Getting your Trinity Audio player ready...
Robert F. Kennedy Jr., U.S. President Donald Trump's nominee for health secretary who was confirmed on Thursday by the U.S. Senate, has spasmodic dysphonia, a neurological disorder causing involuntary vocal cord spasms that result in a strained, rough voice. During his Senate confirmation hearing, his condition made his speech difficult to understand.
Kennedy, 71, has said the disorder began affecting his voice at age 42. "At the time, I made much of my income from public speaking, addressing large crowds without amplification," he said in a February 2024 interview during his presidential campaign.
ABC host Jimmy Kimmel mocked Kennedy’s condition. "The hearing was rocky to say the least, and not just because it sounds like he swallowed a bag of rocks," Kimmel said. Kennedy has also been ridiculed on social media, particularly on TikTok.
What is spasmodic dysphonia?
“Spasmodic dysphonia is a type of dystonia, a neurological disorder causing involuntary muscle contractions,” explained Dr. Yael Shapira Galitz, deputy head of Kaplan Medical Center’s otolaryngology unit.
“While dystonia can affect various body parts, the most common form impacts the neck, causing instability and difficulty holding the head upright. It can also affect eyelids, limbs and other body systems,” she added.
About 250,000 Americans are estimated to have some form of dystonia, making it the third most common movement disorder after essential tremor and Parkinson’s Disease. The condition results from a disruption in the brain’s basal ganglia, which regulate muscle movement, leading to involuntary spasms that interfere with daily function.
Get the Ynetnews app on your smartphone: Google Play: https://bit.ly/4eJ37pE | Apple App Store: https://bit.ly/3ZL7iNv
"Our vocal cords function by muscle contractions that move them during speech," Shapira Galitz explained. "To produce sound, the cords must close tightly enough to create sound waves but not so tightly that airflow is blocked."
In dystonia, the brain's control over these muscle contractions is impaired, causing speech disruptions. The most common form involves excessive closure of the vocal cords, leading to severe hoarseness and strained speech.
Impact on daily life
According to the Dysphonia International organization, many people with the disorder feel their voice doesn’t reflect their emotions, personality or professional capabilities.
This mismatch can cause significant emotional distress, job loss, career changes and social isolation. "Severe hoarseness can make daily functioning, socializing and professional interactions very difficult," Shapira Galitz noted.
What are the treatment options?
While there’s no cure for the disorder, treatments can help manage symptoms. Some medications reduce muscle spasms by affecting brain activity, and deep brain stimulation is considered in severe cases. Other approaches include physical therapy, speech therapy and acupuncture.
The most common treatment for spasmodic dysphonia is Botox injections into the vocal cords. "Botox relaxes the muscles, reducing involuntary spasms and improving voice quality," Shapira Galitz said.
"Since its effects are temporary, injections must be repeated every few months. Specialized voice exercises, similar to physical therapy for the vocal cords, can also help improve speech control," she added.