Evaluating Possible Auditory and Psychological Biomarkers of Sound Intolerance

听觉过敏和噪声敏感性是声音耐受性降低（DST）障碍的类型，并且经常 报告耳鸣和头部受伤的患者分别。当患者出现任何程度的DST时， 最重要的是解决容忍声音的问题，因为它对日常生活的各个方面都有负面影响。 功能;严重的DST表现为日常声音被认为太大，压倒性的， 烦人了由于缺乏对DST的研究，有关基本方面的知识有限 其病理生理学和如何最好地治疗它。本申请的总体目标是测试两个 DST的概念模型，听觉模型（目标1）和心理模型（目标2），以确定 严重DST的病因。 当退伍军人在诊所看到声音不耐受的投诉（即，严重DST）、医疗保健 医生不知道如何帮助病人。没有客观的测试来诊断DST和 通常使用的响度感知的行为评估可导致DST症状加重， 情绪困扰此外，标准测试组合不提供关于 问题的根本性质。这一建议是实现我们长期目标的第一步， 了解DST的病因，并最终为临床医生提供他们需要的信息， 治疗这些疾病。为了实现我们的目标，使用响度感知的行为测量是至关重要的 不会引起不必要的痛苦或加重DST症状。分类响度缩放（CLS） 是用于量化响度判断的自动化程序。这项建议的一部分将是完善公务员薪酬制度 这样才能满足这个需求。 本研究的设计是使用生理测量来测试概念模型的多个阶段， 听觉和心理功能。通过研究听觉和心理之间的关系， 生物标志物，这项研究将提供临床相关的信息，在缺陷存在的感觉和/或 导致严重DST的神经结构。这些知识将指导未来的研究， 可以开发针对导致严重DST的潜在机制的治疗。本研究是 采取必要措施，提供循证方法来指导临床决策， 有严重DST的退伍军人。 所提出的工作成果具有理论和临床影响。本文中概述的实验 该提案将阐明导致严重DST的潜在病理生理学，并导致有效和高效的 定量指标，可以成为一个标准化的测试电池的一部分，用于评估这种健康状况。 此外，通过识别危险因素，包括心理健康对DST程度的影响， 这一建议将指导未来关于护理路径发展的研究，这一路径将是跨学科的， 设计，可以解决严重DST的复杂性，并为医疗保健专业人员提供资源 他们需要最好地满足任何程度DST患者的需求。

Hyperacusis and noise sensitivity are types of decreased sound tolerance (DST) disorders, and frequently reported in patients with tinnitus and head injury respectively. When any degree of DST is seen in patients, it is paramount to address the problems tolerating sounds because it negatively impacts every aspect of daily functioning; severe DST manifests as everyday sounds being perceived as too loud, overwhelming, and annoying. Due to the paucity of research on DST, limited knowledge exists pertaining to fundamental aspects of its pathophysiology and how best to treat it. The overall objectives of this application are to test two conceptual models of DST, an auditory model (Aim 1) and a psychological model (Aim 2) to determine the etiology of severe DST. When Veterans are seen in the clinic with complaints of sound intolerance (i.e., severe DST), health care providers are uncertain how to help their patients. There are no objective tests to diagnose DST and the commonly used behavioral assessment of loudness perception can result in exacerbating DST symptoms and emotional distress. Additionally, the standard test battery does not provide any useful information as to the underlying nature of the problem. This proposal is the first step to achieve our long-term goals of understanding the etiology of DST and ultimately, provide clinicians the information they need to effectively treat these disorders. To accomplish our goals, it is critical to use a behavioral measure of loudness perception that does not cause unnecessary distress or exacerbate DST symptoms. Categorical Loudness Scaling (CLS) is an automated procedure used to quantify loudness judgments. Part of this proposal will be to refine the CLS procedure so that it meets this need. The design of this study is to test multiple stages of the conceptual models using physiological measures of auditory and psychological function. By examining the relationship between auditory and psychological biomarkers, this study will provide clinically relevant information on where deficits exist in sensory and/or neurological structures that lead to severe DST. This knowledge will guide future studies so that rehabilitative treatments can be developed targeting the underlying mechanism that leads to severe DST. This research is taking the necessary steps to provide an evidence-based approach to direct clinical decision-making for Veterans with severe DST. Outcomes of the proposed work have both theoretical and clinical impact. The experiments outlined in this proposal will elucidate the underlying pathophysiology that leads to severe DST and result in valid and efficient quantitative metrics that could become part of a standardized test battery for evaluating this health condition. Additionally, by identifying risk factors, including the influence of mental health on degree of DST, outcomes of this proposal will guide future studies on the development of a care path, one that will be interdisciplinary in its design, that can address the complexity of severe DST and provide health care professionals the resources they need to best meet the needs of their patients with any degree of DST.