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Bramhall NF, Theodoroff SM, McMillan GP, Kampel SD, Buran BN. Associations Between Physiological Correlates of Cochlear Synaptopathy and Tinnitus in a Veteran Population. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4635-4652. [PMID: 37889209 DOI: 10.1044/2023_jslhr-23-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE Animal models and human temporal bones indicate that noise exposure is a risk factor for cochlear synaptopathy, a possible etiology of tinnitus. Veterans are exposed to high levels of noise during military service. Therefore, synaptopathy may explain the high rates of noise-induced tinnitus among Veterans. Although synaptopathy cannot be directly evaluated in living humans, animal models indicate that several physiological measures are sensitive to synapse loss, including the auditory brainstem response (ABR), the middle ear muscle reflex (MEMR), and the envelope following response (EFR). The purpose of this study was to determine whether tinnitus is associated with reductions in physiological correlates of synaptopathy that parallel animal studies. METHOD Participants with normal audiograms were grouped according to Veteran status and tinnitus report (Veterans with tinnitus, Veterans without tinnitus, and non-Veteran controls). The effects of being a Veteran with tinnitus on ABR, MEMR, and EFR measurements were independently modeled using Bayesian regression analysis. RESULTS Modeled point estimates of MEMR and EFR magnitude showed reductions for Veterans with tinnitus compared with non-Veterans, with the most evident reduction observed for the EFR. Two different approaches were used to provide context for the Veteran tinnitus effect on the EFR by comparing to age-related reductions in EFR magnitude and synapse numbers observed in previous studies. These analyses suggested that EFR magnitude/synapse counts were reduced in Veterans with tinnitus by roughly the same amount as over 20 years of aging. CONCLUSION These findings suggest that cochlear synaptopathy may contribute to tinnitus perception in noise-exposed Veterans. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24347761.
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Affiliation(s)
- Naomi F Bramhall
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Garnett P McMillan
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
| | - Sean D Kampel
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
| | - Brad N Buran
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
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Theodoroff SM, McMillan GP, Frederick MT, Random C, Thielman E, Vergis S, Cherian K, Cherian N. Prevalence of Somatosensory Tinnitus in Veterans With Tinnitus. Ear Hear 2022; 43:1593-1596. [PMID: 35234171 DOI: 10.1097/aud.0000000000001210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The primary objective was to estimate the prevalence of somatosensory tinnitus (ST) among Veterans with tinnitus. DESIGN Three hundred four Veterans with tinnitus were phone screened for ST by performing and reporting on a series of head/neck/jaw maneuvers. A random sample of 12 individuals who screened positive and five who screened negative attended an in-person visit to confirm the presence/absence of ST. RESULTS Of the 304 Veterans, 12 could not complete the screening maneuvers, 205 screened positive, and 87 screened negative. A Bayesian estimator that combines phone screening and in-person exam results establishes the prevalence of ST among Veterans with tinnitus at 56% with a 90% Bayesian confidence interval of 45% to 65%. CONCLUSIONS At least half of Veterans with tinnitus have ST, suggesting that a sizable at-need population exists. Treatment addressing the biomechanical component has the potential to improve tinnitus symptoms.
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Affiliation(s)
- Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
- Oregon Health & Science University, Department of Otolaryngology - Head & Neck Surgery, Portland, Oregon, USA
| | - Garnett P McMillan
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Melissa T Frederick
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Chan Random
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Emily Thielman
- VA RR&D National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, Oregon, USA
| | - Shiny Vergis
- VA Portland Health Care System, Physical Medicine and Rehabilitation Service, Portland, Oregon, USA
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Gui SY, Wu KJ, Sun Y, Chen YN, Liang HR, Liu W, Lu Y, Hu CY. Traffic noise and adiposity: a systematic review and meta-analysis of epidemiological studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:55707-55727. [PMID: 35320480 DOI: 10.1007/s11356-022-19056-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Traffic noise has attracted much attention as a significant and intractable public health threat. This study was designed as a systematical review to explore the association of traffic noise with different indicators of obesity, thus providing updated quantitative estimates for the pooled effect estimates of the existing literature. We conducted an extensive search for epidemiological studies that investigated the association of traffic noise with obesity in three electronic databases till February 23, 2021. We used random-effects meta-analysis to calculate the summary effect estimates for each 10-dB(A) increase in noise and compared the highest with the lowest category of noise in relation to seven obesity indicators. Meanwhile, we assessed the risk of bias and the overall quality of the evidence of each study as well as the level of evidence for each exposure-outcome pair. The initial search identified 30 studies, 13 of which were ultimately included. The meta-analysis for the highest versus the lowest category of noise exposure was generally associated with higher waist circumfluence (WC) ranging from 0.326 cm (95% confidence interval (CI) = 0.078, 0.574) to 0.705 cm (95% CI = 0.071, 1.340) and higher odds of central obesity ranging from 1.055 (95% CI = 1.000, 1.109) to 1.167 (95% CI = 1.037, 1.298). When the continuous exposure (each 10 dB(A) increase in noise) was introduced, similar results were found. This study indicated positive associations of traffic noise with WC and central obesity. However, in consideration of some limitations, there is an urgent need for future studies to increase the sample size, discriminate the etiological differences in different noise and obesity indicators, and thoroughly consider socioeconomic status.
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Affiliation(s)
- Si-Yu Gui
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678 Furong Road, Hefei, 230601, China
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Ke-Jia Wu
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue Sun
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yue-Nan Chen
- Department of Clinical Pharmacy, School of Pharmacy, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Huan-Ru Liang
- Department of Clinical Medicine, The Second School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Wen Liu
- Department of Clinical Medicine, The First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China
| | - Yao Lu
- Department of Anesthesiology, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei, 230022, China.
- Key Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
| | - Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, China.
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Li A, Liao W, Xie J, Song L, Zhang X. Plasma Proteins as Occupational Hazard Risk Monitors for Populations Working in Harsh Environments: A Mendelian Randomization Study. Front Public Health 2022; 10:852572. [PMID: 35602164 PMCID: PMC9120921 DOI: 10.3389/fpubh.2022.852572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/30/2022] [Indexed: 11/25/2022] Open
Abstract
Harsh work environments can include very cold, hot, dusty, and noisy workplaces, as well as exposure in the workplace with chemicals and other fumes, cigarette smoke, and diesel exhaust. Although working in these harsh environments can have a negative effect on health, there are no effective biomarkers for monitoring health conditions until workers develop disease symptoms. Plasma protein concentrations, which reflect metabolism and immune status, have great potential as biomarkers for various health conditions. Using a Mendelian-randomization (MR) design, this study analyzed the effects of these harsh environments on plasma proteins to identify proteins that can be used as biomarkers of health status. Preliminary analysis using inverse variance weighted (IVW) method with a p-value cutoff of 0.05 showed that workplace environments could affect the concentrations of hundreds of plasma proteins. After filtering for sensitivity via MR-Egger, and Weighted Median MR approaches, 28 plasma proteins altered by workplace environments were identified. Further MR analysis showed that 20 of these plasma proteins, including UNC5D, IGFBP1, SCG3, ST3GAL6, and ST3GAL2 are affected by noisy workplace environments; TFF1, RBM39, ACYP2, STAT3, GRB2, CXCL1, EIF1AD, CSNK1G2, and CRKL that are affected by chemical fumes; ADCYAP1, NRSN1, TMEM132A, and CA10 that are affected by passive smoking; LILRB2, and TENM4 that are affected by diesel exhaust, are associated with the risk of at least one disease. These proteins have the potential to serve as biomarkers to monitor the occupational hazards risk of workers working in corresponding environments. These findings also provide clues to study the biological mechanisms of occupational hazards.
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Affiliation(s)
- Ang Li
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wenjing Liao
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Junyang Xie
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Lijuan Song
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaowen Zhang
- Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- State Key Laboratory of Respiratory Disease, Guangzhou, China
- *Correspondence: Xiaowen Zhang
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卢 佩, 陈 嘉, 杨 晶, 钱 明, 孙 佰, 马 鹏, 王 卫, 王 维, 伦 玉, 卢 连. [A cross-sectional study and risk factors analysis of tinnitus in flight support personnel of PLA air force]. LIN CHUANG ER BI YAN HOU TOU JING WAI KE ZA ZHI = JOURNAL OF CLINICAL OTORHINOLARYNGOLOGY, HEAD, AND NECK SURGERY 2022; 36:90-94. [PMID: 35172543 PMCID: PMC10128311 DOI: 10.13201/j.issn.2096-7993.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Indexed: 06/14/2023]
Abstract
Objective:The aim of this study is to understand the epidemiological characteristics of tinnitus among flight support personnel and analyze its audiological characteristics and related risk factors. Methods:The information of tinnitus was collected by a method of cross-sectional investigation using questionnaire survey and audiology test among the flight support personnel of two stations of PLA air force. Results:The incidence of tinnitus among 666 subjects included was 24.2%, the THI grade was mainly grade 1 and grade 2. There were differences in THI scores among groups with different working years, but only differences in tinnitus incidence among groups with different frequency of hearing loss. Multivariate logistic regression analysis showed that grade of high frequency hearing loss(OR=1.39), conscious hearing loss(OR=1.79) and frequency of asking others to repeat words(OR=1.64) were independent risk factors of tinnitus. The incidence of HF-HL and EHF-HL in ears with tinnitus among 0-5 working years was higher than that without tinnitus, while the incidence of EHF-HL in ears with tinnitus was not different from that without tinnitus among 6-10 and >10 working years. There was moderate correlation between THI scores and SAS standard scores(r=0.759), and weak correlation between THI scores and PSQI scores(r=0.445). Conclusion:The risk of tinnitus in high-frequency hearing loss and recessive hearing loss is increased; working years can affect the severity of tinnitus, while hearing conditions at different frequencies only affect the incidence of tinnitus; with increasing age, noise exposure plays a role in the occurrence of tinnitus decreasing gradually.
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Affiliation(s)
- 佩恒 卢
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 嘉伟 陈
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 晶 杨
- 94754 部队医院94754 Military Hospital
| | - 明锋 钱
- 北部战区空军保障部卫生处Health Office of Logistics Department from Northern Theater Air Force of PLA
| | - 佰星 孙
- 93169 部队医院93169 Military Hospital
| | - 鹏炜 马
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 卫龙 王
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 维娜 王
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 玉强 伦
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
| | - 连军 卢
- 空军军医大学唐都医院耳鼻咽喉头颈外科(西安,710038)Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, 710038, China
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Clark KD, Garinis AC, Konrad-Martin D. Incorporating Patient Narratives to Enhance Audiological Care and Clinical Research Outcomes. Am J Audiol 2021; 30:916-921. [PMID: 34410834 DOI: 10.1044/2021_aja-20-00228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose The engagement of patients as key stakeholders in their experience of care processes is a critical component of quality improvement efforts for both clinical care and translational research. Increasingly, health care systems are soliciting input from patients on care processes and experiences through surveys, patient interviews, and patient video narratives. The purpose of this viewpoint article is twofold: (a) to describe the increasing role of patient narratives about their experiences with adverse health conditions to inform patient-centered research and quality improvement efforts and (b) to present three patient narratives that highlight the real-world impacts of hearing loss and tinnitus, the life enhancing impacts of aural rehabilitation, and the importance of prospective ototoxicity monitoring in individuals with complex health conditions. Conclusion Patient narratives provide individual patient perspectives that can be used to build awareness of the range of experiences and impact of hearing disorders, and to explore patient preferences for when and how to implement hearing-related clinical services.
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Affiliation(s)
- Khaya D. Clark
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Hearing Center of Excellence, Department of Defense, San Antonio, TX
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland
| | - Angela C. Garinis
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
- Oregon Hearing Research Center, Oregon Health & Science University, Portland
| | - Dawn Konrad-Martin
- National Center for Rehabilitative Auditory Research, VA Portland Health Care System, OR
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Boutté AM, Thangavelu B, Nemes J, LaValle CR, Egnoto M, Carr W, Kamimori GH. Neurotrauma Biomarker Levels and Adverse Symptoms Among Military and Law Enforcement Personnel Exposed to Occupational Overpressure Without Diagnosed Traumatic Brain Injury. JAMA Netw Open 2021; 4:e216445. [PMID: 33861330 PMCID: PMC8052592 DOI: 10.1001/jamanetworkopen.2021.6445] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
IMPORTANCE There is a scientific and operational need to define objective measures of exposure to low-level overpressure (LLOP) and concussion-like symptoms among persons with specialized occupations. OBJECTIVE To evaluate serum levels of neurotrauma biomarkers and their association with concussion-like symptoms reported by LLOP-exposed military and law enforcement personnel who are outwardly healthy and cleared to perform duties. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study, conducted from January 23, 2017, to October 21, 2019, used serum samples and survey data collected from healthy, male, active-duty military and law enforcement personnel assigned to operational training at 4 US Department of Defense and civilian law enforcement training sites. Personnel aged 18 years or older with prior LLOP exposure but no diagnosed traumatic brain injury or with acute blast exposure during sampling participated in the study. Serum samples from 30 control individuals were obtained from a commercial vendor. MAIN OUTCOMES AND MEASURES Serum levels of glial fibrillary acidic protein, ubiquitin carboxyl hydrolase (UCH)-L1, neurofilament light chain, tau, amyloid β (Aβ)-40, and Aβ-42 from a random sample (30 participants) of the LLOP-exposed cohort were compared with those of 30 age-matched controls. Associations between biomarker levels and self-reported symptoms or operational demographics in the remainder of the study cohort (76 participants) were assessed using generalized linear modeling or Spearman correlations with age as a covariate. RESULTS Among the 30 randomly sampled participants (mean [SD] age, 32 [7.75] years), serum levels of UCH-L1 (mean difference, 4.92; 95% CI, 0.71-9.14), tau (mean difference, 0.16; 95% CI, -0.06 to 0.39), Aβ-40 (mean difference, 138.44; 95% CI, 116.32-160.56), and Aβ-42 (mean difference, 4.97; 95% CI, 4.10-5.83) were elevated compared with those in controls. Among the remaining cohort of 76 participants (mean [SD] age, 34 [7.43] years), ear ringing was reported by 44 (58%) and memory or sleep problems were reported by 24 (32%) and 20 (26%), respectively. A total of 26 participants (34%) reported prior concussion. Amyloid β-42 levels were associated with ear ringing (F1,72 = 7.40; P = .008) and memory problems (F1,72 = 9.20; P = .003). CONCLUSIONS AND RELEVANCE The findings suggest that long-term LLOP exposure acquired during occupational training may be associated with serum levels of neurotrauma biomarkers. Assessment of biomarkers and concussion-like symptoms among personnel considered healthy at the time of sampling may be useful for military occupational medicine risk management.
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Affiliation(s)
- Angela M. Boutté
- Brain Trauma Neuroprotection Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Bharani Thangavelu
- Brain Trauma Neuroprotection Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Jeffrey Nemes
- Blast Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Christina R. LaValle
- Blast Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Mike Egnoto
- Blast Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Walter Carr
- Blast Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Gary H. Kamimori
- Blast Induced Neurotrauma Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Maryland
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