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Keur-Huizinga L, Huizinga NA, Zekveld AA, Versfeld NJ, van de Ven SRB, van Dijk WAJ, de Geus EJC, Kramer SE. Effects of hearing acuity on psychophysiological responses to effortful speech perception. Hear Res 2024; 448:109031. [PMID: 38761554 DOI: 10.1016/j.heares.2024.109031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/02/2024] [Accepted: 05/13/2024] [Indexed: 05/20/2024]
Abstract
In recent studies, psychophysiological measures have been used as markers of listening effort, but there is limited research on the effect of hearing loss on such measures. The aim of the current study was to investigate the effect of hearing acuity on physiological responses and subjective measures acquired during different levels of listening demand, and to investigate the relationship between these measures. A total of 125 participants (37 males and 88 females, age range 37-72 years, pure-tone average hearing thresholds at the best ear between -5.0 to 68.8 dB HL and asymmetry between ears between 0.0 and 87.5 dB) completed a listening task. A speech reception threshold (SRT) test was used with target sentences spoken by a female voice masked by male speech. Listening demand was manipulated using three levels of intelligibility: 20 % correct speech recognition, 50 %, and 80 % (IL20 %/IL50 %/IL80 %, respectively). During the task, peak pupil dilation (PPD), heart rate (HR), pre-ejection period (PEP), respiratory sinus arrhythmia (RSA), and skin conductance level (SCL) were measured. For each condition, subjective ratings of effort, performance, difficulty, and tendency to give up were also collected. Linear mixed effects models tested the effect of intelligibility level, hearing acuity, hearing asymmetry, and tinnitus complaints on the physiological reactivity (compared to baseline) and subjective measures. PPD and PEP reactivity showed a non-monotonic relationship with intelligibility level, but no such effects were found for HR, RSA, or SCL reactivity. Participants with worse hearing acuity had lower PPD at all intelligibility levels and showed lower PEP baseline levels. Additionally, PPD and SCL reactivity were lower for participants who reported suffering from tinnitus complaints. For IL80 %, but not IL50 % or IL20 %, participants with worse hearing acuity rated their listening effort to be relatively high compared to participants with better hearing. The reactivity of the different physiological measures were not or only weakly correlated with each other. Together, the results suggest that hearing acuity may be associated with altered sympathetic nervous system (re)activity. Research using psychophysiological measures as markers of listening effort to study the effect of hearing acuity on such measures are best served by the use of the PPD and PEP.
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Affiliation(s)
- Laura Keur-Huizinga
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
| | - Nicole A Huizinga
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands; Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Adriana A Zekveld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Niek J Versfeld
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Sjors R B van de Ven
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Wieke A J van Dijk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Eco J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sophia E Kramer
- Amsterdam UMC location Vrije Universiteit Amsterdam, Otolaryngology - Head and Neck Surgery, Ear & Hearing, Amsterdam Public Health Research Institute, De Boelelaan 1117, Amsterdam, the Netherlands
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2
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Langguth B, Shiao AS, Lai JT, Chi TS, Weber F, Schecklmann M, Li LPH. Tinnitus and treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:131-147. [PMID: 37806713 DOI: 10.1016/bs.pbr.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Tinnitus, a frequent disorder, is the conscious perception of a sound in the absence of a corresponding external acoustic sound source in the sense of a phantom sound. Although the majority of people who perceive a tinnitus sound can cope with it and are only minimaly impaired in their quality of lfe, 2-3% of the population perceive tinnitus as a major problem. Recently it has been proposed that the two groups should be differentiated by distict terms: "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. There is overwhelming evidence that a high tinnitus burden is associated with the increased occurrence of comorbidities, including depression. Since no causal therapeutic options are available for patients with tinnitus at the present time, the identification and adequate treatment of relevant comorbidities is of great importance for the reduction of tinnitus distress. This chapter deals with the relationship between tinnitus and depression. The neuronal mechanisms underlying tinnitus will first be discussed. There will also be an overview about depression and treatment resistant depression (TRD). A comprehensive review about the state-of-the-art evidences of the relationship between tinnitus and TRD will then be provided.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - An-Suey Shiao
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Jen-Tsung Lai
- Department of Otolaryngology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Tai-Shih Chi
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Franziska Weber
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Lieber Po-Hung Li
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan; Faculty of Medicine, and Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan; Integrated Brain Research Laboratory, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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3
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Manohar S, Chen GD, Li L, Liu X, Salvi R. Chronic stress induced loudness hyperacusis, sound avoidance and auditory cortex hyperactivity. Hear Res 2023; 431:108726. [PMID: 36905854 DOI: 10.1016/j.heares.2023.108726] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/22/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Hyperacusis, a debilitating loudness intolerance disorder, has been linked to chronic stress and adrenal insufficiency. To investigate the role of chronic stress, rats were chronically treated with corticosterone (CORT) stress hormone. Chronic CORT produced behavioral evidence of loudness hyperacusis, sound avoidance hyperacusis, and abnormal temporal integration of loudness. CORT treatment did not disrupt cochlear or brainstem function as reflected by normal distortion product otoacoustic emissions, compound action potentials, acoustic startle reflexex, and auditory brainstem responses. In contrast, the evoked response from the auditory cortex was enhanced up to three fold after CORT treatment. This hyperactivity was associated with a significant increase in glucocorticoid receptors in auditory cortex layers II/III and VI. Basal serum CORT levels remained normal after chronic CORT stress whereas reactive serum CORT levels evoked by acute restraint stress were blunted (reduced) after chronic CORT stress; similar changes were observed after chronic, intense noise stress. Taken together, our results show for the first time that chronic stress can induce hyperacusis and sound avoidance. A model is proposed in which chronic stress creates a subclinical state of adrenal insufficiency that establishes the necessary conditions for inducing hyperacusis.
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Affiliation(s)
- Senthilvelan Manohar
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY 14214, USA
| | - Guang-Di Chen
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY 14214, USA
| | - Li Li
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY 14214, USA
| | - Xiaopeng Liu
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY 14214, USA
| | - Richard Salvi
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY 14214, USA.
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4
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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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Basso L, Boecking B, Neff P, Brueggemann P, Peters EMJ, Mazurek B. Hair-cortisol and hair-BDNF as biomarkers of tinnitus loudness and distress in chronic tinnitus. Sci Rep 2022; 12:1934. [PMID: 35121746 PMCID: PMC8817043 DOI: 10.1038/s41598-022-04811-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
The role of stress and its neuroendocrine mediators in tinnitus is unclear. In this study, we measure cortisol as an indicator of hypothalamus–pituitary–adrenal (HPA) axis alterations and brain-derived neurotrophic factor (BDNF) as a marker of adaptive neuroplasticity in hair of chronic tinnitus patients to investigate relationships with tinnitus-related and psychological factors. Cross-sectional data from chronic tinnitus inpatients were analyzed. Data collection included hair sampling, pure tone audiometry, tinnitus pitch and loudness matching, and psychometric questionnaires. Elastic net regressions with n-fold cross-validation were performed for cortisol (N = 91) and BDNF (N = 87). For hair-cortisol (R2 = 0.10), the strongest effects were sampling in autumn and body-mass index (BMI) (positive), followed by tinnitus loudness (positive) and smoking (negative). For hair-BDNF (R2 = 0.28), the strongest effects were hearing aid use, shift work (positive), and tinnitus loudness (negative), followed by smoking, tinnitus-related distress (Tinnitus Questionnaire), number of experienced traumatic events (negative), and physical health-related quality of life (Short Form-12 Health Survey) (positive). These findings suggest that in chronic tinnitus patients, higher perceived tinnitus loudness is associated with higher hair-cortisol and lower hair-BDNF, and higher tinnitus-related distress with lower hair-BDNF. Regarding hair-BDNF, traumatic experiences appear to have additional stress-related effects, whereas hearing aid use and high physical health-related quality of life appear beneficial. Implications include the potential use of hair-cortisol and hair-BDNF as biomarkers of tinnitus loudness or distress and the need for intensive future research into chronic stress-related HPA axis and neuroplasticity alterations in chronic tinnitus.
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Affiliation(s)
- Laura Basso
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland.,Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Petra Brueggemann
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Giessen, Germany.,Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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Salvi R, Radziwon K, Manohar S, Auerbach B, Ding D, Liu X, Lau C, Chen YC, Chen GD. Review: Neural Mechanisms of Tinnitus and Hyperacusis in Acute Drug-Induced Ototoxicity. Am J Audiol 2021; 30:901-915. [PMID: 33465315 DOI: 10.1044/2020_aja-20-00023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Tinnitus and hyperacusis are debilitating conditions often associated with age-, noise-, and drug-induced hearing loss. Because of their subjective nature, the neural mechanisms that give rise to tinnitus and hyperacusis are poorly understood. Over the past few decades, considerable progress has been made in deciphering the biological bases for these disorders using animal models. Method Important advances in understanding the biological bases of tinnitus and hyperacusis have come from studies in which tinnitus and hyperacusis are consistently induced with a high dose of salicylate, the active ingredient in aspirin. Results Salicylate induced a transient hearing loss characterized by a reduction in otoacoustic emissions, a moderate cochlear threshold shift, and a large reduction in the neural output of the cochlea. As the weak cochlear neural signals were relayed up the auditory pathway, they were progressively amplified so that the suprathreshold neural responses in the auditory cortex were much larger than normal. Excessive central gain (neural amplification), presumably resulting from diminished inhibition, is believed to contribute to hyperacusis and tinnitus. Salicylate also increased corticosterone stress hormone levels. Functional imaging studies indicated that salicylate increased spontaneous activity and enhanced functional connectivity between structures in the central auditory pathway and regions of the brain associated with arousal (reticular formation), emotion (amygdala), memory/spatial navigation (hippocampus), motor planning (cerebellum), and motor control (caudate/putamen). Conclusion These results suggest that tinnitus and hyperacusis arise from aberrant neural signaling in a complex neural network that includes both auditory and nonauditory structures.
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Affiliation(s)
- Richard Salvi
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Kelly Radziwon
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Senthilvelan Manohar
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Ben Auerbach
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Dalian Ding
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Xiaopeng Liu
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Condon Lau
- Department of Physics, City University of Hong Kong
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, China
| | - Guang-Di Chen
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
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7
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Reinhart P, Griffin K, Micheyl C. Changes in Heart Rate Variability Following Acoustic Therapy in Individuals With Tinnitus. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:1413-1419. [PMID: 33820426 DOI: 10.1044/2021_jslhr-20-00596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose The aim of the study was to investigate changes in autonomic function, as measured by heart rate variability, in individuals with tinnitus following acoustic therapy implemented using tinnitus maskers presented via hearing aids. Method Twenty-six individuals with tinnitus and hearing impairment completed an 8-week field trial wearing hearing aids providing acoustic therapy via three tinnitus masker options set just below minimum masking level. Tinnitus handicap was measured using the Tinnitus Handicap Inventory at baseline (before starting acoustic therapy) and posttreatment (at end of 8-week trial). Resting heart rate and heart rate variability were measured using electrocardiography at baseline and posttreatment. Results There was a significant decrease in tinnitus handicap posttreatment compared to baseline. There was no change in heart rate, but there was a significant increase in heart rate variability posttreatment compared to baseline. Conclusions Acoustic therapy using tinnitus maskers delivered via hearing aids provided tinnitus relief and produced a concurrent increase in heart rate variability, suggesting a decrease in stress. Heart rate variability is a potential biomarker for tracking efficacy of acoustic therapy; however, further research is required.
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Noreña AJ, Lacher-Fougère S, Fraysse MJ, Bizaguet E, Grevin P, Thai-Van H, Moati L, Le Pajolec C, Fournier P, Ohresser M. A contribution to the debate on tinnitus definition. PROGRESS IN BRAIN RESEARCH 2021; 262:469-485. [PMID: 33931192 DOI: 10.1016/bs.pbr.2021.01.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tinnitus is generally defined as an auditory perception in the absence of environmental sound stimulation. However, this definition is quite incomplete as it omits an essential aspect, the patient's point of view. This point of view constitutes, first and foremost, a global and unified lived experience, which is not only sensory (localization, loudness, pitch and tone), but also cognitive (thoughts, attentiveness, behaviors) and emotional (discomfort, suffering). This experience can be lived in a very unpleasant way and consequently have a very negative impact on quality of life. This article proposes and justifies a new definition for tinnitus elaborated by a group of French clinicians and researchers, which is more in line with its phenomenology. It also provides a minimum knowledge base, including possibilities for clinical care, hoping to eradicate all misinformation, misconceptions and inappropriate attitudes or practices toward this condition. Here is the short version of our definition: Tinnitus is an auditory sensation without an external sound stimulation or meaning, which can be lived as an unpleasant experience, possibly impacting quality of life.
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Affiliation(s)
- Arnaud J Noreña
- Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France.
| | | | | | | | | | - Hung Thai-Van
- Hôpital Edouard Herriot, Pavillon U, Place d'Arsonval, Lyon, France
| | | | | | - Philippe Fournier
- Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
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Haider HF, Hoare DJ, Ribeiro SF, Ribeiro D, Caria H, Trigueiros N, Borrego LM, Szczepek AJ, Papoila AL, Elarbed A, da Luz Martins M, Paço J, Sereda M. Evidence for biological markers of tinnitus: A systematic review. PROGRESS IN BRAIN RESEARCH 2021; 262:345-398. [PMID: 33931188 DOI: 10.1016/bs.pbr.2021.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Subjective tinnitus is a phantom sound heard only by the affected person and may be a symptom of various diseases. Tinnitus diagnosis and monitoring is based on subjective audiometric and psychometric methods. This review aimed to synthesize evidence for tinnitus presence or its severity. We searched several electronic databases, citation searches of the included primary studies through Web of Science, and further hand searches. At least two authors performed all systematic review steps. Sixty-two records were included and were categorized according the biological variable. Evidence for possible tinnitus biomarkers come from oxidative stress, interleukins, steroids and neurotransmitters categories. We found conflicting evidence for full blood count, vitamins, lipid profile, neurotrophic factors, or inorganic ions. There was no evidence for an association between tinnitus and the remaining categories. The current review evidences that larger studies, with stricter exclusion criteria and powerful harmonized methodological design are needed. Protocol published on PROSPERO (CRD42017070998).
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Affiliation(s)
- Haúla F Haider
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal; Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
| | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sara F Ribeiro
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Diogo Ribeiro
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Helena Caria
- Deafness Research Group, BTR Unit, BioISI, Faculty of Sciences, University of Lisbon (FCUL), Portugal; ESS/IPS-Biomedical Sciences Department, School of Health, Polytechnic Institute of Setubal, Portugal
| | - Nuno Trigueiros
- ENT Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Luís Miguel Borrego
- Department of Immunology, Chronic Diseases Research Center (CEDOC), Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal; Department of Immunoallergy, LUZ SAUDE, Hospital da Luz, Lisbon, Portugal
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ana Luísa Papoila
- Bioestatistics Department, Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal
| | - Asma Elarbed
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Maria da Luz Martins
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - João Paço
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Magdalena Sereda
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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FOULADI DEHAGHI BEHZAD, KHADEMIAN FAZLOLLAH, AHMADI ANGALI KAMBIZ. Non-auditory effects of industrial chronic noise exposure on workers; change in salivary cortisol pattern. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 61:E650-E653. [PMID: 33628973 PMCID: PMC7888391 DOI: 10.15167/2421-4248/jpmh2020.61.4.1380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 10/30/2020] [Indexed: 12/04/2022]
Abstract
Background Noise has different auditory and non-auditory effects on human. In noisy environments, noise as a non-specific stressor can activates the hypothalamic-pituitary-adrenal axis (HPA, cortisol). The aim of this study was to evaluate the effect of chronic exposure to noise on salivary cortisol on industrial workers. Methods This cross-sectional study had a case/control design. 136 male workers (68 workers were exposed to chronic industrial noise, and 68 other workers were exposed to background noise) voluntarily enrolled in the study. The equivalent noise level was measured at workstations and salivary cortisol for both case and control groups was measured at the beginning (6 AM) and also at the end of work shift (4 PM). The amount of change in the average of the values of the two groups were compared with each other. Results The measured Leq8h (equivalent continuous sound level) in case and control groups were 87.43 dB-A and 67.6 dB-A, respectively. Comparison of salivary cortisol levels change in groups shows a significant differences in control groups for salivary cortisol in the morning and in the evening samples (p < 0.05); but not in the case group (p = 0.052). Also, comparison of salivary cortisol levels changes with noise exposure experience in the case subgroups revealed no significant difference (p > 0.05). Conclusion This study showed that chronic exposure to industrial noise can lead to a change in pattern of salivary cortisol secretion especially in the evening (at the end of the work shift), in a way that instead of its normal decrease, an increase happened.
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Affiliation(s)
- BEHZAD FOULADI DEHAGHI
- Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Occupational Health, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Correspondence: Behzad Fouladi Dehaghi, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran - Tel.: 06 1337385138 - E-mail:
| | - FAZLOLLAH KHADEMIAN
- Department of Occupational Health, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - KAMBIZ AHMADI ANGALI
- Environmental Technologies Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of bio-statistical, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Abstract
In this chapter, I address the topic of tinnitus in the context of the patient's trajectory of care, with special attention to psychological comorbidities. Although most patients will cope with tinnitus and need no more than information and reassurance from professionals, a proportion of patients will need more supportive management. Assessment of psychological comorbidities is important to determine how urgent they should be seen in the clinic and their specific needs. The most frequent complaints are stress, depression, and anxiety. Although the direction of this relationship is still unclear (are comorbidities at the origin of tinnitus or are they a consequence of it), it is evident that the more serious comorbidities are at the onset of tinnitus, the worse the prognosis. Therefore, an assessment at the initial visit in the clinic is of utmost importance. There are valid and reliable psychometric tools to quickly draw a portrait of the psychological state of patients that can be used by audiologists, psychologists, or doctors. Therapeutic avenues can then be discussed with the patients to ensure them the best support possible.
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Sanders PJ, Doborjeh ZG, Doborjeh MG, Kasabov NK, Searchfield GD. Prediction of Acoustic Residual Inhibition of Tinnitus Using a Brain-Inspired Spiking Neural Network Model. Brain Sci 2021; 11:52. [PMID: 33466500 PMCID: PMC7824871 DOI: 10.3390/brainsci11010052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/23/2020] [Accepted: 01/02/2021] [Indexed: 02/07/2023] Open
Abstract
Auditory Residual Inhibition (ARI) is a temporary suppression of tinnitus that occurs in some people following the presentation of masking sounds. Differences in neural response to ARI stimuli may enable classification of tinnitus and a tailored approach to intervention in the future. In an exploratory study, we investigated the use of a brain-inspired artificial neural network to examine the effects of ARI on electroencephalographic function, as well as the predictive ability of the model. Ten tinnitus patients underwent two auditory stimulation conditions (constant and amplitude modulated broadband noise) at two time points and were then characterised as responders or non-responders, based on whether they experienced ARI or not. Using a spiking neural network model, we evaluated concurrent neural patterns generated across space and time from features of electroencephalographic data, capturing the neural dynamic changes before and after stimulation. Results indicated that the model may be used to predict the effect of auditory stimulation on tinnitus on an individual basis. This approach may aid in the development of predictive models for treatment selection.
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Affiliation(s)
- Philip J. Sanders
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Zohreh G. Doborjeh
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Maryam G. Doborjeh
- Information Technology and Software Engineering Department, Auckland University of Technology, Auckland 1010, New Zealand;
| | - Nikola K. Kasabov
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland 1010, New Zealand;
- Intelligent Systems Research Centre, Ulster University, Derry/Londonderry BT48 7JL, UK
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand
| | - Grant D. Searchfield
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
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Zhang J, Huang S, Nan W, Zhou H, Wang J, Wang H, Salvi R, Yin S. Switching Tinnitus-On: Maps and source localization of spontaneous EEG. Clin Neurophysiol 2020; 132:345-357. [PMID: 33450557 DOI: 10.1016/j.clinph.2020.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify the spectrotemporal changes and sources in patients that could "turn on" tinnitus with multichannel electroencephalography (EEG) system. METHODS Multichannel EEG was recorded from six patients during the Tinnitus-On and Tinnitus-Off states. The EEG power spectrum and eLORETA-based sources were measured. RESULTS There was a global increase in delta and theta during Tinnitus-On plus large changes in alpha 1 and alpha 2. During the Tinnitus-On state, many new sources in delta, theta, alpha 1 and gamma bands emerged in the opposite hemisphere in the inferior temporal gyrus (Brodmann area, BA 20), middle temporal gyrus (BA 21), lateral perirhinal cortex (BA 36), ventral entorhinal cortex (BA 28) and anterior pole of the temporal gyrus (BA 38). CONCLUSIONS The emergence of new delta, theta and gamma band sources in the inferior temporal gyrus (BA 20), middle temporal gyrus (BA 21) and lateral perirhinal cortex (BA 36) plus the appearance of new delta and theta sources in the ventral entorhinal cortex (BA28) and anterior pole of the temporal lobe (BA 38) may comprise a network capable of evoking the phantom sound of tinnitus by simultaneously engaging brain regions involved in memory, sound recognition, and distress which together contribute to tinnitus severity. SIGNIFICANCE The sudden appearance of new sources of activity in the opposite hemisphere within the inferior temporal gyrus, middle temporal gyrus and perirhinal cortex may initiate the perception of tinnitus perception.
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Affiliation(s)
- Jiajia Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Shujian Huang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Huiqun Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Jian Wang
- School of Communication Science and Disorders, Dalhousie University, Halifax, Canada
| | - Hui Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Richard Salvi
- SUNY Distinguished Professor Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, USA
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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15
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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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16
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Too loud? Do powered hand dryers violate federal noise exposure standards? Am J Otolaryngol 2020; 41:102507. [PMID: 32354479 DOI: 10.1016/j.amjoto.2020.102507] [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: 04/16/2020] [Accepted: 04/18/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to determine if high-powered air hand dryers produce sufficient noise to warrant concern over acoustic trauma as determined by federally established standards. STUDY DESIGN Prospective observational field data collection SETTING: Urban and suburban community SUBJECTS AND METHODS: Using a NIOSH developed and calibrated soundmeter app, powered hand dryers were measured throughout two metropolitan areas. Ear level measurements were performed while drying wet hands. Recorded variables included average LAeq, Time-Weighted Average, Max and Peak Levels, Noise Dose, and Projected Dose according to NIOSH and OSHA standards, and all three major weighting networks (A, C, and Z). RESULTS Fifty-four trials were performed at 27 locations. Average dryer run time was 28.9 s (range 14-45 s). Average LAeq (dBA), average maximum level (dBA), and average TWA (dBA) were 90.46 ± 5.32, 94.86 ± 5.73, 59.90 ± 6.80, respectively. The noise generated exceeded published manufacturer specifications. However, even with estimated cumulative daily exposure, the noise generated by these dryers did not exceed federal safety standards. CONCLUSIONS Air-powered hand dryers produce noise output at a level that many would find subjectively uncomfortable with some brands/models consistently producing noise in excess of 90 dBA. Nonetheless, these dryers do not produce sound exceeding NIOSH standards for noise exposure.
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Jackson JG. The Cortisol Awakening Response: A Feasibility Study Investigating the Use of the Area Under the Curve With Respect to Increase as an Effective Objective Measure of Tinnitus Distress. Am J Audiol 2019; 28:583-596. [PMID: 31318575 DOI: 10.1044/2019_aja-18-0174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Tinnitus is a chronic medical condition that can result in distress, concentration difficulties, and clinical depression. An effective, objective measure of tinnitus distress does not currently exist. Endocrinal studies into the condition have been few, with those investigating the cortisol awakening response limited in scope. It was hypothesized that distressed individuals with tinnitus would awaken and be unable to effectively prepare for the day ahead due to a blunted cortisol response. Method Twenty individuals with varying tinnitus distress were compared with a control group (n = 10) in a pilot study, which measured salivary cortisol concentrations on awakening. Multiple exclusion variables were applied. Results In line with previous studies, total cortisol volume (as measured by area under the curve) was not found to be significantly different in the most distressed individuals with tinnitus, F(2, 26) = 0.254, p = .777ns. However, a separate measure of changing cortisol levels-the area under the curve with respect to increase (or AUCi)-was found to be significantly less robust in those individuals reporting the most severe tinnitus distress, F(2, 26) = 7.671, p = .002. This indicates that fewer resources would be available to cope with the demands of the day ahead. Additionally, the AUCi correlated negatively with tinnitus distress later the same day. Conclusions Relationships between proposed objective and self-reported components of self-reported tinnitus distress are considered, with some aspects of tinnitus distress more closely related to physiological mechanisms than others. It is suggested that, with further research, the cortisol awakening response (AUCi) may be put forward as a credible objective biomarker of tinnitus distress.
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Affiliation(s)
- James George Jackson
- Psychology, Sociology and Criminology Group, School of Social and Health Sciences, Leeds Trinity University, Horsforth, United Kingdom
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18
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Szibor A, Mäkitie A, Aarnisalo AA. Tinnitus and suicide: An unresolved relation. Audiol Res 2019; 9:222. [PMID: 31275536 PMCID: PMC6580142 DOI: 10.4081/audiores.2019.222] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 05/21/2019] [Indexed: 12/02/2022] Open
Abstract
Tinnitus is an auditory phantom sensation which can be a devastating condition for the affected person causing annoyance and discomfort. It may be associated with psychiatric conditions. Patients with highly annoying tinnitus and different comorbidities may have a higher risk of expressing suicidal behaviour and ideation. We aimed to review available reports on the prevalence of suicide and suicidal behaviour with tinnitus patients in order to collate current concepts and to identify possible alarming signs and risk factors. A comprehensive search for appropriate studies listed in PubMed, Ovid and Cochrane databases was conducted using appropriate keyword combinations. We identified 22 publications including original articles, case reports and reviews of which 10 fit our stringent search criteria. Most importantly, from the present studies it appears not feasible to univocally conclude on the co-incidence of tinnitus and suicide. This is due to methodological differences in these approaches, complex interrelations between tinnitus and other psychiatric comorbidities and confounding factors such as the inclusion of patients suffering from post-traumatic stress disorder. More concerted actions involving different medical disciplines are needed to reflect the ethiological heterogeneity of tinnitus and suicide or suicidal behaviour to test for a relationship.
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Affiliation(s)
- Annett Szibor
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki University Hospital, University of Helsinki, Finland
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19
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Miaskowski C, Paul SM, Mastick J, Abrams G, Topp K, Smoot B, Kober KM, Chesney M, Mazor M, Mausisa G, Schumacher M, Conley YP, Sabes JH, Cheung S, Wallhagen M, Levine JD. Associations Between Perceived Stress and Chemotherapy-Induced Peripheral Neuropathy and Otoxicity in Adult Cancer Survivors. J Pain Symptom Manage 2018; 56:88-97. [PMID: 29524582 PMCID: PMC6015523 DOI: 10.1016/j.jpainsymman.2018.02.021] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 02/27/2018] [Accepted: 02/27/2018] [Indexed: 11/22/2022]
Abstract
CONTEXT The most common adverse effects from neurotoxic chemotherapy are chemotherapy-induced neuropathy (CIPN), hearing loss, and tinnitus. Although associations between perceived stress and persistent pain, hearing loss, and tinnitus are documented, no studies have examined these associations in cancer survivors who received neurotoxic chemotherapy. OBJECTIVES In this cross-sectional study, we evaluated for associations between perceived stress and the occurrence of CIPN, hearing loss, and tinnitus, in 623 adult cancer survivors who received platinum and/or taxane compounds. METHODS Survivors completed self-report measures of hearing loss, tinnitus, and perceived stress (i.e., Impact of Events Scale-Revised [IES-R]). Separate logistic regression analyses were done for each neurotoxicity to evaluate whether each of the IES-R subscale (i.e., intrusion, avoidance, hyperarousal) and total scores made a significant independent contribution to neurotoxicity group membership. RESULTS Of the 623 survivors in this study, 68.4% had CIPN, 34.5% reported hearing loss, and 31.0% reported tinnitus. Older age, higher body mass index, poorer functional status, being born prematurely, cancer diagnosis, and higher intrusion (P = 0.013), hyperarousal (P = 0.014), and total (P = 0.047) IES-R scores were associated with CIPN. Older age, being male, poorer functional status, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.007) score were associated with hearing loss. Being male, having less education, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.029) score were associated with tinnitus. CONCLUSION These findings suggest that increased levels of perceived stress are associated with the most common chemotherapy-induced neurotoxicities.
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Affiliation(s)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Judy Mastick
- School of Nursing, University of California, San Francisco, California, USA
| | - Gary Abrams
- School of Medicine, University of California, San Francisco, California, USA
| | - Kimberly Topp
- School of Medicine, University of California, San Francisco, California, USA
| | - Betty Smoot
- School of Medicine, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Margaret Chesney
- School of Medicine, University of California, San Francisco, California, USA
| | - Melissa Mazor
- School of Nursing, University of California, San Francisco, California, USA
| | - Grace Mausisa
- School of Nursing, University of California, San Francisco, California, USA
| | - Mark Schumacher
- School of Medicine, University of California, San Francisco, California, USA
| | - Yvette P Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Steven Cheung
- School of Medicine, University of California, San Francisco, California, USA
| | - Margaret Wallhagen
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA; School of Dentistry, University of California, San Francisco, California, USA
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Probst T, Pryss RC, Langguth B, Rauschecker JP, Schobel J, Reichert M, Spiliopoulou M, Schlee W, Zimmermann J. Does Tinnitus Depend on Time-of-Day? An Ecological Momentary Assessment Study with the "TrackYourTinnitus" Application. Front Aging Neurosci 2017; 9:253. [PMID: 28824415 PMCID: PMC5539131 DOI: 10.3389/fnagi.2017.00253] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/17/2017] [Indexed: 12/25/2022] Open
Abstract
Only few previous studies used ecological momentary assessments to explore the time-of-day-dependence of tinnitus. The present study used data from the mobile application “TrackYourTinnitus” to explore whether tinnitus loudness and tinnitus distress fluctuate within a 24-h interval. Multilevel models were performed to account for the nested structure of assessments (level 1: 17,209 daily life assessments) nested within days (level 2: 3,570 days with at least three completed assessments), and days nested within participants (level 3: 350 participants). Results revealed a time-of-day-dependence of tinnitus. In particular, tinnitus was perceived as louder and more distressing during the night and early morning hours (from 12 a.m. to 8 a.m.) than during the upcoming day. Since previous studies suggested that stress (and stress-associated hormones) show a circadian rhythm and this might influence the time-of-day-dependence of tinnitus, we evaluated whether the described results change when statistically controlling for subjectively reported stress-levels. Correcting for subjective stress-levels, however, did not change the result that tinnitus (loudness and distress) was most severe at night and early morning. These results show that time-of-day contributes to the level of both tinnitus loudness and tinnitus distress. Possible implications of our results for the clinical management of tinnitus are that tailoring the timing of therapeutic interventions to the circadian rhythm of individual patients (chronotherapy) might be promising.
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Affiliation(s)
- Thomas Probst
- Georg-Elias-Müller-Institute for Psychology, Georg-August-University GöttingenGöttingen, Germany.,Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Rüdiger C Pryss
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum RegensburgRegensburg, Germany
| | - Josef P Rauschecker
- Program in Cognitive and Computational Systems, Georgetown University WashingtonWashington, DC, United States.,Institute for Advanced Study, Technical University MunichMunich, Germany
| | - Johannes Schobel
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Manfred Reichert
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Myra Spiliopoulou
- Department of Technical and Business Information Systems, Otto-von-Guericke-University MagdeburgMagdeburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum RegensburgRegensburg, Germany
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Betz LT, Mühlberger A, Langguth B, Schecklmann M. Stress Reactivity in Chronic Tinnitus. Sci Rep 2017; 7:41521. [PMID: 28134346 PMCID: PMC5278380 DOI: 10.1038/srep41521] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/21/2016] [Indexed: 12/20/2022] Open
Abstract
Tinnitus is primarily an auditory symptom. Yet not only patients and clinicians, but also current pathophysiological models relate the onset and maintenance of tinnitus to stress. Here physiological and psychological stress reactivity was investigated in 19 patients with subjective chronic tinnitus and 19 comparable healthy controls. All participants underwent five consecutive measurements in one session including three resting conditions and two stress tasks in between (mental arithmetic and concentration on tinnitus/ear noise). Stress reactivity was assessed by heart rate (HR), heart rate variability (HRV) and subjective ratings for each of the five measurements. In patients with tinnitus, mean HR was overall decreased and blunted in response to acute stress induced by mental arithmetic compared to controls. HRV measures did not differ between both groups. Tinnitus sufferers indicated more subjective stress and increased awareness of tinnitus after the mental arithmetic task (during both resting and concentration on tinnitus measurements), but perceived similar levels of stress during mental arithmetic stress. In contrast to controls, HR and HRV were not correlated and also strain reports and physiological data were not associated in tinnitus. Our data show hints for a de-synchronization of physiological and psychological stress reactivity in chronic tinnitus.
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Affiliation(s)
- Linda T Betz
- University of Regensburg, Department of Psychiatry and Psychotherapy, Regensburg, Germany
| | - Andreas Mühlberger
- University of Regensburg, Department of Psychology (Clinical Psychology and Psychotherapy), Regensburg, Germany
| | - Berthold Langguth
- University of Regensburg, Department of Psychiatry and Psychotherapy, Regensburg, Germany
| | - Martin Schecklmann
- University of Regensburg, Department of Psychiatry and Psychotherapy, Regensburg, Germany
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22
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Koch P, Stranzinger J, Nienhaus A, Kozak A. Musculoskeletal Symptoms and Risk of Burnout in Child Care Workers - A Cross-Sectional Study. PLoS One 2015; 10:e0140980. [PMID: 26488770 PMCID: PMC4619302 DOI: 10.1371/journal.pone.0140980] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/02/2015] [Indexed: 11/19/2022] Open
Abstract
Objectives German child care workers' job satisfaction is influenced by the consequences of unfavourable underlying conditions. Child care workers tend to suffer from psychosocial stress, as they feel that their work is undervalued. The objective of the present study is to investigate how the psychosocial factors of the effort-reward imbalance (ERI) model influence musculoskeletal symptoms (MS) and the risk of burnout. To our knowledge this is the first study investigating the association between the factors of the ERI model and MS in child care workers. Methods and Findings Data from 199 child care workers were examined in a cross-sectional study. Psychosocial factors were recorded with the ERI questionnaire. MS was recorded with the Nordic Questionnaire and risk of burnout with the Personal Burnout scale of the Copenhagen Burnout Inventory. Multivariate analysis was performed using linear and logistic regression models. The response rate was 57%. In most of the sample (65%), an effort-reward imbalance was observed. 56% of the child care workers were at risk of burnout and 58% reported MS. Factors associated with risk of burnout were subjective noise exposure (OR: 4.4, 95%CI: 1.55–12.29) and overcommitment (OR: 3.4; 95%CI: 1.46–7.75). There were statistically significant associations between MS and overcommitment (low back pain—OR: 2.2, 95%CI: 1.04–4.51), low control (overall MS OR: 3.8; 95%CI: 1.68–3.37) and risk of burnout (overall MS OR: 2.3, 95%CI: 1.01–5.28). For ERI no statistically significant associations were found with reference to risk of burnout or MS. Conclusion Overcommitment in child care workers is related to MS and risk of burnout. There is also evidence that low control is associated with MS and subjective noise exposure with risk of burnout. Effort-reward imbalance is not related to either outcome. This occupational health risk assessment identifies changeable working factors in different types of facilities.
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Affiliation(s)
- Peter Koch
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- * E-mail:
| | - Johanna Stranzinger
- Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany
| | - Albert Nienhaus
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
- Health Protection Division (FBG), Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Pappelallee 33, 22089 Hamburg, Germany
| | - Agnessa Kozak
- Centre of Excellence for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
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Kol E, Aydın P, Dursun O. The effectiveness of environmental strategies on noise reduction in a pediatric intensive care unit: creation of single-patient bedrooms and reducing noise sources. J SPEC PEDIATR NURS 2015; 20:210-7. [PMID: 25943006 DOI: 10.1111/jspn.12116] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/27/2015] [Accepted: 03/27/2015] [Indexed: 11/27/2022]
Abstract
PURPOSE Noise is a substantial problem for both patients and healthcare workers in hospitals. This study aimed to determine the effectiveness of environmental strategies (creating single-patient rooms and reducing noise sources) in noise reduction in a pediatric intensive care unit. DESIGN AND METHODS Noise measurement in the unit was conducted in two phases. In the first phase, measurements aimed at determining the unit's present level of noise were performed over 4 weeks in December 2013. During the month following the first measurement phase, the intensive care unit (ICU) was moved to a new location and noise-reducing strategies were implemented. The second phase, in May 2014, measured noise levels in the newly constructed environment. RESULTS The noise levels before and after environmental changes were statistically significant at 72.6 dB-A and 56 dB-A, respectively (p < .05). PRACTICE IMPLICATIONS Single-patient rooms and noise-reducing strategies can be effective in controlling environmental noise in the ICU.
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Affiliation(s)
- Emine Kol
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Perihan Aydın
- Pediatric Intensive Care Unit, Akdeniz University Hospital, Antalya, Turkey
| | - Oguz Dursun
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Intensive Care, Akdeniz University, Antalya, Turkey
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24
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Tinnitus prevalence in the city of São Paulo. Braz J Otorhinolaryngol 2015; 81:167-76. [PMID: 25631578 PMCID: PMC9449016 DOI: 10.1016/j.bjorl.2014.12.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 07/20/2014] [Indexed: 11/23/2022] Open
Abstract
Introduction The public and private health care in the city of São Paulo has no data on tinnitus prevalence. Objective Determine tinnitus prevalence in São Paulo city. Study design Series study. Methods Cross-sectional study by field questionnaire with 1960 interviews. Predictor variables included gender, age, tinnitus. Results The prevalence of tinnitus was 22%. It affects more women (26%) than men (17%) and increases with advancing age. Approximately one third of cases (32%) assert that they have constant tinnitus (i.e., “ringing”), while most describe intermittent tinnitus (68%). The majority (64%) reported feeling annoyed, while others (36%) denied any annoyance. Among women, the occurrence of an annoying tinnitus was significantly higher (73%) than among men (50%). The percentages were: mildly annoying (11%), moderately annoying (55%), and severely annoying (34%). Tinnitus interferes with daily activities in 18% of those reporting to be annoyed. Conclusion The population in the city of São Paulo suffering from tinnitus was more prevalent than previously estimated. Generally, it affects more women and those without occupation, and increases significantly with age. Most respondents described the tinnitus as annoying, and this was more prevalent in females. The degree of discomfort measured by a Visual Analogue Scale showed moderate tinnitus, with responses averaging 6.3.
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Canlon B, Theorell T, Hasson D. Associations between stress and hearing problems in humans. Hear Res 2013; 295:9-15. [DOI: 10.1016/j.heares.2012.08.015] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Revised: 08/24/2012] [Accepted: 08/27/2012] [Indexed: 12/20/2022]
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Lopez-Gonzalez MA, Cherta G, Nieto JA, Esteban F. Otology versus Otosociology. ISRN OTOLARYNGOLOGY 2012; 2012:145317. [PMID: 23762611 PMCID: PMC3664198 DOI: 10.5402/2012/145317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 10/03/2012] [Indexed: 11/23/2022]
Abstract
Otology concerns the biological study of ear alterations and diseases, solely. So, the diagnosis of audiovestibular diseases tends to be idiopathic or is based on theoretical concepts such as idiopathic sudden deafness, Ménière disease, benign paroxysmal positional vertigo, tinnitus, hyperacusis, or idiopathic facial paralysis. The treatment for these pathologies is symptomatic. Otosociology takes the aetiology and pathogenesis of the ear and situates them within the social and cultural environment of the patient. Then, audiovestibular disease is based on evidence, and the treatment options seek to solve the causes and consequences produced. Otosociology should be considered as a new discipline. Otosociology came into being since otology does not provide definitive solutions for the audiovestibular alterations produced from the point of view of the ear, whereas otosociology finds these solutions within the social/cultural environment of the patient. Where otology emphasises the diseases of the ear, otosociology deals with social manifestations. Where otology deals with idiopathic diseases, otosociology deals with causes and pathogeny produced by interactions in the social and cultural surroundings of the patient. Where otology offers symptomatic treatment, otosociology offers treatment of causes and consequences. Otosociology can fill significant voids in audiovestibular processes from the perspective of the patient's social environment.
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Affiliation(s)
- Miguel A. Lopez-Gonzalez
- UGC Otorhinolaryngology, Virgen of Rocio University Hospital, C/Manuel Siurot, s/n 41.013 Sevilla, Spain
| | - Georgina Cherta
- Faculty of Political Sciences and Sociology, National University of Distance Education, 29.006 Malaga, Spain
| | - Jose A. Nieto
- Faculty of Political Sciences and Sociology, University of Madrid, 28.080 Madrid, Spain
| | - Francisco Esteban
- UGC Otorhinolaryngology, Virgen of Rocio University Hospital, C/Manuel Siurot, s/n 41.013 Sevilla, Spain
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Fournier P, Hébert S. Gap detection deficits in humans with tinnitus as assessed with the acoustic startle paradigm: does tinnitus fill in the gap? Hear Res 2012; 295:16-23. [PMID: 22688322 DOI: 10.1016/j.heares.2012.05.011] [Citation(s) in RCA: 121] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 05/27/2012] [Accepted: 05/30/2012] [Indexed: 11/19/2022]
Abstract
The measurement of tinnitus in humans relies on subjective measures such as self-report, visual analog scales and questionnaires. Gap detection impairments have been tested in animals in an attempt to objectify the presence of tinnitus. The main purpose of this study was to investigate the gap startle paradigm in human participants with high-frequency tinnitus. Fifteen adults with bilateral high-frequency tinnitus but normal hearing at standard frequencies and seventeen matched controls without tinnitus were tested. The psychoacoustic characteristics of the tinnitus spectrum (pitch and loudness) were assessed using novel participant-directed custom-made methods. The startle task consisted of startle-alone, prepulse inhibition and gap-in-noise condition at low- and high-background noise frequencies. All measurements were retested after several months. Data indicate normal prepulse inhibition but higher reactivity to the startle sounds in the tinnitus group in comparison with controls. Most importantly, the tinnitus group displayed a consistent deficit in gap processing at both low- and high-background noise frequencies. All effects were identified consistently and were reproducible at retest. We propose that the higher reactivity to startle might reflect hyperacusis and that the gap deficit might be an index of abnormal cortical auditory processing in tinnitus.
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Affiliation(s)
- Philippe Fournier
- École d'orthophonie et d'audiologie, Faculty of medicine, Université de Montréal, C.P.6128, succ. Centre-Ville, Montréal, QC, Canada H3C 3J7
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Abstract
OBJECTIVES Depressive symptoms are common in individuals with tinnitus and may substantially aggravate their distress. The mechanisms, however, by which depression and tinnitus mutually interact are still not fully understood. METHODS Here we review neurobiological knowledge relevant for the interplay between depression and tinnitus. RESULTS Neuroimaging studies confirm the existence of neural circuits that are activated both in depression and tinnitus. Studies of neuroendocrine function demonstrate alterations of the HPA-axis in depression and, more recently, in tinnitus. Studies addressing neurotransmission suggest that the dorsal cochlear nucleus that is typically hyperactive in tinnitus, is also involved in the control of attention and emotional responses via projections to the locus coeruleus, the reticular formation and the raphe nuclei. Impaired hippocampal neurogenesis has been documented in animals with tinnitus after noise trauma, as in animal models of depression. Finally, from investigations of human candidate genes, there is some evidence to suggest that variant BDNF may act as a common susceptibility factor in both disorders. CONCLUSIONS These parallels in the pathophysiology of tinnitus and depression argue against comorbidity by chance and against depression as pure reaction on tinnitus. Instead, they stand for a complex interplay between tinnitus and depression. Implications for tinnitus treatment are discussed.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
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Hasson D, Theorell T, Wallén MB, Leineweber C, Canlon B. Stress and prevalence of hearing problems in the Swedish working population. BMC Public Health 2011; 11:130. [PMID: 21345187 PMCID: PMC3056746 DOI: 10.1186/1471-2458-11-130] [Citation(s) in RCA: 109] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 02/23/2011] [Indexed: 01/15/2023] Open
Abstract
Background Current human and experimental studies are indicating an association between stress and hearing problems; however potential risk factors have not been established. Hearing problems are projected to become among the top ten disabilities according to the WHO in the near future. Therefore a better understanding of the relationships between stress and hearing is warranted. Here we describe the prevalence of two common hearing problems, i.e. hearing complaints and tinnitus, in relation to different work-and health-related stressors. Methods A total of 18,734 individuals were invited to participate in the study, out of which 9,756 (52%) enrolled. Results The results demonstrate a clear and mostly linear relationship between higher prevalence of hearing problems (tinnitus or hearing loss or both) and different stressors, e.g. occupational, poorer self-rated health, long-term illness, poorer sleep quality, and higher burnout scores. Conclusions The present study unambiguously demonstrates associations between hearing problems and various stressors that have not been previously described for the auditory system. These findings will open new avenues for future investigations.
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Affiliation(s)
- Dan Hasson
- Karolinska Institutet, Department of Physiology and Pharmacology, Stockholm, Sweden.
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Abstract
This article reviews recent articles relevant to tinnitus-related distress (TRD). Recent studies provide evidence that 1) chronic tinnitus, which occurs in a significant percentage of adults, has stress-inducing effects similar to those of other chronic health problems; 2) the effects of tinnitus on distress are worse in individuals who have certain personality characteristics, such as type D personality and anxiety sensitivity; 3) neural activity in TRD is similar to that for pain and depression; 4) tinnitus leads to less distress in individuals who accept their condition; and 5) cognitive-behavioral treatments, including relaxation training, attention-control training, and acceptance activities, tend to reduce TRD. The recent findings suggest that it would be good practice for mental health professionals to ask patients, especially older patients, about tinnitus and to offer psychological treatment for TRD in appropriate cases. Future research on TRD might explore the extent to which the problem is genetic and the possibility of preventing TRD in individuals who have recently developed persistent tinnitus.
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Affiliation(s)
- John M Malouff
- Department of Psychology, University of New England, Armidale, NSW, Australia.
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Holmes S, Padgham ND. ‘‘Ringing in the Ears’’: Narrative Review of Tinnitus and Its Impact. Biol Res Nurs 2011; 13:97-108. [DOI: 10.1177/1099800410382290] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
About 10% of the population experiences tinnitus, a common and distressing symptom characterized by the perception of sound in the absence of external stimuli. There is, however, marked heterogeneity in etiology, perception, and extent of distress among those who experience tinnitus. Reactions to tinnitus vary from simple awareness to severe irritation; some people have difficulty in hearing because of the loudness of the noise. Severe tinnitus causes many, often psychological, symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). For some, tinnitus is temporary, for others it is longstanding. Although many people adjust successfully, others are disabled by tinnitus; approximately 5% experience persistent and severe symptoms affecting their lifestyle and significantly reducing their quality of life. Because tinnitus is poorly understood and no single therapeutic approach is effective for all patients, many patients are told that ‘‘nothing can be done’’ and they must ‘‘learn to live with it.’’ In spite of these challenges, there is remarkably little relevant nursing literature on tinnitus. This literature review was conducted to explore current knowledge of tinnitus, including prevalence, causes and diagnosis, and assessment. Its psychosocial effects and impact on individuals are considered. Implications for practice are discussed—demonstrating that understanding the full impact of the condition and identifying patients’ needs are essential to effective care.
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Affiliation(s)
- Susan Holmes
- Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK,
| | - Nigel D. Padgham
- Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent. CT1 3NG, UK
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Fitzgerald L. Blunted affect is associated with hypothalamic--pituitary--adrenal axis (HPA) hypoactivity and elevated CSF-interleukin-1 beta (IL-1β) in response to lumbar puncture. Biol Res Nurs 2010; 13:164-74. [PMID: 21044970 DOI: 10.1177/1099800410383558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Proinflammatory activity has been suggested as one of the psychophysiological mechanisms responsible for the health risks associated with stress and mood disorders. There have been limited studies evaluating central immune and hypothalamic- pituitary-adrenal (HPA) axis responses to experimental stress in healthy women. The current study compared, under a controlled condition, the baseline measures and biological and psychological responses to a physical stressor (lumbar puncture [LP]) of healthy women who exhibited an abnormal serum cortisol response (nonresponders [NRs]) to the LP to those of normal controls (responders [Rs]), allowing assessment of stress responsivity and the functional integrity of the feedback system of the HPA axis, sympathetic nervous system (SNS), and neuroimmune axis. METHOD Serum adrenocorticotropic hormone (ACTH), cortisol, interleukin (IL)-6, IL-1sR, and central IL-1β, IL-6, norepineprhine (NE), corticotropin-releasing factor (CRF), and affective states (using the Stress Symptom Rating Questionnaire) were measured in five NRs and seven Rs. RESULTS Compared with NR subjects, Rs had significantly higher levels of ACTH and central IL-1β, higher ratings of attention, and lower perceived stress and anxiety. There were no differences between the groups in serum cortisol, IL-6, or IL-1sR or in central IL-6, NE, and CRF. CONCLUSIONS Women with significantly elevated IL-1β (NRs) responded to an extreme physical stressor with an attenuated HPA system and abnormal subjective ratings compared to healthy women with lower values of central IL-1β. These findings support the suppression of the effects of HPA-axis cortisol on proinflammatory cytokine production. It is possible that these differences in the psychoneuroimmunological profiles of NRs will lead to increased psychobiological vulnerability and predict future health risk.
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Affiliation(s)
- Leah Fitzgerald
- University of California, Los Angeles, School of Nursing, Los Angeles, CA, USA.
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Holmes S, Padgham ND. Review paper: more than ringing in the ears: a review of tinnitus and its psychosocial impact. J Clin Nurs 2009; 18:2927-37. [DOI: 10.1111/j.1365-2702.2009.02909.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Hasson D, Theorell T, Liljeholm-Johansson Y, Canlon B. Psychosocial and physiological correlates of self-reported hearing problems in male and female musicians in symphony orchestras. Int J Psychophysiol 2009; 74:93-100. [PMID: 19666059 DOI: 10.1016/j.ijpsycho.2009.07.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2009] [Revised: 07/01/2009] [Accepted: 07/27/2009] [Indexed: 11/29/2022]
Abstract
Experimental and epidemiological research indicate an association between long-term stress and hearing problems, yet the mechanisms underlying these disorders are not yet fully established. Thus, in order to better understand the pathogenesis of stress-related hearing problems, the present study explored the symptoms and general physiological and psychosocial status of musicians in symphony orchestras. Orchestral musicians are an ideal group to study since physical, psychosocial, work-environmental and acoustic stressors are highly prevalent. The subjects where obtained from two different studies. The first group included 250 participants from 12 orchestras and is entitled "the epidemiological study". The second group, entitled "the longitudinal study", included 47 musicians who were assessed at five occasions (every half year) during two years. Thirty-one of the 47 participants were selected for sampling of physiological variables, i.e. 24-hour ECG to assess heart rate variability to evaluate the synergistic action of the autonomic system as well as saliva cortisol and testosterone levels. The results indicate that self-reported hearing problems are associated with perceived poorer psychosocial environment, as well as mental health symptoms and stress. High-frequency power of heart rate variability (parasympathetic activity) showed a negative relationship to hearing problems, implying a poorer ability to "unwind" from stress. Cortisol levels were not correlated to hearing problems whereas testosterone levels showed a tendency to be lower in subjects with hearing problems than in others. These findings provide evidence for a relationship between long-term stress and self-reported hearing problems and demonstrate a protective role of parasympathetic and anabolic activity on hearing status.
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Affiliation(s)
- Dan Hasson
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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