Auditory Plasticity Training for Traumatic Brain Injury

Overseen By Rocio Norman, PhD

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: The University of Texas Health Science Center at San Antonio

Disqualifiers: Major neurological, psychiatric conditions, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

80 Participants Needed

Trial Summary

What is the purpose of this trial?

The investigators are working on a project to help people who have had mild brain injuries hear better. Sometimes, these injuries can make it hard for people to hear clearly, especially in noisy places or when trying to tell where sounds are coming from. The project is testing special training exercises that have helped healthy people improve their hearing in these situations. The goal is to see if these exercises can also help people with mild traumatic brain injuries (mTBI). If these exercises work, they could help doctors give better treatment to people with hearing problems after a brain injury. This would be especially helpful for soldiers who need to stay ready for duty. It could also make life better for veterans who struggle with hearing issues and help lower the cost of healthcare.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Auditory Plasticity Training for Traumatic Brain Injury?

Research shows that auditory training can improve hearing function and brain processing in people with hearing difficulties, including those with traumatic brain injuries. Studies indicate that this type of training can lead to better understanding of speech in noisy environments and enhance cognitive functions, suggesting its potential benefit for individuals with brain injuries. ^{1 2 3 4 5}

Is Auditory Plasticity Training safe for humans?

There is limited published research on the safety of Auditory Plasticity Training, but anecdotal and clinical data suggest it is generally safe for treating auditory disorders. More high-quality studies are needed to confirm its safety across different conditions. ^{2 3 5 6 7}

How is Auditory Plasticity Training different from other treatments for traumatic brain injury?

Auditory Plasticity Training is unique because it focuses on enhancing the brain's ability to adapt and reorganize in response to sound, leveraging the brain's natural plasticity to improve auditory processing. Unlike other treatments, it specifically targets the auditory cortex to improve hearing and cognitive functions through structured auditory exercises. ^{5 8 9 10 11}

Research Team

Rocio Norman, PhD

Principal Investigator

The University of Texas Health Science Center at San Antonio

Eligibility Criteria

This trial is for individuals who have experienced mild traumatic brain injuries or concussions and are facing challenges with hearing, especially in noisy environments or pinpointing the direction of sounds. It aims to help improve their auditory capabilities.

Inclusion Criteria

English is the primary language

History of mTBI by self report

Exclusion Criteria

Pure tone threshold (mean of 0.5-4.0 kHz) > 40dB HL

I do not have major neurological or psychiatric conditions besides mild traumatic brain injury.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Participants undergo Speech in Noise (SPiN) and Spatial Hearing training at home over 8 days, with up to two, 10 min sessions each day, for a total of 15 training sessions.

2 weeks

Follow-up

Participants are monitored for changes in hearing abilities, including frequency following response and spatial hearing precision.

1 month + 10 days

Treatment Details

Interventions

• Auditory Plasticity Training

Trial Overview The study is examining the effectiveness of special auditory training exercises designed to enhance speech understanding in noise and spatial hearing abilities. Participants will be divided into groups to receive different types of hearing training.

Participant Groups

Group I: Spatial Hearing Training Control Group Treatment as Usual (TAU) Experimental Treatment 1 Intervention

Young to middle-age mTBI patients (age 18-55 yrs.) with various degrees of central hearing impairment will be randomly assigned to a treatment as usual group

Group II: SPiN Control Group Treatment as Usual (TAU) Active Control 1 Intervention

Young to middle-age mTBI patients (age 18-55 yrs.) with various degrees of central hearing impairment will be randomly assigned to a treatment as usual group

Group III: Speech in Noise Training (SPiN) Active Control 1 Intervention

Young to middle-age mTBI patients (age 18-55 yrs.) with various degrees of central hearing impairment will be randomly assigned to this training group

Group IV: Spatial Hearing Training Active Control 1 Intervention

Young to middle-age mTBI patients (age 18-55 yrs.) with various degrees of central hearing impairment will be randomly assigned to this training group

Who Is Running the Clinical Trial?

The University of Texas Health Science Center at San Antonio

Lead Sponsor

Trials

486

Recruited

92,500+

United States Department of Defense

Collaborator

Trials

940

Recruited

339,000+

Findings from Research

A study involving six adults aged 20 to 37 with severe traumatic brain injury showed that acoustically controlled auditory training led to long-term improvements in auditory processing, as evidenced by changes in brainstem response measurements one year after training.

The training resulted in increased amplitudes and improved latencies in auditory brainstem responses, indicating enhanced auditory function, while behavioral assessments remained stable, suggesting lasting benefits from the training program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Behavioral and electrophysiological auditory processing measures in traumatic brain injury after acoustically controlled auditory training: a long-term study. Figueiredo, CC., Andrade, AN., Marangoni-Castan, AT., et al.[2018]

Patients with mild traumatic brain injury (mTBI) showed lower activation in the auditory cortex during listening tasks compared to normative controls, indicating potential auditory processing deficits.

The study found reduced connectivity between the left and right auditory cortices in mTBI patients, especially those with clinical auditory processing deficits, suggesting that functional MRI can effectively assess auditory function in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Central auditory processing disorders after mild traumatic brain injury. Santhanam, P., Meehan, A., Orrison, WW., et al.[2019]

Individuals with mild traumatic brain injury showed significant improvements in behavioral tests of central auditory processing six months after completing formal auditory training, indicating the training's effectiveness.

Despite the behavioral improvements, electrophysiological measures (P300 assessments) remained stable over time, suggesting that while training can enhance auditory processing skills, it may not affect the underlying neural responses measured by P300.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mild Traumatic Brain Injury: Long-Term Follow-Up of Central Auditory Processing After Auditory Training. Buriti, AKL., Gil, D.[2022]

The brain's ability to adapt and improve hearing function remains strong even in older adults, as shown by studies that link neural changes to better speech understanding in noisy environments.

Auditory training strategies can significantly enhance speech-in-noise perception and cognitive function, highlighting the importance of tailored treatment approaches for individuals facing hearing challenges.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory Training: Evidence for Neural Plasticity in Older Adults. Anderson, S., Kraus, N.[2022]

Auditory training (AT) is a crucial rehabilitation method for patients with central auditory processing disorder (CAPD), helping to address specific auditory deficits through targeted protocols.

Current research indicates that AT is effective in improving auditory difficulties in individuals with CAPD, although more data is needed to fully establish its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory Training for Central Auditory Processing Disorder. Weihing, J., Chermak, GD., Musiek, FE.[2020]

Auditory integration training (AIT) is a promising treatment for auditory disorders, including sound sensitivity and auditory processing issues, although research is still limited.

Preliminary data suggests that AIT may improve word recognition scores in noisy environments for children with various auditory disorders, indicating potential efficacy in enhancing auditory processing abilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Auditory Integration Training: One Clinician's View. Madell, JR.[2019]

A review of studies on auditory training for older adults with hearing loss since 2013 found that most studies had low to moderate quality, highlighting issues like lack of blinding, control groups, and small sample sizes.

The effectiveness of auditory training remains uncertain, indicating a need for future high-quality randomized controlled trials to better assess long-term outcomes and various measures of effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Methodological Considerations for Auditory Training Interventions for Adults With Hearing Loss: A Rapid Review. Gaeta, L., Stark, RK., Ofili, E.[2021]

Research on the rodent auditory cortex has significantly advanced our understanding of how learning and sensory experiences can induce changes in brain structure and function, particularly during critical and post-critical periods of development.

Recent studies highlight the potential of auditory training as a practical tool to improve auditory processing abilities in both children with developmental impairments and adults with acquired auditory deficits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lifelong plasticity in the rat auditory cortex: basic mechanisms and role of sensory experience. de Villers-Sidani, E., Merzenich, MM.[2019]

Auditory input and experience can lead to significant plasticity in the auditory cortex, with changes that can be rapid or long-term, depending on factors like attention and learning strategies.

While most auditory plasticity is adaptive and can enhance auditory performance, maladaptive changes associated with cochlear trauma and partial hearing loss can lead to conditions like tinnitus.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Plasticity in the auditory system. Irvine, DRF.[2019]

A study involving 29 adult cochlear implant users with partial deafness found that while the proposed auditory training was deemed useful for rehabilitation, it was also considered difficult, particularly for identifying mid- and high-frequency sounds.

Women reported significantly more difficulties than men in performing the auditory training exercises, highlighting the need for tailored support in rehabilitation programs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[The effectiveness of the auditory training of the subjects presenting with partial deafness following cochlear implantation as reported by the patients and speech therapists]. Solnitsa, I., Kobosko, I., Pankovska, A., et al.[2014]

The auditory cortex can undergo significant plastic changes throughout life, adapting to new auditory experiences, such as after cochlear implantation, which can be beneficial for hearing recovery.

However, prolonged exposure to certain acoustic environments can lead to changes similar to those caused by noise trauma, and in children, a lack of auditory stimulation can hinder normal cortical development.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of sound in adult and developmental auditory cortical plasticity. Eggermont, JJ.[2008]

References

1. Brazil pubmed.ncbi.nlm.nih.gov

Behavioral and electrophysiological auditory processing measures in traumatic brain injury after acoustically controlled auditory training: a long-term study. [2018]

2. United States pubmed.ncbi.nlm.nih.gov

Central auditory processing disorders after mild traumatic brain injury. [2019]

3. Korea (South) pubmed.ncbi.nlm.nih.gov

Mild Traumatic Brain Injury: Long-Term Follow-Up of Central Auditory Processing After Auditory Training. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Auditory Training: Evidence for Neural Plasticity in Older Adults. [2022]

5. United States pubmed.ncbi.nlm.nih.gov

Auditory Training for Central Auditory Processing Disorder. [2020]

6. United States pubmed.ncbi.nlm.nih.gov

Auditory Integration Training: One Clinician's View. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Methodological Considerations for Auditory Training Interventions for Adults With Hearing Loss: A Rapid Review. [2021]

8. Netherlands pubmed.ncbi.nlm.nih.gov

Lifelong plasticity in the rat auditory cortex: basic mechanisms and role of sensory experience. [2019]

9. Netherlands pubmed.ncbi.nlm.nih.gov

Plasticity in the auditory system. [2019]

10. Russia (Federation) pubmed.ncbi.nlm.nih.gov

[The effectiveness of the auditory training of the subjects presenting with partial deafness following cochlear implantation as reported by the patients and speech therapists]. [2014]

11. United States pubmed.ncbi.nlm.nih.gov

The role of sound in adult and developmental auditory cortical plasticity. [2008]