Background: Alterations in speech have long been identified as indicators of various neurologic conditions including traumatic brain injury (TBI), neurodegenerative diseases, and stroke. TBIs that can be assessed using the Glasgow Coma Scale often result in speech symptoms such as dysarthria and occasionally neurogenic stuttering. The manifestation of symptoms including the specific changes in speech occurring in mild TBIs (or concussions) may differ from more severe head injuries. This work aims to compare speech fluency in sport-related concussion to baseline performance as well as non-athlete controls. Methods: A total of 230 Division I student athletes participated in pre-season speech testing. Of these, 12 students (18-22 years) who sustained a concussion also participated in speech testing in the days following diagnosis of concussion. Samples of picture descriptions were independently coded by three trained raters as 17 error types within the three traditional categories of errors defined in fluency analysis (Stuttering-Like Disfluency, Articulation Error, Other Disfluency). Results: Within-subjects analysis comparing the difference in percent error scores at baseline and post-concussion revealed significant differences for interjections (t(11)=-2.678, p< .05). The Other Disfluency category was also significantly different (t(11)= -2.735, p< .05), with more errors occurring after a concussion. No change in the Stuttering-Like Disfluency (t(11)= -0.799, p>.05) or Articulation Error category (t(11)=-0.045, p>.05) was found. Conclusions: These results demonstrate that speech changes occur following mild sports-related concussions. Specifically, the rate of interjections increased in a limited sample of college athletes who sustain a concussion. Changes in additional error types (fillers, pauses) were trending, but were not significant potentially due to the low sample size. Future studies should consider speech as a diagnostic tool for concussion.
Executive functioning is fundamental to motor processes that involve decision-making, and yet, the role of cognitive control during speech production is not well understood. The purpose of this study was to examine the relationship between auditory attentional decision-making ability and changes in acoustic parameters and speech error rates during sensorimotor integration for speech production. Seventeen healthy individuals first completed an auditory analog of the Attentional Network Test to assess attentional decision-making and then read passages under delayed auditory feedback (DAF). None of the acoustic parameters (speech rate, mean and standard deviation of fundamental frequency and intensity) were related to metrics of cognitive processing. However, auditory processing speed, measured as reaction time to pitch identifications (r = -0.58, p < 0.05) and auditory location identifications (r = -0.66, p < 0.05), was significantly related to the total number of dysfluencies (across articulation errors, stuttering-like disfluencies, and other disfluencies) under DAF. In other words, individuals who made quick auditory discriminations produced more dysfluencies under DAF. While preliminary, these findings suggest that cognitive functions including executive control are engaged during speech production. These findings can be understood in the context of diffusion models of decision-making and the impact of cognition on speech perception.
BackgroundAlterations 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.MethodsA 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.ResultsRepeated 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).ConclusionResults 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.
Traumatic brain injuries (TBIs) cause immediate and temporary alterations in brain function that result in a variety of symptoms including impacts on speech. Symptoms of dysarthria and aphasia occur but are primarily reported in moderate-severe injuries. Less is known about the specific changes in acoustic parameters and language that occur in mild concussions. A total of 250 athletes at Seton Hall University participated in baseline speech testing. Speech testing was performed again in a subset of 15 athletes who sustained a mild concussion (within 72 h). Speech and language analysis was performed on samples derived from a picture description task. Statistical comparisons showed minimal changes in acoustic parameters on average, but individual differences were present. Specifically, some individuals presented with a flatter prosody and/or lower mean pitch than others post-injury compared to baseline. Although no clear pattern of acoustic changes emerged, language analysis (semantics, syntax, morphology) showed an overall reduction of complexity of productions. Language outcomes indicate that changes in speech symptoms occur even in mild cases. Further investigations should examine the speech and language changes after a head injury against the individual’s complete symptom profile and neurological regions of damage in a larger sample size.
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