Abstract
Background/objectiveChanges 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.MethodsUsing 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.ResultsLongitudinal 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.ConclusionsCompared 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.
Highlights
Individuals with migraine report changes in speech during migraine attacks and several studies have documented speech difficulty during the aura phase of the attack as well as prior to and during the attack [1,2,3]
We hypothesized that individuals with post-traumatic headache (PTH) would have alterations in speech compared to healthy controls without history of mild traumatic brain injury (mTBI)
The overarching goal of this study was to determine whether objective features measured from speech samples obtained from individuals with acute PTH could provide a surrogate measure of headache burden, which could have utility in the future for tracking headache persistence and recovery
Summary
Individuals with migraine report changes in speech during migraine attacks and several studies have documented speech difficulty during the aura phase of the attack as well as prior to and during the attack [1,2,3]. In order to determine speech changes in individuals with PTH, we used a speech elicitation task embedded within a mobile app to assess objective measures of speech that relate to a combination of motor and cognitive-linguistic components of speech These include sentence speaking rate, pause rate during spontaneous speech production, pitch (average pitch and pitch variance), vowel and consonant articulation precision, and vowel space area. These measures were collected to: 1) investigate speech differences between individuals with PTH and healthy controls, and 2) assess whether individuals with PTH have speech changes during headaches compared to when they are headachefree
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