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National Center for Rehabilitative Auditory Research (NCRAR)

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Naomi Bramhall, Au.D., Ph.D.

Email: naomi.bramhall@va.gov
Telephone: 503-220-8262 x54692

Current appointments:

Research Investigator, NCRAR
Clinical Audiologist, Audiology & Speech Pathology Service, VA Portland Health Care System
Assistant Professor, Otolaryngology, Oregon Health & Science University

Dr. Bramhall’s research focuses on:

  • Identifying auditory physiological measures in humans that can be used for diagnosis of cochlear deafferentation, the disruption of the afferent connection between the peripheral and central auditory system due to loss of inner hair cells, cochlear synapses, or spiral ganglion cells.
  • Determining the perceptual consequences of cochlear deafferentation. 

Because animal models and human temporal bone studies suggest that noise exposure can lead to significant cochlear synapse loss, Dr. Bramhall is particularly interested in auditory physiological characteristics of Veterans with a history of military noise exposure.

Research projects (Current and recently completed):

Resolving the Paradox of Hearing Complaints with a Normal Audiogram: Differential Diagnosis and Perceptual Impacts of Cochlear Deafferentation. VA RR&D, Merit Award, 2022-2026

Listening effort during complex speech perception. American Speech-Language-Hearing Foundation Independent Clinical Research Grant December 2019-November 2021. 
The objective of this study was to determine if listening effort during complex speech perception, as measured through pupillometry, is increased among individuals with normal audiograms who have auditory physiological hallmarks of cochlear deafferentation, such as reduced ABR wave I amplitude and/or MEMR magnitude. Elevated listening effort may explain why it has been difficult to demonstrate clear relationships between complex speech perception and physiological indicators of cochlear deafferentation. This study will determine whether listening effort during speech perception is a better indicator of perceptual deficits related to cochlear deafferentation than speech perception performance itself. If deafferentation contributes to difficulty with complex speech perception, future development of specialized hearing aid algorithms or pharmaceuticals for synapse regeneration or repair can be used to treat deafferentation-related speech perception difficulties.

Uncovering physiological markers of hidden hearing loss. VA RR&D, Career Development Award, 2016-2021
This study aimed to identify physiological measures (e.g., auditory brainstem response (ABR), envelope following response, middle ear muscle reflex (MEMR), and middle and late auditory evoked potentials) that can detect cochlear deafferentation in young Veterans who have experienced high levels of noise exposure. These measures will provide the basis for a future clinical test battery to diagnose cochlear deafferentation. In addition, physiological measures will be evaluated for their relationships with two proposed perceptual consequences of cochlear deafferentation, tinnitus and hyperacusis.

Noise-induced cochlear neuronal degeneration and its perceptual consequences. VA RR&D, Career Development Award, 2014-2016
This study investigated the relationship between ABR wave I amplitude and noise exposure history in young Veterans and non-Veterans with a history of firearm use. In addition, associations between ABR wave I amplitude and predicted perceptual impacts of cochlear deafferentation (tinnitus, hyperacusis, and speech perception difficulty) were evaluated.

  • Bramhall, N.F., Konrad-Martin, D., McMillan, G. (2018). Tinnitus and Auditory Perception After a History of Noise Exposure: Relationship to Auditory Brainstem Response Measures. Ear and Hearing, 39: 881-894.
  • Bramhall, N.F., Konrad-Martin, D., McMillan, G.P., Griest, S.E. (2017). Auditory Brainstem Response Altered in Humans With Noise Exposure Despite Normal Outer Hair Cell Function. Ear and Hearing, 38: e1-e12.

Selected publications:

  • Griest-Hines, S. E., Bramhall, N. F., Reavis, K. M., Theodoroff, S. M., Henry, J. A. (2021). Development and Initial Validation of the Lifetime Exposure to Noise and Solvents Questionnaire in U.S. Service Members and Veterans. Am J Audiol, 1-15.
  • Bramhall, N., Konrad-Martin, D., McMillan, G. (2018). Tinnitus and Auditory Perception After a History of Noise Exposure: Relationship to Auditory Brainstem Response Measures. Ear and Hearing, 39: 881-894.
  • Bramhall, N.F., Konrad-Martin, D., McMillan, G.P., Griest, S.E. (2017). Auditory Brainstem Response Altered in Humans With Noise Exposure Despite Normal Outer Hair Cell Function. Ear and Hearing, 38: e1-e12.
  • Bramhall, N., Ong, B., Ko, J., Parker, M. (2015). Speech Perception Ability in Noise is Correlated with Auditory Brainstem Response Wave I Amplitude. Journal of the American Academy of Audiology, 26: 509-17.
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