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.

听觉亢进和噪声敏感是声音容忍度下降（DST）障碍的两种类型，并且经常发生