Impaired auditory processing and neural representation of speech in noise among symptomatic post-concussion adults.
Kathy R Vander Werff, Brian Rieger
PMID 31317775WHAT IT FOUND
Overall early brain responses did not clearly differ between concussion and controls, but noise affected concussion participants more, and active listening responses to speech were poorer than controls.
This does not show all concussion patients have auditory processing deficits.
Key findings
01During the active listening task, the concussion group as a whole had smaller P3 brain responses, slower button presses, and poorer detection of the rare sound than controls.
02Background noise reduced P2 amplitude and delayed P1, N1, and P2 latencies more in the concussion group than in controls.
03In exploratory subgroup analysis, the 9 concussion participants with abnormal auditory test performance had smaller P2 amplitudes in noise than the 19 with normal performance.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The analysed concussion group was small, and the auditory test subgroups were very small and unequal. Multiple statistical tests were not corrected for multiple comparisons, so some findings may be fragile. Four concussion participants were excluded for insufficient test effort, which may affect generalisability. Participants were not selected for auditory symptoms, and only some had abnormal auditory test scores, so findings may not apply to all symptomatic concussion patients. Hearing thresholds allowed some peripheral hearing differences, and distortion-product otoacoustic emission differences were present in the left ear, so peripheral factors cannot be fully ruled out. The P2 component may reflect attention or other top-down factors, not only sensory auditory processing. The study was observational and did not test treatment, so it cannot show that these brain responses cause functional problems or respond to therapy.
Declared interests
The supplied text does not include a conflict-of-interest statement. The publication type notes NIH extramural research support.
The easy way to misread this
Do not conclude that every symptomatic post-concussion adult has impaired auditory processing. The overall early brain response comparison did not show a clear difference, and only a subset of the concussion group had abnormal auditory test scores. The subgroup findings were exploratory and involved few participants.