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Makani P, Thioux M, Koops EA, Pyott SJ, van Dijk P. Hyperacusis in Tinnitus Individuals Is Associated with Smaller Gray Matter Volumes in the Supplementary Motor Area Regardless of Hearing Levels. Brain Sci 2024; 14:726. [PMID: 39061466 PMCID: PMC11275185 DOI: 10.3390/brainsci14070726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/11/2024] [Accepted: 07/12/2024] [Indexed: 07/28/2024] Open
Abstract
Recent evidence suggests a connection between hyperacusis and the motor system of the brain. For instance, our recent study reported that hyperacusis in participants with tinnitus and hearing loss is associated with smaller gray matter volumes in the supplementary motor area (SMA). Given that hearing loss can affect gray matter changes in tinnitus, this study aimed to determine if the changes reported in our previous findings of smaller SMA gray matter volumes in hyperacusis persist in the absence of hearing loss. Data for this study were gathered from four prior studies conducted between 2004 and 2019 at the University Medical Centre Groningen (UMCG). A total of 101 participants with tinnitus and either clinically normal hearing (normal hearing with tinnitus or NHT, n = 35) or bilateral sensorineural hearing loss (hearing loss with tinnitus or HLT, n = 66) were included across four studies. Hyperacusis was determined by a score of ≥22 on the Hyperacusis Questionnaire (HQ). In the NHT group, 22 (63%) participants scored ≥22 on the HQ (NHT with hyperacusis: mean age 44.1 years, 12 females), while in the HLT group, 25 (38%) participants scored ≥22 on the HQ (HLT with hyperacusis: mean age 59.5 years, 10 females). The 2 × 2 between-group ANOVAs revealed that hyperacusis is associated with smaller SMA gray matter volumes, regardless of hearing levels. Notably, the smaller SMA gray matter volumes in hyperacusis were primarily influenced by the attentional subscales of the HQ. The association between hyperacusis and the motor system may indicate a constant alertness to sounds and a readiness for motor action.
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Affiliation(s)
- Punitkumar Makani
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Marc Thioux
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Elouise A. Koops
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Sonja J. Pyott
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology—Head and Neck Surgery, University of Groningen, University Medical Center Groningen, 9700 RB Groningen, The Netherlands; (P.M.); (E.A.K.); (S.J.P.); (P.v.D.)
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, 9713 AV Groningen, The Netherlands
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Musumano LB, Hatzopoulos S, Fancello V, Bianchini C, Bellini T, Pelucchi S, Skarżyński PH, Skarżyńska MB, Ciorba A. Hyperacusis: Focus on Gender Differences: A Systematic Review. Life (Basel) 2023; 13:2092. [PMID: 37895473 PMCID: PMC10608418 DOI: 10.3390/life13102092] [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: 09/19/2023] [Revised: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND While gender differences of several diseases have been already described in the literature, studies in the area of hyperacusis are still scant. Despite the fact that hyperacusis is a condition that severely affects the patient's quality of life, it is not well investigated; a comprehensive understanding of its features, eventually including gender differences, could be a valuable asset in developing clinical intervention strategies. AIM To evaluate gender differences among subjects affected by hyperacusis. METHODS A literature search was conducted focused on adult patients presenting hyperacusis, using the MedLine bibliographic database. Relevant peer-reviewed studies, published in the last 20 years, were sought. A total of 259 papers have been identified, but only 4 met the inclusion criteria. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. RESULTS The four selected papers included data from 604 patients; of these, 282 subjects resulted as affected by hyperacusis (125 females and 157 males). Questionnaires for analyzing factors affecting the attentional, social and emotional variance of hyperacusis (such as VAS, THI, TSCH, MASH) were administered to all included subjects. The data suggest that there are no hyperacusis gender-specific differences in the assessed population samples. CONCLUSIONS The literature data suggest that males and females exhibit a similar level of hyperacusis. However, in light of the subjective nature of this condition, the eventual set up of further tests to assess hyperacusis features could be very helpful in the near future.
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Affiliation(s)
- Lucia Belen Musumano
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
| | - Stavros Hatzopoulos
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
| | - Virginia Fancello
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
| | - Chiara Bianchini
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
| | - Tiziana Bellini
- Centre for Studies on Gender Medicine, University of Ferrara, 44121 Ferrara, Italy;
| | - Stefano Pelucchi
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
| | - Piotr Henryk Skarżyński
- Institute of Sensory Organs, 1 Mokra Street, 05-830 Kajetany, Poland; (P.H.S.); (M.B.S.)
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, 10 Mochnackiego Street, 02-042 Warsaw, Poland
- Heart Failure and Cardiac Rehabilitation Department, Faculty of Dental Medicine, Medical University of Warsaw, 8 Kondratowicza Street, 03-242 Warsaw, Poland
| | - Magdalena B. Skarżyńska
- Institute of Sensory Organs, 1 Mokra Street, 05-830 Kajetany, Poland; (P.H.S.); (M.B.S.)
- Center of Hearing and Speech Medincus, 05-830 Warsaw, Poland
- Pharmacy Department, Department of Pharmacotherapy and Pharmaceutical Care, Medical University of Warsaw, 02-042 Warsaw, Poland
| | - Andrea Ciorba
- ENT and Audiology Unit, Department of Neurosciences and Rehabilitation, University of Ferrara, 44121 Ferrara, Italy; (L.B.M.); (S.H.); (C.B.); (S.P.); (A.C.)
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Yukhnovich EA, Alter K, Sedley W. Nuances in intensity deviant asymmetric responses as a biomarker for tinnitus. PLoS One 2023; 18:e0289062. [PMID: 37549154 PMCID: PMC10406247 DOI: 10.1371/journal.pone.0289062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/11/2023] [Indexed: 08/09/2023] Open
Abstract
We attempted to replicate a potential tinnitus biomarker in humans based on the Sensory Precision Integrative Model of Tinnitus called the Intensity Mismatch Asymmetry. A few advances on the design were also included, including tighter matching of participants for gender, and a control stimulus frequency of 1 kHz to investigate whether any differences between control and tinnitus groups are specific to the tinnitus frequency or domain-general. The expectation was that there would be asymmetry in the MMN responses between tinnitus and control groups at the tinnitus frequency, but not at the control frequency, where the tinnitus group would have larger, more negative responses to upward deviants than downward deviants, and the control group would have the opposite pattern or lack of a deviant direction effect. However, no significant group differences were found. There was a striking difference in response amplitude to control frequency stimuli compared to tinnitus frequency stimuli, which could be an intrinsic quality of responses to these frequencies or could reflect high frequency hearing loss in the sample. Additionally, the upward deviants elicited stronger MMN responses in both groups at tinnitus frequency, but not at the control frequency. Factors contributing to these discrepant results at the tinnitus frequency could include hyperacusis, attention, and wider contextual effects of other frequencies used in the experiment (i.e. the control frequency in other blocks).
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Affiliation(s)
- Ekaterina A. Yukhnovich
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Kai Alter
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
- Faculty of Modern and Medieval Languages and Linguistics and the Languages Sciences Interdisciplinary Research Centre, University of Cambridge, Cambridge, United Kingdom
| | - William Sedley
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne, United Kingdom
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Makani P, Koops EA, Pyott SJ, van Dijk P, Thioux M. Hyperacusis is associated with smaller gray matter volumes in the supplementary motor area. Neuroimage Clin 2023; 38:103425. [PMID: 37137255 PMCID: PMC10176058 DOI: 10.1016/j.nicl.2023.103425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
Hyperacusis is a disorder in loudness perception characterized by increased sensitivity to ordinary environmental sounds and associated with otologic conditions, including hearing loss and tinnitus (the phantom perception of sound) as well as neurologic and neuropsychiatric conditions. Hyperacusis is believed to arise centrally in the brain; however, the underlying causes are unknown. To gain insight into differences in brain morphology associated with hyperacusis, we undertook a retrospective case-control study comparing whole-brain gray matter morphology in participants with sensorineural hearing loss and tinnitus who either scored above or below the threshold for hyperacusis based on a standard questionnaire. We found that participants reporting hyperacusis had smaller gray matter volumes and cortical sheet thicknesses in the right supplementary motor area (SMA), independent of anxiety, depression, tinnitus burden, or sex. In fact, the right SMA volumes extracted from an independently defined volume of interest could accurately classify participants. Finally, in a subset of participants where functional data were also available, we found that individuals with hyperacusis showed increased sound-evoked responses in the right SMA compared to individuals without hyperacusis. Given the role of the SMA in initiating motion, these results suggest that in hyperacusis the SMA is involved in a motor response to sounds.
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Affiliation(s)
- Punitkumar Makani
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands.
| | - Elouise A Koops
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Department of Radiology, Massachusetts General Hospital-Harvard Medical School, Boston, USA
| | - Sonja J Pyott
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Marc Thioux
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
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What Should Be Considered When Assessing Hyperacusis? A Qualitative Analysis of Problems Reported by Hyperacusis Patients. Brain Sci 2022; 12:brainsci12121615. [PMID: 36552075 PMCID: PMC9775019 DOI: 10.3390/brainsci12121615] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/27/2022] Open
Abstract
Hyperacusis (decreased sound tolerance) is a prevalent complaint. Yet, to date, no research has qualitatively evaluated the types of problems experienced by adults with hyperacusis. Our service evaluation aims to determine the hyperacusis-related problem domains reported by patients and the degree to which these domains were reported together. Retrospective analysis was conducted on an anonymised clinical dataset from 306 patients who attended a UK tinnitus and hyperacusis treatment centre between 1994 and 2017. Conventional content analysis was used to categorise responses to the question 'Why is hyperacusis a problem?' into domains which were then subjected to a cluster analysis. Twenty-five problem domains were identified, of which 12 were further classified into three overarching categories. 'Fear', 'Reduced quality of life' and 'Physical reaction to sound' were most frequently reported problems. Cluster analysis revealed that 'Sleep difficulties' and 'Despondency', were commonly reported together. Adults with hyperacusis face many challenges in their everyday lives. The nature of these problems indicates the need to develop complex interventions and assessments to aid management of hyperacusis. Current hyperacusis questionnaires may be useful in identifying some problem domains, but further assessment thorough patient interviews is required to fully explore all potential problems and make informed decisions about treatment.
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6
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Hyperacusis: Loudness Intolerance, Fear, Annoyance and Pain. Hear Res 2022; 426:108648. [DOI: 10.1016/j.heares.2022.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
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Jacquemin L, Cardon E, Michiels S, Luyten T, Van der Wal A, De Hertogh W, Vanderveken OM, Van de Heyning P, Lammers MJW, Van Rompaey V, Gilles A. Hyperacusis: demographic, audiological, and clinical characteristics of patients at the ENT department. Eur Arch Otorhinolaryngol 2022; 279:4899-4907. [PMID: 35298688 DOI: 10.1007/s00405-022-07336-4] [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: 12/17/2021] [Accepted: 02/28/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE To document whether patients with and without hyperacusis differ from each other on demographic, audiological, and clinical characteristics. METHODS Based on the Hyperacusis Questionnaire's (HQ) cut-off (HQ > 28), a total of 2301 participants were divided into patients with and without hyperacusis. Demographic data, scores on self-reported questionnaires [Tinnitus Functional Index (TFI), Visual Analogue Scale of tinnitus loudness (VASloudness), Hospital Anxiety Depression Scale (HADS)], and audiological parameters were retrospectively analysed to determine differential factors between the two groups. RESULTS In total, 10.9% of the patients was classified as hyperacusis patients (n = 251). They reported a significant, higher tinnitus severity (mean difference of 19 points on TFI) and mental distress (mean difference of 4 points on the HADS subscales) (p < 0.001) than patients without hyperacusis. Moreover, this group consisted of more women (45% % in hyperacusis group vs. 35% in non-hyperacusis group) and women scored significantly higher on the HQ (p < 0.001) and TFI (p < 0.01). CONCLUSION Patients with hyperacusis have distinctive characteristics. The presence of hyperacusis in combination with tinnitus can indicate a higher need for psychoeducation. Patients that present themselves with hyperacusis without tinnitus complaints remain a minority, yet might be underdiagnosed. Hence, future studies should disentangle tinnitus from hyperacusis. In clinical practice, greater efforts are required to increase knowledge about hyperacusis as a primary or secondary complaint and to provide individualized treatment for these patients.
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Affiliation(s)
- Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium. .,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
| | - Emilie Cardon
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Sarah Michiels
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.,REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
| | - Tine Luyten
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annemarie Van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Antwerp University, Antwerp, Belgium.,Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, VU Amsterdam, Amsterdam, The Netherlands
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Antwerp University, Antwerp, Belgium
| | - Olivier M Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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Huang K, Chen D, Wang F, Yang L. Prediction of dispositional dialectical thinking from resting-state electroencephalography. Brain Behav 2021; 11:e2327. [PMID: 34423595 PMCID: PMC8442598 DOI: 10.1002/brb3.2327] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/20/2021] [Accepted: 08/02/2021] [Indexed: 11/20/2022] Open
Abstract
This study aims to explore the possibility of predicting the dispositional level of dialectical thinking using resting-state electroencephalography signals. Thirty-four participants completed a self-reported measure of dialectical thinking, and their resting-state electroencephalography was recorded. After wave filtration and eye movement removal, time-frequency electroencephalography signals were converted into four frequency domains: delta (1-4 Hz), theta (4-7 Hz), alpha (7-13 Hz), and beta (13-30 Hz). Functional principal component analysis with B-spline approximation was then applied for feature reduction. Five machine learning methods (support vector regression, least absolute shrinkage and selection operator, K-nearest neighbors, random forest, and gradient boosting decision tree) were applied to the reduced features for prediction. The model ensemble technique was used to create the best performing final model. The results showed that the alpha wave of the electroencephalography signal in the early period (12-15 s) contributed most to the prediction of dialectical thinking. With data-driven electrode selection (FC1, FCz, Fz, FC3, Cz, AFz), the prediction model achieved an average coefficient of determination of 0.45 on 200 random test sets. Furthermore, a significant positive correlation was found between the alpha value of standardized low-resolution electromagnetic tomography activity in the right dorsal anterior cingulate cortex and dialectical self-scale score. The prefrontal and midline alpha oscillations of resting electroencephalography are good predictors of the dispositional level of dialectical thinking, possibly reflecting these brain structures' involvement in dialectical thinking.
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Affiliation(s)
- Kun Huang
- Center for Statistical Science and Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - Dian Chen
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Fei Wang
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China.,Laboratory of Brain and Intelligence, Tsinghua University, Beijing, China
| | - Lijian Yang
- Center for Statistical Science and Department of Industrial Engineering, Tsinghua University, Beijing, China
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9
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Smit AL, Stegeman I, Eikelboom RH, Baguley DM, Bennett RJ, Tegg-Quinn S, Bucks RS, Stokroos RJ, Hunter M, Atlas MD. Prevalence of Hyperacusis and Its Relation to Health: The Busselton Healthy Ageing Study. Laryngoscope 2021; 131:E2887-E2896. [PMID: 34291459 PMCID: PMC9292021 DOI: 10.1002/lary.29768] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 07/04/2021] [Accepted: 07/13/2021] [Indexed: 11/15/2022]
Abstract
Importance The prevalence of hyperacusis and its relationship with mental and general health is unknown in a nonclinical sample. Therefore, we aimed to determine the prevalence of hyperacusis and its relation with hearing, general and mental health in a population‐based study. Study Design Prospective population‐based study. Material and Methods This study uses data from the Busselton Healthy Ageing Study (BHAS). A sample of 5,107 eligible inhabitants aged 45 to 70 years completed a detailed questionnaire and a clinical assessment. A positive answer to “Do you consider yourself sensitive or intolerant to everyday sounds” was used to indicate hyperacusis. Logistic regression was used to examine the association between hearing, mental and general health factors, and hyperacusis. Results Of 5,107 participants, 775 (15.2%) reported hyperacusis. The majority of participants with hyperacusis reported an occasional effect on daily life (72.0%). Being female, older in age, having a lower income, physical or mental health difficulties, more severe hearing loss, and tinnitus were all associated with the presence of hyperacusis. Individuals who experience hearing impairment, poorer general or mental health have a higher possibility of hyperacusis having an effect on their daily life. Conclusions In this community population‐based cohort study, we found a prevalence of hyperacusis of 15.2%. Individuals with hearing loss, mental health problems, and lower physical health have a higher possibility of experiencing effects on their daily life associated with their hyperacusis. Unravelling the relationship between hyperacusis hearing, general and mental health can be of major importance for a better understanding of the condition and its consequences. Level of Evidence 2 Laryngoscope, 131:E2887–E2896, 2021
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Affiliation(s)
- Adriana L Smit
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert H Eikelboom
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,Department of Speech Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa.,Ear Science Institute Australia, Subiaco, Australia
| | - David M Baguley
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, U.K.,NIHR Nottingham Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, U.K
| | - Rebecca J Bennett
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia, Subiaco, Australia
| | - Susan Tegg-Quinn
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia, Subiaco, Australia.,School of Human Sciences, The University of Western Australia, Perth, Australia
| | - Romola S Bucks
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Robert J Stokroos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michael Hunter
- Busselton Health Study Centre, Busselton Population Medical Research Institute, Perth, Australia.,School of Population and Global Health, University of Western Australia, Perth, Australia
| | - Marcus D Atlas
- Ear Sciences Centre, The University of Western Australia, Nedlands, Australia.,Ear Science Institute Australia, Subiaco, Australia
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10
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Ausland JHL, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA, Johnsen M, Friborg O, Rosenvinge JH, Eggen AE, Krog NH. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015-2016). PLoS One 2021; 16:e0247880. [PMID: 33651844 PMCID: PMC7924755 DOI: 10.1371/journal.pone.0247880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.
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Affiliation(s)
- Jannike H-L Ausland
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- * E-mail:
| | - Bo Engdahl
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Ólöf A. Steingrímsdóttir
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Christopher S. Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Jan H. Rosenvinge
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anne E. Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Norun H. Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
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11
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Saxena U, Singh BP, Kumar SBR, Chacko G, Bharath KNSV. Acoustic Reflexes in Individuals Having Hyperacusis of the Auditory Origin. Indian J Otolaryngol Head Neck Surg 2020; 72:497-502. [PMID: 33088781 DOI: 10.1007/s12070-020-02002-9] [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: 06/25/2020] [Accepted: 07/22/2020] [Indexed: 10/23/2022] Open
Abstract
Functional role of the acoustic reflex in preventing over stimulation of the inner auditory system by decreasing sound intensity along with the previous reports of acoustic reflex abnormalities in individuals having hyperacusis point towards the involvement of acoustic reflex deficit in the origin of hyperacusis especially when any medical condition leading to hyperacusis is not associated. However this issue remains contradictory owing to limited comprehensive investigation. This study was undertaken to ascertain the relationship between hyperacusis and the acoustic reflex. Threshold, amplitude and latency of the acoustic reflex were measured in two different groups of individuals having hyperacusis; Group 1: 14 individuals having hyperacusis with hearing loss (HwHL) and Group 2: 17 individuals having hyperacusis without hearing loss (HwoHL). Control group (Group 3) consisted of 15 normal hearing individuals who never experienced hyperacusis. Result showed a significant group effect on all the measured characteristics of the acoustic reflex. ARTs were found to be significantly higher in HwHL and HwoHL when compared to NHwoH. ARTs were statistically similar for HwoHL and NHwoH. HwoHL's ARAs and ARLs were significantly smaller and prolonged, respectively, when compared to HwHL and NHwoH. HwHL and NHwoH had statistically similar ARAs and ARLs. This study confirms acoustic reflex abnormalities in some individuals having hyperacusis with or without hearing loss. It further highlight the importance of involving acoustic reflex testing in the assessment of hyperacusis especially when hyperacusis is not associated with hearing loss or any other medical condition that may lead to hyperacusis.
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Affiliation(s)
- Udit Saxena
- MAA Institute of Speech and Hearing, Osmania University, Hyderabad, India.,Department (Speech and Hearing), MAA ENT Hospital, Hyderabad, India
| | - Bhanu Pratap Singh
- Department of ENT, Hind Institute of Medical Sciences, Uttar Pradesh, Sitapur, India
| | - S B Rathna Kumar
- Ali Yavar Jung National Institute of Speech and Hearing Disabilities (Divyangjan), Mumbai, India
| | - Gish Chacko
- MAA Institute of Speech and Hearing, Osmania University, Hyderabad, India
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12
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Knipper M, Hofmeier B, Singer W, Wolpert S, Klose U, Rüttiger L. [Differentiating cochlear synaptopathies into different hearing disorders]. HNO 2019; 67:406-416. [PMID: 30963221 DOI: 10.1007/s00106-019-0660-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Due to demographic change and altered recreational behavior, a rapid increase in hearing deficits is expected in the next 20-30 years. Consequently, the risk of age-related loss of speech discrimination, tinnitus, hyperacusis, or-as recently shown-dementia, will also increase. There are increasing indications that the loss of specific hearing fibers in humans and animals is involved in various hearing disorders. This fiber loss can be caused by cochlear synaptopathy or deafferentation and does not necessarily lead to clinically measurable threshold changes. Animal experiments have shown that reduced auditory nerve activity due to acoustic trauma or aging can be centrally compensated by disproportionately elevated and faster auditory brainstem responses (ABR). The analysis of the suprathreshold amplitudes of auditory evoked brain stem potentials and their latency in combination with non-invasive imaging techniques such as magnetic resonance imaging can help to identify the central compensatory ability of subjects and to assign defined hearing deficits.
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Affiliation(s)
- M Knipper
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland.
| | - B Hofmeier
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland
| | - W Singer
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland
| | - S Wolpert
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland
| | - U Klose
- MR-Forschung, Abteilung für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum Tübingen, Tübingen, Deutschland
| | - L Rüttiger
- Universitätsklinik für Hals-Nasen-Ohren-Heilkunde, Plastische Operationen, Sektion Molekulare Hörphysiologie, Hörforschungszentrum Tübingen (THRC), Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Deutschland
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Abstract
Background Hyperacusis is a troublesome symptom that can have a marked negative impact on quality of life. Objectives To identify major research questions in hyperacusis. Materials and methods Review of gaps in knowledge regarding hyperacusis, and where opportunities may lie to address these. Results Eight major research questions were identified as priorities for future research. These were: What is the prevalence of hyperacusis in adults and children? What are the risk factors associated with hyperacusis? What is the natural history of hyperacusis? How is ‘pain hyperacusis’ perceived? What mechanisms are involved in hyperacusis? What is the relationship between hyperacusis and tinnitus? Can a questionnaire be developed that accurately measures the impact of hyperacusis and can be used as a treatment outcome measure? What treatments, alone or in combination, are effective for hyperacusis? Conclusion This clinical/researcher-led project identified major research questions in hyperacusis. A further development to identify patient-prioritized research will follow.
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Xu XM, Jiao Y, Tang TY, Lu CQ, Zhang J, Salvi R, Teng GJ. Altered Spatial and Temporal Brain Connectivity in the Salience Network of Sensorineural Hearing Loss and Tinnitus. Front Neurosci 2019; 13:246. [PMID: 30941010 PMCID: PMC6433888 DOI: 10.3389/fnins.2019.00246] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 03/01/2019] [Indexed: 12/20/2022] Open
Abstract
Sensorineural hearing loss (SNHL), sometimes accompanied with tinnitus, is associated with dysfunctions within and outside the classical auditory pathway. The salience network, which is anchored in bilateral anterior insula and dorsal anterior cingulate cortex, has been implicated in sensory integration. Partial auditory deprivation could alter the characteristics of the salience network and other related brain areas, thereby contributing to hearing impairments-induced neuropsychiatric symptoms. To test this hypothesis, we performed fMRI scanning and neuropsychological tests on 32 subjects with long-term bilateral hearing impairment and 30 well-matched Controls. Non-directional functional connectivity and directional Granger causality analysis were used to identify aberrant spatial and temporal patterns of connections targeting bilateral anterior insula and dorsal anterior cingulate cortex. We found that the left anterior insula showed decreased connectivity with right precentral gyrus and superior frontal gyrus. The connections between the dorsal anterior cingulate cortex and middle frontal gyrus, superior parietal gyrus and supplementary motor area (SMA) were also reduced. Relative to Controls, SNHL patients showed abnormal effective connectivity of the salience network, including inferior temporal gyrus, cerebellum lobule VI, lobule VIII, precentral gyrus, middle frontal gyrus and SMA. Furthermore, correlation analysis demonstrated that some of these atypical connectivity measures were correlated with performance of neuropsychiatric tests. These findings suggest that the inefficient modulation of the salience network might contribute to the neural basis of SNHL and tinnitus, as well as associated cognition and emotion deficits.
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Affiliation(s)
- Xiao-Min Xu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Yun Jiao
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Jian Zhang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
| | - Richard Salvi
- Center for Hearing and Deafness, University at Buffalo, Buffalo, NY, United States
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, Nanjing, China
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15
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Hofmeier B, Wolpert S, Aldamer ES, Walter M, Thiericke J, Braun C, Zelle D, Rüttiger L, Klose U, Knipper M. Reduced sound-evoked and resting-state BOLD fMRI connectivity in tinnitus. NEUROIMAGE-CLINICAL 2018; 20:637-649. [PMID: 30202725 PMCID: PMC6128096 DOI: 10.1016/j.nicl.2018.08.029] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 01/02/2023]
Abstract
The exact neurophysiological basis of chronic tinnitus, which affects 10-15% of the population, remains unknown and is controversial at many levels. It is an open question whether phantom sound perception results from increased central neural gain or not, a crucial question for any future therapeutic intervention strategies for tinnitus. We performed a comprehensive study of mild hearing-impaired participants with and without tinnitus, excluding participants with co-occurrences of hyperacusis. A right-hemisphere correlation between tinnitus loudness and auditory perceptual difficulty was observed in the tinnitus group, independent of differences in hearing thresholds. This correlation was linked to reduced and delayed sound-induced suprathreshold auditory brain responses (ABR wave V) in the tinnitus group, suggesting subsided rather than exaggerated central neural responsiveness. When anatomically predefined auditory regions of interest were analysed for altered sound-evoked BOLD fMRI activity, it became evident that subcortical and cortical auditory regions and regions involved in sound detection (posterior insula, hippocampus), responded with reduced BOLD activity in the tinnitus group, emphasizing reduced, rather than increased, central neural gain. Regarding previous findings of evoked BOLD activity being linked to positive connectivities at rest, we additionally analysed r-fcMRI responses in anatomically predefined auditory regions and regions associated with sound detection. A profound reduction in positive interhemispheric connections of homologous auditory brain regions and a decline in the positive connectivities between lower auditory brainstem regions and regions involved in sound detection (hippocampus, posterior insula) were observed in the tinnitus group. The finding went hand-in-hand with the emotional (amygdala, anterior insula) and temporofrontal/stress-regulating regions (prefrontal cortex, inferior frontal gyrus) that were no longer positively connected with auditory cortex regions in the tinnitus group but were instead positively connected to lower-level auditory brainstem regions. Delayed sound processing, reduced sound-evoked BOLD fMRI activity and altered r-fcMRI in the auditory midbrain correlated in the tinnitus group and showed right hemisphere dominance as did tinnitus loudness and perceptual difficulty. The findings suggest that reduced central neural gain in the auditory stream may lead to phantom perception through a failure to energize attentional/stress-regulating networks for contextualization of auditory-specific information. Reduced auditory-specific information flow in tinnitus has until now escaped detection in humans, as low-level auditory brain regions were previously omitted from neuroimaging studies. TRIAL REGISTRATION German Clinical Trials Register DRKS0006332.
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Key Words
- ABR wave
- ABR, auditory brainstem response
- BA, Brodmann area
- BA13A, anterior insula
- BA13P, posterior insula
- BA28, entorhinal cortex
- BB-chirp, broadband chirp
- BERA, brainstem-evoked response audiometry
- CN, cochlear nucleus
- CSF, cerebrospinal fluid
- Cortisol
- DL, dorsolateral
- EFR, envelope-followed responses
- ENT, ear, nose and throat
- FA, flip angle
- FDR, false discovery rate
- FOV, field of view
- FWHM, full width at half maximum
- G-H-S, Goebel-Hiller-Score
- HF-chirp, high-frequency chirp
- HPA, hypothalamic-pituitary-adrenal
- High-SR AF, high-spontaneous firing rates auditory fibers
- IC, inferior colliculus
- L, left
- LF-chirp, low-frequency chirp
- Low-SR AF, low-spontaneous firing rates auditory fibers
- M, medial
- MGB, medial geniculate body
- MNI, Montreal Neurological Institute
- PFC, prefrontal cortex
- PTA, pure tone audiogram
- R, right
- ROI, region of interest
- SD, standard deviation
- SOC, superior olivary complex
- SPL, sound pressure level
- SPM, Statistical Parametric Mapping
- TA, acquisition time
- TE, echo time
- TR, repetition time
- Tinnitus
- VBM, voxel-based morphometry
- fMRI
- r-fcMRI
- rCBF, resting-state cerebral blood flow
- rCBV, resting-state cerebral blood volume
- zFC, z-values functional connectivity
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Affiliation(s)
- Benedikt Hofmeier
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Stephan Wolpert
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Ebrahim Saad Aldamer
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Moritz Walter
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - John Thiericke
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany/HNO Ärzte Praxis Part GmbB, Aschaffenburg, Germany
| | - Christoph Braun
- MEG Center, University Hospital Tübingen, Otfried-Müller-Str. 47, D-72076 Tübingen, Germany
| | - Dennis Zelle
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University Hospital Tübingen, Hoppe-Seyler-Str. 3, D-73076 Tübingen, Germany.
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, Hearing Research Center Tübingen, Molecular Physiology of Hearing, University of Tübingen, Elfriede-Aulhorn-Str. 5, D-72076 Tübingen, Germany.
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Palumbo DB, Alsalman O, De Ridder D, Song JJ, Vanneste S. Misophonia and Potential Underlying Mechanisms: A Perspective. Front Psychol 2018; 9:953. [PMID: 30008683 PMCID: PMC6034066 DOI: 10.3389/fpsyg.2018.00953] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 05/24/2018] [Indexed: 02/01/2023] Open
Abstract
There is a growing research interest in the diagnosis rate of misophonia, a condition characterized by a negative emotional/autonomic reaction to specific everyday sounds. Diagnosis of misophonia requires a thorough case history and audiological test procedures. Associative and non-associative learning models for understanding the underlying mechanisms of misophonia have been presented. Currently, there is no cure or pharmaceutical agent for misophonia; however, therapy programs addressing misophonia and its characteristics do exist. Investigation of comorbid conditions and other psychological therapy strategies might help to reveal more about the underlying mechanisms and potentially lead to a successful treatment method.
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Affiliation(s)
- Devon B Palumbo
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Ola Alsalman
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
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17
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Park JM, Kim WJ, Ha JB, Han JJ, Park SY, Park SN. Effect of sound generator on tinnitus and hyperacusis. Acta Otolaryngol 2018; 138:135-139. [PMID: 29043888 DOI: 10.1080/00016489.2017.1386801] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Sound generator (SG) plays a role as effective sound therapy of tinnitus retaining therapy (TRT) in patients with severe tinnitus (Category 1) or hyperacusis (Category 3). This study was performed to evaluate the therapeutic effect of SGs. METHODS A total of 120 tinnitus patients who visited our tinnitus clinic and were treated with SG along with TRT from January 2008 to December 2016 were included. The patients were divided into two groups by tinnitus category; 78 patients of category 1 and 42 patients of category 3. Their medical records including questionnaires regarding tinnitus severity were retrospectively reviewed to evaluate the therapeutic effect of SGs on tinnitus and hyperacusis. RESULTS Category 3 patients included more female patients, were younger than category 1 patients (p = .001), and were prescribed SG earlier due to their severe symptom of hyperacusis. (p = .004) All patients showed significant improvements on all categories of tinnitus visual analogue scale (VAS) scores and tinnitus handicap inventory (THI) scores after six months use of SG (p < .05). Loudness discomfort levels measured by pure tone audiometry were significantly improved in category 3 group after six months use of SGs. CONCLUSION SG with TRT seems to be an effective treatment modality for all tinnitus patients, especially those with comorbid hyperacusis.
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Affiliation(s)
- Jung Mee Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woo Jin Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Bu Ha
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Ju Han
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So Young Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Han JJ, Jang JH, Ridder DD, Vanneste S, Koo JW, Song JJ. Increased parietal circuit-breaker activity in delta frequency band and abnormal delta/theta band connectivity in salience network in hyperacusis subjects. PLoS One 2018; 13:e0191858. [PMID: 29370266 PMCID: PMC5785008 DOI: 10.1371/journal.pone.0191858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 01/13/2018] [Indexed: 11/18/2022] Open
Abstract
Recent studies have suggested that hyperacusis, an abnormal hypersensitivity to ordinary environmental sounds, may be characterized by certain resting-state cortical oscillatory patterns, even with no sound stimulus. However, previous studies are limited in that most studied subjects with other comorbidities that may have affected cortical activity. In this regard, to assess ongoing cortical oscillatory activity in idiopathic hyperacusis patients with no comorbidities, we compared differences in resting-state cortical oscillatory patterns between five idiopathic hyperacusis subjects and five normal controls. The hyperacusis group demonstrated significantly higher electrical activity in the right auditory-related cortex for the gamma frequency band and left superior parietal lobule (SPL) for the delta frequency band versus the control group. The hyperacusis group also showed significantly decreased functional connectivity between the left auditory cortex (AC) and left orbitofrontal cortex (OFC), between the left AC and left subgenual anterior cingulate cortex (sgACC) for the gamma band, and between the right insula and bilateral dorsal anterior cingulate cortex (dACC) and between the left AC and left sgACC for the theta band versus the control group. The higher electrical activity in the SPL may indicate a readiness of “circuit-breaker” activity to shift attention to forthcoming sound stimuli. Also, because of the disrupted salience network, consisting of the dACC and insula, abnormally increased salience to all sound stimuli may emerge, as a consequence of decreased top-down control of the AC by the dACC and dysfunctional emotional weight attached to auditory stimuli by the OFC. Taken together, abnormally enhanced attention and salience to forthcoming sound stimuli may render hyperacusis subjects hyperresponsive to non-noxious auditory stimuli.
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Affiliation(s)
- Jae Joon Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ji Hye Jang
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School for Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, Texas, United States of America
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
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19
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Huang Y, Mohan A, De Ridder D, Sunaert S, Vanneste S. The neural correlates of the unified percept of alcohol-related craving: a fMRI and EEG study. Sci Rep 2018; 8:923. [PMID: 29343732 PMCID: PMC5772563 DOI: 10.1038/s41598-017-18471-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 12/12/2017] [Indexed: 12/24/2022] Open
Abstract
Alcohol addiction is accompanied by aberrant neural activity. Previously, task-based fMRI and resting-state EEG studies have revealed that craving, a critical component of addiction, is linked to abnormal activity in cortical regions including the dorsal anterior cingulate cortex (dACC), nucleus accumbens (NAcc), posterior cingulate cortex (PCC) and pregenual anterior cingulate cortex (pgACC), etc. In this study, we combine these two imaging techniques to investigate a group of alcohol-addicted patients and provide convergent evidence for the neural correlates of craving not only in alcohol but substance abuse in general. We observe abnormal BOLD signal levels in the dACC, NAcc, pgACC, PCC, amygdala, and parahippocampus (PHC) in a cue-reactivity fMRI experiment. These findings are consistent with increased beta-band activity in the dACC and pgACC in resting-state EEG. We further observe desynchronization characterized by decreased functional connectivity in cue-based fMRI and hypersynchronization characterized by increased functional connectivity between these regions in the theta frequency band. The results of our study show a consistent pattern of alcohol craving elicited by external cues and internal desires. Given the advantage of superior spatial and temporal resolution, we hypothesize a "central craving network" that integrates the different aspects of alcohol addiction into a unified percept.
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Affiliation(s)
- Yuefeng Huang
- Lab for Clinical & Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at, Dallas, USA
| | - Anusha Mohan
- Lab for Clinical & Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at, Dallas, USA
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Stefan Sunaert
- Translational MRI, Department of Imaging and Pathology & Medical Imaging Research Center, Department of Radiology, Katholieke Universiteit Leuven - University of Leuven, Leuven, Belgium
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at, Dallas, USA.
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20
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Ralli M, Salvi RJ, Greco A, Turchetta R, De Virgilio A, Altissimi G, Attanasio G, Cianfrone G, de Vincentiis M. Characteristics of somatic tinnitus patients with and without hyperacusis. PLoS One 2017; 12:e0188255. [PMID: 29161302 PMCID: PMC5697853 DOI: 10.1371/journal.pone.0188255] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/05/2017] [Indexed: 12/14/2022] Open
Abstract
Objective Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis. Patients and methods 172 somatic tinnitus patients with (n = 82) and without (n = 90) hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history. Results Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a) were older (43.38 vs 39.12 years, p = 0.05), (b) were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04), (c) had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02) and (d) scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001) and subjective hearing level (8.04 vs 1.83, p<0.001). Conclusion Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients.
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Affiliation(s)
- Massimo Ralli
- Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, Rome, Italy
- * E-mail:
| | - Richard J. Salvi
- Center for Hearing and Deafness, University at Buffalo, Buffalo, New York, United States of America
- Department of Audiology and Speech-Language Pathology, Asia University, Taichung, Taiwan
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
| | - Rosaria Turchetta
- Department of Sense Organs, Sapienza University of Rome, Rome, Italy
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No auditory experience, no tinnitus: Lessons from subjects with congenital- and acquired single-sided deafness. Hear Res 2017; 354:9-15. [DOI: 10.1016/j.heares.2017.08.002] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2017] [Revised: 06/10/2017] [Accepted: 08/09/2017] [Indexed: 11/18/2022]
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Song JJ, Kim K, Sunwoo W, Mertens G, Van de Heyning P, De Ridder D, Vanneste S, Lee SY, Park KJ, Choi H, Choi JW. A Quantitative Electroencephalography Study on Cochlear Implant-Induced Cortical Changes in Single-Sided Deafness with Tinnitus. Front Hum Neurosci 2017; 11:210. [PMID: 28572760 PMCID: PMC5435818 DOI: 10.3389/fnhum.2017.00210] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
The mechanism of tinnitus suppression after cochlear implantation (CI) in single-sided deafness (SSD) is not fully understood. In this regard, by comparing pre- and post-CI quantitative electroencephalography (qEEG), we explored cortical changes relevant to tinnitus improvement. In SSD patients who underwent CI, qEEG data were collected: (1) before CI, (2) 6 months post-operatively with CI-on, and (3) 30 min after CI-off and source-localized cortical activity/functional connectivity analyses were performed. Compared to the pre-operative baseline, the CI-on condition demonstrated significantly decreased activity in the right auditory- and orbitofrontal cortices (OFC) for the delta frequency band as well as decreased connectivity between the auditory cortex/posterior cingulate cortex for the delta/beta2 bands. Meanwhile, compared to the CI-off condition, the CI-on condition displayed decreased activity in the right auditory cortices/OFC for the delta band, and in bilateral auditory cortices, left inferior frontal cortex/OFC for the gamma band. However, qEEG analyses showed no significant differences between the CI-off and baseline conditions. CI induced overall decreased cortical activity and functional connectivity. However, judging from no differences between the CI-off and baseline conditions, CI-induced cortical activity and functional connectivity changes are not by cortical plastic changes, but by dynamic peripheral reafferentation.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Kyungsoo Kim
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Woongsang Sunwoo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital AntwerpEdegem, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital AntwerpEdegem, Belgium
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of OtagoDunedin, New Zealand
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, RichardsonTX, USA
| | - Sang-Youp Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Kyung-Joon Park
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Hongsoo Choi
- Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Ji-Woong Choi
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
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Bae YJ, Jeon YJ, Choi BS, Koo JW, Song JJ. The Role of MRI in Diagnosing Neurovascular Compression of the Cochlear Nerve Resulting in Typewriter Tinnitus. AJNR Am J Neuroradiol 2017; 38:1212-1217. [PMID: 28385885 DOI: 10.3174/ajnr.a5156] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/25/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND AND PURPOSE Typewriter tinnitus, a symptom characterized by paroxysmal attacks of staccato sounds, has been thought to be caused by neurovascular compression of the cochlear nerve, but the correlation between radiologic evidence of neurovascular compression of the cochlear nerve and symptom presentation has not been thoroughly investigated. The purpose of this study was to examine whether radiologic evidence of neurovascular compression of the cochlear nerve is pathognomonic in typewriter tinnitus. MATERIALS AND METHODS Fifteen carbamazepine-responding patients with typewriter tinnitus and 8 control subjects were evaluated with a 3D T2-weighted volume isotropic turbo spin-echo acquisition sequence. Groups 1 (16 symptomatic sides), 2 (14 asymptomatic sides), and 3 (16 control sides) were compared with regard to the anatomic relation between the vascular loop and the internal auditory canal and the presence of neurovascular compression of the cochlear nerve with/without angulation/indentation. RESULTS The anatomic location of the vascular loop was not significantly different among the 3 groups (all, P > .05). Meanwhile, neurovascular compression of the cochlear nerve on MR imaging was significantly higher in group 1 than in group 3 (P = .032). However, considerable false-positive (no symptoms with neurovascular compression of the cochlear nerve on MR imaging) and false-negative (typewriter tinnitus without demonstrable neurovascular compression of the cochlear nerve) findings were also observed. CONCLUSIONS Neurovascular compression of the cochlear nerve was more frequently detected on the symptomatic side of patients with typewriter tinnitus compared with the asymptomatic side of these patients or on both sides of control subjects on MR imaging. However, considering false-positive and false-negative findings, meticulous history-taking and the response to the initial carbamazepine trial should be regarded as more reliable diagnostic clues than radiologic evidence of neurovascular compression of the cochlear nerve.
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Affiliation(s)
- Y J Bae
- From the Departments of Radiology (Y.J.B., B.S.C.)
| | - Y J Jeon
- Otorhinolaryngology-Head and Neck Surgery (Y.J.J., J.-W.K., J.-J.S.), Seoul National University Bundang Hospital, Seongnam, Korea
| | - B S Choi
- From the Departments of Radiology (Y.J.B., B.S.C.)
| | - J-W Koo
- Otorhinolaryngology-Head and Neck Surgery (Y.J.J., J.-W.K., J.-J.S.), Seoul National University Bundang Hospital, Seongnam, Korea
| | - J-J Song
- Otorhinolaryngology-Head and Neck Surgery (Y.J.J., J.-W.K., J.-J.S.), Seoul National University Bundang Hospital, Seongnam, Korea.
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Abstract
Homeostasis is the basis of modern medicine and allostasis, a further elaboration of homeostasis, has been defined as stability through change, which was later modified to predictive reference resetting. It has been suggested that pleasure is related to salience (behavioral relevance), and withdrawal has been linked to allostasis in addictive types. The question arises how the clinical and neural signatures of pleasure, salience, allostasis and withdrawal relate, both in a non-addicted and addicted state. Resting state EEGs were performed in 66 people, involving a food-addicted obese group, a non-food addicted obese group and a lean control group. Correlation analyses were performed on behavioral data, and correlation, comparative and conjunction analyses were performed to extract electrophysiological relationships between pleasure, salience, allostasis and withdrawal. Pleasure/liking seems to be the phenomenological expression that enough salient stimuli are obtained, and withdrawal can be seen as a motivational incentive because due to allostatic reference resetting, more stimuli are required. In addition, in contrast to non-addiction, a pathological, non-adaptive salience attached to food results in withdrawal mediated through persistent allostatic reference resetting.
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Pseudo-low Frequency Hearing Loss and Its Improvement After Treatment May Be Objective Signs of Significant Vascular Pathology in Patients With Pulsatile Tinnitus. Otol Neurotol 2016; 37:1344-9. [DOI: 10.1097/mao.0000000000001179] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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De Ridder D, Manning P, Leong SL, Ross S, Sutherland W, Horwath C, Vanneste S. The brain, obesity and addiction: an EEG neuroimaging study. Sci Rep 2016; 6:34122. [PMID: 27658351 PMCID: PMC5034231 DOI: 10.1038/srep34122] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 09/07/2016] [Indexed: 01/16/2023] Open
Abstract
Obesity is among the greatest challenges facing healthcare systems with 20% of the world’s population afflicted. Great controversy exists whether obesity can be regarded as an addictive disorder or not. Recently the Yale Food Addiction Scale questionnaire has been developed as a tool to identify individuals with traits of addiction towards food. Using clinical and source localized EEG data we dichotomize obesity. Brain activity in food-addicted and non-food-addicted obese people is compared to alcohol-addicted and non-addicted lean controls. We show that food addiction shares common neural brain activity with alcohol addiction. This ‘addiction neural brain activity’ consists of the dorsal and pregenual anterior cingulate cortex, parahippocampal area and precuneus. Furthermore, common neural obesity neural brain activity exists as well. The ‘obesity neural brain activity’ consists of dorsal and pregenual anterior cingulate cortex, posterior cingulate extending into the precuneus/cuneus as well as the parahippocampal and inferior parietal area. However food-addicted differ from non-food-addicted obese people by opposite activity in the anterior cingulate gyrus. This food addiction and non-food-addiction obesity dichotomy demonstrates there is at least 2 different kinds of obesity with overlapping network activity, but different in anterior cingulate cortex activity.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Patrick Manning
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Sook Ling Leong
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | - Samantha Ross
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Wayne Sutherland
- Section of Endocrinology, Department of Medicine, Dunedin School of Medicine, University of Otago, New Zealand
| | - Caroline Horwath
- Department of Human Nutrition, Dunedin School of Medicine, University of Otago, New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, University of Texas at Dallas, USA
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Kim CS, Kim SY, Choi H, Koo JW, Yoo SY, An GS, Lee K, Choi I, Song JJ. Transmastoid reshaping of the sigmoid sinus: preliminary study of a novel surgical method to quiet pulsatile tinnitus of an unrecognized vascular origin. J Neurosurg 2016; 125:441-9. [DOI: 10.3171/2015.6.jns15961] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
A dominant sigmoid sinus with focal dehiscence or thinning (DSSD/T) of the overlying bony wall is a commonly encountered, but frequently overlooked, cause of vascular pulsatile tinnitus (VPT). Also, the pathophysiological mechanism of sound perception in patients with VPT remains poorly understood. In the present study, a novel surgical method, termed transmastoid SS-reshaping surgery, was introduced to ameliorate VPT in patients with DSSD/T. The authors reviewed a case series, analyzed the surgical outcomes, and suggested the pathophysiological mechanism of sound perception. The theoretical background underlying VPT improvement after transmastoid SS-reshaping surgery was also explored.
METHODS
Eight patients with VPT that was considered attributable to DSSD/T underwent transmastoid SS-reshaping surgery between February 2010 and February 2015. The mean postoperative follow-up period was 9.5 months (range 4–13 months). Transmastoid SS-reshaping surgery featured simple mastoidectomy, partial compression of the SS using harvested cortical bone chips, and reinforcement of the bony SS wall with bone cement. Perioperative medical records, imaging results, and audiological findings were comprehensively reviewed.
RESULTS
In 7 of the 8 patients (87.5%), the VPT abated immediately after surgery. Statistically significant improvements in tinnitus loudness and distress were evident on numeric rating scales. Three patients with preoperative ipsilesional low-frequency hearing loss exhibited postoperative improvements in their low-frequency hearing thresholds. No major postoperative complications were encountered except in the first subject, who experienced increased intracranial pressure postoperatively. This subsided after a revision operation for partial decompression of the SS.
CONCLUSIONS
Transmastoid SS-reshaping surgery may be a good surgical option in patients with DSSD/T, a previously unrecognized cause of VPT. Redistribution of severely asymmetrical blood flow, reinforcement of the bony SS wall with bone cement to reconstruct a soundproof barrier, and disconnection of a problematic sound conduction route via simple mastoidectomy silence VPT.
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Affiliation(s)
- Chong Sun Kim
- 1Seoul National University College of Medicine
- 2Soree Ear Clinic
| | - So Young Kim
- 3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and
| | - Hyunseok Choi
- 3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and
| | - Ja-Won Koo
- 3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and
| | | | - Gwang Seok An
- 5Graduate School of Convergence Science and Technology, Seoul National University, Seoul
| | - Kyogu Lee
- 5Graduate School of Convergence Science and Technology, Seoul National University, Seoul
| | - Inyong Choi
- 6Department of Communication Sciences and Disorders, The University of Iowa, Iowa City, Iowa
| | - Jae-Jin Song
- 3Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea; and
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Chen YC, Feng Y, Xu JJ, Mao CN, Xia W, Ren J, Yin X. Disrupted Brain Functional Network Architecture in Chronic Tinnitus Patients. Front Aging Neurosci 2016; 8:174. [PMID: 27458377 PMCID: PMC4937025 DOI: 10.3389/fnagi.2016.00174] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/28/2016] [Indexed: 12/16/2022] Open
Abstract
Purpose: Resting-state functional magnetic resonance imaging (fMRI) studies have demonstrated the disruptions of multiple brain networks in tinnitus patients. Nonetheless, several studies found no differences in network processing between tinnitus patients and healthy controls (HCs). Its neural bases are poorly understood. To identify aberrant brain network architecture involved in chronic tinnitus, we compared the resting-state fMRI (rs-fMRI) patterns of tinnitus patients and HCs. Materials and Methods: Chronic tinnitus patients (n = 24) with normal hearing thresholds and age-, sex-, education- and hearing threshold-matched HCs (n = 22) participated in the current study and underwent the rs-fMRI scanning. We used degree centrality (DC) to investigate functional connectivity (FC) strength of the whole-brain network and Granger causality to analyze effective connectivity in order to explore directional aspects involved in tinnitus. Results: Compared to HCs, we found significantly increased network centrality in bilateral superior frontal gyrus (SFG). Unidirectionally, the left SFG revealed increased effective connectivity to the left middle orbitofrontal cortex (OFC), left posterior lobe of cerebellum (PLC), left postcentral gyrus, and right middle occipital gyrus (MOG) while the right SFG exhibited enhanced effective connectivity to the right supplementary motor area (SMA). In addition, the effective connectivity from the bilateral SFG to the OFC and SMA showed positive correlations with tinnitus distress. Conclusions: Rs-fMRI provides a new and novel method for identifying aberrant brain network architecture. Chronic tinnitus patients have disrupted FC strength and causal connectivity mostly in non-auditory regions, especially the prefrontal cortex (PFC). The current findings will provide a new perspective for understanding the neuropathophysiological mechanisms in chronic tinnitus.
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Affiliation(s)
- Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Yuan Feng
- 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
| | - Cun-Nan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Wenqing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Jun Ren
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
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Neural substrates predicting short-term improvement of tinnitus loudness and distress after modified tinnitus retraining therapy. Sci Rep 2016; 6:29140. [PMID: 27381994 PMCID: PMC4933976 DOI: 10.1038/srep29140] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 06/14/2016] [Indexed: 12/30/2022] Open
Abstract
Although tinnitus retraining therapy (TRT) is efficacious in most patients, the exact mechanism is unclear and no predictor of improvement is available. We correlated the extent of improvement with pre-TRT quantitative electroencephalography (qEEG) findings to identify neural predictors of improvement after TRT. Thirty-two patients with debilitating tinnitus were prospectively enrolled, and qEEG data were recorded before their initial TRT sessions. Three months later, these qEEG findings were correlated with the percentage improvements in the Tinnitus Handicap Inventory (THI) scores, and numeric rating scale (NRS) scores of tinnitus loudness and tinnitus perception. The THI score improvement was positively correlated with the pre-treatment activities of the left insula and the left rostral and pregenual anterior cingulate cortices (rACC/pgACC), which control parasympathetic activity. Additionally, the activities of the right auditory cortices and the parahippocampus, areas that generate tinnitus, negatively correlated with improvements in loudness. Improvements in the NRS scores of tinnitus perception correlated positively with the pre-TRT activities of the bilateral rACC/pgACC, areas suggested to form the core of the noise-canceling system. The current study supports both the classical neurophysiological and integrative models of tinnitus; our results serve as a milestone in the development of precision medicine in the context of TRT.
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Objectification and Differential Diagnosis of Vascular Pulsatile Tinnitus by Transcanal Sound Recording and Spectrotemporal Analysis. Otol Neurotol 2016; 37:613-20. [DOI: 10.1097/mao.0000000000001005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim SH, An GS, Choi I, Koo JW, Lee K, Song JJ. Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis. PLoS One 2016; 11:e0157722. [PMID: 27351198 PMCID: PMC4924851 DOI: 10.1371/journal.pone.0157722] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 06/05/2016] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Although vascular pulsatile tinnitus (VPT) has been classified as "objective", VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis. METHODS TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment. VPT was recorded using an inserted microphone with the subjects placed in both upright and supine positions with 1) a neutral head position, 2) head rotated to the tinnitus side, 3) head rotated to the non-tinnitus side, and 4) a neutral position with ipsi-lesional manual cervical compression. The recorded signals were analyzed in both time and time-frequency domains by performing a short-time Fourier transformation. RESULTS The pre-treatment ear canal signals of all VPT patients demonstrated pulse-synchronous periodic structures and acoustic characteristics that were representative of their presumptive vascular pathologies, whereas those the controls exhibited smaller peaks and weak periodicities. Compared with the pre-treatment signals, the post-treatment signals exhibited significantly reduced peak- and root mean square amplitudes upon time domain analysis. Additionally, further sub-band analysis confirmed that the pulse-synchronous signal of all subjects was not identifiable after treatment and, in particular, that the signal decrement was statistically significant at low frequencies. Moreover, the post-treatment signals of the VPT subjects revealed no significant differences when compared to those of the control group. CONCLUSION We reconfirmed that the TSR/STA method is an effective modality to objectify VPT. In addition, the potential role of the TSR/STA method in the objective evaluation of treatment outcomes in patients with VPT was proven. Further studies incorporating a larger sample size and more refined recording techniques are warranted.
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Affiliation(s)
- Shin Hye Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medical Center, Seoul, Korea
| | - Gwang Seok An
- Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
| | - Inyong Choi
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, United States of America
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyogu Lee
- Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, Korea
- * E-mail: (JJS); (KL)
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail: (JJS); (KL)
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Hyperacousie : mise au point pour le médecin du travail. ARCH MAL PROF ENVIRO 2015. [DOI: 10.1016/j.admp.2015.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kim K, Punte AK, Mertens G, Van de Heyning P, Park KJ, Choi H, Choi JW, Song JJ. A novel method for device-related electroencephalography artifact suppression to explore cochlear implant-related cortical changes in single-sided deafness. J Neurosci Methods 2015; 255:22-8. [PMID: 26231621 DOI: 10.1016/j.jneumeth.2015.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 07/10/2015] [Accepted: 07/13/2015] [Indexed: 11/15/2022]
Affiliation(s)
- Kyungsoo Kim
- Department of Information and Communication Engineering, DGIST, Daegu, Republic of Korea
| | - Andrea Kleine Punte
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Antwerp, Edegem, Belgium
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Antwerp, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Antwerp, Edegem, Belgium
| | - Kyung-Joon Park
- Department of Information and Communication Engineering, DGIST, Daegu, Republic of Korea
| | - Hongsoo Choi
- Department of Robotics Engineering, DGIST, Daegu, Republic of Korea
| | - Ji-Woong Choi
- Department of Information and Communication Engineering, DGIST, Daegu, Republic of Korea.
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
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Chen YC, Xia W, Luo B, Muthaiah VPK, Xiong Z, Zhang J, Wang J, Salvi R, Teng GJ. Frequency-specific alternations in the amplitude of low-frequency fluctuations in chronic tinnitus. Front Neural Circuits 2015; 9:67. [PMID: 26578894 PMCID: PMC4624866 DOI: 10.3389/fncir.2015.00067] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/15/2015] [Indexed: 12/13/2022] Open
Abstract
Tinnitus, a phantom ringing, buzzing, or hissing sensation with potentially debilitating consequences, is thought to arise from aberrant spontaneous neural activity at one or more sites within the central nervous system; however, the location and specific features of these oscillations are poorly understood with respect to specific tinnitus features. Recent resting-state functional magnetic resonance imaging (fMRI) studies suggest that aberrant fluctuations in spontaneous low-frequency oscillations (LFO) of the blood oxygen level-dependent (BOLD) signal may be an important factor in chronic tinnitus; however, the role that frequency-specific components of LFO play in subjective tinnitus remains unclear. A total of 39 chronic tinnitus patients and 41 well-matched healthy controls participated in the resting-state fMRI scans. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) in two different frequency bands (slow-4: 0.027–0.073 Hz and slow-5: 0.01–0.027 Hz). We observed significant differences between tinnitus patients and normal controls in ALFF/fALFF in the two bands (slow-4 and slow-5) in several brain regions including the superior frontal gyrus (SFG), inferior frontal gyrus, middle temporal gyrus, angular gyrus, supramarginal gyrus, and middle occipital gyrus. Across the entire subject pool, significant differences in ALFF/fALFF between the two bands were found in the midbrain, basal ganglia, hippocampus and cerebellum (Slow 4 > Slow 5), and in the middle frontal gyrus, supramarginal gyrus, posterior cingulate cortex, and precuneus (Slow 5 > Slow 4). We also observed significant interaction between frequency bands and patient groups in the orbitofrontal gyrus. Furthermore, tinnitus distress was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-4 band in left SFG, whereas tinnitus duration was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-5 band in left SFG. Resting-state fMRI provides an unbiased method for identifying aberrant spontaneous LFO occurring throughout the central nervous system. Chronic tinnitus patients have widespread abnormalities in ALFF and fALFF slow-4 and slow-5 band which are correlated with tinnitus distress and duration. These results provide new insights on the neuropathophysiology of chronic tinnitus; therapies capable of reversing these aberrant patterns may reduce tinnitus distress.
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Affiliation(s)
- Yu-Chen Chen
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China ; Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Wenqing Xia
- Medical School, Southeast University Nanjing, China
| | - Bin Luo
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Vijaya P K Muthaiah
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Zhenyu Xiong
- Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo, Buffalo NY, USA
| | - Jian Zhang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China
| | - Jian Wang
- Department of Physiology, Southeast University Nanjing, China ; School of Human Communication Disorders, Dalhousie University, Halifax NS, Canada
| | - Richard Salvi
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China
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Neural substrates of conversion deafness in a cochlear implant patient: a molecular imaging study using H₂¹⁵O-PET. Otol Neurotol 2015; 35:1780-4. [PMID: 25166017 DOI: 10.1097/mao.0000000000000560] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Conversion deafness is characterized by sudden hearing loss without any identifiable cause. In the current study, we investigated presumed conversion deafness in a cochlear implant user using H₂¹⁵O-positron emission tomography (PET) scan with speech and noise stimuli in conjunction with audiologic tests such as impedance test and auditory response telemetry. Also, by performing a follow-up PET scan after recovery and comparing prerecovery and postrecovery scans, we attempted to find possible neural substrates of conversion deafness. PATIENT A 51-year-old man with conversion deafness after 4 years of successful cochlear implant use. INTERVENTION Supportive psychotherapy. MAIN OUTCOME MEASURES Prerecovery and postrecovery H₂¹⁵O-PET scans RESULTS The prerecovery H₂¹⁵O-PET scan revealed auditory cortex activation by sound stimuli, which verified normal stimulation of the central auditory pathway. Notably, compared with the prerecovery state, the postrecovery state showed relative activation in the right auditory cortex both under the speech and noise stimulus conditions. Moreover, the bilateral prefrontal and parietal areas were activated more in the postrecovery state than in the prerecovery state. In other words, relative deactivation of the prefronto-parieto-temporal network, a network responsible for conscious sensory perception, or relative dysfunction of top-down and bottom-up attention shifting mediated by the ventral and the dorsal parietal cortices, may have resulted in conversion deafness in the patient. CONCLUSION Relative deactivation of the prefronto-parieto-temporal network or dysfunction in the ventral and the dorsal parietal cortices may be related to the development of conversion deafness.
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Song JJ, Kim YJ, Kim SY, An YS, Kim K, Lee SY, Koo JW. Sinus Wall Resurfacing for Patients With Temporal Bone Venous Sinus Diverticulum and Ipsilateral Pulsatile Tinnitus. Neurosurgery 2015. [DOI: 10.1227/neu.0000000000000902] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND:
Pulsatile tinnitus (PT) caused by venous sinus diverticulum is a relatively common, potentially incapacitating condition. Although treatment via an external approach or endovascular coiling has been reported, much remains unknown about the possible pathophysiological mechanisms and appropriate management of PT.
OBJECTIVE:
To review our case series of PT resulting from either sigmoid sinus diverticulum (SSD) or middle cranial fossa venous sinus diverticulum (MFD-VS) and to discuss the possible pathophysiological mechanisms and desirable treatment options.
METHODS:
Four PT patients with either SSD or MFD-VS were treated with transmastoid resurfacing. In 1 case, a revision operation was performed as a result of recurrence of PT 4.5 years after the initial operation. The medical records and temporal bone imaging findings were retrospectively reviewed.
RESULTS:
PT was resolved in all cases immediately after transmastoid resurfacing, but 1 patient in whom bone wax was used for initial resurfacing experienced PT 4.5 years later. The PT was successfully managed with revision resurfacing with autologous bone chips/bone cement. In the other cases, the resolution of PT lasted throughout a median follow-up of 5.75 years. Notably, 2 of 4 cases had preoperative low-frequency hearing loss (LFHL) and experienced immediate postoperative improvement in LFHL.
CONCLUSION:
PT resulting from either SSD or MFD-VS can be treated successfully with transmastoid resurfacing of the venous wall. Preoperative ipsilesional LFHL and the improvement of hearing threshold after surgical intervention may be preoperative and postoperative surrogate objective signatures of PT. To ensure the resolution of symptoms, secure reconstruction with firm materials and long-term follow-up are mandatory.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Young-Jin Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - So Young Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Yun Suk An
- Department of Otorhinolaryngology–Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Kanghyeon Kim
- Department of Otorhinolaryngology–Head and Neck Surgery, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology–Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Song JJ, Vanneste S, De Ridder D. Dysfunctional noise cancelling of the rostral anterior cingulate cortex in tinnitus patients. PLoS One 2015; 10:e0123538. [PMID: 25875099 PMCID: PMC4395158 DOI: 10.1371/journal.pone.0123538] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/05/2015] [Indexed: 12/31/2022] Open
Abstract
Background Peripheral auditory deafferentation and central compensation have been regarded as the main culprits of tinnitus generation. However, patient-to-patient discrepancy in the range of the percentage of daytime in which tinnitus is perceived (tinnitus awareness percentage, 0 – 100%), is not fully explicable only by peripheral deafferentation, considering that the deafferentation is a stable persisting phenomenon but tinnitus is intermittently perceived in most patients. Consequently, the involvement of a dysfunctional noise cancellation mechanism has recently been suggested with regard to the individual differences in reported tinnitus awareness. By correlating the tinnitus awareness percentage with resting-state source-localized electroencephalography findings, we may be able to retrieve the cortical area that is negatively correlated with tinnitus awareness percentage, and then the area may be regarded as the core of the noise cancelling system that is defective in patients with tinnitus. Methods and Findings Using resting-state cortical oscillation, we investigated 80 tinnitus patients by correlating the tinnitus awareness percentage with their source-localized cortical oscillatory activity and functional connectivity. The activity of bilateral rostral anterior cingulate cortices (ACCs), left dorsal- and pregenual ACCs for the delta band, bilateral rostral/pregenual/subgenual ACCs for the theta band, and left rostral/pregenual ACC for the beta 1 band displayed significantly negative correlations with tinnitus awareness percentage. Also, the connectivity between the left primary auditory cortex (A1) and the rostral ACC, as well as between the left A1 and the subgenual ACC for the beta 1 band, were negatively correlated with tinnitus awareness percentage. Conclusions These results may designate the role of the rostral ACC as the core of the descending noise cancellation system, and thus dysfunction of the rostral ACC may result in perception of tinnitus. The present study also opens a possibility of tinnitus modulation by neuromodulatory approaches targeting the rostral ACC.
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Affiliation(s)
- Jae Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
- * E-mail:
| | - Sven Vanneste
- Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Edegem, Belgium
- Lab for Auditory and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, United States of America
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- BRAIN, Sint Augustinus Hospital, Antwerp, Belgium
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Altered intra- and interregional synchronization in resting-state cerebral networks associated with chronic tinnitus. Neural Plast 2015; 2015:475382. [PMID: 25734018 PMCID: PMC4334979 DOI: 10.1155/2015/475382] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 12/20/2014] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Subjective tinnitus is hypothesized to arise from aberrant neural activity; however, its neural bases are poorly understood. To identify aberrant neural networks involved in chronic tinnitus, we compared the resting-state functional magnetic resonance imaging (fMRI) patterns of tinnitus patients and healthy controls. MATERIALS AND METHODS Resting-state fMRI measurements were obtained from a group of chronic tinnitus patients (n = 29) with normal hearing and well-matched healthy controls (n = 30). Regional homogeneity (ReHo) analysis and functional connectivity analysis were used to identify abnormal brain activity; these abnormalities were compared to tinnitus distress. RESULTS Relative to healthy controls, tinnitus patients had significant greater ReHo values in several brain regions including the bilateral anterior insula (AI), left inferior frontal gyrus, and right supramarginal gyrus. Furthermore, the left AI showed enhanced functional connectivity with the left middle frontal gyrus (MFG), while the right AI had enhanced functional connectivity with the right MFG; these measures were positively correlated with Tinnitus Handicap Questionnaires (r = 0.459, P = 0.012 and r = 0.479, P = 0.009, resp.). CONCLUSIONS Chronic tinnitus patients showed abnormal intra- and interregional synchronization in several resting-state cerebral networks; these abnormalities were correlated with clinical tinnitus distress. These results suggest that tinnitus distress is exacerbated by attention networks that focus on internally generated phantom sounds.
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Song JJ, Vanneste S, Lazard DS, Van de Heyning P, Park JH, Oh SH, De Ridder D. The role of the salience network in processing lexical and nonlexical stimuli in cochlear implant users: an ALE meta-analysis of PET studies. Hum Brain Mapp 2015; 36:1982-94. [PMID: 25619989 DOI: 10.1002/hbm.22750] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 12/08/2014] [Accepted: 01/13/2015] [Indexed: 11/06/2022] Open
Abstract
Previous positron emission tomography (PET) studies have shown that various cortical areas are activated to process speech signal in cochlear implant (CI) users. Nonetheless, differences in task dimension among studies and low statistical power preclude from understanding sound processing mechanism in CI users. Hence, we performed activation likelihood estimation meta-analysis of PET studies in CI users and normal hearing (NH) controls to compare the two groups. Eight studies (58 CI subjects/92 peak coordinates; 45 NH subjects/40 peak coordinates) were included and analyzed, retrieving areas significantly activated by lexical and nonlexical stimuli. For lexical and nonlexical stimuli, both groups showed activations in the components of the dual-stream model such as bilateral superior temporal gyrus/sulcus, middle temporal gyrus, left posterior inferior frontal gyrus, and left insula. However, CI users displayed additional unique activation patterns by lexical and nonlexical stimuli. That is, for the lexical stimuli, significant activations were observed in areas comprising salience network (SN), also known as the intrinsic alertness network, such as the left dorsal anterior cingulate cortex (dACC), left insula, and right supplementary motor area in the CI user group. Also, for the nonlexical stimuli, CI users activated areas comprising SN such as the right insula and left dACC. Previous episodic observations on lexical stimuli processing using the dual auditory stream in CI users were reconfirmed in this study. However, this study also suggests that dual-stream auditory processing in CI users may need supports from the SN. In other words, CI users need to pay extra attention to cope with degraded auditory signal provided by the implant.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
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Tyler RS, Pienkowski M, Roncancio ER, Jun HJ, Brozoski T, Dauman N, Coelho CB, Andersson G, Keiner AJ, Cacace AT, Martin N, Moore BCJ. A review of hyperacusis and future directions: part I. Definitions and manifestations. Am J Audiol 2014; 23:402-19. [PMID: 25104073 DOI: 10.1044/2014_aja-14-0010] [Citation(s) in RCA: 177] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Hyperacusis can be extremely debilitating, and at present, there is no cure. We provide an overview of the field, and possible related areas, in the hope of facilitating future research. METHOD We review and reference literature on hyperacusis and related areas. We have divided the review into 2 articles. In Part I, we discuss definitions, epidemiology, different etiologies and subgroups, and how hyperacusis affects people. In Part II, we review measurements, models, mechanisms, and treatments, and we finish with some suggestions for further research. RESULTS Hyperacusis encompasses a wide range of reactions to sound, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Many different causes have been proposed, and it will be important to appreciate and quantify different subgroups. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including psychoacoustical measures, questionnaires, and brain imaging. CONCLUSIONS Hyperacusis can make life difficult for many, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.
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Affiliation(s)
| | | | | | | | - Tom Brozoski
- Southern Illinois University School of Medicine, Springfield
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Salloum RH, Yurosko C, Santiago L, Sandridge SA, Kaltenbach JA. Induction of enhanced acoustic startle response by noise exposure: dependence on exposure conditions and testing parameters and possible relevance to hyperacusis. PLoS One 2014; 9:e111747. [PMID: 25360877 PMCID: PMC4216136 DOI: 10.1371/journal.pone.0111747] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/07/2014] [Indexed: 11/28/2022] Open
Abstract
There has been a recent surge of interest in the development of animal models of hyperacusis, a condition in which tolerance to sounds of moderate and high intensities is diminished. The reasons for this decreased tolerance are likely multifactorial, but some major factors that contribute to hyperacusis are increased loudness perception and heightened sensitivity and/or responsiveness to sound. Increased sound sensitivity is a symptom that sometimes develops in human subjects after acoustic insult and has recently been demonstrated in animals as evidenced by enhancement of the acoustic startle reflex following acoustic over-exposure. However, different laboratories have obtained conflicting results in this regard, with some studies reporting enhanced startle, others reporting weakened startle, and still others reporting little, if any, change in the amplitude of the acoustic startle reflex following noise exposure. In an effort to gain insight into these discrepancies, we conducted measures of acoustic startle responses (ASR) in animals exposed to different levels of sound, and repeated such measures on consecutive days using a range of different startle stimuli. Since many studies combine measures of acoustic startle with measures of gap detection, we also tested ASR in two different acoustic contexts, one in which the startle amplitudes were tested in isolation, the other in which startle amplitudes were measured in the context of the gap detection test. The results reveal that the emergence of chronic hyperacusis-like enhancements of startle following noise exposure is highly reproducible but is dependent on the post-exposure thresholds, the time when the measures are performed and the context in which the ASR measures are obtained. These findings could explain many of the discrepancies that exist across studies and suggest guidelines for inducing in animals enhancements of the startle reflex that may be related to hyperacusis.
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Affiliation(s)
- Rony H. Salloum
- Department of Neurosciences, The Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Christopher Yurosko
- Department of Neurosciences, The Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Lia Santiago
- Head and Neck Institute, The Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Sharon A. Sandridge
- Head and Neck Institute, The Cleveland Clinic, Cleveland, Ohio, United States of America
| | - James A. Kaltenbach
- Department of Neurosciences, The Cleveland Clinic, Cleveland, Ohio, United States of America
- Head and Neck Institute, The Cleveland Clinic, Cleveland, Ohio, United States of America
- * E-mail:
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Aberrant spontaneous brain activity in chronic tinnitus patients revealed by resting-state functional MRI. NEUROIMAGE-CLINICAL 2014; 6:222-8. [PMID: 25379434 PMCID: PMC4215464 DOI: 10.1016/j.nicl.2014.09.011] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 09/12/2014] [Accepted: 09/13/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The neural mechanisms that give rise to the phantom sound of tinnitus are poorly understood. This study aims to investigate whether aberrant spontaneous brain activity exists in chronic tinnitus patients using resting-state functional magnetic resonance imaging (fMRI) technique. MATERIALS AND METHODS A total of 31 patients with chronic tinnitus patients and 32 healthy age-, sex-, and education-matched healthy controls were prospectively examined. Both groups had normal hearing thresholds. We calculated the amplitude of low-frequency fluctuations (ALFFs) of fMRI signals to measure spontaneous neuronal activity and detect the relationship between fMRI information and clinical data of tinnitus. RESULTS Compared with healthy controls, we observed significant increased ALFF within several selected regions including the right middle temporal gyrus (MTG), right superior frontal gyrus (SFG), and right angular gyrus; decreased ALFF was detected in the left cuneus, right middle occipital gyrus and bilateral thalamus. Moreover, tinnitus distress correlated positively with increased ALFF in right MTG and right SFG; tinnitus duration correlated positively with higher ALFF values in right SFG. CONCLUSIONS The present study confirms that chronic tinnitus patients have aberrant ALFF in many brain regions, which is associated with specific clinical tinnitus characteristics. ALFF disturbance in specific brain regions might be used to identify the neuro-pathophysiological mechanisms in chronic tinnitus patients.
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Meyer M, Luethi MS, Neff P, Langer N, Büchi S. Disentangling tinnitus distress and tinnitus presence by means of EEG power analysis. Neural Plast 2014; 2014:468546. [PMID: 25276437 PMCID: PMC4168245 DOI: 10.1155/2014/468546] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 01/16/2023] Open
Abstract
The present study investigated 24 individuals suffering from chronic tinnitus (TI) and 24 nonaffected controls (CO). We recorded resting-state EEG and collected psychometric data to obtain information about how chronic tinnitus experience affects the cognitive and emotional state of TI. The study was meant to disentangle TI with high distress from those who suffer less from persistent tinnitus based on both neurophysiological and behavioral data. A principal component analysis of psychometric data uncovers two distinct independent dimensions characterizing the individual tinnitus experience. These independent states are distress and presence, the latter is described as the perceived intensity of sound experience that increases with tinnitus duration devoid of any considerable emotional burden. Neuroplastic changes correlate with the two independent components. TI with high distress display increased EEG activity in the oscillatory range around 25 Hz (upper β-band) that agglomerates over frontal recording sites. TI with high presence show enhanced EEG signal strength in the δ-, α-, and lower γ-bands (30-40 Hz) over bilateral temporal and left perisylvian electrodes. Based on these differential patterns we suggest that the two dimensions, namely, distress and presence, should be considered as independent dimensions of chronic subjective tinnitus.
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Affiliation(s)
- Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Institute of Psychology, University of Zurich, Andreasstrasse 15/2, 8050 Zurich, Switzerland
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Cognitive Psychology Unit (CPU), University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Matthias S. Luethi
- Biological Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Institute of Psychology, University of Zurich, Andreasstrasse 15/2, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Institute for Computer Music and Sound Technology (ICST), University of the Arts (ZHdK), Zurich, Switzerland
| | - Nicolas Langer
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Children's Hospital Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- City College New York, New York, NY, USA
- Child Mind Institute, New York, NY, USA
| | - Stefan Büchi
- Child Mind Institute, New York, NY, USA
- Clinic for Psychotherapy and Psychosomatics “Hohenegg”, Meilen, Switzerland
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Abstract
Background Many people with tinnitus also suffer from hyperacusis. Both clinical and basic scientific data indicate an overlap in pathophysiologic mechanisms. In order to further elucidate the interplay between tinnitus and hyperacusis we compared clinical and demographic characteristics of tinnitus patients with and without hyperacusis by analyzing a large sample from an international tinnitus patient database. Materials The default dataset import [November 1st, 2012] from the Tinnitus Research Initiative [TRI] Database was used for analyses. Hyperacusis was defined by the question “Do sounds cause you pain or physical discomfort?” of the Tinnitus Sample Case History Questionnaire. Patients who answered this question with “yes” were contrasted with “no”-responders with respect to 41 variables. Results 935 [55%] out of 1713 patients were characterized as hyperacusis patients. Hyperacusis in tinnitus was associated with younger age, higher tinnitus-related, mental and general distress; and higher rates of pain disorders and vertigo. In relation to objective audiological assessment patients with hyperacusis rated their subjective hearing function worse than those without hyperacusis. Similarly the tinnitus pitch was rated higher by hyperacusis patients in relation to the audiometrically determined tinnitus pitch. Among patients with tinnitus and hyperacusis the tinnitus was more frequently modulated by external noise and somatic maneuvers, i.e., exposure to environmental sounds and head and neck movements change the tinnitus percept. Conclusions Our findings suggest that the comorbidity of hyperacusis is a useful criterion for defining a sub-type of tinnitus which is characterized by greater need of treatment. The higher sensitivity to auditory, somatosensory and vestibular input confirms the notion of an overactivation of an unspecific hypervigilance network in tinnitus patients with hyperacusis.
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