Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury

Henry, James A.; Zaugg, Tara L.; Myers, Paula J.; Schmidt, Candice; Griest, Susan; Legro, Marcia W.; Kaelin, Christine; Thielman, Emily J.; Storzbach, Daniel; McMillan, Garnett P.; Carlson, Kathleen F.

doi:10.1682/jrrd.2010.07.0125

Cited by 28 publications

(28 citation statements)

References 51 publications

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“…In examining the severity of the symptoms captured using PROMs, over half of the mTBI participants who reported hearing loss had an HHIA sore classified as significant, emphasizing the impact hearing loss as a symptom in particular has on these patients’ emotional and physical health. Almost two‐thirds of the mTBI participants reported tinnitus, which was a significantly higher proportion than in the control group, who had a tinnitus prevalence of 16.4%, consistent with previous published rates found of the general population . Whereas all control participants scored within the slight to mild range on the THI, over one‐third of the mTBI group had a moderate to catastrophic classification, highlighting the increased level of disability in these patients.…”

Section: Discussionsupporting

confidence: 88%

“…Almost two-thirds of the mTBI participants reported tinnitus, which was a significantly higher proportion than in the control group, who had a tinnitus prevalence of 16.4%, consistent with previous published rates found of the general population. 40 Whereas all control participants scored within the slight to mild range on the THI, over one-third of the mTBI group had a moderate to catastrophic classification, highlighting the increased level of disability in these patients. Lastly, almost half of mTBI participants who complained of hyperacusis had clinically significant symptoms as determined by the HQ.…”

Section: Fig 4 (A) Percentage Of Mtbi Versus Controls Patients Withmentioning

confidence: 91%

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Patient‐reported auditory handicap measures following mild traumatic brain injury

et al. 2019

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Objectives/Hypothesis Few studies have specifically addressed auditory complaints in patients with nonblast mild traumatic brain injury (mTBI). Herein, we aimed to investigate auditory symptoms in patients following mTBI using patient‐reported outcome measures. Study Design Retrospective analysis of prospectively collected data in a tertiary‐care hospital. Methods The patients included those with mTBI (cases) and those without mTBI (controls). Individuals (≥18 years old) with and without mTBI were screened. Exclusion criteria included history of otologic disorders, blast injury, or occupational noise exposure. Primary outcomes included the Hearing Handicap Inventory for Adults (HHIA), Tinnitus Handicap Inventory (THI), and Hyperacusis Questionnaire (HQ). Secondary outcomes included subjective auditory complaints. Results From September 2017 to September 2018, 52 patients with mTBI and 55 controls met inclusion and exclusion criteria. The mean time between mTBI and survey intake was 70.6 months. The mean age and gender were 51.5 years old and 73% female in the mTBI group, and 46.1 years old and 56.3% female in the control group (P = .112 and P = .105, respectively). Patients with mTBI reported hyperacusis (67.3% of all mTBI patients), hearing loss (61.5%), and tinnitus (61.5%), compared to 8.3%, 12.7%, and 16.4%, respectively, for control subjects (P < .0001). The mean HHIA score in the mTBI group was 38.3 versus 8.5 in controls (P = .002). The mean THI score was 27.4 in the mTBI group and 3.1 in controls (P < .0001). The mean HQ score was 26.5 in mTBI group and 7.3 in controls (P = .001). Conclusions Auditory symptoms and associated handicap were common in patients with nonblast mTBI compared to age‐matched controls. Findings have implications for the pathophysiology and management of symptoms in this patient population. Level of Evidence 3 Laryngoscope, 130:761–767, 2020

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Section: Discussionsupporting

confidence: 88%

Section: Fig 4 (A) Percentage Of Mtbi Versus Controls Patients Withmentioning

confidence: 91%

Patient‐reported auditory handicap measures following mild traumatic brain injury

et al. 2019

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“…Meikle and Griest (1989) suggested that “men exposed to long-duration occupational noise tend to report tinnitus that is in ‘both ears,’ while tinnitus that is due to illness or other non-noise-related causes tends to be localized in the head.” (p. 74) Vernon (1978) may have been the first to posit that tinnitus located within the head may be due to head injury. In a recent study (Henry et al, 2012), almost half of the participants with moderate to severe traumatic brain injury reported that their tinnitus was perceived “inside the head,” whereas only 8% of the participants without traumatic brain injury reported this same perception. If these findings of differential tinnitus location are repeated in further trials, then this could have implications regarding underlying mechanisms of tinnitus generation.…”

Section: Discussionmentioning

confidence: 97%

Individual Patient Factors Associated with Effective Tinnitus Treatment

et al. 2014

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Background Little is known about patient factors that might influence outcomes of tinnitus interventions. Determining such factors would offer insights into why some individuals benefit from tinnitus intervention whereas others do not. Purpose The purpose of this study was to evaluate selected patient factors that may be associated with outcomes of tinnitus intervention. Factors studied include demographics, tinnitus characteristics, psychoacoustic tinnitus measures, audiometric data, and overall physical/emotional health status. Research Design A retrospective analysis was performed on data obtained from a controlled clinical study that compared factors associated with tinnitus relief after tinnitus masking and tinnitus retraining therapy. Study Sample A total of 126 military veterans participated in this controlled clinical study. Of these, 89 completed outcome measures at both baseline and 12 mo and were included in the present analysis. Data Collection and Analysis A “responder” to intervention was identified as having a decrease (improvement) of 20 or more points on the Tinnitus Handicap Inventory between baseline and 12 mo. A “nonresponder” did not achieve a 20-point improvement on the Tinnitus Handicap Inventory. Individual patient factors were examined using independent t-tests or χ2 analysis. A logistic regression model was used to determine how well each factor predicted treatment outcome (responder or nonresponder) while controlling for each of the other factors. Results Five patient factors were significantly different (p ≤ 0.05) between responders and nonresponders. Responders tended to (1) be younger in age; (2) have better low-frequency hearing sensitivity; (3) have greater problems with overall hearing; (4) be more likely to have tinnitus for shorter durations; and (5) perceive their tinnitus to be located “in the head” versus “in the ears.” A logistic regression was then performed to determine how well each factor predicted the treatment outcome (responder versus nonresponder) while controlling for each of the other factors. Results from the logistic regression revealed two of the five factors, localization of tinnitus and self-report of hearing problems, to be statistically significant. Conclusions Examining the association of individual patient factors to a specific tinnitus intervention yielded several significant findings. Although these findings are not definitive, they reveal the capability that exists to perform these kinds of analyses to investigate relationships between individual patient characteristics and outcomes of intervention for tinnitus. Prospective research using systematic approaches is needed to identify these relationships that would contribute toward the ability to differentially predict outcomes of various tinnitus interventions. Obtaining this information would lead to more targeted therapy and ultimately more effective intervention.

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“…An example of telehealth for rehabilitation is tinnitus management for Veterans and military personnel with TBI [117]. Another example is the emerging use of remote monitoring devices to assess visual structure and function [118].…”

Section: New Technological Approaches Affecting Rehabilitationmentioning

confidence: 99%