An Integrated Physical Regulation Theory and Classification of Acute Tinnitus

Combined Bifrontal Transcranial Direct Current Stimulation and Auditory Stroop Training in Chronic Tinnitus

Patients with tinnitus experience difficulties in cognitive control and executive functions. Many of which are regarded as the cause of tinnitus rather than its complications. Methods for the improvement of inhibitory and cognitive control seem to be effective in the control of tinnitus. In this study, transcranial direct current stimulation and auditory Stroop exercise were have been to improve inhibitory control and the ability to ignore tinnitus in patients suffering from chronic tinnitus. 34 patients with chronic tinnitus (> 6 months) were randomly divided into two groups. The first group consist of 17 patients who received 6 sessions of tDCS followed by 6 sessions of auditory Stroop training. The second group received 6 sessions of sham tDCS followed by 6 sessions of auditory Stroop training. The initial evaluations including pure tone audiometry, psychoacoustic measurements, tinnitus handicap inventory (THI) survey and visual analog scale (VAS) of annoyance and loudness were performed before, immediately after, and one month after the tDCS, sham, and Stroop training. The results of this study revealed a significant reduction in THI score, VAS of loudness, and annoyance of tinnitus. A significant correlation was detected between the reaction time of incongruent words in the Stroop task and improvement of THI score and VAS of annoyance. Combined tDCS and Stroop training efficiently improve chronic tinnitus.

Subjective tinnitus patients with normal pure-tone hearing still suffer more informational masking in the noisy environment

Subjective tinnitus patients experience more hearing difficulties than normal peers in complex hearing environments, even though most of these patients have normal pure-tone hearing thresholds. Using speech recognition tasks under different masking conditions can provide insight into whether the effects of tinnitus are lateralized and the mechanisms behind the effects. By simulating sound field recordings, we obtain a target speech sentence that can be perceived as presented on one side and noise or speech masking with or without spatial separation from it. Our study used the virtual sound field technique to investigate the difference in speech recognition ability between chronic subjective tinnitus patients and a normal-hearing control group under the four masking conditions (speech-spectrum noise masking or two-talker speech masking, with or without perceived spatial separation). Experiment 1 showed no differences for target speech perceived location (left or right), which rules out a lateralization of the effect of tinnitus patients. Experiment 2 further found that although tinnitus patients had weaker performance than normal people in very complex auditory scenarios, when the spatial cue of the target speech exists, they can make good use of this cue to make up for the original processing disadvantage and achieve a similar performance as the normal-hearing group. In addition, the current study distinguished the effects of informational masking and energetic masking on speech recognition in patients with tinnitus and normal hearing. The results suggest that the impact of tinnitus on speech recognition in patients is more likely to occur in the auditory center rather than the periphery.

Long-Term Prognosis of Tinnitus Associated with Idiopathic Sudden Sensorineural Hearing Loss

OBJECTIVE

To analyze the factors affecting the long-term prognosis of tinnitus accompanied by unilateral idiopathic sudden sensorineural hearing loss (SSNHL).

METHODS

A total of 161 patients with sudden hearing loss (HL) accompanied by tinnitus were enrolled. All patients had two separate telephone follow-ups and were asked about changes in tinnitus. The severity of tinnitus at admission and the outcome at discharge were assessed in terms of the patients' sex, age, level of HL, type of audiogram, etc. Results: The prognosis of tinnitus after SSNHL had no relationship with grades of HL or hearing recovery. Initial tinnitus level was remarkably associated with tinnitus improvement at discharge and was an independent risk factor for the long-term prognosis of residual tinnitus after SSNHL (odds ratio 0.722, 95% confidence interval 0.550-0.949, p = 0.019), and the median recovery time was 23.00 ± 3.80 months.

CONCLUSIONS

Residual tinnitus after SSNHL has a tendency of self-recovery. The short-term prognosis of tinnitus may be related to psychological changes caused by hearing recovery, while the long-term prognosis of residual tinnitus after SSNHL is related only to the initial tinnitus level, with a median recovery time of approximately 2 years.