To conduct this study, 300 individuals who experience chronic tinnitus will be enrolled and stratified by age decades 18-30, 31-40, 41-50, 51-60, 61-70 and 71+ (50 subjects per decade). Each subject will complete testing that will include tinnitus loudness and pitch matching, noise-band matching, forced-choice double staircase, and minimum masking level. Testing for these measures will be accomplished using our automated, self-guided Tinnitus Evaluation System (TES). Subjects will also complete the Tinnitus Functional Index and a visual numeric scale of tinnitus loudness prior to each test session. All testing will be repeated at 1, 3, and 6 months, enabling analyses of test-retest reliability and normal variation of the measures in the absence of intervention. A subset of 60 subjects (10 per age decade) will also perform manual testing of loudness and pitch matching, noise-band matching, and minimum masking level to facilitate a comparison of results obtained with automated versus manual testing. The end product will be a set of age-specific reference standards for each psychoacoustic measure of tinnitus, suitable for application to clinical and research samples. Testing will occur throughout the 3-year funding period. Concurrently, the TES will be upgraded to an integrated touch- screen system. Currently, the TES consists of a PC computer connected via USB port to the TES Module (control device to facilitate patient responses). An upgrade is required to update this technology that was developed over 6 years ago to conduct the previous study. To accomplish this upgrade, we plan to integrate all components into a single unit. The unit will consist of a touch-screen industrial controller and the current TES Module (mounted adjacent to each other within a common enclosure), and attached ER-4B insert earphones. With this upgrade, current technology will be made available to audiologists who perform tinnitus psychoacoustic testing, using a fully-automated system that has been validated for reliability and tested to establish normative responses of the measures. The fulfillment of this project will produce both the upgraded TES and normative data to facilitate interpretation of individual responses to tinnitus psychoacoustic testing.
Tinnitus is the most common of all the service-connected disabilities for military Veterans. By the end of Fiscal Year 2012, a total of 971,990 Veterans were service connected for tinnitus. Interventions purporting to reduce the perception of tinnitus show promise, but they require accurate and reliable measurement of perceptual characteristics of tinnitus, which is the focus of this study. The project will result in normative standards of outcome measures that can be utilized immediately upon completion of the study. The Tinnitus Evaluation System (TES) is a fully functional automated testing system that will be used to obtain the measures. Concurrently, the TES will be upgraded to a single-unit testing system by our engineering team. Completion of the project will result in normative data and state-of-the-art instrumentation that will contribute toward obtaining valid and reliable assessments of tinnitus perceptual characteristics. Reaching this goal can impact VA audiology clinics that routinely obtain these measures with Veterans.
