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Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort.
Mil Med. 2019 12 01; 184(11-12):839-846.MM

Abstract

INTRODUCTION

Mild TBI (TBI) is associated with up to a 75.7% incidence of tinnitus, and 33.0% of tinnitus patients at the US Veterans Administration carry a diagnosis of post-traumatic stress syndrome (PTSD). Yet factors contributing to new onset or exacerbation of tinnitus remain unclear.

MATERIALS AND METHODS

Here we measure intermittent and constant tinnitus at two time points to ascertain whether pre-existing or co-occurring traumatic brain injury (TBI), hearing loss, or post-traumatic stress disorder (PTSD) predicts new onset, lack of recovery and/or worsening of tinnitus in 2,600 United States Marines who were assessed before and after a combat deployment.

RESULTS

Ordinal regression revealed that constant tinnitus before deployment was likely to continue after deployment (odds ratio [OR] = 28.62, 95% confidence interval [CI]: 9.84,83.26). Prior intermittent tinnitus increased risk of post-deployment constant tinnitus (OR = 4.95, CI: 2.97,8.27). Likelihood of tinnitus progression increased with partial PTSD (OR = 2.39, CI: 1.50,3.80) and TBI (OR = 1.59, CI: 1.13,2.23), particularly for blast TBI (OR = 2.01, CI: 1.27,3.12) and moderate to severe TBI (OR = 2.57, CI: 1.46,4.51). Tinnitus progression also increased with low frequency hearing loss (OR = 1.94, CI: 1.05,3.59), high frequency loss (OR = 3.01, CI: 1.91,4.76) and loss across both low and high frequency ranges (OR = 5.73, CI: 2.67,12.30).

CONCLUSIONS

Screening for pre-existing or individual symptoms of PTSD, TBI, and hearing loss may allow for more focused treatment programs of comorbid disorders. Identification of those personnel vulnerable to tinnitus or its progression may direct increased acoustic protection for those at risk.

Authors+Show Affiliations

VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA. Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA. Harvard University School of Public Health, 677 Huntington Ave, Boston, MA.VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA. Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA. Department of Psychiatry, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA.VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA. Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA. Department of Psychiatry, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA.Department of Radiology, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA.VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA. Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA. Department of Psychological Sciences, Loyola University New Orleans, 6363 St. Charles Ave., Box 194, New Orleans, LA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30793178

Citation

Clifford, Royce E., et al. "Impact of TBI, PTSD, and Hearing Loss On Tinnitus Progression in a US Marine Cohort." Military Medicine, vol. 184, no. 11-12, 2019, pp. 839-846.
Clifford RE, Baker D, Risbrough VB, et al. Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort. Mil Med. 2019;184(11-12):839-846.
Clifford, R. E., Baker, D., Risbrough, V. B., Huang, M., & Yurgil, K. A. (2019). Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort. Military Medicine, 184(11-12), 839-846. https://doi.org/10.1093/milmed/usz016
Clifford RE, et al. Impact of TBI, PTSD, and Hearing Loss On Tinnitus Progression in a US Marine Cohort. Mil Med. 2019 12 1;184(11-12):839-846. PubMed PMID: 30793178.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort. AU - Clifford,Royce E, AU - Baker,Dewleen, AU - Risbrough,Victoria B, AU - Huang,Mingxiong, AU - Yurgil,Kate A, PY - 2018/10/04/received PY - 2018/12/18/revised PY - 2019/01/14/accepted PY - 2019/2/23/pubmed PY - 2020/8/8/medline PY - 2019/2/23/entrez KW - hearing loss KW - post-traumatic stress disorder KW - tinnitus KW - traumatic brain injury SP - 839 EP - 846 JF - Military medicine JO - Mil Med VL - 184 IS - 11-12 N2 - INTRODUCTION: Mild TBI (TBI) is associated with up to a 75.7% incidence of tinnitus, and 33.0% of tinnitus patients at the US Veterans Administration carry a diagnosis of post-traumatic stress syndrome (PTSD). Yet factors contributing to new onset or exacerbation of tinnitus remain unclear. MATERIALS AND METHODS: Here we measure intermittent and constant tinnitus at two time points to ascertain whether pre-existing or co-occurring traumatic brain injury (TBI), hearing loss, or post-traumatic stress disorder (PTSD) predicts new onset, lack of recovery and/or worsening of tinnitus in 2,600 United States Marines who were assessed before and after a combat deployment. RESULTS: Ordinal regression revealed that constant tinnitus before deployment was likely to continue after deployment (odds ratio [OR] = 28.62, 95% confidence interval [CI]: 9.84,83.26). Prior intermittent tinnitus increased risk of post-deployment constant tinnitus (OR = 4.95, CI: 2.97,8.27). Likelihood of tinnitus progression increased with partial PTSD (OR = 2.39, CI: 1.50,3.80) and TBI (OR = 1.59, CI: 1.13,2.23), particularly for blast TBI (OR = 2.01, CI: 1.27,3.12) and moderate to severe TBI (OR = 2.57, CI: 1.46,4.51). Tinnitus progression also increased with low frequency hearing loss (OR = 1.94, CI: 1.05,3.59), high frequency loss (OR = 3.01, CI: 1.91,4.76) and loss across both low and high frequency ranges (OR = 5.73, CI: 2.67,12.30). CONCLUSIONS: Screening for pre-existing or individual symptoms of PTSD, TBI, and hearing loss may allow for more focused treatment programs of comorbid disorders. Identification of those personnel vulnerable to tinnitus or its progression may direct increased acoustic protection for those at risk. SN - 1930-613X UR - https://www.unboundmedicine.com/medline/citation/30793178/Impact_of_TBI_PTSD_and_Hearing_Loss_on_Tinnitus_Progression_in_a_US_Marine_Cohort_ L2 - https://academic.oup.com/milmed/article-lookup/doi/10.1093/milmed/usz016 DB - PRIME DP - Unbound Medicine ER -