MUSC’s Hearing Research Program
Guest: Dr. Judy Dubno – Otolaryngology/Head & Neck Surgery, MUSC
Host: Dr. Linda Austin – Psychiatrist, MUSC
Dr. Linda Austin: Dr. Judy Dubno is Professor of Otolaryngology, which is the field of medicine related to ear, nose, and throat. We’ve been talking about the different kinds of hearing loss. In this podcast, however, let’s focus on research going on here at MUSC on hearing loss. What do you think are the most exciting directions of research here?
Dr. Judy Dubno: Thank you, Dr. Austin. I’m very excited to talk with you, today, about the Hearing Research Program, which is a collaborative program of research involving a large number of clinical and basic scientists representing many disciplines. The program was founded in 1987, so it’s been in existence for quite a long time. It was founded by John Mills, with help from Richard Schmiedt and Bradley Shultey. It has now grown to include about 30 faculty and staff, based in the College of Medicine, the Department of Otolaryngology (ENT), and the Department of Pathology.
It’s a combination of basic science studies and clinical studies. And, because hearing loss is one of the most common health concerns in the United States, affecting a large number of people, especially older people, a lot of our research focuses on hearing loss due to aging. Hearing loss is often also caused by exposure to noise and certain kinds of drugs.
One of our research programs, directed by Lisa Cunningham, is studying certain proteins that occur naturally in the body which may prevent damage to the inner ear caused by exposure to drugs and noise. One of the goals of her study is to find a way to get that protein working before the damaging effects of noise or drugs occur. And that would be a great breakthrough, because if you knew you were going into a noisy environment, or you knew you were going to take a drug that could damage your hearing, you would be able to take a pill, before going into that noisy environment, which would reduce the damaging effects of noise.
Dr. Linda Austin: I would think that could be incredibly important for young people who, for example, are learning to shoot a pistol for the police or military, or kids who are musicians, or going to a rock concert.
Dr. Judy Dubno: That’s right. In addition, there are millions of people in the United States who have noisy occupations, and they have to work in noisy environments for long hours. If they could take some sort of medication before going into that noisy environment, they could protect their hearing significantly. This, of course, is the long-term goal of the research. We’re not quite there yet. But, through basic science studies, we’re hoping that someday there will be such a way to prevent noise-induced hearing loss; due to certain drugs.
Another basic study that we’re conducting, directed by Hainan Lang, is looking at how certain nerve cells in the auditory system work and how to protect those nerve cells from the damaging effects of certain substances that increase as we get older. In addition to those basic science studies, the Hearing Research Program includes a large number of clinical studies of hearing where, again, the focus is mostly on hearing loss due to aging.
Dr. Linda Austin: And just to explain the difference between basic studies and clinical studies, basic studies are really done in the lab, usually not with actual live human beings, but looking at other models for looking at hearing loss. In clinical studies, you’re usually using live human beings.
Dr. Judy Dubno: That’s correct. And, in the more than 20 years since our program began, we’ve created a large database of measures of hearing from nearly 1000 adults in the Charleston area who have participated in, an continue to participate in, our program. Lois Mathews and Fu-Shing Lee, who was a statistician, have been involved in that part of the program since its inception, for more than 20 years now. Michelle Edwards is our participant recruitment coordinator. She’s the person that goes out in the community and talks to people about our program, and encourages them to become members of our program. Our research is, of course, is dependent on people being interested in our research, and participating in our studies.
Dr. Linda Austin: And why would someone want to do that? What is the benefit for the participant?
Dr. Judy Dubno: Part of it is because they’re interested in science, and interested in helping other people who have hearing loss. We explain to our participants that they would not likely get a direct benefit themselves from participating, but they would be able to participate in research that would provide a long-term benefit to others in the future.
Dr. Linda Austin: So they can be part of science, in the march of science. It’s a great contribution.
Dr. Judy Dubno: That’s right. We also explain to them the results of the hearing test that we do. So, they would get some information about their hearing. And if they have questions about difficulties they have with communication, or if they wear a hearing aid and have questions about them, we do help them where we can; refer them to audiologists or otolaryngologists, if they need to see physicians or audiologists about their hearing problems.
I should also say that ours is a longitudinal study. That means that we obtain the same measures from our participants every two to three years. In addition, we invite them to come to the lab yearly so we can check on how they’re doing. And, a longitudinal study, measuring the same thing every year, or every two to three years, is a very precise way of detecting changes in hearing as people get older. At the same time, we’re going to, with their permission, obtain DNA and a detailed family history to determine if certain genes are associated with age-related hearing loss.
Another focus of our research is on hearing aids. That part of the research is conducted by Jayne Ahlstrom and Amy Horwitz. Hearing aids are the most common form of treatment for sensory neural hearing loss, but many people are unhappy with their hearing aids, or do not seek treatment for their hearing loss. Our studies are aimed at understanding why people do not achieve benefits from hearing aids so that better technology can be developed, or better rehabilitation programs can be designed to allow people to understand the speech that they’re now able to hear.
Dr. Linda Austin: At MUSC, are there any studies going on in which we’re working with inventors, developers, of hearing aids to test out new technologies?
Dr. Judy Dubno: Currently, we are not, but we’re hoping, with the continued development of the bioengineering program at MUSC, to collaborate with bioengineers to develop better hearing aids, and to apply the information we’ve learned from our basic studies to develop better technology.
I did want to tell you about one of the newest parts of our program that uses brain imaging to study human hearing. These studies use MRI. An MRI is something that many of you may be familiar with. We use MRI that examines the brain and brain structures. We also use something called Functional MRI to examine brain activity while listening to speech. These measures provide exquisite images of parts of the brain that are active during speech recognition, so we can study how that activation changes with age.
We will also be using brain imaging to see changes in brain activation that occur after using a hearing aid. That will allow us to study how people learn to use these new sounds that become available, and see what the contribution of the brain is to learning these new sounds. We often say that hearing doesn’t just occur in the ear, but it also occurs in the brain, and the brain is a very large contributor to our understanding of speech.
Another member of our program, Kelly Harris, is combining brain imaging with recordings of electrical activity along the scalp. Some of you who’ve had an EEG test have gone through that experience. So, she’s combining brain imaging and a form of EEG to determine how changes in understanding sounds occur as someone gets older.
Before ending, I would like to acknowledge two groups who have been key to the success of our research program. We are very grateful to the National Institutes of Health, whose grants have supported our research for more than 30 years. We are also indebted to our participants for the generous, and enthusiastic, contribution of their time to our studies. And I’d like to thank you, Dr. Austin, for the opportunity to tell your listeners about MUSC’s Hearing Research Program.
Dr. Linda Austin: Well, it’s really fascinating, Dr. Dubno, and it’s so important, because as people are living longer and longer, so many of us will, really, need the benefits of this research. Dr. Dubno, if somebody wants to participate as a research subject, how can they get involved?
Dr. Judy Dubno: They can call the Hearing Research Program. The number is (843) 792-7977. The person who answers will provide information about our program and how they can volunteer as a participant.
Dr. Linda Austin: Dr. Dubno, thank you so much for talking with us today.
Dr. Judy Dubno: Thank you, Dr. Austin.
If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection at: (843) 792-1414.