Altered speech patterns in subjects with post-traumatic headache due to mild traumatic brain injury

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.

Clusters of conditions among US service members diagnosed with mild TBI from 2017 through 2019

“…Based on this analysis, it seems many mTBI patients will experience several disparate psychological issues simultaneously. Our research, which found that conditions associated with speech disorders clustered together with headache symptoms aligns with research showing that mTBI patients experiencing post–traumatic headache experience changes in speech ( 28 ). The clustering of visual disorders, ear disorders, cognitive, and sleep disorders may have occurred because of the physiological nature of mTBI.…”

Developing multivariable models for predicting headache improvement in patients with acute post‐traumatic headache attributed to mild traumatic brain injury: A preliminary study

“…Participants included in this study were enrolled over a period of 3 years (2019–2022). A subset of individuals included in this study were included in a prior publication 7 . However, this is the primary analysis aimed at predicting headache improvement based on clinical questionnaires completed within 0–59 days post‐mTBI.…”

Articulation Rate, Pauses, and Disfluencies in Professional Fighters: Potential Speech Biomarkers for Repetitive Head Injury

“…Pause behavior can also be affected by cognitive and linguistic factors, and increased pausing is associated with TBI and dementia. 18,19,[46][47][48] The speech of fighters was also characterized by more frequent disfluencies. For MT disfluencies (ie, interjections, phrase revisions), fighters produced more than 1 additional disfluency per passage than controls.…”