Characterizing the Effects of Chronic Substance Misuse on Auditory and Vestibular Function

描述慢性药物滥用对听觉和前庭功能的影响

• 批准号: 10744343
• 负责人: Amanda Chiao
• 金额: $ 58.94万
• 依托单位: TEXAS TECH UNIVERSITY HEALTH SCIENCES CENTER AT EL PASO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-03 至 2028-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10744343
• 关键词: Accidents; Adult; Affect; Afferent Pathways; Age; Alcohols; Anxiety; Audiology; Auditory; Auditory Brainstem Responses; Automobile Driving; Awareness; Biological; Biometry; Caring; Case Study; Chronic; Cochlea; Cochlear Hearing Loss; Communication; Communication Barriers; Complication; Control Groups; Data; Development; Diagnosis; Diagnostic; Early identification; Employment; Epidemiology; Equilibrium; Equity; Ethnic Origin; Frequencies; Functional disorder; Future; Goals; Hair Cells; Head; Health; Healthcare; Hearing; Hearing Tests; Illicit Drugs; Incidence; Intervention; Ischemia; Knowledge; Labyrinth; Literature; Measures; Medicine; Mental Health; Minority; Minority Groups; Modeling; Noise; Not Hispanic or Latino; Opioid; Otolaryngology; Outcome; Overdose; Participant; Patients; Pattern; Peripheral; Personal Satisfaction; Persons; Pharmaceutical Preparations; Physiological; Physiology; Population; Positioning Attribute; Prevalence; Probability; Quality of life; Questionnaires; Race; Recommendation; Recovery; Rehabilitation therapy; Reporting; Research; Research Design; Residual state; Risk; Risk Factors; Secondary to; Severities; Sex Differences; Site; Societies; Socioeconomic Status; Speech Perception; Substance Use Disorder; System; Testing; Time; Trauma; Unemployment; Vascularization; Vestibular Hair Cells; Vestibular loss; Visual Acuity; Work; addiction; alcohol misuse; behavior measurement; biological sex; childhood hearing loss; cohort; comorbidity; coronavirus pandemic; demographics; equilibration disorder; fall risk; health disparity; hearing impairment; hearing loss risk; hearing range; human old age (65+); improved; low socioeconomic status; marginalization; minority communities; minority health disparity; novel; oculomotor; opioid misuse; otoacoustic emission; ototoxicity; permanent hearing loss; physical conditioning; prescription opioid; recruit; risk prediction; sex; social; social factors; socioeconomics; speech in noise; substance misuse; substance use; vestibular pathway

Accumulating reports indicate that substance use disorders (SUDs) and overdoses result in hearing loss (HL) and vestibular loss (VL). This is problematic because hearing and balance are important for communication, employment, mental health, physical independence, and overall quality of life. HL and VL would have a greater negative impact on people with SUDs, as this population already struggles with a higher incidence of mental health issues, unemployment, and poorer quality of life. People of minority status with HL/VL are further marginalized because of socioeconomic and/or cultural barriers to audiological healthcare. Unfortunately, the literature on substance-misuse-related HL is sporadic and primarily consists of case reports describing various degrees of either temporary or permanent HL from illicit drugs or prescribed opioid misuse. Even less is known about the effects of SUDs on the vestibular system. A few studies indicate alcohol misuse impairs balance, and opioids and alcohol disrupt peripheral and central vestibular function. The existing studies suggest differential effects on the inner ear based on substance type and use patterns. There is a critical lack of rigorous research using objective measures to identify the peripheral and central effects of SUDs on hearing and vestibular function. Likewise, the influence of health comorbidity, demographics, socioeconomic position, and substance-use patterns on HL/VL in the SUD population has not been investigated. Our project goals are to improve our knowledge of the impact of SUDs on hearing and vestibular function and to identify who is most at risk for HL/VL. To accomplish these goals, we will be the first to investigate peripheral and central hearing (Aim 1) and vestibular (Aim 2) function in a large cohort of diverse people who have SUDs, recruited across three regionally unique study sites. Data will be compared to an age-sex-race or ethnicity-matched control group without SUDs. Last, we will determine the predictive health, demographic, socioeconomic, and substance-use factors that increase the risk of developing HL/VL secondary to substance misuse (Aim 3). We hypothesize that chronic substance misuse will affect the auditory and/or vestibular systems like mechanisms underlying oto- vestibulotoxic medications. Based on the literature, we hypothesize that more health comorbidities, older age, being of non-Hispanic White background, lower socioeconomic position, and riskier substance-use patterns will predict the severity of HL or VL. Biological sex differences are unclear in the existing HL/VL literature; however, our results will help elucidate sex differences in HL/VL and SUDs. SUDs and overdoses have significantly increased since the coronavirus pandemic and disproportionately so among minority populations. Thus, this work is timely and important because early HL/VL intervention is key to minimizing health and social burdens, but care is impeded in SUD and minority populations. Our findings will enhance awareness among professionals who serve people with SUDs so they can make appropriate diagnoses and recommendations. The results will inform our future work to develop accessible, equitable interventions for people with SUDs and health disparities.

越来越多的报告表明，物质使用障碍（SUD）和药物过量会导致听力损失（HL）和前庭损失（VL）。这是有问题的，因为听力和平衡对于沟通、就业、心理健康、身体独立和整体生活质量很重要。 HL 和 VL 将对 SUD 患者产生更大的负面影响，因为该人群已经在与较高的心理健康问题发生率、失业和较差的生活质量作斗争。由于听力保健方面的社会经济和/或文化障碍，患有 HL/VL 的少数民族群体进一步被边缘化。不幸的是，有关药物滥用相关 HL 的文献很少，主要由描述非法药物或处方阿片类药物滥用造成的不同程度的暂时性或永久性 HL 的病例报告组成。关于 SUD 对前庭系统的影响知之甚少。一些研究表明，滥用酒精会损害平衡，阿片类药物和酒精会破坏外周和中枢前庭功能。现有研究表明，根据物质类型和使用模式，对内耳的影响存在差异。目前严重缺乏使用客观措施来确定 SUD 对听力和前庭功能的外周和中枢影响的严格研究。同样，健康合并症、人口统计、社会经济地位和物质使用模式对 SUD 人群中 HL/VL 的影响尚未得到调查。我们的项目目标是提高我们对 SUD 对听力和前庭功能影响的了解，并确定谁最有可能患 HL/VL。为了实现这些目标，我们将首先对一大群患有 SUD 的不同人群进行外周和中枢听力（目标 1）以及前庭（目标 2）功能的研究，这些人群是在三个区域独特的研究中心招募的。数据将与没有 SUD 的年龄、性别、种族或种族匹配的对照组进行比较。最后，我们将确定预测健康、人口、社会经济和药物使用因素，这些因素会增加继发药物滥用而发生 HL/VL 的风险（目标 3）。我们假设长期滥用药物会影响听觉和/或前庭系统，例如耳前庭毒性药物的潜在机制。根据文献，我们假设更多的健康合并症、年龄较大、非西班牙裔白人背景、较低的社会经济地位和较高风险的物质使用模式将预测 HL 或 VL 的严重程度。现有的 HL/VL 文献中尚不清楚生物性别差异；然而，我们的结果将有助于阐明 HL/VL 和 SUD 的性别差异。自冠状病毒大流行以来，SUD 和药物过量显着增加，并且在少数族裔中尤其如此。因此，这项工作是及时且重要的，因为早期 HL/VL 干预是最小化健康和社会负担的关键，但在 SUD 和少数民族人群中护理受到阻碍。我们的研究结果将提高为 SUD 患者提供服务的专业人员的认识，以便他们能够做出适当的诊断和建议。研究结果将为我们未来的工作提供参考，为患有 SUD 和健康差异的人们制定易于获得、公平的干预措施。