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Posttraumatic Stress DisorderNCT05981391

Neurobiological Similarities of Tinnitus and PTSD

An observational study of Posttraumatic Stress Disorder and Tinnitus, run by The University of Texas Health Science Center at San Antonio at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Psychiatric distress caused by PTSD may increase attention toward tinnitus, as well as perceived loudness and discomfort. It is important to understand how tinnitus-related distress and PTSD negatively interact together, in order to develop more effective therapeutic approaches. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Posttraumatic Stress Disorder, Tinnitus
What is being tested?
resting-state functional MRI, Clinician Administered PTSD Scale for the DSM-5 (CAPS-5) and Tympanometry
How many people
64 participants
Where
1 siteUnited States
Study dates
4 Feb 2021to 1 Nov 2024
Phase
Observational
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: This study will consent and screen veterans and active duty service members to include 120 for analysis. Subjects will be recruited from the San Antonio community. Women and minorities will be actively recruited into the study.

Who may be able to join

  • Male and female DEERS eligible veterans and active duty service members, ages 18 and above
  • preferred language is English and able to read and speak English at a 6th grade level
  • those with PTSD (T\&P; PO) must meet full criteria for PTSD diagnosis based on the DSM-5 and assessed by an independent evaluator using the CAPS-5
  • those with chronic, constant tinnitus (T\&P, TO) will be identified by self-report and confirmed with the audiometric assessment.

Who cannot join

  • psychiatric hospitalization in the last 12 months
  • significant cognitive impairment determined by inability to comprehend screening assessment
  • psychiatric problems and/or high suicide risk warranting immediate intervention
  • neurobiological disorders, Meniere's disease
  • Temporomandibular disorders that affect tinnitus, per self-report
  • history of major head trauma with loss of consciousness for 20 minutes or more as determined by the History of Head Injuries questionnaire
Show all 10Show fewer
  • history of seizures
  • conditions that would prevent completion of fMRI scan (any type of electronic, mechanical, or magnetic implant, coil, filter, or stent, any type of surgical clip or staple, shunt, any type of metal object, hearing aid, spinal fusion, halo vest, IV access port, eyelid spring, artificial eye, artificial heart valve, biostimulator, severe hyperacusis)
  • active conductive pathology/hearing loss as determined by audiometric assessment.
  • Those with tinnitus (T\&P; TO) will be excluded if their tinnitus is intermittent, objective, or pulsatile, or present for less than 6 months.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • UT Health San Antonio

    San Antonio, Texas, 78229

Other trials in United States

About this study

Official title: An Evaluation of Neurobiological Similarities of Tinnitus and Posttraumatic Stress Disorder

Psychiatric distress caused by PTSD may increase attention toward tinnitus, as well as perceived loudness and discomfort. It is important to understand how tinnitus-related distress and PTSD negatively interact together, in order to develop more effective therapeutic approaches. Understanding symptoms and neurobiological mechanisms using functional magnetic resonance imaging (fMRI), can lead to the necessary knowledge to develop effective interventions for individuals who suffer from both conditions.

Read the detailed description

Tinnitus and posttraumatic stress disorder (PTSD) are two of the most common service-connected disabilities for active-duty Service Members and Veterans. Tinnitus and PTSD are highly co-morbid, yet distinct disorders. Tinnitus is an auditory disorder in which an illusory auditory percept is experienced, usually as ringing, buzzing, or whooshing sounds, despite no external objective noise source. On the other hand, PTSD is a trauma-related disorder, and is identified by intrusions of the traumatic event, avoidance of reminders, negative alterations in cognition and mood, and hypervigilance or hyperarousal. Similarities between tinnitus and PTSD have been documented among Cambodian refugees, as well as among U.S. Veteran samples. Moreover, the latest neuroimaging data from a recent clinical trial indicated that the auditory-vigilance network was the most dysregulated among active-duty service members with PTSD, compared to combat controls and civilian controls. Due to similar symptoms between tinnitus-related distress and PTSD, and similar dysregulated resting-state brain networks, it remains important to more fully understand how these two distinct disorders may be related. This study will be the first to prospectively examine the overt emotional, behavioral, and cognitive symptoms related to tinnitus-related distress and PTSD, and the overlapping functional connectivity between tinnitus and PTSD. Investigators will examine the overlapping symptoms and neurobiological mechanisms by conducting audiometric and psychological assessments and resting-state functional magnetic resonance imaging (fMRI) among 120 participants (30 with tinnitus and PTSD, 30 with only PTSD, 30 with only tinnitus, and 30 healthy controls). Participants will be recruited from the Frank Tejeda PTSD Clinic and the Audiology Clinic within the South Texas VA Health Care System, and the Hearing Center of Excellence at Lackland Air Force Base. Canonical correlations will be conducted to examine the symptom overlap between tinnitus and PTSD (Aim 1). Investigators aim to neurobiologically characterize tinnitus and PTSD, both separately and conjointly, by conducting fMRI (Aim 2). Investigators also aim to apply modeling to psychometric and neurofunctional data to identify specific regions of the auditory-vigilance network associated with distress related to tinnitus and PTSD. Understanding the shared cognitive, emotional, and behavioral symptoms and neurobiology associated with tinnitus and PTSD will help clinicians and researchers fully understand tinnitus and PTSD independently and conjointly. Results will lead to the identification of neurobiological markers for tinnitus and PTSD, identification of a different phenotype for individuals with both conditions, and development of behavioral and neuro-modulatory therapies that can reduce distress and impairment.

Being tested
resting-state functional MRI, Clinician Administered PTSD Scale for the DSM-5 (CAPS-5), Tympanometry, Tinnitus Assessment, Otoscopy
Keywords
resting-state fMRI, PTSD, tinnitus, military, veterans
Medical subject headings
Stress Disorders, Post-Traumatic, Tinnitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • resting-state functional MRIDiagnostic test

    We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 60-75 min). These data are a main outcome. Data will be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement.

  • Clinician Administered PTSD Scale for the DSM-5 (CAPS-5)Diagnostic test

    The CAPS-5 is a semi-structured interview, conducted by an independent evaluator, that measures DSM-5 symptoms of PTSD. Presence of at least one intrusion symptom, one avoidance symptom, two cognition and mood symptoms, and two arousal symptoms for 1 month or more are required to reach the diagnostic threshold.

  • TympanometryDiagnostic test

    Tympanometry will be conducted to assess ear canal volume (cm cubed), maximum pressure (daPa) peak compliance (ml), and type (A, AD, AS, B, B-High, C) for each ear) at 226-Hz admittance.

  • Tinnitus AssessmentDiagnostic test

    Tinnitus acoustic assessment (for tinnitus participants only): Tinnitus ear (left, right, bilateral), pitch matched frequency (Hz) and loudness matched intensity (dB) will be conducted. When available, the tinnitus acoustic assessment only will be repeated at the RII, on the same day and prior to the fMRI scan, to demonstrate reproducibility of results.

  • OtoscopyDiagnostic test

    Otoscopy is a clinical procedure used to examine structures of the ear, particularly the external auditory canal, tympanic membrane, and middle ear

  • Pure tone air and bone-conductionDiagnostic test

    Pure tone air- and bone-conduction threshold will be conducted to evaluate audiometry and masking levels in both ears, from 250 Hz. To 16000 Hz.

  • Speech testingDiagnostic test

    Speech testing will be conducted in both ears, which will include speech reception threshold, speech reception threshold masking level, word recognition presentation level, and word recognition masking level.

  • Loudness DiscomfortDiagnostic test

    Loudness discomfort levels will be tested in both right and left ears, from 500Hz to 4000Hz and speech reception threshold.

  • Quick Speech in Noise TestDiagnostic test

    Quick Speech in Noise Test (QuickSIN) is a quick method for clinicians to quantify a patient's ability to hear in noise (1 minute).

  • Distortion-Product Otoacoustic Emissions (DPOAE)Diagnostic test

    Distortion-Product Otoacoustic Emissions (DPOAE) is an automated evaluation of cochlear function. A sensitive microphone is placed in the ear canal via a probe assembly with a disposable ear-tip attached to perform and record the measurements. DPOAEs will be elicited at multiple frequencies in both ears (10 min).

Study groups in NCT05981391
Study groupRoleWhat they receive
Tinnitus and PTSD (T+P)Active duty service members and/or veterans with PTSD and tinnitus.
Receives: Diagnostic Test: resting-state functional MRI; Diagnostic Test: Clinician Administered PTSD Scale for the DSM-5 (CAPS-5); Diagnostic Test: Tympanometry; Diagnostic Test: Tinnitus Assessment; Diagnostic Test: Otoscopy; Diagnostic Test: Pure tone air and bone-conduction; Diagnostic Test: Speech testing; Diagnostic Test: Loudness Discomfort; Diagnostic Test: Quick Speech in Noise Test; Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE)
Tinnitus Only (TO)Active duty service members and/or veterans with only tinnitus/no PTSD.
Receives: Diagnostic Test: resting-state functional MRI; Diagnostic Test: Tympanometry; Diagnostic Test: Tinnitus Assessment; Diagnostic Test: Otoscopy; Diagnostic Test: Pure tone air and bone-conduction; Diagnostic Test: Speech testing; Diagnostic Test: Loudness Discomfort; Diagnostic Test: Quick Speech in Noise Test; Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE)
PTSD Only (PO)Active duty service members and/or veterans with only PTSD/no tinnitus.
Receives: Diagnostic Test: resting-state functional MRI; Diagnostic Test: Clinician Administered PTSD Scale for the DSM-5 (CAPS-5); Diagnostic Test: Tympanometry; Diagnostic Test: Otoscopy; Diagnostic Test: Pure tone air and bone-conduction; Diagnostic Test: Speech testing; Diagnostic Test: Loudness Discomfort; Diagnostic Test: Quick Speech in Noise Test; Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE)
Healthy ControlsActive duty service members and/or veterans with no PTSD and no tinnitus.
Receives: Diagnostic Test: resting-state functional MRI; Diagnostic Test: Tympanometry; Diagnostic Test: Otoscopy; Diagnostic Test: Pure tone air and bone-conduction; Diagnostic Test: Speech testing; Diagnostic Test: Loudness Discomfort; Diagnostic Test: Quick Speech in Noise Test; Diagnostic Test: Distortion-Product Otoacoustic Emissions (DPOAE)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Resting-State Functional MRI

    We will acquire BOLD fMRI images in an unstimulated state using an extended time-series (300 whole-brain volumes over ~ 30 min) and assess for activation within the Auditory Vigilance Network. These data are a main outcome. Data were be processed on an ongoing basis to ensure integrity, and includes controlling for white matter, cerebral spinal fluid, and movement.

    BOLD levels were transformed to Z-scores, a statistical measure that conveys how many standard deviations the data points are away from the dataset. A Z-score of 0 represents the population mean. For each of the regions reported in the Auditory Vigilance Network, each positive point represents one standard deviation above the population mean. These positive Z-scores represent more brain activation within these regions.

    Measured: 30 minutes of acquired data

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Aug 2023
  2. Study start4 Feb 2021
  3. Primary completion1 Nov 2024
  4. Study completion1 Nov 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05981391
Sponsor's protocol ID
HSC20200573HU
Other IDs
5K23MH122579
Status last verified
Jul 2025
First submitted
31 Jul 2023
Last updated
8 Jul 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

An observational study of Posttraumatic Stress Disorder and Tinnitus, run by The University of Texas Health Science Center at San Antonio at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Jul 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Jul 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Resting-State Functional MRI (time frame: 30 minutes of acquired data). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jul 2025.

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