Comprehension after Concussion: An Analysis of the Impact of Mild Traumatic Brain Injury and Related Symptoms on Sentence and Word-Pair Comprehension




Flaugher, Tara L

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Millions suffer a concussion, or mild traumatic brain injury (mTBI), annually. Some will experience persistent symptoms, like slow processing, poor sleep quality, and difficulty carrying a conversation, which can also occur in non-injured individuals. This dissertation explored how mTBI-related symptoms in both injured and non-injured populations affect word and sentence-level comprehension. A multi-methodology approach, which included self-reported symptoms, event-related potentials (ERP), and behavioral measures, was used. Chapter 1 reviews mTBI and language comprehension literature and presents a scoping review of available clinical tools. Chapter 2 presents a listening comprehension study where higher neurobehavioral symptoms after chronic mTBI resulted in slower sentence processing times only when instructions were provided with no time constraints. Chapter 3 presents a self-paced reading comprehension study where the P600, an ERP index for grammatical errors, was equivalent in amplitude for both injured and non-injured groups but was more focally distributed and correlated with sleep quality after chronic mTBI. Chapter 4 presents a word-pair paradigm where non-injured individuals actively predicted a noun after reading an adjective, which created high predictable, low predictable, or incongruent word pairs. Symptoms did not modulate the N400 effect, an ERP index of meaning comprehension, though post-hoc analyses suggested potential avenues for future research. Chapter 5 revealed the importance of validating stimuli obtained from lexical databases for comprehension studies. Chapter 6 presents conclusions and future directions for this nascent research area. This dissertation demonstrates the value of a multi-method approach and the importance of considering symptoms when investigating language comprehension after chronic mTBI.



concussion, event-related potentials, language, mild traumatic brain injury, semantics, syntax



Neuroscience, Developmental and Regenerative Biology