Evaluating Possible Auditory and Psychological Biomarkers of Sound Intolerance

评估声音不耐受的可能听觉和心理生物标志物

• 批准号: 10196970
• 负责人: Sarah Theodoroff
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-07-01 至 2024-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10196970
• 关键词: Address; Adult; Agreement; Anxiety; Anxiety Disorders; Auditory; Auditory Evoked Potentials; Auditory system; Autonomic nervous system; Behavior assessment; Binaural; Biological Markers; Caring; Categories; Clinic; Clinical; Consensus; Craniocerebral Trauma; Development; Diagnosis; Disease; Distress; Etiology; Functional disorder; Future; Galvanic Skin Response; Goals; Growth; Health; Health Personnel; Health Professional; Hyperacusis; Individual; Injury; Judgment; Knowledge; Lead; Loudness; Loudness Perception; Measures; Mental Health; Modeling; Nature; Neurologic; Neuronal Plasticity; Noise; Outcome; Outcome Measure; Pain; Patients; Physiological; Population; Post-Concussion Syndrome; Post-Traumatic Stress Disorders; Procedures; Psychological Models; Psychophysiology; Reaction; Recovery; Rehabilitation therapy; Reporting; Research; Resources; Risk Factors; Sensory; Severities; Standardization; Stress; Structure; Sympathetic Nervous System; Symptoms; Testing; Tinnitus; Traumatic Brain Injury; Variant; Veterans; Work; acoustic reflex; base; behavior measurement; clinical decision-making; clinically relevant; comorbidity; daily functioning; design; effective therapy; emotional distress; evidence base; experimental study; neurophysiology; psychologic; rehabilitation strategy; response; sound; theories

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.

超值和噪声敏感性是降低声音耐受性（DST）疾病的类型，并且经常 报道了耳鸣和头部损伤患者。当患者中看到任何程度的DST时，它是 最重要的是解决容忍声音的问题，因为它会对每日的各个方面产生负面影响 功能；严重的DST表现为每天的声音被认为太响亮，压倒性和 恼人的。由于缺乏对DST的研究，与基本方面有关的知识有限 它的病理生理学以及如何最好地治疗它。此应用程序的总体目标是测试两个 DST的概念模型，听觉模型（AIM 1）和心理模型（AIM 2），以确定 严重DST的病因。 当在诊所看到退伍军人时，有声音不耐受的抱怨（即严重的DST），医疗保健 提供者不确定如何帮助患者。没有客观测试可以诊断DST和 常用的响度感知行为评估会导致DST症状加剧和 情绪困扰。此外，标准测试电池没有提供有关该电池的任何有用信息 问题的根本性质。该提议是实现我们长期目标的第一步 了解DST的病因，最终为临床医生提供有效的信息 治疗这些疾病。为了实现我们的目标，使用响度感知的行为度量至关重要 这不会引起不必要的困扰或加剧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。该建议的一部分将是完善CLS 程序以满足这一需求。 这项研究的设计是使用生理指标来测试概念模型的多个阶段 听觉和心理功能。通过检查听觉与心理之间的关系 生物标志物，这项研究将提供有关感官和/或中存在障碍的临床相关信息 导致严重DST的神经结构。这些知识将指导未来的研究，以便康复 可以开发针对导致严重DST的基本机制的治疗方法。这项研究是 采取必要的步骤提供基于证据的方法来直接临床决策 严重DST的退伍军人。 拟议工作的结果既具有理论和临床影响。在此概述的实验 提案将阐明导致严重DST的潜在病理生理学，并导致有效，有效 可以成为评估这种健康状况的标准测试电池的一部分的定量指标。 此外，通过确定危险因素，包括心理健康对DST程度的影响，结果 该提案将指导未来的有关护理道路发展的研究，这将是跨学科的研究 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 他们需要最佳地满足患者的需求。