Mapping the Neurophysiological Link Between Voice and Autonomic Function: A Scoping Review

Vocal production requires coordinated control of respiratory, laryngeal, and autonomic sys-tems. In individuals with high vocal demand, this physiological load may influence autonomic regulation, even without voice disorders. This scoping review mapped current evidence on the relationship between voice production and autonomic nervous system (ANS) activity in adults, focusing on studies assessing concurrently both systems. A systematic search was conducted in PubMed, Scopus, Web of Science, Embase, and CINAHL (2010–2025) following PRISMA-ScR guidelines. Eligible studies included adults performing structured vocal tasks with concurrent autonomic measurements. Data were extracted and synthesized descriptively. Fif-teen studies met inclusion criteria. Most involved healthy adults with high vocal demand; some included participants with subclinical or functional voice traits. Vocal tasks ranged from singing and sustained phonation to speech under cognitive or emotional load. Autonomic measures included heart rate (HR), heart rate variability (HRV), electrodermal activity (EDA), blood pressure (BP), among others. Four thematic trends emerged: autonomic synchroniza-tion during group vocalization; modulation of autonomic tone by vocal rhythm and structure; voice–ANS interplay under stress; and physiological coupling in hyperfunctional vocal behav-iours. Review findings confirm that vocal activity can shape autonomic function, supporting integration of autonomic markers into experimental and clinical voice research.