Neurobiological Similarities of Tinnitus and PTSD
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ClinicalTrials.gov Identifier: NCT05981391 |
Recruitment Status :
Recruiting
First Posted : August 8, 2023
Last Update Posted : May 8, 2024
|
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Condition or disease | Intervention/treatment |
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Posttraumatic Stress Disorder Tinnitus | Diagnostic Test: resting-state functional MRI Diagnostic Test: Clinician Administered PTSD Scale for the DSM-5 (CAPS-5) Diagnostic Test: Tympanometry Diagnostic Test: Tinnitus Assessment Diagnostic Test: Otoscopy Diagnostic Test: Pure tone air and bone-conduction Diagnostic Test: Speech testing Diagnostic Test: Loudness Discomfort Diagnostic Test: Quick Speech in Noise Test Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE) |
Study Type : | Observational |
Estimated Enrollment : | 120 participants |
Observational Model: | Case-Control |
Time Perspective: | Cross-Sectional |
Official Title: | An Evaluation of Neurobiological Similarities of Tinnitus and Posttraumatic Stress Disorder |
Actual Study Start Date : | February 4, 2021 |
Estimated Primary Completion Date : | January 31, 2025 |
Estimated Study Completion Date : | January 31, 2025 |
Group/Cohort | Intervention/treatment |
---|---|
Tinnitus and PTSD (T+P)
Active duty service members and/or veterans with PTSD and tinnitus.
|
Diagnostic Test: resting-state functional MRI
We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement. Diagnostic Test: Clinician Administered PTSD Scale for the DSM-5 (CAPS-5) The CAPS-5 is a semi-structured interview, conducted by an independent evaluator, that measures DSM-5 symptoms of PTSD. Presence of at least one intrusion symptom, one avoidance symptom, two cognition and mood symptoms, and two arousal symptoms for 1 month or more are required to reach the diagnostic threshold. Diagnostic Test: Tympanometry Tympanometry will be conducted to assess ear canal volume (cm cubed), maximum pressure (daPa) peak compliance (ml), and type (A, AD, AS, B, B-High, C) for each ear) at 226-Hz admittance. Diagnostic Test: Tinnitus Assessment Tinnitus acoustic assessment (for tinnitus participants only): Tinnitus ear (left, right, bilateral), pitch matched frequency (Hz) and loudness matched intensity (dB) will be conducted. When available, the tinnitus acoustic assessment only will be repeated at the RII, on the same day and prior to the fMRI scan, to demonstrate reproducibility of results. Diagnostic Test: Otoscopy Otoscopy is a clinical procedure used to examine structures of the ear, particularly the external auditory canal, tympanic membrane, and middle ear Diagnostic Test: Pure tone air and bone-conduction Pure tone air- and bone-conduction threshold will be conducted to evaluate audiometry and masking levels in both ears, from 250 Hz. To 16000 Hz. Diagnostic Test: Speech testing Speech testing will be conducted in both ears, which will include speech reception threshold, speech reception threshold masking level, word recognition presentation level, and word recognition masking level. Diagnostic Test: Loudness Discomfort Loudness discomfort levels will be tested in both right and left ears, from 500Hz to 4000Hz and speech reception threshold. Diagnostic Test: Quick Speech in Noise Test Quick Speech in Noise Test (QuickSIN) is a quick method for clinicians to quantify a patient's ability to hear in noise (1 minute). Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE) Distortion-Product Otoacoustic Emissions (DPOAE) is an automated evaluation of cochlear function. A sensitive microphone is placed in the ear canal via a probe assembly with a disposable ear-tip attached to perform and record the measurements. DPOAEs will be elicited at multiple frequencies in both ears (10 min). |
Tinnitus Only (TO)
Active duty service members and/or veterans with only tinnitus/no PTSD.
|
Diagnostic Test: resting-state functional MRI
We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement. Diagnostic Test: Tympanometry Tympanometry will be conducted to assess ear canal volume (cm cubed), maximum pressure (daPa) peak compliance (ml), and type (A, AD, AS, B, B-High, C) for each ear) at 226-Hz admittance. Diagnostic Test: Tinnitus Assessment Tinnitus acoustic assessment (for tinnitus participants only): Tinnitus ear (left, right, bilateral), pitch matched frequency (Hz) and loudness matched intensity (dB) will be conducted. When available, the tinnitus acoustic assessment only will be repeated at the RII, on the same day and prior to the fMRI scan, to demonstrate reproducibility of results. Diagnostic Test: Otoscopy Otoscopy is a clinical procedure used to examine structures of the ear, particularly the external auditory canal, tympanic membrane, and middle ear Diagnostic Test: Pure tone air and bone-conduction Pure tone air- and bone-conduction threshold will be conducted to evaluate audiometry and masking levels in both ears, from 250 Hz. To 16000 Hz. Diagnostic Test: Speech testing Speech testing will be conducted in both ears, which will include speech reception threshold, speech reception threshold masking level, word recognition presentation level, and word recognition masking level. Diagnostic Test: Loudness Discomfort Loudness discomfort levels will be tested in both right and left ears, from 500Hz to 4000Hz and speech reception threshold. Diagnostic Test: Quick Speech in Noise Test Quick Speech in Noise Test (QuickSIN) is a quick method for clinicians to quantify a patient's ability to hear in noise (1 minute). Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE) Distortion-Product Otoacoustic Emissions (DPOAE) is an automated evaluation of cochlear function. A sensitive microphone is placed in the ear canal via a probe assembly with a disposable ear-tip attached to perform and record the measurements. DPOAEs will be elicited at multiple frequencies in both ears (10 min). |
PTSD Only (PO)
Active duty service members and/or veterans with only PTSD/no tinnitus.
|
Diagnostic Test: resting-state functional MRI
We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement. Diagnostic Test: Clinician Administered PTSD Scale for the DSM-5 (CAPS-5) The CAPS-5 is a semi-structured interview, conducted by an independent evaluator, that measures DSM-5 symptoms of PTSD. Presence of at least one intrusion symptom, one avoidance symptom, two cognition and mood symptoms, and two arousal symptoms for 1 month or more are required to reach the diagnostic threshold. Diagnostic Test: Tympanometry Tympanometry will be conducted to assess ear canal volume (cm cubed), maximum pressure (daPa) peak compliance (ml), and type (A, AD, AS, B, B-High, C) for each ear) at 226-Hz admittance. Diagnostic Test: Otoscopy Otoscopy is a clinical procedure used to examine structures of the ear, particularly the external auditory canal, tympanic membrane, and middle ear Diagnostic Test: Pure tone air and bone-conduction Pure tone air- and bone-conduction threshold will be conducted to evaluate audiometry and masking levels in both ears, from 250 Hz. To 16000 Hz. Diagnostic Test: Speech testing Speech testing will be conducted in both ears, which will include speech reception threshold, speech reception threshold masking level, word recognition presentation level, and word recognition masking level. Diagnostic Test: Loudness Discomfort Loudness discomfort levels will be tested in both right and left ears, from 500Hz to 4000Hz and speech reception threshold. Diagnostic Test: Quick Speech in Noise Test Quick Speech in Noise Test (QuickSIN) is a quick method for clinicians to quantify a patient's ability to hear in noise (1 minute). Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE) Distortion-Product Otoacoustic Emissions (DPOAE) is an automated evaluation of cochlear function. A sensitive microphone is placed in the ear canal via a probe assembly with a disposable ear-tip attached to perform and record the measurements. DPOAEs will be elicited at multiple frequencies in both ears (10 min). |
Healthy Controls
Active duty service members and/or veterans with no PTSD and no tinnitus.
|
Diagnostic Test: resting-state functional MRI
We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement. Diagnostic Test: Tympanometry Tympanometry will be conducted to assess ear canal volume (cm cubed), maximum pressure (daPa) peak compliance (ml), and type (A, AD, AS, B, B-High, C) for each ear) at 226-Hz admittance. Diagnostic Test: Otoscopy Otoscopy is a clinical procedure used to examine structures of the ear, particularly the external auditory canal, tympanic membrane, and middle ear Diagnostic Test: Pure tone air and bone-conduction Pure tone air- and bone-conduction threshold will be conducted to evaluate audiometry and masking levels in both ears, from 250 Hz. To 16000 Hz. Diagnostic Test: Speech testing Speech testing will be conducted in both ears, which will include speech reception threshold, speech reception threshold masking level, word recognition presentation level, and word recognition masking level. Diagnostic Test: Loudness Discomfort Loudness discomfort levels will be tested in both right and left ears, from 500Hz to 4000Hz and speech reception threshold. Diagnostic Test: Quick Speech in Noise Test Quick Speech in Noise Test (QuickSIN) is a quick method for clinicians to quantify a patient's ability to hear in noise (1 minute). Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE) Distortion-Product Otoacoustic Emissions (DPOAE) is an automated evaluation of cochlear function. A sensitive microphone is placed in the ear canal via a probe assembly with a disposable ear-tip attached to perform and record the measurements. DPOAEs will be elicited at multiple frequencies in both ears (10 min). |
- Resting-State Functional MRI [ Time Frame: 30 minutes of acquired data ]We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement.
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Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
Sexes Eligible for Study: | All |
Accepts Healthy Volunteers: | Yes |
Sampling Method: | Probability Sample |
Inclusion Criteria:
- Male and female DEERS eligible veterans and active duty service members, ages 18 and above
- preferred language is English and able to read and speak English at a 6th grade level
- those with PTSD (T&P; PO) must meet full criteria for PTSD diagnosis based on the DSM-5 and assessed by an independent evaluator using the CAPS-5
- those with chronic, constant tinnitus (T&P, TO) will be identified by self-report and confirmed with the audiometric assessment.
Exclusion Criteria:
- psychiatric hospitalization in the last 12 months
- significant cognitive impairment determined by inability to comprehend screening assessment
- psychiatric problems and/or high suicide risk warranting immediate intervention
- neurobiological disorders, Meniere's disease
- Temporomandibular disorders that affect tinnitus, per self-report
- history of major head trauma with loss of consciousness for 20 minutes or more as determined by the History of Head Injuries questionnaire
- history of seizures
- conditions that would prevent completion of fMRI scan (any type of electronic, mechanical, or magnetic implant, coil, filter, or stent, any type of surgical clip or staple, shunt, any type of metal object, hearing aid, spinal fusion, halo vest, IV access port, eyelid spring, artificial eye, artificial heart valve, biostimulator, severe hyperacusis)
- active conductive pathology/hearing loss as determined by audiometric assessment.
- Those with tinnitus (T&P; TO) will be excluded if their tinnitus is intermittent, objective, or pulsatile, or present for less than 6 months.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05981391
United States, Texas | |
UT Health San Antonio | Recruiting |
San Antonio, Texas, United States, 78229 | |
Contact: Amanda Flores, BA 210-562-6726 floresa13@uthscsa.edu | |
Principal Investigator: John Moring, PhD |
Responsible Party: | John Moring, Assistant Professor, The University of Texas Health Science Center at San Antonio |
ClinicalTrials.gov Identifier: | NCT05981391 |
Other Study ID Numbers: |
HSC20200573HU 5K23MH122579 ( U.S. NIH Grant/Contract ) |
First Posted: | August 8, 2023 Key Record Dates |
Last Update Posted: | May 8, 2024 |
Last Verified: | May 2024 |
Studies a U.S. FDA-regulated Drug Product: | No |
Studies a U.S. FDA-regulated Device Product: | No |
resting-state fMRI PTSD tinnitus military veterans |
Tinnitus Stress Disorders, Traumatic Stress Disorders, Post-Traumatic Trauma and Stressor Related Disorders Mental Disorders Hearing Disorders |
Ear Diseases Otorhinolaryngologic Diseases Sensation Disorders Neurologic Manifestations Nervous System Diseases |