151
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Hullfish J, Abenes I, Yoo HB, De Ridder D, Vanneste S. Frontostriatal network dysfunction as a domain-general mechanism underlying phantom perception. Hum Brain Mapp 2019; 40:2241-2251. [PMID: 30648324 DOI: 10.1002/hbm.24521] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/05/2018] [Accepted: 01/01/2019] [Indexed: 12/16/2022] Open
Abstract
In the present study, we use resting state fMRI to investigate whether nucleus accumbens (NAc) and extended frontostriatal networks are involved in the pathology of auditory phantom perception, i.e., tinnitus, through a study of functional connectivity. We hypothesize that resting state functional connectivity involving NAc will be increased relative to what is observed in healthy subjects and that this connectivity will correlate with clinical measures of tinnitus such as percept loudness, duration of symptoms, etc. We show that a large sample of patients with chronic tinnitus (n = 90) features extensive functional connectivity involving NAc that is largely absent in healthy subjects (n = 94). We further show that connectivity involving NAc correlates significantly with tinnitus percept loudness and the duration of tinnitus symptoms, even after controlling for the effects of age and hearing loss. The loudness correlation, which involves NAc and parahippocampal cortex, is consistent with existing literature identifying the parahippocampus as a tinnitus generator. Our results further suggest that frontostriatal connectivity may predict the transition from acute to chronic tinnitus, analogous to what is seen in the pain literature. We discuss these ideas and suggest fruitful avenues for future research.
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Affiliation(s)
- Jeffrey Hullfish
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
| | - Ian Abenes
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
| | - Hye Bin Yoo
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas.,Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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152
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Vanneste S, Alsalman O, De Ridder D. Top-down and Bottom-up Regulated Auditory Phantom Perception. J Neurosci 2019; 39:364-378. [PMID: 30389837 PMCID: PMC6360282 DOI: 10.1523/jneurosci.0966-18.2018] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/18/2018] [Accepted: 10/20/2018] [Indexed: 02/07/2023] Open
Abstract
Auditory phantom percepts such as tinnitus are associated with auditory deafferentation. The idea is that auditory deafferentation limits the amount of information the brain can acquire to make sense of the world. Because of this, auditory deafferentation increases the uncertainty of the auditory environment. To minimize uncertainty, the deafferented brain will attempt to obtain or fill in the missing information. A proposed multiphase compensation model suggests two distinct types of bottom-up related tinnitus: an auditory cortex related tinnitus and a parahippocampal cortex related tinnitus. The weakness of this model is that it cannot explain why some people without hearing loss develop tinnitus, whereas conversely others with hearing loss do not develop tinnitus. In this human study, we provide evidence for a top-down type of tinnitus associated with a deficient noise-cancelling mechanism. A total of 72 participants (age: 40.96 ± 7.67 years; males: 48; females: 24) were recruited for this study. We demonstrate that top-down related tinnitus is related to a change in the pregenual anterior cingulate cortex that corresponds to increased activity in the auditory cortex. This is in accordance with the idea that tinnitus can have different generators as proposed in a recent model that suggests that different compensation mechanisms at a cortical level can be linked to phantom percepts.SIGNIFICANCE STATEMENT Chronic tinnitus affects 15% of the population worldwide. The term "tinnitus" however represents a highly heterogeneous condition, as evidenced by the fact that there are no effective treatments or even an adequate understanding of the underlying neural mechanisms. Consistent with this idea, our research shows that tinnitus indeed has different subtypes related to hearing loss. In a human study tightly controlled for hearing loss, we establish a tinnitus subtype associated with a deficient top-down noise-cancelling mechanism, which distinguishes it from bottom-up subtypes. We demonstrate that top-down related tinnitus relates to a change in the pregenual anterior cingulate cortex that corresponds to increased activity in the auditory cortex, whereas bottom-up tinnitus instead relates to changes in the parahippocampal cortex.
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Affiliation(s)
- Sven Vanneste
- Laboratory for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080, and
| | - Ola Alsalman
- Laboratory for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas 75080, and
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand
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153
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Hu S, Anschuetz L, Huth ME, Sznitman R, Blaser D, Kompis M, Hall DA, Caversaccio M, Wimmer W. Association Between Residual Inhibition and Neural Activity in Patients with Tinnitus: Protocol for a Controlled Within- and Between-Subject Comparison Study. JMIR Res Protoc 2019; 8:e12270. [PMID: 30626571 PMCID: PMC6329433 DOI: 10.2196/12270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 01/19/2023] Open
Abstract
Background Electroencephalography (EEG) studies indicate possible associations between tinnitus and changes in the neural activity. However, inconsistent results require further investigation to better understand such heterogeneity and inform the interpretation of previous findings. Objective This study aims to investigate the feasibility of EEG measurements as an objective indicator for the identification of tinnitus-associated neural activities. Methods To reduce heterogeneity, participants served as their own control using residual inhibition (RI) to modulate the tinnitus perception in a within-subject EEG study design with a tinnitus group. In addition, comparison with a nontinnitus control group allowed for a between-subjects comparison. We will apply RI stimulation to generate tinnitus and nontinnitus conditions in the same subject. Furthermore, high-frequency audiometry (up to 13 kHz) and tinnitometry will be performed. Results This work was funded by the Infrastructure Grant of the University of Bern, Bern, Switzerland and Bernafon AG, Bern, Switzerland. Enrollment for the study described in this protocol commenced in February 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019. Conclusions This study design helps in comparing the neural activity between conditions in the same individual, thereby addressing a notable limitation of previous EEG tinnitus studies. In addition, the high-frequency assessment will help to analyze and classify tinnitus symptoms beyond the conventional clinical standard. International Registered Report Identifier (IRRID) RR1-10.2196/12270
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Affiliation(s)
- Suyi Hu
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus E Huth
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Sznitman
- Ophthalmic Technology Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Daniela Blaser
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Kompis
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Deborah A Hall
- National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham University Hospitals National Health Service Trust, Queens Medical Centre, Nottingham, United Kingdom.,Malaysia Campus, University of Nottingham, Semeniyh, Malaysia
| | - Marco Caversaccio
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wilhelm Wimmer
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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154
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Langguth B, Elgoyhen AB, Cederroth CR. Therapeutic Approaches to the Treatment of Tinnitus. Annu Rev Pharmacol Toxicol 2019; 59:291-313. [DOI: 10.1146/annurev-pharmtox-010818-021556] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Tinnitus is a highly prevalent condition that is associated with hearing loss in most cases. In the absence of external stimuli, phantom perceptions of sounds emerge from alterations in neuronal activity within central auditory and nonauditory structures. Pioneering studies using lidocaine revealed that tinnitus is susceptible to pharmacological interventions. However, lidocaine is not effective in all patients, and no other drug has been identified with clear efficacy for the long-term treatment of tinnitus. In this review, we present recent advances in tinnitus research, including more detailed knowledge of its pathophysiology and involved neurotransmitter systems. Moreover, we summarize results from animal and clinical treatment studies as well as from studies that identified tinnitus as a side effect of pharmacological treatments. Finally, we focus on challenges in the development of pharmacological compounds for the treatment of tinnitus, namely the limitations of available animal models and of standardized clinical research methodologies.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, and Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
| | - Ana Belen Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Héctor N. Torres,” Consejo Nacional de Investigaciones Científicas y Técnicas, 1428 Buenos Aires, Argentina
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, 1121 Buenos Aires, Argentina
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155
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Neff P, Zielonka L, Meyer M, Langguth B, Schecklmann M, Schlee W. Comparison of Amplitude Modulated Sounds and Pure Tones at the Tinnitus Frequency: Residual Tinnitus Suppression and Stimulus Evaluation. Trends Hear 2019; 23:2331216519833841. [PMID: 30871419 PMCID: PMC6421608 DOI: 10.1177/2331216519833841] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 01/03/2019] [Accepted: 01/16/2019] [Indexed: 12/26/2022] Open
Abstract
Recent studies have compared tinnitus suppression, or residual inhibition, between amplitude- and frequency-modulated (AM) sounds and noises or pure tones (PT). Results are indicative, yet inconclusive, of stronger tinnitus suppression of modulated sounds especially near the tinnitus frequency. Systematic comparison of AM sounds at the tinnitus frequency has not yet been studied in depth. The current study therefore aims at further advancing this line of research by contrasting tinnitus suppression profiles of AM and PT sounds at the matched tinnitus frequency (i.e., 10 and 40 Hz AM vs. PT). Participants with chronic, tonal tinnitus (n = 29) underwent comprehensive psychometric, audiometric, tinnitus matching, and acoustic stimulation procedures. Stimuli were presented for 3 minutes in two loudness regimes (60 dB sensation level [SL], minimum masking level [MML] + 6 dB, control sound: SL -6 dB) and amplitude modulated with 0, 10, or 40 Hz. Tinnitus loudness suppression was measured after the stimulation every 30 seconds. In addition, stimuli were rated regarding their valence and arousal. Results demonstrate only trends for better tinnitus suppression for the 10 Hz modulation and presentation level of 60 dB SL compared with PT, whereas nonsignificant results are reported for 40 Hz and MML + 6 dB, respectively. Furthermore, the 10 Hz AM at 60 dB SL and the 40 Hz AM at MML + 6 dB (trend) stimuli were better tolerated as elicited by valence ratings. We conclude that 10 Hz AM sounds at the tinnitus frequency may be useful to further elucidate the phenomenon of residual inhibition.
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Affiliation(s)
- Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
- University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Switzerland
| | - Lisa Zielonka
- Department of Medicine, University of Regensburg, Germany
| | - Martin Meyer
- University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Switzerland
- Division of Neuropsychology, Department of Psychology, University of Zurich, Switzerland
- Tinnitus-Zentrum, Charité – Universitätsmedizin, Berlin, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
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156
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Chai Z, Ma C, Jin X. Cortical stimulation for treatment of neurological disorders of hyperexcitability: a role of homeostatic plasticity. Neural Regen Res 2019; 14:34-38. [PMID: 30531066 PMCID: PMC6262991 DOI: 10.4103/1673-5374.243696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hyperexcitability of neural network is a key neurophysiological mechanism in several neurological disorders including epilepsy, neuropathic pain, and tinnitus. Although standard paradigm of pharmacological management of them is to suppress this hyperexcitability, such as having been exemplified by the use of certain antiepileptic drugs, their frequent refractoriness to drug treatment suggests likely different pathophysiological mechanism. Because the pathogenesis in these disorders exhibits a transition from an initial activity loss after injury or sensory deprivation to subsequent hyperexcitability and paroxysmal discharges, this process can be regarded as a process of functional compensation similar to homeostatic plasticity regulation, in which a set level of activity in neural network is maintained after injury-induced activity loss through enhanced network excitability. Enhancing brain activity, such as cortical stimulation that is found to be effective in relieving symptoms of these disorders, may reduce such hyperexcitability through homeostatic plasticity mechanism. Here we review current evidence of homeostatic plasticity in the mechanism of acquired epilepsy, neuropathic pain, and tinnitus and the effects and mechanism of cortical stimulation. Establishing a role of homeostatic plasticity in these disorders may provide a theoretical basis on their pathogenesis as well as guide the development and application of therapeutic approaches through electrically or pharmacologically stimulating brain activity for treating these disorders.
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Affiliation(s)
- Zhi Chai
- Basic Medical College, Shanxi Key Laboratory of Innovative Drugs for Serious Illness Based on Inflammatory Reactions, Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, Shanxi Province, China
| | - Cungen Ma
- Basic Medical College, Shanxi Key Laboratory of Innovative Drugs for Serious Illness Based on Inflammatory Reactions, Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong; Institute of Brain Science, Shanxi Datong University, Datong, Shanxi Province, China
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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157
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Zheng W, Peng Z, Pengfei Z, Jing L, Heyu D, Hongxia Y, Yawen L, Zhengyu Z, Shusheng G, Zhenghan Y, Han L, Zhenchang W. Long-term reactions to pulsatile tinnitus are marked by weakened short-range functional connectivity within a brain network in the right temporal lobe. J Magn Reson Imaging 2018; 49:1629-1637. [PMID: 30575157 DOI: 10.1002/jmri.26545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/29/2018] [Accepted: 10/02/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There have been recent efforts to characterize brain functional activity features in patients with pulsatile tinnitus (PT). These efforts have revealed evidence of aberrant functional connectivity (FC) of the right middle temporal gyrus (MTG) in PT patients with prolonged disease duration. PURPOSE To assess the possible predictive effect of aberrant FC of MTG in PT patients with prolonged disease duration. STUDY TYPE Retrospective. POPULATION Thirty-four patients with recent-onset PT (RPTIN), 24 patients with long-term PT (LPTIN), and 35 age-, gender-, and education-matched healthy controls were enrolled. FIELD STRENGTH/SEQUENCE 3.0T MRI system and echo-planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence. ASSESSMENT Functional MRI data preprocessing was performed in Data Processing & Analysis for Brain Imaging (DPABI) and Statistical Parametric Mapping (SPM) 8. The FC analyses were conducted using the software REST. STATISTICAL TESTS One-way analysis of covariance was conducted between three groups with age and gender as covariates, and post-hoc analysis was used to identify the sources of group effects. Pearson's correlation analysis was conducted for the z-values of altered FC strength in the PT group and the clinical data. RESULTS Among hubs belonging to the executive control network, the default mode network (DMN), and limbic network, the strength of FC was mainly decreased in the patient groups compared with normal controls (P < 0.05). Relative to RPTIN patients and normal controls, LPTIN patients were further characterized by significantly decreased FC between several short-range brain regions adjacent to the seed (P < 0.05). Finally, disease duration was negatively correlated with decreased FC between the seed and right fusiform gyrus/parahippocampal gyrus, right inferior frontal gyrus, and right MTG (a brain area adjacent to the seed region). DATA CONCLUSION Long-term reactions to PT mainly involved weakened short-range FC, especially within a functional network in the right temporal lobe. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Wang Zheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Zhang Peng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Zhao Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Li Jing
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Ding Heyu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Yin Hongxia
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Liu Yawen
- School of Biological Science and Medical Engineering, Beihang University, Beijing, P.R. China
| | - Zhang Zhengyu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Gong Shusheng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Yang Zhenghan
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Lv Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Wang Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
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158
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Cederroth CR, Dyhrfjeld-Johnsen J, Langguth B. An update: emerging drugs for tinnitus. Expert Opin Emerg Drugs 2018; 23:251-260. [DOI: 10.1080/14728214.2018.1555240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany
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159
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Mohan A, Davidson C, De Ridder D, Vanneste S. Effective connectivity analysis of inter- and intramodular hubs in phantom sound perception – identifying the core distress network. Brain Imaging Behav 2018; 14:289-307. [DOI: 10.1007/s11682-018-9989-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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160
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Painter DR, Dwyer MF, Kamke MR, Mattingley JB. Stimulus-Driven Cortical Hyperexcitability in Individuals with Charles Bonnet Hallucinations. Curr Biol 2018; 28:3475-3480.e3. [DOI: 10.1016/j.cub.2018.08.058] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/10/2018] [Accepted: 08/29/2018] [Indexed: 01/23/2023]
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161
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Hullfish J, Abenes I, Kovacs S, Sunaert S, De Ridder D, Vanneste S. Functional brain changes in auditory phantom perception evoked by different stimulus frequencies. Neurosci Lett 2018; 683:160-167. [PMID: 30075284 DOI: 10.1016/j.neulet.2018.07.043] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/24/2018] [Accepted: 07/30/2018] [Indexed: 12/22/2022]
Abstract
Bayesian models of brain function such as active inference and predictive coding offer a general theoretical framework with which to explain several aspects of normal and disordered brain function. Of particular interest to the present study is the potential for such models to explain the pathology of auditory phantom perception, i.e. tinnitus. To test this framework empirically, we perform an fMRI experiment on a large clinical sample (n = 75) of the human chronic tinnitus population. The experiment features a within-subject design based on two experimental conditions: subjects were presented with sound stimuli matched to their tinnitus frequency (TF) as well as similar stimuli presented at a control frequency (CF). The responses elicited by these stimuli, as measured using both activity and functional connectivity, were then analyzed both within and between conditions. Given the Bayesian-brain framework, we hypothesize that TF stimuli will elicit greater activity and/or functional connectivity in areas related to the cognitive and emotional aspects of tinnitus, i.e. tinnitus-related distress. We conversely hypothesize that CF stimuli will elicit greater activity/connectivity in areas related to auditory perception and attention. We discuss our results in the context of this framework and suggest future directions for empirical testing.
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Affiliation(s)
- Jeffrey Hullfish
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Ian Abenes
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA
| | - Silvia Kovacs
- Translational MRI, Department of Imaging and Pathology & Medical Imaging Research Center, Department of Radiology, Catholic University of Leuven, Leuven 3000, Belgium
| | - Stefan Sunaert
- Translational MRI, Department of Imaging and Pathology & Medical Imaging Research Center, Department of Radiology, Catholic University of Leuven, Leuven 3000, Belgium
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin 9054, New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX 75080, USA.
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162
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Han Q, Zhang Y, Liu D, Wang Y, Feng Y, Yin X, Wang J. Disrupted local neural activity and functional connectivity in subjective tinnitus patients: evidence from resting-state fMRI study. Neuroradiology 2018; 60:1193-1201. [PMID: 30159629 DOI: 10.1007/s00234-018-2087-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 08/21/2018] [Indexed: 01/10/2023]
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163
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Gault R, Mcginnity TM, Coleman S. A Computational Model of Thalamocortical Dysrhythmia in People With Tinnitus. IEEE Trans Neural Syst Rehabil Eng 2018; 26:1845-1857. [PMID: 30106678 DOI: 10.1109/tnsre.2018.2863740] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Tinnitus is a problem that affects a diverse range of people. One common trait amongst people with tinnitus is the presence of hearing loss, which is apparent in over 90% of the cohort. It is postulated that the remainder of people with tinnitus have hidden hearing loss in the form of cochlear synaptopathy. The loss of hearing sensation is thought to cause a reduction in the bottom-up excitatory signals of the auditory pathway leading to a change in the frequency of thalamocortical oscillations known as thalamocortical dysrhythmia (TCD). The downward shift in oscillatory behavior, characteristic of TCD, has been recorded experimentally but the underlying mechanisms responsible for TCD in tinnitus subjects cannot be directly observed. This paper investigates these underlying mechanisms by creating a biologically faithful model of the auditory periphery and thalamocortical network, called the central auditory processing (CAP) model. The proposed model replicates tinnitus related activity in the presence of hearing loss and hidden hearing loss in the form of cochlear synaptopathy. The results of this paper show that, both the bottom-up and top-down changes are required in the auditory system for tinnitus related hyperactivity to coexist with TCD, contrary to the theoretical model for TCD. The CAP model provides a novel modeling approach to account for tinnitus related activity with and without hearing loss. Moreover, the results provide additional clarity to the understanding of TCD and tinnitus and provide direction for future approaches to treating tinnitus.
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164
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Cai Y, Huang D, Chen Y, Yang H, Wang CD, Zhao F, Liu J, Sun Y, Chen G, Chen X, Xiong H, Zheng Y. Deviant Dynamics of Resting State Electroencephalogram Microstate in Patients With Subjective Tinnitus. Front Behav Neurosci 2018; 12:122. [PMID: 29988458 PMCID: PMC6024160 DOI: 10.3389/fnbeh.2018.00122] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 06/04/2018] [Indexed: 12/20/2022] Open
Abstract
Given the importance of central reorganization and tinnitus, we undertook the current study to investigate changes to electroencephalogram (EEG) microstates and their association with the clinical symptoms in tinnitus. High-density (128 channel) EEG was used to explore changes in microstate features in 15 subjects with subjective tinnitus and 17 age-matched controls. Correlations between microstate parameters and subjective tinnitus symptoms were also analyzed. An increased presence of class A microstate and decreased presence of class D microstate were found in coverage and lifespan of microstate parameters in the tinnitus patients. Syntax analysis also demonstrated an aberrant pattern of activity, with reduced transitions from class D to class B in tinnitus patients. Moreover, a significant positive correlation of tinnitus loudness with increased lifespan of microstate class C was found. Significant differences in temporal characteristics and syntax of the EEG microstate classes were found at rest between tinnitus patients and the healthy subjects. Our study indicates that EEG microstates may provide a possible valuable method to study large-scale brain networks, which may in turn be beneficial to investigation of the neurophysiological mechanisms behind tinnitus.
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Affiliation(s)
- Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Dong Huang
- College of Mathematics and Informatics, South China Agricultural University, Guangzhou, China
| | - Yanhong Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Chang-Dong Wang
- School of Data and Computer Science, Sun Yat-sen University, Guangzhou, China
| | - Fei Zhao
- Department of Speech Language Therapy and Hearing Science, Cardiff Metropolitan University, Cardiff, United Kingdom.,Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Jiahao Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Yingfeng Sun
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Guisheng Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Xiaoting Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Hao Xiong
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.,Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
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165
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Yadollahpour A, Mayo M, Saki N, Rashidi S, Bayat A. A chronic protocol of bilateral transcranial direct current stimulation over auditory cortex for tinnitus treatment: Dataset from a double-blinded randomized controlled trial. F1000Res 2018; 7:733. [PMID: 30356442 PMCID: PMC6178906 DOI: 10.12688/f1000research.14971.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 11/30/2022] Open
Abstract
Preliminary studies have demonstrated the therapeutic potential of transcranial direct current stimulation (tDCS) for chronic tinnitus. However, the findings are controversial and most of the studies investigated effects of a single session of tDCS and short after-effects, ranging from hours to days. To our knowledge, there is no published study investigating the effects of a chronic protocol of bilateral tDCS over auditory cortex (AC) with one month follow-up in a double blinded randomized clinical trial. This dataset presents the results of a double-blinded placebo controlled trial investigating the effects of chronic protocol (10 sessions) of tDCS over AC with 1 month follow-up. The data of the two groups, real tDCS (n=25) and sham tDCS (n=15), are reported. The dataset includes three main data groups: patient- and tinnitus-specific data, data of the primary and secondary outcomes, and data on the adverse effects of and tolerability to tDCS. The first group includes demographic information, audiometric assessments, and tinnitus-specific characteristics. The second group includes tinnitus handicap inventory (THI) scores, tinnitus loudness, and tinnitus related distress based on 0-10 numerical visual analogue scale (VAS) scores. The values of the primary and secondary outcomes for pre-intervention and at different time points following interventions are presented. THI scores pre-intervention and immediately post-intervention and at 1 month follow-up; the scores of tinnitus loudness and distress scores for pre-intervention, and immediately, 1 hour, 1 week, and at 1 month after the last stimulation session are presented. Moreover, the adverse effects of and tolerability to the tDCS were assessed using a customized questionnaire after the last tDCS session. This dataset can be used alone or in combination with other datasets using advanced statistical analyses and modeling to investigate the treatment efficacy of tDCS in chronic intractable tinnitus.
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Affiliation(s)
- Ali Yadollahpour
- Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Bioelectromagnetic Clinic, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Miguel Mayo
- Department of Otorhinolaryngology, A Coruña University Hospital Complex, A Coruña, Spain
| | - Nader Saki
- Bioelectromagnetic Clinic, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Samaneh Rashidi
- Hearing Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Arash Bayat
- Hearing Research Center, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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166
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Impact of Tinnitus on Cognitive Function in Forensic Neuropsychology Context. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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167
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Li T, Liu J, Li L, Xin Y, Zhang K, Song Y, Xiong S, Ma F. Observation of Lidocaine-suppressed Decrease of Magnesium in Salicylate-induced Tinnitus with an Online Electrochemical System. ELECTROANAL 2018. [DOI: 10.1002/elan.201700855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Tao Li
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Lijuan Li
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Ying Xin
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Ke Zhang
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Yu Song
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Shan Xiong
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
| | - Furong Ma
- Department of Otolaryngology Head and Neck Surgery; Third Hospital of Peking University; Beijing 100191 China
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168
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How stimulation frequency and intensity impact on the long-lasting effects of coordinated reset stimulation. PLoS Comput Biol 2018; 14:e1006113. [PMID: 29746458 PMCID: PMC5963814 DOI: 10.1371/journal.pcbi.1006113] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 05/22/2018] [Accepted: 04/03/2018] [Indexed: 12/31/2022] Open
Abstract
Several brain diseases are characterized by abnormally strong neuronal synchrony. Coordinated Reset (CR) stimulation was computationally designed to specifically counteract abnormal neuronal synchronization processes by desynchronization. In the presence of spike-timing-dependent plasticity (STDP) this may lead to a decrease of synaptic excitatory weights and ultimately to an anti-kindling, i.e. unlearning of abnormal synaptic connectivity and abnormal neuronal synchrony. The long-lasting desynchronizing impact of CR stimulation has been verified in pre-clinical and clinical proof of concept studies. However, as yet it is unclear how to optimally choose the CR stimulation frequency, i.e. the repetition rate at which the CR stimuli are delivered. This work presents the first computational study on the dependence of the acute and long-term outcome on the CR stimulation frequency in neuronal networks with STDP. For this purpose, CR stimulation was applied with Rapidly Varying Sequences (RVS) as well as with Slowly Varying Sequences (SVS) in a wide range of stimulation frequencies and intensities. Our findings demonstrate that acute desynchronization, achieved during stimulation, does not necessarily lead to long-term desynchronization after cessation of stimulation. By comparing the long-term effects of the two different CR protocols, the RVS CR stimulation turned out to be more robust against variations of the stimulation frequency. However, SVS CR stimulation can obtain stronger anti-kindling effects. We revealed specific parameter ranges that are favorable for long-term desynchronization. For instance, RVS CR stimulation at weak intensities and with stimulation frequencies in the range of the neuronal firing rates turned out to be effective and robust, in particular, if no closed loop adaptation of stimulation parameters is (technically) available. From a clinical standpoint, this may be relevant in the context of both invasive as well as non-invasive CR stimulation.
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169
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Ruan Q, Yu Z, Zhang W, Ruan J, Liu C, Zhang R. Cholinergic Hypofunction in Presbycusis-Related Tinnitus With Cognitive Function Impairment: Emerging Hypotheses. Front Aging Neurosci 2018; 10:98. [PMID: 29681847 PMCID: PMC5897739 DOI: 10.3389/fnagi.2018.00098] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 03/22/2018] [Indexed: 01/21/2023] Open
Abstract
Presbycusis (age-related hearing loss) is a potential risk factor for tinnitus and cognitive deterioration, which result in poor life quality. Presbycusis-related tinnitus with cognitive impairment is a common phenotype in the elderly population. In these individuals, the central auditory system shows similar pathophysiological alterations as those observed in Alzheimer's disease (AD), including cholinergic hypofunction, epileptiform-like network synchronization, chronic inflammation, and reduced GABAergic inhibition and neural plasticity. Observations from experimental rodent models indicate that recovery of cholinergic function can improve memory and other cognitive functions via acetylcholine-mediated GABAergic inhibition enhancement, nicotinic acetylcholine receptor (nAChR)-mediated anti-inflammation, glial activation inhibition and neurovascular protection. The loss of cholinergic innervation of various brain structures may provide a common link between tinnitus seen in presbycusis-related tinnitus and age-related cognitive impairment. We hypothesize a key component of the condition is the withdrawal of cholinergic input to a subtype of GABAergic inhibitory interneuron, neuropeptide Y (NPY) neurogliaform cells. Cholinergic denervation might not only cause the degeneration of NPY neurogliaform cells, but may also result in decreased AChR activation in GABAergic inhibitory interneurons. This, in turn, would lead to reduced GABA release and inhibitory regulation of neural networks. Reduced nAChR-mediated anti-inflammation due to the loss of nicotinic innervation might lead to the transformation of glial cells and release of inflammatory mediators, lowering the buffering of extracellular potassium and glutamate metabolism. Further research will provide evidence for the recovery of cholinergic function with the use of cholinergic input enhancement alone or in combination with other rehabilitative interventions to reestablish inhibitory regulation mechanisms of involved neural networks for presbycusis-related tinnitus with cognitive impairment.
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Affiliation(s)
- Qingwei Ruan
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Zhuowei Yu
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Weibin Zhang
- Shanghai Institute of Geriatrics and Gerontology, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, and Research Center of Aging and Medicine, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian Ruan
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chunhui Liu
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ruxin Zhang
- Department of Otolaryngology, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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170
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Vanneste S, Song JJ, De Ridder D. Thalamocortical dysrhythmia detected by machine learning. Nat Commun 2018; 9:1103. [PMID: 29549239 PMCID: PMC5856824 DOI: 10.1038/s41467-018-02820-0] [Citation(s) in RCA: 131] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 01/02/2018] [Indexed: 12/30/2022] Open
Abstract
Thalamocortical dysrhythmia (TCD) is a model proposed to explain divergent neurological disorders. It is characterized by a common oscillatory pattern in which resting-state alpha activity is replaced by cross-frequency coupling of low- and high-frequency oscillations. We undertook a data-driven approach using support vector machine learning for analyzing resting-state electroencephalography oscillatory patterns in patients with Parkinson’s disease, neuropathic pain, tinnitus, and depression. We show a spectrally equivalent but spatially distinct form of TCD that depends on the specific disorder. However, we also identify brain areas that are common to the pathology of Parkinson’s disease, pain, tinnitus, and depression. This study therefore supports the validity of TCD as an oscillatory mechanism underlying diverse neurological disorders. Thalamocortical dysrhythmia has been proposed to occur in a number of neurological and psychiatric disorders. Here, the authors use a data-driven approach to demonstrate thalamocortical dysrhythmia occurs in individuals with Parkinson’s disease, neuropathic pain, tinnitus, and depression.
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Affiliation(s)
- Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, 75080, USA.
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, 13620, Korea.
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, 9054, New Zealand
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171
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Bayat A, Mayo M, Rashidi S, Saki N, Yadollahpour A. Repeated sessions of bilateral transcranial direct current stimulation on intractable tinnitus: a study protocol for a double-blind randomized controlled trial. F1000Res 2018; 7:317. [PMID: 29707203 PMCID: PMC5887075 DOI: 10.12688/f1000research.13558.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 12/20/2022] Open
Abstract
Background: Transcranial Direct Current Stimulation (tDCS) is reportedly a potential treatment option for chronic tinnitus. The main drawbacks of previous studies are short term follow up and focusing on the efficacy of single session tDCS. This study aims to investigate the therapeutic efficacy, adverse effects (AEs) and tolerability of repeated sessions of bilateral tDCS over auditory cortex (AC) on tinnitus symptoms Methods: This will be a double-blinded randomized placebo controlled parallel trial on patients (n=90) with intractable chronic tinnitus (> 2 years) randomly divided into three groups of anodal, cathodal, and sham tDCS. In the sham treatment, after 30 sec the device will be turned OFF without informing the patients. The tDCS protocol consists of 10 sessions (daily 20 min session; 2 mA current for 5 consecutive days per week and 2 consecutive weeks) applied through 35 cm 2 electrodes. The primary outcome is tinnitus handicap inventory (THI) which will be assessed pre- and post-intervention and at one month follow-up. The secondary outcomes are tinnitus loudness and distress to be assessed using a visual analogue scale (VAS) pre-intervention, and immediately, one hour, one week, and one month after last stimulation. The AEs and tolerability of patients will be evaluated after each session using a customized questionnaire. Possible interactions between the disease features and treatment response will be evaluated. Discussion: To our knowledge this is the first study to investigate the effects of repeated sessions of tDCS on chronic tinnitus symptoms with one month follow-up. In addition, the AEs, and tolerability of patients will be studied. In addition, the possible interactions between the disease specific features including the hearing loss, laterality, type of tinnitus, and treatment response will be evaluated. Trial registration: The study has been registered as a clinical trial in Iranian Registry of Clinical Trial ( IRCT2016110124635N6) on the 01/06/2017.
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Affiliation(s)
- Arash Bayat
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Miguel Mayo
- Department of Otorhinolaryngology, A Coruña University Hospital Complex, A Coruña, 15006, Spain
| | - Samaneh Rashidi
- Bioelectromagnetic Clinic, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61936-73111, Iran
| | - Nader Saki
- Hearing Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
| | - Ali Yadollahpour
- Bioelectromagnetic Clinic, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61936-73111, Iran.,Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-33118, Iran
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172
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Vielsmeier V, Schecklmann M, Schlee W, Kreuzer PM, Poeppl TB, Rupprecht R, Langguth B, Lehner A. A Pilot Study of Peripheral Muscle Magnetic Stimulation as Add-on Treatment to Repetitive Transcranial Magnetic Stimulation in Chronic Tinnitus. Front Neurosci 2018. [PMID: 29515350 PMCID: PMC5826218 DOI: 10.3389/fnins.2018.00068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
While brain stimulation techniques have been examined as treatment options for chronic tinnitus for many years, they have recently been extended to multimodal treatment approaches. As chronic tinnitus is often accompanied by comorbid muscular tension in the neck and back, we performed a one-arm pilot study to explore the feasibility of a new multimodal treatment approach. In detail, repetitive peripheral magnetic stimulation (rPMS) of the back was performed before and after each session of repetitive transcranial magnetic stimulation (rTMS) of the brain. Data of 41 patients were analyzed, all of which were treated with ten sessions of rTMS of the left prefrontal and left temporoparietal cortex followed by rPMS of the neck and back muscles. Tinnitus severity was measured using the tinnitus questionnaire (TQ). Neck pain was assessed using the neck pain and disability scale (NPAD). The new treatment approach was feasible and well accepted by the majority of patients. However, the overall patient group did not improve significantly in either of the questionnaires. If patients were divided in different subgroups depending on whether they were suffering from neck pain or somatosensory tinnitus, explorative post-hoc tests suggested differential effects: patients with both neck pain and somatosensory tinnitus had better outcomes than patients without those conditions or with neck pain only. This was true for both the TQ and the NPAD. This effect was of transient nature though: the TQ score went back to its baseline level after a follow-up period of 12 weeks. Based on our results we recommend that in studies that investigate tinnitus treatments targeting somatosensory afferents patients should be stratified according to somatic co-morbidities and somatosensory influence on the tinnitus percept. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov, NCT02306447.
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Affiliation(s)
- Veronika Vielsmeier
- Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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173
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Schlee W, Hall DA, Canlon B, Cima RFF, de Kleine E, Hauck F, Huber A, Gallus S, Kleinjung T, Kypraios T, Langguth B, Lopez-Escamez JA, Lugo A, Meyer M, Mielczarek M, Norena A, Pfiffner F, Pryss RC, Reichert M, Requena T, Schecklmann M, van Dijk P, van de Heyning P, Weisz N, Cederroth CR. Innovations in Doctoral Training and Research on Tinnitus: The European School on Interdisciplinary Tinnitus Research (ESIT) Perspective. Front Aging Neurosci 2018; 9:447. [PMID: 29375369 PMCID: PMC5770576 DOI: 10.3389/fnagi.2017.00447] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/29/2017] [Indexed: 12/23/2022] Open
Abstract
Tinnitus is a common medical condition which interfaces many different disciplines, yet it is not a priority for any individual discipline. A change in its scientific understanding and clinical management requires a shift toward multidisciplinary cooperation, not only in research but also in training. The European School for Interdisciplinary Tinnitus research (ESIT) brings together a unique multidisciplinary consortium of clinical practitioners, academic researchers, commercial partners, patient organizations, and public health experts to conduct innovative research and train the next generation of tinnitus researchers. ESIT supports fundamental science and clinical research projects in order to: (1) advancing new treatment solutions for tinnitus, (2) improving existing treatment paradigms, (3) developing innovative research methods, (4) performing genetic studies on, (5) collecting epidemiological data to create new knowledge about prevalence and risk factors, (6) establishing a pan-European data resource. All research projects involve inter-sectoral partnerships through practical training, quite unlike anything that can be offered by any single university alone. Likewise, the postgraduate training curriculum fosters a deep knowledge about tinnitus whilst nurturing transferable competencies in personal qualities and approaches needed to be an effective researcher, knowledge of the standards, requirements and professionalism to do research, and skills to work with others and to ensure the wider impact of research. ESIT is the seed for future generations of creative, entrepreneurial, and innovative researchers, trained to master the upcoming challenges in the tinnitus field, to implement sustained changes in prevention and clinical management of tinnitus, and to shape doctoral education in tinnitus for the future.
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Affiliation(s)
- Winfried Schlee
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Deborah A Hall
- NIHR Nottingham Hearing Biomedical Research Centre, Nottingham, United Kingdom.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Barbara Canlon
- Section of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Rilana F F Cima
- Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Emile de Kleine
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Franz Hauck
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Alex Huber
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Switzerland
| | - Silvano Gallus
- Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Switzerland
| | - Theodore Kypraios
- NIHR Nottingham Hearing Biomedical Research Centre, Nottingham, United Kingdom
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - José A Lopez-Escamez
- Otology and Neurotology Group, Department of Genomic Medicine, Centro Pfizer - Universidad de Granada - Junta de Andalucía de Genómica e Investigación Oncológica (GENYO), Granada, Spain.,Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Hospital Universitario Virgen de las Nieves, Universidad de Granada, Granada, Spain
| | - Alessandra Lugo
- Department of Environmental Health Sciences, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marzena Mielczarek
- Department of Otolaryngology, Laryngological Oncology, Audiology, and Phoniatrics, Medical University of Lodz, Lodz, Poland
| | - Arnaud Norena
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Flurin Pfiffner
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Switzerland
| | - Rüdiger C Pryss
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Teresa Requena
- Otology and Neurotology Group, Department of Genomic Medicine, Centro Pfizer - Universidad de Granada - Junta de Andalucía de Genómica e Investigación Oncológica (GENYO), Granada, Spain
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum Regensburg, University of Regensburg, Regensburg, Germany
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Paul van de Heyning
- Department of ORL and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Nathan Weisz
- Division of Physiological Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Christopher R Cederroth
- Section of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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174
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Schmidt SA, Zimmerman B, Bido Medina RO, Carpenter-Thompson JR, Husain FT. Changes in gray and white matter in subgroups within the tinnitus population. Brain Res 2018; 1679:64-74. [DOI: 10.1016/j.brainres.2017.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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175
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Pairing sound with vagus nerve stimulation modulates cortical synchrony and phase coherence in tinnitus: An exploratory retrospective study. Sci Rep 2017; 7:17345. [PMID: 29230011 PMCID: PMC5725594 DOI: 10.1038/s41598-017-17750-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 11/30/2017] [Indexed: 12/24/2022] Open
Abstract
Recent research has shown that vagus nerve stimulation (VNS) paired with tones or with rehabilitative training can help patients to achieve reductions in tinnitus perception or to expedite motor rehabilitation after suffering an ischemic stroke. The rationale behind this treatment is that VNS paired with experience can drive neural plasticity in a controlled and therapeutic direction. Since previous studies observed that gamma activity in the auditory cortex is correlated with tinnitus loudness, we assessed resting-state source-localized EEG before and after one to three months of VNS-tone pairing in chronic tinnitus patients. VNS-tone pairing reduced gamma band activity in left auditory cortex. VNS-tone pairing also reduced the phase coherence between the auditory cortex and areas associated with tinnitus distress, including the cingulate cortex. These results support the hypothesis that VNS-tone pairing can direct therapeutic neural plasticity. Targeted plasticity therapy might also be adapted to treat other conditions characterized by hypersynchronous neural activity.
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176
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Güntensperger D, Thüring C, Meyer M, Neff P, Kleinjung T. Neurofeedback for Tinnitus Treatment - Review and Current Concepts. Front Aging Neurosci 2017; 9:386. [PMID: 29249959 PMCID: PMC5717031 DOI: 10.3389/fnagi.2017.00386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022] Open
Abstract
An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.
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Affiliation(s)
- Dominik Güntensperger
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Christian Thüring
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
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177
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Alonso-Valerdi LM, Ibarra-Zarate DI, Tavira-Sánchez FJ, Ramírez-Mendoza RA, Recuero M. Electroencephalographic evaluation of acoustic therapies for the treatment of chronic and refractory tinnitus. BMC EAR, NOSE, AND THROAT DISORDERS 2017; 17:9. [PMID: 29209149 PMCID: PMC5704517 DOI: 10.1186/s12901-017-0042-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 11/15/2017] [Indexed: 11/10/2022]
Abstract
Background To date, a large number of acoustic therapies have been applied to treat tinnitus. The effect that produces those auditory stimuli is, however, not well understood yet. Furthermore, the conventional clinical protocol is based on a trial-error procedure, and there is not a formal and adequate treatment follow-up. At present, the only way to evaluate acoustic therapies is by means of subjective methods such as analog visual scale and ad-hoc questionnaires. Methods This protocol seeks to establish an objective methodology to treat tinnitus with acoustic therapies based on electroencephalographic (EEG) activity evaluation. On the hypothesis that acoustic therapies should produce perceptual and cognitive changes at a cortical level, it is proposed to examine neural electrical activity of patients suffering from refractory and chronic tinnitus in four different stages: at the beginning of the experiment, at one week of treatment, at five weeks of treatment, and at eight weeks of treatment. Four of the most efficient acoustic therapies found at the moment are considered: retraining, auditory discrimination, enriched acoustic environment, and binaural. Discussion EEG has become a standard brain imaging tool to quantify and qualify neural oscillations, which are basically spatial, temporal, and spectral patterns associated with particular perceptual, cognitive, motor and emotional processes. Neural oscillations have been traditionally studied on the basis of event-related experiments, where time-locked and phase-locked responses (i.e., event-related potentials) along with time-locked but not necessary phase-locked responses (i.e., event-related (de) synchronization) have been essentially estimated. Both potentials and levels of synchronization related to auditory stimuli are herein proposed to assess the effect of acoustic therapies. Trial registration Registration Number: ISRCTN14553550. ISRCTN Registry: BioMed Central. Date of Registration: October 31st, 2017.
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Affiliation(s)
- Luz María Alonso-Valerdi
- Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey, Eugenio Garza Sada 2501, 64849 Monterrey, NL Mexico
| | - David I Ibarra-Zarate
- Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey, Eugenio Garza Sada 2501, 64849 Monterrey, NL Mexico.,Massachusetts Institute of Technology, Cambridge, MA USA
| | - Francisco J Tavira-Sánchez
- Grupo de Investigación en Instrumentación y Acústica Aplicada (I2A2), Universidad Politécnica de Madrid, Carretera de Valencia km 7, 28031 Madrid, Spain
| | - Ricardo A Ramírez-Mendoza
- Escuela de Ingeniería y Ciencias, Tecnológico de Monterrey, Eugenio Garza Sada 2501, 64849 Monterrey, NL Mexico
| | - Manuel Recuero
- Grupo de Investigación en Instrumentación y Acústica Aplicada (I2A2), Universidad Politécnica de Madrid, Carretera de Valencia km 7, 28031 Madrid, Spain
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178
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Kleinjung T, Thüring C, Güntensperger D, Neff P, Meyer M. [Neurofeedback for the treatment of chronic tinnitus : Review and future perspectives]. HNO 2017; 66:198-204. [PMID: 29143096 DOI: 10.1007/s00106-017-0432-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neurofeedback is a noninvasive neuromodulation technique employing real-time display of brain activity in terms of electroencephalography (EEG) signals to teach self-regulation of distinct patterns of brain activity or influence brain activity in a targeted manner. The benefit of this approach for control of symptoms in attention deficit disorders, hyperactivity, depression, and migraine has been proven. Studies in recent years have also repeatedly shown this treatment to improve tinnitus symptoms, although it has not become established as routine therapy. The primary focus of this review is the rational of EEG neurofeedback for tinnitus treatment and the currently available data from published studies. Furthermore, alternative neurofeedback protocols using real-time functional magnetic resonance imaging (fMRI) measurements for tinnitus control are considered. Finally, this article highlights how modern EEG analysis (source localization, connectivity) and the improving understanding of tinnitus pathology can contribute to development of more focused neurofeedback protocols for more sustainable control of tinnitus.
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Affiliation(s)
- T Kleinjung
- Klinik für Ohren‑, Nasen‑, Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz.
| | - C Thüring
- Klinik für Ohren‑, Nasen‑, Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz
| | - D Güntensperger
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
| | - P Neff
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
| | - M Meyer
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
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179
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Landgrebe M, Hajak G, Wolf S, Padberg F, Klupp P, Fallgatter AJ, Polak T, Höppner J, Haker R, Cordes J, Klenzner T, Schönfeldt-Lecuona C, Kammer T, Graf E, Koller M, Kleinjung T, Lehner A, Schecklmann M, Pöppl TB, Kreuzer P, Frank E, Langguth B. 1-Hz rTMS in the treatment of tinnitus: A sham-controlled, randomized multicenter trial. Brain Stimul 2017; 10:1112-1120. [DOI: 10.1016/j.brs.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 01/01/2023] Open
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180
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Araneda R, Renier L, Dricot L, Decat M, Ebner-Karestinos D, Deggouj N, De Volder AG. A key role of the prefrontal cortex in the maintenance of chronic tinnitus: An fMRI study using a Stroop task. NEUROIMAGE-CLINICAL 2017; 17:325-334. [PMID: 29159044 PMCID: PMC5675730 DOI: 10.1016/j.nicl.2017.10.029] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/11/2017] [Accepted: 10/28/2017] [Indexed: 01/13/2023]
Abstract
Introduction Since we recently showed in behavioural tasks that the top-down cognitive control was specifically altered in tinnitus sufferers, here we wanted to establish the link between this impaired executive function and brain alterations in the frontal cortex in tinnitus patients. Method Using functional magnetic resonance imaging (fMRI), we monitored the brain activity changes in sixteen tinnitus patients (TP) and their control subjects (CS) while they were performing a spatial Stroop task, both in audition and vision. Results We observed that TP differed from CS in their functional recruitment of the dorsolateral prefrontal cortex (dlPFC, BA46), the cingulate gyrus and the ventromedial prefrontal cortex (vmPFC, BA10). This recruitment was higher during interference conditions in tinnitus participants than in controls, whatever the sensory modality. Furthermore, the brain activity level in the right dlPFC and vmPFC correlated with the performance in the Stroop task in TP. Conclusion Due to the direct link between poor executive functions and prefrontal cortex alterations in TP, we postulate that a lack of inhibitory modulation following an impaired top-down cognitive control may maintain tinnitus by hampering habituation mechanisms. This deficit in executive functions caused by prefrontal cortex alterations would be a key-factor in the generation and persistence of tinnitus.
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Affiliation(s)
- Rodrigo Araneda
- Institute of Neuroscience, MSL-IN Lab., Université Catholique de Louvain, Belgium
| | - Laurent Renier
- Institute of Neuroscience, MSL-IN Lab., Université Catholique de Louvain, Belgium
| | - Laurence Dricot
- Institute of Neuroscience, MSL-IN Lab., Université Catholique de Louvain, Belgium
| | - Monique Decat
- Department of Oto-Rhino-Laryngology & Head and Neck Surgery, Université Catholique de Louvain and Cliniques Universitaires St-Luc, Belgium
| | | | - Naïma Deggouj
- Institute of Neuroscience, MSL-IN Lab., Université Catholique de Louvain, Belgium; Department of Oto-Rhino-Laryngology & Head and Neck Surgery, Université Catholique de Louvain and Cliniques Universitaires St-Luc, Belgium
| | - Anne G De Volder
- Institute of Neuroscience, MSL-IN Lab., Université Catholique de Louvain, Belgium.
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181
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Demarquay G, Ducros A, Montavont A, Mauguiere F. Migraine with brainstem aura: Why not a cortical origin? Cephalalgia 2017; 38:1687-1695. [PMID: 29073774 DOI: 10.1177/0333102417738251] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Migraine with brainstem aura is defined as a migraine with aura including at least two of the following symptoms: dysarthria, vertigo, tinnitus, hypacusis, diplopia, ataxia and/or decreased level of consciousness. Aim The aim of this study is to review data coming from clinical observations and functional mapping that support the role of the cerebral cortex in the initiation of brainstem aura symptoms. Results Vertigo can result from a vestibular cortex dysfunction, while tinnitus and hypacusis can originate within the auditory cortex. Diplopia can reflect a parieto-occipital involvement. Dysarthria can be caused by dysfunctions located in precentral gyri. Ataxia can reflect abnormal processing of vestibular, sensory, or visual inputs by the parietal lobe. Alteration of consciousness can be caused by abnormal neural activation within specific consciousness networks that include prefrontal and posterior parietal cortices. Conclusion Any symptom of so-called brainstem aura can originate within the cortex. Based on these data, we suggest that brainstem aura could have a cortical origin. This hypothesis would explain the co-occurrence of typical and brainstem aura during attacks and would fit with the theory of cortical spreading depression. We propose that migraine with brainstem aura should be classified as a typical migraine aura.
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Affiliation(s)
- Geneviève Demarquay
- 1 Department of Neurology, Hospices Civils de Lyon, Lyon, France.,2 Lyon Neuroscience Research Center (CRNL), Brain Dynamics and Cognition Team (Dycog), INSERM U1028, CNRS UMR5292, Lyon, France
| | - Anne Ducros
- 3 Department of Neurology, Montpellier University Hospital, France.,4 Medical School of Montpellier University (UM), France
| | | | - François Mauguiere
- 1 Department of Neurology, Hospices Civils de Lyon, Lyon, France.,5 Lyon Neuroscience Research Center (CRNL), Neuropain team, INSERM U1028, CNRS UMR5292, Lyon, France.,6 Lyon 1 University, Lyon, France
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182
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Poeppl TB, Langguth B, Lehner A, Frodl T, Rupprecht R, Kreuzer PM, Landgrebe M, Schecklmann M. Brain stimulation-induced neuroplasticity underlying therapeutic response in phantom sounds. Hum Brain Mapp 2017; 39:554-562. [PMID: 29064602 DOI: 10.1002/hbm.23864] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/25/2022] Open
Abstract
Noninvasive brain stimulation can modify phantom sounds for longer periods by modulating neural activity and putatively inducing regional neuroplastic changes. However, treatment response is limited and there are no good demographic or clinical predictors for treatment outcome. We used state-of-the-art voxel-based morphometry (VBM) to investigate whether transcranial magnetic stimulation-induced neuroplasticity determines therapeutic outcome. Sixty subjects chronically experiencing phantom sounds (i.e., tinnitus) received repetitive transcranial magnetic stimulation (rTMS) of left dorsolateral prefrontal and temporal cortex according to a protocol that has been shown to yield a significantly higher number of treatment responders than sham stimulation and previous stimulation protocols. Structural magnetic resonance imaging was performed before and after rTMS. In VBM whole-brain analyses (P < 0.05, FWE corrected), we assessed longitudinal gray matter changes as well as structural connectivity between the ensuing regions. We observed longitudinal mesoscopic gray matter changes of left dorsolateral prefontal (DLPFC), left operculo-insular, and right inferior temporal cortex (ITC) in responders (N = 22) but not nonresponders (N = 38), as indicated by a group × time interaction and post-hoc tests. These results were neither influenced by age, sex, hearing loss nor by tinnitus laterality, duration, and severity at baseline. Furthermore, we found robust DLPFC-insula and insula-ITC connectivity in responders, while only relatively weak DLPFC-insula connectivity and no insula-ITC connectivity could be demonstrated in nonresponders. Our results reinforce the implication of nonauditory brain regions in phantom sounds and suggest the dependence of therapeutic response on their neuroplastic capabilities. The latter in turn may depend on (differences in) their individual structural connectivity. Hum Brain Mapp 39:554-562, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Lech Mangfall Hospital, Agatharied, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
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183
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Beukes EW, Manchaiah V, Valien TE, Baguley DM, Allen PM, Andersson G. Positive experiences related to living with tinnitus: A cross-sectional survey. Clin Otolaryngol 2017; 43:489-495. [PMID: 28994194 DOI: 10.1111/coa.13002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2017] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The aim of this study was to gain insights related to positive experiences reported by adults with tinnitus living in the United Kingdom. DESIGN A cross-sectional survey design was used in a sample of adults with tinnitus who were interested in undertaking an Internet-based intervention for tinnitus. SETTING The study was UK wide and data collection was online. PARTICIPANTS Participants consisted of 240 adults (137 males, 103 females), with an average age of 48.16 years and average tinnitus duration of 11.52 years (SD: 11.88). MAIN OUTCOME MEASURES Tinnitus severity was measured by means of the Tinnitus Functional Index. To evaluate the secondary effects of tinnitus, the Insomnia Severity Index, the Hearing Handicap Inventory for Adults-Screening Version and the Cognitive Failures Questionnaires were administered. Positive experiences related to tinnitus were explored using an open-ended question format. RESULTS Around a third of participants (32.5%) reported positive experiences associated with tinnitus. The number of positive responses ranged from one to eight responses per participant, although there were fewer participants with more than one positive response. The predominant themes concerned for (i) coping; (ii) personal development; (iii) support, and to a lesser extent (iv) outlook. Younger participants, those with a lower hearing disability and those with fewer cognitive failures were more likely to report positive experiences associated with having tinnitus. CONCLUSIONS This study has identified that personal development and a positive outlook are possible despite experiencing tinnitus. Ways to facilitate positive experiences related to tinnitus should be promoted, as these may reduce the negative consequences associated with tinnitus. The most prevalent positive theme was the ability to cope with tinnitus. Positive experiences were also drawn from having clinical and other support networks. This highlights the importance of providing tinnitus interventions that can assist people in coping with tinnitus, particularly to those less likely to relate tinnitus to any positive experiences. Those most likely to be helped include those who are older with greater cognitive difficulties and a greater hearing disability.
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Affiliation(s)
- E W Beukes
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK
| | - V Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA.,Linnaeus Centre HEAD, Swedish Institute for Disability Research, Department of Behavioral Science and Learning, Linköping University, Linköping, Sweden.,Audiology India, Mysore, India.,Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
| | - T E Valien
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, USA
| | - D M Baguley
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK.,National Institute for Health Research, Nottingham Biomedical Research Centre, Ropewalk House, The Ropewalk, Nottingham, UK.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - P M Allen
- Department of Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK.,Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, UK
| | - G Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
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184
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Schilling A, Krauss P, Gerum R, Metzner C, Tziridis K, Schulze H. A New Statistical Approach for the Evaluation of Gap-prepulse Inhibition of the Acoustic Startle Reflex (GPIAS) for Tinnitus Assessment. Front Behav Neurosci 2017; 11:198. [PMID: 29093668 PMCID: PMC5651238 DOI: 10.3389/fnbeh.2017.00198] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/03/2017] [Indexed: 12/25/2022] Open
Abstract
Background: An increasingly used behavioral paradigm for the objective assessment of a possible tinnitus percept in animal models has been proposed by Turner and coworkers in 2006. It is based on gap-prepulse inhibition (PPI) of the acoustic startle reflex (ASR) and usually referred to as GPIAS. As it does not require conditioning it became the method of choice to study neuroplastic phenomena associated with the development of tinnitus. Objective: It is still controversial if GPIAS is really appropriate for tinnitus screening, as the hypothesis that a tinnitus percept impairs the gap detection ability ("filling-in interpretation" is still questioned. Furthermore, a wide range of criteria for positive tinnitus detection in GPIAS have been used across different laboratories and there still is no consensus on a best practice for statistical evaluation of GPIAS results. Current approaches are often based on simple averaging of measured PPI values and comparisons on a population level without the possibility to perform valid statistics on the level of the single animal. Methods: A total number of 32 animals were measured using the standard GPIAS paradigm with varying number of measurement repetitions. Based on this data further statistical considerations were performed. Results: We here present a new statistical approach to overcome the methodological limitations of GPIAS. In a first step we show that ASR amplitudes are not normally distributed. Next we estimate the distribution of the measured PPI values by exploiting the full combinatorial power of all measured ASR amplitudes. We demonstrate that the amplitude ratios (1-PPI) are approximately lognormally distributed, allowing for parametrical testing of the logarithmized values and present a new statistical approach allowing for a valid and reliable statistical assessment of PPI changes in GPIAS. Conclusion: Based on our statistical approach we recommend using a constant criterion, which does not systematically depend on the number of measurement repetitions, in order to divide animals into a tinnitus and a non-tinnitus group. In particular, we recommend using a constant threshold based on the effect size as criterion, as the effect size, in contrast to the p-value, does not systematically depend on the number of measurement repetitions.
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Affiliation(s)
- Achim Schilling
- Experimental Otolaryngology, ENT Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Biophysics Group, Department of Physics, Center for Medical Physics and Technology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Patrick Krauss
- Experimental Otolaryngology, ENT Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.,Biophysics Group, Department of Physics, Center for Medical Physics and Technology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Richard Gerum
- Biophysics Group, Department of Physics, Center for Medical Physics and Technology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Claus Metzner
- Biophysics Group, Department of Physics, Center for Medical Physics and Technology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Konstantin Tziridis
- Experimental Otolaryngology, ENT Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Holger Schulze
- Experimental Otolaryngology, ENT Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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185
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Azevedo AA, Figueiredo RR, Elgoyhen AB, Langguth B, Penido NDO, Schlee W. Tinnitus Treatment with Oxytocin: A Pilot Study. Front Neurol 2017; 8:494. [PMID: 28983279 PMCID: PMC5613090 DOI: 10.3389/fneur.2017.00494] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 09/04/2017] [Indexed: 11/13/2022] Open
Abstract
Introduction Tinnitus is the perception of sound in the absence of an external stimulus. It is a frequent condition for which there is as yet no pharmacological treatment approved. Auditory and non-auditory pathways are involved in tinnitus’ pathophysiology. Oxytocin is a neurohormone and eventual neurotransmitter that plays a complex role in social cognition and behavior. Objective To evaluate the potential of oxytocin as a tinnitus treatment. Study design Two studies were performed. Study 1 was a long-term open pilot study, while study 2 investigated short-term effects with a double-blinded placebo-controlled cross-over study. Setting Ambulatory ENT care. Subjects and method In study 1, 15 patients were investigated over a 10-week period in an open pilot study. In study 2, 16 patients were included in a placebo-controlled crossover trial to investigate short-term effects following a single dose. Results For the long-term study (study 1), analysis of variance revealed a significant decrease in tinnitus sensation, both for the Tinnitus Handicap Inventory and Clinical Global Impression (CGI). Also, the short-term effects in study 2 revealed a significant reduction of tinnitus because of the oxytocin nasal spray as measured with the Visual Analog Scale and the CGI Scale. Conclusion These preliminary studies demonstrated that oxytocin may represent a helpful tool for treating tinnitus and further larger controlled studies are warranted.
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Affiliation(s)
| | | | - Ana Belen Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres", CONICET, Buenos Aires, Argentina.,Facultad de Medicina, Instituto de Farmacología, Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | | | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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186
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The relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. The Journal of Laryngology & Otology 2017; 131:1017-1025. [DOI: 10.1017/s0022215117001803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractObjectives:Chronic tinnitus is associated with reduced auditory input, which results in changes in the central auditory system. This study aimed to examine the relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. For audiometry, the parameters represented the edge frequency of hearing loss, the frequency of maximum hearing loss and the frequency range of hearing loss. For distortion product otoacoustic emissions, the parameters were the frequency of lowest distortion product otoacoustic emission amplitudes and the frequency range of reduced distortion product otoacoustic emissions.Method:Sixty-seven patients (45 males, 22 females) with subjective chronic tinnitus, aged 18 to 73 years, were included.Results:No correlation was found between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. However, tinnitus pitch fell mostly within the frequency range of hearing loss.Conclusion:The current study seems to confirm the relationship between tinnitus pitch and the frequency range of hearing loss, thus supporting the homeostatic plasticity model.
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187
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Langguth B, Hund V, Landgrebe M, Schecklmann M. Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics. Front Neurol 2017; 8:440. [PMID: 28894434 PMCID: PMC5581323 DOI: 10.3389/fneur.2017.00440] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/10/2017] [Indexed: 12/13/2022] Open
Abstract
Background Both clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics. Method The Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches. Results Data from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general), and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache. Conclusion The observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Verena Hund
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Hausham, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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188
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Krick CM, Argstatter H, Grapp M, Plinkert PK, Reith W. Heidelberg Neuro-Music Therapy Enhances Task-Negative Activity in Tinnitus Patients. Front Neurosci 2017; 11:384. [PMID: 28736515 PMCID: PMC5500649 DOI: 10.3389/fnins.2017.00384] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 06/19/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Suffering from tinnitus causes mental distress in most patients. Recent findings point toward a diminished activity of the brain's default-mode network (DMN) in subjects with mental disorders including depression or anxiety and also recently in subjects with tinnitus-related distress. We recently developed a therapeutic intervention, namely the Heidelberg Neuro-Music Therapy (HNMT), which shows an effective reduction of tinnitus-related distress following a 1-week short-term treatment. This approach offers the possibility to evaluate the neural changes associated with the improvements in tinnitus distress. We previously reported gray matter (GM) reorganization in DMN regions and in primary auditory areas following HNMT in cases of recent-onset tinnitus. Here we evaluate on the same patient group, using functional MRI (fMRI), the activity of the DMN following the improvements tinnitus-related distress related to the HNMT intervention. Methods: The DMN activity was estimated by the task-negative activation (TNA) during long inter-trial intervals in a word recognition task. The level of TNA was evaluated twice, before and after the 1-week study period, in 18 treated tinnitus patients (“treatment group,” TG), 21 passive tinnitus controls (PTC), and 22 active healthy controls (AC). During the study, the participants in TG and AC groups were treated with HNMT, whereas PTC patients did not receive any tinnitus-specific treatment. Therapy-related effects on DMN activity were assessed by comparing the pairs of fMRI records from the TG and PTC groups. Results: Treatment of the TG group with HNMT resulted in an augmented DMN activity in the PCC by 2.5% whereas no change was found in AC and PTC groups. This enhancement of PCC activity correlated with a reduction in tinnitus distress (Spearman Rho: −0.5; p < 0.005). Conclusion: Our findings show that an increased DMN activity, especially in the PCC, underlies the improvements in tinnitus-related distress triggered by HNMT and identify the DMN as an important network involved in therapeutic improvements.
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Affiliation(s)
- Christoph M Krick
- Department for Neuroradiology, Saarland University HospitalHomburg, Germany
| | - Heike Argstatter
- German Research Centre for Music Therapy ResearchHeidelberg, Germany
| | - Miriam Grapp
- German Research Centre for Music Therapy ResearchHeidelberg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital for Ear, Nose, and Throat, University of HeidelbergHeidelberg, Germany
| | - Wolfgang Reith
- Department for Neuroradiology, Saarland University HospitalHomburg, Germany
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189
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Schlee W, Hall DA, Edvall NK, Langguth B, Canlon B, Cederroth CR. Visualization of Global Disease Burden for the Optimization of Patient Management and Treatment. Front Med (Lausanne) 2017; 4:86. [PMID: 28674694 PMCID: PMC5475418 DOI: 10.3389/fmed.2017.00086] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/06/2017] [Indexed: 12/27/2022] Open
Abstract
Background The assessment and treatment of complex disorders is challenged by the multiple domains and instruments used to evaluate clinical outcome. With the large number of assessment tools typically used in complex disorders comes the challenge of obtaining an integrative view of disease status to further evaluate treatment outcome both at the individual level and at the group level. Radar plots appear as an attractive visual tool to display multivariate data on a two-dimensional graphical illustration. Here, we describe the use of radar plots for the visualization of disease characteristics applied in the context of tinnitus, a complex and heterogeneous condition, the treatment of which has shown mixed success. Methods Data from two different cohorts, the Swedish Tinnitus Outreach Project (STOP) and the Tinnitus Research Initiative (TRI) database, were used. STOP is a population-based cohort where cross-sectional data from 1,223 non-tinnitus and 933 tinnitus subjects were analyzed. By contrast, the TRI contained data from 571 patients who underwent various treatments and whose Clinical Global Impression (CGI) score was accessible to infer treatment outcome. In the latter, 34,560 permutations were tested to evaluate whether a particular ordering of the instruments could reflect better the treatment outcome measured with the CGI. Results Radar plots confirmed that tinnitus subtypes such as occasional and chronic tinnitus from the STOP cohort could be strikingly different, and helped appreciate a gender bias in tinnitus severity. Radar plots with greater surface areas were consistent with greater burden, and enabled a rapid appreciation of the global distress associated with tinnitus in patients categorized according to tinnitus severity. Permutations in the arrangement of instruments allowed to identify a configuration with minimal variance and maximized surface difference between CGI groups from the TRI database, thus affording a means of optimally evaluating the outcomes in individual patients. Conclusion We anticipate such a tool to become a starting point for more sophisticated measures in clinical outcomes, applicable not only in the context of tinnitus but also in other complex diseases where the integration of multiple variables is needed for a comprehensive evaluation of treatment response.
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Affiliation(s)
- Winfried Schlee
- Department for Psychiatry and Psychotherapy, University Hospital Regensburg, Regensburg, Germany
| | - Deborah A Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Niklas K Edvall
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Berthold Langguth
- Department for Psychiatry and Psychotherapy, University Hospital Regensburg, Regensburg, Germany
| | - Barbara Canlon
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Christopher R Cederroth
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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190
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Adamchic I, Toth T, Hauptmann C, Walger M, Langguth B, Klingmann I, Tass PA. Acute effects and after-effects of acoustic coordinated reset neuromodulation in patients with chronic subjective tinnitus. Neuroimage Clin 2017; 15:541-558. [PMID: 28652968 PMCID: PMC5476468 DOI: 10.1016/j.nicl.2017.05.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/21/2017] [Accepted: 05/22/2017] [Indexed: 11/20/2022]
Abstract
Chronic subjective tinnitus is an auditory phantom phenomenon characterized by abnormal neuronal synchrony in the central auditory system. As shown computationally, acoustic coordinated reset (CR) neuromodulation causes a long-lasting desynchronization of pathological synchrony by downregulating abnormal synaptic connectivity. In a previous proof of concept study acoustic CR neuromodulation, employing stimulation tone patterns tailored to the dominant tinnitus frequency, was compared to noisy CR-like stimulation, a CR version significantly detuned by sparing the tinnitus-related pitch range and including substantial random variability of the tone spacing on the frequency axis. Both stimulation protocols caused an acute relief as measured with visual analogue scale scores for tinnitus loudness (VAS-L) and annoyance (VAS-A) in the stimulation-ON condition (i.e. 15 min after stimulation onset), but only acoustic CR neuromodulation had sustained long-lasting therapeutic effects after 12 weeks of treatment as assessed with VAS-L, VAS-A scores and a tinnitus questionnaire (TQ) in the stimulation-OFF condition (i.e. with patients being off stimulation for at least 2.5 h). To understand the source of the long-lasting therapeutic effects, we here study whether acoustic CR neuromodulation has different electrophysiological effects on oscillatory brain activity as compared to noisy CR-like stimulation under stimulation-ON conditions and immediately after cessation of stimulation. To this end, we used a single-blind, single application, cross over design in 18 patients with chronic tonal subjective tinnitus and administered three different 16-minute stimulation protocols: acoustic CR neuromodulation, noisy CR-like stimulation and low frequency range (LFR) stimulation, a CR type stimulation with deliberately detuned pitch and repetition rate of stimulation tones, as control stimulation. We measured VAS-L and VAS-A scores together with spontaneous EEG activity pre-, during- and post-stimulation. Under stimulation-ON conditions acoustic CR neuromodulation and noisy CR-like stimulation had similar effects: a reduction of VAS-L and VAS-A scores together with a decrease of auditory delta power and an increase of auditory alpha and gamma power, without significant differences. In contrast, LFR stimulation had significantly weaker EEG effects and no significant clinical effects under stimulation-ON conditions. The distinguishing feature between acoustic CR neuromodulation and noisy CR-like stimulation were the electrophysiological after-effects. Acoustic CR neuromodulation caused the longest significant reduction of delta and gamma and increase of alpha power in the auditory cortex region. Noisy CR-like stimulation had weaker and LFR stimulation hardly any electrophysiological after-effects. This qualitative difference further supports the assertion that long-term effects of acoustic CR neuromodulation on tinnitus are mediated by a specific disruption of synchronous neural activity. Furthermore, our results indicate that acute electrophysiological after-effects might serve as a marker to further improve desynchronizing sound stimulation.
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Affiliation(s)
- Ilya Adamchic
- Institute of Neuroscience and Medicine-Neuromodulation (INM-7), Jülich Research Center, Jülich 52428, Germany
| | - Timea Toth
- Institute of Neuroscience and Medicine-Neuromodulation (INM-7), Jülich Research Center, Jülich 52428, Germany
| | - Christian Hauptmann
- Institute of Neuroscience and Medicine-Neuromodulation (INM-7), Jülich Research Center, Jülich 52428, Germany
| | - Martin Walger
- Jean-Uhrmacher-Institute for Clinical ENT-Research, University of Cologne, Geibelstraße 29-31, Cologne 50931, Germany; Department of Otorhinolaryngology, Head and Neck Surgery, Audiology and Pediatric Audiology, University of Cologne, Kerpener Str. 62, Cologne 50937, Germany.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum, Universitätsstraße 84, Regensburg 93053, Germany; Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany.
| | - Ingrid Klingmann
- Pharmaplex bvba, Avenue Saint-Hubert 51, Wezembeek-Oppem 1970, Belgium.
| | - Peter Alexander Tass
- Institute of Neuroscience and Medicine-Neuromodulation (INM-7), Jülich Research Center, Jülich 52428, Germany; Department of Neurosurgery, Stanford University, 300 Pasteur Drive, Stanford, CA 94305-5327, USA; Department of Neuromodulation, University of Cologne, Gleueler Straße 176-178, Cologne 50935, Germany.
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191
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Neff P, Michels J, Meyer M, Schecklmann M, Langguth B, Schlee W. 10 Hz Amplitude Modulated Sounds Induce Short-Term Tinnitus Suppression. Front Aging Neurosci 2017; 9:130. [PMID: 28579955 PMCID: PMC5437109 DOI: 10.3389/fnagi.2017.00130] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/19/2017] [Indexed: 01/24/2023] Open
Abstract
Objectives: Acoustic stimulation or sound therapy is proposed as a main treatment option for chronic subjective tinnitus. To further probe the field of acoustic stimulations for tinnitus therapy, this exploratory study compared 10 Hz amplitude modulated (AM) sounds (two pure tones, noise, music, and frequency modulated (FM) sounds) and unmodulated sounds (pure tone, noise) regarding their temporary suppression of tinnitus loudness. First, it was hypothesized that modulated sounds elicit larger temporary loudness suppression (residual inhibition) than unmodulated sounds. Second, with manipulation of stimulus loudness and duration of the modulated sounds weaker or stronger effects of loudness suppression were expected, respectively. Methods: We recruited 29 participants with chronic tonal tinnitus from the multidisciplinary Tinnitus Clinic of the University of Regensburg. Participants underwent audiometric, psychometric and tinnitus pitch matching assessments followed by an acoustic stimulation experiment with a tinnitus loudness growth paradigm. In a first block participants were stimulated with all of the sounds for 3 min each and rated their subjective tinnitus loudness to the pre-stimulus loudness every 30 s after stimulus offset. The same procedure was deployed in the second block with the pure tone AM stimuli matched to the tinnitus frequency, manipulated in length (6 min), and loudness (reduced by 30 dB and linear fade out). Repeated measures mixed model analyses of variance (ANOVA) were calculated to assess differences in loudness growth between the stimuli for each block separately. Results: First, we found that all sounds elicit a short-term suppression of tinnitus loudness (seconds to minutes) with strongest suppression right after stimulus offset [F(6, 1331) = 3.74, p < 0.01]. Second, similar to previous findings we found that AM sounds near the tinnitus frequency produce significantly stronger tinnitus loudness suppression than noise [vs. Pink noise: t(27) = -4.22, p < 0.0001]. Finally, variants of the AM sound matched to the tinnitus frequency reduced in sound level resulted in less suppression while there was no significant difference observed for a longer stimulation duration. Moreover, feasibility of the overall procedure could be confirmed as scores of both tinnitus loudness and questionnaires were lower after the experiment [tinnitus loudness: t(27) = 2.77, p < 0.01; Tinnitus Questionnaire: t(27) = 2.06, p < 0.05; Tinnitus Handicap Inventory: t(27) = 1.92, p = 0.065]. Conclusion: Taken together, these results imply that AM sounds, especially in or around the tinnitus frequency, may induce larger suppression than unmodulated sounds. Future studies should thus evaluate this approach in longitudinal studies and real life settings. Furthermore, the putative neural relation of these sound stimuli with a modulation rate in the EEG α band to the observed tinnitus suppression should be probed with respective neurophysiological methods.
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Affiliation(s)
- Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of ZurichZurich, Switzerland.,University Research Priority Program "Dynamics of Healthy Aging", University of ZurichZurich, Switzerland
| | - Jakob Michels
- Department of Medicine, University of RegensburgRegensburg, Germany
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of ZurichZurich, Switzerland.,University Research Priority Program "Dynamics of Healthy Aging", University of ZurichZurich, Switzerland.,Cognitive Psychology Unit, University of KlagenfurtKlagenfurt, Austria
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of RegensburgRegensburg, Germany
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192
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EEG oscillatory power dissociates between distress- and depression-related psychopathology in subjective tinnitus. Brain Res 2017; 1663:194-204. [DOI: 10.1016/j.brainres.2017.03.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 02/20/2017] [Accepted: 03/04/2017] [Indexed: 12/12/2022]
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193
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Fuller T, Cima R, Langguth B, Mazurek B, Waddell A, Hoare DJ, Vlaeyen JWS. Cognitive behavioural therapy for tinnitus. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2017. [DOI: 10.1002/14651858.cd012614] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Thomas Fuller
- Maastricht University; Department of Clinical Psychological Science; Universiteitssingel 40 Maastricht Netherlands 6200 MD
- Adelante, Centre for Expertise in Rehabilitation & Audiology; Zandbergsweg 111 Hoensbroek Limburg Netherlands 6432 CC
| | - Rilana Cima
- Maastricht University; Department of Clinical Psychological Science; Universiteitssingel 40 Maastricht Netherlands 6200 MD
- Adelante, Centre for Expertise in Rehabilitation & Audiology; Zandbergsweg 111 Hoensbroek Limburg Netherlands 6432 CC
| | - Berthold Langguth
- University of Regensburg; Department of Psychiatry and Psychotherapy; Universitätsstraße 84 Regensburg Germany 93053
| | - Birgit Mazurek
- Charité - Universitätsmedizin Berlin; Luisenstrasse 13 Berlin Germany 10117
| | - Angus Waddell
- Great Western Hospital; ENT Department; Marlborough Road Swindon UK SN3 6BB
| | - Derek J Hoare
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham; NIHR Nottingham Biomedical Research Centre; Ropewalk House, 113 The Ropewalk Nottingham UK NG1 5DU
| | - Johan WS Vlaeyen
- KU Leuven University; Research Group Health Psychology; Tiensestraat 102 - 3000 Leuven Belgium
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194
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Kreuzer PM, Poeppl TB, Rupprecht R, Vielsmeier V, Lehner A, Langguth B, Schecklmann M. Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus? Front Neurol 2017; 8:126. [PMID: 28428769 PMCID: PMC5382205 DOI: 10.3389/fneur.2017.00126] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Prefrontal and temporo-parietal repetitive transcranial magnetic stimulation (rTMS) in patients suffering from chronic tinnitus have shown significant but only moderate effectiveness with high interindividual variability in treatment response. This open-label pilot study was designed to examine the general feasibility of an individualized fronto-temporal rTMS protocol and to explore what criteria are needed for a more detailed evaluation in randomized clinical studies. METHODS During the first session of a 2-week rTMS protocol, we applied different rTMS protocols to the left and right temporo-parietal and dorsolateral prefrontal cortex (DLPFC) in 25 tinnitus patients. Short trains of 1, 5, 10, and 20 Hz and continuous theta burst stimulation were applied, and patients were asked for immediate tinnitus reductions after each train. If a patient reported such improvements, rTMS treatment was applied over nine sessions with a combined protocol consisting of the most effective frontal and the most effective temporo-parietal stimulation protocol. Those patients who did not improve after the test session were treated with a standard prefrontal plus temporo-parietal protocol (20 Hz over left DLPFC + 1 Hz over temporo-parietal cortex). RESULTS Almost half of the patients (12 of 25) reported immediate tinnitus reductions during the test session. In this group, the mean pre- to post-treatment amelioration in the tinnitus questionnaire was higher (medium to high effect sizes) in contrast to the patients who did not respond to the test session. Treatment outcome remained stable over a follow-up period of 10 weeks. DISCUSSION Individualized rTMS was shown to be feasible and effective in chronic tinnitus. The results obtained from this study provide tentative evidence in support of an individualized rTMS treatment approach and might provide a basis for a "tailored" application of rTMS in tinnitus and other neuropsychiatric disorders.
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Affiliation(s)
- Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Timm B. Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Veronika Vielsmeier
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
- Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
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195
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De Ridder D, Perera S, Vanneste S. State of the Art: Novel Applications for Cortical Stimulation. Neuromodulation 2017; 20:206-214. [PMID: 28371170 DOI: 10.1111/ner.12593] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/13/2017] [Accepted: 01/30/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Electrical stimulation via implanted electrodes that overlie the cortex of the brain is an upcoming neurosurgical technique that was hindered for a long time by insufficient knowledge of how the brain functions in a dynamic, physiological, and pathological way, as well as by technological limitations of the implantable stimulation devices. METHODS This paper provides an overview of cortex stimulation via implantable devices and introduces future possibilities to improve cortex stimulation. RESULTS Cortex stimulation was initially used preoperatively as a technique to localize functions in the brain and only later evolved into a treatment technique. It was first used for pain, but more recently a multitude of pathologies are being targeted by cortex stimulation. These disorders are being treated by stimulating different cortical areas of the brain. Risks and complications are essentially similar to those related to deep brain stimulation and predominantly include haemorrhage, seizures, infection, and hardware failures. For cortex stimulation to fully mature, further technological development is required to predict its outcomes and improve stimulation designs. This includes the development of network science-based functional connectivity approaches, genetic analyses, development of navigated high definition transcranial alternating current stimulation, and development of pseudorandom stimulation designs for preventing habituation. CONCLUSION In conclusion, cortex stimulation is a nascent but very promising approach to treating a variety of diseases, but requires further technological development for predicting outcomes, such as network science based functional connectivity approaches, genetic analyses, development of navigated transcranial electrical stimulation, and development of pseudorandom stimulation designs for preventing habituation.
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Affiliation(s)
- Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | | | - Sven Vanneste
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand.,The University of Texas at Dallas, Richardson, TX, USA
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196
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Poeppl T, Langguth B, Lehner A, Rupprecht R, Kreuzer P, Landgrebe M, Schecklmann M. P310 Brain stimulation-induced neuroplasticity underlying therapeutic response in phantom sounds. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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197
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Langguth B, Landgrebe M, Schlee W, Schecklmann M, Vielsmeier V, Steffens T, Staudinger S, Frick H, Frick U. Different Patterns of Hearing Loss among Tinnitus Patients: A Latent Class Analysis of a Large Sample. Front Neurol 2017; 8:46. [PMID: 28265258 PMCID: PMC5316929 DOI: 10.3389/fneur.2017.00046] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 01/31/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The heterogeneity of tinnitus is a major challenge for tinnitus research. Even if a complex interaction of many factors is involved in the etiology of tinnitus, hearing loss (HL) has been identified as the most relevant etiologic factor. Here, we used a data-driven approach to identify patterns of hearing function in a large sample of tinnitus patients presenting in a tinnitus clinic. METHODS Data from 2,838 patients presenting at the Tinnitus Center of the University Regensburg between 2007 and 2014 have been analyzed. Standard audiometric data were frequency-wise categorized in four categories [a: normal hearing (0-20 dB HL); b: moderate HL (25-50 dB HL; representing outer hair cell loss); c: severe HL (>50 dB HL; representing outer and inner hair cell loss); d: no data available] and entered in a latent class analysis, a statistical method to find subtypes of cases in multivariate categorical data. To validate the clinical relevance of the identified latent classes, they were compared with respect to clinical and demographic characteristics of their members. RESULTS The classification algorithm identified eight distinct latent classes with an excellent separation. Patient classes differed with respect to demographic (e.g., age, gender) and clinical characteristics (e.g., tinnitus location, tinnitus severity, gradual, or abrupt onset, etc.). DISCUSSION Our results demonstrate that data-driven categorization of hearing function seems to be a promising approach for profiling tinnitus patients, as it revealed distinct subtypes that reflect prototypic forms of HL and that differ in several relevant clinical characteristics.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; kbo Lech-Mangfall-Klinik Agatharied, Hausham, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Veronika Vielsmeier
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany; Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Thomas Steffens
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany; Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Susanne Staudinger
- Interdisciplinary Tinnitus Center of the University of Regensburg , Regensburg , Germany
| | - Hannah Frick
- Department of Statistical Science, University College London , London , UK
| | - Ulrich Frick
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; HSD University of Applied Sciences, Cologne, Germany
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198
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Wegger M, Ovesen T, Larsen DG. Acoustic Coordinated Reset Neuromodulation: A Systematic Review of a Novel Therapy for Tinnitus. Front Neurol 2017; 8:36. [PMID: 28243221 PMCID: PMC5304262 DOI: 10.3389/fneur.2017.00036] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/26/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND There are growing technological advances in the development of sound-based methods for the treatment of tinnitus. Most of these methods intend to affect the speculated underlying neurological causes of tinnitus. Acoustic coordinated reset (CR) neuromodulation is one of them. A novel method that as of yet seems inadequately reviewed. PURPOSE To evaluate the current evidence on acoustic CR neuromodulation as a method for the treatment of tinnitus and to assess whether the method can be implemented in daily clinical practice. METHODS A systematic literature search was performed in 13 databases in the period from February 1, 2015 to May 1, 2016. Studies regarding acoustic CR neuromodulation as a treatment method for tinnitus were included in the present review. RESULTS A total of 8 studies were eligible for being reviewed comprising a total of 329 patients. Overall, the evidence level of the published literature was low. The main findings in the included studies were that acoustic CR neuromodulation was safe and well tolerated and most patients reported reduction of tinnitus symptoms. The neurophysiological basis of the method was claimed to be desynchronization, anti-kindling, and change of abnormal frequency couplings in a widespread tinnitus network comprising both auditory and non/auditory brain areas based on EEG analyses. CONCLUSION The available evidence is insufficient for clinical implementation of acoustic CR neuromodulation. The limited level of evidence suggests that acoustic CR neuromodulation may have positive effects on tinnitus symptoms. Preliminary electroencephalographic data are compatible with the claim that tinnitus reduction after CR treatment is mediated by a desynchronizing effect. However, a proof for this claim is still lacking.
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Affiliation(s)
- Marie Wegger
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Therese Ovesen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Otorhinolaryngology, Holstebro Regional Hospital, Holstebro, Denmark
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199
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Moreno-Paublete R, Canlon B, Cederroth CR. Differential Neural Responses Underlying the Inhibition of the Startle Response by Pre-Pulses or Gaps in Mice. Front Cell Neurosci 2017; 11:19. [PMID: 28239338 PMCID: PMC5302757 DOI: 10.3389/fncel.2017.00019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 01/23/2017] [Indexed: 11/17/2022] Open
Abstract
Gap pre-pulse inhibition of the acoustic startle (GPIAS) is a behavioral paradigm used for inferring the presence of tinnitus in animal models as well as humans. In contrast to pre-pulse inhibition (PPI), the neural circuitry controlling GPIAS is poorly understood. To increase our knowledge on GPIAS, a comparative study with PPI was performed in mice combining these behavioral tests and c-Fos activity mapping in brain areas involved in the inhibition of the acoustic startle reflex (ASR). Both pre-pulses and gaps efficiently inhibited the ASR and abolished the induction of c-Fos in the pontine reticular nucleus. Differential c-Fos activation was found between PPI and GPIAS in the forebrain whereby PPI activated the lateral globus pallidus and GPIAS activated the primary auditory cortex. Thus, different neural maps are regulating the inhibition of the startle response by pre-pulses or gaps. To further investigate this differential response to PPI and GPIAS, we pharmacologically disrupted PPI and GPIAS with D-amphetamine or Dizocilpine (MK-801) to target dopamine efflux and to block NMDA receptors, respectively. Both D-amp and MK-801 efficiently decreased PPI and GPIAS. We administered Baclofen, an agonist GABAB receptor, but failed to detect any robust rescue of the effects of D-amp and MK-801 suggesting that PPI and GPIAS are GABAB-independent. These novel findings demonstrate that the inhibition of the ASR by pre-pulses or gaps is orchestrated by different neural pathways.
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Affiliation(s)
- Rocio Moreno-Paublete
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet Stockholm, Sweden
| | - Barbara Canlon
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet Stockholm, Sweden
| | - Christopher R Cederroth
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet Stockholm, Sweden
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High-Resolution fMRI of Auditory Cortical Map Changes in Unilateral Hearing Loss and Tinnitus. Brain Topogr 2017; 30:685-697. [DOI: 10.1007/s10548-017-0547-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 01/18/2017] [Indexed: 12/19/2022]
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