Blast-exposed Veterans with Auditory Complaints

描述(由申请人提供)： VA匹兹堡医疗系统(VAPHS)的临床听力专家观察到，出现自我报告听力问题的退伍军人数量大幅增加，但在使用标准测听测试电池进行测试时，他们的听力灵敏度正常或接近正常。这些退伍军人的主要抱怨是在背景噪音中听不到语言，初步临床数据表明，在中央听觉处理的一些测试中表现不佳。此外，当安装了温和增益的开放式助听器时，这些患者报告说，他们的听力相关问题有所减少。几乎所有这些退伍军人都报告了爆炸暴露和脑震荡的病史，而伊拉克自由行动/持久自由行动(OIF/OEF)部署了，并描述了与脑震荡后综合征相一致的症状。其他退伍军人医疗中心和军事设施的临床听觉学家也报告了患有mTBI的退伍军人的类似听觉模式，尽管这组退伍军人的听觉问题尚未得到很好的描述或研究(Fausti等人，2009；Lew等人，2007)。这项研究是针对这些退伍军人提出的临床投诉而进行的，目的是通过广泛评估他们的听觉和听觉相关特征，更好地了解他们的问题。一组有爆炸暴露史、符合mTBI病史、听力测试结果正常的退伍军人，但显著的听力抱怨将通过标准听力测试组件、健康状况和生活质量问卷、听觉生理测试程序和行为中枢听觉处理测试进行评估。我们还将进行言语知觉和心理声学任务，以及言语工作记忆和语言加工测试，以更好地了解他们通过听力听、记和处理言语和语言的能力的各个方面。还将进行一项与听觉语言处理任务平行的阅读测试，以确定是否有任何已发现的语言处理问题仅限于听觉系统。将与一组听力和脑损伤阴性的退伍军人以及一组患有创伤后应激障碍(PTSD)但没有爆炸暴露或脑损伤史的退伍军人进行比较。此外，并存的创伤后应激障碍的影响 将会被检查。其次，将测试为这群退伍军人配备温和增益助听器的好处，这些助听器可以放大语音频谱的高频部分。从这项研究中获得的信息将是阐明这些退伍军人问题的第一步，并将为未来侧重于具体缺陷机制的研究奠定基础。这项研究还应有助于为这一人群制定一套有效的评估和干预措施。

DESCRIPTION (provided by applicant): Clinical audiologists at the VA Pittsburgh Healthcare System (VAPHS) have observed a substantive increase in the number of Veteran's presenting with self-reported hearing problems but who demonstrate normal or near normal hearing sensitivity when tested with a standard audiometric test battery. The primary complaint of these Veterans is difficulty hearing speech in background noise, and preliminary clinical data have suggested poor performance on some tests of central auditory processing. Moreover, when fitted with mild- gain open-fit hearing aids, which amplify the high-frequency part of the speech spectrum, these patients have reported a reduction in their hearing-related problems. Nearly all of these Veterans have reported histories of blast exposure and concussion while Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) deployed and described symptoms consistent with post-concussive syndrome. Similar auditory patterns for Veterans with mTBI have been reported by clinical audiologists from other VA medical centers and military facilities although the auditory problems of this group of Veterans have not been well described or studied (Fausti et al., 2009; Lew et al., 2007). This study was developed in response to the clinical complaints offered by these Veterans, with the goal being to better understand their problems by extensively assessing their auditory and auditory-related characteristics. A group of Veterans with histories of blast exposure, histories consistent with mTBI, and normal audiometric results, but notable auditory complaints will be evaluated with a standard audiometric test battery, health status and quality of life questionnaires, auditory physiological test procedures, and behavioral central auditory processing tests. We also will administer speech perception and psychoacoustic tasks, and verbal working memory and language processing tests to better understand various aspects of their ability to hear, remember, and process speech and language through audition. A reading test that parallels an auditory language-processing task also will be administered to determine if any identified language processing problems are limited to the auditory system. Comparisons will be made to a control group of Veterans who are negative for auditory and brain impairments, as well as to a group of Veterans with Post Traumatic Stress Disorder (PTSD) but without histories of blast exposure or brain injury. In addition, the influences of coexisting PTSD will be examined. Secondarily, the benefit of fitting this population of Veterans with mild-gain hearing aids that amplify the high-frequency part of the speech spectrum will be tested. The information obtained from this study will be a first step in elucidating the problems of these Veterans and will lay the groundwork for future studies that will focus on specific deficit mechanisms. This study also should contribute to the development of an effective assessment battery and interventions for this population.