Motor speech and motor limb status in athletes following a concussion

Abstract

Motor speech disorders have a significant impact on an individual's quality of life, social interaction, employment, academic performance, and self-esteem. The prevalence of motor speech disorders following a sports-related concussion (SRC) is limited, specifically in the case of severe concussions, repeated concussions, an occurrence of intracranial bleeding, and brainstem and peripheral nerve damage that may occur secondary to an SRC [1]. What data does exist is limited to a small number of cases reported as part of a larger sample of severe TBI, and across several different sports activities. The need for the identification of motor speech dysfunction in a well-defined group of student-athletes will make a significant contribution to our understanding of the consequences of SRC on the cognitive-communication behavior of student-athletes.According to the Centers for Disease Control and Prevention [2], 138 people die every day in the United States, from traumatic brain injuries (TBI). The yearly incidence of TBI is estimated to be between 1.6 million and 3 million for recreational sports [2]. A large percentage of these victims are within the pediatric range, 5-18 years old, which accounts for the majority of sports-related concussions [3]. Gessel et al. [4] reported that the majority of concussions, at the high school level, result from participation in Purpose: There is limited research on the effects of an acute concussion on motor speech production in student-athletes. This study investigated the effects of a concussion on (1) speech alternating motion rates and (2) finger repetition task.Methods: Eighteen individuals with a concussion and 18 individuals in a healthy comparison (HC) group, matched for age and years of education served as participants. Oral diadochokinetic sequential motion rates (SMR) and alternating motion rates (AMR) were measured using Kay Elemetrics Computerized Speech Lab, model 4500. A finger repetition task was also evaluated.Results: Independent-samples t-tests revealed statistically significant differences in mean syllable repetition rate between groups: SMRs (p < 0.001), AMR /puh/ (p < 0.001), AMR /tuh/ (p < 0.001), and AMR /kuh/ (p < 0.001). Also, a statistically significant difference was found for the finger repetition task (p < 0.05).Conclusions: Participants with a concussion produced SMR and AMR speech-like tasks and finger repetition tasks significantly slower than a matched healthy control group.

Sports Related Concussion Impacts Speech Rate and Muscle Function

“…Speech rate during DDK tasks has shown promise for distinguishing SRC from controls 21 . Preliminary findings from a small mixed sample of patients with SRC and non-SRC mild TBI found slower DDK rates in patients compared to controls 13 . The present study builds on this preliminary evidence to comprehensively quantify DDK speech rate across objective and subjective measures and to examine, for the first time, any articulatory muscle differences using surface electromyography (sEMG), in athletes with SRC compared to controls.…”

“…All participants completed three practice attempts of each task to establish familiarity with the protocol and ensure correct performance. Segmentation was performed in Audacity audio manipulation software (https://www.audacityteam.org/) and analyzed using an automated MatLab script following general guidelines described by Salvatore et al and other recent publications 13,26,27 . Briefly, this analysis applied a dB and frequency filter between 5-75 dB that speech is most likely to be present during this study ( Figure 1).…”

“…Estimated Average Time Per Syllable (TPS): Final segmentations included the 2 nd -11 th correctly produced target 13 . These ten productions were used in the statistical analyses described below.…”

“…Speech production is a complex neuromotor process dependent on millisecond timing and coordination of a large number of cortical and subcortical structures and muscle groups [1][2][3][4] . The temporal features of speech motor control are particularly sensitive to subtle changes in neural function and have been leveraged as early indicators of neurological impairment associated with Parkinson's disease 5 , Huntington's disease 6,7 , Amyotrophic Lateral Sclerosis 8,9 , Chronic Traumatic Encephalopathy (CTE) 10,11 and traumatic brain injury (TBI) 12,13 . Speech timing changes may also be an important early indicator of sports-related concussions (SRC), a subset of TBI.…”

Fluency Changes due to Sports-Related Concussion

“…Changes in speech are typically not captured on commonly used symptom inventories for milder injuries and sports-related sideline assessments (Schatz et al, 2006;Asken et al, 2020). However, early evidence has shown significant alterations in rate of speech (Salvatore et al, 2019) and articulatory precision (Chong et al, 2021) in the presence of concussion. Recent case reports of disturbances in fluency have also been reported (Robertson & Diaz, 2020;Rose et al, 2021;Toldi & Jones, 2021).…”