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Svobodová V, Profant O, Škoch A, Tintěra J, Tóthová D, Chovanec M, Čapková D, Syka J. The effect of aging, hearing loss, and tinnitus on white matter in the human auditory system revealed with fixel-based analysis. Front Aging Neurosci 2024; 15:1283660. [PMID: 38264549 PMCID: PMC10803717 DOI: 10.3389/fnagi.2023.1283660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/12/2023] [Indexed: 01/25/2024] Open
Abstract
Introduction Aging negatively influences the structure of the human brain including the white matter. The objective of our study was to identify, using fixel-based morphometry, the age induced changes in the pathways connecting several regions of the central auditory system (inferior colliculus, Heschl's gyrus, planum temporale) and the pathways connecting these structures with parts of the limbic system (anterior insula, hippocampus and amygdala). In addition, we were interested in the extent to which the integrity of these pathways is influenced by hearing loss and tinnitus. Methods Tractographic data were acquired using a 3 T MRI in 79 volunteers. The participants were categorized into multiple groups in accordance with their age, auditory thresholds and tinnitus status. Fixel-based analysis was utilized to identify alterations in the subsequent three parameters: logarithm of fiber cross-section, fiber density, fiber density and cross-section. Two modes of analysis were used: whole brain analysis and targeted analysis using fixel mask, corresponding to the pathways connecting the aforementioned structures. Results A significantly negative effect of aging was present for all fixel-based metrics, namely the logarithm of the fiber cross-section, (7 % fixels in whole-brain, 14% fixels in fixel mask), fiber density (5 % fixels in whole-brain, 15% fixels in fixel mask), fiber density and cross section (7 % fixels in whole-brain, 19% fixels in fixel mask). Expressed age-related losses, exceeding 30% fixels, were particularly present in pathways connecting the auditory structures with limbic structures. The effect of hearing loss and/or tinnitus did not reach significance. Conclusions Our results show that although an age-related reduction of fibers is present in pathways connecting several auditory regions, the connections of these structures with limbic structures are even more reduced. To what extent this fact influences the symptoms of presbycusis, such as decreased speech comprehension, especially in noise conditions, remains to be elucidated.
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Affiliation(s)
- Veronika Svobodová
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czechia
| | - Oliver Profant
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University in Prague, University Hospital Královské Vinohrady, Prague, Czechia
| | - Antonín Škoch
- Department of Radiodiagnostic and Interventional Radiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Jaroslav Tintěra
- Department of Radiodiagnostic and Interventional Radiology, Institute of Clinical and Experimental Medicine, Prague, Czechia
| | - Diana Tóthová
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czechia
| | - Martin Chovanec
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University in Prague, University Hospital Královské Vinohrady, Prague, Czechia
| | - Dora Čapková
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Charles University in Prague, University Hospital Královské Vinohrady, Prague, Czechia
| | - Josef Syka
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
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Rosemann S, Rauschecker JP. Increased fiber density of the fornix in patients with chronic tinnitus revealed by diffusion-weighted MRI. Front Neurosci 2023; 17:1293133. [PMID: 38192511 PMCID: PMC10773749 DOI: 10.3389/fnins.2023.1293133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/05/2023] [Indexed: 01/10/2024] Open
Abstract
Up to 45% of the elderly population suffer from chronic tinnitus - the phantom perception of sound that is often perceived as ringing, whistling, or hissing "in the ear" without external stimulation. Previous research investigated white matter changes in tinnitus patients using diffusion-weighted magnetic resonance imaging (DWI) to assess measures such as fractional anisotropy (a measure of microstructural integrity of fiber tracts) or mean diffusivity (a measure for general water diffusion). However, findings overlap only minimally and are sometimes even contradictory. We here present the first study encompassing higher diffusion data that allow to focus on changes in tissue microstructure, such as number of axons (fiber density) and macroscopic alterations, including axon diameter, and a combination of both. In order to deal with the crossing-fibers problem, we applied a fixel-based analysis using a constrained spherical deconvolution signal modeling approach. We investigated differences between tinnitus patients and control participants as well as how cognitive abilities and tinnitus distress are related to changes in white matter morphology in chronic tinnitus. For that aim, 20 tinnitus patients and 20 control participants, matched in age, sex and whether they had hearing loss or not, underwent DWI, audiometric and cognitive assessments, and filled in questionnaires targeting anxiety and depression. Our results showed increased fiber density in the fornix in tinnitus patients compared to control participants. The observed changes might, reflect compensatory structural alterations related to the processing of negative emotions or maladaptive changes related to the reinforced learning of the chronic tinnitus sensation. Due to the low sample size, the study should be seen as a pilot study that motivates further research to investigate underlying white matter morphology alterations in tinnitus.
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Affiliation(s)
- Stephanie Rosemann
- Laboratory of Integrative Neuroscience and Cognition, Department of Neuroscience, Georgetown University Medical Center, Washington, DC, 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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Husain FT, Khan RA. Review and Perspective on Brain Bases of Tinnitus. J Assoc Res Otolaryngol 2023; 24:549-562. [PMID: 37919556 PMCID: PMC10752862 DOI: 10.1007/s10162-023-00914-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
In advancing our understanding of tinnitus, some of the more impactful contributions in the past two decades have come from human brain imaging studies, specifically the idea of both auditory and extra-auditory neural networks that mediate tinnitus. These networks subserve both the perception of tinnitus and the psychological reaction to chronic, continuous tinnitus. In this article, we review particular studies that report on the nodes and links of such neural networks and their inter-network connections. Innovative neuroimaging tools have contributed significantly to the increased understanding of anatomical and functional connections of attention, emotion-processing, and default mode networks in adults with tinnitus. We differentiate between the neural correlates of tinnitus and those of comorbid hearing loss; surprisingly, tinnitus and hearing loss when they co-occur are not necessarily additive in their impact and, in rare cases, additional tinnitus may act to mitigate the consequences of hearing loss alone on the brain. The scale of tinnitus severity also appears to have an impact on brain networks, with some of the alterations typically attributed to tinnitus reaching significance only in the case of bothersome tinnitus. As we learn more about comorbid conditions of tinnitus, such as depression, anxiety, hyperacusis, or even aging, their contributions to the network-level changes observed in tinnitus will need to be parsed out in a manner similar to what is currently being done for hearing loss or severity. Together, such studies advance our understanding of the heterogeneity of tinnitus and will lead to individualized treatment plans.
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Affiliation(s)
- Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 S. Sixth Street, Champaign, IL, 61820, USA.
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
| | - Rafay A Khan
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA
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Chen Q, Lv H, Wang Z, Li X, Wang X, Huang Y, Zhao P, Yang Z, Gong S, Wang Z. Multimodal quantitative magnetic resonance imaging of the thalamus in tinnitus patients with different outcomes after sound therapy. CNS Neurosci Ther 2023; 29:4070-4081. [PMID: 37392024 PMCID: PMC10651975 DOI: 10.1111/cns.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/08/2023] [Accepted: 06/18/2023] [Indexed: 07/02/2023] Open
Abstract
AIMS This study systematically investigated structural and functional alterations in the thalamus and its subregions using multimodal magnetic resonance imaging (MRI) and examined its clinical relevance in tinnitus patients with different outcomes after sound therapy (narrowband noise). METHODS In total, 60 patients with persistent tinnitus and 57 healthy controls (HCs) were recruited. Based on treatment efficacy, 28 patients were categorized into the effective group and 32 into the ineffective group. Five MRI measurements of the thalamus and its seven subregions, including gray matter volume, fractional anisotropy, fractional amplitude of low-frequency fluctuation, and functional connectivity (FC), were obtained for each participant and compared between the groups. RESULTS Patients in both the groups exhibited widespread functional and diffusion abnormalities in the whole thalamus and several subregions, with more obvious changes observed in the effective group. All tinnitus patients had abnormal FC compared with the HCs; FC differences between the two patient groups were only observed in the striatal network, auditory-related cortex, and the core area of the limbic system. We combined the multimodal quantitative thalamic alterations and used it as an imaging indicator to evaluate prognosis before sound therapy and achieved a sensitivity of 71.9% and a specificity of 85.7%. CONCLUSION Similar patterns of thalamic alterations were identified in tinnitus patients with different outcomes, with more obvious changes observed in the effective group. Our findings support the tinnitus generation hypothesis of frontostriatal gating system dysfunction. A combination of multimodal quantitative thalamic properties may be used as indicators to predict tinnitus prognosis before sound therapy.
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Affiliation(s)
- Qian Chen
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Han Lv
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhaodi Wang
- Department of OtolaryngologyBeijing Jingmei Group General HospitalBeijingChina
| | - Xiaoshuai Li
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xinghao Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | | | - Pengfei Zhao
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenghan Yang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenchang Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
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Elmer S, Schmitt R, Giroud N, Meyer M. The neuroanatomical hallmarks of chronic tinnitus in comorbidity with pure-tone hearing loss. Brain Struct Funct 2023; 228:1511-1534. [PMID: 37349539 PMCID: PMC10335971 DOI: 10.1007/s00429-023-02669-0] [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: 02/05/2023] [Accepted: 06/13/2023] [Indexed: 06/24/2023]
Abstract
Tinnitus is one of the main hearing impairments often associated with pure-tone hearing loss, and typically manifested in the perception of phantom sounds. Nevertheless, tinnitus has traditionally been studied in isolation without necessarily considering auditory ghosting and hearing loss as part of the same syndrome. Hence, in the present neuroanatomical study, we attempted to pave the way toward a better understanding of the tinnitus syndrome, and compared two groups of almost perfectly matched individuals with (TIHL) and without (NTHL) pure-tone tinnitus, but both characterized by pure-tone hearing loss. The two groups were homogenized in terms of sample size, age, gender, handedness, education, and hearing loss. Furthermore, since the assessment of pure-tone hearing thresholds alone is not sufficient to describe the full spectrum of hearing abilities, the two groups were also harmonized for supra-threshold hearing estimates which were collected using temporal compression, frequency selectivity und speech-in-noise tasks. Regions-of-interest (ROI) analyses based on key brain structures identified in previous neuroimaging studies showed that the TIHL group exhibited increased cortical volume (CV) and surface area (CSA) of the right supramarginal gyrus and posterior planum temporale (PT) as well as CSA of the left middle-anterior part of the superior temporal sulcus (STS). The TIHL group also demonstrated larger volumes of the left amygdala and of the left head and body of the hippocampus. Notably, vertex-wise multiple linear regression analyses additionally brought to light that CSA of a specific cluster, which was located in the left middle-anterior part of the STS and overlapped with the one found to be significant in the between-group analyses, was positively associated with tinnitus distress level. Furthermore, distress also positively correlated with CSA of gray matter vertices in the right dorsal prefrontal cortex and the right posterior STS, whereas tinnitus duration was positively associated with CSA and CV of the right angular gyrus (AG) and posterior part of the STS. These results provide new insights into the critical gray matter architecture of the tinnitus syndrome matrix responsible for the emergence, maintenance and distress of auditory phantom sensations.
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Affiliation(s)
- Stefan Elmer
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
- Competence Center Language & Medicine, University of Zurich, Zurich, Switzerland
| | - Raffael Schmitt
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
| | - Nathalie Giroud
- Department of Computational Linguistics, Computational Neuroscience of Speech & Hearing, University of Zurich, Zurich, Switzerland
- Center for Neuroscience Zurich, University and ETH of Zurich, Zurich, Switzerland
- Competence Center Language & Medicine, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Department of Comparative Language Science, University of Zurich, Zurich, Switzerland
- Center for Neuroscience Zurich, University and ETH of Zurich, Zurich, Switzerland
- Center for the Interdisciplinary Study of Language Evolution (ISLE), University of Zurich, Zurich, Switzerland
- Cognitive Psychology Unit, Alpen-Adria University, Klagenfurt, Austria
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Dobel C, Junghöfer M, Mazurek B, Paraskevopoulos E, Groß J. Tinnitus and Multimodal Cortical Interaction. Laryngorhinootologie 2023; 102:S59-S66. [PMID: 37130531 PMCID: PMC10184662 DOI: 10.1055/a-1959-3021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The term of subjective tinnitus is used to describe a perceived noise without an external sound source. Therefore, it seems to be obvious that tinnitus can be understood as purely auditory, sensory problem. From a clinical point of view, however, this is a very inadequate description, as there are significant comorbidities associated with chronic tinnitus. Neurophysiological investigations with different imaging techniques give a very similar picture, because not only the auditory system is affected in chronic tinnitus patients, but also a widely ramified subcortical and cortical network. In addition to auditory processing systems, networks consisting of frontal and parietal regions are particularly disturbed. For this reason, some authors conceptualize tinnitus as a network disorder rather than a disorder of a circumscribed system. These findings and this concept suggest that tinnitus must be diagnosed and treated in a multidisciplinary and multimodal manner.
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Affiliation(s)
- Christian Dobel
- Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Jena, Jena
| | - Markus Junghöfer
- Institut für Biomagnetismus und Biosignalanalyse, Universität Münster, Münster
| | - Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Berlin
| | | | - Joachim Groß
- Institut für Biomagnetismus und Biosignalanalyse, Universität Münster, Münster
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The role of the medial geniculate body of the thalamus in the pathophysiology of tinnitus and implications for treatment. Brain Res 2022; 1779:147797. [DOI: 10.1016/j.brainres.2022.147797] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/25/2021] [Accepted: 01/13/2022] [Indexed: 01/12/2023]
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Khan RA, Sutton BP, Tai Y, Schmidt SA, Shahsavarani S, Husain FT. A large-scale diffusion imaging study of tinnitus and hearing loss. Sci Rep 2021; 11:23395. [PMID: 34862447 PMCID: PMC8642521 DOI: 10.1038/s41598-021-02908-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/16/2021] [Indexed: 11/09/2022] Open
Abstract
Subjective, chronic tinnitus, the perception of sound in the absence of an external source, commonly occurs with many comorbidities, making it a difficult condition to study. Hearing loss, often believed to be the driver for tinnitus, is perhaps one of the most significant comorbidities. In the present study, white matter correlates of tinnitus and hearing loss were examined. Diffusion imaging data were collected from 96 participants-43 with tinnitus and hearing loss (TINHL), 17 with tinnitus and normal hearing thresholds (TINNH), 17 controls with hearing loss (CONHL) and 19 controls with normal hearing (CONNH). Fractional anisotropy (FA), mean diffusivity and probabilistic tractography analyses were conducted on the diffusion imaging data. Analyses revealed differences in FA and structural connectivity specific to tinnitus, hearing loss, and both conditions when comorbid, suggesting the existence of tinnitus-specific neural networks. These findings also suggest that age plays an important role in neural plasticity, and thus may account for some of the variability of results in the literature. However, this effect is not seen in tractography results, where a sensitivity analysis revealed that age did not impact measures of network integration or segregation. Based on these results and previously reported findings, we propose an updated model of tinnitus, wherein the internal capsule and corpus callosum play important roles in the evaluation of, and neural plasticity in response to tinnitus.
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Affiliation(s)
- Rafay A Khan
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Bradley P Sutton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Yihsin Tai
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, 47303, USA
| | - Sara A Schmidt
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA
| | - Somayeh Shahsavarani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.,Mortimer B. Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, 10027, USA
| | - Fatima T Husain
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA. .,Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA. .,Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, 61801, USA.
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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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Tracking white-matter brain modifications in chronic non-bothersome acoustic trauma tinnitus. NEUROIMAGE-CLINICAL 2021; 31:102696. [PMID: 34029920 PMCID: PMC8163994 DOI: 10.1016/j.nicl.2021.102696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Tractography was compared between two groups of tinnitus and control participants. Diffusion was modeled with ss3t-CSD allowing apparent fiber density (AFD) calculation. 27 bundles of interest were chosen for their link to the auditory and limbic systems. AFD was significantly increased in the tinnitus group in the right frontal isthmus. AFD in the acoustic radiations was not significantly different between the groups.
Subjective tinnitus is a symptom characterized by the perception of sound with no external acoustic source, most often accompanied by co-morbidities. To date, the specific role of white matter abnormalities related to tinnitus reaches no consensus in the literature. The goal of this study was to explore the structural connectivity related to tinnitus percept per se, thus focusing on a specific population presenting chronic non-bothersome tinnitus of similar etiology (noise induced) without co-morbidities. We acquired diffusion-weighted images with high angular resolution in a homogeneous group of mildly impacted tinnitus participants (n = 19) and their matched controls (n = 19). We focused the study on two subsets of fiber bundles of interest: on one hand, we extracted the acoustic radiation and further included any intersecting fiber bundles; on the other hand, we explored the tracts related to the limbic system. We modeled the diffusion signal using constrained spherical deconvolution. We conducted a deep-learning based tractography segmentation and mapped Apparent Fiber Density (AFD) on the bundles of interest. C, as well as Fractional Anisotropy (FA) and FOD peak amplitude for comparison. Between group statistical comparison was performed along the 27 tracts of interest controlling for confounding hearing loss, tinnitus severity, and duration since onset. We tested a potential correlation with hearing loss, tinnitus duration and tinnitus handicap score along these tracts. In the tinnitus group, we observed increased AFD related to chronic tinnitus percept after acoustic trauma in two main white matter regions. First, in the right hemisphere, in the isthmus between inferior temporal and inferior frontal cortices, in the uncinate fasciculus (UF), and in the inferior fronto-occipital bundle (IFO). Second, in the left hemisphere, underneath the superior parietal region in the thalamo parietal tract and parieto-occipital pontine tract. Between-group differences in the acoustic radiations were not significant with AFD but were with FA. Furthermore, significant correlations with hearing loss were found in the left hemisphere in the inferior longitudinal fasciculus and in the fronto-pontine tract. No additional correlation was found with tinnitus duration nor with tinnitus handicap, as reflected by THI scores. The regions that displayed tinnitus related increased AFD also displayed increased FA. The isthmus of the UF and IFO in the right hemisphere appear to be involved with a number of neuropsychiatric and traumatic disorders confirming the involvement of the limbic system even in chronic non-bothersome tinnitus subjects, potentially suggesting a common pathway between these pathologies. White matter changes underneath the superior parietal cortex found here in tinnitus participants supports the implication of an auditory-somatosensory pathway in tinnitus perception.
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Chen Q, Lv H, Wang Z, Wei X, Zhao P, Yang Z, Gong S, Wang Z. Lateralization effects in brain white matter reorganization in patients with unilateral idiopathic tinnitus: a preliminary study. Brain Imaging Behav 2021; 16:11-21. [PMID: 33830430 DOI: 10.1007/s11682-021-00472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 03/14/2021] [Indexed: 12/01/2022]
Abstract
Idiopathic tinnitus can cause significant auditory-related brain structural and functional changes in patients. However, changes in patterns of the lateralization effects in idiopathic tinnitus have yet to be established, especially on white matter (WM) reorganization. In this study, we studied 19 left-sided and 19 right-sided idiopathic tinnitus (LSIT, RSIT) patients and 19 healthy controls (HCs). We combined applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analyses to investigate altered features of the auditory-related brain WM. We also conducted correlation analyses between the clinical variables and WM changes in the patients. Compared with the HCs, both sided tinnitus patients showed significant auditory-related brain WM alterations. More interestingly, the LSIT patients demonstrated a greater decrease in white matter volume (WMV) in the right medial superior frontal gyrus (SFG) than the RSIT; meanwhile, we also found that compared with the RSIT group, the LSIT group showed significantly increased fractional anisotropy (FA) in the body of the corpus callosum (CC), left cingulum, and right superior longitudinal fasciculus (SLF) and decreased mean diffusivity (MD) in the body of CC. Moreover, relative to the RSIT group, the LSIT group also exhibited increases in WM axial diffusivity (AD) in the left SLF, left cingulum, right middle cerebellar peduncle (MCP), left thalamus, and bilateral forceps major (FM) and decreases in radial diffusivity (RD) in the genu of CC. Additionally, the FA value of the right SLF was closely associated with tinnitus severity in the LSIT. Our study suggests that lateralization has a significant effect on WM reorganization in patients with idiopathic tinnitus; in particular, LSIT patients may experience more severe and widespread alterations in WMV and WM microstructure than the RSIT group, and all these changes are indirectly auditory related. These findings provide new useful information that can lead to a better understanding of the tinnitus mechanisms.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
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Yousef A, Hinkley LB, Nagarajan SS, Cheung SW. Neuroanatomic Volume Differences in Tinnitus and Hearing Loss. Laryngoscope 2021; 131:1863-1868. [PMID: 33811641 DOI: 10.1002/lary.29549] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 03/12/2021] [Accepted: 03/22/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To investigate neuroanatomic volume differences in tinnitus and hearing loss. STUDY DESIGN Cross-sectional. METHODS Sixteen regions of interest (ROIs) in adults (43 male, 29 female) were examined using 3Tesla structural magnetic resonance imaging in four cohorts: 1) tinnitus with moderate hearing loss (N = 31), 2) moderate hearing loss only (N = 15), 3) tinnitus with normal hearing (N = 17), and 4) normal hearing only (N = 13). ROI volumes were corrected for brain size, age, and sex variations. Analysis of covariance (ANCOVA) and post hoc Tukey's test were used to isolate the effects of tinnitus and hearing loss on volume differences. Effect sizes were calculated as the fraction of total variance (η2 ) in ANCOVA models and percent of mean volume difference relative to mean total volume. RESULTS The four cohort ANCOVA revealed tinnitus and hearing loss cohorts to have increased volume in the corona radiata (η2 = 0.192; P = .0018) and decreased volume in the nucleus accumbens (η2 = 0.252; P < .0001), caudate nucleus (η2 = 0.188; P = .002), and inferior fronto-occipital fasciculus (η2 = 0.250; P = .0001). Tinnitus with normal hearing showed decreased volume in the nucleus accumbens (22.0%; P = .001) and inferior fronto-occipital fasciculus (18.1%; P = .002), and hearing loss only showed increased volume in the corona radiata (10.7%; P = .01) and decreased volume in the nucleus accumbens (22.1%; P = .001), caudate nucleus (16.1%; P = .004), and inferior fronto-occipital fasciculus (18.3%; P = .003). CONCLUSION Tinnitus and hearing loss have overlapping effects on neurovolumetric alterations, especially impacting the nucleus accumbens and inferior fronto-occipital fasciculus. Neurovolumetric studies on tinnitus or hearing loss can be more complete by accounting for those two clinical dimensions separately and jointly. LEVEL OF EVIDENCE 3 Laryngoscope, 131:1863-1868, 2021.
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Affiliation(s)
- Andrew Yousef
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A
| | - Leighton B Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, U.S.A
| | - Srikantan S Nagarajan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, U.S.A
| | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, California, U.S.A
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Ahmed S, Mohan A, Yoo HB, To WT, Kovacs S, Sunaert S, De Ridder D, Vanneste S. Structural correlates of the audiological and emotional components of chronic tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 262:487-509. [PMID: 33931193 DOI: 10.1016/bs.pbr.2021.01.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The objective is to investigate white matter tracts, more specifically the arcuate fasciculus and acoustic radiation, in tinnitus and assess their relationship with distress, loudness and hearing loss. DTI images were acquired for 58 tinnitus patients and 65 control subjects. Deterministic tractography was first performed to visualize the arcuate fasciculus and acoustic radiation tracts bilaterally and to calculate tract density, fractional anisotropy, radial diffusivity, and axial diffusivity for tinnitus and control subjects. Tinnitus patients had a significantly reduced tract density compared to controls in both tracts of interest. They also exhibited increased axial diffusivity in the left acoustic radiation, as well as increased radial diffusivity in the left arcuate fasciculus, and both the left and right acoustic radiation. Furthermore, they exhibited decreased fractional anisotropy in the left arcuate fasciculus, as well as the left and right acoustic radiation tracts. Partial correlation analysis showed: (1) a negative correlation between arcuate fasciculus tract density and tinnitus distress, (2) a negative correlation between acoustic radiation tract density and hearing loss, (3) a negative correlation between acoustic radiation tract density and loudness, (4) a positive correlation between left arcuate fasciculus and tinnitus distress for radial diffusivity, (5) a negative correlation between left arcuate fasciculus and tinnitus distress for fractional anisotropy, (6) a positive correlation between left and right acoustic radiation and hearing loss for radial diffusivity, (7) No correlation between any of the white matter characteristics and tinnitus loudness. Structural alterations in the acoustic radiation and arcuate fasciculus correlate with hearing loss and distress in tinnitus but not tinnitus loudness showing that loudness is a more functional correlate of the disorder which does not manifest structurally.
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Affiliation(s)
- Shaheen Ahmed
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States
| | - Anusha Mohan
- Global Brain Health Institute & Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Hye Bin Yoo
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States
| | - Wing Ting To
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Silvia Kovacs
- Translational MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Stefan Sunaert
- Translational MRI, Department of Imaging and Pathology, KU Leuven, Leuven, Belgium
| | - Dirk De Ridder
- School of Nursing & Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States; Global Brain Health Institute & Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
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Chen Q, Lv H, Wang Z, Wei X, Zhao P, Yang Z, Gong S, Wang Z. Brain Structural and Functional Reorganization in Tinnitus Patients Without Hearing Loss After Sound Therapy: A Preliminary Longitudinal Study. Front Neurosci 2021; 15:573858. [PMID: 33776630 PMCID: PMC7991098 DOI: 10.3389/fnins.2021.573858] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 02/22/2021] [Indexed: 02/05/2023] Open
Abstract
Sound therapy is one of the most common first-line treatments for idiopathic tinnitus. We aimed to investigate the brain structural and functional alterations between patients with idiopathic tinnitus without hearing loss (HL) and healthy controls (HCs) and between patients before and after sound therapy (narrow band noise). Structural and resting-state functional images were acquired from 13 tinnitus patients without HL and 18 HCs before and after 6 months of narrow band sound therapy (only patients received the treatment). Voxel-based morphometry (VBM) and independent component analysis (ICA) were conducted to separately investigate the brain structural and functional changes. Associations between brain changes and clinical variables were also performed. After the treatment, the % improvement of THI score was −1.30% (± 63.40%). Compared with HCs, tinnitus patients showed gray matter and white matter atrophy in the left middle temporal gyrus at baseline, and the gray matter volume was further reduced after the treatment. The patients also showed increased white matter volume in the cingulum (cingulate), right calcarine, left rolandic operculum, and left parietal and frontal lobes. Additionally, compared with HCs, tinnitus patients exhibited positive [medial visual network (mVN) and sensorimotor network (SMN), mVN and auditory network (AN)] and negative [mVN and lateral visual network (lVN)] internetwork functional connectivity (FC) at baseline and negative [left frontoparietal network (LFPN) and dorsal attention network (DAN), AN and posterior default mode network (pDMN)] internetwork FC after the narrow band sound therapy. The patients also showed negative [LFPN and right frontoparietal network (RFPN), LFPN and RFPN, anterior default mode network (aDMN) and AN, aDMN and DAN] internetwork FC after the treatment when compared with baseline. Our findings suggest that although the outcomes of idiopathic tinnitus patients without HL were not very good when the improvement of THI scores was used as an evaluation indicator, the patients experienced significant differences in auditory-related and non-auditory-related brain reorganization before and after the narrow band sound therapy, that is, sound therapy may have a significant effect on brain reorganization in patients with idiopathic tinnitus. This study may provide some new useful information for the understanding of mechanisms underlying idiopathic tinnitus.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Chen Q, Wang Z, Lv H, Zhao P, Yang Z, Gong S, Wang Z. Reorganization of Brain White Matter in Persistent Idiopathic Tinnitus Patients Without Hearing Loss: Evidence From Baseline Data. Front Neurosci 2020; 14:591. [PMID: 32612504 PMCID: PMC7308730 DOI: 10.3389/fnins.2020.00591] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/13/2020] [Indexed: 12/19/2022] Open
Abstract
It remains unknown whether tinnitus or tinnitus-related hearing loss (HL) could indirectly impair or reshape the white matter (WM) of the human brain. We aim to explore the possible brain WM change in tinnitus patients without HL and further to investigate their associations with clinical variables. Structural and diffusion tensor imaging (DTI) of 20 idiopathic tinnitus patients without HL and 22 healthy controls (HCs) were obtained. Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis were conducted to investigate the differences in WM volume and integrity between patients and HCs, separately. We extracted WM parameters to determine a sensitive imaging index to differentiate the idiopathic tinnitus patients from the HCs in the early stage. Correlations between the clinical variables and WM indices were also performed in patients. Compared with the controls, the tinnitus patients without HL exhibited significant decreased fractional anisotropy (FA) in the body and genu of corpus callosum (CC), left cingulum (LC) and right cingulum (RC), and right superior longitudinal fasciculus (RSLF) and increase in mean diffusivity (MD) in the body of CC in WM. Moreover, the patients also showed decreases in WM axial diffusivity (AD) in LC, left superior longitudinal fasciculus (LSLF), and right interior cerebellar peduncle (ICP) and increases in radial diffusivity (RD) in the body and genu of CC and RSLF (p < 0.05, voxel-level FWE corrected). Furthermore, the increased RD value of the genu of CC is closely associated with the tinnitus handicap inventory (THI) subscale scores. No WMV changes were detected in tinnitus patients. We combined the altered WM integrity index of body and genu of CC and LC and RSLF as an index to differentiate the two groups and reached a sensitivity of 100% and a specificity of 77.3%. Our findings suggest that tinnitus without HL is associated with significant alterations of WM integrity. These changes may be irrespective of the duration and other clinical performance. The combination of diffusion indices of body and genu of CC and LC and RSLF might be used as the potential useful imaging index for the diagnosis of persistent idiopathic tinnitus without HL in the early stage.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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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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Zhang Z, Jia X, Guan X, Zhang Y, Lyu Y, Yang J, Jiang T. White Matter Abnormalities of Auditory Neural Pathway in Sudden Sensorineural Hearing Loss Using Diffusion Spectrum Imaging: Different Findings From Tinnitus. Front Neurosci 2020; 14:200. [PMID: 32269506 PMCID: PMC7109467 DOI: 10.3389/fnins.2020.00200] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 02/24/2020] [Indexed: 01/06/2023] Open
Abstract
Sudden sensorineural hearing loss (SSNHL) is a complex and challenging emergency which requires evidence regarding its pathophysiological changes to guide the treatment. The aim of this study was to evaluate the white matter integrity of the auditory neural pathway in patients with unilateral SSNHL in acute stage by using diffusion spectrum imaging tractography. In the present study, 60 individuals with acute SSNHL (29 males, 50.7 ± 11.8 years) and 25 healthy controls (13 males, 45.2 ± 13.2 years) underwent diffusion spectrum imaging tractography and high resolution T1 structural examinations using a 3T magnetic resonance imaging system. The areas of the auditory neural pathway were defined as regions of interest (ROIs). The quantitative anisotropy (QA) and the generalized fractional anisotropy (GFA) were compared between the patients with unilateral SSNHL and controls in these ROIs. We further evaluated the correlation between the parameter values and hearing loss level. The mean pure tone audiometry of patients at the onset presentation was 63.2 ± 26.2 dB. The right-sided SSNHL was involved in 25 (41.7%) cases and the left-sided in 35 (58.3%) cases. The QA values in the contralateral medial geniculate body, the bilateral anterior corona radiata and the anterior limb of internal capsule were significantly reduced in SSNHL patients compared to controls. In addition, the decrease QA value of the contralateral medial geniculate body was related to the increase severity of disease, even after controlling potential confounding factors. The present study demonstrated that patients with SSNHL exhibited altered integrity of white matter in the auditory neural pathway. Furthermore, the decreased QA values in the contralateral medial geniculate body might predict the severity of this disease. In the present study, tinnitus has not been found to effect in brain area obviously.
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Affiliation(s)
- Zihao Zhang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiuqin Jia
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Xiaojiao Guan
- Department of Radiology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Yi Zhang
- Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yuelei Lyu
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Jing Yang
- Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Tao Jiang
- Department of Radiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Shahsavarani S, Khan RA, Husain FT. Tinnitus and the Brain: A Review of Functional and Anatomical Magnetic Resonance Imaging Studies. ACTA ACUST UNITED AC 2019. [DOI: 10.1044/2019_pers-sig6-2019-0001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
The tinnitus patient population is inherently heterogeneous. Although tinnitus often co-occurs with hearing loss and is more frequent among elderly people, it affects all age groups with varying hearing sensitivity. In addition, tinnitus severity and patients' reaction to tinnitus vary across individuals. Regardless of the metrics used to measure tinnitus handicap, on one end of the severity spectrum are the patients who have managed to habituate to their tinnitus; at the other end are those who are extremely bothered by tinnitus, and often have a confluence of related comorbidities of mood disorders. Understanding the neural correlates of tinnitus while accounting for such variations could benefit clinicians, helping them modify and objectively monitor tinnitus management strategies. Brain imaging, specifically magnetic resonance imaging, is an excellent tool to study the functional and structural properties of the neural networks involved in tinnitus and tinnitus severity.
Method
In this article, we review studies that employ magnetic resonance imaging-based neuroimaging techniques including resting-state functional connectivity, voxel-based morphometry, and diffusion tensor imaging to investigate underlying functional and structural neural correlates of tinnitus to address overarching dimensions of a person's reaction to tinnitus, namely, audition, emotion, and attention.
Results
We discuss findings from brain imaging studies in the context of theories and models proposed for tinnitus generation and persistence.
Conclusion
These studies have revealed tinnitus-related alteration in the auditory, emotion, and attention neural networks. Future research is required to better understand these changes in the neural circuitry based on tinnitus comorbidities and severity, and to refine existing theoretical models.
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Affiliation(s)
- Somayeh Shahsavarani
- Department of Speech and Hearing Science, University of Illinois at Urbana–Champaign, Champaign
- Neuroscience Program, University of Illinois at Urbana–Champaign, Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign
| | - Rafay Ali Khan
- Neuroscience Program, University of Illinois at Urbana–Champaign, Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign
| | - Fatima Tazeena Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana–Champaign, Champaign
- Neuroscience Program, University of Illinois at Urbana–Champaign, Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign, Champaign
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Qiu S, Liu T, Cao G, Wu K, Zhao T. Treatment of intracranial hemorrhage with neuroendoscopy guided by body surface projection. Medicine (Baltimore) 2019; 98:e15503. [PMID: 31083190 PMCID: PMC6531271 DOI: 10.1097/md.0000000000015503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND We aimed to study the feasibility of body surface projection in neuroendoscopic treatment of intracranial hemorrhage (ICH), and to evaluate the prognosis of muscle strength using diffusion tensor imaging (DTI) technique. METHODS We utilized 3D-SLICER software and adopted hematoma body surface projection orientation to eliminate ICH by using neuroendoscope for 69 cases of spontaneous intracerebral hemorrhage. The standard of correct location was determined by the direct view of hematoma at the first operation. Evacuation rate by comparing computed tomography (CT) before and after the surgery and Glasgow coma scale (GCS) was computed. DTI was used for pyramidal tract imaging 3 weeks after the operation, while the prognosis of muscle strength was assessed after 6 months. The control group included 69 patients with basal ganglia hemorrhage who received conservative treatment during the same period. RESULTS The hematoma evacuation rate was 90.75% in average. The average GCS score rose by 4 points one week after the surgery. The shape of pyramidal tract affected the prognosis of body muscle strength, and the simple disruption type was the worst. There was no difference in mortality between the surgery group (10.1%) and the conservative group (4.3%). The muscle strength improvement value and modulate RANK score (MRS) in the surgery group were better than the control group. CONCLUSION It is convenient and feasible to use the surface projection to determine the target of operation, and the clearance rate of hematoma is high. Pyramidal tract imaging can predict the prognosis of muscle strength.
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Xu XM, Jiao Y, Tang TY, Zhang J, Lu CQ, Salvi R, Teng GJ. Sensorineural hearing loss and cognitive impairments: Contributions of thalamus using multiparametric MRI. J Magn Reson Imaging 2019; 50:787-797. [PMID: 30694013 DOI: 10.1002/jmri.26665] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/10/2019] [Accepted: 01/11/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The thalamus is an integrative hub conveying sensory information between cortical areas and related to cognition. However, alterations of the thalamus following partial hearing deprivation remains unknown. PURPOSE To investigate the modifications of the thalamus and its seven subdivisions in terms of structure, function, and perfusion in subjects with sensorineural hearing loss (SNHL), as well as their associations with SNHL-induced cognitive impairments. STUDY TYPE Cross-sectional study. SUBJECTS Thirty-seven bilateral long-term SNHL patients and 38 well-matched controls. FIELD STRENGTH 3 T/BOLD, T1 -weighted imaging, arterial spin labeling (ASL). ASSESSMENT Quantitative measurements in the thalamus and subdivisions were obtained, including the relative volume, fractional amplitude of low-frequency fluctuation (fALFF) within slow 5 (0.01-0.027 Hz), slow 4 (0.027-0.073 Hz), and combined frequency (0.01-0.073 Hz), as well as the whole-brain functional connectivity. Twenty-five SNHL patients and 20 controls underwent ASL scanning. Then correlation analysis was computed between all significant changes and cognition tests. STATISTICAL TESTS Continuous and categorical variables were compared by independent-sample t-test and chi-square test, respectively. Quantitative MRI measurement comparisons were corrected for multiple comparison, and functional connectivity (FC) analysis used two-sample t-test with false-discovery rate correction. Area under the curve (AUC) in receiver operating characteristic curve analysis was applied to evaluate the power of alterations in differentiating SNHL and controls. RESULTS No significant difference in the relative volume and perfusion of seven thalamus subdivisions were observed, but a decrease in fALFF in SNHL. SNHL showed reduced thalamic connectivity with the cerebellum lobule VIII, ventral anterior cingulate cortex, insula, superior temporal gyrus, media temporal gyrus, medial frontal gyrus, Heschl's gyrus, and temporal pole. And some FC abnormalities exhibited positive correlations with cognitive tests and high discriminative power (0.8 < AUC < 1) in two groups. DATA CONCLUSION SNHL led to decreased thalamic activity and widespread weakened connectivity with other brain areas. LEVEL OF EVIDENCE 2 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019;50:787-797.
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Affiliation(s)
- Xiao-Min Xu
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Yun Jiao
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Jian Zhang
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
| | - Richard Salvi
- Center for Hearing and Deafness, University at Buffalo, Buffalo, New York, USA
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular Imaging and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing, China
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23
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Shang Y, Hinkley LB, Cai C, Subramaniam K, Chang YS, Owen JP, Garrett C, Mizuiri D, Mukherjee P, Nagarajan SS, Cheung SW. Functional and Structural Brain Plasticity in Adult Onset Single-Sided Deafness. Front Hum Neurosci 2018; 12:474. [PMID: 30538626 PMCID: PMC6277679 DOI: 10.3389/fnhum.2018.00474] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 11/12/2018] [Indexed: 01/09/2023] Open
Abstract
Single-sided deafness (SSD) or profound unilateral hearing loss obligates the only serviceable ear to capture all acoustic information. This loss of binaural function taxes cognitive resources for accurate listening performance, especially under adverse environments or challenging tasks. We hypothesized that adults with SSD would manifest both functional and structural brain plasticity compared to controls with normal binaural hearing. We evaluated functional alterations using magnetoencephalographic imaging (MEGI) of brain activation during performance of a moderately difficult auditory syllable sequence reproduction task and assessed structural integrity using diffusion tensor imaging (DTI). MEGI showed the SSD cohort to have increased induced oscillations in the theta band over the left superior temporal cortex and decreased induced gamma band oscillations over the frontal and parietal cortices between 175 and 475 ms following stimulus onset. DTI showed the SSD cohort to have extensive fractional anisotropy (FA) reduction in both auditory and non-auditory tracts and regions. Overlaying functional and structural changes revealed by the two imaging techniques demonstrated close registration of cortical areas and white matter tracts that expressed brain plasticity. Hence, complete loss of input from one ear in adulthood triggers both functional and structural alterations to dorsal temporal and frontal-parietal areas.
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Affiliation(s)
- Yingying Shang
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Otorhinolaryngology, Peking Union Medical College Hospital, Beijing, China
| | - Leighton B Hinkley
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Chang Cai
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Karuna Subramaniam
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Yi-Shin Chang
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Julia P Owen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Coleman Garrett
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Danielle Mizuiri
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Pratik Mukherjee
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Srikantan S Nagarajan
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, United States.,Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, United States
| | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, CA, United States
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24
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Schmidt SA, Zimmerman B, Bido Medina RO, Carpenter-Thompson JR, Husain FT. Changes in gray and white matter in subgroups within the tinnitus population. Brain Res 2018; 1679:64-74. [DOI: 10.1016/j.brainres.2017.11.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 10/18/2022]
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25
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Ouyang J, Pace E, Lepczyk L, Kaufman M, Zhang J, Perrine SA, Zhang J. Blast-Induced Tinnitus and Elevated Central Auditory and Limbic Activity in Rats: A Manganese-Enhanced MRI and Behavioral Study. Sci Rep 2017; 7:4852. [PMID: 28687812 PMCID: PMC5501813 DOI: 10.1038/s41598-017-04941-w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 04/27/2017] [Indexed: 02/06/2023] Open
Abstract
Blast-induced tinitus is the number one service-connected disability that currently affects military personnel and veterans. To elucidate its underlying mechanisms, we subjected 13 Sprague Dawley adult rats to unilateral 14 psi blast exposure to induce tinnitus and measured auditory and limbic brain activity using manganese-enhanced MRI (MEMRI). Tinnitus was evaluated with a gap detection acoustic startle reflex paradigm, while hearing status was assessed with prepulse inhibition (PPI) and auditory brainstem responses (ABRs). Both anxiety and cognitive functioning were assessed using elevated plus maze and Morris water maze, respectively. Five weeks after blast exposure, 8 of the 13 blasted rats exhibited chronic tinnitus. While acoustic PPI remained intact and ABR thresholds recovered, the ABR wave P1-N1 amplitude reduction persisted in all blast-exposed rats. No differences in spatial cognition were observed, but blasted rats as a whole exhibited increased anxiety. MEMRI data revealed a bilateral increase in activity along the auditory pathway and in certain limbic regions of rats with tinnitus compared to age-matched controls. Taken together, our data suggest that while blast-induced tinnitus may play a role in auditory and limbic hyperactivity, the non-auditory effects of blast and potential traumatic brain injury may also exert an effect.
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Affiliation(s)
- Jessica Ouyang
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Edward Pace
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Laura Lepczyk
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Michael Kaufman
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Jessica Zhang
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Shane A Perrine
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, 48201, USA
| | - Jinsheng Zhang
- Department of Otolaryngology and Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, 48201, USA.
- Department of Communication Sciences & Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, 48201, USA.
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26
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Chen YC, Wang F, Wang J, Bo F, Xia W, Gu JP, Yin X. Resting-State Brain Abnormalities in Chronic Subjective Tinnitus: A Meta-Analysis. Front Hum Neurosci 2017; 11:22. [PMID: 28174532 PMCID: PMC5258692 DOI: 10.3389/fnhum.2017.00022] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 01/11/2017] [Indexed: 11/13/2022] Open
Abstract
Purpose: The neural mechanisms that give rise to the phantom sound of tinnitus have not been fully elucidated. Neuroimaging studies have revealed abnormalities in resting-state activity that could represent the neural signature of tinnitus, but there is considerable heterogeneity in the data. To address this issue, we conducted a meta-analysis of published neuroimaging studies aimed at identifying a common core of resting-state brain abnormalities in tinnitus patients. Methods: A systematic search was conducted for whole-brain resting-state neuroimaging studies with SPECT, PET and functional MRI that compared chronic tinnitus patients with healthy controls. The authors searched PubMed, Science Direct, Web of Knowledge and Embase databases for neuroimaging studies on tinnitus published up to September 2016. From each study, coordinates were extracted from clusters with significant differences between tinnitus subjects and controls. Meta-analysis was performed using the activation likelihood estimation (ALE) method. Results: Data were included from nine resting-state neuroimaging studies that reported a total of 51 distinct foci. The meta-analysis identified consistent regions of increased resting-state brain activity in tinnitus patients relative to controls that included, bilaterally, the insula, middle temporal gyrus (MTG), inferior frontal gyrus (IFG), parahippocampal gyrus, cerebellum posterior lobe and right superior frontal gyrus. Moreover, decreased brain activity was only observed in the left cuneus and right thalamus. Conclusions: The current meta-analysis is, to our knowledge, the first to demonstrate a characteristic pattern of resting-state brain abnormalities that may serve as neuroimaging markers and contribute to the understanding of neuropathophysiological mechanisms for chronic tinnitus.
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Affiliation(s)
- Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Fang Wang
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Jie Wang
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Fan Bo
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Wenqing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Jian-Ping Gu
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
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27
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Gattu R, Akin FW, Cacace AT, Hall CD, Murnane OD, Haacke EM. Vestibular, balance, microvascular and white matter neuroimaging characteristics of blast injuries and mild traumatic brain injury: Four case reports. Brain Inj 2016; 30:1501-1514. [DOI: 10.1080/02699052.2016.1219056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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28
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Rauschecker JP, May ES, Maudoux A, Ploner M. Frontostriatal Gating of Tinnitus and Chronic Pain. Trends Cogn Sci 2016; 19:567-578. [PMID: 26412095 DOI: 10.1016/j.tics.2015.08.002] [Citation(s) in RCA: 154] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Revised: 08/04/2015] [Accepted: 08/07/2015] [Indexed: 12/18/2022]
Abstract
Tinnitus and chronic pain are sensory-perceptual disorders associated with negative affect and high impact on well-being and behavior. It is now becoming increasingly clear that higher cognitive and affective brain systems are centrally involved in the pathology of both disorders. We propose that the ventromedial prefrontal cortex and the nucleus accumbens are part of a central 'gatekeeping' system in both sensory modalities, a system which evaluates the relevance and affective value of sensory stimuli and controls information flow via descending pathways. If this frontostriatal system is compromised, long-lasting disturbances are the result. Parallels in both systems are striking and mutually informative, and progress in understanding central gating mechanisms might provide a new impetus to the therapy of tinnitus and chronic pain.
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Affiliation(s)
- Josef P Rauschecker
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA; Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, Munich, Germany; Institute for Advanced Study, Technische Universität München, Munich, Germany.
| | - Elisabeth S May
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, Munich, Germany
| | - Audrey Maudoux
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
| | - Markus Ploner
- Department of Neurology and TUM-Neuroimaging Center, Technische Universität München, Munich, Germany
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29
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Yoo HB, De Ridder D, Vanneste S. White Matter Changes in Tinnitus: Is It All Age and Hearing Loss? Brain Connect 2016; 6:84-93. [DOI: 10.1089/brain.2015.0380] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hye Bin Yoo
- Lab for Clinical & Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
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30
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Gunbey HP, Gunbey E, Aslan K, Bulut T, Unal A, Incesu L. Limbic-Auditory Interactions of Tinnitus: An Evaluation Using Diffusion Tensor Imaging. Clin Neuroradiol 2015; 27:221-230. [DOI: 10.1007/s00062-015-0473-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Accepted: 09/29/2015] [Indexed: 01/08/2023]
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31
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White matter integrity associated with clinical symptoms in tinnitus patients: A tract-based spatial statistics study. Eur Radiol 2015; 26:2223-32. [DOI: 10.1007/s00330-015-4034-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/26/2015] [Accepted: 09/17/2015] [Indexed: 10/23/2022]
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32
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Impairments of thalamic resting-state functional connectivity in patients with chronic tinnitus. Eur J Radiol 2015; 84:1277-84. [DOI: 10.1016/j.ejrad.2015.04.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2015] [Revised: 03/23/2015] [Accepted: 04/04/2015] [Indexed: 11/15/2022]
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33
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Canlon B. Progress in hearing research 2014. Hear Res 2014; 311:1-2. [PMID: 25151010 DOI: 10.1016/j.heares.2014.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 02/18/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Barbara Canlon
- Karolinska Institutet, Department of Physiology and Pharmacology, von Eulers vag 8, 171 77 Stockholm, Sweden.
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34
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Diffusion imaging of auditory and auditory-limbic connectivity in tinnitus: preliminary evidence and methodological challenges. Neural Plast 2014; 2014:145943. [PMID: 25050181 PMCID: PMC4090469 DOI: 10.1155/2014/145943] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/26/2014] [Indexed: 11/23/2022] Open
Abstract
Subjective tinnitus, or “ringing in the ears,” is perceived by 10 to 15 percent of the adult population and causes significant suffering in a subset of patients. While it was originally thought of as a purely auditory phenomenon, there is increasing evidence that the limbic system influences whether and how tinnitus is perceived, far beyond merely determining the patient's emotional reaction to the phantom sound. Based on functional imaging and electrophysiological data, recent articles frame tinnitus as a “network problem” arising from abnormalities in auditory-limbic interactions. Diffusion-weighted magnetic resonance imaging is a noninvasive method for investigating anatomical connections in vivo. It thus has the potential to provide anatomical evidence for the proposed changes in auditory-limbic connectivity. However, the few diffusion imaging studies of tinnitus performed to date have inconsistent results. In the present paper, we briefly summarize the results of previous studies, aiming to reconcile their results. After detailing analysis methods, we then report findings from a new dataset. We conclude that while there is some evidence for tinnitus-related increases in auditory and auditory-limbic connectivity that counteract hearing-loss related decreases in auditory connectivity, these results should be considered preliminary until several technical challenges have been overcome.
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35
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A brain centred view of psychiatric comorbidity in tinnitus: from otology to hodology. Neural Plast 2014; 2014:817852. [PMID: 25018882 PMCID: PMC4074975 DOI: 10.1155/2014/817852] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/18/2014] [Accepted: 05/05/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Comorbid psychiatric disorders are frequent among patients affected by tinnitus. There are mutual clinical influences between tinnitus and psychiatric disorders, as well as neurobiological relations based on partially overlapping hodological and neuroplastic phenomena. The aim of the present paper is to review the evidence of alterations in brain networks underlying tinnitus physiopathology and to discuss them in light of the current knowledge of the neurobiology of psychiatric disorders. Methods. Relevant literature was identified through a search on Medline and PubMed; search terms included tinnitus, brain, plasticity, cortex, network, and pathways. Results. Tinnitus phenomenon results from systemic-neurootological triggers followed by neuronal remapping within several auditory and nonauditory pathways. Plastic reorganization and white matter alterations within limbic system, arcuate fasciculus, insula, salience network, dorsolateral prefrontal cortex, auditory pathways, ffrontocortical, and thalamocortical networks are discussed. Discussion. Several overlapping brain network alterations do exist between tinnitus and psychiatric disorders. Tinnitus, initially related to a clinicoanatomical approach based on a cortical localizationism, could be better explained by an holistic or associationist approach considering psychic functions and tinnitus as emergent properties of partially overlapping large-scale neural networks.
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36
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Adjamian P, Hall DA, Palmer AR, Allan TW, Langers DRM. Neuroanatomical abnormalities in chronic tinnitus in the human brain. Neurosci Biobehav Rev 2014; 45:119-33. [PMID: 24892904 PMCID: PMC4148481 DOI: 10.1016/j.neubiorev.2014.05.013] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 05/19/2014] [Accepted: 05/25/2014] [Indexed: 12/23/2022]
Abstract
We review brain anatomical studies of tinnitus. We evaluate the “gating mechanism” in light of the evidence from these studies. We discuss the results and the possible causes of disparity between findings. Overall, the evidence for structural abnormalities in tinnitus is unconvincing. We identify methodological concerns and suggest strategies for future research.
In this paper, we review studies that have investigated brain morphology in chronic tinnitus in order to better understand the underlying pathophysiology of the disorder. Current consensus is that tinnitus is a disorder involving a distributed network of peripheral and central pathways in the nervous system. However, the precise mechanism remains elusive and it is unclear which structures are involved. Given that brain structure and function are highly related, identification of anatomical differences may shed light upon the mechanism of tinnitus generation and maintenance. We discuss anatomical changes in the auditory cortex, the limbic system, and prefrontal cortex, among others. Specifically, we discuss the gating mechanism of tinnitus and evaluate the evidence in support of the model from studies of brain anatomy. Although individual studies claim significant effects related to tinnitus, outcomes are divergent and even contradictory across studies. Moreover, results are often confounded by the presence of hearing loss. We conclude that, at present, the overall evidence for structural abnormalities specifically related to tinnitus is poor. As this area of research is expanding, we identify some key considerations for research design and propose strategies for future research.
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Affiliation(s)
- Peyman Adjamian
- MRC Institute of Hearing Research, University Park, Nottingham NG7 2RD, United Kingdom.
| | - Deborah A Hall
- National Institute for Health Research (NIHR), Nottingham Hearing Biomedical Research Unit, University of Nottingham, Ropewalk House, 113 The Ropewalk, Nottingham NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
| | - Alan R Palmer
- MRC Institute of Hearing Research, University Park, Nottingham NG7 2RD, United Kingdom
| | - Thomas W Allan
- MRC Institute of Hearing Research, University Park, Nottingham NG7 2RD, United Kingdom
| | - Dave R M Langers
- National Institute for Health Research (NIHR), Nottingham Hearing Biomedical Research Unit, University of Nottingham, Ropewalk House, 113 The Ropewalk, Nottingham NG1 5DU, United Kingdom; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2UH, United Kingdom
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