An exploratory investigation of speech-in-noise ability and cognitive performance in young adult contact sport athletes

Objective To explore speech-in-noise abilities and cognitive performance in young adult contact sport athletes exposed to repetitive head impacts (RHI).Design An exploratory cross-sectional study using standardized speech-in-noise and neuropsychological assessments alongside self-reported sporting history, listening‑in‑noise ability, and concussion history as proxy indicators of exposure.Study sample Twenty-four athletes (17 females, 7 males; median age 20 years, range 18–29 years) actively participating in the contact sport of rugby union in Sheffield, UK.Results Elevated rates of impairment relative to normative expectations were observed on the Listening in Spatialized Noise–Sentences (LiSN-S) High Cue (30.8%) and Low Cue (38.5%) tests and the Trail Making Test (TMT) A (19.2%) and B (73.1%). Low rates of impairment were observed on the LiSN-S Total Advantage test (3.8%), the Montreal Cognitive Assessment (3.8%) and the Rey Auditory Verbal Learning Test trials (0%) and long delay (3.8%). Statistically significant (p < 0.01) group-level Z-score deviations were observed for the LiSN-S High Cue, LiSN-S Low Cue, RAVLT total, and TMT B tests. No significant correlations were observed between exposure proxies (years of participation and self-reported number of concussions) and any speech-in-noise measures and cognitive measures.Conclusions These exploratory findings, while not establishing causality or clinical impairment, warrant further investigation into speech-in-noise performance as a potential and previously under-considered area of vulnerability in contact sport athletes exposed to repetitive head impacts (RHI).