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Cai R, Ling L, Ghimire M, Brownell KA, Caspary DM. Tinnitus-related increases in single-unit activity in awake rat auditory cortex correlate with tinnitus behavior. Hear Res 2024; 445:108993. [PMID: 38518392 DOI: 10.1016/j.heares.2024.108993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
Tinnitus is known to affect 10-15 % of the population, severely impacting 1-2 % of those afflicted. Canonically, tinnitus is generally a consequence of peripheral auditory damage resulting in maladaptive plastic changes in excitatory/inhibitory homeostasis at multiple levels of the central auditory pathway as well as changes in diverse nonauditory structures. Animal studies of primary auditory cortex (A1) generally find tinnitus-related changes in excitability across A1 layers and differences between inhibitory neuronal subtypes. Changes due to sound-exposure include changes in spontaneous activity, cross-columnar synchrony, bursting and tonotopic organization. Few studies in A1 directly correlate tinnitus-related changes in neural activity to an individual animal's behavioral evidence of tinnitus. The present study used an established condition-suppression sound-exposure model of chronic tinnitus and recorded spontaneous and driven single-unit responses from A1 layers 5 and 6 of awake Long-Evans rats. A1 units recorded from animals with behavioral evidence of tinnitus showed significant increases in spontaneous and sound-evoked activity which directly correlated to the animal's tinnitus score. Significant increases in the number of bursting units, the number of bursts/minute and burst duration were seen for A1 units recorded from animals with behavioral evidence of tinnitus. The present A1 findings support prior unit recording studies in auditory thalamus and recent in vitro findings in this same animal model. The present findings are consistent with sensory cortical studies showing tinnitus- and neuropathic pain-related down-regulation of inhibition and increased excitation based on plastic neurotransmitter and potassium channel changes. Reducing A1 deep-layer tinnitus-related hyperactivity is a potential target for tinnitus pharmacotherapy.
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Affiliation(s)
- Rui Cai
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Lynne Ling
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Madan Ghimire
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Kevin A Brownell
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Donald M Caspary
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States.
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Cacace AT, Berri B. Blast Overpressures as a Military and Occupational Health Concern. Am J Audiol 2023; 32:779-792. [PMID: 37713532 DOI: 10.1044/2023_aja-23-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
PURPOSE This tutorial reviews effects of environmental stressors like blast overpressures and other well-known acoustic contaminants (continuous, intermittent, and impulsive noise) on hearing, tinnitus, vestibular, and balance-related functions. Based on the overall outcome of these effects, detailed consideration is given to the health and well-being of individuals. METHOD Because hearing loss and tinnitus are consequential in affecting quality of life, novel neuromodulation paradigms are reviewed for their positive abatement and treatment-related effects. Examples of clinical data, research strategies, and methodological approaches focus on repetitive transcranial magnetic stimulation (rTMS) and electrical stimulation of the vagus nerve paired with tones (VNSt) for their unique contributions to this area. RESULTS Acoustic toxicants transmitted through the atmosphere are noteworthy for their propensity to induce hearing loss and tinnitus. Mounting evidence also indicates that high-level rapid onset changes in atmospheric sound pressure can significantly impact vestibular and balance function. Indeed, the risk of falling secondary to loss of, or damage to, sensory receptor cells in otolith organs (utricle and saccule) is a primary reason for this concern. As part of the complexities involved in VNSt treatment strategies, vocal dysfunction may also manifest. In addition, evaluation of temporospatial gait parameters is worthy of consideration based on their ability to detect and monitor incipient neurological disease, cognitive decline, and mortality. CONCLUSION Highlighting these respective areas underscores the need to enhance information exchange among scientists, clinicians, and caregivers on the benefits and complications of these outcomes.
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Affiliation(s)
- Anthony T Cacace
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
| | - Batoul Berri
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
- Department of Otolaryngology, University of Michigan, Ann Arbor
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Jimoh Z, Marouf A, Zenke J, Leung AWS, Gomaa NA. Functional Brain Regions Linked to Tinnitus Pathology and Compensation During Task Performance: A Systematic Review. Otolaryngol Head Neck Surg 2023; 169:1409-1423. [PMID: 37522290 DOI: 10.1002/ohn.459] [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: 03/05/2023] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE To systematically search the literature and organize relevant advancements in the connection between tinnitus and the activity of different functional brain regions using functional magnetic resonance imaging (fMRI). DATA SOURCES MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Web of Science, ProQuest Dissertations & Theses Global, Cochrane Database of Systematic Reviews, and PROSPERO from inception to April 2022. REVIEW METHODS Studies with adult human subjects who suffer from tinnitus and underwent fMRI to relate specific regions of interest to tinnitus pathology or compensation were included. In addition, fMRI had to be performed with a paradigm of stimuli that would stimulate auditory brain activity. Exclusion criteria included non-English studies, animal studies, and studies that utilized a resting state magnetic resonance imaging or other imaging modalities. RESULTS The auditory cortex may work to dampen the effects of central gain. Results from different studies show variable changes in the Heschl's gyrus (HG), with some showing increased activity and others showing inhibition and volume loss. After controlling for hyperacusis and other confounders, tinnitus does not seem to influence the inferior colliculus (IC) activation. However, there is decreased connectivity between the auditory cortex and IC. The cochlear nucleus (CN) generally shows increased activation in tinnitus patients. fMRI evidence indicates significant inhibition of thalamic gating. Activating the thalamus may be of important therapeutic potential. CONCLUSION Patients with tinnitus have significantly altered neuronal firing patterns, especially within the auditory network, when compared to individuals without tinnitus. Tinnitus and hyperacusis commonly coexist, making differentiation of the effects of these 2 phenomena frequently difficult.
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Affiliation(s)
- Zaharadeen Jimoh
- Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Azmi Marouf
- Department of Otolaryngology-Head and Neck Surgery, Case Western Reserve School of Medicine and University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Julianna Zenke
- Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Ada W S Leung
- Department of Occupational Therapy, Neuroscience, and Mental Health Institute, Faculty of Rehabilitation Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Nahla A Gomaa
- Division of Otolaryngology-Head and Neck Surgery, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Kim E, Kang H, Noh TS, Oh SH, Suh MW. Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement. Neurologia 2023; 38:475-485. [PMID: 37659838 DOI: 10.1016/j.nrleng.2021.01.007] [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: 08/25/2020] [Accepted: 01/06/2021] [Indexed: 09/04/2023] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. METHODS We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. RESULTS Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. CONCLUSIONS Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.
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Affiliation(s)
- E Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - H Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - T-S Noh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - S-H Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - M-W Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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Ghimire M, Cai R, Ling L, Brownell KA, Hackett TA, Llano DA, Caspary DM. Increased pyramidal and VIP neuronal excitability in rat primary auditory cortex directly correlates with tinnitus behaviour. J Physiol 2023; 601:2493-2511. [PMID: 37119035 PMCID: PMC10330441 DOI: 10.1113/jp284675] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/25/2023] [Indexed: 04/30/2023] Open
Abstract
Tinnitus affects roughly 15%-20% of the population while severely impacting 10% of those afflicted. Tinnitus pathology is multifactorial, generally initiated by damage to the auditory periphery, resulting in a cascade of maladaptive plastic changes at multiple levels of the central auditory neuraxis as well as limbic and non-auditory cortical centres. Using a well-established condition-suppression model of tinnitus, we measured tinnitus-related changes in the microcircuits of excitatory/inhibitory neurons onto layer 5 pyramidal neurons (PNs), as well as changes in the excitability of vasoactive intestinal peptide (VIP) neurons in primary auditory cortex (A1). Patch-clamp recordings from PNs in A1 slices showed tinnitus-related increases in spontaneous excitatory postsynaptic currents (sEPSCs) and decreases in spontaneous inhibitory postsynaptic currents (sIPSCs). Both measures could be correlated to the rat's behavioural evidence of tinnitus. Tinnitus-related changes in PN excitability were independent of changes in A1 excitatory or inhibitory cell numbers. VIP neurons, part of an A1 local circuit that can control the excitation of layer 5 PNs via disinhibitory mechanisms, showed significant tinnitus-related increases in excitability that directly correlated with the rat's behavioural tinnitus score. That PN and VIP changes directly correlated to tinnitus behaviour suggests an important role in A1 tinnitus pathology. Tinnitus-related A1 changes were similar to findings in studies of neuropathic pain in somatosensory cortex suggesting a common pathology of these troublesome perceptual impairments. Improved understanding between excitatory, inhibitory and disinhibitory sensory cortical circuits can serve as a model for testing therapeutic approaches to the treatment of tinnitus and chronic pain. KEY POINTS: We identified tinnitus-related changes in synaptic function of specific neuronal subtypes in a reliable animal model of tinnitus. The findings show direct and indirect tinnitus-related losses of normal inhibitory function at A1 layer 5 pyramidal cells, and increased VIP excitability. The findings are similar to what has been shown for neuropathic pain suggesting that restoring normal inhibitory function at synaptic inputs onto A1 pyramidal neurons (PNs) could conceptually reduce tinnitus discomfort.
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Affiliation(s)
- Madan Ghimire
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois 62702
| | - Rui Cai
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois 62702
| | - Lynne Ling
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois 62702
| | - Kevin A. Brownell
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois 62702
| | - Troy A. Hackett
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | - Daniel A. Llano
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
- Beckman Institute, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Donald M. Caspary
- Department of Pharmacology, Southern Illinois University School of Medicine, Springfield, Illinois 62702
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Fernández M, Cuesta M, Sanz R, Cobo P. Comparison of Tinnitus Handicap Inventory and Tinnitus Functional Index as Treatment Outcomes. Audiol Res 2022; 13:23-31. [PMID: 36648924 PMCID: PMC9844388 DOI: 10.3390/audiolres13010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Tinnitus is an audiological disorder for which there are no objective measuring tools. Thus, many self-report questionnaires have been proposed to assess its severity. These questionnaires have been judged for their capacity to assess the tinnitus severity at baseline, their sensitivity to treatment-related changes (responsiveness), and their resolution. METHODS The most widely used questionnaires for clinical and research studies are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). While both questionnaires have been recognized as good evaluators of the baseline tinnitus severity, the latter is considered to be more responsive to changes following treatments. OBJECTIVES The aim of this work is to provide a preliminary comparison of the performance of both questionnaires in the initial and final tinnitus severity assessment of a cohort of patients undergoing a four-month Enriched Acoustic Environment (EAE) therapy. RESULTS The EAE therapy provided a 30 and 26 point reduction in THI and TFI, respectively. A good correlation is obtained between the THI and TFI questionnaires at baseline and after the treatment. CONCLUSION At baseline, the THI provided a higher score than the TFI for a higher degree of tinnitus but a lower score for lower tinnitus severity. Both THI and TFI were good questionnaires for baseline assessment and for treatment-related changes. The THI provided a slightly higher score drop than the TFI following the treatment, although the TFI had better resolution.
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Affiliation(s)
- Marta Fernández
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - María Cuesta
- Institute of Physical and Information Technologies (ITEFI), CSIC, Serrano 144, 28006 Madrid, Spain
| | - Ricardo Sanz
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Pedro Cobo
- Institute of Physical and Information Technologies (ITEFI), CSIC, Serrano 144, 28006 Madrid, Spain
- Correspondence: ; Tel.: +34-915618806
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Aberrant Resting-State Functional Connectivity of the Dorsal Attention Network in Tinnitus. Neural Plast 2022; 2021:2804533. [PMID: 35003251 PMCID: PMC8741389 DOI: 10.1155/2021/2804533] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/23/2021] [Accepted: 12/15/2021] [Indexed: 01/17/2023] Open
Abstract
Previous functional magnetic resonance imaging (fMRI) analyses have shown that the dorsal attention network (DAN) is involved in the pathophysiological changes of tinnitus, but few relevant studies have been conducted, and the conclusions to date are not uniform. The purpose of this research was to test whether there is a change in intrinsic functional connectivity (FC) patterns between the DAN and other brain regions in tinnitus patients. Thirty-one patients with persistent tinnitus and thirty-three healthy controls were enrolled in this study. A group independent component analysis (ICA), degree centrality (DC) analysis, and seed-based FC analysis were conducted. In the group ICA, the tinnitus patients showed increased connectivity in the left superior parietal gyrus in the DAN compared to the healthy controls. Compared with the healthy controls, the tinnitus patients showed increased DC in the left inferior parietal gyrus and decreased DC in the left precuneus within the DAN. The clusters within the DAN with significant differences in the ICA or DC analysis between the tinnitus patients and the healthy controls were selected as regions of interest (ROIs) for seeds. The tinnitus patients exhibited significantly increased FC from the left superior parietal gyrus to several brain regions, including the left inferior parietal gyrus, the left superior marginal gyrus, and the right superior frontal gyrus, and decreased FC to the right anterior cingulate cortex. The tinnitus patients exhibited decreased FC from the left precuneus to the left inferior occipital gyrus, left calcarine cortex, and left superior frontal gyrus compared with the healthy controls. The findings of this study show that compared with healthy controls, tinnitus patients have altered functional connections not only within the DAN but also between the DAN and other brain regions. These results suggest that it may be possible to improve the disturbance and influence of tinnitus by regulating the DAN.
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Implications of Transcranial Magnetic Stimulation as a Treatment Modality for Tinnitus. J Clin Med 2021; 10:jcm10225422. [PMID: 34830704 PMCID: PMC8622674 DOI: 10.3390/jcm10225422] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/10/2021] [Accepted: 11/14/2021] [Indexed: 12/24/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, neuromodulating technique for brain hyperexcitability disorders. The objective of this paper is to discuss the mechanism of action of rTMS as well as to investigate the literature involving the application of rTMS in the treatment of tinnitus. The reviewed aspects of the protocols included baseline evaluation, the total number of sessions, frequency and the total number of stimuli, the location of treatment, and the outcome measures. Even with heterogeneous protocols, most studies utilized validated tinnitus questionnaires as baseline and outcome measures. Low frequency (1 Hz) stimulation throughout 10 consecutive sessions was the most widely used frequency and treatment duration; however, there was no consensus on the total number of stimuli necessary to achieve significant results. The auditory cortex (AC) was the most targeted location, with most studies supporting changes in neural activity with multi-site stimulation to areas in the frontal cortex (FC), particularly the dorsolateral prefrontal cortex (DLPFC). The overall efficacy across most of the reviewed trials reveals positive statistically significant results. Though rTMS has proven to impact neuroplasticity at the microscopic and clinical level, further studies are warranted to demonstrate and support the clinical use of rTMS in tinnitus treatment with a standardized protocol.
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Lv H, Chen Q, Wei X, Liu C, Zhao P, Wang Z, Yang Z, Gong S, You H, Wang Z. Sound therapy can modulate the functional connectivity of the auditory network. Prog Neuropsychopharmacol Biol Psychiatry 2021; 110:110323. [PMID: 33838149 DOI: 10.1016/j.pnpbp.2021.110323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 04/03/2021] [Accepted: 04/04/2021] [Indexed: 02/07/2023]
Abstract
The functional connectivity of the auditory network is considered to be important in the development of tinnitus. We hypothesized that sound therapy, as a commonly used effective treatment for tinnitus, can modulate the functional connectivity of the auditory network. In this prospective observational study, we recruited 27 tinnitus patients who had undergone 12 weeks of sound therapy and 27 matched healthy controls. For the two groups of subjects, resting-state functional magnetic resonance imaging was acquired both at baseline and at the 12th week. We utilized independent component analysis and seed-based functional connectivity analysis to characterize the connectivity features of the auditory network. Interaction effects between the two groups and the two scans within the auditory network were observed, which were driven by increased functional connectivity in the left primary auditory cortex (PAC) and decreased values in the secondary auditory cortex (SAC) in tinnitus patients after treatment. Increased connections between the auditory network and limbic network, as well as decreased values with the bilateral thalami, were identified. The effects were mainly driven by the functional connectivity alterations of the SAC rather than that of the PAC. Significant positive correlations between the percent improvement in the Tinnitus Handicap Inventory (THI) score and the percentage change rates of functional connectivity between the SAC and bilateral thalami were observed. Our study contributes to the understanding of the mechanism of tinnitus and effective sound therapy, providing evidence to support the theory of a gain adaptation mechanism that quantifies the recovered gating function of the thalamus in tinnitus patients.
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Affiliation(s)
- Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Chunli Liu
- Department of Otolaryngology, The Affiliated Hospital of Chengde Medical College, Hebei 067000, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Hong You
- Liver Research Center, Beijing Key Laboratory of Translational Medicine in Liver Cirrhosis, National Clinical Research Center for Digestive Disease, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Díaz I, Colmenárez-Raga AC, Pérez-González D, Carmona VG, Plaza Lopez I, Merchán MA. Effects of Multisession Anodal Electrical Stimulation of the Auditory Cortex on Temporary Noise-Induced Hearing Loss in the Rat. Front Neurosci 2021; 15:642047. [PMID: 34393701 PMCID: PMC8358804 DOI: 10.3389/fnins.2021.642047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/30/2021] [Indexed: 11/13/2022] Open
Abstract
The protective effect of the efferent system against acoustic trauma (AT) has been shown by several experimental approaches, including damage to one ear, sectioning of the olivocochlear bundle (OCB) in the floor of the IV ventricle, and knock-in mice overexpressing outer hair cell (OHC) cholinergic receptors, among others. Such effects have been related to changes in the regulation of the cholinergic efferent system and in cochlear amplification, which ultimately reverse upon protective hearing suppression. In addition to well-known circuits of the brainstem, the descending corticofugal pathway also regulates efferent neurons of the olivary complex. In this study, we applied our recently developed experimental paradigm of multiple sessions of electrical stimulation (ES) to activate the efferent system in combination with noise overstimulation. ABR thresholds increased 1 and 2 days after AT (8-16 kHz bandpass noise at 107 dB for 90 min) recovering at AT + 14 days. However, after multiple sessions of epidural anodal stimulation, no changes in thresholds were observed following AT. Although an inflammatory response was also observed 1 day after AT in both groups, the counts of reactive macrophages in both experimental conditions suggest decreased inflammation in the epidural stimulation group. Quantitative immunocytochemistry for choline acetyltransferase (ChAT) showed a significant decrease in the size and optical density of the efferent terminals 1 day after AT and a rebound at 14 days, suggesting depletion of the terminals followed by a long-term compensatory response. Such a synthesis recovery was significantly higher upon cortical stimulation. No significant correlation was found between ChAT optical density and size of the buttons in sham controls (SC) and ES/AT + 1day animals; however, significant negative correlations were shown in all other experimental conditions. Therefore, our comparative analysis suggests that cochleotopic cholinergic neurotransmission is also better preserved after multisession epidural stimulation.
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Affiliation(s)
- Iván Díaz
- Instituto de Neurociencias de Castilla y León (INCYL), Universidad de Salamanca, Salamanca, Spain
| | | | - David Pérez-González
- Instituto de Neurociencias de Castilla y León (INCYL), Universidad de Salamanca, Salamanca, Spain
| | - Venezia G Carmona
- Instituto de Neurociencias de Castilla y León (INCYL), Universidad de Salamanca, Salamanca, Spain
| | - Ignacio Plaza Lopez
- Instituto de Neurociencias de Castilla y León (INCYL), Universidad de Salamanca, Salamanca, Spain
| | - Miguel A Merchán
- Instituto de Neurociencias de Castilla y León (INCYL), Universidad de Salamanca, Salamanca, Spain
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Brinkmann P, Kotz SA, Smit JV, Janssen MLF, Schwartze M. Auditory thalamus dysfunction and pathophysiology in tinnitus: a predictive network hypothesis. Brain Struct Funct 2021; 226:1659-1676. [PMID: 33934235 PMCID: PMC8203542 DOI: 10.1007/s00429-021-02284-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/21/2021] [Indexed: 01/12/2023]
Abstract
Tinnitus is the perception of a 'ringing' sound without an acoustic source. It is generally accepted that tinnitus develops after peripheral hearing loss and is associated with altered auditory processing. The thalamus is a crucial relay in the underlying pathways that actively shapes processing of auditory signals before the respective information reaches the cerebral cortex. Here, we review animal and human evidence to define thalamic function in tinnitus. Overall increased spontaneous firing patterns and altered coherence between the thalamic medial geniculate body (MGB) and auditory cortices is observed in animal models of tinnitus. It is likely that the functional connectivity between the MGB and primary and secondary auditory cortices is reduced in humans. Conversely, there are indications for increased connectivity between the MGB and several areas in the cingulate cortex and posterior cerebellar regions, as well as variability in connectivity between the MGB and frontal areas regarding laterality and orientation in the inferior, medial and superior frontal gyrus. We suggest that these changes affect adaptive sensory gating of temporal and spectral sound features along the auditory pathway, reflecting dysfunction in an extensive thalamo-cortical network implicated in predictive temporal adaptation to the auditory environment. Modulation of temporal characteristics of input signals might hence factor into a thalamo-cortical dysrhythmia profile of tinnitus, but could ultimately also establish new directions for treatment options for persons with tinnitus.
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Affiliation(s)
- Pia Brinkmann
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Universiteitssingel 40, 6229, Maastricht, The Netherlands.
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Universiteitssingel 40, 6229, Maastricht, The Netherlands
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Zuyderland Medical Center, Sittard/Heerlen, the Netherlands
| | - Marcus L F Janssen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, University of Maastricht, Universiteitssingel 40, 6229, Maastricht, The Netherlands
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12
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Altered functional connectivity of the thalamus in tinnitus patients is correlated with symptom alleviation after sound therapy. Brain Imaging Behav 2021; 14:2668-2678. [PMID: 31900891 DOI: 10.1007/s11682-019-00218-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Altered functional connectivity (FC) of the thalamus has been proven to be an important finding in tinnitus patients. Tinnitus can be effectively desensitized by sound therapy. However, it is still unclear whether and how sound therapy affects the FC of the thalamus. Resting-state functional magnetic resonance imaging data and anatomical data were longitudinally collected from 25 idiopathic tinnitus patients before and after 12 weeks of sound therapy by using adjusted narrow band noise and from 25 matched healthy controls at the same time interval without any intervention. The FC of bilateral thalami were analyzed by setting the left and right thalamus as the regions of interest. Significant main effect of group on the FC of the thalamus were found mainly in the key components of the default mode network, limbic network, salience network, cognitive control network, auditory network and occipital region. FC values between the thalamus, inferior frontal gyrus (IFG), and anterior cingulate cortex (ACC) featured higher values in the tinnitus group at baseline compared to the healthy controls and restoration in tinnitus patients after treatment. Decreased Tinnitus Handicap Inventory (THI) scores and decreased FC values between the right thalamus and right IFG were positively correlated (r = 0.476, P = 0.016). Abnormal FC of the thalamus is associated with multiple brain networks. Sound therapy has a normalizing effect on the enhanced FC of the thalamus-IFG and thalamus-ACC, representing decreased tinnitus attention control and less involvement of the noise-canceling system.
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13
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Kim E, Kang H, Noh TS, Oh SH, Suh MW. Auditory cortex hyperconnectivity before rTMS is correlated with tinnitus improvement. Neurologia 2021; 38:S0213-4853(21)00023-2. [PMID: 33722455 DOI: 10.1016/j.nrl.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/19/2020] [Accepted: 01/06/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Repetitive transcranial magnetic stimulation (rTMS) has been used as a potential treatment for tinnitus; however, its effectiveness is variable and unpredictable. We hypothesized that resting-state functional connectivity before rTMS may be correlated with rTMS treatment effectiveness. METHODS We applied 1-Hz rTMS to the left primary auditory (A1) and dorsolateral prefrontal cortices (DLPFC) of 10 individuals with tinnitus and 10 age-matched controls. Resting-state functional magnetic resonance imaging (fMRI) studies were performed approximately one week before rTMS. Seed-based connectivity analyses were conducted for each individual, with seed regions as rTMS target areas. RESULTS Compared to controls, the left superior temporal areas showed significantly increased positive connectivity with the left A1 and negative connectivity with the left DLPFC in the tinnitus group. The left frontoparietal and right cerebellar areas showed significantly increased negative connectivity with the left A1 and positive connectivity with the left DLPFC. Seed-based hyperconnectivity was correlated with tinnitus improvement (pre-rTMS vs. 2-week post-rTMS Tinnitus Handicap Inventory scores). Tinnitus improvement was significantly correlated with left A1 hyperconnectivity; however, no correlation was observed with left DLPFC connectivity. Positive rTMS outcomes were associated with significantly increased positive connectivity in bilateral superior temporal areas and significantly increased negative connectivity in bilateral frontal areas. CONCLUSIONS Our results suggest that oversynchronisation of left A1 connectivity before rTMS of the left A1 and DLPFC is associated with treatment effectiveness.
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Affiliation(s)
- E Kim
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - H Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea.
| | - T-S Noh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - S-H Oh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - M-W Suh
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea; Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea.
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14
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Hu J, Cui J, Xu JJ, Yin X, Wu Y, Qi J. The Neural Mechanisms of Tinnitus: A Perspective From Functional Magnetic Resonance Imaging. Front Neurosci 2021; 15:621145. [PMID: 33642982 PMCID: PMC7905063 DOI: 10.3389/fnins.2021.621145] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/05/2021] [Indexed: 12/18/2022] Open
Abstract
Tinnitus refers to sound perception in the absence of external sound stimulus. It has become a worldwide problem affecting all age groups especially the elderly. Tinnitus often accompanies hearing loss and some mood disorders like depression and anxiety. The comprehensive adverse effects of tinnitus on people determine the severity of tinnitus. Understanding the mechanisms of tinnitus and related discomfort may be beneficial to the prevention and treatment, and then getting patients out of tinnitus distress. Functional magnetic resonance imaging (fMRI) is a powerful technique for characterizing the intrinsic brain activity and making us better understand the tinnitus neural mechanism. In this article, we review fMRI studies published in recent years on the neuroimaging mechanisms of tinnitus. The results have revealed various neural network alterations in tinnitus patients, including the auditory system, limbic system, default mode network, attention system, and some other areas involved in memory, emotion, attention, and control. Moreover, changes in functional connectivity and neural activity in these networks are related to the perception, persistence, and severity of tinnitus. In summary, the neural mechanism of tinnitus is a complex regulatory mechanism involving multiple networks. Future research is needed to study these neural networks more accurately to refine the tinnitus models.
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Affiliation(s)
- Jinghua Hu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jinluan Cui
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jianwei Qi
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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15
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Zhang J, Firestone E, Elattma A. Animal Models of Tinnitus Treatment: Cochlear and Brain Stimulation. Curr Top Behav Neurosci 2021; 51:83-129. [PMID: 34282563 DOI: 10.1007/7854_2021_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromodulation, via stimulation of a variety of peripheral and central structures, is used to suppress tinnitus. However, investigative limitations in humans due to ethical reasons have made it difficult to decipher the mechanisms underlying treatment-induced tinnitus relief, so a number of animal models have arisen to address these unknowns. This chapter reviews animal models of cochlear and brain stimulation and assesses their modulatory effects on behavioral evidence of tinnitus and its related neural correlates. When a structure is stimulated, localized modulation, often presenting as downregulation of spontaneous neuronal spike firing rate, bursting and neurosynchrony, occurs within the brain area. Through anatomical projections and transmitter pathways, the interventions activate both auditory- and non-auditory structures by taking bottom-up ascending and top-down descending modes to influence their target brain structures. Furthermore, it is the brain oscillations that cochlear or brain stimulation evoke and connect the prefrontal cortex, striatal systems, and other limbic structures to refresh neural networks and relieve auditory, attentive, conscious, as well as emotional reactive aspects of tinnitus. This oscillatory neural network connectivity is achieved via the thalamocorticothalamic circuitry including the lemniscal and non-lemniscal auditory brain structures. Beyond existing technologies, the review also reveals opportunities for developing advanced animal models using new modalities to achieve precision neuromodulation and tinnitus abatement, such as optogenetic cochlear and/or brain stimulation.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Communication Sciences and Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, USA.
| | - Ethan Firestone
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ahmed Elattma
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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16
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Naples JG, Sadler S, Watson N, Miller LE, Alterman RL. A tale of two tinnituses: Does hearing status influence central tinnitus localization? Med Hypotheses 2020; 146:110444. [PMID: 33303306 DOI: 10.1016/j.mehy.2020.110444] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 11/12/2020] [Accepted: 11/29/2020] [Indexed: 11/19/2022]
Abstract
Tinnitus is a complex symptom that manifests as the perception of sound in the absence of external stimuli. There are various patient-related factors and co-morbidities associated with tinnitus, however, the impact of hearing status on tinnitus is poorly understood. Various works suggest that tinnitus may originate in the central nervous system (CNS). Reports of tinnitus resolution following central insult provide further support for this concept. Based on these reports of tinnitus resolution, a line of research evaluating deep brain stimulation (DBS) of the caudate as a therapy for tinnitus has emerged. The emerging data show early promise and independent evaluation of this work suggests that hearing status may influence localization of tinnitus within the caudate. We closely review the available reports of tinnitus resolution following central insult and tinnitus outcomes in DBS to hypothesize that the CNS origins of tinnitus may vary based on hearing status. Our interpretation of the available literature suggests that the anterior aspect of the caudate may be a location for tinnitus intervention in patients with normal hearing or mild hearing loss (HL) and more posterior locations in the caudate may be a region of intervention in patients with moderate/ severe HL. Ultimately, this concept may shift the paradigm of thought on tinnitus to offer clinically and anatomically relevant information with targeted therapeutic options.
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Affiliation(s)
- James G Naples
- Beth Israel Deaconess Medical Center, Harvard Medical School, Division of Otolaryngology-Head and Neck Surgery, 85 Binney St, Ground Floor, Boston, MA 02215, United States.
| | - Samantha Sadler
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States
| | - Nathan Watson
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, United States
| | - Lauren E Miller
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Division of Otolaryngology - Head and Neck Surgery, 243 Charles Street, Boston, MA 02114, United States
| | - Ron L Alterman
- Beth Israel Deaconess Medical Center, Harvard Medical School, Division of Neurosurgery, 110 Francis St, Suite 3B, Boston, MA 02215, United States
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17
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Gabr TA, Lasheen RM. Binaural Interaction in Tinnitus Patients. Audiol Neurootol 2020; 25:315-322. [PMID: 32403111 DOI: 10.1159/000507274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 03/13/2020] [Indexed: 11/19/2022] Open
Abstract
The auditory brainstem response (ABR) is a commonly used objective clinical measure for hearing evaluation. It can be also used to draw conclusions about the functioning of distinct stages of the auditory pathway including the binaural processing stages using the binaural interaction component (BIC) of the ABR. OBJECTIVE To study binaural processing in normal hearing subjects complaining of tinnitus. METHODS Sixty cases with bilateral normal peripheral hearing were included in this work, divided into 2 groups, i.e., group 1 (comprised of 30 healthy subjects representing the control group) and group 2 (comprised of 30 subjects with tinnitus representing the study group). All of the subjects were submitted to a basic audiological evaluation (including pure tone audiometry, speech audiometry, and immittancemetry) and ABR audiometry recorded in monaural and then binaural conditions. RESULTS In monaural recording, the tinnitus group showed significantly delayed latencies of waves I, III, and V in addition to significantly reduced wave I and III amplitudes when compared with the controls. Similar significant findings were found when binaural ABR responses were compared between both groups. Comparing BIC between both groups showed significant earlier BIC for latencies of waves I and V in the control group, while the BIC for amplitudes showed similar results in both groups. CONCLUSIONS These finding suggest the presence of binaural processing deficits in tinnitus patients at different levels along the ascending auditory pathway.
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Affiliation(s)
- Takwa A Gabr
- Audiovestibular Medicine, Faculty of Medicine, Kafrelsheikh University, Kafr El-Shaikh, Egypt
| | - Reham M Lasheen
- Audiovestibular Unit, Faculty of Medicine, Tanta University, Tanta, Egypt,
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18
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Abstract
Device-based clinical treatments for tinnitus are predominantly sound based and include ear-level sound generators, hearing aids, cochlear implants, and tinnitus treatment devices. They are intended for patients with bothersome tinnitus. Bothersome tinnitus is characterized by problems with sleep, concentration, and mood. Most people with bothersome tinnitus have hearing loss and would benefit from amplification; however, not all patients are willing to use hearing aids. Tinnitus treatment devices are available to assist those who are not good candidates for amplification, and include devices used while sleeping and devices used for specified periods during the day.
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19
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Kochilas HL, Cacace AT, Arnold A, Seidman MD, Tarver WB. Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing. Laryngoscope Investig Otolaryngol 2020; 5:286-296. [PMID: 32337360 PMCID: PMC7178458 DOI: 10.1002/lio2.364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/23/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE In individuals with chronic tinnitus, our interest was to determine whether daily low-level electrical stimulation of the vagus nerve paired with tones (paired-VNSt) for tinnitus suppression had any adverse effects on motor-speech production and physiological acoustics of sustained vowels. Similarly, we were also interested in evaluating for changes in pure-tone thresholds, word-recognition performance, and minimum-masking levels. Both voice and hearing functions were measured repeatedly over a period of 1 year. STUDY DESIGN Longitudinal with repeated-measures. METHODS Digitized samples of sustained frontal, midline, and back vowels (/e/, /o/, /ah/) were analyzed with computer software to quantify the degree of jitter, shimmer, and harmonic-to-noise ratio contained in these waveforms. Pure-tone thresholds, monosyllabic word-recognition performance, and MMLs were also evaluated for VNS alterations. Linear-regression analysis was the benchmark statistic used to document change over time in voice and hearing status from a baseline condition. RESULTS Most of the regression functions for the vocal samples and audiometric variables had slope values that were not significantly different from zero. Four of the nine vocal functions showed a significant improvement over time, whereas three of the pure tone regression functions at 2-4 kHz showed some degree of decline; all changes observed were for the left ear, all were at adjacent frequencies, and all were ipsilateral to the side of VNS. However, mean pure-tone threshold changes did not exceed 4.29 dB from baseline and therefore, would not be considered clinically significant. In some individuals, larger threshold shifts were observed. No significant regression/slope effects were observed for word-recognition or MMLs. CONCLUSION Quantitative voice analysis and assessment of audiometric variables showed minimal if any evidence of adverse effects using paired-VNSt over a treatment period of 1 year. Therefore, we conclude that paired-VNSt is a safe tool for tinnitus abatement in humans without significant side effects. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Helen L. Kochilas
- North Atlanta Ears, Nose, Throat & Allergy, AlpharettaGeorgia
- Present address:
North Atlanta Ears, Nose, Throat & AllergyAlpharettaGeorgia
| | - Anthony T. Cacace
- Department of Communication Sciences & Disorders, Wayne State University, DetroitMichigan
| | - Amy Arnold
- The Hearing Clinic, BrightonMichigan
- Present address:
The Hearing ClinicBrightonMichigan
| | - Michael D. Seidman
- Florida ENT Surgical Specialists, Florida Hospital Medical Group, Head & Neck Surgery Center of Florida, CelebrationFlorida
- Present address:
Florida Hospital Medical GroupHead & Neck Surgery Center of FloridaCelebrationFlorida
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20
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Deklerck AN, Marechal C, Pérez Fernández AM, Keppler H, Van Roost D, Dhooge IJM. Invasive Neuromodulation as a Treatment for Tinnitus: A Systematic Review. Neuromodulation 2019; 23:451-462. [DOI: 10.1111/ner.13042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/09/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Ann N. Deklerck
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
| | - Celine Marechal
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
| | | | - Hannah Keppler
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences Ghent University Ghent Belgium
- Department of Otorhinolaryngology Ghent University Hospital Ghent Belgium
| | - Dirk Van Roost
- Department of Neurosurgery Ghent University Hospital Ghent Belgium
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair Ghent University Ghent Belgium
| | - Ingeborg J. M. Dhooge
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
- Department of Otorhinolaryngology Ghent University Hospital Ghent Belgium
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21
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Han L, Na Z, Chunli L, Yuchen C, Pengfei Z, Hao W, Xu C, Peng Z, Zheng W, Zhenghan Y, Shusheng G, Zhenchang W. Baseline Functional Connectivity Features of Neural Network Nodes Can Predict Improvement After Sound Therapy Through Adjusted Narrow Band Noise in Tinnitus Patients. Front Neurosci 2019; 13:614. [PMID: 31333394 PMCID: PMC6620714 DOI: 10.3389/fnins.2019.00614] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/29/2019] [Indexed: 12/17/2022] Open
Abstract
Previous resting-state functional magnetic resonance imaging (fMRI) studies have shown neural connectivity alterations after the treatment of tinnitus. We aim to study the value of the baseline functional connectivity features of neural network nodes to predict outcomes of sound therapy through adjusted narrow band noise. The fMRI data of 27 untreated tinnitus patients and 27 matched healthy controls were analyzed. We calculated the graph-theoretical metric degree centrality (DC) to characterize the functional connectivity of the neural network nodes. Therapeutic outcomes are determined by the changes in the Tinnitus Handicap Inventory (THI) score after a 12-week intervention. The connectivity of 10 brain nodes in tinnitus patients was significantly increased at baseline. The functional connectivity of right insula, inferior parietal lobule (IPL), bilateral thalami, and left middle temporal gyrus was significantly modified with the sound therapy, and such changes correlated with THI changes in tinnitus patients. Receiver operating characteristic curve analyses revealed that the measurements from the five brain regions were effective at classifying improvement after therapy. After age, gender, and education correction, the adjusted area under the curve (AUC) values for the bilateral thalami were the highest (left, 0.745; right, 0.708). Our study further supported the involvement of the fronto-parietal-cingulate network in tinnitus and found that the connectivity of the thalamus at baseline is an object neuroimaging-based indicator to predict clinical outcome of sound therapy through adjusted narrow band noise.
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Affiliation(s)
- Lv Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zeng Na
- National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Liu Chunli
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.,Department of Otolaryngology, Affiliated Hospital of Chengde Medical College, Chengde, China
| | - Chen Yuchen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Zhao Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wang Hao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Cheng Xu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhang Peng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wang Zheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yang Zhenghan
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Gong Shusheng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wang Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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22
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Han L, Yawen L, Hao W, Chunli L, Pengfei Z, Zhengyu Z, Zhaodi W, Zhenghan Y, Shusheng G, Zhenchang W. Effects of sound therapy on resting‐state functional brain networks in patients with tinnitus: A graph‐theoretical‐based study. J Magn Reson Imaging 2019; 50:1731-1741. [PMID: 31095830 DOI: 10.1002/jmri.26796] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Lv Han
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Liu Yawen
- School of Biological Science and Medical EngineeringBeihang University Beijing China
| | - Wang Hao
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Liu Chunli
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical University Beijing China
- Department of OtolaryngologyAffiliated Hospital of Chengde Medical College Hebei China
| | - Zhao Pengfei
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Zhang Zhengyu
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Wang Zhaodi
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Yang Zhenghan
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Gong Shusheng
- School of Biological Science and Medical EngineeringBeihang University Beijing China
| | - Wang Zhenchang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
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23
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Low-intensity repetitive transcranial magnetic stimulation over prefrontal cortex in an animal model alters activity in the auditory thalamus but does not affect behavioural measures of tinnitus. Exp Brain Res 2019; 237:883-896. [DOI: 10.1007/s00221-018-05468-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 12/29/2018] [Indexed: 12/19/2022]
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24
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Rammo R, Ali R, Pabaney A, Seidman M, Schwalb J. Surgical Neuromodulation of Tinnitus: A Review of Current Therapies and Future Applications. Neuromodulation 2018; 22:380-387. [DOI: 10.1111/ner.12793] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/16/2018] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Richard Rammo
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
| | - Rushna Ali
- Department of Neurological SurgeryVanderbilt UniversityNashville TN USA
| | - Aqueel Pabaney
- Department of Neurosurgery, Grandview Medical CenterKettering Health NetworkDayton OH USA
| | - Michael Seidman
- Department of OtolaryngologyFlorida Hospital Celebration HealthCelebration FL USA
| | - Jason Schwalb
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
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25
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Reddy KVK, Chaitanya VK, Babu GR. Efficacy of Tinnitus Retraining Therapy, A Modish Management of Tinnitus: Our Experience. Indian J Otolaryngol Head Neck Surg 2018; 71:95-98. [PMID: 30906722 DOI: 10.1007/s12070-018-1392-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/03/2018] [Indexed: 11/28/2022] Open
Abstract
Tinnitus retraining therapy involves masking of tinnitus at sound perception level in combination with structured counselling sessions. To assess efficacy of Tinnitus retraining therapy (TRT) in Patients of Tinnitus with Sensori Neural Hearing loss. Prospective study was carried out on patients who presented with Tinnitus in ENT OPD from December 2015 to December 2016. Severity of tinnitus was documented using Tinnitus handicap inventory scale. Response to tinnitus is evaluated at the end of 3 months. In our study 57 patients in age group 21-78 years were selected and Tinnitus retraining therapy was administered. Most of patients had moderate (75.43%) perception of tinnitus before initiation of therapy. After completion of therapy tinnitus completely disappeared in 34 (59.65%) patients. Improvement in Tinnitus perception was observed in total of 49 (85.96%) patients. There was no improvement in Tinnitus perception in 8 (14.03%) patients. TRT aims in reducing the tinnitus perception by inducing habituation of tinnitus-induced reactions allowing patients to achieve control over their tinnitus, live a normal life, and participate in everyday activities.
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Affiliation(s)
- K Vasu Kumar Reddy
- ENT, Quarters No 97, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - V Krishna Chaitanya
- ENT, Quarters No 97, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
| | - G Ramesh Babu
- ENT, Quarters No 97, Narayana Medical College and Hospital, Chinthareddypalem, Nellore, Andhra Pradesh 524003 India
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26
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Ahsan SF, Luo H, Zhang J, Kim E, Xu Y. An animal model of deep brain stimulation for treating tinnitus: A proof of concept study. Laryngoscope 2017; 128:1213-1222. [PMID: 28925013 DOI: 10.1002/lary.26876] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/21/2017] [Accepted: 08/01/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE This proof-of-concept study aimed to demonstrate therapeutic effects of deep brain stimulation (DBS) on noise-induced tinnitus. STUDY DESIGN Experimental animal study. METHODS After Institutional Animal Care and Use Committee approval, nine adult rats were implanted in the caudate nucleus with custom-made electrode array. The rats were exposed to noise to induce tinnitus. Auditory brainstem response was performed to evaluate hearing threshold changes. Noise-induced tinnitus and its suppression by DBS were evaluated using the gap-detection acoustic startle reflex behavioral paradigm and electrophysiological evaluation of modulatory effects on neural correlates of tinnitus. Various stimulation parameters were used to determine the most effective ones in affecting behavioral changes, along with corresponding neural activity in the caudate nucleus. The correlation between the caudate nucleus and auditory cortex also was determined. Analysis of variance with Bonferroni correction was performed to examine DBS-induced effects on behavioral evidence of tinnitus. RESULTS Bursting activity, a neural marker of tinnitus, was noted to decrease compared to baseline in tinnitus (+) animals. After stimulation, spontaneous and bursting activity increased in the tinnitus (+) animals but decreased in the tinnitus (-) animals. Behavioral data suggested suppression of tinnitus after DBS. These effects lasted up to 5 days. To our knowledge, this is the first development of an animal model to test deep brain stimulation of the caudate region for the treatment of tinnitus. CONCLUSIONS Deep brain stimulation of the caudate nucleus can modulate tinnitus in a rat model of tinnitus. LEVEL OF EVIDENCE NA. Laryngoscope, 128:1213-1222, 2018.
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Affiliation(s)
- Syed F Ahsan
- Otology/Neurotology, Department of Otolaryngology/Head and Neck Surgery, Kaiser Permanente-Orange County, Anaheim, California
| | - Hao Luo
- Department of Otolaryngology/Head and Neck Surgery, Wayne State University, Detroit, Michigan, U.S.A
| | - Jinsheng Zhang
- Department of Otolaryngology/Head and Neck Surgery, Wayne State University, Detroit, Michigan, U.S.A.,Department of Communication Sciences and Disorders, Wayne State University, Detroit, Michigan, U.S.A
| | - Eric Kim
- Department of Engineering, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
| | - Yong Xu
- Department of Engineering, Wayne State University School of Medicine, Detroit, Michigan, U.S.A
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Diges I, Simón F, Cobo P. Assessing Auditory Processing Deficits in Tinnitus and Hearing Impaired Patients with the Auditory Behavior Questionnaire. Front Neurosci 2017; 11:187. [PMID: 28428741 PMCID: PMC5382167 DOI: 10.3389/fnins.2017.00187] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 03/21/2017] [Indexed: 12/21/2022] Open
Abstract
Background and Purpose: Auditory processing disorders (APD), tinnitus and hearing loss (HL) are typical issues reported by patients in audiologic clinics. These auditory impairments can be concomitant or mutually excluding. APD are not necessarily accompanied by significant HL, whereas many adults exhibit peripheral HL and typical cognitive deficits often associated with APD. Since HL, tinnitus and APD affects to several parts of the ascending auditory pathway from the periphery to the auditory cortex, there could be some interrelationship between them. For instance, tinnitus has been reported to degrade the auditory localization capacity. Tinnitus is believed to be triggered by deafferentation of normal peripheral input to the central auditory system. This peripheral deficit can be accompanied by HL or not, since a type of permanent cochlear damage (thus deafferentation) without an elevation of hearing thresholds might persist. Therefore, a combined study of APD, tinnitus and HL on the same cohort of patients can be audiologically relevant and worthy. Methods: Statistical analysis is applied to a cohort of 305 patients attending an audiology clinic in Madrid (Spain). This group of patients is first categorized in four subgroups, namely, HLTG (with tinnitus and HL), NHLTG (with tinnitus and without HL), HLNTG (with HL but no tinnitus), and NHLNTG (neither tinnitus nor HL). The statistical variables include Age, Average Auditory Threshold (ATT), for assessing HL, Tinnitus Handicap Inventory (THI), for measuring tinnitus, and a new 25-item Auditory Behavior Questionnaire (ABQ), for scoring APD. Factor analysis is applied to arrange these items into 4 subscales. The internal consistency reliability of this ABQ is confirmed by calculating Cronbach's coefficients α. The test-retest reliability is assessed by the intraclass correlation coefficients, ICC. Statistical techniques applied to the data set include descriptive analysis of variables and Spearman rank correlations (ρ) between them. Results: Overall reliability of ABQ is confirmed by an α value of 0.89 and by an ICC of 0.91. Regarding the internal consistency reliability, the four subscales prove a fairly good consistency with α coefficients above 0.7. Average values of statistical variables show significantly lower age of patients with tinnitus and no HL, which can provide a cue of noise overexposure of this segment of population. These younger patients show also decreased ABQ and similar THI in comparison with patients in the other subgroups. A strong correlation (ρ = 0.63) was found between AAT and Age for the HLNTG subgroup. For the HLTG subgroup, a moderate correlation (ρ = 0.44) was found between ABQ and THI. Conclusion: The utilized questionnaire (ABQ), together with AAT and THI, can help to study comorbid hearing impairments in patients regularly attending an audiological clinic.
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Affiliation(s)
- Isabel Diges
- ACURE-Tinnitus and Hyperacusis ClinicMadrid, Spain
| | - Francisco Simón
- Institute of Physical and Information Technologies, Consejo Superior de Investigaciones Científicas (CSIC)Madrid, Spain
| | - Pedro Cobo
- Institute of Physical and Information Technologies, Consejo Superior de Investigaciones Científicas (CSIC)Madrid, Spain
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Saldaña E. All the way from the cortex: a review of auditory corticosubcollicular pathways. THE CEREBELLUM 2016; 14:584-96. [PMID: 26142291 DOI: 10.1007/s12311-015-0694-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Enrico Mugnaini has devoted part of his long and fruitful neuroscientific career to investigating the structural similarities between the cerebellar cortex and one of the first relay stations of the mammalian auditory pathway: the dorsal cochlear nucleus. The hypothesis of the cerebellar-like nature of the superficial layers of the dorsal cochlear nucleus received definitive support with the discovery and extensive characterization in his laboratory of unipolar brush cells, a neuron type unique to certain regions of the cerebellar cortex and to the granule cell domains of the cochlear nuclei. Paradoxically, a different line of research carried out in his laboratory revealed that, unlike the mammalian cerebellar cortex, the dorsal cochlear nucleus receives direct projections from the cerebral cortex, a fact that constitutes one of the main differences between the cerebellum and the dorsal cochlear nucleus. In an article published in 1995, Mugnaini's group described in detail the novel direct projections from the rat auditory neocortex to various subcollicular auditory centers, including the nucleus sagulum, the paralemniscal regions, the superior olivary complex, and the cochlear nuclei (Feliciano et al., Auditory Neuroscience 1995; 1:287-308). This review gives Enrico Mugnaini credit for his seminal contribution to the knowledge of auditory corticosubcollicular projections and summarizes how this growing field has evolved in the last 20 years.
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Affiliation(s)
- Enrique Saldaña
- Neurohistology Laboratory, Neuroscience Institute of Castilla y León (INCyL), University of Salamanca, 37007, Salamanca, Spain. .,Department of Cell Biology and Pathology, Medical School, University of Salamanca, 37007, Salamanca, Spain. .,Institute of Biomedical Research of Salamanca (IBSAL), 37007, Salamanca, Spain.
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Greenberg D, Meerton L, Graham J, Vickers D. Developing an assessment approach for perceptual changes to tinnitus sound characteristics for adult cochlear implant recipients. Int J Audiol 2016; 55:392-404. [PMID: 27146518 DOI: 10.3109/14992027.2016.1172391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the impact of cochlear implantation on tinnitus suppression, characteristics, localization, and duration. DESIGN A cochlear implant (CI) recipient-focused postal questionnaire survey. STUDY SAMPLE The questionnaire was posted, with consent, to 100 adults who had received a unilateral CI at the RNTNEH between 1988 and 1999. All adults spoke English as their first language and were postlingually deafened. Sixty-eight adults (38 female, 29 male, one unspecified) aged 31-80 years (mean 61 years) completed and returned the questionnaire without interview. RESULTS With the processor 'ON', CI recipients experienced total or partial suppression of tinnitus ipsilateral to their CI in 57% of cases, and in 43% where tinnitus was perceived contralateral to the CI. The percentage of CI recipients who experienced high tone tinnitus was reduced from 60% pre-implant to 29% post-implant with the processor 'ON' while pulsatile tinnitus was reduced from 38% pre-implant to 13% post-implant. CIs were also found to reduce the tonal complexity and duration, and change the source localization of tinnitus post-implantation. CONCLUSIONS Perceptual changes to tinnitus can take place post-implantation. Changes can occur within the four categories explored: tinnitus suppression, characteristics, localization, and duration of awareness per day.
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Affiliation(s)
| | - Leah Meerton
- b Royal National Throat , Nose & Ear Hospital , London , UK
| | - John Graham
- b Royal National Throat , Nose & Ear Hospital , London , UK
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Prognostic value of mean platelet volume on tinnitus. The Journal of Laryngology & Otology 2015; 130:162-5. [PMID: 26653396 DOI: 10.1017/s0022215115003254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume. METHODS This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups. RESULTS Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm(3) in the study group and 7.28 ± 0.56 μm(3) in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05). CONCLUSION The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.
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Gao PP, Zhang JW, Fan SJ, Sanes DH, Wu EX. Auditory midbrain processing is differentially modulated by auditory and visual cortices: An auditory fMRI study. Neuroimage 2015; 123:22-32. [PMID: 26306991 DOI: 10.1016/j.neuroimage.2015.08.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 08/15/2015] [Accepted: 08/18/2015] [Indexed: 11/19/2022] Open
Abstract
The cortex contains extensive descending projections, yet the impact of cortical input on brainstem processing remains poorly understood. In the central auditory system, the auditory cortex contains direct and indirect pathways (via brainstem cholinergic cells) to nuclei of the auditory midbrain, called the inferior colliculus (IC). While these projections modulate auditory processing throughout the IC, single neuron recordings have samples from only a small fraction of cells during stimulation of the corticofugal pathway. Furthermore, assessments of cortical feedback have not been extended to sensory modalities other than audition. To address these issues, we devised blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) paradigms to measure the sound-evoked responses throughout the rat IC and investigated the effects of bilateral ablation of either auditory or visual cortices. Auditory cortex ablation increased the gain of IC responses to noise stimuli (primarily in the central nucleus of the IC) and decreased response selectivity to forward species-specific vocalizations (versus temporally reversed ones, most prominently in the external cortex of the IC). In contrast, visual cortex ablation decreased the gain and induced a much smaller effect on response selectivity. The results suggest that auditory cortical projections normally exert a large-scale and net suppressive influence on specific IC subnuclei, while visual cortical projections provide a facilitatory influence. Meanwhile, auditory cortical projections enhance the midbrain response selectivity to species-specific vocalizations. We also probed the role of the indirect cholinergic projections in the auditory system in the descending modulation process by pharmacologically blocking muscarinic cholinergic receptors. This manipulation did not affect the gain of IC responses but significantly reduced the response selectivity to vocalizations. The results imply that auditory cortical gain modulation is mediated primarily through direct projections and they point to future investigations of the differential roles of the direct and indirect projections in corticofugal modulation. In summary, our imaging findings demonstrate the large-scale descending influences, from both the auditory and visual cortices, on sound processing in different IC subdivisions. They can guide future studies on the coordinated activity across multiple regions of the auditory network, and its dysfunctions.
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Affiliation(s)
- Patrick P Gao
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Jevin W Zhang
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Shu-Juan Fan
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Dan H Sanes
- Center for Neural Science, New York University, New York, NY 10003, United States
| | - Ed X Wu
- Laboratory of Biomedical Imaging and Signal Processing, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Electrical and Electronic Engineering, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Anatomy, The University of Hong Kong, Pokfulam, Hong Kong SAR, China; Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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Descending and tonotopic projection patterns from the auditory cortex to the inferior colliculus. Neuroscience 2015; 300:325-37. [DOI: 10.1016/j.neuroscience.2015.05.032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 04/27/2015] [Accepted: 05/14/2015] [Indexed: 11/20/2022]
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Markovitz CD, Hogan PS, Wesen KA, Lim HH. Pairing broadband noise with cortical stimulation induces extensive suppression of ascending sensory activity. J Neural Eng 2015; 12:026006. [PMID: 25686163 PMCID: PMC4359690 DOI: 10.1088/1741-2560/12/2/026006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The corticofugal system can alter coding along the ascending sensory pathway. Within the auditory system, electrical stimulation of the auditory cortex (AC) paired with a pure tone can cause egocentric shifts in the tuning of auditory neurons, making them more sensitive to the pure tone frequency. Since tinnitus has been linked with hyperactivity across auditory neurons, we sought to develop a new neuromodulation approach that could suppress a wide range of neurons rather than enhance specific frequency-tuned neurons. APPROACH We performed experiments in the guinea pig to assess the effects of cortical stimulation paired with broadband noise (PN-Stim) on ascending auditory activity within the central nucleus of the inferior colliculus (CNIC), a widely studied region for AC stimulation paradigms. MAIN RESULTS All eight stimulated AC subregions induced extensive suppression of activity across the CNIC that was not possible with noise stimulation alone. This suppression built up over time and remained after the PN-Stim paradigm. SIGNIFICANCE We propose that the corticofugal system is designed to decrease the brain's input gain to irrelevant stimuli and PN-Stim is able to artificially amplify this effect to suppress neural firing across the auditory system. The PN-Stim concept may have potential for treating tinnitus and other neurological disorders.
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Affiliation(s)
- Craig D. Markovitz
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Patrick S. Hogan
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Kyle A. Wesen
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Hubert H. Lim
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
- University of Minnesota, Department of Otolaryngology-Head and Neck Surgery, Minneapolis, MN USA
- University of Minnesota, Institute for Translational Neuroscience, Minneapolis, MN USA
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Markovitz CD, Smith BT, Gloeckner CD, Lim HH. Investigating a new neuromodulation treatment for brain disorders using synchronized activation of multimodal pathways. Sci Rep 2015; 5:9462. [PMID: 25804410 PMCID: PMC4372796 DOI: 10.1038/srep09462] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/06/2015] [Indexed: 11/21/2022] Open
Abstract
Neuromodulation is an increasingly accepted treatment for neurological and psychiatric disorders but is limited by its invasiveness or its inability to target deep brain structures using noninvasive techniques. We propose a new concept called Multimodal Synchronization Therapy (mSync) for achieving targeted activation of the brain via noninvasive and precisely timed activation of auditory, visual, somatosensory, motor, cognitive, and limbic pathways. In this initial study in guinea pigs, we investigated mSync using combined activation of just the auditory and somatosensory pathways, which induced differential and timing dependent plasticity in neural firing within deep brain and cortical regions of the auditory system. Furthermore, by varying the location of somatosensory stimulation across the body, we increased or decreased spiking activity across different neurons. These encouraging results demonstrate the feasibility of systematically modulating the brain using mSync. Considering that hearing disorders such as tinnitus and hyperacusis have been linked to abnormal and hyperactive firing patterns within the auditory system, these results open up the possibility for using mSync to decrease this pathological activity by varying stimulation parameters. Incorporating multiple types of pathways beyond just auditory and somatosensory inputs and using other activation patterns may enable treatment of various brain disorders.
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Affiliation(s)
- Craig D Markovitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN USA
| | - Benjamin T Smith
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN USA
| | - Cory D Gloeckner
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN USA
| | - Hubert H Lim
- 1] Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN USA [2] Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN USA [3] Institute for Translational Neuroscience, University of Minnesota, Minneapolis, MN USA
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Altered inhibitory control and increased sensitivity to cross-modal interference in tinnitus during auditory and visual tasks. PLoS One 2015; 10:e0120387. [PMID: 25763867 PMCID: PMC4357462 DOI: 10.1371/journal.pone.0120387] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 01/23/2015] [Indexed: 12/31/2022] Open
Abstract
Tinnitus is the perception of sound in the absence of external stimulus. Currently, the pathophysiology of tinnitus is not fully understood, but recent studies indicate that alterations in the brain involve non-auditory areas, including the prefrontal cortex. In experiment 1, we used a go/no-go paradigm to evaluate the target detection speed and the inhibitory control in tinnitus participants (TP) and control subjects (CS), both in unimodal and bimodal conditions in the auditory and visual modalities. We also tested whether the sound frequency used for target and distractors affected the performance. We observed that TP were slower and made more false alarms than CS in all unimodal auditory conditions. TP were also slower than CS in the bimodal conditions. In addition, when comparing the response times in bimodal and auditory unimodal conditions, the expected gain in bimodal conditions was present in CS, but not in TP when tinnitus-matched frequency sounds were used as targets. In experiment 2, we tested the sensitivity to cross-modal interference in TP during auditory and visual go/no-go tasks where each stimulus was preceded by an irrelevant pre-stimulus in the untested modality (e.g. high frequency auditory pre-stimulus in visual no/no-go condition). We observed that TP had longer response times than CS and made more false alarms in all conditions. In addition, the highest false alarm rate occurred in TP when tinnitus-matched/high frequency sounds were used as pre-stimulus. We conclude that the inhibitory control is altered in TP and that TP are abnormally sensitive to cross-modal interference, reflecting difficulties to ignore irrelevant stimuli. The fact that the strongest interference effect was caused by tinnitus-like auditory stimulation is consistent with the hypothesis according to which such stimulations generate emotional responses that affect cognitive processing in TP. We postulate that executive functions deficits play a key-role in the perception and maintenance of tinnitus.
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Krick CM, Grapp M, Daneshvar-Talebi J, Reith W, Plinkert PK, Bolay HV. Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy. Front Neurosci 2015; 9:49. [PMID: 25745385 PMCID: PMC4333796 DOI: 10.3389/fnins.2015.00049] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/04/2015] [Indexed: 12/19/2022] Open
Abstract
Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-min sessions of individualized therapy implemented over 1 week. Clinical improvement and long-term effects over several years have previously been published. However, the underlying neural basis of the therapy's success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG) and healthy active controls (AC). Non-treated patients were also included as passive controls (PTC). As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (Two-Way ANOVA) revealed structural gray matter (GM) increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG vs. AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be assumed.
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Affiliation(s)
- Christoph M Krick
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Miriam Grapp
- German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
| | | | - Wolfgang Reith
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital for Ear, Nose, and Throat, University of Heidelberg Heidelberg, Germany
| | - Hans Volker Bolay
- Music Therapy Tinnitus Outpatient Department, German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
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The olivocochlear reflex strength and cochlear sensitivity are independently modulated by auditory cortex microstimulation. J Assoc Res Otolaryngol 2015; 16:223-40. [PMID: 25663383 DOI: 10.1007/s10162-015-0509-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/21/2015] [Indexed: 12/20/2022] Open
Abstract
In mammals, efferent projections to the cochlear receptor are constituted by olivocochlear (OC) fibers that originate in the superior olivary complex. Medial and lateral OC neurons make synapses with outer hair cells and with auditory nerve fibers, respectively. In addition to the OC system, there are also descending projections from the auditory cortex that are directed towards the thalamus, inferior colliculus, cochlear nucleus, and superior olivary complex. Olivocochlear function can be assessed by measuring a brainstem reflex mediated by auditory nerve fibers, cochlear nucleus neurons, and OC fibers. Although it is known that the OC reflex is activated by contralateral acoustic stimulation and produces a suppression of cochlear responses, the influence of cortical descending pathways in the OC reflex is largely unknown. Here, we used auditory cortex electrical microstimulation in chinchillas to study a possible cortical modulation of cochlear and auditory nerve responses to tones in the absence and presence of contralateral noise. We found that cortical microstimulation produces two different peripheral modulations: (i) changes in cochlear sensitivity evidenced by amplitude modulation of cochlear microphonics and auditory nerve compound action potentials and (ii) enhancement or suppression of the OC reflex strength as measured by auditory nerve responses, which depended on the intersubject variability of the OC reflex. Moreover, both corticofugal effects were not correlated, suggesting the presence of two functionally different efferent pathways. These results demonstrate that auditory cortex electrical microstimulation independently modulates the OC reflex strength and cochlear sensitivity.
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Partial to complete suppression of unilateral noise-induced tinnitus in rats after cyclobenzaprine treatment. J Assoc Res Otolaryngol 2014; 16:263-72. [PMID: 25526855 DOI: 10.1007/s10162-014-0500-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/25/2014] [Indexed: 12/24/2022] Open
Abstract
Some forms of tinnitus are believed to arise from abnormal central nervous system activity following a single or repeated noise exposure, for which there are no widely accepted pharmacological treatments. One central site that could be related to tinnitus awareness or modulation is the locus coeruleus, a brainstem structure associated with stress, arousal, and attention. In the present study, we evaluated the effects of cyclobenzaprine, a drug known to act on the rat locus coeruleus, on noise-induced tinnitus using Gap Prepulse Inhibition of the Acoustic Startle (GPIAS). In untreated rats, brief silent gaps presented prior to a 5-10-kHz bandpass startling stimulus produced robust GPIAS. Treatment with cyclobenzaprine alone had no effect on the ability of gaps to suppress the startle response. When animals were exposed to intense narrow-band (126 dB SPL, 16 kHz, 100 Hz BW) unilateral noise, GPIAS was significantly reduced, suggesting the presence of tinnitus. Following the noise exposure, a subset of rats that maintained a robust startle response continued to show GPIAS impairment at 6-20 kHz, 40 days post-noise, suggesting chronic tinnitus. When this subset of animals was treated with cyclobenzaprine, at a dose that had no significant effects on the startle response (0.5 mg/kg), GPIAS recovered partially or to near baseline levels at the affected frequencies. These results were consistent with the absence of tinnitus. By 48 h post-treatment, evidence of tinnitus re-emerged. Our results suggest that cyclobenzaprine was effective in transiently suppressing noise-induced tinnitus in rats.
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Lanting CP, de Kleine E, Langers DRM, van Dijk P. Unilateral tinnitus: changes in connectivity and response lateralization measured with FMRI. PLoS One 2014; 9:e110704. [PMID: 25329557 PMCID: PMC4203817 DOI: 10.1371/journal.pone.0110704] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 09/25/2014] [Indexed: 12/26/2022] Open
Abstract
Tinnitus is a percept of sound that is not related to an acoustic source outside the body. For many forms of tinnitus, mechanisms in the central nervous system are believed to play a role in the pathology. In this work we specifically assessed possible neural correlates of unilateral tinnitus. Functional magnetic resonance imaging (fMRI) was used to investigate differences in sound-evoked neural activity between controls, subjects with left-sided tinnitus, and subjects with right-sided tinnitus. We assessed connectivity patterns between auditory nuclei and the lateralization of the sound-evoked responses. Interestingly, these response characteristics did not relate to the laterality of tinnitus. The lateralization for left- or right ear stimuli, as expressed in a lateralization index, was considerably smaller in subjects with tinnitus compared to that in controls, reaching significance in the right primary auditory cortex (PAC) and the right inferior colliculus (IC). Reduced functional connectivity between the brainstem and the cortex was observed in subjects with tinnitus. These differences are consistent with two existing models that relate tinnitus to i) changes in the corticothalamic feedback loops or ii) reduced inhibitory effectiveness between the limbic system and the thalamus. The vermis of the cerebellum also responded to monaural sound in subjects with unilateral tinnitus. In contrast, no cerebellar response was observed in control subjects. This suggests the involvement of the vermis of the cerebellum in unilateral tinnitus.
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Affiliation(s)
- Cornelis P. Lanting
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands
- * E-mail:
| | - Emile de Kleine
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands
| | - Dave R. M. Langers
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- National Institute for Health Research, Nottingham Hearing Biomedical Research Unit, School of Clinical Sciences, University of Nottingham, Queen’s Medical Centre, Nottingham, United Kingdom
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands
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40
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Kalappa BI, Brozoski TJ, Turner JG, Caspary DM. Single unit hyperactivity and bursting in the auditory thalamus of awake rats directly correlates with behavioural evidence of tinnitus. J Physiol 2014; 592:5065-78. [PMID: 25217380 DOI: 10.1113/jphysiol.2014.278572] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Tinnitus is an auditory percept without an environmental acoustic correlate. Contemporary tinnitus models hypothesize tinnitus to be a consequence of maladaptive plasticity-induced disturbance of excitation-inhibition homeostasis, possibly convergent on medial geniculate body (MGB, auditory thalamus) and related neuronal networks. The MGB is an obligate acoustic relay in a unique position to gate auditory signals to higher-order auditory and limbic centres. Tinnitus-related maladaptive plastic changes of MGB-related neuronal networks may affect the gating function of MGB and enhance gain in central auditory and non-auditory neuronal networks, resulting in tinnitus. The present study examined the discharge properties of MGB neurons in the sound-exposure gap inhibition animal model of tinnitus. MGB single unit responses were obtained from awake unexposed controls and sound-exposed adult rats with behavioural evidence of tinnitus. MGB units in animals with tinnitus exhibited enhanced spontaneous firing, altered burst properties and increased rate-level function slope when driven by broadband noise and tones at the unit's characteristic frequency. Elevated patterns of neuronal activity and altered bursting showed a significant positive correlation with animals' tinnitus scores. Altered activity of MGB neurons revealed additional features of auditory system plasticity associated with tinnitus, which may provide a testable assay for future therapeutic and diagnostic development.
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Affiliation(s)
- Bopanna I Kalappa
- Southern Illinois University School of Medicine Department of Pharmacology, Springfield, IL, USA
| | - Thomas J Brozoski
- Southern Illinois University School of Medicine Department of Surgery, Division of Otolaryngology, Springfield, IL, USA
| | - Jeremy G Turner
- Southern Illinois University School of Medicine Department of Surgery, Division of Otolaryngology, Springfield, IL, USA Department of Psychology-Illinois College, Jacksonville, IL, USA
| | - Donald M Caspary
- Southern Illinois University School of Medicine Department of Pharmacology, Springfield, IL, USA Southern Illinois University School of Medicine Department of Surgery, Division of Otolaryngology, Springfield, IL, USA
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41
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Luo H, Pace E, Zhang X, Zhang J. Blast-Induced tinnitus and spontaneous firing changes in the rat dorsal cochlear nucleus. J Neurosci Res 2014; 92:1466-77. [DOI: 10.1002/jnr.23424] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 11/05/2022]
Affiliation(s)
- Hao Luo
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Edward Pace
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Xueguo Zhang
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
| | - Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery; Wayne State University School of Medicine; Detroit Michigan
- Department of Communication Sciences and Disorders; Wayne State University College of Liberal Arts and Sciences; Detroit Michigan
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42
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Boyen K, de Kleine E, van Dijk P, Langers DR. Tinnitus-related dissociation between cortical and subcortical neural activity in humans with mild to moderate sensorineural hearing loss. Hear Res 2014; 312:48-59. [DOI: 10.1016/j.heares.2014.03.001] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Revised: 02/21/2014] [Accepted: 03/04/2014] [Indexed: 01/17/2023]
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43
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Shekhawat GS, Searchfield GD, Stinear CM. Randomized Trial of Transcranial Direct Current Stimulation and Hearing Aids for Tinnitus Management. Neurorehabil Neural Repair 2013; 28:410-9. [DOI: 10.1177/1545968313508655] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background. The perception of sound in the absence of an external sound is tinnitus. Tinnitus can have a severe negative impact on quality of life. Objective. This trial investigated whether multisession anodal transcranial direct current stimulation (tDCS) of the left temporoparietal area would enhance sound therapy from hearing aids. Methods. Forty participants (mean age = 54 years) experiencing chronic tinnitus (minimum 2 years) completed a 7-month long double-blind randomized clinical trial. Participants were randomized into 2 groups: control receiving sham tDCS and experimental receiving tDCS. Each group underwent multisession (5 consecutive sessions with 24-hour gap) anodal tDCS (2 mA intensity and 20 minutes duration) of the left temporoparietal area, followed by hearing aid use for 6 months. The impact of tDCS and hearing aid use on tinnitus was assessed using questionnaires (primary measure: Tinnitus Functional Index) and minimum masking level measurement. Results. There was a significant reduction in the overall Tinnitus Functional Index score with time, F(2, 37) = 11.9, P = .0001, for both the groups. Similar patterns were seen for secondary measures. tDCS appeared to have a positive effect on minimum masking levels but not questionnaire responses. Conclusions. After 3 months of hearing aid use, there were significant improvements in tinnitus, which were sustained at 6 months of use. The hearing aid effects appeared independent of tDCS. Further investigations of tDCS or other neuromodulators priming the auditory system for sound therapy based tinnitus treatments are warranted.
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Affiliation(s)
| | - Grant D. Searchfield
- University of Auckland, Auckland, New Zealand
- Tinnitus Research Initiative, Regensburg, Germany
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44
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Johnson MD, Lim HH, Netoff TI, Connolly AT, Johnson N, Roy A, Holt A, Lim KO, Carey JR, Vitek JL, He B. Neuromodulation for brain disorders: challenges and opportunities. IEEE Trans Biomed Eng 2013; 60:610-24. [PMID: 23380851 PMCID: PMC3724171 DOI: 10.1109/tbme.2013.2244890] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The field of neuromodulation encompasses a wide spectrum of interventional technologies that modify pathological activity within the nervous system to achieve a therapeutic effect. Therapies including deep brain stimulation, intracranial cortical stimulation, transcranial direct current stimulation, and transcranial magnetic stimulation have all shown promising results across a range of neurological and neuropsychiatric disorders. While the mechanisms of therapeutic action are invariably different among these approaches, there are several fundamental neuroengineering challenges that are commonly applicable to improving neuromodulation efficacy. This paper reviews the state-of-the-art of neuromodulation for brain disorders and discusses the challenges and opportunities available for clinicians and researchers interested in advancing neuromodulation therapies.
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Affiliation(s)
- Matthew D Johnson
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA.
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45
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Luo H, Zhang X, Nation J, Pace E, Lepczyk L, Zhang J. Tinnitus suppression by electrical stimulation of the rat dorsal cochlear nucleus. Neurosci Lett 2012; 522:16-20. [PMID: 22683504 DOI: 10.1016/j.neulet.2012.05.072] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2012] [Revised: 04/25/2012] [Accepted: 05/28/2012] [Indexed: 11/18/2022]
Abstract
Previous studies indicate that the dorsal cochlear nucleus (DCN) may serve as a generator and/or modulator of noise-induced tinnitus. This prompted an interest to investigate the modulatory role of the DCN in tinnitus suppression. In this study, we chronically implanted the DCN of rats with behavioral evidence of intense tone-induced tinnitus. Behavioral evidence of tinnitus was measured using a gap detection acoustic startle reflex paradigm. Our results demonstrated that electrical stimulation of the DCN suppressed behavioral evidence of tinnitus, especially at high frequencies. The data suggest that the DCN may be used as a target to suppress tinnitus through a bottom-up neuromodulation approach. The underlying mechanism of DCN-stimulation-induced tinnitus suppression was discussed by comparing it with other stimulation modalities.
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Affiliation(s)
- Hao Luo
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 Saint Antoine, Detroit, MI 48201, USA
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