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: 10409682
• 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/10409682
• 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; Persons; 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; noise exposure; 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.

听力过敏症和噪声敏感性是声音耐受性降低(DST)障碍的类型，而且经常 分别报道了耳鸣患者和颅脑损伤患者。当在患者身上发现任何程度的DST时，它是 最重要的是解决容忍声音的问题，因为它对日常生活的方方面面都有负面影响 功能正常；严重的DST表现为日常声音被认为太响亮、压倒性和 真烦人。由于对DST的研究很少，有关基本方面的知识有限 它的病理生理学以及如何最好地治疗它。这个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 重症DST的病因学。 当退伍军人在诊所被发现有声音不耐受(即严重的DST)时，医疗保健 医疗服务提供者不确定如何帮助他们的患者。目前还没有客观的测试来诊断DST和 常用的响度感知行为评估会导致DST症状和 精神上的痛苦。此外，标准测试电池不提供任何有关 问题的根本性质。这项建议是我们实现以下长期目标的第一步 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 这不会造成不必要的痛苦或加剧DST症状。范畴响度标度(CLS) 是一种用于量化音量判断的自动化程序。这项建议的一部分将是完善CLS 程序，以满足这一需要。 这项研究的设计是测试概念模型的多个阶段，使用生理测量 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，这项研究将提供有关感觉和/或哪里存在缺陷的临床相关信息 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DST的潜在机制开发治疗方法。这项研究是 采取必要步骤，为指导临床决策提供循证方法 患有严重DST的退伍军人。 拟议工作的结果具有理论和临床影响。这篇文章中概述的实验 提案将阐明导致严重DST的潜在病理生理机制，并导致有效和有效的 量化指标可能成为评估这种健康状况的标准化测试组合的一部分。 此外，通过确定风险因素，包括精神健康对DST程度的影响， 这项建议将指导未来对护理路径的发展的研究，这条路径将是一条跨学科的 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具有任何程度DST的患者的需求。