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Patel S, Grabowski C, Dayalu V, Testa AJ. Speech error rates after a sports-related concussion. Front Psychol 2023; 14:1135441. [PMID: 36960009 PMCID: PMC10027790 DOI: 10.3389/fpsyg.2023.1135441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 02/13/2023] [Indexed: 03/09/2023] Open
Abstract
Background Alterations in speech have long been identified as indicators of various neurologic conditions including traumatic brain injury, neurodegenerative diseases, and stroke. The extent to which speech errors occur in milder brain injuries, such as sports-related concussions, is unknown. The present study examined speech error rates in student athletes after a sports-related concussion compared to pre-injury speech performance in order to determine the presence and relevant characteristics of changes in speech production in this less easily detected neurologic condition. Methods A within-subjects pre/post-injury design was used. A total of 359 Division I student athletes participated in pre-season baseline speech testing. Of these, 27 athletes (18-22 years) who sustained a concussion also participated in speech testing in the days immediately following diagnosis of concussion. Picture description tasks were utilized to prompt connected speech samples. These samples were recorded and then transcribed for identification of errors and disfluencies. These were coded by two trained raters using a 6-category system that included 14 types of error metrics. Results Repeated measures analysis of variance was used to compare the difference in error rates at baseline and post-concussion. Results revealed significant increases in the speech error categories of pauses and time fillers (interjections/fillers). Additionally, regression analysis showed that a different pattern of errors and disfluencies occur after a sports-related concussion (primarily time fillers) compared to pre-injury (primarily pauses). Conclusion Results demonstrate that speech error rates increase following even mild head injuries, in particular, sports-related concussion. Furthermore, the speech error patterns driving this increase in speech errors, rate of pauses and interjections, are distinct features of this neurological injury, which is in contrast with more severe injuries that are marked by articulation errors and an overall reduction in verbal output. Future studies should consider speech as a diagnostic tool for concussion.
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Affiliation(s)
- Sona Patel
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
- Department of Medical Sciences, Hackensack Meridian School of Medicine, Nutley, NJ, United States
- *Correspondence: Sona Patel,
| | - Caryn Grabowski
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
| | - Vikram Dayalu
- Department of Speech-Language Pathology, Seton Hall University, Nutley, NJ, United States
| | - Anthony J. Testa
- Center for Sports Medicine, Seton Hall University, South Orange, NJ, United States
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Norman RS, Mueller KD, Huerta P, Shah MN, Turkstra LS, Power E. Discourse Performance in Adults With Mild Traumatic Brain Injury, Orthopedic Injuries, and Moderate to Severe Traumatic Brain Injury, and Healthy Controls. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:67-83. [PMID: 34694868 PMCID: PMC9135020 DOI: 10.1044/2021_ajslp-20-00299] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/22/2021] [Accepted: 04/19/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Adults with mild traumatic brain injury (mTBI) are at risk for communication disorders, yet studies exploring cognitive-communication performance are currently lacking. AIMS This aim of this study was to characterize discourse-level performance by adults with mTBI on a standardized elicitation task and compare it to (a) healthy adults, (b) adults with orthopedic injuries (OIs), and (c) adults with moderate to severe TBI. METHOD This study used a cross-sectional design. The participants included mTBI and OI groups recruited prospectively from an emergency medicine department. Moderate to severe TBI and healthy data were acquired from TalkBank. One-way analyses of variance were used to compare mean linguistic scores. RESULTS Seventy participants across all groups were recruited. Groups did not differ on demographic variables. The study found significant differences in both content and productivity measures among the groups. Variables did not appear sensitive to differentiate between mTBI and OI groups. DISCUSSION Cognitive and language performance of adults with mTBI is a pressing clinical issue. Studies exploring language with carefully selected control groups can influence the development of sensitive measures to identify individuals with cognitive-communication deficits.
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Affiliation(s)
- Rocío S. Norman
- Department of Communication Sciences and Disorders, The University of Texas Health Science Center at San Antonio
| | - Kimberly D. Mueller
- Department of Communication Sciences and Disorders, University of Wisconsin–Madison
| | - Paola Huerta
- Department of Communication Sciences and Disorders, The University of Texas Health Science Center at San Antonio
| | - Manish N. Shah
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin–Madison
| | - Lyn S. Turkstra
- Speech-Language Pathology Program, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Emma Power
- Speech Pathology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
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Ekhart C, van Hunsel F, van Harten P, van Baarsen J, Yingying T, Bast B. Drug-Induced Stuttering: Occurrence and Possible Pathways. Front Psychiatry 2021; 12:692568. [PMID: 34512414 PMCID: PMC8423914 DOI: 10.3389/fpsyt.2021.692568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Stuttering is a well-known condition that affects mainly children. Often, they recover as they get older. However, a drug-induced form of stuttering may occur at any age. The aim of the present study was to detect drugs that have been associated with stuttering and discuss the mechanisms involved. Method: A descriptive study based on reports submitted to the global pharmacovigilance database VigiBase of the WHO was conducted. Results: A total of 3,385 reports of dysphemia were retrieved from VigiBase. These reports were contributed by 51 countries. Antiepileptics, antidepressants, immunosuppressants, antipsychotics, and centrally acting sympathomimetics were among the most frequently implicated drugs. Conclusion: A wide variety of drugs has been linked to the occurrence or recurrence of stuttering. Several mechanisms, such as increased dopamine levels, reduction of GABA, anticholinergic properties of drugs, or changes in serotonin levels, have been associated with the development of drug-induced stuttering. Paradoxically, agents known to reduce stuttering in some people may induce it in others.
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Affiliation(s)
- Corine Ekhart
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, Netherlands
| | | | - Peter van Harten
- Research Department, Psychiatric Centre GGz Centraal, Innova, Amersfoort, Netherlands.,Department of Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | | | - Tan Yingying
- Linguistic Institute, Shanghai International Studies University, Shanghai, China
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Toldi J, Jones J. A Case of Acute Stuttering Resulting after a Sports-related Concussion. Curr Sports Med Rep 2021; 20:10-12. [PMID: 33395124 DOI: 10.1249/jsr.0000000000000795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- James Toldi
- Institute for Brain Protection Sciences, Division of Sports Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, FL
| | - Jared Jones
- Department of Family Medicine, University of South Alabama, Mobile, AL
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Robertson SC, Diaz K. Case Report of Acquired Stuttering After Soccer-Related Concussion: Functional Magnetic Resonance Imaging as a Prognostic Tool. World Neurosurg 2020; 142:401-403. [DOI: 10.1016/j.wneu.2020.06.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/28/2020] [Accepted: 06/30/2020] [Indexed: 10/23/2022]
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Norman RS, Swan AA, Jenkins A, Ballard M, Amuan M, Pugh MJ. Updating and Refining Prevalence Rates of Traumatic Brain Injury–Related Communication Disorders Among Post-9/11 Veterans: A Chronic Effects of Neurotrauma Consortium Study. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-20-00011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
To describe the prevalence of communication disorders in a cohort of 84,377 deployed post-9/11 veterans stratified by blast traumatic brain injury (TBI) exposure. Secondary aim was to evaluate the association between postconcussion symptoms, such as posttraumatic stress disorder, depression, anxiety, insomnia, pain, headache, substance use disorder, and auditory problems, among veterans with and without a communication disorder diagnosis.
Method
This is a retrospective study of the prevalence of aphasia, apraxia of speech and dysarthria, cognitive-communication disorder, fluency, and voice disorders among veterans, stratified by TBI severity and blast status. Data were obtained from the national Operation Enduring Freedom, Operation Iraqi Freedom, and Operation New Dawn roster file provided by the Department of Veterans Affairs Office of Public Health and the Veterans Affairs' TBI screening and subsequent comprehensive TBI evaluation.
Results
Cognitive-communication disorder was the most prevalent diagnosis, comprising 57.1% of all communication disorder diagnoses, followed by voice disorder (19%) and aphasia (16%). Increased age was significantly associated with higher rates of aphasia, apraxia of speech/dysarthria, and voice disorder.
Conclusions
The current study shows that, while the overall total number of communication disorder diagnoses was higher in the blast groups than in the nonblast groups, TBI severity was a more significant risk factor for a diagnosis, with veterans in the more severe groups at a higher risk of being diagnosed with a communication disorder when compared to those with mild TBI and no blast exposure. In order to better inform rehabilitation and clinical management of communication conditions, it is critical to examine the influence of blast and postconcussive symptoms in post-9/11 veterans.
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Affiliation(s)
- Rocío S. Norman
- Department of Communication Sciences and Disorders, School of Health Professions, University of Texas Health Science Center at San Antonio
| | - Alicia A. Swan
- Department of Psychology, University of Texas at San Antonio
| | - Angela Jenkins
- Department of Communication Sciences and Disorders, School of Health Professions, University of Texas Health Science Center at San Antonio
| | - Matthew Ballard
- Department of Communication Sciences and Disorders, School of Health Professions, University of Texas Health Science Center at San Antonio
| | - Megan Amuan
- VA Salt Lake City Health Care System, Informatics, Decision-Enhancement, and Analytic Sciences Center, UT
| | - Mary Jo Pugh
- VA Salt Lake City Health Care System, Informatics, Decision-Enhancement, and Analytic Sciences Center, UT
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City
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Penttilä N, Korpijaakko-Huuhka AM, Kent RD. Disfluency clusters in speakers with and without neurogenic stuttering following traumatic brain injury. JOURNAL OF FLUENCY DISORDERS 2019; 59:33-51. [PMID: 30641458 DOI: 10.1016/j.jfludis.2019.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 12/01/2018] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
PURPOSE Analyze the characteristics and rate of disfluency clusters in adults with and without neurogenic stuttering after traumatic brain injury (TBI). METHOD Twenty adults with TBI participated in this study, including 10 with neurogenic stuttering (Group B) and 10 without -stuttering (Group A). Disfluency clusters in speech samples were classified into three types: Stuttering-like (SLD), other (OD), and mixed (MIX). RESULTS Speakers with and without neurogenic stuttering produced the same mean number of disfluency clusters. In addition, the mean length of clusters did not differ between these speaker groups although the longest clusters did. The most frequently occurring cluster type for people with neurogenic stuttering was MIX and OD for people without stuttering. Although the speakers in Group A produced stuttering-like disfluencies, these never occurred together to form a SLD type cluster. For Group B, the starter units of the clusters were usually stuttering-like disfluencies, while for Group A, the starter units were mostly interruptions. CONCLUSIONS Compared to non-stuttering speakers, stuttering after TBI did not increase the number of clusters, but rather lengthened them. In speakers with neurogenic stuttering, the number and length of clusters were related to the manifestation of other communication deficits, not to the frequency of stuttering-like disfluencies. Still, SLD clusters occurred only in those people with neurogenic stuttering. These findings raise questions about the nature of both neurogenic stuttering and the dynamics of disfluency clustering.
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Affiliation(s)
- Nelly Penttilä
- Faculty of Social Sciences, University of Tampere, 33610 Tampere, Finland.
| | | | - Raymond D Kent
- Waisman Center, University of Wisconsin-Madison, 53705 Madison WI, United States
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