Prosodic processing post traumatic brain injury - a systematic review

Ilie et al. Systematic Reviews (2017) 6:1 DOI 10.1186/s13643-016-0385-3 RESEARCH Open Access Prosodic processing post traumatic brain injury - a systematic review Gabriela Ilie1*, Michael D. Cusimano2,3 and Wenshan Li4 Abstract Background: Traumatic brain injury (TBI) survivors often report difficulties with understanding and producing paralinguistic cues, as well as understanding and producing basic communication tasks. However, a large range of communicative deficits in this population cannot be adequately explained by linguistic impairment. The review examines prosodic processing performance post-TBI, its relationship with injury severity, brain injury localization, recovery and co-occurring psychiatric or mental health issues post-TBI Methods: A systematic review using several databases including MEDLINE, EMBASE, Cochrane, LLBA (Linguistics and Language Behaviour Abstract) and Web of Science (January 1980 to May 2015), as well as a manual search of the cited references of the selected articles and the search cited features of PubMed was performed. The search was limited to comparative analyses between individuals who had a TBI and non-injured individuals (control). The review included studies assessing prosodic processing outcomes after TBI has been formally diagnosed. Articles that measured communication disorders, prosodic impairments, aphasia, and recognition of various aspects of prosody were included. Methods of summary included study characteristics, sample characteristics, demographics, auditory processing task, age at injury, brain localization of the injury, time elapsed since TBI, reports between TBI and mental health, socialization and employment difficulties. There were no limitations to the population size, age or gender. Results were reported according to the PRISMA guidelines. Two raters evaluated the quality of the articles in the search, extracted data using data abstraction forms and assessed the external and internal validity of the studies included using STROBE criteria. Agreement between the two raters was very high (Cohen’s kappa = .89, P < 0.001). Results are reported according to the PRISMA guidelines. Results: A systematic review of 5212 records between 1980 and 2015 revealed 206 potentially eligible studies and 8 case-control studies (3 perspective and 5 retrospective) met inclusion and exclusion criteria for content and quality. Performance on prosodic processing tasks was found to be impaired among all participants with a history of TBI (ages ranged from 8 to 70 years old), compared to those with no history of TBI, in all eight studies examined. Compared with controls, individuals with a history of TBI had statistically significantly slower reaction time in identifying emotions from prosody and impaired processing of prosodic information that is muffled, non-sense, competing, or in conflict (prosody versus semantics). Heterogeneous findings on correlations between specific brain locations and prosodic processing impairment were reported. Psychiatric issues, employment status or social integration post-TBI were scarcely reported but, when reported, they co-occurred with a history of TBI and prosodic impairments. (Continued on next page) * Correspondence: 1 Faculty of Medicine, Dalhousie University, 5790 University Avenue, 4th Floor, Rm. 401, Halifax, NS B3H 4R2, Canada Full list of author information is available at the end of the article © The Author(s). 2016 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Ilie et al. Systematic Reviews (2017) 6:1 Page 2 of 18 (Continued from previous page) Conclusions: The current review confirms the relationship between impaired prosodic processing and history of TBI. Future studies should collect and report comprehensive details about severity of TBI, location of brain injury and time elapsed since injury, as they could key influence factors to the extent of prosodic processing impairments and recovery from auditory processing impairments post-TBI. The exploration of prosodic processing tasks as a possible neuropsychological marker of TBI diagnosis and recovery is warranted. Keywords: Traumatic brain injury, Prosodic processing, Speech prosody, Psychiatry, Recovery marker Background Over the past 15 years, traumatic brain injuries (TBIs) have been on the rise and have become a public health care issue in North America [1–10]. The main mechanism of TBI among infants age 0–4, are falls, among adolescents age 10 to 20 are sport related injuries, and among adults are traffic collisions, falls, and assaults [2–4, 7, 11, 12]. Fallrelated head injuries are approximately four times greater among older adults (over 65) compared to adults less than 65 years old [2–4]. Based on hospitalized and nonhospitalized records, estimates indicate that more males than females sustain TBIs [1–4, 11]. TBIs have large societal and economic toll [8, 13] and also affect the individual as TBI affects quality of life, including challenges to the individual’s ability to return to work or school and sustain relationships with family, friends, and community [2–4, 7]. Symptoms associated with TBI involve sensitivity to sounds (increased irritability with loud and/or high pitched sounds) along with various physiological, cognitive, and emotional symptoms including dizziness, headaches, sensitivity to light, mood changes, irritability, diminished focused attention, and slow reaction time [2, 4, 5, 7, 8, 11, 14]. Post-TBI symptoms are difficult to diagnose and prognosis as to whether the symptoms will persist or lead to adverse conditions is difficult [8, 11, 14]. Cognitive, functional, occupational and physical outcomes, as well as social reintegration post-TBI often present a challenge and are issues that have drawn much scientific attention in recent years. For example, adults with a history of TBI report increased current daily cigarette smoking, use of cannabis and non-medically prescribed opioids have significantly higher odds of being currently diagnosed with ADHD and report a greater number of roadrelated aggression and traffic collisions [12, 15]. Several population studies of adolescents and adults revealed that history of TBI is associated with increased symptoms of depression, anxiety, negative affect, and suicidal ideation [12, 16, 17, 18]. Furthermore, a systematic review by Rogers and Read [19] found that TBI patients are particularly at risk of developing major depression, gener (...truncated)