PMC7970997

Second-Language Acquisition and First-Language Attrition of Speech: The Production of Arabic and English Short Vowels [4]

Research article Kornder L, Alharbi AS, Foltz A · · 2026

Abstract reading summary — source excerpts
Opening excerpt
This study investigates if two groups of experienced late bilinguals (Arabic-English, English-Arabic) produce the Arabic vowels /ɪ, u, a/ and the English vowels /ɪ, ʊ, æ/ with nativelike formant values (F1, F2) compared with Arabic and English monolinguals, respectively.
Closing excerpt
Results show that bilinguals who produce nativelike L2 vowels are also able to maintain native L1 productions, suggesting that an increased L2 proficiency does not inevitably entail a decline in L1 proficiency.
Interpretation limits
Verbatim excerpts from the authors’ abstract; the closing excerpt may describe a finding, limitation or recommendation. Design, population, effect size and uncertainty have not been independently extracted or appraised. Read the complete abstract and linked paper before interpreting the findings.
Read complete abstract (126 words)

This study investigates if two groups of experienced late bilinguals (Arabic-English, English-Arabic) produce the Arabic vowels /ɪ, u, a/ and the English vowels /ɪ, ʊ, æ/ with nativelike formant values (F1, F2) compared with Arabic and English monolinguals, respectively. We aimed to characterize the relationship between second-language (L2) acquisition and first-language (L1) attrition of vowels, that is, does nativelike acquisition of an L2 vowel correspond to attrition of a phonetically similar L1 vowel, and vice versa? Moreover, we explored if nativelikeness of bilingual vowel productions is influenced by the predictor variable sound discrimination aptitude. Results show that bilinguals who produce nativelike L2 vowels are also able to maintain native L1 productions, suggesting that an increased L2 proficiency does not inevitably entail a decline in L1 proficiency.

Abstract reproduced from the open-access article under the recorded cc by licence; © the authors. PMID 40785265 · DOI · PMC13195066

Key reviews and meta-analyses

The most cited review-type papers among PubMed’s best-match results for this heading, listed with bibliographic details only. Follow the links for the full text and access terms.

  • Research article Recommended Protocols for Instrumental Assessment of Voice: American Speech-Language-Hearing Association Expert Panel to Develop a Protocol for Instrumental Assessment of Vocal Function [5]
    Patel RR, Awan SN, Barkmeier-Kraemer J, Courey M, Deliyski D, Eadie T, et al. · Am J Speech Lang Pathol · 2018 · cited 510 times (Europe PMC)
  • Research article Beyond the right hemisphere: brain mechanisms mediating vocal emotional processing [6]
    Schirmer A, Kotz SA · Trends Cogn Sci · 2006 · cited 466 times (Europe PMC)
  • Research article Perceptual evaluation of voice quality: review, tutorial, and a framework for future research [7]
    Kreiman J, Gerratt BR, Kempster GB, Erman A, Berke GS · J Speech Hear Res · 1993 · cited 425 times (Europe PMC)
  • Research article Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge [8]
    Van Houtte E, Van Lierde K, Claeys S · J Voice · 2011 · cited 231 times (Europe PMC)
  • Research article Assessment of voice quality: Current state-of-the-art [9]
    Barsties B, De Bodt M · Auris Nasus Larynx · 2015 · cited 157 times (Europe PMC)
  • Research article Current understanding and review of the literature: vocal fold scarring [10]
    Hansen JK, Thibeault SL · J Voice · 2006 · cited 144 times (Europe PMC)

References

  1. Themistocleous C, Eckerström M, Kokkinakis D. Voice quality and speech fluency distinguish individuals with Mild Cognitive Impairment from Healthy Controls. . 2020. PMID 32658934 · DOI · PMC7357785
  2. Wang J, Zhang L, Liu T, Pan W, Hu B, Zhu T. Acoustic differences between healthy and depressed people: a cross-situation study. . 2019. PMID 31615470 · DOI · PMC6794822
  3. Nguyen DD, McCabe P, Thomas D, Purcell A, Doble M, Novakovic D, et al.. Acoustic voice characteristics with and without wearing a facemask. . 2021. PMID 33707509 · DOI · PMC7970997
  4. Kornder L, Alharbi AS, Foltz A. Second-Language Acquisition and First-Language Attrition of Speech: The Production of Arabic and English Short Vowels. . 2026. PMID 40785265 · DOI · PMC13195066
  5. Patel RR, Awan SN, Barkmeier-Kraemer J, Courey M, Deliyski D, Eadie T, et al.. Recommended Protocols for Instrumental Assessment of Voice: American Speech-Language-Hearing Association Expert Panel to Develop a Protocol for Instrumental Assessment of Vocal Function. Am J Speech Lang Pathol. 2018. PMID 29955816 · DOI
  6. Schirmer A, Kotz SA. Beyond the right hemisphere: brain mechanisms mediating vocal emotional processing. Trends Cogn Sci. 2006. PMID 16321562 · DOI
  7. Kreiman J, Gerratt BR, Kempster GB, Erman A, Berke GS. Perceptual evaluation of voice quality: review, tutorial, and a framework for future research. J Speech Hear Res. 1993. PMID 8450660 · DOI
  8. Van Houtte E, Van Lierde K, Claeys S. Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge. J Voice. 2011. PMID 20400263 · DOI
  9. Barsties B, De Bodt M. Assessment of voice quality: Current state-of-the-art. Auris Nasus Larynx. 2015. PMID 25440411 · DOI
  10. Hansen JK, Thibeault SL. Current understanding and review of the literature: vocal fold scarring. J Voice. 2006. PMID 15964741 · DOI

About this article

Sources
NLM Medical Subject Headings (definition, synonyms); NCBI PubMed (counts, identifiers); Europe PMC (open-access abstracts and citation counts).
Verification
Every reference was resolved against PubMed on 2026-10-31; title, year and DOI matched.
Review state
automated source verified; no human expert review has been recorded yet.
Version
1, last updated 2026-10-31.

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Related research topics

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All 542 articles in Anatomy and Physiology →

At a glance

9,287
PubMed records on this heading
28%
published since 2020
630
review articles
309
randomized trials
10
verified references below

Counts come from PubMed on 2026-10-31; they show how much has been written, not how strong the evidence is.

Related topics See all →

  • VoiceAnatomy and Physiology
  • LarynxAnatomy and Physiology
  • Cost of IllnessClinical Research
  • Quality-Adjusted Life YearsClinical Research
  • Abdominal CavityAnatomy and Physiology

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