National Center for Rehabilitative Auditory Research

国家听力康复研究中心

• 批准号: 10043832
• 负责人: Martin Patrick Feeney
• 金额: --
• 依托单位: PORTLAND VA MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-10-01 至 2022-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10043832
• 关键词: Acoustics; Adult; Aging; Area; Audiology; Auditory; Auditory Evoked Potentials; Auditory system; Behavioral; Caring; Clinical Assessment Tool; Clinical assessments; Cognitive Therapy; Collaborations; Communities; Conflict (Psychology); Cues; Detection; Development; Devices; Diabetes Mellitus; Diagnosis; Disease; Education and Outreach; Equilibrium; Evaluation; Fall prevention; Financial compensation; Frequencies; Functional disorder; Funding; Gait; Goals; Health; Health Services Research; Health behavior; Healthcare; Healthcare Systems; Hearing; Hearing Aids; Hyperacusis; Infrastructure; Legal patent; Long-Term Effects; Longitudinal Studies; Methods; Military Personnel; Modeling; Monitor; Multi-Institutional Clinical Trial; Musculoskeletal Equilibrium; Noise; Noise-Induced Hearing Loss; Outcome; Peer Review; Physiological; Post-Traumatic Stress Disorders; Prevention; Primary Prevention; Rehabilitation Centers; Rehabilitation therapy; Research; Research Personnel; Research Training; Risk; Sensorineural Hearing Loss; Sensory; Sensory Aids; Series; Services; Speech Perception; Standardization; Strategic Planning; Students; System; TBI Patients; Technology; Tinnitus; Training; Translational Research; Traumatic Brain Injury; United States National Institutes of Health; Veterans; age effect; auditory feedback; auditory rehabilitation; balance prosthesis; base; clinical implementation; disability; epidemiology study; equilibration disorder; externship; falls; hearing impairment; hearing screening; hidden hearing loss; improved; motivational enhancement therapy; motor deficit; neuroimaging; ototoxicity; outreach program; portability; prediction algorithm; prevent; programs; repetitive transcranial magnetic stimulation; research and development; research clinical testing; symposium; targeted treatment; uptake

The Center model employed by the National Center for Rehabilitative Auditory Research (NCRAR) uses core funding to provide infrastructure that supports core investigators, who then leverage this support to garner external peer-reviewed funding, and to support education/outreach activities. Research is planned in the areas of Diagnosis and Assessment, Rehabilitation, and Prevention of auditory and balance dysfunction in Veterans. Education/outreach programs will include biennial conferences, a monthly seminar series, NIH-funded T-35 audiology student research training, and year-long externships for 4th year Au.D. students in collaboration with the VA Portland Health Care System (VAPORHCS) Audiology Service. Technology-wise, further development is planned for NCRAR's OtoID, a patent-pending high-frequency portable audiometer, and for an upgrade to a recently patented Tinnitus Evaluation System, which will be used in a study to standardize tinnitus evaluation. Some examples of studies planned in each of our key research areas are: Diagnosis and Assessment 1) standardization of assessment for tinnitus and hyperacusis; 2) continued development of wideband auditory assessment tools for the clinical evaluation of hearing in Veterans; 3) clinical assessment of central auditory deficits resulting from blast exposure, traumatic brain injury (TBI), and their interaction with post-traumatic stress disorder; 4) new physiologic and behavioral methods to identify “hidden hearing loss” resulting from excessive noise exposure; 5) effects of aging and TBI on dynamic gait control and balance dysfunction; 6) a longitudinal study of auditory dysfunction in Veterans with diabetes to understand the long-term effects of diabetes on the auditory system; and 7) use of behavioral methods to assess the effects of imprecise temporal processing and reduced frequency selectivity associated with sensorineural hearing loss, and the use of auditory evoked potentials to explore the effects of aging and hearing loss on speech perception in noise. Rehabilitation 1) refinement of Progressive Tinnitus Management (PTM) as an interdisciplinary, stepped- care program that combines acoustic therapy and Cognitive-Behavioral Therapy. In collaboration with Health Services Research and Development (HSR&D) and researchers at the VAPORHCS, PTM will be readied for implementation throughout VA; 2) a multi-center clinical trial of repetitive transcranial magnetic stimulation (rTMS) for the relief of tinnitus, along with efforts to identify best methods for magnet placement; 3) continued research on hearing-aid orientation and use of motivational interviewing to improve hearing aid outcome; 4) studies on hearing health behaviors to increase hearing health care uptake and successful rehabilitation; 5) balance rehabilitation using auditory feedback, and targeted therapy for balance disorders based on identified sensory and/or motor deficits in patients with TBI; and 6) use of neuroimaging methods to determine the impact of training on the use of assistive ambulatory devices in Veterans with MS. Prevention 1) continuation of an epidemiology study on noise induced hearing loss and tinnitus in recently discharged Veterans with the goal of developing algorithms for predicting risk of tinnitus and hearing loss with the goal of preventing the development of tinnitus and hearing loss during military service; 2) clinical implementation of NCRAR's comprehensive VA ototoxicity monitoring program in collaboration with HSR&D researchers at VAPORHCS; 3) continued focus on community-based adult hearing screening will be explored using the results of ongoing studies and the principles of Health-Behaviors research; 4) falls prevention using ambulatory device training and automated falls detection in Veterans with MS; and 5) effect of cued step timing on dynamic balance to serve as the basis for a balance prosthesis. KEYWORDS: hearing loss, tinnitus, postural balance, diagnosis, rehabilitation, primary prevention, sensory aids, translational research

国家康复研究中心（NCRAR）使用的中心模型使用 提供支持核心调查人员的基础设施的核心资金，然后他们利用这一支持给Garner 外部同行评审资金，并支持教育/外展活动。计划在该地区进行研究 退伍军人的诊断和评估，康复以及预防听觉和平衡功能障碍。 教育/外展计划将包括双年展会议，每月开创性系列，NIH资助的T-35 听力学学生研究培训和为期一年的实习生授课第四年。与学生合作 VA波特兰医疗保健系统（Vaporhcs）听力学服务。技术方面，进一步发展 计划用于Ncrar的Otoid，一种申请专利的高频便携式听力计，并升级到 最近获得专利的耳鸣评估系统，该系统将在研究中用于标准化耳鸣评估。 我们每个关键研究领域计划的研究示例是： 诊断和评估1）耳鸣和超源的评估标准化； 2）继续 开发宽带听觉评估工具，用于对退伍军人的听力进行临床评估； 3） 爆炸暴露，脑外伤（TBI）和 它们与创伤后应激障碍的相互作用； 4）识别的新生理和行为方法 由于噪音过多而导致的“隐藏听力损失”； 5）衰老和TBI对动态步态的影响 控制和平衡功能障碍； 6）糖尿病退伍军人的听觉功能障碍的纵向研究 了解糖尿病对听觉系统的长期影响； 7）使用行为方法 评估浸渍临时处理的影响和与之相关的频率选择性降低 感官听力损失以及听觉的使用引起的潜力探索衰老和 噪音中语音感知的听力损失。 康复1）渐进性耳鸣管理（PTM）作为跨学科，阶梯 结合声学疗法和认知行为疗法的护理计划。与健康合作 服务研究与开发（HSR＆D）和Vaporhcs的研究人员将准备PTM 整个VA的实施； 2）重复经颅磁刺激的多中心临床试验 （RTMS）用于缓解耳鸣，并努力确定磁铁放置的最佳方法； 3）继续 助听器方向的研究和使用动机访谈以改善助听器结果； 4） 关于听力健康行为的研究，以增加听力保健的吸收和成功的康复； 5） 使用听觉反馈来平衡康复，并根据已确定的平衡障碍进行针对性的治疗 TBI患者的感觉和/或运动定义； 6）使用神经成像方法来确定 培训对使用MS的退伍军人使用辅助门诊设备的影响。 预防1）延续了一项关于噪声诱导听力损失和耳鸣的流行病学研究 退伍军人的目的是开发算法，以预测耳鸣的风险和听力损失 防止耳鸣和兵役期间听力损失的目的； 2）临床 与HSR＆D合作实施NCRAR的综合VA耳毒性监测计划 Vaporhcs的研究人员； 3）将继续探讨基于社区的成人听力筛查 利用正在进行的研究结果和健康行为研究的原则； 4）预防瀑布 具有MS的退伍军人的卧床设备训练和自动瀑布检测； 5）提示步骤时机的效果 在动态平衡上，作为平衡假体的基础。 关键词：听力损失，耳鸣，姿势平衡，诊断，康复，初级预防，感官 艾滋病，翻译研究