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ORIGINAL RESEARCH article

Front. Neurosci.

Sec. Auditory Cognitive Neuroscience

Central auditory processing is altered after traumatic brain injury in Tanzanian adults

Provisionally accepted
Jonathan D LichtensteinJonathan D Lichtenstein1,2*Christopher E NiemczakChristopher E Niemczak1,2Abigail FellowsAbigail Fellows3Lindsay J WoodLindsay J Wood2Shufaa MasoudShufaa Masoud4Alexis RooneyAlexis Rooney5Monika AdhikariMonika Adhikari1Albert MagoheAlbert Magohe1,4Jay C. BuckeyJay C. Buckey1,2
  • 1Dartmouth College Geisel School of Medicine, Hanover, United States
  • 2Dartmouth Hitchcock Medical Center, Lebanon, United States
  • 3Dartmouth College, Hanover, United States
  • 4Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
  • 5Audiology, Montclair State University, Montclair, United States

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Traumatic brain injury (TBI) damages pathways throughout the brain and is a significant global health concern, particularly in low-and middle-income countries, where the incidence is high and long-term deficits are prevalent. This study explores the utility of central auditory processing (CAP) testing as a marker of previous TBI. Seventy individuals with a history of moderate to severe TBI (msTBI) were matched by age and sex to 46 healthy controls in Dar es Salaam, Tanzania. Participants underwent comprehensive behavioral CAP testing, including tests of speech-in-noise ability, temporal resolution, and dichotic listening. Multivariate logistic regression showed the Triple Digit Test (TDT) (p<.001) significantly predicted msTBI status, independent of age and peripheral hearing ability. Elastic net modeling supported these findings, highlighting TDT performance as the most robust predictor of msTBI history. A history of msTBI is associated with poorer CAP performance, particularly on speech-in-noise tests. These tests could serve as accessible, resource-efficient tools for assessing brain function related to TBI in clinical and resource-limited settings. Studies in larger, more diverse populations are needed to explore their predictive utility for long-term cognitive outcomes after TBI.

Keywords: assessment, Central auditory processing, LMICs (low and middle income countries), Sub-Sahara Africa (SSA), Traumatic Brain Injury

Received: 08 Oct 2025; Accepted: 03 Dec 2025.

Copyright: © 2025 Lichtenstein, Niemczak, Fellows, Wood, Masoud, Rooney, Adhikari, Magohe and Buckey. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Jonathan D Lichtenstein

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material