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Inguscio BMS, Rossi D, Giliberto G, Vozzi A, Borghini G, Babiloni F, Greco A, Attanasio G, Cartocci G. Bridging the Gap between Psychophysiological and Audiological Factors in the Assessment of Tinnitus: An EEG Investigation in the Beta Band. Brain Sci 2024; 14:570. [PMID: 38928570 PMCID: PMC11202302 DOI: 10.3390/brainsci14060570] [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: 04/29/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND Despite substantial progress in investigating its psychophysical complexity, tinnitus remains a scientific and clinical enigma. The present study, through an ecological and multidisciplinary approach, aims to identify associations between electroencephalographic (EEG) and psycho-audiological variables. METHODS EEG beta activity, often related to stress and anxiety, was acquired from 12 tinnitus patients (TIN group) and 7 controls (CONT group) during an audio cognitive task and at rest. We also investigated psychological (SCL-90-R; STAI-Y; BFI-10) and audiological (THI; TQ12-I; Hyperacusis) variables using non-parametric statistics to assess differences and relationships between and within groups. RESULTS In the TIN group, frontal beta activity positively correlated with hyperacusis, parietal activity, and trait anxiety; the latter is also associated with depression in CONT. Significant differences in paranoid ideation and openness were found between groups. CONCLUSIONS The connection between anxiety trait, beta activity in the fronto-parietal cortices and hyperacusis provides insights into brain functioning in tinnitus patients, offering quantitative descriptions for clinicians and new multidisciplinary treatment hypotheses.
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Affiliation(s)
- Bianca Maria Serena Inguscio
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
- BrainSigns Srl, 00198 Rome, Italy;
| | - Dario Rossi
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
- BrainSigns Srl, 00198 Rome, Italy;
| | - Giovanna Giliberto
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
| | | | - Gianluca Borghini
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
- BrainSigns Srl, 00198 Rome, Italy;
| | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
- BrainSigns Srl, 00198 Rome, Italy;
- Department of Computer Science, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy;
| | | | - Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy; (B.M.S.I.); (D.R.); (G.G.); (G.B.); (F.B.)
- BrainSigns Srl, 00198 Rome, Italy;
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van Genuchten S, Gilles A, Mertens G, Andries E, Cardon E, Van Rompaey V, Lammers M, Vanderveken OM, Jacquemin L. Tinnitus suppression by means of cochlear implantation: does it affect cognition? Eur Arch Otorhinolaryngol 2024; 281:2281-2291. [PMID: 38052757 DOI: 10.1007/s00405-023-08339-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 11/06/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Recent literature suggests that tinnitus can impact cognition, but results were varied due to a diversity in investigated aspects of cognition and utilized tests, as well as the possible influence of confounding factors. The purpose of this study was to assess the impact of tinnitus loudness on cognition by use of a within-subjects design in patients with a cochlear implant (CI). In this population, tinnitus loudness can be modulated by switching the CI on or off as CI is known to highly suppress tinnitus. METHODS A total of 18 CI users completed two versions of the Repeatable Battery for Assessment of Neuropsychological Status for Hearing Impaired individuals (RBANS-H), once in unaided condition and once in best aided condition. Tinnitus suppression was defined as a difference in score on a visual-analogue scale (VAS) of at least one point out of ten between these two conditions. RESULTS No significant differences in RBANS-H scores were found between the suppression and no suppression group, nor for the suppression group alone. No significant correlations between tinnitus loudness and RBANS-H were found, neither for the suppression group alone, nor for the group as a whole. CONCLUSION The current study shows no significant effect of tinnitus loudness on cognition, which contradicts previous literature. This discrepancy could be explained by the use of a within-subjects design, which controls for confounding factors. Future research should include a larger and more diverse study sample to draw definitive conclusions on this topic.
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Affiliation(s)
- Sarah van Genuchten
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Annick Gilles
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium.
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Ellen Andries
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Emilie Cardon
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Marc Lammers
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Olivier M Vanderveken
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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3
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Coco L, Hooker ER, Gilbert TA, Harker GR, Clark KD, Reavis KM, Henry JA, Zaugg TL, Carlson KF. The Impact of Tinnitus Severity on Work Functioning among U.S. Military Veterans with Tinnitus. Semin Hear 2024; 45:40-54. [PMID: 38370516 PMCID: PMC10872655 DOI: 10.1055/s-0043-1770152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Tinnitus is highly prevalent among military Veterans. Severe tinnitus can be associated with negative impacts on daily life. Veterans with severe tinnitus may also have greater difficulties in functional roles, including work. However, few studies have explicitly explored this relationship. Traumatic brain injury (TBI), also prevalent among Veterans, is associated with tinnitus and can additionally impair work functioning. This quantitative investigation used a population-based survey to assess the relationship between tinnitus severity, measured using the Tinnitus Functional Index (TFI), and the impact of tinnitus on work, measured using a composite score from the Tinnitus History Questionnaire, among a stratified random sample of VA healthcare-using Veterans diagnosed with tinnitus, with and without comorbid TBI. Analyses were weighted to account for sampling design and Veteran non-response; multiple imputation was used to account for missing data. Results indicated that for every 1-point increase in TFI score, there was an average 8% increase in the odds of reporting a high level of impact on work functioning (OR: 1.08; 95% CI: 1.06, 1.11). Veterans with a comorbid TBI diagnosis, compared with those without, were more likely to have high tinnitus-related impact on work functioning (OR: 2.69, 95% CI: 1.85, 3.91), but the relationship between tinnitus severity and the impact of tinnitus on work functioning did not differ by TBI status. These data can help researchers and clinicians understand complex symptoms experienced by Veterans with tinnitus, with and without TBI, supporting the improved provision of clinical services to these patients.
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Affiliation(s)
- Laura Coco
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon
- School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, California
| | - Elizabeth R. Hooker
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon
| | - Tess A. Gilbert
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon
| | - Graham R. Harker
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | - Khaya D. Clark
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Kelly M. Reavis
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | - James A. Henry
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- Department of Otolaryngology/Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon
| | - Tara L. Zaugg
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
| | - Kathleen F. Carlson
- VA Health Services Research & Development Center of Innovation, Center to Improve Veteran Involvement in Care (CIVIC), VA Portland Health Care System, Portland, Oregon
- VA Rehabilitation Research & Development Service, National Center for Rehabilitative Auditory Research (NCRAR), Veterans Affairs Portland Health Care System, Portland, Oregon
- School of Public Health, Oregon Health & Science University, Portland, Oregon
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Smith LJ, Wilkinson D, Bodani M, Surenthiran SS. Cognition in vestibular disorders: state of the field, challenges, and priorities for the future. Front Neurol 2024; 15:1159174. [PMID: 38304077 PMCID: PMC10830645 DOI: 10.3389/fneur.2024.1159174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024] Open
Abstract
Vestibular disorders are prevalent and debilitating conditions of the inner ear and brain which affect balance, coordination, and the integration of multisensory inputs. A growing body of research has linked vestibular disorders to cognitive problems, most notably attention, visuospatial perception, spatial memory, and executive function. However, the mechanistic bases of these cognitive sequelae remain poorly defined, and there is a gap between our theoretical understanding of vestibular cognitive dysfunction, and how best to identify and manage this within clinical practice. This article takes stock of these shortcomings and provides recommendations and priorities for healthcare professionals who assess and treat vestibular disorders, and for researchers developing cognitive models and rehabilitation interventions. We highlight the importance of multidisciplinary collaboration for developing and evaluating clinically relevant theoretical models of vestibular cognition, to advance research and treatment.
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Affiliation(s)
- Laura J. Smith
- Centre for Preventative Neurology, Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - David Wilkinson
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
| | - Mayur Bodani
- School of Psychology, Keynes College, University of Kent, Kent, United Kingdom
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5
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Mazurek B. Multidimensional considerations in tinnitus. HNO 2024; 72:43-45. [PMID: 37728747 DOI: 10.1007/s00106-023-01357-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/21/2023]
Affiliation(s)
- Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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6
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Gasparre D, Pepe I, Laera D, Abbatantuono C, De Caro MF, Taurino A, D’Erasmo D, Fanizzi P, Antonucci LA, Pantaleo A, Cavallaro G, Pontillo V, Taurisano P, Quaranta N. Cognitive functioning and psychosomatic syndromes in a subjective tinnitus sample. Front Psychol 2023; 14:1256291. [PMID: 38192387 PMCID: PMC10773809 DOI: 10.3389/fpsyg.2023.1256291] [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: 07/10/2023] [Accepted: 12/04/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Tinnitus is the perception of a sound in the absence of any corresponding external sound source. Current research suggests a relationship among emotional, cognitive, and psychosomatic symptoms and the occurrence or maintenance of chronic tinnitus. This study aimed to detect the prevalence and role of psychosomatic conditions, as defined by the Diagnostic Criteria for Psychosomatic Research (DCPR), and cognitive functioning in a group of patients with tinnitus. Methods Sixty-two patients with subjective tinnitus and 62 non-tinnitus controls were recruited from the Otorhinolaryngology Unit of the University of Bari. Pure-tone audiometry was performed in all tinnitus subjects, and sound level tolerance was evaluated. Additionally, tinnitus handicap (Tinnitus Handicap Inventory [THI]), psychopathological symptoms (Symptom Checklist-90, Revised [SCL-90-R]), anxiety (State-Trait Anxiety Inventory [STAI-Y1/2]), depression (Beck Depression Inventory [BDI]), cognitive impairment (Mini-Mental State Examination [MMSE]), executive functions (Frontal Assessment Battery [FAB]), and psychosomatic syndromes (DCPR) were evaluated. Parametric and non-parametric tests were used to detect cognitive and symptomatological differences between patients and controls. The predictivity of these factors for tinnitus severity was studied using multiple regression (Backward Elimination). All tests were considered significant at p < 0.05 (family wise error corrected for each comparison). Results 69.4% tinnitus patients met multiple DCPR criteria, compared to 32.3% of controls. Tinnitus patients exhibited elevated rates of illness denial (ꭓ2 = 9.02; p < 0.009), demoralization (ꭓ2 = 8.05; p < 0.018), somatization (ꭓ2 = 4.92; p < 0.063) and functional symptoms (ꭓ2 = 5.21; p < 0.06) scoring significantly higher on the BDI, STAI-Y1, and STAI-Y2, and SCL-90-R compared to controls. Patients with tinnitus showed lower MMSE scores, compared to controls (t = -2.282; p < 0.001). No association between tinnitus severity and global cognitive impairment emerged. Conversely, executive function deficits were associated to tinnitus severity. Among the cognitive and psychological factors, only trait anxiety, one or more psychosomatic syndromes, and somatization clusters were strongly correlated with tinnitus severity. Discussion Our findings suggest a relationship between tinnitus severity, psychological, psychosomatic symptoms, and frontal impairment. Additionally, the influence of tinnitus on cognitive functions paves the way for integrated, multidisciplinary diagnostic and treatment options for patients. Although preliminary, our findings highlight the importance of early cognitive and psychological screening to improve patients' quality of life.
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Affiliation(s)
- Daphne Gasparre
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Ilaria Pepe
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Domenico Laera
- Clinical Psychology Service, Mental Health Department, ASL Taranto, Taranto, Italy
| | - Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Maria Fara De Caro
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessandro Taurino
- Department of Education, Psychology, Communication, University of Bari, Palazzo Chiaia-Napolitano, Bari, Italy
| | - Daniele D’Erasmo
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Piero Fanizzi
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Linda A. Antonucci
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Alessandra Pantaleo
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giada Cavallaro
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Vito Pontillo
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
| | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience “DiBraiN”, University of Bari “Aldo Moro”, Bari, Italy
| | - Nicola Quaranta
- Otolaryngology Unit, Department of Biomedical Sciences, Neuroscience and Sensory Organs, University of Bari Aldo Moro, Bari, Italy
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Sommerhalder N, Neff P, Bureš Z, Profant O, Kleinjung T, Meyer M. Deficient central mechanisms in tinnitus: Exploring the impact on speech comprehension and executive functions. Hear Res 2023; 440:108914. [PMID: 37979435 DOI: 10.1016/j.heares.2023.108914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/18/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023]
Abstract
Many individuals with chronic subjective tinnitus report significant problems in comprehending speech in adverse listening situations. A large body of studies has provided evidence to support the notion that deficits in speech-in-noise (SIN) are prevalent in the tinnitus population, while some studies have challenged these findings. Elemental auditory perception is usually only minimally or not impaired. In addition, deficits in cognitive functions, particularly executive functions, have also been observed in individuals with tinnitus. Given these previous findings, we theorize that deficient central mechanisms may be responsible for the reported speech comprehension problems in tinnitus. 25 participants suffering from chronic subjective tinnitus and 25 control participants, between 23 and 58 years of age, were examined in a cross-sectional design. The groups were case-matched for age, sex, education, and hearing loss. A large audiometric battery was used ranging from threshold and supra-threshold tasks to spoken sentence level speech tasks. Additionally, four cognitive tests were performed, primarily covering the area of executive functions. Tinnitometry and tinnitus-related questionnaires were applied to complement sample description and allow for secondary analyses. We hypothesized that tinnitus participants score lower in complex speech comprehension tasks and executive function tasks compared to healthy controls, while no group differences in elementary audiometric tasks were expected. As expected, individuals with chronic subjective tinnitus scored lower in the SIN and gated speech task, while there were no differences in the basic speech recognition threshold task and the other elementary auditory perception tasks. The cognitive tests revealed clear deficits in interference control in the Stroop task, but not in the Flanker task, in the tinnitus group. There were no differences in inhibition or working memory tasks. Our results clearly delineate differences between tinnitus individuals and control participants in two tests on speech intelligibility under adverse listening conditions. Further, the poorer performance in a task of interference control in individuals with tinnitus points towards an impaired central executive control in individuals with tinnitus. Taken together, our (partly) exploratory study provides novel evidence to the view that deficient central executive system in individuals with tinnitus probably account for impaired speech comprehension.
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Affiliation(s)
- Nick Sommerhalder
- Evolutionary Neuroscience of Language, Department of Comparative Language Science, University of Zurich, Zurich, Switzerland.
| | - Patrick Neff
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland; Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Zbyněk Bureš
- Department of Cognitive Systems and Neurosciences, Czech Institute of Informatics, Robotics and Cybernetics, Czech Technical University in Prague, Prague, Czech Republic; Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Oliver Profant
- Department of Otorhinolaryngology, Third Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Auditory Neuroscience, Institute of Experimental Medicine, Czech Academy of Sciences, Prague, Czech Republic
| | - Tobias Kleinjung
- Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Evolutionary Neuroscience of Language, Department of Comparative Language Science, University of Zurich, Zurich, Switzerland; Center for the Interdisciplinary Study of Language Evolution, University of Zurich, Zurich, Switzerland; Cognitive Psychology Unit, Alpen-Adria University of Klagenfurt, Klagenfurt, Austria
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8
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Mazurek B. [Multidimensional considerations in tinnitus. German version]. HNO 2023; 71:619-621. [PMID: 37747494 DOI: 10.1007/s00106-023-01362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2023] [Indexed: 09/26/2023]
Affiliation(s)
- Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
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Cartocci G, Inguscio BMS, Giliberto G, Vozzi A, Giorgi A, Greco A, Babiloni F, Attanasio G. Listening Effort in Tinnitus: A Pilot Study Employing a Light EEG Headset and Skin Conductance Assessment during the Listening to a Continuous Speech Stimulus under Different SNR Conditions. Brain Sci 2023; 13:1084. [PMID: 37509014 PMCID: PMC10377270 DOI: 10.3390/brainsci13071084] [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: 06/16/2023] [Revised: 07/07/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Background noise elicits listening effort. What else is tinnitus if not an endogenous background noise? From such reasoning, we hypothesized the occurrence of increased listening effort in tinnitus patients during listening tasks. Such a hypothesis was tested by investigating some indices of listening effort through electroencephalographic and skin conductance, particularly parietal and frontal alpha and electrodermal activity (EDA). Furthermore, tinnitus distress questionnaires (THI and TQ12-I) were employed. Parietal alpha values were positively correlated to TQ12-I scores, and both were negatively correlated to EDA; Pre-stimulus frontal alpha correlated with the THI score in our pilot study; finally, results showed a general trend of increased frontal alpha activity in the tinnitus group in comparison to the control group. Parietal alpha during the listening to stimuli, positively correlated to the TQ12-I, appears to reflect a higher listening effort in tinnitus patients and the perception of tinnitus symptoms. The negative correlation between both listening effort (parietal alpha) and tinnitus symptoms perception (TQ12-I scores) with EDA levels could be explained by a less responsive sympathetic nervous system to prepare the body to expend increased energy during the "fight or flight" response, due to pauperization of energy from tinnitus perception.
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Affiliation(s)
- Giulia Cartocci
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Department of Research and Development, BrainSigns Ltd., 00198 Rome, Italy
| | - Bianca Maria Serena Inguscio
- Department of Research and Development, BrainSigns Ltd., 00198 Rome, Italy
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Giovanna Giliberto
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Alessia Vozzi
- Department of Research and Development, BrainSigns Ltd., 00198 Rome, Italy
- SAIMLAL Department, Sapienza University of Rome, 00185 Rome, Italy
| | - Andrea Giorgi
- Department of Research and Development, BrainSigns Ltd., 00198 Rome, Italy
- SAIMLAL Department, Sapienza University of Rome, 00185 Rome, Italy
| | - Antonio Greco
- Department of Sense Organs, Sapienza University of Rome, 00161 Rome, Italy
| | - Fabio Babiloni
- Department of Molecular Medicine, Sapienza University of Rome, 00161 Rome, Italy
- Department of Research and Development, BrainSigns Ltd., 00198 Rome, Italy
- Department of Computer Science, Hangzhou Dianzi University, Hangzhou 310005, China
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10
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Bulla J, Brueggemann P, Wrzosek M, Klasing S, Boecking B, Basso L, Nyamaa A, Psatha S, Rose M, Mazurek B. Limited Link of Common Blood Parameters with Tinnitus. J Clin Med 2023; 12:jcm12113814. [PMID: 37298009 DOI: 10.3390/jcm12113814] [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: 04/17/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
Background: Tinnitus severity is generally assessed by psychometric and audiological instruments. However, no objective measure exists to evaluate the subjective discomfort and suffering caused by this hearing phenomenon. The objective of this work was to determine the possible blood parameters for diagnostics and therapy. Methods: We measured tinnitus distress by using the Tinnitus Questionnaire (TQ) and collected tinnitus-related audiological measures, namely the hearing threshold (HT), tinnitus loudness (TL), and sensation level (SL, i.e., the tinnitus loudness/hearing threshold at a tinnitus frequency). Blood samples were taken from 200 outpatients of the Tinnitus Centre of the Charité, and 46 routine blood count parameters were examined. The possible interactions were determined by (robust) linear models. Results: Tinnitus distress and audiological measurements were largely uncorrelated but could partly be predicted by selected blood parameters. First, the erythrocyte counts predicted tinnitus distress to a small extent. Second, the levels of vitamin D3 explained about 6% of tinnitus loudness and, age-dependently, the hearing threshold variability. Last, the levels of uric acid explained about 5% of the sensation level variability. Conclusions: Tinnitus is a multidimensional phenomenon. The marginal influences of blood markers suggest the possible roles of inflammation and oxidative stress produced by psychological or somatic burdens. Clinically, a vitamin D substitution (in older patients) might have a hearing-protective effect.
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Affiliation(s)
- Jan Bulla
- Department of Mathematics, University of Bergen, 5020 Bergen, Norway
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
| | - Petra Brueggemann
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Małgorzata Wrzosek
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University in Poznan, 60-568 Poznań, Poland
| | - Sven Klasing
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Laura Basso
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Amarjargal Nyamaa
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Stamatina Psatha
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Matthias Rose
- Medical Department, Clinic of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
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11
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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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12
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Mazurek B, Böcking B, Dobel C, Rose M, Brüggemann P. Tinnitus and Influencing Comorbidities. Laryngorhinootologie 2023; 102:S50-S58. [PMID: 37130530 PMCID: PMC10184670 DOI: 10.1055/a-1950-6149] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Numerous studies show that impairments in chronic tinnitus are closely connected with psychosomatic and other concomitant symptoms. This overview summarizes some of these studies. Beyond hearing loss, individual interactions of medical and psychosocial stress factors as well as resources are of central importance. Tinnitus related distress reflects a large number of intercorrelated, psychosomatic influences - such as personality traits, stress reactivity and depression or anxiety - which can be accompanied by cognitive difficulties and should be conceptualized and assessed within a vulnerability-stress-reaction model. Superordinate factors such as age, gender or education level can increase vulnerability to stress. Therefore, diagnosis and therapy of chronic tinnitus be individualised, multidimensional and interdisciplinary. Multimodal psychosomatic therapy approaches aim to address individually constellated medical, audiological and psychological influences in order to sustainably increase the quality of life of those affected. Counselling in the first contact is also indispensable for diagnosis and therapy.
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Affiliation(s)
- Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Berlin
| | | | - Christian Dobel
- Klinik und Poliklinik für HNO-Heilkunde, Universitätsklinikum Jena, Jena
| | - Matthias Rose
- Medizinische Klinik m. S. Psychosomatik, Charité - Universitätsmedizin Berlin, Berlin
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13
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Rosemann S, Rauschecker JP. Disruptions of default mode network and precuneus connectivity associated with cognitive dysfunctions in tinnitus. Sci Rep 2023; 13:5746. [PMID: 37029175 PMCID: PMC10082191 DOI: 10.1038/s41598-023-32599-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/29/2023] [Indexed: 04/09/2023] Open
Abstract
Tinnitus is the perception of a ringing, buzzing or hissing sound "in the ear" without external stimulation. Previous research has demonstrated changes in resting-state functional connectivity in tinnitus, but findings do not overlap and are even contradictory. Furthermore, how altered functional connectivity in tinnitus is related to cognitive abilities is currently unknown. Here we investigated resting-state functional connectivity differences between 20 patients with chronic tinnitus and 20 control participants matched in age, sex and hearing loss. All participants underwent functional magnetic resonance imaging, audiometric and cognitive assessments, and filled in questionnaires targeting anxiety and depression. Significant differences in functional connectivity between tinnitus patients and control participants were not obtained. However, we did find significant associations between cognitive scores and functional coupling of the default mode network and the precuneus with the superior parietal lobule, supramarginal gyrus, and orbitofrontal cortex. Further, tinnitus distress correlated with connectivity between the precuneus and the lateral occipital complex. This is the first study providing evidence for disruptions of default mode network and precuneus coupling that are related to cognitive dysfunctions in tinnitus. The constant attempt to decrease the tinnitus sensation might occupy certain brain resources otherwise available for concurrent cognitive operations.
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Affiliation(s)
- Stephanie Rosemann
- Laboratory of Integrative Neuroscience and Cognition, Department of Neuroscience, Georgetown University Medical Center, 3970 Reservoir Rd NW, Washington, DC, 20057, USA.
| | - Josef P Rauschecker
- Laboratory of Integrative Neuroscience and Cognition, Department of Neuroscience, Georgetown University Medical Center, 3970 Reservoir Rd NW, Washington, DC, 20057, USA
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14
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Zhang C, Wang X, Ding Z, Zhou H, Liu P, Xue X, Wang L, Jiang Y, Chen J, Shen W, Yang S, Wang F. Study on tinnitus-related electroencephalogram microstates in patients with vestibular schwannomas. Front Neurosci 2023; 17:1159019. [PMID: 37090804 PMCID: PMC10118047 DOI: 10.3389/fnins.2023.1159019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 03/16/2023] [Indexed: 04/08/2023] Open
Abstract
Tinnitus is closely associated with cognition functioning. In order to clarify the central reorganization of tinnitus in patients with vestibular schwannoma (VS), this study explored the aberrant dynamics of electroencephalogram (EEG) microstates and their correlations with tinnitus features in VS patients. Clinical and EEG data were collected from 98 VS patients, including 76 with tinnitus and 22 without tinnitus. Microstates were clustered into four categories. Our EEG microstate analysis revealed that VS patients with tinnitus exhibited an increased frequency of microstate C compared to those without tinnitus. Furthermore, correlation analysis demonstrated that the Tinnitus Handicap Inventory (THI) score was negatively associated with the duration of microstate A and positively associated with the frequency of microstate C. These findings suggest that the time series and syntax characteristics of EEG microstates differ significantly between VS patients with and without tinnitus, potentially reflecting abnormal allocation of neural resources and transition of functional brain activity. Our results provide a foundation for developing diverse treatments for tinnitus in VS patients.
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Affiliation(s)
- Chi Zhang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiaoguang Wang
- Zhan Tan Temple Outpatient Department, Central Medical Branch of PLA General Hospital, Beijing, China
| | - Zhiwei Ding
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Hanwen Zhou
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Peng Liu
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Xinmiao Xue
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Li Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Yuke Jiang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Jiyue Chen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- Medical School of Chinese PLA, Beijing, China
| | - Weidong Shen
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Shiming Yang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fangyuan Wang
- The First Medical Center, Chinese PLA General Hospital, Beijing, China
- College of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
- The Sixth Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Fangyuan Wang,
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15
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Watson N, Schaper FLWVJ, Jabbour S, Sadler S, Bain PA, Fox MD, Naples JG. Is There an Optimal Repetitive Transcranial Magnetic Stimulation Target to Treat Chronic Tinnitus? Otolaryngol Head Neck Surg 2023; 168:300-306. [PMID: 35671136 DOI: 10.1177/01945998221102082] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/04/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Chronic tinnitus is a clinical symptom that affects 10% to 15% of the adult population. Repetitive transcranial magnetic stimulation (rTMS) is a promising treatment, but significant heterogeneity exists in the treatment outcomes and stimulation parameters. In this study, we perform a qualitative systematic review to determine if there is an optimal rTMS site to treat tinnitus. DATA SOURCES A literature search was performed by searching the MEDLINE, Embase, Web of Science, and Cochrane databases. REVIEW METHODS Sham-controlled studies in adults were included that contained >10 patients with tinnitus for >3 months and utilized 10 to 20 electroencephalography coordinates. Study outcomes were considered positive if the treatment arm reported a significant reduction in the primary tinnitus score relative to sham. RESULTS There were 1211 studies screened. Nineteen studies met the inclusion criteria, and 8 unique stimulation sites were reported. Studies had 53.7 ± 46.0 patients (mean ± SD). The mean duration of follow-up was 10.3 ± 9.6 weeks. Positive outcomes regarding tinnitus suppression were reported in 5 of 5 (100%) studies stimulating the temporoparietal junction midway between T3 and P3 or between T4 and P4. Tinnitus suppression at all other sites was less frequent with a combined success rate of only 8 of 14 (57.1%). CONCLUSION Significant heterogeneity exists in the literature in regard to the optimal transcranial magnetic stimulation target. These preliminary findings suggest that the temporoparietal junction midway between T3 and P3 or T4 and P4 is a promising nonauditory rTMS target in the setting of chronic tinnitus. Future research should elucidate the effectiveness of this site for tinnitus suppression.
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Affiliation(s)
| | | | - Sandrine Jabbour
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Paul A Bain
- Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael D Fox
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - James G Naples
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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16
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Hong ES, Kim HS, Hong SK, Pantazis D, Min BK. Deep learning-based electroencephalic diagnosis of tinnitus symptom. Front Hum Neurosci 2023; 17:1126938. [PMID: 37206311 PMCID: PMC10189886 DOI: 10.3389/fnhum.2023.1126938] [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: 12/18/2022] [Accepted: 04/11/2023] [Indexed: 05/21/2023] Open
Abstract
Tinnitus is a neuropathological phenomenon caused by the recognition of external sound that does not actually exist. Existing diagnostic methods for tinnitus are rather subjective and complicated medical examination procedures. The present study aimed to diagnose tinnitus using deep learning analysis of electroencephalographic (EEG) signals while patients performed auditory cognitive tasks. We found that, during an active oddball task, patients with tinnitus could be identified with an area under the curve of 0.886 through a deep learning model (EEGNet) using EEG signals. Furthermore, using broadband (0.5 to 50 Hz) EEG signals, an analysis of the EEGNet convolutional kernel feature maps revealed that alpha activity might play a crucial role in identifying patients with tinnitus. A subsequent time-frequency analysis of the EEG signals indicated that the tinnitus group had significantly reduced pre-stimulus alpha activity compared with the healthy group. These differences were observed in both the active and passive oddball tasks. Only the target stimuli during the active oddball task yielded significantly higher evoked theta activity in the healthy group compared with the tinnitus group. Our findings suggest that task-relevant EEG features can be considered as a neural signature of tinnitus symptoms and support the feasibility of EEG-based deep-learning approach for the diagnosis of tinnitus.
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Affiliation(s)
- Eul-Seok Hong
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Hyun-Seok Kim
- Biomedical Engineering Research Center, Asan Medical Center, Seoul, Republic of Korea
| | - Sung Kwang Hong
- Department of Otolaryngology, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Dimitrios Pantazis
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, United States
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Byoung-Kyong Min
- Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
- Institute of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
- *Correspondence: Byoung-Kyong Min,
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17
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Clarke NA, Akeroyd MA, Henshaw H, Hall DA, Mohamad WNW, Hoare DJ. The executive disruption model of tinnitus distress: Model validation in two independent datasets using factor score regression. Front Psychol 2023; 14:1006349. [PMID: 36844272 PMCID: PMC9950568 DOI: 10.3389/fpsyg.2023.1006349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/06/2023] [Indexed: 02/12/2023] Open
Abstract
This study presents the executive disruption model (EDM) of tinnitus distress and subsequently validates it statistically using two independent datasets (the Construction Dataset: n = 96 and the Validation Dataset: n = 200). The conceptual EDM was first operationalised as a structural causal model (construction phase). Then multiple regression was used to examine the effect of executive functioning on tinnitus-related distress (validation phase), adjusting for the additional contributions of hearing threshold and psychological distress. For both datasets, executive functioning negatively predicted tinnitus distress score by a similar amount (the Construction Dataset: β = -3.50, p = 0.13 and the Validation Dataset: β = -3.71, p = 0.02). Theoretical implications and applications of the EDM are subsequently discussed; these include the predictive nature of executive functioning in the development of distressing tinnitus, and the clinical utility of the EDM.
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Affiliation(s)
- Nathan A Clarke
- Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health and Care Research (NIHR) Biomedical Research Centre, Nottingham, United Kingdom
| | - Michael A Akeroyd
- Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom
| | - Helen Henshaw
- National Institute for Health and Care Research (NIHR) Biomedical Research Centre, Nottingham, United Kingdom
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom.,School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
| | - Wan Najibah Wan Mohamad
- Audiology Programme, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | - Derek J Hoare
- Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health and Care Research (NIHR) Biomedical Research Centre, Nottingham, United Kingdom
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18
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Patil JD, Alrashid MA, Eltabbakh A, Fredericks S. The association between stress, emotional states, and tinnitus: a mini-review. Front Aging Neurosci 2023; 15:1131979. [PMID: 37207076 PMCID: PMC10188965 DOI: 10.3389/fnagi.2023.1131979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Extensive literature supporting the view of tinnitus induced stress in patients is available. However, limited evidence has been produced studying the opposite, that is, does stress cause tinnitus? The hypothalamus pituitary adrenal axis, one of the main neuroendocrine systems involved in stress response, is commonly disturbed in tinnitus patients. Patients with chronic tinnitus have been shown to develop abnormal responses to psycho-social stress, where the hypothalamus pituitary adrenal axis response is weaker and delayed, suggesting chronic stress contributes to the development of chronic tinnitus. The sympathetic branch of the autonomic nervous system also plays a major role in stress response and its chronic hyperactivity seems to be involved in developing tinnitus. Psycho-social stress has been shown to share the same probability of developing tinnitus as occupational noise and contributes to worsening tinnitus. Additionally, exposure to high stress levels and occupational noise doubles the likelihood of developing tinnitus. Interestingly, short-term stress has been shown to protect the cochlea in animals, but chronic stress exposure has negative consequences. Emotional stress also worsens pre-existing tinnitus and is identified as an important indicator of tinnitus severity. Although there is limited body of literature, stress does seem to play a vital role in the development of tinnitus. This review aims to highlight the association between stress, emotional states, and the development of tinnitus while also addressing the neural and hormonal pathways involved.
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Affiliation(s)
- Jayaditya Devpal Patil
- Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- *Correspondence: Jayaditya Devpal Patil,
| | | | - Ayah Eltabbakh
- Royal College of Surgeons in Ireland, Al Muharraq, Bahrain
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19
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Li W, Ma X, Wang Q, He X, Qu X, Zhang L, Chen L, Liu Z. Intrinsic Network Changes in Bilateral Tinnitus Patients with Cognitive Impairment: A Resting-State Functional MRI Study. Brain Sci 2022; 12:brainsci12081049. [PMID: 36009112 PMCID: PMC9405767 DOI: 10.3390/brainsci12081049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/16/2022] Open
Abstract
Previous studies have found a link between tinnitus and cognitive impairment, even leading to dementia. However, the mechanisms underlying this association are not clear. The purpose of this study was to explore intrinsic network changes in tinnitus and hearing loss patients with cognitive disorders. We included 17 individuals with bilateral idiopathic tinnitus, hearing loss, and cognitive impairment (PA) and 21 healthy controls. We identified resting-state networks (RSNs) and measured intra-network functional connectivity (FC) values via independent component analysis (ICA). We also evaluated correlations between RSNs and clinical characteristics. Compared with the healthy controls, the PA group showed decreased connectivity within the ventral attention network, dorsal attention network (DAN), visual network, left frontoparietal network, right frontoparietal network, sensorimotor network, and increased connectivity within the executive control network. MoCA (Montreal Cognitive Assessment) scores were negatively correlated with the FC values for left calcarine within the DAN. We identified abnormal intrinsic connectivity in several brain networks, mainly involving cognitive control, vision, sensorimotor function, and the cerebellum, in tinnitus patients with cognitive impairment. It may be possible to use the FC strength of the left calcarine within the DAN as an imaging marker to predict cognitive impairment in tinnitus patients.
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Affiliation(s)
- Wei Li
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Xiaobo Ma
- Department of Otolaryngology Head and Neck Surgery, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Qian Wang
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Xueying He
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
- Department of Radiology, Medical School of Nanjing University, Afliated Drum Tower Hospital, Nanjing 210008, China
| | - Xiaoxia Qu
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Lirong Zhang
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Lanyue Chen
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
| | - Zhaohui Liu
- Department of Radiology, Capital Medical University, Beijing Tongren Hospital, Beijing 100730, China
- Correspondence: ; Tel.: +86-10-582-680-34
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20
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Tinnitus: impact on patients in relation to audiological findings. The Journal of Laryngology & Otology 2022; 136:760-764. [DOI: 10.1017/s002221512100459x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTinnitus is a common auditory disorder in which patients experience noise in the absence of an external source. It is a consequence of irreversible cochlear damage. This study examined the distortion product otoacoustic emissions and P300 components of event-related potentials.MethodThis study included a control group of 25 normal-hearing adults not complaining of tinnitus and a study group that consisted of 45 normal-hearing adults complaining of tinnitus. Measures included patient history, basic audiological evaluation, the Arabic version of Tinnitus Handicap Inventory, distortion product otoacoustic emissions testing and P300 recording.ResultsThe study group showed significantly higher hearing thresholds at all frequencies as well as delayed latencies and reduced amplitude of P300. The Tinnitus Handicap Inventory showed mean scores of 35.2 ± 16.9, and the distortion product gram showed higher amplitudes in the control group.ConclusionPatients with tinnitus might have neural dysfunction at either peripheral or central levels of the auditory pathway.
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21
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Rosemann S, Rauschecker JP. Neuroanatomical alterations in middle frontal gyrus and the precuneus related to tinnitus and tinnitus distress. Hear Res 2022; 424:108595. [DOI: 10.1016/j.heares.2022.108595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 07/25/2022] [Accepted: 07/31/2022] [Indexed: 11/04/2022]
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22
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Yuan Y, Cai Y, Wu J, Li J, Huang X, Chen G, Lan L, Huang H, Dong H, Zheng Y, Yue Z. Tinnitus Affects Endogenous But Not Exogenous Auditory Attention Orienting. Am J Audiol 2022; 31:737-745. [PMID: 35858248 DOI: 10.1044/2022_aja-21-00128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose:
Previous studies have demonstrated that people with tinnitus show attention dysfunctions. In this study, we investigated the influence of tinnitus on attention orienting, especially whether the ability of attention orienting could be modulated by the degree of tinnitus.
Method:
Fifty-nine and 54 unilateral tinnitus participants were included in Experiment 1 and Experiment 2, respectively. All participants reported subjective tinnitus for at least 3 months and were divided into a mild tinnitus group (Tinnitus Handicap Inventory [THI] < 37) or a moderate to severe tinnitus group (THI ≥ 37) according to the THI score. An auditory exogenous attention task and an auditory endogenous attention task were adopted. In the exogenous task, a target sound following a cue sound was presented on either the left or right side. Participants were required to discriminate whether the target was pure tone or white noise. In the endogenous task, participants were required to pay attention to the stimuli on one side and judge the pitch of a target sound. Mixed-design analyses of variance were conducted for the mean reaction times and accuracy across the experimental conditions.
Results:
Our results showed that in the endogenous attention task, compared with the mild tinnitus group, moderate to severe tinnitus participants had better performance for stimuli presented on the tinnitus side but not on the nontinnitus side. In contrast, in the exogenous attention task, no differences were found between mild and moderate to severe tinnitus groups.
Conclusion:
The results suggest that the degree of tinnitus influences the performance of auditory endogenous attention but not auditory exogenous attention orienting.
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Affiliation(s)
- Yichen Yuan
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
- Shenzhen-Shanwei Central Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China
| | - Jiashuang Wu
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
| | - Jiahong Li
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Xiayin Huang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Guisheng Chen
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Liping Lan
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Hemei Huang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Hanwen Dong
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Hearing and Speech-Language Science, Sun Yat-sen University, Guangzhou, China
- Shenzhen-Shanwei Central Hospital, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, China
| | - Zhenzhu Yue
- Department of Psychology, Sun Yat-sen University, Guangzhou, China
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De Ridder D, Vanneste S, Song JJ, Adhia D. Tinnitus and the triple network model: a perspective. Clin Exp Otorhinolaryngol 2022; 15:205-212. [PMID: 35835548 PMCID: PMC9441510 DOI: 10.21053/ceo.2022.00815] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Tinnitus is defined as the conscious awareness of a sound without an identifiable external sound source, and tinnitus disorder as tinnitus with associated suffering. Chronic tinnitus has been anatomically and phenomenologically separated into three pathways: a lateral “sound” pathway, a medial “suffering” pathway, and a descending noise-canceling pathway. Here, the triple network model is proposed as a unifying framework common to neuropsychiatric disorders. It proposes that abnormal interactions among three cardinal networks—the self-representational default mode network, the behavioral relevance-encoding salience network and the goal-oriented central executive network—underlie brain disorders. Tinnitus commonly leads to negative cognitive, emotional, and autonomic responses, phenomenologically expressed as tinnitus-related suffering, processed by the medial pathway. This anatomically overlaps with the salience network, encoding the behavioral relevance of the sound stimulus. Chronic tinnitus can also become associated with the self-representing default mode network and becomes an intrinsic part of the self-percept. This is likely an energy-saving evolutionary adaptation, by detaching tinnitus from sympathetic energy-consuming activity. Eventually, this can lead to functional disability by interfering with the central executive network. In conclusion, these three pathways can be extended to a triple network model explaining all tinnitus-associated comorbidities. This model paves the way for the development of individualized treatment modalities.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jae-Jin Song
- Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Divya Adhia
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
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Simoes J, Bulla J, Neff P, Pryss R, Marcrum SC, Langguth B, Schlee W. Daily Contributors of Tinnitus Loudness and Distress: An Ecological Momentary Assessment Study. Front Neurosci 2022; 16:883665. [PMID: 35864989 PMCID: PMC9294456 DOI: 10.3389/fnins.2022.883665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTinnitus is a heterogeneous condition which may be associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by capturing the fluctuations of tinnitus symptoms, such as distress and loudness, and psychological processes, such as emotional arousal, overall stress, mood, and concentration and how these variables interact over time. Whether any of those variables have an influence over the next day, that is, whether any of these variables are auto- or cross-correlated, is still unanswered.ObjectivesAssess whether behavioral and symptom-related data from tinnitus users from the TrackYourTinnitus (TYT) mobile app have an impact on tinnitus loudness and distress on subsequent days.MethodsAnonymized data was collected from 278 users of the iOS or Android TYT apps between 2014 and 2020. Tinnitus-related distress, tinnitus loudness, concentration level, mood, emotional arousal, and overall stress level were assessed using either a slider or the Wong-Baker Pain FACES scale via a daily survey. Three modeling strategies were used to investigate whether tinnitus loudness and distress are affected by previous days symptoms or psychological processes: auto- and cross correlations, regressions with elastic net regularization, and subgrouping within group iterative multiple model estimation (S-GIMME).ResultsNo autocorrelation or cross-correlation was observed at the group level between the variables assessed. However, application of the regression models with elastic net regularization identified individualized predictors of tinnitus loudness and distress for most participants, with the models including contemporaneous and lagged information from the previous day. S-GIMME corroborated these findings by identifying individualized predictors of tinnitus loudness and distress from the previous day.DiscussionWe showed that tinnitus loudness and tinnitus distress are affected by the contemporaneous and lagged dynamics of behavioral and emotional processes measured through EMA. These effects were seen at the group, and individual levels. The relevance EMA and the implications of the insights derived from it for tinnitus care are discussed, especially considering current trends toward the individualization of tinnitus care.
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Affiliation(s)
- Jorge Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- *Correspondence: Jorge Simoes
| | - Jan Bulla
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
- Department of Psychology, Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Steven C. Marcrum
- Department of Otolaryngology, University Hospital Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Bromis K, Sarafidis M, Manta O, Kouris I, Vellidou E, Schlee W, Koutsouris D. Predicting the optimal therapeutic intervention for tinnitus patients using random forest regression: A preliminary study of UNITI's decision support system model. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:2655-2658. [PMID: 36085810 DOI: 10.1109/embc48229.2022.9871331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Tinnitus is the conscious perception of a phantom sound in absence of an external or internal stimulus. More than 1 in 7 adults in the EU experience tinnitus and for a large proportion of them tinnitus is an intrusive, persistent, and disabling condition, which impairs their life quality. Therefore, tinnitus is posed as a major global burden, which requires a precision-medicine approach in terms of treatments that are tailored to individual patients, due to its high heterogeneity. UNITI is a research and innovation project which aims towards this goal, unifying treatments and interventions for tinnitus. In the context UNITI, a randomized controlled trial (RCT) is being conducted and all the participants' data will be utilized for the development of a clinical decision support system (CDSS). This CDSS will predict the optimal therapeutic intervention for a tinnitus patient based on their profile. In this paper, we present a preliminary study of the CDSS model development process. We describe the available input data, the pre-processing steps conducted, the algorithms tested to model the CDSS' prediction, the models' results, and the future work in the context of this project. The R2 score of the selected model is currently 0.65, indicating that its development process is in the right direction but further tuning and hyperparameter optimization is needed. Clinical Relevance- The proposed model will be integrated in a CDSS aiming at indicating the optimal treatment strategy for a tinnitus patient based their personal profile.
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Cortical auditory evoked potentials, brain signal variability and cognition as biomarkers to detect the presence of chronic tinnitus. Hear Res 2022; 420:108489. [DOI: 10.1016/j.heares.2022.108489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/03/2022] [Accepted: 03/19/2022] [Indexed: 12/31/2022]
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Waechter S, Wilson WJ, Magnusson M, Brännström KJ. Extended High Frequency Hearing, but Not Tinnitus, Is Associated With Every-Day Cognitive Performance. Front Psychol 2022; 13:913944. [PMID: 35774957 PMCID: PMC9237571 DOI: 10.3389/fpsyg.2022.913944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 05/16/2022] [Indexed: 12/21/2022] Open
Abstract
Research into the potential associations between tinnitus and cognition has investigated specific cognitive domains in laboratory settings despite adults with tinnitus reporting broad cognitive difficulties in every-day life. To address this limitation, the present study compared performance and perceived exertion on a visual office-like task in 38 adults with tinnitus (19 with normal hearing and 19 with hearing loss) and 38 adults without tinnitus (19 with normal hearing and 19 with hearing loss) matched for age, sex and educational background. All participants were also assessed for hearing, anxiety and depression, and participants with tinnitus were also assessed for tinnitus handicap. No associations were found between presence of tinnitus and cognitive performance (mean total rate correct score on the visual office-like task being 2.9 for the tinnitus group, 2.8 for the control group, p = 0.612) and perceived exertion (mean ratings of perceived exertion on the Borg CR10-scale being 5.8 for the tinnitus group, 6.5 for the control group, p = 0.063) on the visual office-like task when corrected for standard (0.125 to 8 kHz) and extended high frequency (10 to 16 kHz) hearing thresholds, anxiety, and depression. The correction for extended high frequency average (10, 12.5, 14, and 16 kHz) hearing threshold was significant for performance (p = 0.009) but not perceived exertion on the visual office-like task. Overall, the results showed extended high frequency hearing, but not tinnitus, was associated with every-day cognitive performance. This indicates clinical testing of hearing thresholds above 8 kHz could support clinicians’ identification and management of cognitive difficulties. One management method suggested by the current findings would include provision of auditory stimulation at frequencies exceeding the frequency response of many current hearing aids.
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Affiliation(s)
- Sebastian Waechter
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
- *Correspondence: Sebastian Waechter,
| | - Wayne J. Wilson
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, QLD, Australia
| | - Måns Magnusson
- Department of Otorhinolaryngology, Lund University, Lund, Sweden
| | - K. Jonas Brännström
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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The effectiveness of the combined transcranial direct current stimulation (tDCS) and tailor-made notched music training (TMNMT) on psychoacoustic, psychometric, and cognitive indices of tinnitus patients. Am J Otolaryngol 2022; 43:103274. [PMID: 34715486 DOI: 10.1016/j.amjoto.2021.103274] [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: 08/11/2021] [Revised: 09/26/2021] [Accepted: 10/14/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Tinnitus network(s) consists of pathways in the auditory cortex, frontal cortex, and the limbic system. The cortical hyperactivity caused by tinnitus may be suppressed by neuromodulation techniques. Due to the lack of definitive treatment for tinnitus and limited usefulness of the individual methods, in this study, a combination of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) and tailor-made notched music training (TMNMT) was used. MATERIAL AND METHODS In this descriptive-analytic study, 26 patients with chronic unilateral tinnitus of the right ear were randomly divided into the clinical trial group (CTG) and the control group (CG). In both groups, six sessions of tDCS with 2 mA intensity for 20 min, with anode on F4 and cathode on F3, were conducted. Simultaneous with tDCS sessions, and based on TMNMT, the participant was asked to listen passively for 120 min/day, to a CD containing her/his favorite music with a proper notch applied in its spectrum according to the individual's tinnitus The treatment outcome was measured by, psychoacoustic (loudness-matching), psychometric (awareness, loudness and annoyance Visual Analogue Scale (VAS) scores, and Tinnitus Handicap Inventory (THI)) scores, and cognitive assessments (randomized dichotic digits test (RDDT) and dichotic auditory-verbal memory test (DAVMT)). Repeated measurement test was used for statistical analyses. RESULTS In the CTG, the tinnitus loudness and annoyance VAS scores, and THI were reduced significantly (p = 0.001). In addition, the DAVMT and RDDT scores were enhanced (p = 0.001). Such changes were not observed in the CG (p > 0.05). CONCLUSION The combination of tDCS and TMNMT led to a reduction in the loudness, awareness, annoyance, and also disability induced by tinnitus in CTG. Furthermore, this method showed an improvement of cognitive functions (auditory divided attention, selective attention and working memory) in the CTG.
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Evaluation of stress and cognitive skills in individuals with tinnitus complaints. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1056873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vasudevan H, Ganapathy K, Palaniswamy HP, Searchfield G, Rajashekhar B. Systematic review and meta-analysis on the effect of continuous subjective tinnitus on attention and habituation. PeerJ 2021; 9:e12340. [PMID: 34900408 PMCID: PMC8628620 DOI: 10.7717/peerj.12340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Attention and habituation are two domains known to play key roles in the perception and maintenance of tinnitus. The heterogeneous nature of tinnitus and the methodologies adopted by various studies make it difficult to generalize findings. The current review aims at assessing and synthesizing evidence on the possible roles of attention and habituation in continuous subjective tinnitus. Methodology The literature search included five databases (PubMed, Scopus, Web of Sciences, CINAHL and ProQuest) that resulted in 1,293 articles, published by July 2019. Studies on attention and/or habituation in individuals with tinnitus using either behavioural or electrophysiological tests were included in the review after a quality assessment. Results Seventeen studies on attention in tinnitus were included in the narrative synthesis. Two meta-analyses were performed to assess the role of attention in tinnitus using a behavioural methodology (z = 4.06; p < 0.0001) and P300 amplitude (z = 2.70; p = 0.007) with 531 participants. With respect to habituation, the review indicates the lack of quality articles for habituation inclusion in the narrative synthesis. Conclusions The review highlights that selective domains of attention were consistently impaired in individuals with tinnitus. Habituation, on the other hand, needs further exploration.
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Affiliation(s)
- Harini Vasudevan
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Kanaka Ganapathy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Grant Searchfield
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
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Hamza Y, Zeng FG. Tinnitus Is Associated With Improved Cognitive Performance in Non-hispanic Elderly With Hearing Loss. Front Neurosci 2021; 15:735950. [PMID: 34776845 PMCID: PMC8581543 DOI: 10.3389/fnins.2021.735950] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Because hearing loss is a high-risk factor for cognitive decline, tinnitus, a comorbid condition of hearing loss, is often presumed to impair cognition. The present cross-sectional study aimed to delineate the interaction of tinnitus and cognition in the elderly with and without hearing loss after adjusting for covariates in race, age, sex, education, pure tone average, hearing aids, and physical well-being. Participants included 643 adults (60–69 years old; 51.3% females) from the National Health and Nutrition Examination Survey (NHANES, 2011–2012), and 1,716 (60–69 years old; 60.4% females) from the Hispanic Community Health Study (HCHS, 2008–2011). Multivariable linear and binary logistic regression was used to assess the association between tinnitus and cognition in the two sub-cohorts of normal hearing (NHANES, n = 508; HCHS, n = 1264) and hearing loss (NHANES, n = 135; HCHS, n = 453). Cognitive performance was measured as a composite z-score from four cognitive tests: The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD)-word learning, CERAD-animal fluency, CERAD-word list recall, and the digit symbol substitution test (DSST) in NHANES, and a comparable Hispanic version of these four tests in HCHS. Multivariable linear regression revealed no association between tinnitus and cognition, except for the NHANES (non-Hispanic) participants with hearing loss, where the presence of tinnitus was associated with improved cognitive performance (Mean = 0.3; 95% CI, 0.1–0.5; p, 0.018). Using the 25th percentile score of the control (i.e., normal hearing and no tinnitus) as a threshold for poor cognitive performance, the absence of tinnitus increased the risk for poor cognitive performance (OR = 5.6, 95% CI, 1.9–17.2; p, 0.002). Sensitivity analysis found a positive correlation between tinnitus duration and cognitive performance in the NHANES cohort [F(4,140), 2.6; p, 0.037]. The present study finds no evidence for the assumption that tinnitus impairs cognitive performance in the elderly. On the contrary, tinnitus is associated with improved cognitive performance in the non-Hispanic elderly with hearing loss. The present result suggests that race be considered as an important and relevant factor in the experimental design of tinnitus research. Future longitudinal and imaging studies are needed to validate the present findings and understand their mechanisms.
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Affiliation(s)
- Yasmeen Hamza
- Center for Hearing Research, Department of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, CA, United States
| | - Fan-Gang Zeng
- Center for Hearing Research, Department of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, Otolaryngology-Head and Neck Surgery, University of California, Irvine, Irvine, CA, United States
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Escobar-Castro DI, Vivas-Cortés MDJ, Espinosa-Cepeda CP, Zamora-Romero AM, Peñuela-Epalza ME. Hearing loss symptoms and leisure noise exposure in university students in Barranquilla, Colombia. Codas 2021; 34:e20200379. [PMID: 34787235 PMCID: PMC9886120 DOI: 10.1590/2317-1782/20212020379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/01/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE The aim of this study was to investigate the total weekly exposure to leisure noise among university students and to assess its association with self-reported symptoms of hypoacusis. METHODS This is a cross-sectional survey. An online questionnaire based on the "Noise Exposure Questionnaire", plus 11 questions regarding hearing loss were sent to 730 randomly selected students. Participants self-reported time spent on different leisure noise activities and their subjective evaluation of the loudness of these activities, converted into equivalent noise levels, were used to estimate weekly noise exposure levels that were compared to occupational noise limits (> 85 dBA = hazardous). Inference statistics was applied to relate hearing symptoms and "likely or having some degree of hearing loss" with hazardous weekly leisure noise exposure levels. RESULTS Ninety-three percent of the participants reported at least one hypoacusis symptom. The most frequent sound-related ear symptom was tinnitus (72%). Fifty-five percent of the individuals presented weekly exposure to noise >85 dBA. Symptoms of hearing loss were more prevalent in those exposed to weekly noise levels >85 dBA. CONCLUSION This study suggests that there may be hearing loss caused by exposure to high levels of leisure noise in a large part of the study population. Health promotion of hearing conservation should be emphasized at university level. Objective repeated measurement of hearing acuity should be part of integral health services for the youth population.
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Affiliation(s)
| | | | | | | | - Martha Elena Peñuela-Epalza
- Departamento de Salud Pública, División Ciencias de la Salud, Universidad del Norte - Barranquilla (Atlántico), Colombia.
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Knipper M, Mazurek B, van Dijk P, Schulze H. Too Blind to See the Elephant? Why Neuroscientists Ought to Be Interested in Tinnitus. J Assoc Res Otolaryngol 2021; 22:609-621. [PMID: 34686939 PMCID: PMC8599745 DOI: 10.1007/s10162-021-00815-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
A curative therapy for tinnitus currently does not exist. One may actually exist but cannot currently be causally linked to tinnitus due to the lack of consistency of concepts about the neural correlate of tinnitus. Depending on predictions, these concepts would require either a suppression or enhancement of brain activity or an increase in inhibition or disinhibition. Although procedures with a potential to silence tinnitus may exist, the lack of rationale for their curative success hampers an optimization of therapeutic protocols. We discuss here six candidate contributors to tinnitus that have been suggested by a variety of scientific experts in the field and that were addressed in a virtual panel discussion at the ARO round table in February 2021. In this discussion, several potential tinnitus contributors were considered: (i) inhibitory circuits, (ii) attention, (iii) stress, (iv) unidentified sub-entities, (v) maladaptive information transmission, and (vi) minor cochlear deafferentation. Finally, (vii) some potential therapeutic approaches were discussed. The results of this discussion is reflected here in view of potential blind spots that may still remain and that have been ignored in most tinnitus literature. We strongly suggest to consider the high impact of connecting the controversial findings to unravel the whole complexity of the tinnitus phenomenon; an essential prerequisite for establishing suitable therapeutic approaches.
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Affiliation(s)
- Marlies Knipper
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre (THRC), Department of Otolaryngology, Head & Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany.
| | - Birgit Mazurek
- Tinnitus Center Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Holger Schulze
- Experimental Otolaryngology, Friedrich-Alexander Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Germany
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Husain FT, Chappell J, Tai Y. An online survey study of the association between tinnitus and hyperacusis using validated questionnaires. Int J Audiol 2021; 61:655-662. [PMID: 34353201 DOI: 10.1080/14992027.2021.1953712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the association between the highly comorbid tinnitus and hyperacusis conditions using standard questionnaires. DESIGN A cross-sectional internet-based survey consisted of general demographic questions, questions about hearing and emotional status, Tinnitus Primary Function Questionnaire (TPFQ), and Hyperacusis Questionnaire (HQ). STUDY SAMPLE Six hundred sixteen completed surveys were obtained primarily from students and staff in a large university. RESULTS About 6% of the respondents could be classified as having hyperacusis based on the criterion of HQ scores ≥ 28 and had significantly increased odds of reporting having tinnitus (OR 10.11; 95% CI 3.76-35.3). Tinnitus severity (TPFQ) and HQ scores were correlated regardless of the hearing loss status. When predicting TPFQ scores, after controlling for demographic factors and affective states, hyperacusis status became an insignificant predictor. In contrast, both affirmative answers to having anxiety and depression, together with hearing loss status and tinnitus were significant predictors of HQ scores. CONCLUSIONS Having hyperacusis did not appear to contribute significantly to tinnitus severity, but having tinnitus contributed to the likelihood of having hyperacusis. Our findings provide a nuanced view of how tinnitus and hyperacusis conditions co-occur and influence each other, which may be valuable to clinicians and researchers.
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Affiliation(s)
- Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jenise Chappell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
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Santacruz JL, Arnold R, Tuinstra J, Stewart RE, van Dijk P. Validation of a Dutch version of the Tinnitus Functional Index in a tertiary referral tinnitus clinic. Heliyon 2021; 7:e07733. [PMID: 34430732 PMCID: PMC8371215 DOI: 10.1016/j.heliyon.2021.e07733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/21/2021] [Accepted: 08/04/2021] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Tinnitus is a condition with a subjective nature that requires self-report questionnaires for its assessment. Aspects such as quality of life, sleep or intrusiveness have been addressed by multiple tinnitus questionnaires, but the high responsiveness to treatment effects of the Tinnitus Functional Index (TFI) makes this questionnaire part of the standard practice in tinnitus screening. To date, the TFI has been translated to more than 20 languages and used in more than 22 countries. In this study, the TFI was translated to Dutch and validated through a clinical population in the Netherlands. METHODS After a back-translation procedure, the Dutch TFI was filled-out by 377 patients in the tinnitus outpatient clinic at the Ear, Nose and Throat (ENT) department of the University Medical Center Groningen, in the Netherlands. Reliability and construct validity of the questionnaire were assessed by correlations with one other tinnitus questionnaire (Tinnitus Handicap Inventory, THI) and with three psychological functioning questionnaires (Rand-36, Cantril's ladder and the Hospital Anxiety and Depression Scale (HADS)). The eight-factor structure of the Dutch TFI was tested by means of exploratory factor analysis using three different models (ICM-CFA, ESEM and ESEM-CFA). RESULTS The Dutch TFI showed a high internal consistency (α = 0.95), and construct validity was proven by moderate-to high-convergent correlations with the THI (r = 0.47-0.79) and by moderate convergent (r = 0.55-0.67) and good-to moderate-divergent (r = 0.12-0.47) correlations with the psychological functioning questionnaires. The eight-factor structure of the TFI was confirmed for the Dutch version by the three models. CONCLUSION The Dutch version of the TFI is a reliable instrument for screening tinnitus impact in a clinical population, and its psychometric properties are comparable to the original TFI and other validated tinnitus questionnaires.
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Affiliation(s)
- Jose L. Santacruz
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, the Netherlands
| | - Rosemarie Arnold
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Jolanda Tuinstra
- University of Groningen, University Medical Center Groningen, Dept. of Health Sciences, the Netherlands
- University of Applied Sciences NHL Stenden, Dept. Health and Social Studies, Leeuwarden, the Netherlands
| | - Roy E. Stewart
- University of Groningen, University Medical Center Groningen, Dept. of Health Sciences, the Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, the Netherlands
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Jensen M, Hüttenrauch E, Müller-Mazzotta J, Stuck BA, Weise C. On the impairment of executive control of attention in chronic tinnitus: Evidence from the attention network test. Behav Brain Res 2021; 414:113493. [PMID: 34329668 DOI: 10.1016/j.bbr.2021.113493] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Abstract
Subjective, chronic tinnitus is a condition that is common in most populations. Whereas many individuals tend to habituate to tinnitus over time, for some their attention seems pathologically drawn towards the sensation. For this subgroup of individuals with severe tinnitus, dysfunctional executive attention has been suggested to be implicated in the failure to habituate. However, since most previous studies have used attention tests with low validity and specificity in this assessment, there is a need for further corroborating studies. In the present study, the Attention Network Test was used to compare mainly the efficiency of executive attention between a group of individuals with chronic tinnitus (TG; n = 33) and a healthy control group (CG; n = 37). The results showed that individuals with chronic tinnitus, compared to the CG, did not present with a specific impairment in executive control of attention, nor in any of the other two attention domains. These findings are discussed in relation to the sampling characteristics in this study, which might have led to the sample being more homogenous and high functioning than samples in tinnitus studies generally. Overall, this study suggests that tinnitus and executive control of attention impairment might not be directly related, and that the latter might not necessarily be associated with the maintenance of the condition.
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Affiliation(s)
- Martin Jensen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany; Eriksholm Research Centre, Snekkersten, Denmark.
| | - Eva Hüttenrauch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Jochen Müller-Mazzotta
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Germany
| | - Boris A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Marburg, Philipps-Universität Marburg, Germany
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Marburg, Germany.
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Macaruso N, Campbell K, Cost C, Sopfe J. Provider Documentation of Tinnitus in Childhood Cancer Survivors. J Pediatr Hematol Oncol 2021; 43:e642-e647. [PMID: 33065711 DOI: 10.1097/mph.0000000000001966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/02/2020] [Indexed: 11/25/2022]
Abstract
Tinnitus is a known complication of treatment for childhood cancer and potentially reduces the quality of life for childhood cancer survivors (CCS). Although current guidelines recommend annual surveillance in CCS at risk for tinnitus, current screening practices among pediatric oncology survivorship providers are unknown. The authors performed a retrospective cohort study to assess the adequacy of current tinnitus screening in survivorship care. The 5.6% prevalence of tinnitus reported by the Childhood Cancer Survivorship Study, the largest ongoing follow-up cohort of CCS, served as the baseline for comparison for our rate of documented positive screening for tinnitus. Survivorship providers identified tinnitus in 3 of 624 (0.48%) eligible CCS, which was significantly lower than the prevalence in the Childhood Cancer Survivorship Study (P<0.0001). Survivorship providers documented any screening for tinnitus (positive or negative) in 15 of 624 (2.4%) CCS. Screening practices significantly differed by ototoxic exposure history and age at follow-up. This study demonstrates that screening and detection of tinnitus are underdocumented by survivorship providers, raising concern for inadequate screening practices. Improved screening may facilitate the recognition and treatment of this late effect, improving the quality of life for CCS.
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Affiliation(s)
- Natalie Macaruso
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
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Understanding Factors That Cause Tinnitus: A Mendelian Randomization Study in the UK Biobank. Ear Hear 2021; 43:70-80. [PMID: 34108397 DOI: 10.1097/aud.0000000000001074] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To investigate the causal role of established risk factors and associated conditions to tinnitus and tinnitus severity in the UK Biobank. DESIGN The prospective cohort study with large dataset of >500,000 individuals. The analytical sample of 129,731 individuals in the UK Biobank of European descent. Participants were recruited from National Health Service registries, baseline age range between 37 and 73 years, response rate to baseline survey 6%. Participants were asked subjective questions about tinnitus and its severity. Previously observed associations (n = 23) were confirmed in the UK Biobank using logistic and ordinal regression models. Two-sample Mendelian randomization approaches were then used to test causal relationships between the 23 predictors and tinnitus and tinnitus severity. The main outcome measures were observational and genetic association between key demographics and determinants and two tinnitus outcomes (current tinnitus and tinnitus severity). RESULTS Prevalence of tinnitus was 20% and severe tinnitus 3.8%. The observational results are consistent with the previous literature, with hearing loss, older age, male gender, high BMI, higher deprivation, higher blood pressure, smoking history, as well as numerous comorbidities being associated with higher odds of current tinnitus. Mendelian randomization results showed causal correlations with tinnitus. Current tinnitus was predicted by genetically instrumented hearing loss (odds ratio [OR]: 8.65 [95% confidence interval (CI): 6.12 to 12.23]), major depression (OR: 1.26 [95% CI: 1.06 to 1.50]), neuroticism (OR: 1.48 [95% CI: 1.28 to 1.71]), and higher systolic blood pressure (OR: 1.01 [95% CI:1.00 to 1.02]). Lower odds of tinnitus were associated with longer duration in education (OR: 0.74 [95% CI: 0.63 to 0.88]), higher caffeine intake (OR: 0.89 [95% CI: 0.83 to 0.95]) and being a morning person (OR: 0.94 [95% CI: 0.90 to 0.98]). Tinnitus severity was predicted by a higher genetic liability to neuroticism (OR: 1.15 [95% CI: 1.06 to 1.26]) and schizophrenia (OR: 1.02 [95% CI: 1.00 to 1.04]). CONCLUSIONS Tinnitus data from the UK Biobank confirm established associated factors in the literature. Genetic analysis determined causal relationships with several factors that expand the understanding of the etiology of tinnitus and can direct future pathways of clinical care and research.
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Sherlock LP, Brungart DS. Functional impact of bothersome tinnitus on cognitive test performance. Int J Audiol 2021; 60:1000-1008. [PMID: 34028309 DOI: 10.1080/14992027.2021.1909760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Individuals with bothersome tinnitus frequently report their concentration is affected. Given that tinnitus is the leading service-connected disability compensated by the United States Department of Veterans Affairs, it is essential to determine whether tinnitus has a functional impact on the operational performance of Service members. Previous studies demonstrated that people with tinnitus perform more poorly on cognitive tests of selective attention and memory than those without tinnitus. This study aimed to compare performance between participants with and without tinnitus on visually based tests of selective attention (flanker task) and short-term memory (spatial letter location) that were self-administered under three auditory conditions (quiet, broadband noise and speech) using a tablet-based test protocol. DESIGN Experimental. STUDY SAMPLE Thirty participants with bothersome tinnitus and 30 control participants, matched for age and hearing loss. RESULTS The results revealed a significantly larger flanker effect and shorter memory span in the tinnitus group compared to the control group, consistent with previous studies. Performance accuracy was comparable between the groups. CONCLUSIONS The results suggest bothersome tinnitus may affect cognitive efficiency more than cognitive performance. The tablet-based protocol has the potential to be implemented clinically as a functional measure of the impact of bothersome tinnitus on concentration.
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Affiliation(s)
- LaGuinn P Sherlock
- Army Hearing Program, U.S. Army Public Health Center, Aberdeen, MD, USA.,Audiology and Speech Pathology Center, Walter Reed National Military Medical Center, Bethesda, MD, USA
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Malesci R, Brigato F, Di Cesare T, Del Vecchio V, Laria C, De Corso E, Fetoni AR. Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links. J Clin Med 2021; 10:1881. [PMID: 33925344 PMCID: PMC8123622 DOI: 10.3390/jcm10091881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Tinnitus is a common and disabling symptom often associated with hearing loss. While clinical practice frequently shows that a certain degree of psychological discomfort often characterizes tinnitus suffers, it has been recently suggested in adults as a determining factor for cognitive decline affecting attention and memory domains. The aim of our systematic review was to provide evidence for a link between tinnitus, psychological distress, and cognitive dysfunction in older patients and to focus on putative mechanisms of this relationship. METHODS We performed a systematic review, finally including 192 articles that were screened. This resulted in 12 manuscripts of which the full texts were included in a qualitative analysis. RESULTS The association between tinnitus and psychological distress, mainly depression, has been demonstrated in older patients, although only few studies addressed the aged population. Limited studies on cognitive dysfunction in aged patients affected by chronic tinnitus are hardly comparable, as they use different methods to validate cognitive impairment. Actual evidence does not allow us with certainty to establish if tinnitus matters as an independent risk factor for cognitive impairment or evolution to dementia. CONCLUSION Tinnitus, which is usually associated with age-related hearing loss, might negatively affect emotional wellbeing and cognitive capacities in older people, but further studies are required to improve the evidence.
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Affiliation(s)
- Rita Malesci
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Francesca Brigato
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
| | - Tiziana Di Cesare
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
| | - Valeria Del Vecchio
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Carla Laria
- Audiology Section, Neuroscience, Reproductive Sciences and Dentistry Department, “Federico II” University, via Pansini 5, 80131 Naples, Italy; (R.M.); (V.D.V.); (C.L.)
| | - Eugenio De Corso
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Anna Rita Fetoni
- Department of Otolaryngology Head & Neck Surgery, School of Medicine, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy; (F.B.); (T.D.C.); (E.D.C.)
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
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Brueggemann P, Neff PKA, Meyer M, Riemer N, Rose M, Mazurek B. On the relationship between tinnitus distress, cognitive performance and aging. PROGRESS IN BRAIN RESEARCH 2021; 262:263-285. [PMID: 33931184 DOI: 10.1016/bs.pbr.2021.01.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
In this study we analyzed psychometric data of 107 individuals who suffer from chronic subjective tinnitus. In particular, we elucidated the relationship between tinnitus-related distress, psychological comorbidities, age, and hearing, and the performance in cognitive concentration and interference tests. Previous research has provided first evidence that individuals with tinnitus may have deficits in cognitive tasks. The present study aimed at extending former research by investigating the relationship between tinnitus distress and cognition. Statistical analyses comprised correlation and regression approaches. We observed a significant relationship between tinnitus distress (tinnitus score, TQ), age and hearing loss and the performance in tests on selective and sustained attention (d2 test) and cognitive interference (Stroop test). Tinnitus distress was identified as the most important predictor of cognitive performance (additionally age for cognitive interference). For other psychometric variables (perceived stress, PSQ; self-efficacy, optimism and pessimism, SWOP) and hearing loss we could not find any meaningful relationship with cognitive performance. The results clearly point to a (currently non-causal) relationship between cognitive skills and distress of tinnitus-related symptoms. Furthermore, the influence of age is noteworthy as this finding implies that with increasing age an appropriate coping with aversive tinnitus symptoms based on proper cognitive functions and age-related hearing dysfunctions, namely inhibition, may become more difficult. Hence, it is suggested to consider cognitive tests as a supplementary measurement in clinical assessment of tinnitus and to raise awareness for the impairing influence of tinnitus on cognition in daily life.
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Affiliation(s)
| | - Patrick K A Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Martin Meyer
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland; Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Natalie Riemer
- Tinnitus-Zentrum, Charité-Universitaetsmedizin, Berlin, Germany
| | - Matthias Rose
- Department of Internal Medicine and Psychosomatics, Charité-Universitaetsmedizin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus-Zentrum, Charité-Universitaetsmedizin, Berlin, Germany.
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Abstract
Tinnitus is the chronic perception of a phantom sound with different levels of related distress. Past research has elucidated interactions of tinnitus distress with audiological, affective and further clinical variables. The influence of tinnitus distress on cognition is underinvestigated. Our study aims at investigating specific influences of tinnitus distress and further associated predictors on cognition in a cohort of n = 146 out-ward clinical tinnitus patients. Age, educational level, hearing loss, Tinnitus Questionnaire (TQ) score, tinnitus duration, speech in noise (SIN), stress, anxiety and depression, and psychological well-being were included as predictors of a machine learning regression approach (elastic net) in three models with scores of a multiple choice vocabulary test (MWT-B), or two trail-making tests (TMT-A and TMT-B), as dependent variables. TQ scores predicted lower MWT-B scores and higher TMT-B test completion time. Stress, emotional, and psychological variables were not found to be relevant predictors in all models with the exception of small positive influences of SIN and depression on TMT-B. Effect sizes were small to medium for all models and predictors. Results are indicative of specific influence of tinnitus distress on cognitive performance, especially on general or crystallized intelligence and executive functions. More research is needed at the delicate intersection of tinnitus distress and cognitive skills needed in daily functioning.
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Phonetic perception but not perception of speaker gender is impaired in chronic tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 260:397-422. [PMID: 33637229 DOI: 10.1016/bs.pbr.2020.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
While tinnitus is known to compromise the perception of speech, it is unclear if the same holds for extralinguistic speaker information. Furthermore, research with simple tone stimuli showed that unilateral tinnitus binds spatial attention, thereby impeding the detection of auditory changes in the non-affected ear. Using dichotic listening tasks, we tested left-ear tinnitus patients and control patients for their ability to ignore speech and speaker information in the task-irrelevant ear. To this end they heard vowel-consonant-vowel (VCV) syllables simultaneously spoken by gender-ambiguous voices in one ear and male or female voices in the contralateral ear. They selectively attended to speech (Exp. 1) or speaker (Exp. 2) information in a designated target ear, by classifying either the consonant (/b/ or /g/) in VCV syllables or voice gender (male or female) while ignoring distractor voices in the other ear. While performance was comparable across groups in the gender task, tinnitus patients responded slower than controls in the consonant task, with no effect of target ear. This suggests that tinnitus hampers phonetic perception in speech, while preserving the processing of extralinguistic speaker information. These findings support the growing evidence for speech perception impairments in tinnitus.
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Lan T, Cao Z, Zhao F, Perham N. The Association Between Effectiveness of Tinnitus Intervention and Cognitive Function-A Systematic Review. Front Psychol 2021; 11:553449. [PMID: 33488438 PMCID: PMC7815700 DOI: 10.3389/fpsyg.2020.553449] [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] [Received: 04/18/2020] [Accepted: 11/27/2020] [Indexed: 11/13/2022] Open
Abstract
Tinnitus refers to the perception of sound in the absence of an external stimulus. This can be problematic and can lead to health problems in some sufferers, including effects on cognitive functions such as attention and memory. Although several studies have examined the effectiveness of tinnitus interventions, e.g., cognitive behavioral therapy and sound therapy, it is still unclear as to the overall quality and limitations of these studies and whether their results could be generalized. Clarification is also needed as to whether poor cognitive function will lead to a less favorable intervention outcome in tinnitus patients. The present systematic review was therefore designed to critically appraise and synthesize findings from randomized controlled trials (RCTs) of tinnitus intervention and its effects on cognition. The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Medline (PubMed), Embase, and PsycINFO were searched. Only RCTs that compared the effectiveness of a tinnitus intervention and a measure of cognitive function in adult participants with tinnitus were included. A total of 8 studies involving 610 participants tested using 11 cognitive function assessment tools (e.g., Stroop Color and Word Test and Visual Continuous Performance Task) and 5 tinnitus intervention outcome measurements (e.g., Tinnitus Handicap Inventory and Tinnitus Questionnaire) were included and analyzed. The outcomes of the review suggest that tinnitus intervention not only facilitates tinnitus management but also improves cognitive functions. It is likely that cognition and emotion play an important role in a patient's adjustment to tinnitus. Whether cognition can predict treatment outcomes is unclear due to insufficient evidence. Future research is needed using a standardized assessment protocol focusing on the effect of sound-based interventions on tinnitus severity and cognitive functions. Studies on whether cognitive function measurement can be used as a predictor for the effectiveness of tinnitus therapy are also needed.
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Affiliation(s)
- Tianxiang Lan
- Centre for Speech and Language Therapy and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Zuwei Cao
- Center for Rehabilitative Auditory Research, Guizhou Provincial People's Hospital, Guiyang, China
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Department of Hearing and Speech Science, Xinhua College, Sun Yat-sen University, Guangzhou, China
| | - Nick Perham
- Department of Applied Psychology, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
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Abstract
This volume has highlighted the many recent advances in tinnitus theory, models, diagnostics, therapies, and therapeutics. But tinnitus knowledge is far from complete. In this chapter, contributors to the Behavioral Neuroscience of Tinnitus consider emerging topics and areas of research needed in light of recent findings. New research avenues and methods to explore are discussed. Issues pertaining to current assessment, treatment, and research methods are outlined, along with recommendations on new avenues to explore with research.
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Tai Y, Husain FT. Association Between Tinnitus Pitch and Consonant Recognition in Noise. Am J Audiol 2020; 29:916-929. [PMID: 33237797 DOI: 10.1044/2020_aja-20-00050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Difficulties in speech-in-noise understanding are often reported in individuals with tinnitus. Building on our previous findings that speech-in-noise performance is correlated with subjective loudness of tinnitus, this study aimed to investigate the effect of tinnitus pitch on consonant recognition in noise. Method Pure-tone audiometry and the Quick Speech-in-Noise Test were conducted on 66 participants categorized into four groups by their hearing sensitivity and self-report of tinnitus. Consonant recognition scores at various frequency ranges were obtained at the 5 dB SNR condition of the Quick Speech-in-Noise Test. Participants with tinnitus also completed a tinnitus pitch-matching procedure. Correlation analyses were conducted between tinnitus pitch and the frequency of the worst consonant recognition, and the error rates based on word and sentence position were compared. Results Regardless of hearing sensitivity, tinnitus pitch did not correlate with the frequency of the worst consonant recognition. Sentence-initial word recognition was affected by hearing loss, whereas sentence-final word recognition was not affected by hearing loss or tinnitus. In contrast to individuals with normal hearing, participants with hearing loss varied in full-sentence recognition, with those reporting tinnitus exhibiting significantly higher error rates. Conclusions The findings suggest that the effect of tinnitus on consonant recognition in noise may involve higher level functions more than perceptual characteristics of tinnitus. Furthermore, for individuals with speech-in-noise concerns, clinical evaluation should address both hearing sensitivity and the presence of tinnitus. Future speech-in-noise studies should incorporate cognitive tests and, possibly, brain imaging to parse out the contribution of cognitive factors, such as cognitive control, in speech-in-noise in tinnitus.
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Affiliation(s)
- Yihsin Tai
- Department of Speech & Hearing Science, University of Illinois at Urbana–Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign
| | - Fatima T. Husain
- Department of Speech & Hearing Science, University of Illinois at Urbana–Champaign
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana–Champaign
- Neuroscience Program, University of Illinois at Urbana–Champaign
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Clarke NA, Henshaw H, Akeroyd MA, Adams B, Hoare DJ. Associations Between Subjective Tinnitus and Cognitive Performance: Systematic Review and Meta-Analyses. Trends Hear 2020; 24:2331216520918416. [PMID: 32436477 PMCID: PMC7243410 DOI: 10.1177/2331216520918416] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Tinnitus is the perception of sound in the absence of a corresponding external sound source, and bothersome tinnitus has been linked to poorer cognitive performance. This review comprehensively quantifies the association between tinnitus and different domains of cognitive performance. The review protocol was preregistered and published in a peer-reviewed journal. The review and analyses were reported according to Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed literature was searched using electronic databases to find studies featuring participants with tinnitus who had undertaken measures of cognitive performance. Studies were assessed for quality and categorized according to an established cognitive framework. Random-effects meta-analyses were performed on various cognitive domains with potential moderator variables assessed where possible. Thirty-eight records were included in the analysis from a total of 1,863 participants. Analyses showed that tinnitus is associated with poorer executive function, processing speed, general short-term memory, and general learning and retrieval. Narrow cognitive domains of Inhibition and Shifting (within executive function) and learning and retrieval (within general learning and retrieval) were also associated with tinnitus.
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Affiliation(s)
- Nathan A Clarke
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Helen Henshaw
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Michael A Akeroyd
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Bethany Adams
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
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Clifford RE, Maihofer AX, Stein MB, Ryan AF, Nievergelt CM. Novel Risk Loci in Tinnitus and Causal Inference With Neuropsychiatric Disorders Among Adults of European Ancestry. JAMA Otolaryngol Head Neck Surg 2020; 146:1015-1025. [PMID: 32970095 PMCID: PMC7516809 DOI: 10.1001/jamaoto.2020.2920] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 07/27/2020] [Indexed: 02/06/2023]
Abstract
Importance Tinnitus affects at least 16 million US adults, but its pathophysiology is complicated, and treatment options remain limited. A heritable component has been identified in family and twin studies; however, no large-scale genome-wide association studies (GWAS) have been accomplished. Objective To identify genetic risk loci associated with tinnitus, determine genetic correlations, and infer possible relationships of tinnitus with hearing loss and neuropsychiatric disorders and traits. Design, Setting, and Participants A GWAS of self-reported tinnitus was performed in the UK Biobank (UKB) cohort using a linear mixed-model method implemented in BOLT-LMM (linear mixed model). Replication of significant findings was sought in the nonoverlapping US Million Veteran Program (MVP) cohort. A total of 172 995 UKB (discovery) and 260 832 MVP (replication) participants of European ancestry with self-report regarding tinnitus and hearing loss underwent genomic analysis. Linkage-disequilibrium score regression and mendelian randomization were performed between tinnitus and hearing loss and neuropsychiatric disorders. Data from the UKB were acquired and analyzed from September 24, 2018, to December 13, 2019. Data acquisition for the MVP cohort was completed July 22, 2019. Data analysis for both cohorts was completed on February 11, 2020. Main Outcomes and Measures Estimates of single nucleotide variation (SNV)-based heritability for tinnitus, identification of genetic risk loci and genes, functional mapping, and replication were performed. Genetic association and inferred causality of tinnitus compared with hearing loss and neuropsychiatric disorders and traits were analyzed. Results Of 172 995 UKB participants (53.7% female; mean [SD], 58.0 [8.2] years), 155 395 unrelated participants underwent SNV-based heritability analyses across a range of tinnitus phenotype definitions that explained approximately 6% of the heritability. The GWAS based on the most heritable model in the full UKB cohort identified 6 genome-wide significant loci and 27 genes in gene-based analyses, with replication of 3 of 6 loci and 8 of 27 genes in 260 832 MVP cohort participants (92.8% men; mean [SD] age, 63.8 [13.2] years). Mendelian randomization indicated that major depressive disorder had a permissive effect (β = 0.133; P = .003) and years of education had a protective effect (β = -0.322, P = <.001) on tinnitus, whereas tinnitus and hearing loss inferred a bidirectional association (β = 0.072, P = .001 and β = 1.546, P = <.001, respectively). Conclusions and Relevance This large GWAS characterizes the genetic architecture of tinnitus, demonstrating modest but significant heritability and a polygenic profile with multiple significant risk loci and genes. Genetic correlation and inferred causation between tinnitus and major depressive disorder, educational level, and hearing impairment were identified, consistent with clinical and neuroimaging evidence. These findings may guide gene-based diagnostic and therapeutic approaches to this pervasive disorder.
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Affiliation(s)
- Royce E Clifford
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, La Jolla
- Harvard School of Public Health, Boston, Massachusetts
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Adam X Maihofer
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Psychiatry, University of California, San Diego, La Jolla
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Allen F Ryan
- Division of Otolaryngology, Department of Surgery, University of California, San Diego, La Jolla
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| | - Caroline M Nievergelt
- Research Service, Veterans Affairs San Diego Healthcare System, San Diego, California
- Department of Psychiatry, University of California, San Diego, La Jolla
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System, San Diego, California
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Elarbed A, Fackrell K, Baguley DM, Hoare DJ. Tinnitus and stress in adults: a scoping review. Int J Audiol 2020; 60:171-182. [PMID: 33000672 DOI: 10.1080/14992027.2020.1827306] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Tinnitus and stress are recurrently reported together. The strength and direction of this relationship is not clear. The aim of this review is to catalogue the evidence of this relationship, how it has been described in adults and which instruments were used. DESIGN Five-stage framework was followed. An online search of databases and published journals were conducted. The main inclusion criteria were original studies published in English and conducted in an adult human population, in which both tinnitus and stress were measured using different instruments. STUDY SAMPLES 5699 records were identified in the searching stage and 50 studies were eligible for data extraction. RESULTS Measurements of perceived stress were most frequently used. Tinnitus patients tend to report louder and more bothersome tinnitus when they are stressed, but not all tinnitus patients associated stress with the onset or the severity of their tinnitus. Any positive correlation reported between stress and tinnitus levels varied in strength according to the used instrument. Post-intervention changes in stress and tinnitus levels showed inconsistency. CONCLUSION There is considerable room for further research to study the relationship between stress and tinnitus. We highlight principal issues that should be considered in future studies.
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Affiliation(s)
- Asma Elarbed
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - David M Baguley
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
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50
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Waechter S, Wilson WJ, Brännström JK. The impact of tinnitus on working memory capacity. Int J Audiol 2020; 60:274-281. [PMID: 33000654 DOI: 10.1080/14992027.2020.1822550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine if tinnitus was related to working memory (WM) in adults and if tinnitus handicap was related to WM in adults with tinnitus. DESIGN Two groups, cross-sectional design. STUDY SAMPLES 76 adults forming a tinnitus group (n = 38) and a control group (n = 38). Each group included 19 adults with normal hearing and 19 adults with hearing loss matched for age, sex and educational backgrounds. All participants completed the visual n-back test; pure tone audiometry (0.125-16 kHz); and the Hospital Anxiety and Depression Scale (HADS). Tinnitus sufferers also completed the Tinnitus Handicap Inventory (THI). RESULTS For all participants, tinnitus was not related to WM scores when corrected for hearing thresholds, anxiety, and depression. The corrections for best ear high-frequency pure-tone average hearing threshold (BEHFPTA: 10, 12.5, 14 and 16 kHz) were significant. For tinnitus sufferers, THI was related to WM scores in the easiest n-back condition, and BEHFPTA was related to WM scores in the easiest and the hardest n-back condition. CONCLUSION Tinnitus was not related to WM scores. Tinnitus handicap was related to some WM scores in tinnitus sufferers. Further investigation of the possible relationship between high-frequency hearing and WM is warranted.
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Affiliation(s)
- Sebastian Waechter
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Wayne J Wilson
- Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Jonas K Brännström
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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