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Marder KG, Cho J, Chincanchan R, Wilson AC, Corlier J, Krantz DE, Ginder ND, Lee JC, Wilke SA, Tadayonnejad R, Levitt J, Ishiyama A, Leuchter MK, Leuchter AF. Sequential Prefrontal and Temporoparietal Repetitive Transcranial Magnetic Stimulation (rTMS) for Treatment of Tinnitus With and Without Comorbid Depression: A Case Series and Systematic Review. Front Neurol 2022; 13:831832. [PMID: 35665054 PMCID: PMC9160187 DOI: 10.3389/fneur.2022.831832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 03/21/2022] [Indexed: 12/04/2022] Open
Abstract
Background Tinnitus distress is related to both the loudness and intrusiveness of the tinnitus percept. Treatment approaches targeting both attentional/limbic and auditory systems may better alleviate tinnitus distress than approaches targeting the auditory system alone. Materials and Methods Ten subjects with chronic tinnitus received sequential rTMS treatment involving: 1) excitatory stimulation administered to the left dorsolateral prefrontal cortex (DLPFC) or inhibitory stimulation administered to the right DLPFC, followed by 2) inhibitory stimulation administered to primary auditory cortex (Heschel's gyrus or HG). A systematic literature review was performed to evaluate the existing literature on sequential repetitive Transcranial Magnetic Stimulation (rTMS) treatment approaches for tinnitus. Results of the case series are interpreted in the context of tinnitus neurobiology and the extant literature. Results Subjects experienced a significant decrease (average 21.7%) in symptoms on the Tinnitus Functional Index (TFI). Those with tinnitus alone experienced a greater mean symptom reduction than those with comorbid MDD (27.7 vs. 17.0%, respectively). Adverse effects were transient and minor. Literature review confirmed that sequential approaches had some advantages compared to single site rTMS; in general, the addition of 1 Hz treatment at DLPFC was superior to single site rTMS in the short term (1-12 weeks), while the addition of 20 Hz treatment at DLPFC appeared superior in the long term (90-180 days). Conclusions Sequential rTMS approaches for the treatment of tinnitus-particularly those administering low-frequency treatment at left DLPFC-merit further investigation.
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Affiliation(s)
- Katharine G. Marder
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Janice Cho
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Ruth Chincanchan
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
| | - Andrew C. Wilson
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Juliana Corlier
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - David E. Krantz
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Nathaniel D. Ginder
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Jonathan C. Lee
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Scott A. Wilke
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Reza Tadayonnejad
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
- Division of Humanities and Social Sciences, California Institute of Technology, Pasadena, CA, USA
| | - Jennifer Levitt
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Akira Ishiyama
- Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michael K. Leuchter
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Andrew F. Leuchter
- TMS Clinical and Research Service, Neuromodulation Division, Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, CA, United States
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Peter N, Kleinjung T, Lippuner R, Boecking B, Brueggemann P, Mazurek B. [German-language versions of the Tinnitus Functional Index : Comparison of the two validated German-language versions of the Tinnitus Functional Index for Switzerland and Germany]. HNO 2021; 70:187-192. [PMID: 34448877 PMCID: PMC8866375 DOI: 10.1007/s00106-021-01099-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/10/2021] [Indexed: 11/29/2022]
Abstract
Hintergrund Es existieren zwei deutschsprachige, validierte Versionen des Tinnitus Functional Index (TFI), eine für die Schweiz und eine für Deutschland. Der TFI gilt als möglicher neuer Standard-Fragebogen für die Evaluation eines Tinnitus-Schweregrads und einer Tinnitus-Therapie. Ziel der Arbeit In Anbetracht der stattfindenden Standardisierung bei der Tinnitus-Evaluation war es unser Ziel, die beiden TFI-Versionen miteinander zu vergleichen und im deutschsprachigem Raum nur eine TFI-Version zu empfehlen. Material und Methoden Die beiden deutschsprachigen TFI-Versionen wurden in einer multizentrischen randomisierten Online-Fragebogenstudie im Cross-over-Design miteinander verglichen. Ergebnisse Die Gesamtscores der beiden TFI-Versionen unterschieden sich in der gesamten Population nicht. Bei weiterer Aufschlüsselung in Bezug auf die Population und Reihenfolge der abgegeben TFI-Versionen zeigten sich allerdings teilweise signifikante Unterschiede mit jedoch nur moderaten Effektstärken. Dies deutet darauf hin, dass sich die beiden Versionen leicht unterscheiden, aber trotzdem miteinander vergleichbar sind. Bei der Faktoranalyse konnten bei der TFI-Version für Deutschland in der gesamten Population wie auch für die schweizerische Population 6 Faktoren extrahiert werden. Hingegen konnten bei der deutschen Population in beiden TFI-Versionen und bei der schweizerischen Population in der schweizerischen TFI-Version nur 5 Faktoren extrahiert werden. Schlussfolgerung Die beiden deutschsprachigen Versionen des TFI sind gut miteinander vergleichbar. Jedoch spricht die Faktoranalyse eher für die Verwendung der TFI-Version für Deutschland im gesamten deutschsprachigen Raum.
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Affiliation(s)
- Nicole Peter
- Klinik für Ohren‑, Nasen- Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Universität Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz.
| | - Tobias Kleinjung
- Klinik für Ohren‑, Nasen- Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Universität Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz
| | - Ricarda Lippuner
- Klinik für Ohren‑, Nasen- Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Universität Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz
| | - Benjamin Boecking
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Deutschland
| | - Petra Brueggemann
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Deutschland
| | - Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Chariteplatz 1, 10117, Berlin, Deutschland
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Hüttenrauch E, Jensen M, Ivanšić D, Dobel C, Weise C. Improving the assessment of functional impairment in tinnitus sufferers: validation of the German version of the Tinnitus Functional Index using a confirmatory factor analysis. Int J Audiol 2021; 61:140-147. [PMID: 34010084 DOI: 10.1080/14992027.2021.1919766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Chronic tinnitus negatively impacts daily functioning. To specifically assess this impairment, the Tinnitus Functional Index (TFI) was developed. The current study investigated the hierarchical, eight-factorial structure for the German TFI and examined its psychometric properties. DESIGN In an online assessment, the TFI and other validated health-related measurements were completed. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure by testing two competing models: (1) a general factor model, and (2) a hierarchical second-order factor model. STUDY SAMPLE 316 research volunteers (59.8% female) with low to moderate tinnitus distress were included. RESULTS CFA revealed an insufficient fit of the data to the general factor model. For the hierarchical second-order factor model, an acceptable model fit was shown (χ2/df ratio = 2.74, RMSEA = 0.07, SRMR = 0.05, CFI = 0.95, TLI = 0.95). Correlational analyses between the TFI and measures assessing tinnitus distress, depression, sleeping difficulties, subjective well-being, and personality dimensions indicated high convergent and moderate discriminant validity. Internal consistency reliability was excellent. CONCLUSIONS The results confirm the hierarchical, eight-factorial structure of the German TFI. The TFI is a promising inventory that should be used on a regular basis.HighlightsThe results of our study confirm the hierarchical eight-factorial structure of the German TFI.Confirmatory factor analysis revealed an acceptable model fit of the data.Convergent validity of the German TFI was high.Discriminant validity of the German TFI was moderate.The German TFI is a reliable questionnaire to assess tinnitus functional impairment.
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Affiliation(s)
- Eva Hüttenrauch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Germany
| | - Martin Jensen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Germany.,Eriksholm Research Center, Part of the Oticon Foundation, Snekkersten, Denmark
| | - Daniela Ivanšić
- Tinnitus-Center, Department of Otorhinolaryngology, Jena University Hospital, Germany
| | - Christian Dobel
- Tinnitus-Center, Department of Otorhinolaryngology, Jena University Hospital, Germany
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Germany
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Peter N, Kleinjung T, Jeker R, Meyer M, Klaghofer R, Weidt S. Tinnitus functional index: validation of the German version for Switzerland. Health Qual Life Outcomes 2017; 15:94. [PMID: 28476163 PMCID: PMC5420117 DOI: 10.1186/s12955-017-0669-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/27/2017] [Indexed: 11/30/2022] Open
Abstract
Background Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. Methods At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach’s alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. Results The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach’s alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. Conclusion The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus. The reliability and validity of this version are comparable with the original version of the TFI. Although this study showed only five factors in the factor analysis, relations to the original eight subscales were identified. Therefore, the German version of the TFI for Switzerland can deliver relevant information regarding the different tinnitus domains. Trial registration Clinical trial registration number on clinicaltrial.gov: NCT01837368.
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Affiliation(s)
- Nicole Peter
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Raphael Jeker
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Martin Meyer
- Department of Psychology, University of Zurich, Andreasstrasse 15, CH-8050, Zurich, Switzerland
| | - Richard Klaghofer
- Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
| | - Steffi Weidt
- Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
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