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Veterans Affairs Auditory Vestibular Research


Among American veterans, the most common service-oriented disabilities are hearing-related problems, including tinnitus: the hearing of sound (often described as a ringing, buzzing, or hissing) when no external sound is present. In 2013, 1.1 million veterans received compensation for tinnitus, and more than 850,000 for hearing loss.

Tinnitus disproportionately affects veterans because of the greater likelihood that they’ve been exposed to loud noise. VA researchers have studied the condition for decades.

Department of Veterans Affairs (VA) research is aimed at discovering the best practices for preventing, diagnosing, and treating hearing loss, tinnitus, and vestibular (balance and spatial orientation) problems. VA investigators study the most common cause of hearing loss – aging – but also devote considerable resources to other origins including infections, allergies, noise or blast exposure, and heredity.

Much of VA’s research into auditory and vestibular issues is coordinated and carried out through the work of the National Center for Rehabilitative Auditory Research (NCRAR) at the Portland, Oregon VA Medical Center (VAMC). NCRAR researchers train and mentor new scientists, disseminate information to clinicians who assess and treat veterans, and provide educational resources to veterans and community members.

anechoic chamber

A research subject localizes sounds coming from an array of speakers in a specially designed anechoic (without echo) chamber. NCRAR photo

NCRAR’s research program, led by Patrick Feeney, PhD, features a unique focus on auditory and vestibular dysfunction and on translating research findings into practice. The program is varied and multidisciplinary, including investigations into the basic biophysiology of the auditory and vestibular systems; the effects of age; the pathways of specific pathologies or disorders; and the effectiveness of specific evaluation and rehabilitation strategies.

Tinnitus, Feeney pointed out, disproportionately affects veterans because of the greater likelihood that they’ve been exposed to loud noise. VA researchers have studied the condition for decades. James Henry, PhD, an NCRAR investigator, was recently awarded the highest honor given to researchers by the VA’s Rehabilitation Research and Development Service (RR&D) – the 2016 Paul B. Magnuson Award – for his development of an incremental treatment approach called Progressive Tinnitus Management (PTM). Developed after years of clinical trials, PTM establishes five levels of assessment and intervention that escalate with the intensity and severity of the tinnitus. The condition can range from mildly irritating (which might involve basic education in managing the condition) to severe (which would typically involve more intensive approaches such as sound therapy, or cognitive behavioral therapy) to completely debilitating (requiring specialized one-on-one services). PTM continues to be adopted as the program of choice in both VA and Department of Defense (DOD) hearing clinics.

Meanwhile, Henry’s team is engaged in a study of the effectiveness of different types of sound-generating devices for tinnitus management, as well as a longitudinal study of the relationship between noise exposure and tinnitus – a study that might yield insight the military could use to design and modify job categories and prevent the exposures that lead to tinnitus.

Another NCRAR team, led by Robert Folmer, PhD, recently completed its investigation of a treatment for chronic tinnitus, known as transcranial magnetic stimulation (TMS). An FDA-approved treatment for depression, TMS is a method of stimulating brain tissue with a magnetic field. Folmer’s team found that TMS reduced the severity of tinnitus for more than half of the participants in the treatment group throughout the six-month duration of the study.

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Craig Collins is a veteran freelance writer and a regular Faircount Media Group contributor who...