{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:25:53Z","timestamp":1773303953591,"version":"3.50.1"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"11-12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Mild TBI (TBI) is associated with up to a 75.7% incidence of tinnitus, and 33.0% of tinnitus patients at the US Veterans Administration carry a diagnosis of post-traumatic stress syndrome (PTSD). Yet factors contributing to new onset or exacerbation of tinnitus remain unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>Here we measure intermittent and constant tinnitus at two time points to ascertain whether pre-existing or co-occurring traumatic brain injury (TBI), hearing loss, or post-traumatic stress disorder (PTSD) predicts new onset, lack of recovery and\/or worsening of tinnitus in 2,600 United States Marines who were assessed before and after a combat deployment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ordinal regression revealed that constant tinnitus before deployment was likely to continue after deployment (odds ratio [OR] = 28.62, 95% confidence interval [CI]: 9.84,83.26). Prior intermittent tinnitus increased risk of post-deployment constant tinnitus (OR = 4.95, CI: 2.97,8.27). Likelihood of tinnitus progression increased with partial PTSD (OR = 2.39, CI: 1.50,3.80) and TBI (OR = 1.59, CI: 1.13,2.23), particularly for blast TBI (OR = 2.01, CI: 1.27,3.12) and moderate to severe TBI (OR = 2.57, CI: 1.46,4.51). Tinnitus progression also increased with low frequency hearing loss (OR = 1.94, CI: 1.05,3.59), high frequency loss (OR = 3.01, CI: 1.91,4.76) and loss across both low and high frequency ranges (OR = 5.73, CI: 2.67,12.30).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Screening for pre-existing or individual symptoms of PTSD, TBI, and hearing loss may allow for more focused treatment programs of comorbid disorders. Identification of those personnel vulnerable to tinnitus or its progression may direct increased acoustic protection for those at risk.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usz016","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T13:37:48Z","timestamp":1550842668000},"page":"839-846","source":"Crossref","is-referenced-by-count":26,"title":["Impact of TBI, PTSD, and Hearing Loss on Tinnitus Progression in a US Marine Cohort"],"prefix":"10.1093","volume":"184","author":[{"given":"Royce E","family":"Clifford","sequence":"first","affiliation":[{"name":"VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Harvard University School of Public Health, 677 Huntington Ave, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dewleen","family":"Baker","sequence":"additional","affiliation":[{"name":"VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Department of Psychiatry, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria B","family":"Risbrough","sequence":"additional","affiliation":[{"name":"VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Department of Psychiatry, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingxiong","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of California San Diego School of Medicine, 9500 Gilman Dr, La Jolla, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0651-5219","authenticated-orcid":false,"given":"Kate A","family":"Yurgil","sequence":"additional","affiliation":[{"name":"VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Drive, San Diego, CA"},{"name":"Department of Psychological Sciences, Loyola University New Orleans, 6363 St. Charles Ave., Box 194, New Orleans, LA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,2,22]]},"reference":[{"key":"2019121323172709100_usz016C1","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.jclinepi.2015.09.016","article-title":"Million Veteran Program: a mega-biobank to study genetic influences on health and disease","volume":"70","author":"Gaziano","year":"2016","journal-title":"J Clin Epidemiol"},{"key":"2019121323172709100_usz016C2","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.heares.2016.05.009","article-title":"A systematic review of the reporting of tinnitus prevalence and severity","volume":"337","author":"McCormack","year":"2016","journal-title":"Hear Res"},{"key":"2019121323172709100_usz016C3","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.amjmed.2010.02.015","article-title":"Prevalence and characteristics of tinnitus among US adults","volume":"123","author":"Shargorodsky","year":"2010","journal-title":"Am J Med"},{"key":"2019121323172709100_usz016C4","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1682\/JRRD.2011.01.0001","article-title":"Audiological issues and hearing loss among Veterans with mild traumatic brain injury","volume":"49","author":"Oleksiak","year":"2012","journal-title":"J Rehabil Res Dev"},{"key":"2019121323172709100_usz016C5","first-page":"E109","article-title":"Tinnitus: prevalence and co-morbidities in a cohort of Iraq and Afghanistan veterans","volume":"30","author":"Swan","year":"2015","journal-title":"J Head Trauma Rehabil"},{"key":"2019121323172709100_usz016C6","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1044\/1059-0889(2007\/015)","article-title":"The association between tinnitus and posttraumatic stress disorder","volume":"16","author":"Fagelson","year":"2007","journal-title":"Am J Audiol"},{"key":"2019121323172709100_usz016C7","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1177\/1084713808319941","article-title":"The role of audiologic evaluation in progressive audiologic tinnitus management","volume":"12","author":"Henry","year":"2008","journal-title":"Trends Amplif"},{"key":"2019121323172709100_usz016C8","first-page":"67","article-title":"Altered top-down cognitive control and auditory processing in tinnitus: evidences from auditory and visual spatial Stroop","volume":"33","author":"Araneda","year":"2015","journal-title":"Restor Neurol Neurosci"},{"key":"2019121323172709100_usz016C9","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.smrv.2012.04.003","article-title":"Tinnitus and insomnia: is hyperarousal the common denominator?","volume":"17","author":"Wallh\u00e4usser-Franke","year":"2013","journal-title":"Sleep Med Rev"},{"key":"2019121323172709100_usz016C10","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1001\/jamapsychiatry.2013.3080","article-title":"Association between traumatic brain injury and risk of posttraumatic stress disorder in active-duty Marines","volume":"71","author":"Yurgil","year":"2014","journal-title":"JAMA Psychiatry"},{"key":"2019121323172709100_usz016C11","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/HTR.0000000000000117","article-title":"Prospective associations between traumatic brain injury and post-deployment tinnitus in Active-Duty Marines","volume":"31","author":"Yurgil","year":"2016","journal-title":"J Head Trauma Rehabil"},{"issue":"10","key":"2019121323172709100_usz016C12","first-page":"E97","article-title":"The Marine Resiliency Study, a prospective multi-system study of predictors of risk and resilience for posttraumatic stress disorder in ground combat Marines: Study methods and pre-deployment participant demographics and 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veterans","volume":"26","author":"Insana","year":"2013","journal-title":"J Trauma Stress"},{"key":"2019121323172709100_usz016C35","doi-asserted-by":"crossref","first-page":"e45599","DOI":"10.1371\/journal.pone.0045599","article-title":"TRI Database Study Group: Trauma-associated tinnitus: audiological, demographic and clinical characteristics","volume":"7","author":"Kreuzer","year":"2012","journal-title":"PLoS One"},{"issue":"1","key":"2019121323172709100_usz016C36","doi-asserted-by":"crossref","first-page":"1512248","DOI":"10.1080\/20008198.2018.1512248","article-title":"A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing \u2013 a multicentre pilot trial","volume":"9","author":"Rikkert","year":"2018","journal-title":"Eur J Psychotraumatol"},{"issue":"2","key":"2019121323172709100_usz016C37","first-page":"118","article-title":"Comorbidity of chronic tinnitus and mental 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