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.

听觉过敏和噪音敏感性是声音耐受性降低 (DST) 疾病的类型，并且经常发生 分别在耳鸣和头部受伤的患者中报告。当患者出现任何程度的 DST 时， 解决声音容忍问题至关重要，因为它会对日常生活的各个方面产生负面影响 发挥作用；严重的夏令时表现为日常声音被认为太大、压倒性的和 恼人的。由于 DST 研究的缺乏，有关基本方面的知识有限 其病理生理学以及如何最好地治疗它。该应用程序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 的病因学。 当退伍军人在诊所发现声音不耐受（即严重 DST）时，医疗保健 提供者不确定如何帮助他们的患者。没有客观的测试来诊断 DST 和 常用的响度感知行为评估可能会导致 DST 症状加剧， 情绪困扰。此外，标准测试电池不提供任何有用的信息 问题的根本性质。该提案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有效治疗所需的信息 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至关重要 不会造成不必要的痛苦或加剧 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。该提案的一部分将是完善 CLS 程序，以满足这种需要。 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。通过检查听觉和心理之间的关系 生物标志物，这项研究将提供关于感觉和/或缺陷存在的临床相关信息 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 可以针对导致严重药敏试验的潜在机制开发治疗方法。这项研究是 采取必要步骤提供基于证据的方法来指导临床决策 患有严重夏令时的退伍军人。 拟议工作的成果具有理论和临床影响。本文概述的实验 该提案将阐明导致严重 DST 的潜在病理生理学，并产生有效且高效的结果 定量指标可以成为评估这种健康状况的标准化测试组的一部分。 此外，通过确定风险因素，包括心理健康对 DST 程度的影响， 该提案将指导未来关于护理路径发展的研究，该路径将是跨学科的 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 他们需要通过任何程度的药敏试验来最好地满足患者的需求。