Smith Dani C, Zhang Jianwei, Jayasuriya Suren, Berisha Visar, Starling Amaal, Schwedt Todd J, Chong Catherine D
Department of Neurology, Mayo Clinic, Phoenix, Arizona, USA.
School of Electrical, Computer and Energy Engineering, Arizona State University, Tempe, Arizona, USA.
Headache. 2025 Mar;65(3):506-515. doi: 10.1111/head.14809. Epub 2024 Aug 28.
Slower speaking rates and higher pause rates are found in individuals with migraine or post-traumatic headache during headache compared to when headache-free. We aimed to determine whether headache intensity influences the speaking rate and pause rate of participants with migraine or acute post-traumatic headache (aPTH) following mild traumatic brain injury (mTBI).
Using a speech elicitation tool, participants with migraine, aPTH, and healthy controls (HC) submitted speech samples over a period of 3 months. Speaking and pause rates were calculated when participants were headache-free and when they had mild or moderate headache. In this observational study, speaking and pause rates in participants with migraine and aPTH were compared to HC, controlling for age, sex, and days since mTBI (participants with aPTH only).
A total of 2902 longitudinal speech samples from 13 individuals with migraine (mean age = 33.5, SD = 6.6; 12 females/1 male), 43 individuals with aPTH (mean age = 44.4, SD = 13.5; 28 females/15 males), and 56 HC (mean age = 40.8, SD = 13.0; 36 females/20 males) were collected. There was no difference in speaking rate between HC and the combined headache cohort of participants (migraine and aPTH) when they had headache freedom or a mild headache. When participants had moderate intensity headache, their speaking rate was significantly slower compared to that of HC and compared to their speaking rate during mild headache intensity or headache freedom. For the combined headache cohort of participants, pause rates were significantly higher when they had headache freedom or had a headache of mild or moderate intensity relative to HC. Compared to participants' pause rate during headache freedom, their pause rate was significantly higher during mild and moderate headache intensity. Participants with aPTH had significantly slower speaking rates compared to participants with migraine during headache freedom, mild headache intensity, and moderate headache intensity. Participants with aPTH had significantly higher pause rates compared to participants with migraine when experiencing moderate headache intensity.
For both aPTH and migraine, more severe headache pain was associated with higher pause rates and slower speaking rates, suggesting that speaking rate and pause rate could serve as objective biomarkers for headache-related pain. Slower speaking rate in participants with aPTH could reflect additional consequences of TBI-related effects on motor control and speech production.
与无头痛时相比，偏头痛或创伤后头痛患者在头痛发作时说话速度较慢且停顿率较高。我们旨在确定头痛强度是否会影响轻度创伤性脑损伤（mTBI）后偏头痛或急性创伤后头痛（aPTH）患者的说话速度和停顿率。
使用言语诱发工具，偏头痛患者、aPTH患者和健康对照（HC）在3个月的时间内提交言语样本。计算参与者无头痛时以及患有轻度或中度头痛时的说话速度和停顿率。在这项观察性研究中，将偏头痛和aPTH患者的说话速度和停顿率与HC进行比较，并控制年龄、性别以及mTBI后的天数（仅适用于aPTH患者）。
共收集了来自13名偏头痛患者（平均年龄=33.5，标准差=6.6；12名女性/1名男性）、43名aPTH患者（平均年龄=44.4，标准差=13.5；28名女性/15名男性）和56名HC（平均年龄=40.8，标准差=13.0；36名女性/2名男性）的2902份纵向言语样本。HC与偏头痛和aPTH患者的联合头痛队列在无头痛或轻度头痛时的说话速度没有差异。当参与者患有中度强度头痛时，他们与HC相比，说话速度明显较慢，并且与轻度头痛强度或无头痛时相比，说话速度也明显较慢。对于偏头痛和aPTH患者的联合头痛队列，在无头痛或患有轻度或中度强度头痛时，其停顿率相对于HC显著更高。与参与者无头痛时的停顿率相比，在轻度和中度头痛强度时，他们的停顿率明显更高。在无头痛、轻度头痛强度和中度头痛强度时，aPTH患者的说话速度明显慢于偏头痛患者。在经历中度头痛强度时，aPTH患者的停顿率明显高于偏头痛患者。
对于aPTH和偏头痛，更严重的头痛疼痛与更高的停顿率和更慢的说话速度相关，这表明说话速度和停顿率可以作为与头痛相关疼痛的客观生物标志物。aPTH患者说话速度较慢可能反映了TBI相关效应在运动控制和言语产生方面的额外后果。
