Network Dysregulation Among Individuals with Comorbid Tinnitus and PTSD


In military veterans with co-occurring PTSD and tinnitus, examine whether a leading psychotherapy for PTSD also leads to reductions in tinnitus-related distress when PTSD is treated successfully. Concurrently, evaluate brain activity before, during, and after PTSD treatment to better understand the brain network disruptions that cause and maintain PTSD and tinnitus and how those brain networks are impacted by successful PTSD treatment.

Along with posttraumatic stress disorder (PTSD), one of the most common combat-related disorders is tinnitus, the illusory perception of noise or ringing in the ears when no actual external noise is present. Although these conditions are very different, they commonly occur together, and resting-state functional magnetic resonance imaging (rs-fMRI) shows that both are associated with abnormalities in similar brain networks.

It is anticipated, then, that the successful treatment of PTSD may also help alleviate the frequency, intensity, duration, and distress of chronic tinnitus. Likewise, a better understanding of the brain mechanisms involved in the cause and maintenance of both disorders, as well as in patient response to treatment, could guide efforts to cure them both, individually and jointly.

With these overarching goals in mind, this STRONG STAR-affiliated pilot study led by John Moring, PhD, of UT Health San Antonio will enroll 12 military veterans who deployed post-9/11 and who suffer from both PTSD and bothersome tinnitus. They will be assessed for tinnitus, tinnitus-related distress, and PTSD prior to undergoing Cognitive Processing Therapy (CPT), one of the gold-standard treatments for PTSD.

Each patient also will undergo rs-fMRI scans prior to starting treatment with CPT, midway through the six-week therapy period, and one month after completing treatment.

Through these assessments and neuroimaging scans, investigators have several aims. For one, they seek to identify symptoms that are shared and unique to PTSD and tinnitus-related distress. These findings could help clinicians better understand the distinct ways each disorder contributes to functional impairment as well as what it is like live with both disorders. That could improve their approach to patient care.

In addition, investigators want to test their hypothesis that, as CPT helps patients recover from PTSD, it also will help reduce tinnitus-related distress. This could provide support for the use of CPT for this purpose.

Importantly, with the neuroimaging scans, researchers also aim to identify the brain network dysregulation associated with tinnitus and PTSD, both in causing and maintaining the disorders, and gauge the impact of successful PTSD treatment with CPT, including whether and how it results in healthier activity within affected brain networks. These findings could be used to generate new and innovative treatments targeting specific brain regions to alleviate tinnitus and PTSD.

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