Auditory biological marker of concussion in children

Nina Kraus,Travis White-Schwoch,Jennifer Krizman,Katherine Cook,Cynthia R Labella,Elaine C Thompson

doi:10.1038/srep39009

Nina Kraus, Travis White-Schwoch + Show 4 more

Open Access

https://doi.org/10.1038/srep39009

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Abstract

Concussions carry devastating potential for cognitive, neurologic, and socio-emotional disease, but no objective test reliably identifies a concussion and its severity. A variety of neurological insults compromise sound processing, particularly in complex listening environments that place high demands on brain processing. The frequency-following response captures the high computational demands of sound processing with extreme granularity and reliably reveals individual differences. We hypothesize that concussions disrupt these auditory processes, and that the frequency-following response indicates concussion occurrence and severity. Specifically, we hypothesize that concussions disrupt the processing of the fundamental frequency, a key acoustic cue for identifying and tracking sounds and talkers, and, consequently, understanding speech in noise. Here we show that children who sustained a concussion exhibit a signature neural profile. They have worse representation of the fundamental frequency, and smaller and more sluggish neural responses. Neurophysiological responses to the fundamental frequency partially recover to control levels as concussion symptoms abate, suggesting a gain in biological processing following partial recovery. Neural processing of sound correctly identifies 90% of concussion cases and clears 95% of control cases, suggesting this approach has practical potential as a scalable biological marker for sports-related concussion and other types of mild traumatic brain injuries.

Highlights

Concussions carry devastating potential for cognitive, neurologic, and socio-emotional disease, but no objective test reliably identifies a concussion and its severity
Children who reported the highest symptom load had the smallest responses to the F0 (regression controlling for sex, R2 = 0.548, F(2, 19) = 10.287, p = 0.001; βF0 =−0.712, p = 0.001)
We found that a cut-off of 0.596 on the regression score achieved a 90% sensitivity and a 95% specificity

Summary

Introduction

Concussions carry devastating potential for cognitive, neurologic, and socio-emotional disease, but no objective test reliably identifies a concussion and its severity. We hypothesize that concussions disrupt the processing of the fundamental frequency, a key acoustic cue for identifying and tracking sounds and talkers, and, understanding speech in noise. Neural processing of sound correctly identifies 90% of concussion cases and clears 95% of control cases, suggesting this approach has practical potential as a scalable biological marker for sports-related concussion and other types of mild traumatic brain injuries. The fundamental frequency (F0) of sound is a chief acoustic cue for everyday listening; tracking the F0 facilitates pitch perception, identifying sounds and talkers, and understanding stress and prosody It should come as no surprise, that individual differences in the neurophysiological processing of the F0 cascade to individual differences in listening skills: across the lifespan, listeners with stronger responses to the F0 hear better in everyday environments[10–12]. Our conceptual framework positions auditory processing—the ability to automatically and efficiently extract meaning from sound—at the nexus of cognitive, sensory, and limbic systems, and argues that insults to any of www.nature.com/scientificreports/

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