Blast Exposed Veterans With Auditory Complaints

NCT ID: NCT02122458

Last Updated: 2023-06-22

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

363 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-01

Study Completion Date

2020-12-31

Brief Summary

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The purpose of this study is to study blast-exposed Veterans who report hearing handicap but show normal or near normal results on standard audiometric testing. The characteristics and nature of their auditory and auditory-related skills will be examined, along with whether coexisting PTSD contributes to the hearing problems of these Veterans. In a preliminary treatment study, a sub-sample of these Veterans will be fitted with mild-gain hearing aids to determine if they benefit from low-level amplification of high-frequency sounds.

Detailed Description

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The purpose of this study is to study blast-exposed Veterans who report hearing handicap but show normal or near normal results on standard audiometric testing. The characteristics and nature of their auditory and auditory-related skills will be examined with a battery of behavioral and physiologic measures. The potential contributions of co-occurring PTSD also will be evaluated. In a preliminary treatment study, a sub-sample of the targeted Veterans will be fitted with mild-gain hearing aids to determine if they benefit from low-level amplification of high-frequency sounds.

This study consists of two parts. In Part 1, four groups of Veterans, aged 20 - 50 years, will complete a battery of auditory and auditory-related assessments to better understand the deficit sources and patterns. The assessment measures will consist of questionnaires, behavioral tests, and auditory physiologic measures. One group will consist of blast-exposed Veterans with auditory problems but no PTSD. The second group will consist of blast-exposed Veterans with auditory problems plus PTSD. The third group will consist of Veterans with PTSD but no reported auditory problems, and the fourth groups will be a normal control group.

In Part 2 of the study (clinical trial portion), a smaller group of participants from the first and second groups will be fitted with mild-gain open-fit hearing aids to determine if they benefit from mild high-frequency amplification. Changes in hearing handicap and speech perception will be compared from baseline to 6-months post-fitting. Perceived hearing aid benefit, hearing aid use time, and intent to continue use will be measured at the end of a 6-month treatment period. A delayed treatment group will be formed from group 1 and will be followed over a 12-month period with hearing aids fitted at 6 months. The participants will be assigned randomly from Part 1 of the study.

The information obtained from this study will help us understand the auditory problems experienced by blast-exposed Veterans and eventually contribute to the development of an efficient and effective assessment battery and intervention approaches.

Conditions

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Hearing Impairment Hearing Aid Fitting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The primary study was diagnostic, with a goal of better understanding and determining the best diagnostic assessment battery for capturing the hearing and auditory problems reported by blast-exposed Veterans. The secondary purpose was to implement a preliminary treatment study to determine if blast-exposed Veterans with hearing complaints, but normal audiometric data benefited from low-gain hearing aids. This secondary treatment study is the clinical trial portion of this study.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Immediate Hearing Aid Treatment: Blast-exposed Only

This group consisted of blast-exposed Veterans with auditory complaints but normal audiometric test results. These Veterans were negative for significant PTSD. They were fitted with open-fit hearing aids that provided mild high-frequency amplification and were monitored for 6 months.

Group Type ACTIVE_COMPARATOR

mild-gain hearing aids with high-frequency emphasis over 6-months

Intervention Type DEVICE

open-fit hearing aids with mild amplification in the high frequencies.

Immediate Hearing Aid Treatment: Blast-exposed with PTSD

This group consisted of blast-exposed Veterans with auditory complaints but normal audiometric test results. These Veterans were comorbid for significant PTSD. They were fitted with open-fit hearing aids that provided mild high-frequency amplification and were monitored for 6 months.

Group Type ACTIVE_COMPARATOR

mild-gain hearing aids with high-frequency emphasis over 6-months

Intervention Type DEVICE

open-fit hearing aids with mild amplification in the high frequencies.

Delayed Hearing Aid Treatment: Blast-exposed Only

This group consisted of blast-exposed Veterans with auditory complaints but normal audiometric test results. These Veterans were negative for significant PTSD. They were fitted with hearing aids after a 6-month delay. Their performance was monitored 6-months pre-fitting and for the 6 months after the fitting.

Group Type ACTIVE_COMPARATOR

mild-gain hearing aids with high-frequency emphasis over 6-months

Intervention Type DEVICE

open-fit hearing aids with mild amplification in the high frequencies.

Non-treatment Diagnostic Testing: Normal

This group consisted of Veterans who completed the same pre-treatment diagnostic testing as the three treatment groups but were not enrolled in the hearing aid treatment protocol. This group included neurotypical Veterans with normal hearing and were negative for blast-exposure and PTSD.

Group Type NO_INTERVENTION

No interventions assigned to this group

Non-Treatment Diagnostic Testing: Blast-exposed Only

This group consisted of Veterans who completed the same pre-treatment diagnostic testing as the three treatment groups but were not enrolled in the hearing aid treatment protocol. This group consisted of blast-exposed Veterans with auditory complaints but normal audiometric test results. They were negative for significant PTSD.

Group Type NO_INTERVENTION

No interventions assigned to this group

Non-treatment Diagnostic Testing: Blast-exposed with PTSD

This group consisted of Veterans who completed the same pre-treatment diagnostic testing as the three treatment groups but were not enrolled in the hearing aid treatment protocol. This group consisted of blast-exposed Veterans with auditory complaints but normal audiometric test results. These Veterans were comorbid for significant PTSD.

Group Type NO_INTERVENTION

No interventions assigned to this group

Non-treatment Diagnostic Testing: PTSD Only

This group consisted of Veterans who completed the same pre-treatment diagnostic testing as the three treatment groups but were not enrolled in the hearing aid treatment protocol. This group was negative for blast-exposure and hearing loss but positive for significant PTSD.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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mild-gain hearing aids with high-frequency emphasis over 6-months

open-fit hearing aids with mild amplification in the high frequencies.

Intervention Type DEVICE

Other Intervention Names

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hearing aids

Eligibility Criteria

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Inclusion Criteria

* age 20 - 50 years; U.S. Veteran;
* English-speaking;
* history of blast exposure and no history of blast exposure;
* history of PTSD and no history of PTSD;
* self-perceived hearing handicap and no self-perceived hearing handicap;
* normal or near normal pure tone hearing thresholds;
* history of brain injury and no history of brain injury;
* normal vision.

Exclusion Criteria

* hyperacusis;
* marked tinnitus;
* pure tone hearing thresholds consistent with a hearing loss;
* greater the 20/30 vision screening results (corrected or uncorrected);
* marked speech perception deficits
Minimum Eligible Age

20 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Sheila R Pratt, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Locations

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VA Portland Health Care System, Portland, OR

Portland, Oregon, United States

Site Status

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Pittsburgh, Pennsylvania, United States

Site Status

Sioux Falls VA Health Care System, Sioux Falls, SD

Sioux Falls, South Dakota, United States

Site Status

Countries

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United States

References

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Gallun FJ, Papesh MA, Lewis MS. Hearing complaints among veterans following traumatic brain injury. Brain Inj. 2017;31(9):1183-1187. doi: 10.1080/02699052.2016.1274781.

Reference Type BACKGROUND
PMID: 28981349 (View on PubMed)

Gallun FJ, Lewis MS, Folmer RL, Diedesch AC, Kubli LR, McDermott DJ, Walden TC, Fausti SA, Lew HL, Leek MR. Implications of blast exposure for central auditory function: a review. J Rehabil Res Dev. 2012;49(7):1059-74. doi: 10.1682/jrrd.2010.09.0166.

Reference Type BACKGROUND
PMID: 23341279 (View on PubMed)

Koerner TK, A Papesh M, Gallun FJ. A Questionnaire Survey of Current Rehabilitation Practices for Adults With Normal Hearing Sensitivity Who Experience Auditory Difficulties. Am J Audiol. 2020 Dec 9;29(4):738-761. doi: 10.1044/2020_AJA-20-00027. Epub 2020 Sep 23.

Reference Type BACKGROUND
PMID: 32966118 (View on PubMed)

Folmer RL, Billings CJ, Diedesch-Rouse AC, Gallun FJ, Lew HL. Electrophysiological assessments of cognition and sensory processing in TBI: applications for diagnosis, prognosis and rehabilitation. Int J Psychophysiol. 2011 Oct;82(1):4-15. doi: 10.1016/j.ijpsycho.2011.03.005. Epub 2011 Mar 16.

Reference Type BACKGROUND
PMID: 21419179 (View on PubMed)

Papesh MA, Stefl AA, Gallun FJ, Billings CJ. Effects of Signal Type and Noise Background on Auditory Evoked Potential N1, P2, and P3 Measurements in Blast-Exposed Veterans. Ear Hear. 2021 Jan/Feb;42(1):106-121. doi: 10.1097/AUD.0000000000000906.

Reference Type BACKGROUND
PMID: 32520849 (View on PubMed)

Hoover EC, Souza PE, Gallun FJ. Auditory and Cognitive Factors Associated with Speech-in-Noise Complaints following Mild Traumatic Brain Injury. J Am Acad Audiol. 2017 Apr;28(4):325-339. doi: 10.3766/jaaa.16051.

Reference Type BACKGROUND
PMID: 28418327 (View on PubMed)

Gallun FJ, Diedesch AC, Kubli LR, Walden TC, Folmer RL, Lewis MS, McDermott DJ, Fausti SA, Leek MR. Performance on tests of central auditory processing by individuals exposed to high-intensity blasts. J Rehabil Res Dev. 2012;49(7):1005-25. doi: 10.1682/jrrd.2012.03.0038.

Reference Type BACKGROUND
PMID: 23341276 (View on PubMed)

Fausti SA, Wilmington DJ, Gallun FJ, Myers PJ, Henry JA. Auditory and vestibular dysfunction associated with blast-related traumatic brain injury. J Rehabil Res Dev. 2009;46(6):797-810. doi: 10.1682/jrrd.2008.09.0118.

Reference Type BACKGROUND
PMID: 20104403 (View on PubMed)

Reavis KM, Snowden JM, Henry JA, Gallun FJ, Lewis MS, Carlson KF. Blast Exposure and Self-Reported Hearing Difficulty in Service Members and Veterans Who Have Normal Pure-Tone Hearing Sensitivity: The Mediating Role of Posttraumatic Stress Disorder. J Speech Lang Hear Res. 2021 Nov 8;64(11):4458-4467. doi: 10.1044/2021_JSLHR-20-00687. Epub 2021 Sep 28.

Reference Type BACKGROUND
PMID: 34582257 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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C1164-R

Identifier Type: -

Identifier Source: org_study_id

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