An Evaluation of Neurobiological Similarities of Tinnitus and PTSD

项目摘要 耳鸣和创伤后应激障碍（PTSD）是两种最常见的与服务有关的残疾 为现役军人和退伍军人。耳鸣和创伤后应激障碍是高度共病，但不同的疾病。 耳鸣是一种听觉障碍，患者会体验到一种虚幻的听觉感受，通常表现为铃声、嗡嗡声， 或嗖嗖声，尽管没有外部客观噪声源。另一方面，创伤后应激障碍是一种与创伤有关的 障碍，并通过创伤事件的侵入，避免提醒， 认知和情绪，以及过度警觉或过度觉醒。耳鸣和创伤后应激障碍之间的相似之处一直是 柬埔寨难民和美国退伍军人样本中的记录。此外，最新 最近的一项临床试验的神经影像学数据表明，神经-警惕网络是最重要的， 与战斗对照组和平民相比， 对照由于耳鸣相关的痛苦和创伤后应激障碍之间的相似症状，以及类似的失调， 休息状态的大脑网络，更充分地了解这两种不同的疾病是如何发生的仍然很重要。 可能是相关的。这项研究将是第一个前瞻性地研究公开的情绪，行为， 与耳鸣相关的痛苦和PTSD相关的认知症状，以及重叠的功能连接 耳鸣和创伤后应激障碍之间的联系我们将通过以下方法来研究重叠的症状和神经生物学机制： 进行听力和心理评估以及静息态功能磁共振 在120名参与者（30名耳鸣和PTSD，30名仅PTSD，30名仅耳鸣， 30例健康对照）。参与者将从Frank Tejeda PTSD诊所和听力学中心招募 南德克萨斯州弗吉尼亚州医疗保健系统内的诊所和拉克兰空气听力卓越中心 部队基地。将进行典型相关性来检查耳鸣和耳鸣之间的症状重叠 PTSD（目标1）。我们的目标是神经生物学特征耳鸣和创伤后应激障碍，无论是单独和联合， 进行fMRI（目标2）。我们还旨在将建模应用于心理测量和神经功能数据，以识别 与耳鸣和创伤后应激障碍相关的痛苦相关的神经-警惕网络的特定区域。 了解与糖尿病相关的共同认知、情绪和行为症状以及神经生物学 耳鸣和创伤后应激障碍将有助于临床医生和研究人员充分了解耳鸣和创伤后应激障碍独立， 结合。结果将导致耳鸣和创伤后应激障碍的神经生物学标志物的识别， 不同的表型的个人与这两个条件，和发展的行为和神经- 可以减轻痛苦和损伤的调节疗法。

Project Summary Tinnitus and posttraumatic stress disorder (PTSD) are two of the most common service-connected disabilities for active-duty Service Members and Veterans. Tinnitus and PTSD are highly co-morbid, yet distinct disorders. Tinnitus is an auditory disorder in which an illusory auditory percept is experienced, usually as ringing, buzzing, or whooshing sounds, despite no external objective noise source. On the other hand, PTSD is a trauma-related disorder, and is identified by intrusions of the traumatic event, avoidance of reminders, negative alterations in cognition and mood, and hypervigilance or hyperarousal. Similarities between tinnitus and PTSD have been documented among Cambodian refugees, as well as among U.S. Veteran samples. Moreover, the latest neuroimaging data from a recent clinical trial indicated that the auditory-vigilance network was the most dysregulated among active-duty service members with PTSD, compared to combat controls and civilian controls. Due to similar symptoms between tinnitus-related distress and PTSD, and similar dysregulated resting-state brain networks, it remains important to more fully understand how these two distinct disorders may be related. This study will be the first to prospectively examine the overt emotional, behavioral, and cognitive symptoms related to tinnitus-related distress and PTSD, and the overlapping functional connectivity between tinnitus and PTSD. We will examine the overlapping symptoms and neurobiological mechanisms by conducting audiometric and psychological assessments and resting-state functional magnetic resonance imaging (fMRI) among 120 participants (30 with tinnitus and PTSD, 30 with only PTSD, 30 with only tinnitus, and 30 healthy controls). Participants will be recruited from the Frank Tejeda PTSD Clinic and the Audiology Clinic within the South Texas VA Health Care System, and the Hearing Center of Excellence at Lackland Air Force Base. Canonical correlations will be conducted to examine the symptom overlap between tinnitus and PTSD (Aim 1). We aim to neurobiologically characterize tinnitus and PTSD, both separately and conjointly, by conducting fMRI (Aim 2). We also aim to apply modeling to psychometric and neurofunctional data to identify specific regions of the auditory-vigilance network associated with distress related to tinnitus and PTSD. Understanding the shared cognitive, emotional, and behavioral symptoms and neurobiology associated with tinnitus and PTSD will help clinicians and researchers fully understand tinnitus and PTSD independently and conjointly. Results will lead to the identification of neurobiological markers for tinnitus and PTSD, identification of a different phenotype for individuals with both conditions, and development of behavioral and neuro- modulatory therapies that can reduce distress and impairment.