Service members and veterans (SMVs) with a history of traumatic brain injury (TBI) or blast-related injury often report difficulties understanding speech in complex environments that are not captured by clinical tests of auditory function. Little is currently known about the relative contribution of other auditory, cognitive, and symptomological factors to these communication challenges. This study evaluated the influence of these factors on subjective and objective measures of hearing difficulties in SMVs with and without a history of TBI or blast exposure. Analyses included 212 U.S. SMVs who completed auditory and cognitive batteries and surveys of hearing and other symptoms as part of a larger longitudinal study of TBI. Objective speech recognition performance was predicted by TBI status, while subjective hearing complaints were predicted by blast exposure. Bothersome tinnitus was associated with a history of more severe TBI. Speech recognition performance deficits and tinnitus complaints were also associated with poorer cognitive function. Hearing complaints were predicted by high frequency hearing loss and reports of more severe PTSD symptoms. These results suggest that SMVs with a history of blast exposure and/or TBI experience communication deficits that go beyond what would be expected based on standard audiometric assessments of their injuries.
Keywords: blast exposure; hearing; service members and veterans; speech perception; tinnitus; traumatic brain injury.
At least a portion of this work is authored by Stefanie E. Kuchinsky, Megan M. Eitel, Rael T. Lange, Louis M. French, Tracey A. Brickell, Sara M. Lippa and Douglas S. Brungart on behalf of the U.S. Government and, as regards Dr. Kuchinsky, Eitel, Lange, French, Brickell, Lippa and Brungart and the U.S. Government, is not subject to copyright protection in the United States. Foreign and other copyrights may apply.