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Chong CD, Zhang J, Li J, Wu T, Dumkrieger G, Nikolova S, Ross K, Stegmann G, Liss J, Schwedt TJ, Jayasuriya S, Berisha V. Altered speech patterns in subjects with post-traumatic headache due to mild traumatic brain injury. J Headache Pain 2021; 22:82. [PMID: 34301180 PMCID: PMC8305503 DOI: 10.1186/s10194-021-01296-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/12/2021] [Indexed: 01/03/2023] Open
Abstract
Background/objective Changes in speech can be detected objectively before and during migraine attacks. The goal of this study was to interrogate whether speech changes can be detected in subjects with post-traumatic headache (PTH) attributed to mild traumatic brain injury (mTBI) and whether there are within-subject changes in speech during headaches compared to the headache-free state. Methods Using a series of speech elicitation tasks uploaded via a mobile application, PTH subjects and healthy controls (HC) provided speech samples once every 3 days, over a period of 12 weeks. The following speech parameters were assessed: vowel space area, vowel articulation precision, consonant articulation precision, average pitch, pitch variance, speaking rate and pause rate. Speech samples of subjects with PTH were compared to HC. To assess speech changes associated with PTH, speech samples of subjects during headache were compared to speech samples when subjects were headache-free. All analyses were conducted using a mixed-effect model design. Results Longitudinal speech samples were collected from nineteen subjects with PTH (mean age = 42.5, SD = 13.7) who were an average of 14 days (SD = 32.2) from their mTBI at the time of enrollment and thirty-one HC (mean age = 38.7, SD = 12.5). Regardless of headache presence or absence, PTH subjects had longer pause rates and reductions in vowel and consonant articulation precision relative to HC. On days when speech was collected during a headache, there were longer pause rates, slower sentence speaking rates and less precise consonant articulation compared to the speech production of HC. During headache, PTH subjects had slower speaking rates yet more precise vowel articulation compared to when they were headache-free. Conclusions Compared to HC, subjects with acute PTH demonstrate altered speech as measured by objective features of speech production. For individuals with PTH, speech production may have been more effortful resulting in slower speaking rates and more precise vowel articulation during headache vs. when they were headache-free, suggesting that speech alterations were related to PTH and not solely due to the underlying mTBI.
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Affiliation(s)
- Catherine D Chong
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA. .,ASU-Mayo Center for Innovative Imaging, Phoenix, AZ, USA.
| | - Jianwei Zhang
- School of Electrical, Computer and Energy Engineering and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Jing Li
- School of Industrial and Systems Engineering, Georgia Tech, Atlanta, GA, USA
| | - Teresa Wu
- ASU-Mayo Center for Innovative Imaging, Phoenix, AZ, USA.,School of Computing, Informatics, Decision Systems Engineering, Arizona State University, Tempe, AZ, USA
| | | | | | | | - Gabriela Stegmann
- College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Julie Liss
- School of Electrical, Computer and Energy Engineering and College of Health Solutions, Arizona State University, Tempe, AZ, USA
| | - Todd J Schwedt
- Department of Neurology, Mayo Clinic, Phoenix, AZ, USA.,ASU-Mayo Center for Innovative Imaging, Phoenix, AZ, USA
| | - Suren Jayasuriya
- School of Electrical, Computer and Energy Engineering and College of Health Solutions, Arizona State University, Tempe, AZ, USA.,School of Arts, Media and Engineering, Arizona State University, Tempe, AZ, USA
| | - Visar Berisha
- School of Electrical, Computer and Energy Engineering and College of Health Solutions, Arizona State University, Tempe, AZ, USA.,College of Health Solutions, Arizona State University, Tempe, AZ, USA
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Hardin KY. Prospective Exploration of Cognitive-Communication Changes With Woodcock-Johnson IV Before and After Sport-Related Concussion. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:894-907. [PMID: 33784181 PMCID: PMC8702850 DOI: 10.1044/2020_ajslp-20-00110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 09/13/2020] [Accepted: 12/21/2020] [Indexed: 06/12/2023]
Abstract
Purpose The purpose of this study was to evaluate changes in cognitive-communication performance using Woodcock-Johnson IV Tests (WJIV) from pre-injury baseline to post sport-related concussion. It was hypothesized that individual subtest performances would decrease postinjury in symptomatic individuals. Method This prospective longitudinal observational nested cohort study of collegiate athletes assessed cognitive-communicative performance at preseason baseline and postinjury. Three hundred and forty-two male and female undergraduates at high risk for sport-related concussion participated in preseason assessments, and 18 individuals met criteria post injury. WJIV subtest domains included Word Finding, Speeded Reading Comprehension, Auditory Comprehension, Verbal Working Memory, Story Retell, and Visual Processing (letter and number). The power calculation was not met, and therefore data were conservatively analyzed with descriptive statistics and a planned subgroup analysis based on symptomatology. Results Individual changes from baseline to postinjury were evaluated using differences in standard score performance. For symptomatic individuals, mean negative decreases in performance were found for Retrieval Fluency, Sentence Reading Fluency, Pattern Matchings, and all cluster scores postinjury. Individual performance declines also included decreases in story retell, verbal working memory, and visual processing. Conclusions This study identified within-subject WJIV performance decline in communication domains post sport-related concussion and reinforces that cognitive-communication dysfunction should be considered in mild traumatic brain injury. Key cognitive-communication areas included speeded naming, reading, and verbal memory, though oral comprehension was not sensitive to change. Future clinical research across diverse populations is needed to expand these preliminary findings.
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Affiliation(s)
- Kathryn Y. Hardin
- Department of Speech, Language, and Hearing Sciences, University of Colorado Boulder
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