Neuropsychological monitoring of current acoustic therapies as alternative treatment of chronic tinnitus

Graph-Based Electroencephalography Analysis in Tinnitus Therapy

Tinnitus is the perception of sounds like ringing or buzzing in the ears without any external source, varying in intensity and potentially becoming chronic. This study aims to enhance the understanding and treatment of tinnitus by analyzing a dataset related to tinnitus therapy, focusing on electroencephalography (EEG) signals from patients undergoing treatment. The objectives of the study include applying various preprocessing techniques to ensure data quality, such as noise elimination and standardization of sampling rates, and extracting essential features from EEG signals, including power spectral density and statistical measures. The novelty of this research lies in its innovative approach to representing different channels of EEG signals as new graph network representations without losing any information. This transformation allows for the use of Graph Neural Networks (GNNs), specifically Graph Convolutional Networks (GCNs) combined with Long Short-Term Memory (LSTM) networks, to model intricate relationships and temporal dependencies within the EEG data. This method enables a comprehensive analysis of the complex interactions between EEG channels. The study reports an impressive accuracy rate of 99.41%, demonstrating the potential of this novel approach. By integrating graph representation and deep learning, this research introduces a new methodology for analyzing tinnitus therapy data, aiming to contribute to more effective treatment strategies for tinnitus sufferers.

Objective Neurophysiological Indices for the Assessment of Chronic Tinnitus Based on EEG Microstate Parameters

Chronic tinnitus is highly prevalent but lacks precise diagnostic or effective therapeutic standards. Its onset and treatment mechanisms remain unclear, and there is a shortage of objective assessment methods. We aim to identify abnormal neural activity and reorganization in tinnitus patients and reveal potential neurophysiological markers for objectively evaluating tinnitus. By way of analyzing EEG microstates, comparing metrics under three resting states (OE, CE, and OECEm) between tinnitus sufferers and controls, and correlating them with tinnitus symptoms. This study reflected specific changes in the EEG microstates of tinnitus patients across multiple resting states, as well as inconsistent correlations with tinnitus symptoms. Microstate parameters were significantly different when patients were in OE and CE states. Specifically, the occurrence of Microstate A and the transition probabilities (TP) from other Microstates to A increased significantly, particularly in the CE state (32-37%, p ≤ 0.05 ); and both correlated positively with the tinnitus intensity. Nevertheless, under the OECEm state, increases were mainly observed in the duration, coverage, and occurrence of Microstate B (15-47%, ), which negatively correlated with intensity ( [Formula: see text]-0.513, ). Additionally, TPx between Microstates C and D were significantly reduced and positively correlated with HDAS levels ( [Formula: see text] 0.548, ). Furthermore, parameters of Microstate D also correlated with THI grades ( [Formula: see text]-0.576, ). The findings of this study could offer compelling evidence for central neural reorganization associated with chronic tinnitus. EEG microstate parameters that correlate with tinnitus symptoms could serve as neurophysiological markers, contributing to future research on the objective assessment of tinnitus.

Initial Response to Combination Therapies for Tinnitus: Lessons Learned From a Retrospective Analysis

OBJECTIVE

To investigate the initial reduction of tinnitus effects by combining common therapies applicable in general otology clinics and establishing optimal treatment strategies.

STUDY DESIGN

Retrospective cohort study.

SETTING

A tertiary university hospital.

PATIENTS

Patients with nonpulsatile subjective tinnitus who visited the hospital between January and December 2022.

INTERVENTIONS

Combination therapies consisting of at least one of the directive counseling based on the neurophysiological model, hearing aids, medication, and/or neuromodulation were performed.

MAIN OUTCOME MEASURES

Tinnitus Handicap Inventory (THI) questionnaire at both their initial visit and 1-month follow-up.

RESULTS

A total of 151 patients were enrolled. THI improvement of 20 points or more was observed in 31.8% of participants. One-way analysis of variance revealed that counseling had a significant reduction in THI, whereas neuromodulation, medication, and hearing aids did not. THI improvement was significantly associated with received counseling, severity of initial THI, and mean loudness discomfort level. Hearing aids and neuromodulation were not significant prognostic factors for improvement.

CONCLUSION

Counseling alone is the best treatment for most patients with tinnitus. There will be other patients with tinnitus that, in addition to counseling, would benefit from hearing aids, medications, and/or certain forms of neuromodulation.

Comparative analysis of acoustic therapies for tinnitus treatment based on auditory event-related potentials

Introduction

So far, Auditory Event-Related Potential (AERP) features have been used to characterize neural activity of patients with tinnitus. However, these EEG patterns could be used to evaluate tinnitus evolution as well. The aim of the present study is to propose a methodology based on AERPs to evaluate the effectiveness of four acoustic therapies for tinnitus treatment.

Methods

The acoustic therapies were: (1) Tinnitus Retraining Therapy (TRT), (2) Auditory Discrimination Therapy (ADT), (3) Therapy for Enriched Acoustic Environment (TEAE), and (4) Binaural Beats Therapy (BBT). In addition, relaxing music was included as a placebo for both: tinnitus sufferers and healthy individuals. To meet this aim, 103 participants were recruited, 53% were females and 47% were males. All the participants were treated for 8 weeks with one of these five sounds, which were moreover tuned in accordance with the acoustic features of their tinnitus (if applied) and hearing loss. They were electroencephalographically monitored before and after their acoustic therapy, and wherefrom AERPs were estimated. The sound effect of acoustic therapies was evaluated by examining the area under the curve of those AERPs. Two parameters were obtained: (1) amplitude and (2) topographical distribution.

Results

The findings of the investigation showed that after an 8-week treatment, TRT and ADT, respectively achieved significant neurophysiological changes over somatosensory and occipital regions. On one hand, TRT increased the tinnitus perception. On the other hand, ADT redirected the tinnitus attention, what in turn diminished the tinnitus perception. Tinnitus handicapped inventory outcomes verified these neurophysiological findings, revealing that 31% of patients in each group reported that TRT increased tinnitus perception, but ADT diminished it.

Discussion

Tinnitus has been identified as a multifactorial condition highly associated with hearing loss, age, sex, marital status, education, and even, employment. However, no conclusive evidence has been found yet. In this study, a significant (but low) correlation was found between tinnitus intensity and right ear hearing loss, left ear hearing loss, heart rate, area under the curve of AERPs, and acoustic therapy. This study raises the possibility to assign acoustic therapies by neurophysiological response of patient.

Chronic Neuropathic Pain: EEG data in eyes open and eyes closed with painDETECT and Brief Pain Inventory reports

Thirty-six chronic neuropathic pain patients (8 men and 28 women) of Mexican nationality with a mean age of 44±13.98 were recruited for EEG signal recording in eyes open and eyes closed resting state condition. Each condition was recorded for 5 min, with a total recording session time of 10 min. An ID number was given to each patient after signing up for the study, with which they answered the painDETECT questionnaire as a screening process for neuropathic pain alongside their clinical history. The day of the recording, the patients answered the Brief Pain Inventory, as an evaluation questionnaire for the interference of the pain with their daily life. Twenty-two EEG channels positioned in accordance with the 10/20 international system were registered with Smarting mBrain device. EEG signals were sampled at 250 Hz with a bandwidth between 0.1 and 100 Hz. The article provides two types of data: (1) raw EEG data in resting state and (2) the report of patients for two validated pain questionnaires. The data described in this article can be used for classifier algorithms considering stratifying chronic neuropathic pain patients with EEG data alongside their pain scores. In sum, this data is of extreme relevance for the pain field, where researchers have been seeking to integrate the pain experience with objective physiological data, such as the EEG.

An Electroencephalography-based Database for studying the Effects of Acoustic Therapies for Tinnitus Treatment

The present database provides demographic (age and sex), clinical (hearing loss and acoustic properties of tinnitus), psychometric (based on Tinnitus Handicapped Inventory and Hospital Anxiety and Depression Scale) and electroencephalographic information of 89 tinnitus sufferers who were semi-randomly treated for eight weeks with one of five acoustic therapies. These were (1) placebo (relaxing music), (2) tinnitus retraining therapy, (3) auditory discrimination therapy, (4) enriched acoustic environment, and (5) binaural beats therapy. Fourteen healthy volunteers who were exposed to relaxing music and followed the same experimental procedure as tinnitus sufferers were additionally included in the study (control group). The database is available at https://doi.org/10.17632/kj443jc4yc.1 . Acoustic therapies were monitored one week after, three weeks after, five weeks after, and eight weeks after the acoustic therapy. This study was previously approved by the local Ethical Committee (CONBIOETICA19CEI00820130520), it was registered as a clinical trial (ISRCTN14553550) in BioMed Central (Springer Nature), the protocol was published in 2016, it attracted L'Oréal-UNESCO Organization as a sponsor, and six journal publications have resulted from the analysis of this database.

Effect of Auditory Discrimination Therapy on Attentional Processes of Tinnitus Patients

Tinnitus is an auditory condition that causes humans to hear a sound anytime, anywhere. Chronic and refractory tinnitus is caused by an over synchronization of neurons. Sound has been applied as an alternative treatment to resynchronize neuronal activity. To date, various acoustic therapies have been proposed to treat tinnitus. However, the effect is not yet well understood. Therefore, the objective of this study is to establish an objective methodology using electroencephalography (EEG) signals to measure changes in attentional processes in patients with tinnitus treated with auditory discrimination therapy (ADT). To this aim, first, event-related (de-) synchronization (ERD/ERS) responses were mapped to extract the levels of synchronization related to the auditory recognition event. Second, the deep representations of the scalograms were extracted using a previously trained Convolutional Neural Network (CNN) architecture (MobileNet v2). Third, the deep spectrum features corresponding to the study datasets were analyzed to investigate performance in terms of attention and memory changes. The results proved strong evidence of the feasibility of ADT to treat tinnitus, which is possibly due to attentional redirection.