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Wang Y, Zeng P, Gu Z, Liu H, Han S, Liu X, Huang X, Shao L, Tao Y. Objective Neurophysiological Indices for the Assessment of Chronic Tinnitus Based on EEG Microstate Parameters. IEEE Trans Neural Syst Rehabil Eng 2024; 32:983-993. [PMID: 38376977 DOI: 10.1109/tnsre.2024.3367982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
Chronic tinnitus is highly prevalent but lacks precise diagnostic or effective therapeutic standards. Its onset and treatment mechanisms remain unclear, and there is a shortage of objective assessment methods. We aim to identify abnormal neural activity and reorganization in tinnitus patients and reveal potential neurophysiological markers for objectively evaluating tinnitus. By way of analyzing EEG microstates, comparing metrics under three resting states (OE, CE, and OECEm) between tinnitus sufferers and controls, and correlating them with tinnitus symptoms. This study reflected specific changes in the EEG microstates of tinnitus patients across multiple resting states, as well as inconsistent correlations with tinnitus symptoms. Microstate parameters were significantly different when patients were in OE and CE states. Specifically, the occurrence of Microstate A and the transition probabilities (TP) from other Microstates to A increased significantly, particularly in the CE state (32-37%, p ≤ 0.05 ); and both correlated positively with the tinnitus intensity. Nevertheless, under the OECEm state, increases were mainly observed in the duration, coverage, and occurrence of Microstate B (15-47%, ), which negatively correlated with intensity ( [Formula: see text]-0.513, ). Additionally, TPx between Microstates C and D were significantly reduced and positively correlated with HDAS levels ( [Formula: see text] 0.548, ). Furthermore, parameters of Microstate D also correlated with THI grades ( [Formula: see text]-0.576, ). The findings of this study could offer compelling evidence for central neural reorganization associated with chronic tinnitus. EEG microstate parameters that correlate with tinnitus symptoms could serve as neurophysiological markers, contributing to future research on the objective assessment of tinnitus.
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Yasoda-Mohan A, Vanneste S. Development, Insults and Predisposing Factors of the Brain's Predictive Coding System to Chronic Perceptual Disorders-A Life-Course Examination. Brain Sci 2024; 14:86. [PMID: 38248301 PMCID: PMC10813926 DOI: 10.3390/brainsci14010086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 01/23/2024] Open
Abstract
The predictive coding theory is currently widely accepted as the theoretical basis of perception and chronic perceptual disorders are explained as the maladaptive compensation of the brain to a prediction error. Although this gives us a general framework to work with, it is still not clear who may be more susceptible and/or vulnerable to aberrations in this system. In this paper, we study changes in predictive coding through the lens of tinnitus and pain. We take a step back to understand how the predictive coding system develops from infancy, what are the different neural and bio markers that characterise this system in the acute, transition and chronic phases and what may be the factors that pose a risk to the aberration of this system. Through this paper, we aim to identify people who may be at a higher risk of developing chronic perceptual disorders as a reflection of aberrant predictive coding, thereby giving future studies more facets to incorporate in their investigation of early markers of tinnitus, pain and other disorders of predictive coding. We therefore view this paper to encourage the thinking behind the development of preclinical biomarkers to maladaptive predictive coding.
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Affiliation(s)
- Anusha Yasoda-Mohan
- Global Brain Health Institute, Trinity College Dublin, D02 R123 Dublin, Ireland;
- Trinity College Institute for Neuroscience, Trinity College Dublin, D02 R123 Dublin, Ireland
- Lab for Clinical & Integrative Neuroscience, School of Psychology, Trinity College Dublin, D02 R123 Dublin, Ireland
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, D02 R123 Dublin, Ireland;
- Trinity College Institute for Neuroscience, Trinity College Dublin, D02 R123 Dublin, Ireland
- Lab for Clinical & Integrative Neuroscience, School of Psychology, Trinity College Dublin, D02 R123 Dublin, Ireland
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Fan T, Guan P, Zhong X, Xiang M, Peng Y, Zhou R, Gong J, Zheng Y, Dai A, Feng J, Yu H, Li J, Li H, Wang Y. Functional Connectivity Alterations and Molecular Characterization of the Anterior Cingulate Cortex in Tinnitus Pathology without Hearing Loss. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2304709. [PMID: 38009798 PMCID: PMC10797451 DOI: 10.1002/advs.202304709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/06/2023] [Indexed: 11/29/2023]
Abstract
Compared with individuals with hearing loss, tinnitus patients without hearing loss have more psychological or emotional problems. Tinnitus is closely associated to abnormal metabolism and function of the limbic system, a key brain region for emotion experience, but the underlying molecular mechanism remains unknown. Using whole-brain microvasculature dynamics imaging, the anterior cingulate cortex (ACC) is identified as a key brain region of limbic system involve in the onset of salicylate-induced tinnitus in mice. In the tinnitus group, there is enhanced purine metabolism, oxidative phosphorylation, and a distinct pattern of phosphorylation in glutamatergic synaptic pathway according to the metabolome profiles, quantitative proteomic, and phosphoproteomic data of mice ACC tissue. Electroencephalogram in tinnitus patients with normal hearing thresholds show that the functional connectivity between pregenual anterior cingulate cortex and the primary auditory cortex is significantly increased for high-gamma frequency band, which is positively correlated with the serum glutamate level. These findings indicate that ACC plays an important role in the pathophysiology of tinnitus by interacting with the primary auditory cortex and provide potential molecular targets in the ACC for tinnitus treatment.
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Affiliation(s)
- Ting Fan
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Peng‐Fei Guan
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Xiao‐Fang Zhong
- Clinical Laboratory CenterChildren's Hospital of Fudan UniversityShanghai201102China
| | - Meng‐Ya Xiang
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Ying‐Qiu Peng
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Ruo‐Qiao Zhou
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Jia‐Min Gong
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
| | - Yu‐Qing Zheng
- Zhejiang Chinese Medical UniversityHangzhouZhejiang310053China
| | - A‐Qiang Dai
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
| | - Jia‐Ling Feng
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
| | - Hong‐Zhe Yu
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Jian Li
- Clinical Laboratory CenterChildren's Hospital of Fudan UniversityShanghai201102China
| | - Hua‐Wei Li
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
| | - Yun‐Feng Wang
- ENT Institute and Department of OtorhinolaryngologyEYE & ENT HospitalFudan UniversityShanghai200031China
- NHC Key Laboratory of Hearing MedicineFudan UniversityShanghai200031China
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Chen Q, Lv H, Wang Z, Li X, Wang X, Huang Y, Zhao P, Yang Z, Gong S, Wang Z. Role of insula and its subregions in progression from recent onset to chronic idiopathic tinnitus. Brain Commun 2023; 5:fcad261. [PMID: 37869577 PMCID: PMC10586310 DOI: 10.1093/braincomms/fcad261] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/08/2023] [Accepted: 10/06/2023] [Indexed: 10/24/2023] Open
Abstract
We determined the structural and functional alterations in the insula and its subregions in patients with idiopathic tinnitus in order to identify the neural changes involved in the progression from recent onset to chronic tinnitus. We recruited 24 recent-onset tinnitus patients, 32 chronic tinnitus patients and 36 healthy controls. We measured the grey matter volume and fractional amplitude of low-frequency fluctuation of the insula and its subregions and the functional connectivity within the insula and between the insula and the rest of the brain. Relationships between MRI and clinical characteristics were estimated using partial correlation analysis. Both recent-onset and chronic tinnitus patients showed decreased fractional amplitude of low-frequency fluctuation in the insula and its subregions, but only chronic tinnitus patients showed bilateral grey matter atrophy in the ventral anterior insula. Abnormal functional connectivity was detected in recent-onset and chronic tinnitus patients relative to the healthy controls, but functional connectivity differences between recent-onset and chronic tinnitus patients were found in only the auditory-related cortex, frontal cortex and limbic system. Functional alterations (fractional amplitude of low-frequency fluctuation and functional connectivity of the left ventral anterior insula), but not structural changes, were correlated with clinical severity. Bilateral grey matter atrophy in the ventral anterior insula decreased regional activities in the left ventral anterior insula and left posterior insula, and abnormal functional connectivity of the insula subregions with auditory and non-auditory areas were implicated in the progression from recent onset to chronic tinnitus. This suggests that tinnitus generation and development occur in a dynamic manner and involve aberrant multi-structural and functional (regional brain activity and abnormal functional connectivity) reorganization of the insula.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaodi Wang
- Department of Otolaryngology, Beijing Jingmei Group General Hospital, Beijing 102300, China
| | - Xiaoshuai Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xinghao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | | | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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Xiong B, Liu Z, Li J, Huang X, Yang J, Xu W, Chen YC, Cai Y, Zheng Y. Abnormal Functional Connectivity Within Default Mode Network and Salience Network Related to Tinnitus Severity. J Assoc Res Otolaryngol 2023; 24:453-462. [PMID: 37436592 PMCID: PMC10504230 DOI: 10.1007/s10162-023-00905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/19/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated that tinnitus is associated with neural changes in the cerebral cortex. This study is aimed at investigating the central nervous characteristics of tinnitus patients with different severity by using a rs-EEG. PARTICIPANTS AND METHODS rs-EEG was recorded in fifty-seven patients with chronic tinnitus and twenty-seven healthy controls. Tinnitus patients were divided into moderate-to-severe tinnitus group and slight-to-mild tinnitus group based on their Tinnitus Handicap Inventory (THI) scores. Source localization and functional connectivity analyses were used to measure the changes in central levels and examine the altered network patterns. The correlation between functional connectivity and tinnitus severity was analyzed. RESULT Compared to the healthy controls, all tinnitus patients showed significant activation in the auditory cortex (middle temporal lobe, BA 21), while moderate-to-severe tinnitus group showed enhanced connectivity between the parahippocampus and posterior cingulate gyrus. Moreover, the moderate-to-severe tinnitus group had enhanced functional connectivity between auditory cortex and insula compared to the slight-to-mild tinnitus group. The connections between the insula and the parahippocampal and posterior cingulate gyrus were positively correlated with THI scores. CONCLUSION The current study reveals that patients with moderate-to-severe tinnitus demonstrate greater changes in the central brain areas, including the auditory cortex, insula, parahippocampus and posterior cingulate gyrus. In addition, enhanced connections were found between the insula and the auditory cortex, as well as the posterior cingulate gyrus and the parahippocampus, which suggests abnormality in the auditory network, salience network, and default mode network. Specifically, the insula is the core region of the neural pathway that is composed of the auditory cortex, insula, and parahippocampus/posterior cingulate gyrus. This suggests that the severity of tinnitus is affected by multiple brain regions.
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Affiliation(s)
- Binbin Xiong
- Zhuhai Hospital Affiliated with Jinan University, Zhuhai, Guangdong, 519000, China
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Zhao Liu
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Jiahong Li
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China
| | - Xiayin Huang
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China
| | - Jing Yang
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Wenqiang Xu
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuexin Cai
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China.
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
| | - Yiqing Zheng
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China.
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China.
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
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Zhang C, Wang X, Ding Z, Zhou H, Liu P, Xue X, Wang L, Jiang Y, Chen J, Shen W, Yang S, Wang F. Study on tinnitus-related electroencephalogram microstates in patients with vestibular schwannomas. Front Neurosci 2023; 17:1159019. [PMID: 37090804 PMCID: PMC10118047 DOI: 10.3389/fnins.2023.1159019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Tinnitus is closely associated with cognition functioning. In order to clarify the central reorganization of tinnitus in patients with vestibular schwannoma (VS), this study explored the aberrant dynamics of electroencephalogram (EEG) microstates and their correlations with tinnitus features in VS patients. Clinical and EEG data were collected from 98 VS patients, including 76 with tinnitus and 22 without tinnitus. Microstates were clustered into four categories. Our EEG microstate analysis revealed that VS patients with tinnitus exhibited an increased frequency of microstate C compared to those without tinnitus. Furthermore, correlation analysis demonstrated that the Tinnitus Handicap Inventory (THI) score was negatively associated with the duration of microstate A and positively associated with the frequency of microstate C. These findings suggest that the time series and syntax characteristics of EEG microstates differ significantly between VS patients with and without tinnitus, potentially reflecting abnormal allocation of neural resources and transition of functional brain activity. Our results provide a foundation for developing diverse treatments for tinnitus in VS patients.
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Affiliation(s)
- Chi Zhang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiaoguang Wang
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
| | - Zhiwei Ding
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Hanwen Zhou
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Peng Liu
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xinmiao Xue
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Li Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yuke Jiang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Jiyue Chen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Weidong Shen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shiming Yang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fangyuan Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Fangyuan Wang,
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Zhang H, Ji L, Wang L, Yin Z, Cen J, Guo Y. Clinical characteristics and psychoacoustic analysis of acute and chronic subjective tinnitus. Laryngoscope Investig Otolaryngol 2023; 8:546-553. [PMID: 37090863 PMCID: PMC10116969 DOI: 10.1002/lio2.1037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/08/2023] [Accepted: 02/19/2023] [Indexed: 03/08/2023] Open
Abstract
Objective This study aimed to understand the demographics, clinical characteristics, and psychoacoustic status of subjective tinnitus patients to explore the factors associated with acute and chronic tinnitus in the general hospitals of Shanghai. Methods A cross-sectional study was conducted to investigate the clinical characteristics and psychoacoustic status of subjective tinnitus patients with history greater than 1 month. Data were collected during January 2021 and January 2022 from eight general hospitals in five districts of Shanghai, China. All patients accepted questionnaires and acoustic examination, then SPSS 22.0 and GraphPad Prism 8.0.2 were applied for data analysis. Results Among the 359 tinnitus patients, 126 cases were diagnosed with acute tinnitus, 58 cases were subacute tinnitus, and 175 cases were chronic tinnitus. Patients with acute and chronic tinnitus differed in terms of side of tinnitus, hearing loss, frequency of tinnitus, severity of tinnitus, anxiety, depression, and sleep status. Different characteristics were included in the multivariate ordinal logistic regression analysis. Persistent tinnitus (OR = 2.00, p = .008), high frequency hearing loss (OR = 4.77, p < .001), depression (OR = 1.23, p < .001) were found to be positively associated with the course of tinnitus. Unilateral tinnitus (OR = 0.48, p = .003), mild (OR = 0.29, p = .001) and moderate (OR = 0.46, p = .038) hearing loss, VAS scores (OR = 0.82, p = .032), anxiety (OR = 0.81, p < .001), THI scores (OR = 0.98, p = .002), and sleep disorders (OR = 0.94, p = .025) were found to be negatively associated with the course of tinnitus. Conclusion Patients with acute tinnitus were at greater risk for anxiety, sleep disturbances, and exacerbation of tinnitus perception, and those with chronic tinnitus were at greater risk for depression. Lay Summary Our study demonstrated that patients with acute tinnitus were at greater risk for anxiety, sleep disturbances, and exacerbation of tinnitus perception, and those with chronic tinnitus were at greater risk for depression.
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Affiliation(s)
- Haopeng Zhang
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lin Ji
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Lihua Wang
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Ziming Yin
- School of Medical Instrument and Food EngineeringUniversity of Shanghai for Science and TechnologyShanghaiChina
| | - Jingtu Cen
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
| | - Yu Guo
- Department of OtolaryngologyShanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese MedicineShanghaiChina
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Du H, Feng X, Qian X, Zhang J, Liu B, Li A, Huang Z, Gao X. Recent-onset and persistent tinnitus: Uncovering the differences in brain activities using resting-state functional magnetic resonance imaging technologies. Front Neurosci 2022; 16:976095. [PMID: 36340775 PMCID: PMC9627982 DOI: 10.3389/fnins.2022.976095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/26/2022] [Indexed: 11/14/2022] Open
Abstract
Objective This study aimed to investigate the differences in intra-regional brain activity and inter-regional functional connectivity between patients with recent-onset tinnitus (ROT) and persistent tinnitus (PT) using resting-state functional magnetic resonance imaging (rs-fMRI), including the amplitude of low-frequency fluctuations (ALFF), regional homogeneity (ReHo), and voxel-wise functional connectivity (FC). Method We acquired rs-fMRI scans from 82 patients (25 without recent-onset tinnitus, 28 with persistent tinnitus, and 29 healthy controls). Age, sex, and years of education were matched across the three groups. We performed ALFF, ReHo, and voxel-wise FC analyses for all patients. Results Compared with the control group, participants with ROT and PT manifested significantly reduced ALFF and ReHo activity within the left and right dorsolateral superior frontal gyrus (SFG) and gyrus rectus (GR). Additional voxel-wise FC revealed decreased connectivity between the dorsolateral SFG (left and right) and the right superior parietal gyrus (SPG), right middle frontal gyrus (MFG), and left medial superior frontal gyrus (mSFG) within these two groups. Significant differences were observed between the ROT and PT groups, with the ROT group demonstrating reduced FC. Conclusion Our data suggest that patients with PT have more difficulty monitoring external stimuli and reorienting attention than patients with ROT. In addition, patients who perceive higher levels of disruption from tinnitus are more likely to develop persistent and debilitating tinnitus once the tinnitus lasts longer than six months. Therefore, we strongly recommend that clinicians implement effective tinnitus management strategies in patients with ROT as soon as possible.
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Affiliation(s)
- Haoliang Du
- Jiangsu Provincial Key Laboratory Medical Discipline, Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Department of Research Institution of Otolaryngology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xu Feng
- Department of Otolaryngology-Head and Neck Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Xiaoyun Qian
- Jiangsu Provincial Key Laboratory Medical Discipline, Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Department of Research Institution of Otolaryngology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jian Zhang
- Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Bin Liu
- Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Ao Li
- Jiangsu Provincial Key Laboratory Medical Discipline, Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Department of Research Institution of Otolaryngology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhichun Huang
- Department of Otolaryngology-Head and Neck Surgery, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
- *Correspondence: Zhichun Huang,
| | - Xia Gao
- Jiangsu Provincial Key Laboratory Medical Discipline, Department of Otolaryngology-Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Department of Research Institution of Otolaryngology, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Xia Gao,
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Amat F, Zimdahl JW, Barry KM, Rodger J, Mulders WHAM. Long-Term Effects of Repetitive Transcranial Magnetic Stimulation on Tinnitus in a Guinea Pig Model. Brain Sci 2022; 12:brainsci12081096. [PMID: 36009159 PMCID: PMC9405768 DOI: 10.3390/brainsci12081096] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022] Open
Abstract
The auditory phantom sensation of tinnitus is associated with neural hyperactivity. Modulating this hyperactivity using repetitive transcranial magnetic stimulation (rTMS) has shown beneficial effects in human studies. Previously, we investigated rTMS in a tinnitus animal model and showed that rTMS over prefrontal cortex (PFC) attenuated tinnitus soon after treatment, likely via indirect effects on auditory pathways. Here, we explored the duration of these beneficial effects. Acoustic trauma was used to induce hearing loss and tinnitus in guinea pigs. Once tinnitus developed, high-frequency (20 Hz), high-intensity rTMS was applied over PFC for two weeks (weekdays only; 10 min/day). Behavioral signs of tinnitus were monitored for 6 weeks after treatment ended. Tinnitus developed in 77% of animals between 13 and 60 days post-trauma. rTMS treatment significantly reduced the signs of tinnitus at 1 week on a group level, but individual responses varied greatly at week 2 until week 6. Three (33%) of the animals showed the attenuation of tinnitus for the full 6 weeks, 45% for 1–4 weeks and 22% were non-responders. This study provides further support for the efficacy of high-frequency repetitive stimulation over the PFC as a therapeutic tool for tinnitus, but also highlights individual variation observed in human studies.
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Affiliation(s)
- Farah Amat
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Jack W. Zimdahl
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Kristin M. Barry
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
| | - Jennifer Rodger
- School of Biological Sciences, University of Western Australia, Crawley, WA 6009, Australia
- Perron Institute for Neurological and Translational Research, Crawley, WA 6009, Australia
| | - Wilhelmina H. A. M. Mulders
- The Auditory Laboratory, School of Human Sciences, University of Western Australia, Crawley, WA 6009, Australia
- Correspondence:
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10
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Can GABAkines Quiet the Noise? The GABAA Receptor Neurobiology and Pharmacology of Tinnitus. Biochem Pharmacol 2022; 201:115067. [DOI: 10.1016/j.bcp.2022.115067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 11/20/2022]
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11
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Lan L, Chen YC, Shang S, Lu L, Xu JJ, Yin X, Wu Y, Cai Y. Topological features of limbic dysfunction in chronicity of tinnitus with intact hearing: New hypothesis for 'noise-cancellation' mechanism. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110459. [PMID: 34666066 DOI: 10.1016/j.pnpbp.2021.110459] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 12/17/2022]
Abstract
PURPOSE The reorganization of the limbic regions extend to general cognitive network is believed to exist in the chronicity of tinnitus with particular 'hubs' contributing to a 'noise-cancellation' mechanism. To test this hypothesis, we investigated the topological brain network of tinnitus in different periods. METHODS Resting-state functional magnetic resonance imaging were obtained from 32 patients with acute tinnitus, 41 patients with chronic tinnitus and 60 age- and gender- matched healthy controls (HC). The topological features of their brain networks were explored using graph theory analysis. RESULTS Common small-world attributes were compared between the three groups, all showed a significantly increased values in Cp, Lp, λ (all p < 0.05). Significantly increased nodal centralities in the left superior frontal gyrus and the right precuneus, significantly decreased nodal centralities in the right inferior temporal gyrus were observed for acute tinnitus patients compared to HC. While for chronic tinnitus patients, there were significant increased nodal centralities in the left hippocampus, amygdala, and temporal pole, but decreased nodal centralities in the right inferior temporal gyrus. Additionally, significant higher nodal centralities were found in bilateral medial superior frontal gyrus for acute tinnitus patients compared to chronic tinnitus patients. Besides, alterations in rich-club organization were found in acute tinnitus patients and chronic tinnitus patients compared with HC, with increased functional connections among rich-club nodes and peripheral nodes in patients with tinnitus. CONCLUSIONS Brain network topological properties altered across prefrontal-limbic-subcortical regions in tinnitus. The existed hubs in tinnitus might indicate an emotional and cognitive burden in 'noise-cancellation' mechanism.
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Affiliation(s)
- Liping Lan
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Song'an Shang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Liyan Lu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
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12
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A survey of brain network analysis by electroencephalographic signals. Cogn Neurodyn 2022; 16:17-41. [PMID: 35126769 PMCID: PMC8807775 DOI: 10.1007/s11571-021-09689-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 04/25/2021] [Accepted: 05/31/2021] [Indexed: 02/03/2023] Open
Abstract
Brain network analysis is one efficient tool in exploring human brain diseases and can differentiate the alterations from comparative networks. The alterations account for time, mental states, tasks, individuals, and so forth. Furthermore, the changes determine the segregation and integration of functional networks that lead to network reorganization (or reconfiguration) to extend the neuroplasticity of the brain. Exploring related brain networks should be of interest that may provide roadmaps for brain research and clinical diagnosis. Recent electroencephalogram (EEG) studies have revealed the secrets of the brain networks and diseases (or disorders) within and between subjects and have provided instructive and promising suggestions and methods. This review summarized the corresponding algorithms that had been used to construct functional or effective networks on the scalp and cerebral cortex. We reviewed EEG network analysis that unveils more cognitive functions and neural disorders of the human and then explored the relationship between brain science and artificial intelligence which may fuel each other to accelerate their advances, and also discussed some innovations and future challenges in the end.
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13
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Lan L, Liu Y, Wu Y, Xu ZG, Xu JJ, Song JJ, Salvi R, Yin X, Chen YC, Cai Y. Specific brain network predictors of interventions with different mechanisms for tinnitus patients. EBioMedicine 2022; 76:103862. [PMID: 35104784 PMCID: PMC8814370 DOI: 10.1016/j.ebiom.2022.103862] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The aberrant brain network that gives rise to the phantom sound of tinnitus is believed to determine the effectiveness of tinnitus therapies involving neuromodulation with repetitive transcranial magnetic stimulation (rTMS) and sound therapy utilizing tailor-made notch music training (TMNMT). To test this hypothesis, we determined how effective rTMS or TMNMT were in ameliorating tinnitus in patients with different functional brain networks. METHODS Resting-state functional MRI was used to construct brain functional networks in patients with tinnitus (41 males/45 females, mean age 49.53±11.19 years) and gender-matched healthy controls (22 males/35 females, mean age 46.23±10.23 years) with independent component analysis (ICA). A 2 × 2 analysis of variance with treatment outcomes (Effective group, EG/Ineffective group, IG) and treatment types (rTMS/TMNMT) was used to test the interaction between outcomes and treatment types associated with functional network connections (FNCs). FINDINGS The optimal neuroimaging indicator for responding to rTMS (AUC 0.804, sensitivity 0.700, specificity 0.913) was FNCs in the salience network-right frontoparietal network (SN-RFPN) while for responding to TMNMT (AUC 0.764, sensitivity 0.864, specificity 0.667) was the combination of FNCs in the auditory network- salience network (AUN-SN) and auditory network-cerebellar network (AUN-CN). INTERPRETATION Tinnitus patients with higher FNCs in the SN-RFPN is associated with a recommendation for rTMS whereas patients with lower FNCs in the AUN-SN and AUN-CN would suggest TMNMT as the better choice. These results indicate that brain network-based measures aid in the selection of the optimal form of treatment for a patient contributing to advances in precision medicine. FUNDING Yuexin Cai is supported by Key R&D Program of Guangdong Province, China (Grant No. 2018B030339001), National Natural Science Foundation of China (82071062), Natural Science Foundation of Guangdong province (2021A1515012038), the Fundamental Research Funds for the Central Universities (20ykpy91), and Sun Yat-Sen Clinical Research Cultivating Program (SYS-Q-201903). Yu-Chen Chen is supported by Medical Science and Technology Development Foundation of Nanjing Department of Health (No. ZKX20037), and Natural Science Foundation of Jiangsu Province (No. BK20211008).
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Affiliation(s)
- Liping Lan
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, Guangdong 510120, China
| | - Yin Liu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zhen-Gui Xu
- Department of Otolaryngology, Nanjing Pukou Central Hospital, Pukou Branch Hospital of Jiangsu Province Hospital, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Richard Salvi
- Center for Hearing and Deafness, University at Buffalo, The State University of New York, Buffalo, United States
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, No.68, Changle Road, Nanjing 210006, China.
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 West Yanjiang Road, Guangzhou, Guangdong 510120, China; Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, China.
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14
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Wei Y, Zhang W, Li Y, Liu X, Zha B, Hu S, Wang Y, Wang X, Yu X, Yang J, Qiu B. Acupuncture Treatment Decreased Temporal Variability of Dynamic Functional Connectivity in Chronic Tinnitus. Front Neurosci 2022; 15:737993. [PMID: 35153654 PMCID: PMC8835346 DOI: 10.3389/fnins.2021.737993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Acupuncture is recommended for the relief of chronic tinnitus in traditional Chinese medicine, but the underlying neural mechanism remains unclear. The human brain is a dynamic system, and it’s unclear about acupuncture’s effects on the dynamic functional connectivity (DFC) of chronic tinnitus. Therefore, this study based on resting-state functional magnetic resonance imaging (fMRI) investigates abnormal DFC in chronic tinnitus patients and the neural activity change evoked by acupuncture treatment for tinnitus. In this study, 17 chronic tinnitus patients and 22 age- and sex-matched normal subjects were recruited, and their tinnitus-related scales and hearing levels were collected. The fMRI data were measured before and after acupuncture, and then sliding-window and k-means clustering methods were used to calculate DFC and perform clustering analysis, respectively. We found that, compared with the normal subjects, chronic tinnitus patients had higher temporal variability of DFC between the supplementary motor area and medial part of the superior frontal gyrus, and it positively correlated with hearing loss. Clustering analysis showed higher transition probability (TP) between connection states in chronic tinnitus patients, and it was positively correlated with tinnitus severity. Furthermore, the findings showed that acupuncture treatment might improve tinnitus. DFC between the posterior cingulate gyrus and angular gyrus in chronic tinnitus patients after acupuncture showed significantly decreased, and it positively correlated with the improvement of tinnitus. Clustering analysis showed that acupuncture treatment might promote chronic tinnitus patients under lower DFC state, and it also positively correlated with the improvement of tinnitus. This study suggests that acupuncture as an alternative therapy method might decrease the tinnitus severity by decreasing the time variability of DFC in chronic tinnitus patients.
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Affiliation(s)
- Yarui Wei
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wanlin Zhang
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yu Li
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiangwei Liu
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Bixiang Zha
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yanming Wang
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiaoxiao Wang
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiaochun Yu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- Xiaochun Yu,
| | - Jun Yang
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
- Jun Yang,
| | - Bensheng Qiu
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- *Correspondence: Bensheng Qiu,
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15
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Symptom dimensions to address heterogeneity in tinnitus. Neurosci Biobehav Rev 2022; 134:104542. [PMID: 35051524 DOI: 10.1016/j.neubiorev.2022.104542] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 01/10/2023]
Abstract
Tinnitus, the auditory phantom percept, is a well-known heterogenous disorder with multiple subtypes. Researchers and clinicians have tried to classify these subtypes according to clinical profiles, aetiologies, and response to treatment with little success. The occurrence of overlapping tinnitus subtypes suggests that the disorder exists along a continuum of severity, with no clear distinct boundaries. In this perspective, we propose a neuro-mechanical framework, viewing tinnitus as a dimensional disorder which is a complex interplay of its behavioural, biological and neurophysiological phenotypes. Moreover, we explore the potential of these dimensions as interacting networks without a common existing cause, giving rise to tinnitus. Considering tinnitus as partially overlapping, dynamically changing, interacting networks, each representing a different aspect of the unified tinnitus percept, suggests that the interaction of these networks determines the phenomenology of the tinnitus, ultimately leading to a dimensional spectrum, rather than a categorical subtyping. A combination of a robust theoretical framework and strong empirical evidence can advance our understanding of the functional mechanisms underlying tinnitus and ultimately, improve treatment strategies.
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16
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Aberrant Resting-State Functional Connectivity of the Dorsal Attention Network in Tinnitus. Neural Plast 2022; 2021:2804533. [PMID: 35003251 PMCID: PMC8741389 DOI: 10.1155/2021/2804533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 01/17/2023] Open
Abstract
Previous functional magnetic resonance imaging (fMRI) analyses have shown that the dorsal attention network (DAN) is involved in the pathophysiological changes of tinnitus, but few relevant studies have been conducted, and the conclusions to date are not uniform. The purpose of this research was to test whether there is a change in intrinsic functional connectivity (FC) patterns between the DAN and other brain regions in tinnitus patients. Thirty-one patients with persistent tinnitus and thirty-three healthy controls were enrolled in this study. A group independent component analysis (ICA), degree centrality (DC) analysis, and seed-based FC analysis were conducted. In the group ICA, the tinnitus patients showed increased connectivity in the left superior parietal gyrus in the DAN compared to the healthy controls. Compared with the healthy controls, the tinnitus patients showed increased DC in the left inferior parietal gyrus and decreased DC in the left precuneus within the DAN. The clusters within the DAN with significant differences in the ICA or DC analysis between the tinnitus patients and the healthy controls were selected as regions of interest (ROIs) for seeds. The tinnitus patients exhibited significantly increased FC from the left superior parietal gyrus to several brain regions, including the left inferior parietal gyrus, the left superior marginal gyrus, and the right superior frontal gyrus, and decreased FC to the right anterior cingulate cortex. The tinnitus patients exhibited decreased FC from the left precuneus to the left inferior occipital gyrus, left calcarine cortex, and left superior frontal gyrus compared with the healthy controls. The findings of this study show that compared with healthy controls, tinnitus patients have altered functional connections not only within the DAN but also between the DAN and other brain regions. These results suggest that it may be possible to improve the disturbance and influence of tinnitus by regulating the DAN.
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17
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Wei X, Lv H, Chen Q, Wang Z, Zhao P, Liu C, Gong S, Yang Z, Wang Z. Surface-Based Amplitude of Low-Frequency Fluctuation Alterations in Patients With Tinnitus Before and After Sound Therapy: A Resting-State Functional Magnetic Resonance Imaging Study. Front Neurosci 2021; 15:709482. [PMID: 34867147 PMCID: PMC8635858 DOI: 10.3389/fnins.2021.709482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 10/28/2021] [Indexed: 11/21/2022] Open
Abstract
This study aimed to investigate abnormal tinnitus activity by evaluating brain surface-based amplitude of low-frequency fluctuation (ALFF) changes detected by resting-state functional magnetic resonance imaging (RS-fMRI) in patients with idiopathic tinnitus before and after 24 weeks of sound therapy. We hypothesized that sound therapy could gradually return cortical local brain function to a relatively normal range. In this prospective observational study, we recruited thirty-three tinnitus patients who had undergone 24 weeks of sound therapy and 26 matched healthy controls (HCs). For the two groups of subjects, we analyzed the spontaneous neural activity of tinnitus patients by cortical ALFF and detected its correlation with clinical indicators of tinnitus. Patients’ Tinnitus Handicap Inventory (THI) scores were assessed to determine the severity of their tinnitus before and after treatment. Two-way mixed model analysis of variance and Pearson’s correlation analysis were used in the statistical analysis. Student–Newman–Keuls tests were used in the post hoc analysis. Interaction effects between the two groups and between the two scans revealing local neural activity as assessed by ALFF were observed in the bilateral dorsal stream visual cortex (DSVC), bilateral posterior cingulate cortex (PCC), bilateral anterior cingulate and medial prefrontal cortex (ACC and MPC), left temporo-parieto-occipital junction (TPOJ), left orbital and polar frontal cortex (OPFC), left paracentral lobular and mid cingulate cortex (PCL and MCC), right insular and frontal opercular cortex (IFOC), and left early visual cortex (EVC). Importantly, local functional activity in the left TPOJ and right PCC in the patient group was significantly lower than that in the HCs at baseline and was increased to relatively normal levels after treatment. The 24-week sound therapy tinnitus group demonstrated significantly higher ALFF in the left TPOJ and right PCC than in the tinnitus baseline group. Also, compared with the HC baseline group and the 24-week HC group, the 24-week sound therapy tinnitus group demonstrated slightly lower or higher ALFF in the left TPOJ and right PCC, and there were no differences between the 24-week sound therapy tinnitus and HC groups. Decreased THI scores and ALFF changes in the abovementioned brain regions were not correlated. Taken together, surface-based RS-fMRI can provide more subtle local functional activity to explain the mechanism of tinnitus treatment, and long-term sound therapy had a normalizing effect on tinnitus patients.
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Affiliation(s)
- Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Chunli Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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18
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Hu J, Xu JJ, Shang S, Chen H, Yin X, Qi J, Wu Y. Cerebral Blood Flow Difference Between Acute and Chronic Tinnitus Perception: A Perfusion Functional Magnetic Resonance Imaging Study. Front Neurosci 2021; 15:752419. [PMID: 34675772 PMCID: PMC8523683 DOI: 10.3389/fnins.2021.752419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: The central nervous mechanism of acute tinnitus is different from that of chronic tinnitus, which may be related to the difference of cerebral blood flow (CBF) perfusion in certain regions. To verify this conjecture, we used arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) in this study to compare the CBF alterations of patients with acute and chronic tinnitus. Methods: The current study included patients with chronic tinnitus (n = 35), acute tinnitus (n = 30), and healthy controls (n = 40) who were age-, sex-, and education-matched. All participants underwent MRI scanning and then ASL images were obtained to measure CBF of the entire brain and analyze the differences between groups as well as the correlations with tinnitus characteristics. Results: The chronic tinnitus group showed increased z-CBF in the right superior temporal gyrus (STG) and superior frontal gyrus (SFG) when compared with the acute tinnitus patients. Further connectivity analysis found enhanced CBF connectivity between the right STG and fusiform gyrus (FG), the right SFG and left middle occipital gyrus (MOG), as well as the right parahippocampal gyrus (PHG). Moreover, in the chronic tinnitus group, the tinnitus handicap questionnaire (THQ) score was positively correlated with the normalized z-CBF of right STG (r = 0.440, p = 0.013). Conclusion: Our results confirmed that the CBF changes in some brain regions were different between acute and chronic tinnitus patients, which was correlated with certain tinnitus characteristics. This is of great value to further research on chronicity of tinnitus, and ASL has a promising application in the measurement of CBF.
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Affiliation(s)
- Jinghua Hu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Song’an Shang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jianwei Qi
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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19
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Chen Q, Lv H, Wang Z, Wei X, Liu J, Zhao P, Yang Z, Gong S, Wang Z. Pretreatment intranetwork connectivity can predict the outcomes in idiopathic tinnitus patients treated with sound therapy. Hum Brain Mapp 2021; 42:4762-4776. [PMID: 34231944 PMCID: PMC8410522 DOI: 10.1002/hbm.25584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 05/28/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022] Open
Abstract
Previous studies demonstrated that brain morphological differences and distinct patterns of neural activation exist in tinnitus patients with different prognoses after sound therapy. This study aimed to explore possible differences in intrinsic network‐level functional connectivity (FC) in patients with different outcomes after sound therapy (narrow band noise). We examined intrinsic FC using resting‐state functional magnetic resonance imaging in 78 idiopathic tinnitus patients (including 35 effectively treated and 43 ineffectively treated) and 52 healthy controls (HCs) via independent component analysis. We also investigated the associations between the differences in FC and clinical variables. Analyses revealed significantly altered intranetwork connectivity in the auditory network (AUN) and some nonauditory‐related networks in the EG/IG patients compared to HCs; compared with EG patients, IG patients showed decreased intranetwork connectivity in the anterior default mode network (aDMN) and AUN. Meanwhile, robust differences were also evident in internetwork connectivity between some nonauditory‐related networks (salience network and executive control network; posterior default mode network and dorsal attention network) in the EG relative to IG patients. We combined intranetwork connectivity in the aDMN and AUN as an imaging indicator to evaluate patient outcomes and screen patients before treatment; this approach reached a sensitivity of 94.3% and a specificity of 76.7%. Our study suggests that tinnitus patients with different outcomes show distinct network‐level functional reorganization patterns. Intranetwork connectivity in the aDMN and AUN may be indicators that can be used to predict prognoses in patients with idiopathic tinnitus and screen patients before sound therapy.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Department of Otolaryngology Head and Neck Surgery, General Hospital of Beijing Jingmei Group, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jiao Liu
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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20
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Song JJ, Park J, Koo JW, Lee SY, Vanneste S, De Ridder D, Hong S, Lim S. The balance between Bayesian inference and default mode determines the generation of tinnitus from decreased auditory input: A volume entropy-based study. Hum Brain Mapp 2021; 42:4059-4073. [PMID: 34076316 PMCID: PMC8288089 DOI: 10.1002/hbm.25539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022] Open
Abstract
Along with phantom pain, tinnitus, a phantom auditory perception occurring in the absence of an external acoustic stimulus, is one of the most representative phantom perceptions that develops in subjects with decreased peripheral sensory input. Although tinnitus is closely associated with peripheral hearing loss (HL), it remains unclear why only some individuals with HL develop tinnitus. In this study, we investigated the differences between 65 HL with tinnitus (HL‐T) and 104 HL with no tinnitus (HL‐NT) using a resting‐state electroencephalography data‐based volume entropy model of the brain network, by comparing the afferent node capacities, that quantify the contribution of each node to the spread of information, of all Brodmann areas. While the HL‐T group showed increased information flow in areas involved in Bayesian inference (the left orbitofrontal cortex, the left subgenual anterior cingulate cortex, and the left ventrolateral prefrontal cortex) and auditory memory storage (the right hippocampus/parahippocampus), the HL‐NT group showed increased afferent node capacity in hub areas of the default mode network (DMN; the right posterior cingulate cortex and the right medial temporal gyrus). These results suggest that the balance of activity between the Bayesian inferential network (updating missing auditory information by retrieving auditory memories from the hippocampus/parahippocampus) and DMN (maintaining the “silent status quo”) determines whether phantom auditory perception occurs in a brain with decreased peripheral auditory input.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaemin Park
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Soonki Hong
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Seonhee Lim
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
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21
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Kikidis D, Vassou E, Schlee W, Iliadou E, Markatos N, Triantafyllou A, Langguth B. Methodological Aspects of Randomized Controlled Trials for Tinnitus: A Systematic Review and How a Decision Support System Could Overcome Barriers. J Clin Med 2021; 10:1737. [PMID: 33923778 PMCID: PMC8074073 DOI: 10.3390/jcm10081737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
Abstract
Although a wide range of tinnitus management interventions is currently under research and a variety of therapeutic interventions have already been applied in clinical practice, no optimal and universal tinnitus treatment has been reached yet. This fact is to some extent a consequence of the high heterogeneity of the methodologies used in tinnitus related clinical studies. In this manuscript, we have identified, summarized, and critically appraised tinnitus-related randomized clinical trials since 2010, aiming at systematically mapping the research conducted in this area. The results of our analysis of the 73 included randomized clinical trials provide important insight on the identification of limitations of previous works, methodological pitfalls or gaps in current knowledge, a prerequisite for the adequate interpretation of current literature and execution of future studies.
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Affiliation(s)
- Dimitrios Kikidis
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Evgenia Vassou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
| | - Eleftheria Iliadou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Nikolaos Markatos
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Aikaterini Triantafyllou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
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