Our previous work has collected normative data for measures of both tinnitus perception and tinnitus functional effects (reactions). Participants with chronic tinnitus, who were not receiving tinnitus-specific intervention, completed tinnitus psychoacoustic measures and tinnitus questionnaires at 0, 1, 3, and 6 months. Participants were included in each of six age ranges (18-30; 31-40; 41-50; 51-60; 61-70; 70+). These data will contribute to age-specific reference values for the different measures once all data analyses are complete (final participant testing occurred on October 30, 2018). The proposed study will extend and expand this effort by: (1) building on the normative standards database by testing a cohort of new participants; (2) assessing long-term repeatability of tinnitus psychoacoustic measures by obtaining additional longitudinal data from participants recalled from the previous study; (3) developing methodology to evaluate individual pitch-perception ability and providing training as needed; (4) evaluating the effect of pitch training on ability to match tinnitus pitch with greater precision; and (5) continuing development of the tablet-based tinnitus evaluation system (TES) for clinical utility by improving the interface and other performance features, and by creating a rapid assessment program to obtain reliable loudness matches and pitch matches in under 10 minutes. To accomplish these objectives, new participants will be enrolled into two separate cohorts of 150 and 100 individuals (total new enrollment n=250). Both cohorts of new participants will meet the same inclusion criteria as used in the previous study. The 150 new participants will undergo repeated testing at baseline and at 1, 3, and 6 months to replicate testing as done during the previous study. The separate cohort of 100 new participants will be enrolled to evaluate a training program for pitch matching. Of these, half will complete a program of pitch- perception testing and training that will be administered prior to the start of baseline testing (comparison of pitch matching data between groups with vs. without training will determine if the program improves within- session reliability of the pitch matching test). Finally, a third cohort of 100 of the previous study's participants will return to repeat testing ~3 years following their baseline testing to obtain long-term reliability data. In addition to data collection, efforts will be ongoing to complete development and validation of the tablet-based TES with the intent to ready this system for clinical application. A test protocol requiring 5-10 minutes is needed for the TES to have the potential to achieve more widespread use among VA audiologists. A rapid TES protocol will be developed, tested, and validated with a subset of participants to achieve this objective. Completing the work described in this application will accomplish many objectives, including making tinnitus psychoacoustic measures more useful and practical for clinical and research utilization.
The Veterans Benefits Administration (VBA) reports that, in Fiscal Year 2018, tinnitus was the most prevalent service-connected (SC) disability for all compensation recipients (1,971,201 Veterans), as well as the most prevalent SC disability among new compensation recipients (157,152 Veterans). Treatments claiming to reduce the sound of tinnitus show promise, but they need reliable measures of tinnitus features such as its loudness, pitch, and maskability. The previous study found age-specific standard ranges for these measurements using our computer-automated Tinnitus Evaluation System (TES). The new study will expand the previous study to: represent all age groups equally, obtain test-retest data over an extended period of time, test a pre-test training program for tinnitus pitch matching, and update the TES for ease of use in VA Audiology clinics. This project will result in more complete standards of tinnitus measurements and state-of-the-art equipment that will promote valid and reliable measurement of how tinnitus sounds to Veterans.
