A pilot clinical trial of the effects of coenzyme Q10 on chronic tinnitus aurium

Migrainous Vertigo, Tinnitus, and Ear Symptoms and Alternatives

Migraine headaches frequently coexist with vestibular symptoms such as vertigo, motion sickness, and gait instability. Migraine-related vasospasm can also damage the inner ear, which results in symptoms such as sudden sensorineural hearing loss and resultant tinnitus. The pathophysiology of these symptoms is not yet fully understood, and despite their prevalence, there is no universally approved management. This review summarizes the data on complementary and integrative medicine in treating patients with migrainous ear disorders.

Auditory Neural Plasticity in Tinnitus Mechanisms and Management

Tinnitus, which is the perception of sound in the absence of a corresponding external acoustic stimulus, including change of hearing and neural plasticity, has become an increasingly important ailment affecting the daily life of a considerable proportion of the population and causing significant burdens for both the affected individuals and society as a whole. Here, we briefly review the epidemiology and classification of tinnitus, and the currently available treatments are discussed in terms of the available evidence for their mechanisms and efficacy. The conclusion drawn from the available evidence is that there is no specific medication for tinnitus treatment at present, and tinnitus management might provide better solutions. Therapeutic interventions for tinnitus should be based on a comprehensive understanding of the etiology and features of individual cases of tinnitus, and more high quality and large-scale research studies are urgently needed to develop more efficacious medications.

Relative bioavailability of coenzyme Q10 formulation for paediatric individualized therapy

OBJECTIVES

Conduct a preliminary comparison of the bioavailability between two formulations: commercial grade coenzyme Q10 (CoQ10) powder (solid formulation) and a new oil-in-water liquid emulsion and their effect on other antioxidants.

METHODS

Six healthy individuals participated in a randomized, crossover, open, consecutive design, with a 2-week washout period. Pharmacokinetic parameters were assessed after a single and multiple intakes of 250 mg CoQ10 given daily for 1 week.

KEY FINDINGS

The differences in the pharmacokinetic parameters of maximum plasma concentration, area under the curve between 0-360 and 0-4 h, elimination half-life were statistically significant with a relative bioavailability of 489% increase over solid CoQ10 formulation. A multiple dose supplementation increased plasma CoQ10 levels in both formulations, liquid emulsion performing better (2.4- vs 3.9-fold for solid and liquid formulation, respectively) without modifications on other antioxidants. Furthermore, the plasma CoQ10 at 7th day was statistically different between formulations (P < 0.05).

CONCLUSIONS

The results obtained showed that liquid emulsion improves the bioavailability of CoQ10 respect to solid form which not only facilitates the individualized administration for the child but in turn could increase the therapeutic efficacy, which should be confirmed by further studies.

Coenzyme Q10 does not protect cochlear hair cells from death in the ischemic organotypic culture

Objective

To evaluate in vitro the effect of coenzyme Q10 (CoQ10) on ischemia-induced hair cell death.

Study Design

Organotypic cochlear cultures of newborn rats were subjected to ischemia with and without CoQ10.

Results

Addition of CoQ10 has not prevented HC loss.

Conclusion

CoQ10 seems to protect against only certain modes of cell death.

In vivo electrochemical monitoring of the change of cochlear perilymph ascorbate during salicylate-induced tinnitus

As one of the most important neurochemicals in biological systems, ascorbate plays vital roles in many physiological and pathological processes. In order to understand the roles of ascorbate in the pathological process of tinnitus, this study demonstrates an in vivo method for real time monitoring of the changes of ascorbate level in the cochlear perilymph of guinea pigs during the acute period of tinnitus induced by local microinfusion of salicylate with carbon fiber microelectrodes (CFMEs) modified with multiwalled carbon nanotubes (MWNTs). To accomplish in vivo electrochemical monitoring of ascorbate in the microenvironment of the cochlear perilymph, the MWNT-modified CFME is used as working electrode, a microsized Ag/AgCl is used as reference electrode, and Pt wire is used as counter electrode. Three electrodes are combined together around a capillary to form integrated capillary-electrodes. The integrated capillary-electrode is carefully implanted into the cochlear perilymph of guinea pigs and used both for externally microinfusing of salicylate into the cochlear perilymph and for real time monitoring of the change of ascorbate levels. The in vivo voltammetric method based on the integrated capillary-electrodes possesses a high selectivity and a good linearity for ascorbate determination in the cochlear perilymph of guinea pigs. With such a method, the basal level of cochlear perilymph ascorbate is determined to be 45.0 ± 5.1 μM (n = 6). The microinfusion of 10 mM salicylate (1 μL/min, 5 min) into the cochlear decreases the ascorbate level to 28 ± 10% of the basal level (n = 6) with a statistical significance (P < 0.05), implying that the decrease in ascorbate level in the cochlear may be associated with salicylate-induced tinnitus. This study essentially offers a new method for in vivo monitoring of the cochlear perilymph ascorbate following the salicylate-induced tinnitus and can thus be useful for investigation on chemical essences involved in tinnitus.

[Pharmacotherapy of acute and chronic hearing loss]

The aetiology of acute hearing loss is mostly idiopathic like sudden sensorineural hearing loss and rarely infectious or vascular. Several studies and meta-analyses of pharmacotherapy are reviewed: In chronic tinnitus there is no indication for pharmacotherapy; sometimes a possible psychosomatic comorbidity has to be treated with psychopharmaceutical agents. Despite a low level of evidence treatment with steroids and initially plasma expanding infusions is recommended for acute tinnitus if there is no spontaneous remission. Intratympanic steroid therapy can be used as an alternative if there is severe hearing loss together with tinnitus.

Coenzyme Q10 and Neurological Diseases

Coenzyme Q10 (CoQ10, or ubiquinone) is a small electron carrier of the mitochondrial respiratory chain with antioxidant properties. CoQ10 supplementation has been widely used for mitochondrial disorders. The rationale for using CoQ10 is very powerful when this compound is primary decreased because of defective synthesis. Primary CoQ10 deficiency is a treatable condition, so heightened "clinical awareness" about this diagnosis is essential. CoQ10 and its analogue, idebenone, have also been widely used in the treatment of other neurodegenerative disorders. These compounds could potentially play a therapeutic role in Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, Friedreich's ataxia, and other conditions which have been linked to mitochondrial dysfunction. This article reviews the physiological roles of CoQ10, as well as the rationale and the role in clinical practice of CoQ10 supplementation in different neurological diseases, from primary CoQ10 deficiency to neurodegenerative disorders.