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Rammal A, Alsinni H, Alkhamesi AA, Alshahrani G, Bouges RN, Shosho RY, Aljuhani MO. The Prevalence of Insomnia Among Patients With Chronic Tinnitus in the General Population of the Kingdom of Saudi Arabia. Cureus 2024; 16:e64295. [PMID: 39130950 PMCID: PMC11316154 DOI: 10.7759/cureus.64295] [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] [Accepted: 07/10/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Tinnitus is a perception of sound without external sound stimulation. Subjective tinnitus is the most common type and is unrelated to external sounds. It is a symptom, not an illness, and is often linked to various psychological factors like anxiety and depression. Insomnia is a personal sense of difficulty falling asleep and issues with sleep initiation, length, consolidation, or quality while having ample chance to sleep, which impairs one's ability to function during the day. Sleep problems are prevalent in individuals with chronic tinnitus. OBJECTIVE We aimed to assess insomnia prevalence in chronic tinnitus patients in Saudi Arabia. METHOD Our study, an online cross-sectional survey, included 434 Saudi participants with chronic insomnia, utilizing a Google Forms questionnaire (Google LLC, Mountain View, California, United States). RESULTS A total of 434 participants responded to the online survey. The most represented age group was 18-25 years, and 319 (73.5%) of the respondents were female. Approximately one-third (34.6%, n=150) were from the southern region. In the sample, 184 (42.4%) participants had bilateral tinnitus, and 105 (24.2%) had had tinnitus for over two years. Around 62.7% of the participants suffered from insomnia due to tinnitus. In terms of sleep quality, 174 (40.1%) participants took over 40 minutes to fall asleep, 85 (19.5%) were often afraid to sleep due to disturbed sleep, and 63 (14.5%) frequently used sleep pills. CONCLUSION Our study of over 400 Saudi chronic tinnitus patients revealed that a large percentage of tinnitus patients have insomnia, influenced by geographic region and tinnitus duration. Our findings offer valuable insights, emphasizing the necessity for additional research to inform interventions aimed at enhancing the quality of life of individuals with chronic tinnitus.
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Affiliation(s)
- Almoaidbellah Rammal
- Otolaryngology - Head and Neck Surgery, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Hussain Alsinni
- Otolaryngology, Al-Jabr Eye, Nose, and Throat Hospital, Alahsa, SAU
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Yu HZ, Gong JM, Hong GW, Zhou RQ, Fu XP, Fan T, Zheng YQ, Peng YQ, Li J, Wang YF. The Effect of Physical Therapy on Somatosensory Tinnitus. J Clin Med 2024; 13:3496. [PMID: 38930025 PMCID: PMC11204550 DOI: 10.3390/jcm13123496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/01/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Objective: The objective of this work was to assess the effect of physical therapy in patients with somatosensory tinnitus (ST) and explore the influence of physical therapy on clinical variables obtained before treatment. Methods: A total of 43 patients with ST were randomized to the immediate-start group (n = 20) and delayed-start group (n = 23). All patients received physical therapy for 1 week (seven sessions). Each session lasted 60 min. The Visual Analogue Scale (VAS), Tinnitus Handicap Inventory (THI), and numerical pain rating scale (NPRS) scores were documented at baseline and after treatment (week 1) for all patients. For subjects in the immediate-start group, the THI, VAS, and NPRS scores were measured after therapy (weeks 6, 9, and 12, respectively). Medical history characteristic functional activity scale (HCFA) scores were measured at baseline to assess the association between somatic symptoms and tinnitus. Results: At week 1, VAS, THI, and NPRS scores of patients in the immediate-start group were improved by 1.25 ± 1.59, 11.10 ± 15.10, and 0.95 ± 1.54 points, respectively, and were significantly higher than those in the delayed-start group (p < 0.05). The change in VAS, THI, and NPRS scores in the treatment group was significantly positively correlated with the scores of the HCFA before treatment (r = 0.786, p < 0.001; r = 0.680, p = 0.001; r = 0.796, p < 0.001). There was no significant difference in THI, VAS, and NPRS scores among patients in the immediate-start group between weeks 1, 6, 9, and 12 after treatment (p > 0.05). Conclusions: Although more participants were necessary in the further study, the study implies that physical therapy can reduce physical pain, improve tinnitus symptoms, and quality of life in ST patients without hearing loss, and the short-term curative effect is stable, especially for tinnitus patients with clear somatic symptoms.
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Affiliation(s)
- Hong-Zhe Yu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jia-Min Gong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Guo-Wei Hong
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ruo-Qiao Zhou
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Xin-Ping Fu
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
| | - Ting Fan
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Yu-Qing Zheng
- Department of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, China;
| | - Ying-Qiu Peng
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
| | - Jian Li
- Clinical Laboratory Center, Children’s Hospital of Fudan University, National Children’s Medical Center, Shanghai 201102, China
| | - Yun-Feng Wang
- ENT Institute and Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China; (H.-Z.Y.); (J.-M.G.); (G.-W.H.); (R.-Q.Z.); (X.-P.F.); (T.F.); (Y.-Q.P.)
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai 200031, China
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Walters RK, Durrant FG, Nguyen SA, Meyer TA, Lambert PR. The Placebo Effect on Tinnitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Otol Neurotol 2024; 45:e263-e270. [PMID: 38361332 DOI: 10.1097/mao.0000000000004139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To quantify the placebo effect in randomized clinical trials treating tinnitus with oral or intratympanic placebo treatment. DATA SOURCES CINAHL, PubMed, and Scopus were searched for articles from conception to October 2022. MESH and key terms such as "tinnitus," "placebo," and "medication" were used to find randomized, placebo-controlled trials. The search was limited to articles in English. METHODS Randomized controlled trials with adult subjects evaluating tinnitus pretreatment and posttreatment with an oral or intratympanic medication versus a placebo arm were included. Crossover studies, studies involving middle/inner ear operations or devices, and studies that exclusively included nonidiopathic etiologies of tinnitus were excluded. Mean tinnitus symptom survey scores for the Tinnitus Handicap Inventory (THI), Tinnitus Severity Index, Tinnitus Functional Index, Tinnitus Handicap Questionnaire, and Visual Analog Scales for tinnitus Intensity/Loudness (VAS-L), Annoyance (VAS-An), and Awareness (VAS-Aw) were extracted for both placebo and experimental groups. RESULTS 953 studies were screened with 23 studies being included in the final analysis. Meta-analysis of mean difference (MD) was calculated using RevMan 5.4. MD between pretreatment and posttreatment THI scores of the placebo arms was 5.6 (95% confidence interval, 3.3-8.0; p < 0.001). MD between pretreatment and posttreatment VAS scores of the placebo groups for Loudness, Annoyance, and Awareness were 0.8 (0.0 to 1.6, p = 0.05), 0.2 (-0.2 to 0.5, p = 0.34), and 0.3 (-0.0 to 0.7, p = 0.08), respectively. CONCLUSIONS Placebo treatment has shown effectiveness in improving patient-reported evaluations of tinnitus when using some standardized metrics such as THI and VAS-L; however, the improvement is not as substantial as nonplacebo treatment.
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Affiliation(s)
| | - Frederick G Durrant
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Shaun A Nguyen
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Ted A Meyer
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
| | - Paul R Lambert
- Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina
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Liu Y, Yang S, Wang Y, Hu J, Xie H, Ni T, Han Z. Efficacy and factors influencing outcomes of customized music therapy combined with a follow-up system in chronic tinnitus patients. J Otolaryngol Head Neck Surg 2023; 52:29. [PMID: 37095562 PMCID: PMC10124025 DOI: 10.1186/s40463-023-00631-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 02/23/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUNDS Tinnitus is a meaningless sound signal perceived by the patients in the absence of auditory stimuli. Due to the complex etiology and unclear mechanism, specific therapies for tinnitus are still in the exploratory stage. In recent years, personalized and customized music therapy has been proposed as an effective method for tinnitus treatment. The aim of this study was to explore the efficacy of customized therapy with a well-designed follow-up system in the treatment of tinnitus through a large sample one arm study and to identify the relevant factors affecting the treatment outcome. METHODS The study investigated a total of 615 patients with unilateral or bilateral chronic tinnitus who received personalized and customized music therapy for 3 months. A complete follow-up system was designed by the professionals. Questionnaires of Tinnitus Handicap Inventory (THI), Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) were used to evaluate the therapeutic effects and relevant factors affecting the efficacy of therapy. RESULTS The results showed a decreasing trend in THI and VAS scores after 3 months of therapy, with statistically significant differences between pre- and post-therapy time points (P < 0.001). All patients were divided into 5 groups according to THI scores, and the mean reduction score in catastrophic, severe, moderate, mild and slight group was 28, 19, 11, 5, 0 respectively. The proportion of tinnitus patients with anxiety was higher than that with depression (70.57% and 40.65%, respectively), and there were statistically significant differences between HADS-A/D scores pre- and post-therapy. Binary logistic regression showed that the baseline of THI, VAS scores, the duration of tinnitus and the state of anxiety prior to therapy were significant influencing factors of therapeutic efficacy. CONCLUSIONS The magnitude of reduction in THI scores after music therapy depended on the severity of the patients' tinnitus, the higher the initial THI scores, the greater the potential for improvement in tinnitus disorders. Music therapy also reduced the anxiety and depression levels of tinnitus patients. Therefore, personalized and customized music therapy with a comprehensive follow-up system may be an effective treatment option for chronic tinnitus patients.
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Affiliation(s)
- Yuehong Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Siyi Yang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Yulu Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Jiahua Hu
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Hongbo Xie
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Tianyi Ni
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China
| | - Zhao Han
- Department of Otorhinolaryngology Head and Neck Surgery, Huadong Hospital Affiliated Fudan University, No. 221 West Yan'an Road, Jing An District, Shanghai, 200040, China.
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Gallo KEB, Corrêa CDC, Gonçalves CGDO, Correia Baran JB, Marques JM, Zeigelboim BS, José MR. Effect of Tinnitus on Sleep Quality and Insomnia. Int Arch Otorhinolaryngol 2023; 27:e197-e202. [PMID: 37125358 PMCID: PMC10147471 DOI: 10.1055/s-0041-1735455] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 05/07/2021] [Indexed: 05/02/2023] Open
Abstract
Introduction Tinnitus is a conscious perception of a sound resulting from abnormal activity within the nervous system. A relevant percentage of tinnitus patients report symptoms severe enough to significantly affect quality of life, including sleep disorders. Objective To analyze the sleep quality, insomnia, daytime sleepiness, and risk of obstructive sleep apnea (OSA) in participants with tinnitus. Methods The sample comprised 18 adults and older adults aged between 18 and 85 years old (mean age = 58.7 ± 17.5 years old), females and males, with complaint of continuous tinnitus for > 1 month. The instruments used were the Tinnitus Handicap Inventory (THI) questionnaire, the Insomnia Severity Index, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the STOP-Bang questionnaire. Results By means of the THI questionnaire, the tinnitus severity degree reported by most participants was mild (27.8%) and moderate (27.8%), having a positive (r = 0.582) and significant (0.011) correlation to sleep quality, measured by means of the Pittsburgh questionnaire. There was a positive correlation between the Insomnia Severity Index and tinnitus handicap (r = 0.499; p = 0.035). A total of 72.2% of the participants self-assessed their sleep quality as poor, in addition to moderate insomnia (27.8%), although there is low risk of OSA (66.7%), without complaints of excessive daytime sleepiness (72.2%). Conclusion Subjects with tinnitus complaint self-rated their sleep quality as poor. Moreover, the higher the reported tinnitus handicap, the greater the symptoms of insomnia. There was no influence of tinnitus in relation to daytime sleepiness and no relationship between the severity of tinnitus and the risk of OSA.
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Affiliation(s)
| | - Camila de Castro Corrêa
- Curso de Fonoaudiologia, Centro Universitário Planalto do Distrito Federal, Brasília, DF, Brazil
| | | | | | - Jair Mendes Marques
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Bianca Simone Zeigelboim
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
| | - Maria Renata José
- Programa de Pós-Graduação em Distúrbios da Comunicação, Universidade Tuiuti do Paraná, Curitiba, PR, Brazil
- Address for correspondence Maria Renata José, PhD Universidade Tuiuti do ParanáRua Padre Ladislau Kula, n° 395, Santo Inácio, Curitiba, PR, CEP 82.010–210Brasil
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Meijers SM, Rademaker M, Meijers RL, Stegeman I, Smit AL. Correlation Between Chronic Tinnitus Distress and Symptoms of Depression: A Systematic Review. Front Neurol 2022; 13:870433. [PMID: 35585851 PMCID: PMC9108431 DOI: 10.3389/fneur.2022.870433] [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: 02/06/2022] [Accepted: 03/30/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives In this systematic review, we aim to evaluate the evidence regarding the correlation between tinnitus distress and the severity of depressive symptoms in patients with chronic tinnitus. Also, the prevalence of clinically relevant depressive symptoms scores in patients with chronic tinnitus was evaluated. Methods We performed a systematic review in PubMed, EMBASE, and the Cochrane library in June 2021 using the terms “depression” and “tinnitus,” and their synonyms, following PRISMA guidelines. Studies were selected on relevance and critically appraised regarding risk of bias using the Newcastle–Ottowa Quality Assessment Scale. Results A total of 1,912 articles were screened on title and abstract after the removal of the duplicates. Eventually, 33 (1.5%) articles were included for the final analysis. Only cross-sectional cohort studies and case–control studies with a low level of evidence and a high risk of bias due to the study design and patient selection were found. Statistically significant correlations between the experienced tinnitus distress and depressive symptoms were reported in 31 out of 33 studies. Clinically relevant depression scores had a prevalence of 4.6–41.7%. Conclusions In this systematic review, in which mostly cross-sectional studies were included, a statistically significant correlation was found between the experienced tinnitus distress and the reported severity of symptoms of depression in patients with chronic tinnitus. A wide range of clinically relevant depression scores were reported in included studies. Due to the high risk of bias of included studies it is not possible to provide a definite answer on the existence of this relationship. Future population-based studies are necessary to provide more clarity.
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Affiliation(s)
| | - Maaike Rademaker
- University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Inge Stegeman
- University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Adriana L. Smit
- University Medical Center Utrecht, Utrecht, Netherlands
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
- *Correspondence: Adriana L. Smit
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Oppitz SJ, Garcia MV, Bruno RS, Zemolin CM, Baptista BO, Turra BO, Barbisan F, da Cruz IBM, da Silveira AF. Supplementation with açaí (Euterpe Oleracea Martius) for the treatment of chronic tinnitus: effects on perception, anxiety levels and oxidative metabolism biomarkers. Codas 2022; 34:e20210076. [PMID: 35107519 PMCID: PMC9886123 DOI: 10.1590/2317-1782/20212021076] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 09/21/2021] [Indexed: 02/03/2023] Open
Abstract
PURPOSE To investigate the effects of antioxidant supplementation with açaí extract on the discomfort with chronic tinnitus and the relationship with the levels of anxiety and oxidative metabolism, not excluding the overlap of diseases. METHODS Randomized, placebo-controlled clinical trial. 30 individuals participated, with an average of 50.5 years, 14 males and 16 females, with normal hearing thresholds or sensorineural hearing loss up to mild degree, divided into two groups: Placebo Group (without active) and, Açaí Group (100mg of açaí extract). The following procedures were applied before and after three months of treatments: Tinnitus Handicap Inventory (THI), Beck's Anxiety Inventory (BAI) and blood samples for evaluation of oxidative stress biomarkers (Lipid Peroxidation and Protein Carbonylation). RESULTS There was a reduction in the discomfort of tinnitus for the açaí group verified through THI (p = 0.006). Significant differences were found in the score of common symptoms for anxiety disorders in the placebo group (p = 0.016), however, the same was not observed for oxidative metabolism biomarkers, although there was a decrease in post-treatment values for all groups. CONCLUSION Oral antioxidant supplementation, with açaí extract, showed favorable effects on tinnitus, reducing discomfort with the symptom, regardless of the underlying etiology, and can be considered a treatment modality. However, the effect of this supplementation on anxiety symptoms and oxidative stress biomarkers needs further investigation.
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Affiliation(s)
- Sheila Jacques Oppitz
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Michele Vargas Garcia
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Rúbia Soares Bruno
- Programa de Pós-graduação em Distúrbios da Comunicação Humana, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Cleide Monteiro Zemolin
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Bruna Olegário Baptista
- Hospital Universitário de Santa Maria, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Bárbara Osmarin Turra
- Departamento de Morfologia, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
| | - Fernanda Barbisan
- Programa de Pós-graduação em Gerontologia, Universidade Federal de Santa Maria – UFSM - Santa Maria (RS), Brasil.
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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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Van Esch B, van der Zaag-Loonen H, Bruintjes T, van Benthem PP. Betahistine in Ménière's Disease or Syndrome: A Systematic Review. Audiol Neurootol 2021; 27:1-33. [PMID: 34233329 DOI: 10.1159/000515821] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 02/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ménière's disease is characterized by recurrent episodes of vertigo, hearing loss, and tinnitus, often with a feeling of fullness in the ear. Although betahistine is thought to be specifically effective for Ménière's disease, no evidence for a benefit from the use of betahistine exists, despite its widespread use. Reassessment of the effect of betahistine for Ménière's disease is now warranted. SEARCH METHODS We searched for randomized controlled trials (RCTs) in the Central Register of Controlled Trials (CENTRAL), Ovid Medline, Ovid Embase, CINAHL, Web of Science, Clinicaltrials.gov, ICTRP, and additional sources for published and unpublished trials, in which betahistine was compared to placebo. DATA COLLECTION AND ANALYSIS Our outcomes involved vertigo, significant adverse effect (upper gastrointestinal discomfort), hearing loss, tinnitus, aural fullness, other adverse effects, and disease-specific health-related quality of life. We used GRADE to assess the quality of the evidence. MAIN RESULTS We included 10 studies: 5 studies used a crossover design and the remaining 5 were parallel-group RCTs. One study with a low risk of bias found no significant difference between the betahistine groups and placebo with respect to vertigo after a long-term follow-up period. No significant difference in the incidence of upper gastrointestinal discomfort was found in 2 studies (low-certainty evidence). No differences in hearing loss, tinnitus, or well-being and disease-specific health-related quality of life were found (low- to very low-certainty of evidence). Data on aural fullness could not be extracted. No significant difference between the betahistine and the placebo groups (low-certainty evidence) could be demonstrated in the other adverse effect outcome with respect to dull headache. The pooled risk ratio for other adverse effect in the long term demonstrated a lower risk in favor of placebo over betahistine. CONCLUSIONS High-quality studies evaluating the effect of betahistine on patients with Ménière's disease are lacking. However, one study with low risk of bias found no evidence of a difference in the effect of betahistine on the primary outcome, vertigo, in patients with Ménière's disease when compared to placebo. The main focus of future research should be on the use of comparable outcome measures by means of patient-reported outcome measures.
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Affiliation(s)
- Babette Van Esch
- Apeldoorn Dizziness Centre/Department of Otorhinolaryngology, Gelre Hospital, Apeldoorn, The Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Hester van der Zaag-Loonen
- Apeldoorn Dizziness Centre/Department of Otorhinolaryngology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Tjasse Bruintjes
- Apeldoorn Dizziness Centre/Department of Otorhinolaryngology, Gelre Hospital, Apeldoorn, The Netherlands.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
| | - Peter Paul van Benthem
- Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Leiden, The Netherlands
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Frumkin MR, Kallogjeri D, Piccirillo JF, Beukes EW, Manchaiah V, Andersson G, Rodebaugh TL. Development and Preliminary Evaluation of the Tinnitus Severity Short Form. Am J Audiol 2021; 30:404-415. [PMID: 34029120 DOI: 10.1044/2021_aja-20-00164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Tinnitus, or the perception of sounds that occur without an external sound source, is a prevalent condition worldwide. For a subset of adults, tinnitus causes significant distress and impairment. Several patient-reported outcome measures have been developed to assess severity of tinnitus distress. However, at present, the field lacks a brief measure that is sensitive to treatment change. The purpose of the current study was to develop and preliminarily validate a brief questionnaire for tinnitus severity from two existing measures of tinnitus-related distress, the Tinnitus Handicap Inventory (THI) and Tinnitus Functional Index (TFI). Method Using data from nine study samples in the United States and United Kingdom, we conducted exploratory and confirmatory factor analyses to identify a short measure with good psychometric properties. We also assessed sensitivity to treatment-related change by examining associations with change in the TFI and THI. Finally, we conducted a confirmatory factor analysis of the final short questionnaire in a new sample of adults seeking treatment for tinnitus-related distress. Results We identified 10 items from the THI and TFI that exhibited limited loadings on secondary factors. The resulting Tinnitus Severity Short Form achieved good to excellent fit, including in a unique sample of individuals seeking online treatment for tinnitus, and appeared sensitive to treatment-related change. Conclusions The Tinnitus Severity Short Form developed in the current study may be a useful tool for the assessment of subjective severity and distress associated with tinnitus, especially when patient burden is a concern. Further research is necessary to fully validate the questionnaire for the assessment of treatment-related change.
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Affiliation(s)
- Madelyn R. Frumkin
- Department of Psychological & Brain Sciences, Washington University in St. Louis, MO
| | - Dorina Kallogjeri
- Department of Otolaryngology – Head & Neck Surgery, Washington University in St. Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head & Neck Surgery, Washington University in St. Louis, MO
| | - Eldre W. Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Psychology and Sport Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX
- Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Karnataka, India
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Sweden
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
| | - Thomas L. Rodebaugh
- Department of Psychological & Brain Sciences, Washington University in St. Louis, MO
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Heggdal POL, Aarsnes LP, Brännström KJ, Aarstad HJ. Psychometric properties of the Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR). Int J Audiol 2021; 61:239-244. [PMID: 34032526 DOI: 10.1080/14992027.2021.1922769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess the psychometric properties of a Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR). DESIGN A survey was sent by post to patients referred with tinnitus as their main complaint to an audiology department. Patients completed a Norwegian version of the Tinnitus Handicap Inventory (THI-NOR), a Norwegian translation of two revised subscales of the Abbreviated profile of hearing aid benefit (APHAB), the General Health Questionnaire (GHQ-12) as well as questionnaires measuring coping expectancies (TOMCATS) and neuroticism (EPI). STUDY SAMPLE Ninety-nine persons with tinnitus. RESULTS No associations were found between THI-scores or pure-tone audiometry, gender or age. The proposed subscales of the original THI were not formed by responses from responders. The total scale shows good psychometric properties. Significant correlations were found between distress as measured by the GHQ-12, coping expectancies as measured by TOMCATS and neuroticism as measured by EPI and THI scores. CONCLUSIONS THI-NOR has psychometric properties similar to those of the Danish translation (THI-DK), from which it was adapted, and to the original THI. THI-NOR seems to be a valid measure of the impact of tinnitus on a person's everyday life. Findings show that the suggested subscales of the questionnaire should be interpreted with caution.
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Affiliation(s)
- Peder O Laugen Heggdal
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - Lorents P Aarsnes
- Department of Otolaryngology/Head and Neck Surgery, Haukeland University Hospital, Bergen, Norway
| | - K Jonas Brännström
- Department of Clinical Science, Section of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Hans Jørgen Aarstad
- Faculty of Medicine and Dentistry, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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12
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Gourishetti SC, Carter C, Nguyen NK, Sherlock L, Eisenman DJ. Presence of hearing loss is predictive of return for further stages of tinnitus therapy following initial education and counseling. Int J Audiol 2020; 60:421-426. [PMID: 33243031 DOI: 10.1080/14992027.2020.1849830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Identify clinical factors that predict the likelihood of patients returning for further evaluation and treatment following stage 1 education and counselling in a staged tinnitus habituation program. DESIGN Retrospective cross-sectional study. Demographics, audiometric findings and Tinnitus Handicap Inventory (THI) scores were used for predictive modelling to determine the likelihood of patients returning for subsequent therapy. STUDY SAMPLES One hundred and ninety consecutive patients treated in an outpatient, staged tinnitus habituation program. RESULTS Improvements in THI scores were observed in all subjects (n = 119, d = 0.49, p < 0.001), both for those without hearing loss (n = 13, d = 0.54, p = 0.03) and those with hearing loss (n = 106, d = 0.48, p < 0.001) following Stage 1 education and counselling. Subjects with hearing loss were 14 times more likely to return for Stage 2 evaluation (p < 0.001) following completion of Stage 1 education and counselling. CONCLUSION Subjects with idiopathic subjective non-pulsatile tinnitus across all degrees of tinnitus severity benefit from group education and counselling alone. Subjects with hearing loss, irrespective of most hearing loss configurations, are more likely to return for subsequent stages of the program.
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Affiliation(s)
- Saikrishna C Gourishetti
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Chelsea Carter
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nicole K Nguyen
- Department of Hearing and Speech Sciences, University of Maryland College Park, College Park, MD, USA
| | - LaGuinn Sherlock
- US Army Public Health Center, Army Hearing Program and Walter Reed National Military Medical Center, Audiology and Speech Pathology Center, Bethesda, MD, USA
| | - David J Eisenman
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
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13
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Hofrichter NA, Brueggemann P, Goebel G, Mazurek B, Rose M. Maintaining the legacy and moving forward: The new tinnitus questionnaire short form version 2. J Psychosom Res 2020; 138:110248. [PMID: 33032023 DOI: 10.1016/j.jpsychores.2020.110248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 08/26/2020] [Accepted: 09/11/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The original 52-item version of the Tinnitus Questionnaire (TQ) is a widely applied self-report instrument to measure tinnitus-related distress. One objective of the current study was the validation of the reported five-factor structure of the German TQ in a new, large sample of patients with chronic tinnitus. Since former studies have yielded conflicting results for the factor structure of the 12-item short version (Mini-TQ), analysis of its factor structure and the generation of a new short version were further study aims. METHODS Data of 7112 subsequent patients with chronic tinnitus that filled out the German 52-item version of the TQ at the Tinnitus Center at Charité University Hospital Berlin, Germany, were included in the study. Statistical analyses included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). RESULTS CFA showed reasonably acceptable fit indices for a five-factor model for the 52-item version of the TQ, at least for RMSEA, one of the three fit indices (RMSEA = 0.059; CFI = 0.871; TLI = 0.861). Factors were called emotional distress, auditory perceptual difficulties, intrusiveness, sleep disturbances, and coping. Another CFA supports a three-factor model of the newly generated 15-item short version (RMSEA = 0.060; CFI = 0.942; TLI = 0.931) with the factors emotional distress, auditory perceptual difficulties, and intrusiveness. CONCLUSION Validation of the German 52-item version of the TQ in a large, new sample of patients with chronic tinnitus supports the previously reported five-factor structure with slight differences concerning the identified factors. The new three-factorial 15-item short version allows a more rapid and economical assessment of tinnitus-related distress.
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Affiliation(s)
- Nienke A Hofrichter
- Department of Internal Medicine and Psychosomatics, Universitaetsmedizin Berlin, Berlin, Germany
| | | | - Gerhard Goebel
- Tinnitus- und Hyperakusis-Zentrum im Neurozentrum Prien, Prien am Chiemsee, Germany
| | - Birgit Mazurek
- Tinnitus Center, Universitaetsmedizin Berlin, Berlin, Germany
| | - Matthias Rose
- Department of Internal Medicine and Psychosomatics, Universitaetsmedizin Berlin, Berlin, Germany.
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Souza DDS, Almeida AA, Andrade SMDS, Machado DGDS, Leitão M, Sanchez TG, Rosa MRDD. Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial. Neurophysiol Clin 2020; 50:289-300. [PMID: 32863109 DOI: 10.1016/j.neucli.2020.07.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/17/2020] [Accepted: 07/17/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES This study aims to determine whether transcranial direct current stimulation (tDCS): a) is effective in the treatment of tinnitus by decreasing its annoyance and severity; b) modulates the cortical electrical activity of such individuals. METHODS A double-blind, placebo-controlled clinical trial was conducted with 24 patients with tinnitus, randomized into two groups: Group 1 (n = 12) received anodal tDCS over the left temporoparietal area (LTA) and cathodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) and Group 2 (n = 12) received placebo intervention. Tinnitus perception using a visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire, in addition to electroencephalogram (EEG) was measured with eyes opened and closed at baseline and after the intervention. For the treatment, patients were subjected to five consecutive sessions of tDCS with the anodal electrode over the LTA and cathodal electrode over the right DLPFC (7 × 5 cm, 2 mA for 20 min). tDCS was turned off after 30 s in the sham group. RESULTS Active tDCS significantly improved tinnitus annoyance and severity. It was associated with decreased beta and theta EEG frequency bands with eyes opened and decreased alpha frequency with eyes closed. sLORETA identified changes in frequency bands in the frontal, temporoparietal, and limbic regions. Finally, there were negative correlations between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. CONCLUSIONS These results demonstrate that tDCS modulates the EEG activity and alleviates tinnitus perception. This effect may be related to baseline EEG activity.
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Affiliation(s)
- Dayse da Silva Souza
- Graduate Program in Cognitive Neuroscience and Behavior, Federal University of Paraiba, João Pessoa, Brazil.
| | - Alexandre Alex Almeida
- Graduate Program in Cognitive Neuroscience and Behavior, Federal University of Paraiba, João Pessoa, Brazil
| | | | | | - Márcio Leitão
- Department of Classical and Vernacular Letters, Federal University of Paraíba, Brazil
| | - Tanit Ganz Sanchez
- University of São Paulo School of Medicine, São Paulo, Brazil; Ganz Sanches Institute of Integrated Otorhinolaryngology, São Paulo, Brazil
| | - Marine Raquel Diniz da Rosa
- Graduate Program in Cognitive Neuroscience and Behavior, Federal University of Paraiba, João Pessoa, Brazil.
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Improved measurement of tinnitus severity: Study of the dimensionality and reliability of the Tinnitus Handicap Inventory. PLoS One 2020; 15:e0237778. [PMID: 32841249 PMCID: PMC7447004 DOI: 10.1371/journal.pone.0237778] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 08/03/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE The Tinnitus Handicap Inventory (THI) is widely used in clinical practice and research as a three-dimensional measure of tinnitus severity. Despite extensive use, its factor structure remains unclear. Furthermore, THI can be considered a reliable measure only if Cronbach's alpha coefficient and Classical Test Theory is used. The more modern and robust Item Response Theory (IRT) has so far not been used to psychometrically evaluate THI. In theory, IRT allows a more precise evaluation of THI's factor structure, reliability, and the quality of individual items. METHOD There were 1115 patients with tinnitus (556 women and 559 men), aged 19-84 years (M = 51.55; SD = 13.28). The dimensionality of THI was evaluated using several models of Confirmatory Factor Analysis and an Item Response Theory approach. Exploratory non-parametric Mokken scaling was applied to determine a unidimensional and robust scale. Several IRT polytomous models were used to assess the overall quality of THI. RESULTS The bifactor model had the best fit (RMSEA = 0.055; CFI = 0.976; SRMR = 0.040) and revealed one strong general factor and several weak specific factors. Mokken scaling generated a reliable unidimensional scale (Loevinger's H = 0.463). In order to refine THI we propose that five items be removed. The IRT Generalized Partial Credit Model generated good parameters in terms of item location (difficulty), discrimination, and information content of items. CONCLUSION Our findings support the use of THI to evaluate tinnitus severity in terms of it being a reliable unidimensional scale. However, clinicians and researchers should rely only on its overall score, which reflects global tinnitus severity. To improve its psychometric quality, several refinements of THI are proposed.
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Daneshi A, Hosseinzadeh F, Mohebbi S, Mohseni M, Mohammadi SS, Asghari A. New marsupialization technique in endolymphatic sac surgery. Laryngoscope Investig Otolaryngol 2020; 5:546-551. [PMID: 32596499 PMCID: PMC7314464 DOI: 10.1002/lio2.403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 04/26/2020] [Accepted: 05/15/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES The aim of the present study was to describe and evaluate the results of a new technique in endolymphatic sac decompression surgery. METHODS Forty-three patients with intractable unilateral Meniere's disease were selected. Endolymphatic sac was identified after simple mastoidectomy, and its lateral layer was incised, using a sickle knife. Outer layer of the sac was turned around and placed under the anterior bony border. RESULTS Mean duration of the follow-up was 24 months. Mean tinnitus handicap index, pure tone average (PTA) on thresholds at 500, 1000, 2000, and 4000 Hz, mean speech reception threshold, mean speech discrimination score, hearing stage, and mean vertigo score before and after surgery were evaluated. CONCLUSION The new marsupialization technique with anterior bony border is a safe and effective way to improve tinnitus, vertigo, and ear fullness among these patients. According to PTA and hearing stage, this surgery can control progressive hearing loss. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Ahmad Daneshi
- ENT and Head & Neck Research Center The Five Senses Institute, Iran University of Medical SciencesTehranIran
| | - Farideh Hosseinzadeh
- ENT and Head & Neck Research Center The Five Senses Institute, Iran University of Medical SciencesTehranIran
| | - Saleh Mohebbi
- Skull Base Research CenterThe Five Senses Institute, Iran University of Medical SciencesTehranIran
| | - Mohammad Mohseni
- ENT and Head & Neck Research Center The Five Senses Institute, Iran University of Medical SciencesTehranIran
| | | | - Alimohamad Asghari
- Skull Base Research CenterThe Five Senses Institute, Iran University of Medical SciencesTehranIran
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17
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Jensen M, Hüttenrauch E, Schmidt J, Andersson G, Chavanon ML, Weise C. Neurofeedback for tinnitus: study protocol for a randomised controlled trial assessing the specificity of an alpha/delta neurofeedback training protocol in alleviating both sound perception and psychological distress in a cohort of chronic tinnitus sufferers. Trials 2020; 21:382. [PMID: 32370767 PMCID: PMC7201543 DOI: 10.1186/s13063-020-04309-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 04/02/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tinnitus is a particularly common condition and can have debilitating psychological consequences for certain people. Although several interventions have been helpful in teaching individuals to better cope with tinnitus, no cure exists at present. Neurofeedback is an emerging treatment modality in tinnitus. Previous studies, utilising an alpha/delta training protocol, have shown promise. However, they were characterised by small sample sizes and a lack of neurofeedback control conditions. Therefore, the aim of this study is to investigate whether an alpha/delta neurofeedback training protocol, compared to beta/theta neurofeedback or a diary control group, is effective in reducing not only the tinnitus sound perception but also the psychological symptoms associated with the condition. METHODS The study is designed as a three-armed randomised controlled trial. Participants are randomly assigned to a) an established neurofeedback protocol for tinnitus (alpha/delta training), b) an active control group (beta/theta training) or c) a diary control group. In the 4-week intervention period, participants in both neurofeedback groups undergo 10 sessions, whereas participants in the diary control group complete a bi-weekly diary. The primary outcomes are between group differences in tinnitus sound perception change, as measured with the Tinnitus Magnitude Index (TMI), and changes in tinnitus distress, measured with the Tinnitus Handicap Inventory (THI), 4 weeks after the start of the intervention. Secondary outcome measures include changes in tinnitus distress, sleep quality, depressive symptoms and whether neurofeedback leads to specific power changes in the trained frequency bands. DISCUSSION This is the first randomised controlled trial examining the efficacy of an alpha/delta neurofeedback training protocol in reducing tinnitus sound perception and the distress associated with the condition. Compared to former studies, the present study is designed to assess both the specificity of an alpha/delta neurofeedback training protocol by including an active comparator and beta/theta neurofeedback training, in addition to controlling for placebo effects by the inclusion of a diary control group. This study aims to contribute to an understanding of the influences of both specific and non-specific effects in neurofeedback treatment for tinnitus. TRIAL REGISTRATION ClinicalTrials.gov: NCT03550430. Registered on 27 May 2018.
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Affiliation(s)
- Martin Jensen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany.
| | - Eva Hüttenrauch
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
| | - Jennifer Schmidt
- HSD Hochschule Döpfer, University of Applied Sciences, Waidmarkt 3 und 9, DE-50676, Köln, Germany
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Mira-Lynn Chavanon
- Department of Psychology, Clinical Child and Adolescent Psychology, Philipps University Marburg, Marburg, Germany
| | - Cornelia Weise
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany
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Factor analysis and evaluation of each item of the tinnitus handicap inventory. Head Face Med 2020; 16:4. [PMID: 32145748 PMCID: PMC7060617 DOI: 10.1186/s13005-020-00217-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/12/2020] [Indexed: 01/01/2023] Open
Abstract
PURPOSE This study aims to examine the availability of subscales in the Tinnitus Handicap Inventory (THI) originally proposed by Newman and the possibility of other useful subscales. We also examine whether each item of the THI could be used to better understand the status of patients with tinnitus. METHODS This study included 1332 patients who answered the THI on their first visit. Confirmatory factor analysis was conducted to the 25 items of the THI to confirm the usefulness of the emotional, functional, and catastrophic subscales. Exploratory factor analysis was performed to discover the availability of other suitable subscales in addition to the proposed subscales. The proportion of patients who chose "yes" in each item of the THI was also examined to understand the status of patients with tinnitus. RESULTS In the confirmatory factor analysis, the emotional, functional, and catastrophic subscales did not fit the model. In the exploratory factor analysis, data were extremely biased to one factor. Examination of each item of the THI showed the tendency of worsening of comorbid symptoms when tinnitus handicap became worse. CONCLUSIONS As a result of the factor analysis, only the total score, not any subscale, would be clinically useful in the THI. Examination of each item of the THI was helpful to understand the status of patients with tinnitus and comorbid symptoms of tinnitus. It is necessary to consider treatment by taking these comorbid symptoms into account.
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Delgado de la Serna P, Plaza-Manzano G, Cleland J, Fernández-de-las-Peñas C, Martín-Casas P, Díaz-Arribas MJ. Effects of Cervico-Mandibular Manual Therapy in Patients with Temporomandibular Pain Disorders and Associated Somatic Tinnitus: A Randomized Clinical Trial. PAIN MEDICINE 2019; 21:613-624. [DOI: 10.1093/pm/pnz278] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Abstract
Objective
This randomized clinical trial investigated the effects of adding cervico-mandibular manual therapies into an exercise and educational program on clinical outcomes in individuals with tinnitus associated with temporomandibular disorders (TMDs).
Methods
Sixty-one patients with tinnitus attributed to TMD were randomized into the physiotherapy and manual therapy group or physiotherapy alone group. All patients received six sessions of physiotherapy treatment including cranio-cervical and temporomandibular joint (TMJ) exercises, self-massage, and patient education for a period of one month. Patients allocated to the manual therapy group also received cervico-mandibular manual therapies targeting the TMJ and cervical and masticatory muscles. Primary outcomes included TMD pain intensity and tinnitus severity. Secondary outcomes included tinnitus-related handicap (Tinnitus Handicap Inventory [THI]), TMD-related disability (Craniofacial Pain and Disability Inventory [CF-PDI]), self-rated quality of life (12-item Short Form Health Survey [SF-12]), depressive symptoms (Beck Depression Inventory [BDI-II]), pressure pain thresholds (PPTs), and mandibular range of motion. Patients were assessed at baseline, one week, three months, and six months after intervention by a blinded assessor.
Results
The adjusted analyses showed better outcomes (all, P < 0.001) in the exercise/education plus manual therapy group (large effect sizes) for TMD pain (η 2 P = 0.153), tinnitus severity (η 2 P = 0.233), THI (η 2 P = 0.501), CF-PDI (η 2 P = 0.395), BDI-II (η 2 P = 0.194), PPTs (0.363 < η 2 P < 0.415), and range of motion (η 2 P = 0.350), but similar changes for the SF-12 (P = 0.622, η 2 P = 0.01) as the exercise/education alone group.
Conclusions
This clinical trial found that application of cervico-mandibular manual therapies in combination with exercise and education resulted in better outcomes than application of exercise/education alone in individuals with tinnitus attributed to TMD.
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Affiliation(s)
| | - Gustavo Plaza-Manzano
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, Madrid, Spain
| | - Joshua Cleland
- Physical Therapist, Rehabilitation Services, Concord Hospital, Concord, New Hampshire
- Faculty, Manual Therapy Fellowship Program, Regis University, Denver, Colorado
- Department of Physical Therapy, Franklin Pierce University, Manchester, New Hampshire, USA
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
- Cátedra de Investigación y Docencia en Fisioterapia: Terapia Manual y Punción Seca, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Patricia Martín-Casas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
| | - María José Díaz-Arribas
- Department of Radiology, Rehabilitation and Physiotherapy, Universidad Complutense de Madrid, Madrid, Spain
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Nascimento IDP, Almeida AA, Diniz J, Martins ML, Freitas TMMWCD, Rosa MRDD. Tinnitus evaluation: relationship between pitch matching and loudness, visual analog scale and tinnitus handicap inventory. Braz J Otorhinolaryngol 2019; 85:611-616. [PMID: 29983341 PMCID: PMC9443066 DOI: 10.1016/j.bjorl.2018.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/02/2018] [Accepted: 05/02/2018] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Tinnitus is a subjective auditory symptom usually associated with a sound, even in the absence of external sound sources. Its diagnosis is complex, and some of the forms of measurement alone or in combination, include self-assessment questionnaires, such as the tinnitus handicap inventory, the visual analog scale and/or pitch and loudness matching. OBJECTIVE To analyze the correlation among three tinnitus measurement methods: tinnitus handicap inventory, visual analog scale and pitch and loudness matching. METHODS The study consisted of 148 patients complaining of chronic tinnitus. An otorhinolaryngological evaluation, anamnesis directed to tinnitus, audiometry (pure tone and speech), imitanciometry, tinnitus handicap inventory, visual analog scale, and pitch and loudness matching were performed. The study was registered in the Ethics Committee of the Institution with no. 0129/12. RESULTS Regarding the frequency of tinnitus handicap inventory responses, a higher occurrence of the mild degree was observed. An average of 6 points was observed on the visual analog scale. The mean loudness matching in the right ear was 20dBNS, and in the left ear was 17dBNS. As for the type of stimulus, the most found was continuous pure tone. The frequency of the pitch sensation was 6000Hz in the largest number of cases. Regarding the measures of tinnitus handicap inventory and the visual analogical scale, a significant correlation was observed, and as one value increases the other also increases. Pitch and loudness matching and the visual analogical scale results are also significant. CONCLUSION There was a significant correlation between the values measured by the tinnitus handicap inventory, visual analogical scale (annoyance) and loudness matching in the evaluation of tinnitus. The selection of any one of the three evaluative methods for tinnitus investigation provides different dimensions of the tinnitus and complements the others.
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Affiliation(s)
- Islan da Penha Nascimento
- Universidade Federal da Paraíba (UFPB), Hospital Universitário Lauro Wanderley (HULW), João Pessoa, PB, Brazil
| | - Anna Alice Almeida
- Universidade Federal da Paraíba (UFPB), Departamento de Fonoaudiologia, João Pessoa, PB, Brazil; Universidade Federal da Paraíba (UFPB)/Universidade Federal do Rio Grande do Norte (UFRN), Programa Associado de Pós-graduação em Fonoaudiologia (PPgFon), Brazil; Universidade Federal da Paraíba (UFPB), Programa de Pós-graduação em Neurociência Cognitiva e Comportamento (PPGNeC), João Pessoa, PB, Brazil; Universidade Federal da Paraíba (UFPB), Programa de Pós-graduação em Modelos de Decisão e Saúde (PPgMDS), João Pessoa, PB, Brazil
| | - José Diniz
- Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Mariana Lopes Martins
- Universidade Federal da Paraíba (UFPB), Departamento de Fonoaudiologia, João Pessoa, PB, Brazil; Universidade Federal da Paraíba (UFPB), Programa de Pós-graduação em Neurociência Cognitiva e Comportamento (PPGNeC), João Pessoa, PB, Brazil
| | | | - Marine Raquel Diniz da Rosa
- Universidade Federal da Paraíba (UFPB), Departamento de Fonoaudiologia, João Pessoa, PB, Brazil; Universidade Federal da Paraíba (UFPB)/Universidade Federal do Rio Grande do Norte (UFRN), Programa Associado de Pós-graduação em Fonoaudiologia (PPgFon), Brazil; Universidade Federal da Paraíba (UFPB), Programa de Pós-graduação em Neurociência Cognitiva e Comportamento (PPGNeC), João Pessoa, PB, Brazil.
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Mohsen S, Mahmoudian S, Talbian S, Pourbakht A. Correlation Analysis of the Tinnitus Handicap Inventory and Distress Network in Chronic Tinnitus: An EEG Study. Basic Clin Neurosci 2019; 10:499-514. [PMID: 32284839 PMCID: PMC7149958 DOI: 10.32598/bcn.9.10.215] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/10/2019] [Accepted: 07/17/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Tinnitus is a common disorder with a considerable amount of distress that affects the patient's daily life. No objective tools were approved for measuring tinnitus distress. It can be estimated only by subjective scales and questionnaires, albeit, the Electroencephalography (EEG) studies have reported some alterations regarding tinnitus distress network. This study aimed to investigate the correlation between Tinnitus Handicap Inventory (THI) and the recorded EEG data. METHODS A total of 33 chronic tinnitus cases (9 females) with the mean age of 42.67 years were recruited. Their THI scores were collected, and a 3-minute EEG recorded with eye closed at resting-state. The correlation analysis was performed on THI scores and the current density in the selected Region of Interests (ROIs) concerning the distress network for the eight frequency bands. The patients grouped depending on the THI cutoff point of 56 into low and high THI groups, and then the groups were compared for source analysis and functional connectivity between ROIs using standardized low-resolution brain electromagnetic tomography. RESULTS A significant positive correlation was seen between THI scores and the electrical activity in the Anterior Cingulate Cortex (ACC), the prefrontal cortex, and the parahippocampus for an alpha band (P<0.05) and in the ACC for beta (P<0.01). Source analysis showed significant differences with increased activity in the high THI group for alpha, beta and gamma bands. Functional connectivity was also elevated in the high THI group between the ROIs in alpha and beta bands. CONCLUSION THI can be a useful tool for measuring tinnitus distress, and it has a high correlation with EEG data.
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Affiliation(s)
- Samer Mohsen
- Department of Otolaryngology, School of Medicine, Damascus University, Damascus, Syria
| | - Saeid Mahmoudian
- ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talbian
- School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Wang JJ, Feng YM, Wang H, Wu YQ, Shi HB, Chen ZN, Yin SK. Changes in tinnitus after vestibular schwannoma surgery. Sci Rep 2019; 9:1743. [PMID: 30742012 PMCID: PMC6370768 DOI: 10.1038/s41598-019-38582-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 01/03/2019] [Indexed: 01/18/2023] Open
Abstract
We designed a prospective study to evaluate changes in tinnitus after vestibular schwannoma (VS) surgery. Subjects included 41 patients who were diagnosed with a VS and underwent translabyrinthine microsurgery (TLM) between January 2015 and May 2016. All patients underwent related examinations and were asked to answer the Tinnitus Handicap Inventory (THI) scale and a visual analog scale (VAS) of tinnitus severity both pre- and postoperatively. Of the 41 patients, 31 (75.6%) suffered from tinnitus before surgery. Microsurgery was associated with an overall decrease in tinnitus (p < 0.001). There was a significant improvement in THI and VAS scores after surgery (p = 0.001 and p = 0.005, respectively). The decrease in THI scores in the low-frequency group was significantly larger than that of the mid- and high-frequency groups after surgery (p = 0.034 and p = 0.001, respectively). The loudness of tinnitus decreased significantly after surgery (p = 0.031). Tinnitus in patients with VS improved after TLM. Patients with mid-/high-frequency tinnitus and louder tinnitus preoperatively seemed to have a worse prognosis than those with low-frequency and quieter tinnitus.
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Affiliation(s)
- Jing-Jing Wang
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Yan-Mei Feng
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Hui Wang
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Ya-Qin Wu
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Hai-Bo Shi
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China
| | - Zheng-Nong Chen
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
| | - Shan-Kai Yin
- Otolaryngology Institute, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, 600 Yishan Road, Shanghai, 200233, China.
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23
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Probst T, Weise C, Andersson G, Kleinstäuber M. Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus. Cogn Behav Ther 2018; 48:52-64. [PMID: 29873278 DOI: 10.1080/16506073.2018.1476582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the "Tinnitus Handicap Inventory" (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance ("Working Alliance Inventory-Short Revised"; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (p < .05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.
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Affiliation(s)
- Thomas Probst
- a Department for Psychotherapy and Biopsychosocial Health , Danube-University Krems , Krems , Austria
| | - Cornelia Weise
- b Department of Clinical Psychology and Psychotherapy , Philipps-University , Marburg , Germany.,c Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research , Linköping University , Linköping , Sweden
| | - Gerhard Andersson
- c Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research , Linköping University , Linköping , Sweden.,d Psychiatry Section, Department of Clinical Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Maria Kleinstäuber
- b Department of Clinical Psychology and Psychotherapy , Philipps-University , Marburg , Germany.,e School of Medicine, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
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van Esch B, van der Zaag-Loonen HJ, Bruintjes T, Murdin L, James A, van Benthem PP. Betahistine for Ménière's disease or syndrome. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2018. [DOI: 10.1002/14651858.cd012914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Babette van Esch
- Gelre Hospital; Apeldoorn Dizziness Centre/Department of Otorhinolaryngology; Albert Schweitzerlaan 31 Apeldoorn Netherlands 7334 DZ
| | - Hester J van der Zaag-Loonen
- Gelre Hospital; Apeldoorn Dizziness Centre/Department of Otorhinolaryngology; Albert Schweitzerlaan 31 Apeldoorn Netherlands 7334 DZ
| | - Tjasse Bruintjes
- Gelre Hospital; Apeldoorn Dizziness Centre/Department of Otorhinolaryngology; Albert Schweitzerlaan 31 Apeldoorn Netherlands 7334 DZ
| | - Louisa Murdin
- Faculty of Brain Sciences, University College London; Ear Institute; London UK
| | - Adrian James
- Hospital for Sick Children; Department of Otolaryngology - Head and Neck Surgery; 555 University Avenue Toronto ON Canada M5G 1X8
| | - Peter Paul van Benthem
- Leiden University Medical Centre; Department of Otorhinolaryngology and Head and Neck Surgery; Leiden Netherlands
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Aqeel M, Ahmed A. Translation, Adaptation and Cross Language Validation of Tinnitus Handicap Inventory in Urdu. J Audiol Otol 2017; 22:13-19. [PMID: 29325390 PMCID: PMC5784365 DOI: 10.7874/jao.2017.00108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 07/31/2017] [Accepted: 09/29/2017] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives Tinnitus is characterized as a perception of numerous auditory sounds in absence of external stimulus. Tinnitus can have a considerable consequence on a person’s quality of life, and is considered to be very complicated to quantify. The aim of this study was to investigate the reliability and validity of Urdu translation of the Tinnitus Handicap Inventory (THI) in Pakistan. It was designed to assess the presence of various auditory sounds without the external stimulus. Scale consisted of 25 items having three subscales functional, emotional, and catastrophic. Subjects and Methods The study comprised into two stages, preliminary and main studies. The results of preliminary study revealed that the overall scale had high internal consistency [alpha coefficient of Urdu version of THI (THI-U)= 0.99, alpha coefficient of English version of THI=0.98]. The overall scale had test-retest correlation over a fifteen days period of interval (0.99). Main study was performed on 110 tinnitus patients. The results of main study showed that the internal consistency and reliability of Urdu version was (α=0.93). The THI-U and its subscales demonstrated good internal consistency reliability ( α =0.81 to 0.86). Results High to moderate correlations were noted between tinnitus symptom ratings. A confirmatory factor analysis was used to validate the three subscales of THI-U, and high inter-correlations were found between the subscales also results revealed that a three-factor model for the THI-U was most tenable. The results displayed that the confirmatory factor analysis confirmed to validate the three subscales of THI-U. Conclusion THI-U might present important information about precise facets of tinnitus distress along with diagnostic interviews in clinical practice.
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Affiliation(s)
- Muhammad Aqeel
- Department of Psychology, Foundation University Islamabad, Rawalpindi Campus, Rawalpindi, Pakistan
| | - Ammar Ahmed
- Department of Psychology, Foundation University Islamabad, Rawalpindi Campus, Rawalpindi, Pakistan
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Peter N, Kleinjung T, Jeker R, Meyer M, Klaghofer R, Weidt S. Tinnitus functional index: validation of the German version for Switzerland. Health Qual Life Outcomes 2017; 15:94. [PMID: 28476163 PMCID: PMC5420117 DOI: 10.1186/s12955-017-0669-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 04/27/2017] [Indexed: 11/30/2022] Open
Abstract
Background Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. Methods At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach’s alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. Results The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach’s alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. Conclusion The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus. The reliability and validity of this version are comparable with the original version of the TFI. Although this study showed only five factors in the factor analysis, relations to the original eight subscales were identified. Therefore, the German version of the TFI for Switzerland can deliver relevant information regarding the different tinnitus domains. Trial registration Clinical trial registration number on clinicaltrial.gov: NCT01837368.
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Affiliation(s)
- Nicole Peter
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland.
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Raphael Jeker
- Department of Otorhinolaryngology, University Hospital of Zurich, Frauenklinikstrasse 24, CH-8091, Zurich, Switzerland
| | - Martin Meyer
- Department of Psychology, University of Zurich, Andreasstrasse 15, CH-8050, Zurich, Switzerland
| | - Richard Klaghofer
- Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
| | - Steffi Weidt
- Department of Psychiatry and Psychotherapy, University Hospital of Zurich, Haldenbachstrasse 18, CH-8091, Zurich, Switzerland
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Wrzosek M, Szymiec E, Klemens W, Kotyło P, Schlee W, Modrzyńska M, Lang-Małecka A, Preis A, Bulla J. Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index. Front Psychol 2016; 7:1871. [PMID: 27965609 PMCID: PMC5126044 DOI: 10.3389/fpsyg.2016.01871] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 11/14/2016] [Indexed: 01/05/2023] Open
Abstract
Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach's α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them suitable for clinical use in Poland.
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Affiliation(s)
- Małgorzata Wrzosek
- Department of Logic and Cognitive Science, Adam Mickiewicz University Poznań, Poland
| | | | | | - Piotr Kotyło
- Audiology and Phoniatrics Clinic, Nofer Institute of Occupational Medicine in Łódź Łódź, Poland
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg Regensburg, Germany
| | | | | | - Anna Preis
- Institute of Acoustics, Adam Mickiewicz University Poznań, Poland
| | - Jan Bulla
- Department of Mathematics, University of Bergen Bergen, Norway
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Alvarez L, Ugarte A, Goiburu M, Urreta Barallobre I, Altuna X. Change in Tinnitus After Acoustic Neuroma Removal Using a Translabyrinthine Approach. A Prospective Study. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016. [DOI: 10.1016/j.otoeng.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Alvarez L, Ugarte A, Goiburu M, Urreta Barallobre I, Altuna X. Estudio prospectivo de la evolución del acúfeno tras exéresis por vía translaberíntica del neurinoma del acústico. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2016; 67:315-323. [DOI: 10.1016/j.otorri.2016.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 01/13/2016] [Accepted: 01/14/2016] [Indexed: 11/16/2022]
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Heinrich S, Rozental A, Carlbring P, Andersson G, Cotter K, Weise C. Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy. Internet Interv 2016; 4:120-130. [PMID: 30135798 PMCID: PMC6096122 DOI: 10.1016/j.invent.2016.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 04/16/2016] [Accepted: 04/17/2016] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Internet-based cognitive behavioral therapy (ICBT) has proven to be an effective treatment in improving patients' ability to cope with tinnitus. However, some patients prefer face-to-face therapy to ICBT, and a few studies have shown considerable dropout rates if the treatment is not guided. This renders it important to identify factors that contribute to the commencement and continuation of ICBT programs. AIMS Because treatment motivation and expectations are important factors in psychological treatment, the aim of our study was to investigate what leads tinnitus patients to seek out ICBT, what helps them to keep up with the treatment, and what (if any) impact these factors have on dropout rates and treatment outcomes. METHOD 112 tinnitus patients taking part in ICBT for tinnitus responded to symptom-related questionnaires at three points in time (pre-treatment, post-treatment, and one-year-follow-up) and to a questionnaire consisting of open-ended questions about their treatment motivation and expectations before beginning treatment. Data were analyzed using qualitative content analysis, and the results were used to divide the participants into groups. The treatment outcomes of these groups were compared using t-tests, χ2-tests, and both one-factorial and mixed ANOVAs. RESULTS Four main categories emerged as factors conducive to starting treatment: 1) Targets participants wanted to address, 2) circumstances that led to participation, 3) attitudes towards the treatment, and 4) training features. Participants identified six facilitators for continuing the treatment: success, training, individual attitude, hope, evidence, and support. Naming specific tinnitus-associated problems as targets was associated with greater improvement from pre-treatment to 1-year-follow-up. Describing an active involvement in the treatment was related to increased improvement from post-treatment to follow-up. CONCLUSION There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results.
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Affiliation(s)
- Sarah Heinrich
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | | | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katherine Cotter
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Cornelia Weise
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany,Department of Behavioural Sciences and Learning, Linnaeus Centre HEAD, Swedish Institute for Disability Research, Linköping University, Linköping, Sweden,Corresponding author at: Philipps-University Marburg, Department of Psychology, Division of Clinical Psychology and Psychotherapy, Gutenbergstrasse 18, 35032 Marburg, Germany
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