Fluency changes due to sports-related concussion

BackgroundAlterations 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. MethodsA 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). ResultsWithin-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. ConclusionsThese 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.