National Center for Rehabilitative Auditory Research

国家听力康复研究中心

• 批准号: 10268979
• 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/10268979
• 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; Hearing problem; Hyperacusis; Infrastructure; Legal patent; Long-Term Effects; Longitudinal Studies; Methods; 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; blast exposure; clinical implementation; disability; epidemiology study; equilibration disorder; externship; falls; hearing impairment; hearing screening; hidden hearing loss; improved; military service; motivational enhancement therapy; motor deficit; neuroimaging; noise exposure; 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

国家康复听觉研究中心 (NCRAR) 采用的中心模型使用 核心资金提供支持核心调查人员的基础设施，然后核心调查人员利用这种支持来获得 外部同行评审资金，并支持这些领域的教育/推广活动。 退伍军人听觉和平衡功能障碍的诊断和评估、康复和预防。 教育/推广计划将包括两年一次的会议、每月一次的研讨会系列、NIH 资助的 T-35 与四年级 Au.D 学生合作进行听力学学生研究培训和为期一年的实习 VA 波特兰医疗保健系统 (VAPORHCS) 听力学服务在技术方面得到进一步发展。 计划用于 NCRAR 的 OtoID（一种正在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，将用于标准化耳鸣评估的研究。 我们每个关键研究领域计划的研究的一些例子是： 诊断和评估 1) 耳鸣和听力过敏的评估标准化 2) 继续； 开发用于退伍军人听力临床评估的宽带听觉评估工具 3) 对爆炸暴露、创伤性脑损伤 (TBI) 和导致的中枢听觉缺陷的临床评估 他们与创伤后应激障碍的相互作用；4）新的生理和行为方法来识别 过度噪音暴露导致的“隐性听力损失”；5）衰老和创伤性脑损伤对动态步态的影响； 控制和平衡功能障碍；6) 患有糖尿病的退伍军人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 评估不精确的时间处理和与相关的频率选择性降低的影响 感音神经性听力损失，以及利用听觉诱发电位来探索衰老和听力损失的影响 噪音中言语感知的听力损失。 康复 1) 将渐进式耳鸣管理 (PTM) 细化为跨学科的、逐步的- 与 Health 合作，结合声学疗法和认知行为疗法的护理计划。 VAPORHCS、PTM 的服务研究与开发 (HSR&D) 和研究人员将做好准备 2) 整个 VA 的重复经颅磁刺激的多中心临床试验； 2) 重复经颅磁刺激的多中心临床试验； (rTMS) 缓解耳鸣，并努力确定放置磁铁的最佳方法 3) 继续； 关于助听器定位和使用动机访谈来改善助听器结果的研究；4) 关于听力健康行为的研究，以提高听力保健的接受度和成功康复 5) 使用听觉反馈进行平衡康复，并根据已确定的平衡障碍进行针对性治疗 TBI 患者的感觉和/或运动缺陷；以及 6) 使用神经影像学方法来确定 培训对患有多发性硬化症的退伍军人使用辅助行走设备的影响。 预防 1）近期继续进行噪声性听力损失和耳鸣的流行病学研究 退役退伍军人的目标是开发算法来预测耳鸣和听力损失的风险 预防服兵役期间出现耳鸣和听力损失的目标 2) 临床； 与 HSR&D 合作实施 NCRAR 综合 VA 耳毒性监测计划 VAPORHCS 的研究人员 3) 将继续探索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) 预防跌倒； 患有多发性硬化症的退伍军人的动态设备训练和自动跌倒检测以及 5) 提示步数计时的效果； 动态平衡作为平衡假肢的基础。 关键词: 听力损失, 耳鸣, 姿势平衡, 诊断, 康复, 一级预防, 感觉 艾滋病、转化研究