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Natarajan N, Batts S, Gombar S, Manickam R, Sagi V, Curhan SG, Stankovic KM. Associations of Tinnitus Incidence with Use of Tumor Necrosis Factor-Alpha Inhibitors among Patients with Autoimmune Conditions. J Clin Med 2023; 12:jcm12051935. [PMID: 36902722 PMCID: PMC10004033 DOI: 10.3390/jcm12051935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 02/20/2023] [Accepted: 02/24/2023] [Indexed: 03/05/2023] Open
Abstract
Tumor necrosis factor-alpha (TNFα) may promote neuroinflammation prompting tinnitus. This retrospective cohort study evaluated whether anti-TNFα therapy influences incident tinnitus risk among adults with autoimmune disorders and no baseline tinnitus selected from a US electronic health records database (Eversana; 1 January 2010-27 January 2022). Patients with anti-TNFα had ≥90-day history pre-index (first autoimmune disorder diagnosis) and ≥180-day follow-up post-index. Random samples (n = 25,000) of autoimmune patients without anti-TNFα were selected for comparisons. Tinnitus incidence was compared among patients with or without anti-TNFα therapy, overall and among at-risk age groups or by anti-TNFα category. High-dimensionality propensity score (hdPS) matching was used to adjust for baseline confounders. Compared with patients with no anti-TNFα, anti-TNFα was not associated with tinnitus risk overall (hdPS-matched HR [95% CI]: 1.06 [0.85, 1.33]), or between groups stratified by age (30-50 years: 1 [0.68, 1.48]; 51-70 years: 1.18 [0.89, 1.56]) or anti-TNFα category (monoclonal antibody vs. fusion protein: 0.91 [0.59, 1.41]). Anti-TNFα was not associated with tinnitus risk among those treated for ≥6 months (hdPS-matched HR [95% CI]: 0.96 [0.69, 1.32]) or ≥12 (1.03 [0.71, 1.5]), or those with RA (1.16 [0.88, 1.53]). Thus, in this US cohort study, anti-TNFα therapy was not associated with tinnitus incidence among patients with autoimmune disorders.
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Affiliation(s)
- Nirvikalpa Natarajan
- Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA
| | - Shelley Batts
- Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA
| | - Saurabh Gombar
- Atropos Health, 71 W 83rd St #3R., New York, NY 10024, USA
- Department of Pathology, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA
| | - Raj Manickam
- Atropos Health, 71 W 83rd St #3R., New York, NY 10024, USA
| | - Varun Sagi
- Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA
| | - Sharon G. Curhan
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115, USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology—Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA
- Department of Neurosurgery, Stanford University School of Medicine, 801 Welch Rd, Palo Alto, CA 94304, USA
- Wu Tsai Neuroscience Institute, Stanford University, 288 Campus Dr, Stanford, CA 94305, USA
- Correspondence:
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Grundfast KM, Jamil TL. Evaluation and Management of Tinnitus: Are There Opportunities for Improvement? Otolaryngol Head Neck Surg 2023; 168:45-58. [PMID: 35349391 DOI: 10.1177/01945998221088286] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To review current information about diagnosis and management of tinnitus aiming to identify opportunities for achieving a cost-effective, efficient, evidence-based approach that meets the needs of tinnitus sufferers. DATA SOURCES PubMed/MEDLINE. REVIEW METHODS In total, 249 relevant published reports were reviewed. Pertinent keywords and MeSH terms identified reports via PubMed and EMBASE. Acknowledged experts were consulted on ways to improve tinnitus management. CONCLUSIONS There may be opportunities to improve evaluation and management of patients with tinnitus using modern modes of communication and a multidisciplinary therapeutic approach. IMPLICATIONS FOR PRACTICE Tinnitus can adversely affect quality of life while being time-consuming and costly to evaluate and manage. Based on both personal experience and the reports of others, patients with tinnitus who choose to see a physician primarily want to know two things: (1) that the tinnitus that is so distressing will not remain at the same level of severity forever and (2) that something can be done to help cope with the tinnitus that is so annoying. Recent advancements in internet communications, social media, information technology, artificial intelligence, machine learning, holistic medical care, mind-body integrative health care, and multidisciplinary approaches in medical therapeutics may be possibly making new ways of meeting the needs of patients with tinnitus.
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Affiliation(s)
- Kenneth M Grundfast
- Boston University School of Medicine, Boston, Massachusetts, USA
- Department of Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston, Massachusetts, USA
- Otology Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Taylor L Jamil
- Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Public Health, Boston, Massachusetts, USA
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Patil JD, Alrashid MA, Eltabbakh A, Fredericks S. The association between stress, emotional states, and tinnitus: a mini-review. Front Aging Neurosci 2023; 15:1131979. [PMID: 37207076 PMCID: PMC10188965 DOI: 10.3389/fnagi.2023.1131979] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Extensive literature supporting the view of tinnitus induced stress in patients is available. However, limited evidence has been produced studying the opposite, that is, does stress cause tinnitus? The hypothalamus pituitary adrenal axis, one of the main neuroendocrine systems involved in stress response, is commonly disturbed in tinnitus patients. Patients with chronic tinnitus have been shown to develop abnormal responses to psycho-social stress, where the hypothalamus pituitary adrenal axis response is weaker and delayed, suggesting chronic stress contributes to the development of chronic tinnitus. The sympathetic branch of the autonomic nervous system also plays a major role in stress response and its chronic hyperactivity seems to be involved in developing tinnitus. Psycho-social stress has been shown to share the same probability of developing tinnitus as occupational noise and contributes to worsening tinnitus. Additionally, exposure to high stress levels and occupational noise doubles the likelihood of developing tinnitus. Interestingly, short-term stress has been shown to protect the cochlea in animals, but chronic stress exposure has negative consequences. Emotional stress also worsens pre-existing tinnitus and is identified as an important indicator of tinnitus severity. Although there is limited body of literature, stress does seem to play a vital role in the development of tinnitus. This review aims to highlight the association between stress, emotional states, and the development of tinnitus while also addressing the neural and hormonal pathways involved.
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Affiliation(s)
- Jayaditya Devpal Patil
- Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- *Correspondence: Jayaditya Devpal Patil,
| | | | - Ayah Eltabbakh
- Royal College of Surgeons in Ireland, Al Muharraq, Bahrain
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Neuroinflammation in Tinnitus. CURRENT OTORHINOLARYNGOLOGY REPORTS 2022. [DOI: 10.1007/s40136-022-00411-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Abstract
Purpose of Review
The current review aims to explore recent studies that have illustrated a link between neuroinflammation and tinnitus and the consequential effect on neuronal functioning. We explore parallels amongst pain and tinnitus pathologies and a novel treatment option.
Recent Findings
Genetic and pharmacological blockage of pro-inflammatory cytokines mitigates the physiological and behavioral tinnitus phenotype in acute rodent models. In addition, recent pain studies target a signaling pathway to prevent the transition from acute to chronic neuropathic pain, which could translate to tinnitus.
Summary
Neuroinflammation likely mediates hyperexcitability of the auditory pathway, driving the development of acute tinnitus. In chronic tinnitus, we believe translational regulation plays a role in maintaining persistent tinnitus signaling. We therefore propose this pathway as a potential therapeutic strategy.
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Basso L, Boecking B, Neff P, Brueggemann P, El-Ahmad L, Brasanac J, Rose M, Gold SM, Mazurek B. Negative Associations of Stress and Anxiety Levels With Cytotoxic and Regulatory Natural Killer Cell Frequency in Chronic Tinnitus. Front Psychol 2022; 13:871822. [PMID: 35814090 PMCID: PMC9262102 DOI: 10.3389/fpsyg.2022.871822] [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: 02/08/2022] [Accepted: 05/25/2022] [Indexed: 12/04/2022] Open
Abstract
Background Depression and anxiety are known to be associated with stress-induced changes in the immune system. Bothersome tinnitus can be related to stress and often co-occurs with depression and anxiety. This study investigates associations of psychological and audiological tinnitus-related factors with inflammatory parameters and immune cell subsets in chronic tinnitus patients as well as treatment-related effects. Methods This longitudinal study of inpatients treated with compact multimodal tinnitus-specific cognitive behavioral therapy included four repeated measurement sessions: baseline (N = 41), treatment end, 7.8-week (N = 35), and 13.8-week follow-up (N = 34). Data collection included audiometric testing, blood sampling, and psychometric questionnaires: Tinnitus Handicap Inventory (THI), Perceived Stress Questionnaire (PSQ-20), and Hospital Anxiety Depression Scale (HADS). Flow cytometry was used to analyze immune cell subsets. Statistical analyses comprised correlation and network analysis (cross-sectional), and linear mixed effect models (longitudinal). Results Bootstrapped network analysis showed negative averaged cross-sectional associations of cytotoxic natural killer (NKc) cell frequency (CD56 + CD16+) and PSQ-20 (−0.21 [−0.48, 0]) and of regulatory natural killer (NKreg) cell frequency (CD56 + CD16dim/−) and HADS anxiety (−0.14 [−0.38, 0]). No significant treatment effects were found. A negative predictive effect of baseline PSQ-20 scores (β = −6.22 [−12.18, −0.26], p = 0.041) and a positive predictive effect of baseline ferritin levels (β = 8.90 [2.76, 15.03], p = 0.004) on NKc cell frequency across the repeated measurement sessions were observed. Conclusion We observed negative relationships between perceived stress levels and NKc cell frequency and between anxiety levels and NKreg cell frequency in chronic tinnitus patients. These exploratory results suggest stress−/anxiety-related immune alterations in bothersome tinnitus but need to be tested in further confirmatory studies with larger sample sizes. The potential of NK cells as biomarkers of emotional distress in chronic tinnitus should be further investigated.
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Affiliation(s)
- Laura Basso
- Tinnitus Center, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Neff
- Center for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Center for Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale de Lausanne, Geneva, Switzerland
- Department of Radiology and Medical Informatics, University of Geneva, Geneva, Switzerland
| | - Petra Brueggemann
- Tinnitus Center, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Linda El-Ahmad
- Medical Department, Section of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Jelena Brasanac
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Rose
- Medical Department, Section of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan M. Gold
- Medical Department, Section of Psychosomatic Medicine, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Institute of Neuroimmunology and Multiple Sclerosis (INIMS), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité – Universitätsmedizin Berlin, Berlin, Germany
- *Correspondence: Birgit Mazurek,
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Boecking B, Klasing S, Walter M, Brueggemann P, Nyamaa A, Rose M, Mazurek B. Vascular-Metabolic Risk Factors and Psychological Stress in Patients with Chronic Tinnitus. Nutrients 2022; 14:nu14112256. [PMID: 35684056 PMCID: PMC9183085 DOI: 10.3390/nu14112256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 05/17/2022] [Indexed: 02/04/2023] Open
Abstract
Little is known about molecular correlates of chronic tinnitus. We examined interrelationships between vascular−metabolic risk factors, perceived stress, and other routine blood values in patients with chronic tinnitus. Two-hundred patients (51% female) were screened for 49 blood parameters pertaining to vascular−metabolic risk, immune function, and redox processes. They further completed perceived stress- and tinnitus-related distress questionnaires. Following descriptive analyses, gender-specific sets of age- and tinnitus-severity-adjusted regression models investigated associations between perceived stress and blood parameters. Patients reported mildly elevated levels of perceived stress. Elevated levels of total cholesterol (65% and 61% of female and male patients, respectively), non-HDL-c (43/50%), LDL-c (56/59%), and lipoprotein_a (28/14%) were accompanied by high rates of overweight (99/100%) and smoking (28/31%). A low-level inflammatory state was accompanied by reduced reactive oxygen species (ROS)-neutralizing capacity (reduced co-enzyme Q10 and SOD1 levels). Most vascular risk factors were not correlated with perceived stress, except for fibrinogen (ß = −0.34) as well as C-reactive protein (ß = −0.31, p < 0.05) in men, and MCV (ß = −0.26, p < 0.05) in women. Interrelations between blood parameters and stress levels need to be investigated within psychobehavioural frameworks across varying distress levels. Alongside psychological interventions, a low-level inflammatory state may be a route for pharmacological therapeutics.
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Affiliation(s)
- Benjamin Boecking
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Sven Klasing
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Michael Walter
- Institute of Clinical Chemistry and Laboratory Medicine, Universitätsmedizin Rostock, 18057 Rostock, Germany;
| | - Petra Brueggemann
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Amarjargal Nyamaa
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Birgit Mazurek
- Tinnitus Center, Charité, Universitätsmedizin Berlin, 10117 Berlin, Germany; (B.B.); (S.K.); (P.B.); (A.N.)
- Correspondence:
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Becker L, Keck A, Rohleder N, Müller-Voggel N. Higher Peripheral Inflammation Is Associated With Lower Orbitofrontal Gamma Power in Chronic Tinnitus. Front Behav Neurosci 2022; 16:883926. [PMID: 35493955 PMCID: PMC9039358 DOI: 10.3389/fnbeh.2022.883926] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic tinnitus, the continuous perception of a phantom sound, is a highly prevalent audiological symptom, for which the underlying pathology has not yet been fully understood. It is associated with neurophysiological alterations in the central nervous system and chronic stress, which can be related with a disinhibition of the inflammatory system. We here investigated the association between resting-state oscillatory activity assessed with Magnetoencephalography (MEG), and peripheral inflammation assessed by C-reactive protein (CRP) in a group of patients with chronic tinnitus (N = 21, nine males, mean age: 40.6 ± 14.6 years). Additionally, CRP was assessed in an age- and sex-matched healthy control group (N = 21, nine males, mean age: 40.9 ± 15.2 years). No MEG data was available for the control group. We found a significant negative correlation between CRP and gamma power in the orbitofrontal cortex in tinnitus patients (p < 0.001), pointing to a deactivation of the orbitofrontal cortex when CRP was high. No significant clusters were found for other frequency bands. Moreover, CRP levels were significantly higher in the tinnitus group than in the healthy controls (p = 0.045). Our results can be interpreted based on findings from previous studies having disclosed the orbitofrontal cortex as part of the tinnitus distress network. We suggest that higher CRP levels and the associated deactivation of the orbitofrontal cortex in chronic tinnitus patients is maintaining the tinnitus percept through disinhibition of the auditory cortex and attentional or emotional top-down processes. Although the direction of the association (i.e., causation) between CRP levels and orbitofrontal gamma power in chronic tinnitus is not yet known, inflammation reducing interventions are promising candidates when developing treatments for tinnitus patients. Overall, our study highlights the importance of considering immune-brain communication in tinnitus research.
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Affiliation(s)
- Linda Becker
- Department of Psychology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
- *Correspondence: Linda Becker
| | - Antonia Keck
- Department of Neurosurgery, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Nicolas Rohleder
- Department of Psychology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Nadia Müller-Voggel
- Department of Neurosurgery, Universitätsklinikum Erlangen, Erlangen, Germany
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Mennink LM, Aalbers MW, van Dijk P, van Dijk JMC. The Role of Inflammation in Tinnitus: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:1000. [PMID: 35207270 PMCID: PMC8878384 DOI: 10.3390/jcm11041000] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/24/2022] Open
Abstract
Subjective tinnitus is the perception of sound without the presence of an external source. Increasing evidence suggests that tinnitus is associated with inflammation. In this systematic review, the role of inflammation in subjective tinnitus was studied. Nine animal and twenty human studies reporting inflammatory markers in both humans and animals with tinnitus were included. It was established that TNF-α and IL-1β are increased in tinnitus, and that microglia and astrocytes are activated as well. Moreover, platelet activation may also play a role in tinnitus. In addition, we elaborate on mechanisms of inflammation in tinnitus, and discuss potential treatment options targeting inflammatory pathways.
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Affiliation(s)
- Lilian M. Mennink
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Department of Otorhinolaryngology/Head & Neck Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Marlien W. Aalbers
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head & Neck Surgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands;
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (M.W.A.); (J.M.C.v.D.)
- Research School of Behavioral and Cognitive Neurosciences (BCN), University Medical Center Groningen, University of Groningen, 9713 AV Groningen, The Netherlands
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Deshpande AK, Bhatt I, Rojanaworarit C. Virtual reality for tinnitus management: a randomized controlled trial. Int J Audiol 2021; 61:868-875. [PMID: 34550862 DOI: 10.1080/14992027.2021.1978568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Sound therapy (ST) and stress reduction regimens have been successfully used to manage tinnitus. Virtual reality (VR) has been used to manage chronic conditions like intractable pain. The aim of the present study was to investigate whether the use of VR in conjunction with ST revealed additional improvements in tinnitus attributes as compared to ST alone. DESIGN This study was a randomised controlled trial (RCT) with a cross-over design. All participants received two interventions - ST alone (control) and ST with VR stimuli (experimental). ST consisted of fractal tones while VR stimuli comprised of nature videos presented via VR goggles. A multilevel mixed-effects linear regression model was used to estimate the intervention effect. STUDY SAMPLE Twenty adults with subjective, continuous, chronic tinnitus participated in the study. RESULTS After adjusting for period and baseline tinnitus loudness, significant improvements were observed in tinnitus loudness and Tinnitus Functional Index scores. Although not statistically significant, mean minimum masking levels were lower after the experimental intervention. CONCLUSIONS Study participants benefitted from the use of VR in conjunction with ST in a laboratory setting. Additional effectiveness trials and blinded RCTs will be needed before validating the use of VR for tinnitus management in clinical settings.
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Affiliation(s)
- Aniruddha K Deshpande
- The Hear-Ring Lab, Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY, USA.,The Long Island AuD Consortium, Garden City, NY, USA
| | - Ishan Bhatt
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA, USA
| | - Chanapong Rojanaworarit
- Department of Health Professions, School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA
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Objective and Measurable Biomarkers in Chronic Subjective Tinnitus. Int J Mol Sci 2021; 22:ijms22126619. [PMID: 34205595 PMCID: PMC8235100 DOI: 10.3390/ijms22126619] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/18/2022] Open
Abstract
Tinnitus is associated with increased social costs and reduced quality of life through sleep disorders or psychological distress. The pathophysiology of chronic subjective tinnitus, which accounts for most tinnitus, has not been clearly elucidated. This is because chronic subjective tinnitus is difficult to evaluate objectively, and there are no objective markers that represent the diagnosis or therapeutic effect of tinnitus. Based on the results of studies on patients with chronic subjective tinnitus, objective and measurable biomarkers that help to identify the pathophysiology of tinnitus have been summarized. A total of 271 studies in PubMed, 303 in EMBASE, and 45 in Cochrane Library were found on biomarkers related to chronic subjective tinnitus published until April 2021. Duplicate articles, articles not written in English, review articles, case reports, and articles that did not match our topic were excluded. A total of 49 studies were included. Three specimens, including blood, saliva, and urine, and a total of 58 biomarkers were used as indicators for diagnosis, evaluation, prognosis, and therapeutic effectiveness of tinnitus. Biomarkers were classified into eight categories comprising metabolic, hemostatic, inflammatory, endocrine, immunological, neurologic, and oxidative parameters. Biomarkers can help in the diagnosis, measure the severity, predict prognosis, and treatment outcome of tinnitus.
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Haider HF, Hoare DJ, Ribeiro SF, Ribeiro D, Caria H, Trigueiros N, Borrego LM, Szczepek AJ, Papoila AL, Elarbed A, da Luz Martins M, Paço J, Sereda M. Evidence for biological markers of tinnitus: A systematic review. PROGRESS IN BRAIN RESEARCH 2021; 262:345-398. [PMID: 33931188 DOI: 10.1016/bs.pbr.2021.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Subjective tinnitus is a phantom sound heard only by the affected person and may be a symptom of various diseases. Tinnitus diagnosis and monitoring is based on subjective audiometric and psychometric methods. This review aimed to synthesize evidence for tinnitus presence or its severity. We searched several electronic databases, citation searches of the included primary studies through Web of Science, and further hand searches. At least two authors performed all systematic review steps. Sixty-two records were included and were categorized according the biological variable. Evidence for possible tinnitus biomarkers come from oxidative stress, interleukins, steroids and neurotransmitters categories. We found conflicting evidence for full blood count, vitamins, lipid profile, neurotrophic factors, or inorganic ions. There was no evidence for an association between tinnitus and the remaining categories. The current review evidences that larger studies, with stricter exclusion criteria and powerful harmonized methodological design are needed. Protocol published on PROSPERO (CRD42017070998).
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Affiliation(s)
- Haúla F Haider
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal; Comprehensive Health Research Centre (CHRC), Lisbon, Portugal.
| | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sara F Ribeiro
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Diogo Ribeiro
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Helena Caria
- Deafness Research Group, BTR Unit, BioISI, Faculty of Sciences, University of Lisbon (FCUL), Portugal; ESS/IPS-Biomedical Sciences Department, School of Health, Polytechnic Institute of Setubal, Portugal
| | - Nuno Trigueiros
- ENT Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Luís Miguel Borrego
- Department of Immunology, Chronic Diseases Research Center (CEDOC), Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal; Department of Immunoallergy, LUZ SAUDE, Hospital da Luz, Lisbon, Portugal
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ana Luísa Papoila
- Bioestatistics Department, Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal
| | - Asma Elarbed
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Maria da Luz Martins
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - João Paço
- ENT Department, Hospital Cuf Tejo-Nova Medical School, Lisbon, Portugal; CUF Academic and Research Medical Center, Lisbon, Portugal
| | - Magdalena Sereda
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Elarbed A, Fackrell K, Baguley DM, Hoare DJ. Tinnitus and stress in adults: a scoping review. Int J Audiol 2020; 60:171-182. [PMID: 33000672 DOI: 10.1080/14992027.2020.1827306] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Tinnitus and stress are recurrently reported together. The strength and direction of this relationship is not clear. The aim of this review is to catalogue the evidence of this relationship, how it has been described in adults and which instruments were used. DESIGN Five-stage framework was followed. An online search of databases and published journals were conducted. The main inclusion criteria were original studies published in English and conducted in an adult human population, in which both tinnitus and stress were measured using different instruments. STUDY SAMPLES 5699 records were identified in the searching stage and 50 studies were eligible for data extraction. RESULTS Measurements of perceived stress were most frequently used. Tinnitus patients tend to report louder and more bothersome tinnitus when they are stressed, but not all tinnitus patients associated stress with the onset or the severity of their tinnitus. Any positive correlation reported between stress and tinnitus levels varied in strength according to the used instrument. Post-intervention changes in stress and tinnitus levels showed inconsistency. CONCLUSION There is considerable room for further research to study the relationship between stress and tinnitus. We highlight principal issues that should be considered in future studies.
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Affiliation(s)
- Asma Elarbed
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - David M Baguley
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
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13
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Marchiori LLDM, Doi MY, Marchiori GDM, de Souza GV, Poli-Frederico RC, Ciquinato DSDA. Interleukin-1 alpha gene polymorphism (IL-1α) and susceptibility to tinnitus in the elderly. Noise Health 2020; 21:77-82. [PMID: 32174642 PMCID: PMC7158897 DOI: 10.4103/nah.nah_67_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Context: To investigate the association between the single nucleotide polymorphism in the position-889 (C/T) of the promoter region of the IL-1α gene and the susceptibility to tinnitus. Method: This was a case-control study with a sample of 108 independent elderly people over 60 years of age. Information on exposure to occupational noise and tinnitus was obtained by interviews. The genetic polymorphism was analyzed by polymerase chain reaction followed by cleavage with restriction enzyme NcoI. Data were analyzed using the Chi-square test, with the significance level set at 5%. For the statistical analysis all individuals with tinnitus on the right ear were eligible. Results: Among elderly with tinnitus, 42.9% had a history of exposure to occupational noise. There was statistically significant association between IL-1α gene polymorphism and tinnitus in subjects without a history of exposure to occupational noise (P = 0.006 and χ2 = 10.39). The elderly with the T allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the C allele. Conclusion: This study suggests an association between the IL-1α gene polymorphism with susceptibility to tinnitus in individuals without a history of exposure to occupational noise. The present study demonstrated that allele T of IL-1α is a protective factor for presence and severity of tinnitus in the elderly and allele C contributes to the pathogenesis of the inflammatory response. The present observation implied the signaling IL-1α is involved in ear aging.
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14
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Systematic Review and Network Meta-analysis of Cognitive and/or Behavioral Therapies (CBT) for Tinnitus. Otol Neurotol 2020; 41:153-166. [DOI: 10.1097/mao.0000000000002472] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Haider HF, Ribeiro SF, Martins C, Ribeiro D, Trigueiros N, Szczepek AJ, Caria H, Hoare DJ, Paço J, Borrego LM. Tinnitus, hearing loss and inflammatory processes in an older Portuguese population. Int J Audiol 2019; 59:323-332. [PMID: 31829778 DOI: 10.1080/14992027.2019.1698775] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objective: Tinnitus is associated with various conditions such as presbycusis, infectious, autoimmune and many other diseases. Our study aims to identify an association between inflammatory markers and the presence of tinnitus or hearing loss (HL).Design: Exploratory study including a structured interview, complete ENT observation, audiological and inflammatory markers evaluation.Study Sample: Sixty women and 54 men (55 to 75 years) from the Portuguese population, with or without sensory presbycusis and/or tinnitus.Results: IL10 levels were significantly lower in participants with tinnitus than in those without tinnitus. Moreover, TGF-β was lower in older participants (p = 0.034), IL1α was higher in participants with tonal tinnitus (p = 0.033), and IL2 was lower in participants who reported partial or complete residual inhibition (p = 0.019). Additionally, we observed a negative correlation between tinnitus duration and IL10 levels (r= -.281), and between HSP70 levels and tinnitus loudness (r= -.377). TNF-α and HSP70 levels appears to be sensitive to the time when samples were collected (morning or afternoon).Conclusions: The results of our study showing fluctuations in inflammatory markers along the hearing loss process, reinforce the idea that inflammatory mechanisms are involved in hearing loss pathogenesis but also in tinnitus. IL10 levels appear significantly altered in tinnitus but not in hearing loss.
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Affiliation(s)
- Haúla F Haider
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Sara F Ribeiro
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Catarina Martins
- Immunology, Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Diogo Ribeiro
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Nuno Trigueiros
- ENT Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Helena Caria
- Departamento de Ciências Biomédicas, Escola Superior de saúde do Instituto Politécnico de Setúbal, Setubal, Portugal.,Faculty of Sciences, BioISI - Biosystems and Integrative Sciences Institute, University of Lisboa, Lisboa, Portugal
| | - Derek J Hoare
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - João Paço
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Luís-Miguel Borrego
- Immunology, Chronic Diseases Research Center (CEDOC), NOVA Medical School, Faculty of Medical Sciences, NOVA Medical School, Lisbon, Portugal.,Luz Saúde, Hospital da Luz, Immunoalergy Department, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Lisbon, Portugal
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17
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Ciminelli P, Machado S, Palmeira M, Carta MG, Beirith SC, Nigri ML, Mezzasalma MA, Nardi AE. Tinnitus: The Sound of Stress? Clin Pract Epidemiol Ment Health 2018; 14:264-269. [PMID: 30972125 PMCID: PMC6407646 DOI: 10.2174/1745017901814010264] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 09/19/2018] [Accepted: 10/02/2018] [Indexed: 11/23/2022]
Abstract
Background: Emotional stress is frequently associated with otologic symptoms as tinnitus and dizziness. Stress can contribute to the beginning or worsening of tinnitus. Objective: The objective of the study is to evaluate the presence of stress symptoms in patients with chronic, subjective tinnitus, and correlate its presence to annoyance associated with tinnitus. Methods: This is a cross-sectional study. One hundred and eighty patients with chronic, subjective tinnitus were included. Patients answered the Tinnitus Handicap Inventory (THI) to evaluate the impact of tinnitus in the quality of life and answered the Lipp's inventory symptoms of stress for adults (ISSL). The data obtained was organized using Excel® 2010, mean values, linear regression and p-value were calculated. Results: Of the 180 patients included in the study, 117 (65%) had stress symptoms, 52 of the 117 (44%) were in the resistance phase and 23 of the 117 (20%) in the exhaustion phase, the remaining was in the alert phase. There was a clear progressive increase in stress as THI raised, with more impact of tinnitus in quality of life. Conclusion: The presence of stress symptoms, measured by ISSL was observed in most of our patients with chronic subjective tinnitus, specially in the resistance and exhaustion phases and it is directly associated with tinnitus annoyance.
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Affiliation(s)
- Patricia Ciminelli
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil.,Lagoa Federal Hospital, Ministry of Health, Rio de Janeiro, Brazil
| | - Sergio Machado
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil.,Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program, Salgado de Oliveira University, Niterói, Brazil
| | - Manoela Palmeira
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil
| | | | | | - Michelle Levitan Nigri
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil
| | - Marco André Mezzasalma
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil
| | - Antonio Egidio Nardi
- Laboratory of Panic & Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, Rua Venceslau Bras, 71 CIPE. Botafogo, Rio de Janeiro, Brazil
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18
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Marchiori LLM, Dias ACM, Gonçalvez AS, Poly-Frederico RC, Doi MY. Association between polymorphism of tumor necrosis factor alpha (tnfα) in the region -308 g/a with tinnitus in the elderly with a history of occupational noise exposure. Noise Health 2018; 20:37-41. [PMID: 29676293 PMCID: PMC5926314 DOI: 10.4103/nah.nah_34_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Context: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern and is often associated with different forms of the hearing loss of varying severity. Aims: To investigate the association between the polymorphism of tumor necrosis factor alpha (TNFα) in the region −308 G/A with the susceptibility to tinnitus in individuals with the history of exposure to occupational noise. Settings and Design: This was a cross-sectional study with a sample of 179 independent elderly people above 60 years of age. Materials and Methods: Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through polymerase chain reaction by restriction fragment length polymorphism. Statistical Analysis Used: Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%. Results: Among elderly with tinnitus (43.01%), 33.76% had a history of exposure to occupational noise. A statistically significant association was found between genotype frequencies of the TNFα gene in the −308 G/A region and the complaint of tinnitus (P = 0.04 and χ2 = 4.19). The elderly with the G allele were less likely to have tinnitus due to occupational noise exposure when compared to those carrying the A allele (OR = 2.74; 95% CI: 1.56–4.81; P < 0.0005). Conclusion: This study suggests an association between the TNFα with susceptibility to tinnitus in individuals with a history of exposure to occupational noise.
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Affiliation(s)
- Luciana L M Marchiori
- Centre of Biological and Health Sciences (CCBS), University of Northern Paraná (UNOPAR), Londrina, PR, Brazil
| | - Ana C M Dias
- Centre of Biological and Health Sciences (CCBS), University of Northern Paraná (UNOPAR), Londrina, PR, Brazil
| | - Alyne S Gonçalvez
- Centre of Biological and Health Sciences (CCBS), University of Northern Paraná (UNOPAR), Londrina, PR, Brazil
| | - Regina C Poly-Frederico
- Research Centre in Health Sciences (CPCS), University of Northern Paraná (UNOPAR), Londrina, PR, Brazil
| | - Marcelo Y Doi
- Research Centre in Health Sciences (CPCS), University of Northern Paraná (UNOPAR), Londrina, PR, Brazil
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Chen XH, Zheng LL. Expression of pro-inflammatory cytokines in the auditory cortex of rats with salicylate-induced tinnitus. Mol Med Rep 2017; 16:5643-5648. [PMID: 28849125 DOI: 10.3892/mmr.2017.7235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 06/06/2017] [Indexed: 11/06/2022] Open
Abstract
Tinnitus often results in severe psychological distress. The present study hypothesized that tinnitus acts as a chronic stressor and induces dysregulation of the production of cytokines. The gap pre‑pulse inhibition of acoustic startle paradigm was applied to test tinnitus‑like behavior in rats. Following this, the mRNA and protein expression levels of interferon (IFN)‑γ, tumor necrosis factor (TNF)‑α, interleukin (IL)‑6 and N‑methyl D‑aspartate receptor subunit 2A (NR2A) were measured in rats subjected to acute and chronic salicylate treatment, using reverse transcription‑quantitative polymerase chain reaction and western blot analysis, respectively. The gap prepulse inhibition of acoustic startle paradigm detected the tinnitus‑like behavior of rats. The expression of TNF‑α and NR2A genes were increased in the auditory cortex (AC) following long‑term administration of salicylate, whereas the expression of IFN‑γ genes decreased; however, the mRNA levels reversed back to normal baseline 14 days following the cease of salicylate administration. IL‑6 gene expression, however, was not fundamentally altered by salicylate treatment. The data demonstrated that chronic salicylate administration induces tinnitus, in part, via dysregulation of cytokines and specific membrane receptors in the AC.
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Affiliation(s)
- Xiang-Hong Chen
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
| | - Li-Li Zheng
- Department of Endocrinology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P.R. China
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20
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Björnsdóttir SV, Triebel J, Arnljótsdóttir M, Tómasson G, Valdimarsdóttir UA. Long-lasting improvements in health-related quality of life among women with chronic pain, following multidisciplinary rehabilitation. Disabil Rehabil 2017; 40:1764-1772. [DOI: 10.1080/09638288.2017.1312565] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Sigrún Vala Björnsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- HNLFI Rehabilitation Clinic, Hveragerði, Iceland
| | - Jan Triebel
- HNLFI Rehabilitation Clinic, Hveragerði, Iceland
- Department of Orthopaedic Surgery, Akademiska, University Hospital Uppsala, Sweden
| | | | - Gunnar Tómasson
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Unnur Anna Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
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21
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A randomised controlled study of mindfulness meditation versus relaxation therapy in the management of tinnitus. The Journal of Laryngology & Otology 2017; 131:501-507. [PMID: 28357966 DOI: 10.1017/s002221511700069x] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Psychotherapeutic interventions have been adopted effectively in the management of tinnitus for a long time. This study compared mindfulness meditation and relaxation therapy for management of tinnitus. METHODS In this randomised controlled trial, patients were recruited for five sessions of mindfulness meditation or five sessions of relaxation therapy. Patients' responses were evaluated using the Tinnitus Reaction Questionnaire as a primary outcome measure, and the Hospital Anxiety and Depression Scale, visual analogue scale and a health status indicator as secondary outcome measures. RESULTS A total of 86 patients were recruited. Thirty-four patients completed mindfulness meditation and 27 patients completed relaxation therapy. Statistically significant improvement was seen in all outcome measures except the health status indicator in both treatment groups. The change in treatment scores was greater in the mindfulness meditation group than in the relaxation therapy group. CONCLUSION This study suggests that although both mindfulness meditation and relaxation therapy are effective in the management of tinnitus, mindfulness meditation is superior to relaxation therapy.
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22
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Koo M, Hwang JH. Risk of tinnitus in patients with sleep apnea: A nationwide, population-based, case-control study. Laryngoscope 2016; 127:2171-2175. [PMID: 27666578 DOI: 10.1002/lary.26323] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 07/31/2016] [Accepted: 08/22/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To investigate the risk of tinnitus in patients with sleep disturbance or sleep apnea. STUDY DESIGN Case control study. METHODS We identified 21,798 middle-aged and elderly patients with otolaryngologist-diagnosed tinnitus between January 1, 2000, and December 31, 2012, from the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance Research Database. A total of 108,990 controls were also identified from the same database based on frequency-matching on 10-year age interval, sex, and year of index date of the cases. Diagnoses of sleep disturbance (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] codes 780.50, 780.52, 307.4) and sleep apnea (ICD-9-CM codes 780.51, 780.53, 780.57) in the cases and controls prior to the index date were assessed. The risks of tinnitus in patients with sleep disturbance and sleep apnea were separately evaluated with multivariate logistic regression analyses. RESULTS The mean age of the total 130,788 patients was 59.8 years, and 47% of them were males. The risk of tinnitus was higher in patients with sleep disturbance compared to those without the condition (adjusted odds ratio [OR] = 1.13, 95% confidence interval [CI] [95% CI] = 1.11-1.17), and the risk of tinnitus was higher in patients with sleep apnea compared to those without the condition (adjusted OR = 1.36, 95% CI = 1.16-1.60). CONCLUSION In this population-based, case-control study, the risk of tinnitus was found to be significantly higher among middle-aged and elderly Taiwanese patients with sleep disturbances, especially with sleep apnea. LEVEL OF EVIDENCE 3b. Laryngoscope, 127:2171-2175, 2017.
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Affiliation(s)
- Malcolm Koo
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan
| | - Juen-Haur Hwang
- Division of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.,Sleep Center, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
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Khan M, Gross J, Haupt H, Jainz A, Niklowitz P, Scherer H, Schmidt FP, Klapp BF, Reisshauer A, Mazurek B. A pilot clinical trial of the effects of coenzyme Q10 on chronic tinnitus aurium. Otolaryngol Head Neck Surg 2016; 136:72-7. [PMID: 17210337 DOI: 10.1016/j.otohns.2006.07.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2006] [Accepted: 07/07/2006] [Indexed: 11/30/2022]
Abstract
OBJECTIVE: To determine the short-term effects of coenzyme Q10 (CoQ10) on the antioxidative status and tinnitus expression in patients with chronic tinnitus aurium. STUDY DESIGN: A 16-week prospective nonrandomized clinical trial (n = 20). Tinnitus and Short Form-36 Questionnaires (TQ/SF-36) were evaluated together with the plasma concentrations of CoQ10, malondialdehyde, and the total antioxidant status. RESULTS: The mean plasma CoQ10 concentration rose under external CoQ10 supply and remained elevated after medication stopped without overall effects on the tinnitus score. However, in a subgroup of 7 patients with low initial plasma CoQ10 concentration and significant increase in the plasma CoQ10 level, a clear decrease in the TQ score was observed. CONCLUSION: In patients with a low plasma CoQ10 concentration, CoQ10 supply may decrease the tinnitus expression. SIGNIFICANCE: This is the first study to examine the effect of CoQ10 in chronic tinnitus aurium. © 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.
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Affiliation(s)
- Martin Khan
- Department of Otorhinolaryngology, Charité-University Medicine Berlin, Berlin, Germany
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Doi MY, Dias ACM, Poly-Frederico RC, Maria MGSR, de Oliveira MN, de Moraes Marchiori LL. Association between polymorphism of interleukin-6 in the region -174G/C and tinnitus in the elderly with a history of occupational noise exposure. Noise Health 2015; 17:406-10. [PMID: 26572700 PMCID: PMC4900473 DOI: 10.4103/1463-1741.169703] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
UNLABELLED Tinnitus is a symptom usually related to cochlear change that may arise from noise exposure and induces expression of proinflammatory cytokines including interleukin-6 (IL6). This study aimed to evaluate the association between the polymorphism of the IL6 gene in the region 174G/C and tinnitus in elderly with history of occupational noise exposure. SETTINGS AND DESIGN This was a cross-sectional study with a sample of 179 independent elderly individuals aged >60 years. Information on exposure to occupational noise was obtained by interviews. Audiological evaluation was performed using pure tone audiometry and genotyped through polymerase chain reaction by restriction fragment length polymorphism (PCR-RFLP). Data were analyzed using the chi-square test and the odds ratio (OR), with the significance level set at 5%. Among the study subjects, 24.6% were homozygous for the G allele, 39.7% were homozygous for the C allele, and 35.8% were heterozygous for IL6 (P > 0.05). Of these, 33.5% reported noise exposure history, with 42.5% having tinnitus. We found significant association between the genotype and allele frequencies of the IL6 -174 gene (rs1800795) and tinnitus among the elderly with history of exposure to occupational noise (P = 0.03). The elderly with the C allele were less likely to have tinnitus associated with history of exposure to occupational noise [OR = 0.167, confidence interval (CI) 95% 0.167-0.749; P = 0.004] when compared to those carrying the G allele. This study suggests that there is an association between polymorphisms in the IL6 gene at region - 174G/C and susceptibility to tinnitus.
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Affiliation(s)
- Marcelo Yugi Doi
- Department of Centre of Research in Health Sciences, University of Northern Parana, Londrina-PR, Brazil
| | | | - Regina Célia Poly-Frederico
- Department of Molecular Biology, Centre of Research in Health Sciences, University of Northern Parana, Londrina-PR, Brazil
| | | | | | - Luciana Lozza de Moraes Marchiori
- Department of Audiology and Speech Therapy, Centre of Research in Health Sciences, University of Northern Parana, Londrina-PR, Brazil
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Plein CT, Harounian J, Floyd E, Irizarry R, Ferzli G, Kidwai S, Rosenfeld RM. A Systematic Review of Eligibility and Outcomes in Tinnitus Trials. Otolaryngol Head Neck Surg 2015; 154:24-32. [DOI: 10.1177/0194599815608160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022]
Abstract
Objective To analyze existing tinnitus treatment trials with regard to eligibility criteria, outcome measures, study quality, and external validity and to recognize the effect of patient demographics, symptom duration, severity, and otologic comorbidity on research findings to help practitioners apply them to patient encounters. Data Sources Systematic literature search conducted by an information specialist for development of the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s tinnitus clinical practice guideline. Review Methods Articles were assessed for eligibility with the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and data extracted by 2 independent investigators. Studies were assessed for methodological quality, inclusion and exclusion criteria, patient demographics, and outcome measures. Results A total of 147 randomized trials met inclusion criteria. Nearly all studies took place in a specialist setting. More than 50% did not explicitly define tinnitus, and 44% used a subjective severity threshold, such as “severely disturbing.” Fifty-four percent required symptom duration of at least 6 months for study eligibility, and up to 33% excluded patients with “organic” hearing loss or otologic conditions. Mean age was 52.2 years, and median follow-up was 3 months. Only 20% had a low risk of bias. Conclusion Randomized trials of tinnitus interventions are most applicable to older adults with tinnitus lasting ≥6 months who are evaluated in specialty settings. High risk of bias, short follow-up, and outcome reporting raise concerns about the validity of findings and may influence how clinicians apply trial results to individual patients and establish treatment expectations, thus demonstrating the need for further quality research in this field.
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Affiliation(s)
- Colleen T. Plein
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Jonathan Harounian
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Elizabeth Floyd
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Rachel Irizarry
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - George Ferzli
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Sarah Kidwai
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
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Associations of Organizational Justice with Tinnitus and the Mediating Role of Depressive Symptoms and Burnout—Findings from a Cross-Sectional Study. Int J Behav Med 2015; 23:190-7. [DOI: 10.1007/s12529-015-9505-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Hwang JH, Chang NC, Chen JC, Chan YC. Expression of Antioxidant Genes in the Mouse Cochlea and Brain in Salicylate-Induced Tinnitus and Effect of Treatment with Spirulina platensis Water Extract. Audiol Neurootol 2015; 20:322-9. [PMID: 26277928 DOI: 10.1159/000381934] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 02/18/2015] [Indexed: 11/19/2022] Open
Abstract
Salicylate increased manganese-superoxide dismutase (Mn-SOD) gene expression, but decreased catalase (CAT) gene expression in the cochlea and various brain regions of mice with tinnitus. Spirulinaplatensis water extract reduced salicylate-induced overexpression of the Mn-SOD gene, but increased salicylate-induced downregulation of the CAT gene. With the exception of significantly increased SOD activity in the brainstem and inferior colliculus of the Spirulina group, SOD and CAT enzyme activities did not differ among the three groups. The tinnitus group had higher malondialdehyde (MDA) levels than the control group in the temporal and the frontal lobes. S.platensis water extract reduced salicylate-induced elevations of MDA levels in many brain areas. We proposed that altered expression of antioxidant genes may reflect states of oxidative stress associated with tinnitus.
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Affiliation(s)
- Juen-Haur Hwang
- Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Dalin, Taiwan
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Björnsdóttir SV, Arnljótsdóttir M, Tómasson G, Triebel J, Valdimarsdóttir UA. Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions. Disabil Rehabil 2015; 38:828-36. [DOI: 10.3109/09638288.2015.1061609] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Sharma A, Newberg AB. Mind-Body Practices and the Adolescent Brain: Clinical Neuroimaging Studies. ADOLESCENT PSYCHIATRY 2015; 5:116-124. [PMID: 27347478 DOI: 10.2174/2210676605666150311223728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Mind-Body practices constitute a large and diverse group of practices that can substantially affect neurophysiology in both healthy individuals and those with various psychiatric disorders. In spite of the growing literature on the clinical and physiological effects of mind-body practices, very little is known about their impact on central nervous system (CNS) structure and function in adolescents with psychiatric disorders. METHOD This overview highlights findings in a select group of mind-body practices including yoga postures, yoga breathing techniques and meditation practices. RESULTS Mind-body practices offer novel therapeutic approaches for adolescents with psychiatric disorders. Findings from these studies provide insights into the design and implementation of neuroimaging studies for adolescents with psychiatric disorders. CONCLUSIONS Clinical neuroimaging studies will be critical in understanding how different practices affect disease pathogenesis and symptomatology in adolescents. Neuroimaging of mind-body practices on adolescents with psychiatric disorders will certainly be an open and exciting area of investigation.
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Affiliation(s)
- Anup Sharma
- University of Pennsylvania School of Medicine, USA
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Safi SZ. A Fresh Look at the Potential Mechanisms of Progressive Muscle Relaxation Therapy on Depression in Female Patients With Multiple Sclerosis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015; 9:e340. [PMID: 26251663 PMCID: PMC4525452 DOI: 10.17795/ijpbs340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/28/2014] [Accepted: 01/21/2015] [Indexed: 11/25/2022]
Abstract
Background: According to the World Health Organization (WHO) report released in 2000, about 121 million people worldwide suffer from depression. The major depressive disorder (MDD) among multiple sclerosis (MS) patients is one of the most common mood disorders experienced during life. MS patients who simultaneously suffer from depression have reported more severe symptoms of disease and slower adaptation to new conditions, which ultimately increase the cost of treatment. Objectives: The aim of this study was to assess the effectiveness of progressive muscle relaxation therapy (PMRT) as an adjunctive therapy for reducing level of depression for MS patients. Materials and Methods: This research had the randomized controlled trial design with pre and posttest. Thirty female patients based on criteria of MS and MDD disease, were selected from the MS Society of Shiraz, Iran. Beck Depression Inventory (BDI-II) was administered at pre and posttest. The participants were randomly allocated to two groups (experimental and control). Twelve sessions of PMRT using Bernstein and Borkovec’s method were held for the experimental group. Levin’s test, covariance and ANOVA with repeated measures were used for data analysis. Results: Experimental and control groups were compared before and after treatment. Analysis of covariance showed that seven levels of depression decreased in the experimental group and analysis of repeated measure showed that 49% of the changes were related to PMRT. Conclusion: According to the results, PMRT is effective in reducing depression. This therapy enables patients to reach relaxation quickly, and thus can cope with depression reactions effectively.
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A Fresh Look at the Potential Mechanisms of Progressive Muscle Relaxation Therapy on Depression in Female Patients With Multiple Sclerosis. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2015. [DOI: 10.5812/ijpbs.340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Seydel C, Haupt H, Szczepek AJ, Hartmann A, Rose M, Mazurek B. Three years later: report on the state of well-being of patients with chronic tinnitus who underwent modified tinnitus retraining therapy. Audiol Neurootol 2014; 20:26-38. [PMID: 25413891 DOI: 10.1159/000363728] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 05/19/2014] [Indexed: 11/19/2022] Open
Abstract
Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.
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Affiliation(s)
- Claudia Seydel
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Effects of salicylate on the inflammatory genes expression and synaptic ultrastructure in the cochlear nucleus of rats. Inflammation 2014; 37:365-73. [PMID: 24092407 DOI: 10.1007/s10753-013-9748-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Aspirin (salicylate), as a common drug that is frequently used for long-term treatment in a clinical setting, has the potential to cause reversible tinnitus. However, few reports have examined the inflammatory cytokines expression and alteration of synaptic ultrastructure in the cochlear nucleus (CN) in a rat model of tinnitus. The tinnitus-like behavior of rats were detected by the gap prepulse inhibition of acoustic startle (GPIAS) paradigm. We investigated the expression levels of the tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), N-methyl D-aspartate receptor subunit 2A (NR2A) mRNA and protein in the CN and compared synapses ultrastructure in the CN of tinnitus rats with normal ones. GPIAS showed that rats with long-term administration of salicylate were experiencing tinnitus, and the mRNA and protein expression levels of TNF-α and NR2A were up-regulated in chronic treatment groups, and they returned to baseline 14 days after cessation of treatment. Furthermore, compared to normal rats, repetitive salicylate-treated rats showed a greater number of presynaptic vesicles, thicker and longer postsynaptic densities, increased synaptic interface curvature. These data revealed that chronic salicylate administration markedly, but reversibly, induces tinnitus possibly via augmentation of the expression of TNF-α and NR2A and cause changes in synaptic ultrastructure in the CN. Long-term administration of salicylate causes neural plasticity changes at the CN level.
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Szczepek AJ, Haupt H, Klapp BF, Olze H, Mazurek B. Biological correlates of tinnitus-related distress: an exploratory study. Hear Res 2014; 318:23-30. [PMID: 25445818 DOI: 10.1016/j.heares.2014.10.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 10/10/2014] [Accepted: 10/15/2014] [Indexed: 01/19/2023]
Abstract
During the process of tinnitus diagnostics, various psychometric instruments are used to measure tinnitus-related distress. The aim of present work was to explore whether candidates for biological correlates of the tinnitus-related distress could be found in peripheral blood of patients and if so, whether there was association between them and psychometric scores that reflect tinnitus-related distress. The concentrations of interleukin-1β (IL1β), interleukin-6 (IL6), tumor necrosis factor-α (TNFα) and a brain-derived neutrotrophic factor (BDNF) were measured in serum of 30 patients diagnosed with chronic tinnitus and tested for correlation with psychometric scores collected on the same day. Spearman's correlation analyses detected significant positive association between the concentrations of tumor necrosis factor α and tinnitus loudness, total perceived stress, tension and depression and a negative association between tumor necrosis factor α and a psychometric score "joy". Concentrations of interleukin-1β correlated with the awareness grade of tinnitus. The correlation between visual analogue scale (VAS) "loudness" and tumor necrosis factor α as well as between "joy" and tumor necrosis factor α retained their significance (p < 0.00167) after the application of Bonferroni correction for multiple testing. Partial correlations removing the effects of age, hearing loss and the duration of tinnitus verified the results obtained using Spearman correlation. We conclude that measuring the concentrations of selected circulating cytokines could possibly become an additional objective element of tinnitus diagnostics in the future.
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Affiliation(s)
- Agnieszka J Szczepek
- Molecular Biology Research Laboratory, Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Heidemarie Haupt
- Molecular Biology Research Laboratory, Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany; Tinnitus Center, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Burghard F Klapp
- Department of Internal Medicine and Psychosomatics, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Heidi Olze
- Molecular Biology Research Laboratory, Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany; Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte and Campus Charité Virchow, Berlin, Germany
| | - Birgit Mazurek
- Molecular Biology Research Laboratory, Department of Otorhinolaryngology, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany; Tinnitus Center, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany.
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Alterations in Vagal-Immune Pathway in Long-Lasting Mental Stress. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 832:45-50. [DOI: 10.1007/5584_2014_10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Hwang JH, Chen JC, Chan YC. Effects of C-phycocyanin and Spirulina on salicylate-induced tinnitus, expression of NMDA receptor and inflammatory genes. PLoS One 2013; 8:e58215. [PMID: 23533584 PMCID: PMC3606192 DOI: 10.1371/journal.pone.0058215] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2012] [Accepted: 01/31/2013] [Indexed: 11/18/2022] Open
Abstract
Effects of C-phycocyanin (C-PC), the active component of Spirulina platensis water extract on the expressions of N-methyl D-aspartate receptor subunit 2B (NR2B), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and cyclooxygenase type 2 (COX-2) genes in the cochlea and inferior colliculus (IC) of mice were evaluated after tinnitus was induced by intraperitoneal injection of salicylate. The results showed that 4-day salicylate treatment (unlike 4-day saline treatment) caused a significant increase in NR2B, TNF-α, and IL-1β mRNAs expression in the cochlea and IC. On the other hand, dietary supplementation with C-PC or Spirulina platensis water extract significantly reduced the salicylate-induced tinnitus and down-regulated the mRNAs expression of NR2B, TNF-α, IL-1β mRNAs, and COX-2 genes in the cochlea and IC of mice. The changes of protein expression levels were generally correlated with those of mRNAs expression levels in the IC for above genes.
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Affiliation(s)
- Juen-Haur Hwang
- Department of Otolaryngology, Buddhist Dalin Tzu-Chi General Hospital, Dalin, Chiayi, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Jin-Cherng Chen
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Neurosurgery, Buddhist Dalin Tzu-Chi General Hospital, Dalin, Chiayi, Taiwan
| | - Yin-Ching Chan
- Department of Food and Nutrition, Providence University, Shalu, Taichung, Taiwan
- * E-mail:
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Schoen M, Nowack K. Reconditioning the stress response with hypnosis CD reduces the inflammatory cytokine IL-6 and influences resilience: a pilot study. Complement Ther Clin Pract 2013; 19:83-8. [PMID: 23561065 DOI: 10.1016/j.ctcp.2012.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/16/2022]
Abstract
AIM The aim of this investigation was to measure the impact of a self-administered hypnosis intervention on resilience and the inflammatory cytokine IL-6. METHOD Over a period of 12 weeks, 11 participants listened to a self-administered hypnosis stress reduction program designed to recondition and improve participants' emotional and physical reactions to perceived work and life stressors. Subjects were administered subjective measures of coping, resilience, and stress tolerance, as well as, IL-6, an objective blood measure of inflammatory activity. RESULTS After 12 weeks, participants were observed to have a significantly lower IL-6 serum level from baseline. Further, participants reported a significant decrease in the use of negative appraisal coping (such as, self-deprecating statements, perfectionism, and catastrophic and pessimistic thinking), and an improvement in eating/nutritional habits following the intervention. Baseline eating/nutritional habits and threat minimization coping significantly predicted a change in serum IL-6 over the course of the intervention in stepwise hierarchical regression analyses. CONCLUSION Pilot study provides support that a brief self-administered CD hypnosis stress reduction program can modify a physiological measure of inflammation (IL-6), and improve coping and resilience in the face of work and life stress.
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Affiliation(s)
- Marc Schoen
- 864 South Robertson Blvd, Suite 206, Los Angeles, CA 90035, USA.
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Role of IL-6 in the etiology of hyperexcitable neuropsychiatric conditions: experimental evidence and therapeutic implications. Future Med Chem 2012. [DOI: 10.4155/fmc.12.156] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Many neuropsychiatric conditions are primed or triggered by different types of stressors. The mechanisms through which stress induces neuropsychiatric disease are complex and incompletely understood. A ‘double hit’ hypothesis of neuropsychiatric disease postulates that stress induces maladaptive behavior in two phases separated by a dormant period. Recent research shows that the pleiotropic cytokine IL-6 is released centrally and peripherally following physical and psychological stress. In this article, we analyze evidence from clinics and animal models suggesting that stress-induced elevation in the levels of IL-6 may play a key role in the etiology of a heterogeneous family of hyperexcitable central conditions including epilepsy, schizophrenic psychoses, anxiety and disorders of the autistic spectrum. The cellular mechanism leading to hyperexcitable conditions might be a decrease in inhibitory/excitatory synaptic balance in either or both temporal phases of the conditions. Following these observations, we discuss how they may have important implications for optimal prophylactic and therapeutic pharmacological treatment.
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Goodin BR, Quinn NB, Kronfli T, King CD, Page GG, Haythornthwaite JA, Edwards RR, Stapleton LM, McGuire L. Experimental pain ratings and reactivity of cortisol and soluble tumor necrosis factor-α receptor II following a trial of hypnosis: results of a randomized controlled pilot study. PAIN MEDICINE 2012; 13:29-44. [PMID: 22233394 DOI: 10.1111/j.1526-4637.2011.01293.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Current evidence supports the efficacy of hypnosis for reducing the pain associated with experimental stimulation and various acute and chronic conditions; however, the mechanisms explaining how hypnosis exerts its effects remain less clear. The hypothalamic-pituitary-adrenal (HPA) axis and pro-inflammatory cytokines represent potential targets for investigation given their purported roles in the perpetuation of painful conditions; yet, no clinical trials have thus far examined the influence of hypnosis on these mechanisms. DESIGN Healthy participants, highly susceptible to the effects of hypnosis, were randomized to either a hypnosis intervention or a no-intervention control. Using a cold pressor task, assessments of pain intensity and pain unpleasantness were collected prior to the intervention (Pre) and following the intervention (Post) along with pain-provoked changes in salivary cortisol and the soluble tumor necrosis factor-α receptor II (sTNFαRII). RESULTS Compared with the no-intervention control, data analyses revealed that hypnosis significantly reduced pain intensity and pain unpleasantness. Hypnosis was not significantly associated with suppression of cortisol or sTNFαRII reactivity to acute pain from Pre to Post; however, the effect sizes for these associations were medium-sized. CONCLUSIONS Overall, the findings from this randomized controlled pilot study support the importance of a future large-scale study on the effects of hypnosis for modulating pain-related changes of the HPA axis and pro-inflammatory cytokines.
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Affiliation(s)
- Burel R Goodin
- University of Florida, Comprehensive Center for Pain Research, Gainesville, FL 32610, USA.
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Garcia-Oscos F, Salgado H, Hall S, Thomas F, Farmer GE, Bermeo J, Galindo LC, Ramirez RD, D’Mello S, Rose-John S, Atzori M. The stress-induced cytokine interleukin-6 decreases the inhibition/excitation ratio in the rat temporal cortex via trans-signaling. Biol Psychiatry 2012; 71:574-82. [PMID: 22196984 PMCID: PMC4732871 DOI: 10.1016/j.biopsych.2011.11.018] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Revised: 10/26/2011] [Accepted: 11/11/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Although it is known that stress elevates the levels of pro-inflammatory cytokines and promotes hyper-excitable central conditions, a causal relationship between these two factors has not yet been identified. Recent studies suggest that increases in interleukin 6 (IL-6) levels are specifically associated with stress. We hypothesized that IL-6 acutely and directly induces cortical hyper-excitability by altering the balance between synaptic excitation and inhibition. METHODS We used patch-clamp to determine the effects of exogenous or endogenous IL-6 on electrically evoked postsynaptic currents on a cortical rat slice preparation. We used control subjects or animals systemically injected with lipopolysaccharide or subjected to electrical foot-shock as rat models of stress. RESULTS In control animals, IL-6 did not affect excitatory postsynaptic currents but selectively and reversibly reduced the amplitude of inhibitory postsynaptic currents with a postsynaptic effect. The IL-6-induced inhibitory postsynaptic currents decrease was inhibited by drugs interfering with receptor trafficking and/or internalization, including wortmannin, Brefeldin A, 2-Br-hexadecanoic acid, or dynamin peptide inhibitor. In both animal models, stress-induced decrease in synaptic inhibition/excitation ratio was prevented by prior intra-ventricular injection of an analog of the endogenous IL-6 trans-signaling blocker gp130. CONCLUSIONS Our results suggest that stress-induced IL-6 shifts the balance between synaptic inhibition and excitation in favor of the latter, possibly by decreasing the density of functional γ-aminobutyric acid A receptors, accelerating their removal and/or decreasing their insertion rate from/to the plasma membrane. We speculate that this mechanism could contribute to stress-induced detrimental long-term increases in central excitability present in a variety of neurological and psychiatric conditions.
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Rosa MRDD, Almeida AAFD, Pimenta F, Silva CG, Lima MAR, Diniz MDFFM. Zumbido e ansiedade: uma revisão da literatura. REVISTA CEFAC 2012. [DOI: 10.1590/s1516-18462012005000009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
O zumbido, som percebido pelo indivíduo sem que haja estímulo externo, resulta da interação dinâmica de centros do sistema nervoso central, incluindo vias auditivas e não auditivas. O resultado desta interação, especialmente sistema límbico e sistema nervoso autônomo, seria responsável pelo desencadeamento de associações emocionais negativas e reações de incômodo em pacientes com zumbido. A ansiedade, condição fisiológica inerente ao ser humano, quando exacerbada gera um transtorno de humor, comprometendo o pensamento, o comportamento e a atividade psicológica. Se um estímulo interno ou externo for interpretado como perigoso ou ameaçador, desencadeará uma reação emocional caracterizada como estado de ansiedade. Este artigo tem como objetivo realizar uma revisão da literatura sobre a relação do zumbido e da ansiedade. Em se tratando do zumbido, a forma como o som é percebido pode ser alterado pela ansiedade, aguçando assim a sensibilidade para detectar sons que parecem uma ameaça em potencial, pois para muitos o zumbido é sinônimo de enfermidade grave. A etiologia do desenvolvimento da depressão e ansiedade pode estar relacionada ao zumbido. Muitos adquirem esse sintoma por problemas físicos e, consequentemente, desenvolvem a depressão e a ansiedade. Outros com graus diferentes de angústias adquirem o zumbido devido ao comprometimento emocional. Dessa forma, existe um vínculo entre o zumbido e problemas emocionais, mas nem sempre é fácil identificar o precursor. Estudos demonstram que pacientes acometidos pelo zumbido apresentam maior tendência ao suicídio, depressão e ansiedade. Além disso, referem o efeito aditivo da ansiedade e da depressão na qualidade de vida e no zumbido dos indivíduos.
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Hwang JH, Chen JC, Yang SY, Wang MF, Chan YC. Expression of tumor necrosis factor-α and interleukin-1β genes in the cochlea and inferior colliculus in salicylate-induced tinnitus. J Neuroinflammation 2011; 8:30. [PMID: 21477330 PMCID: PMC3087687 DOI: 10.1186/1742-2094-8-30] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 04/09/2011] [Indexed: 01/21/2023] Open
Abstract
Background Changes in the gene expressions for tumor necrosis factor-α (TNF-α) and/or interleukin-1β (IL-1β) during tinnitus have not been previously reported. We evaluated tinnitus and mRNA expression levels of TNF-α, IL-1β, and N-methyl D-aspartate receptor subunit 2B (NR2B) genes in cochlea and inferior colliculus (IC) of mice after intraperitoneal injections of salicylate. Methods Forty-eight 3-month-old male SAMP8 mice were randomly and equally divided into two groups: salicylate-treated and saline-treated. All mice were trained to perform an active avoidance task for 5 days. Once conditioned, an active avoidance task was performed 2 hours after daily intraperitoneal injections of saline, either alone or containing 300 mg/kg sodium salicylate. Total numbers of times (tinnitus score) the mice climbed during the inter-trial silent period for 10 trials were recorded daily for 4 days (days 7 to 10), and then mice were euthanized for determination of mRNA expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC at day 10. Results Tinnitus scores increased in response to daily salicylate treatments. The mRNA expression levels of TNF-α increased significantly for the salicylate-treated group compared to the control group in both cochlea (1.89 ± 0.22 vs. 0.87 ± 0.07, P < 0.0001) and IC (2.12 ± 0.23 vs. 1.73 ± 0.22, p = 0.0040). mRNA expression levels for the IL-1β gene also increased significantly in the salicylate group compared to the control group in both cochlea (3.50 ± 1.05 vs. 2.80 ± 0.28, p < 0.0001) and IC (2.94 ± 0.51 versus 1.24 ± 0.52, p = 0.0013). Linear regression analysis revealed a significant positive association between tinnitus scores and expression levels of TNF-α, IL-1β, and NR2B genes in cochlea and IC. In addition, expression levels of the TNF-α gene were positively correlated with those of the NR2Bgene in both cochlea and IC; whereas, the expression levels of the IL-1β gene was positively correlated with that of the NR2B gene in IC, but not in cochlea. Conclusion We conclude that salicylate treatment resulting in tinnitus augments expression of the TNF-α and IL-1β genes in cochlea and IC of mice, and we suggest that these proinflammatory cytokines might lead to tinnitus directly or via modulating the NMDA receptor.
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Affiliation(s)
- Juen-Haur Hwang
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
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Holmes S, Padgham ND. ‘‘Ringing in the Ears’’: Narrative Review of Tinnitus and Its Impact. Biol Res Nurs 2011; 13:97-108. [DOI: 10.1177/1099800410382290] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
About 10% of the population experiences tinnitus, a common and distressing symptom characterized by the perception of sound in the absence of external stimuli. There is, however, marked heterogeneity in etiology, perception, and extent of distress among those who experience tinnitus. Reactions to tinnitus vary from simple awareness to severe irritation; some people have difficulty in hearing because of the loudness of the noise. Severe tinnitus causes many, often psychological, symptoms (e.g., tension, frustration, impaired concentration, disrupted sleep). For some, tinnitus is temporary, for others it is longstanding. Although many people adjust successfully, others are disabled by tinnitus; approximately 5% experience persistent and severe symptoms affecting their lifestyle and significantly reducing their quality of life. Because tinnitus is poorly understood and no single therapeutic approach is effective for all patients, many patients are told that ‘‘nothing can be done’’ and they must ‘‘learn to live with it.’’ In spite of these challenges, there is remarkably little relevant nursing literature on tinnitus. This literature review was conducted to explore current knowledge of tinnitus, including prevalence, causes and diagnosis, and assessment. Its psychosocial effects and impact on individuals are considered. Implications for practice are discussed—demonstrating that understanding the full impact of the condition and identifying patients’ needs are essential to effective care.
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Affiliation(s)
- Susan Holmes
- Faculty of Health and Social Care, Canterbury Christ Church University, Canterbury, Kent, UK,
| | - Nigel D. Padgham
- Kent and Canterbury Hospital, Ethelbert Road, Canterbury, Kent. CT1 3NG, UK
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Top-down and bottom-up mechanisms in mind-body medicine: development of an integrative framework for psychophysiological research. Explore (NY) 2010; 6:29-41. [PMID: 20129310 DOI: 10.1016/j.explore.2009.10.004] [Citation(s) in RCA: 121] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Indexed: 12/15/2022]
Abstract
It has become increasingly evident that bidirectional ("top-down and bottom-up") interactions between the brain and peripheral tissues, including the cardiovascular and immune systems, contribute to both mental and physical health. Therapies directed toward addressing functional links between mind/brain and body may be particularly effective in treating the range of symptoms associated with many chronic diseases. In this paper, we describe the basic components of an integrative psychophysiological framework for research aimed at elucidating the underlying substrates of mind-body therapies. This framework recognizes the multiple levels of the neuraxis at which mind-body interactions occur. We emphasize the role of specific fronto-temporal cortical regions in the representation and control of adverse symptoms, which interact reciprocally with subcortical structures involved in bodily homeostasis and responses to stress. Bidirectional autonomic and neuroendocrine pathways transmit information between the central nervous system and the periphery and facilitate the expression of affective, autonomic, hormonal, and immune responses. We propose that heart rate variability (HRV) and markers of inflammation are important currently available indices of central-peripheral integration and homeostasis within this homeostatic network. Finally, we review current neuroimaging and psychophysiological research from diverse areas of mind-body medicine that supports the framework as a basis for future research on the specific biobehavioral mechanisms of mind-body therapies.
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The impact of Type D personality on health-related quality of life in tinnitus patients is mainly mediated by anxiety and depression. Otol Neurotol 2010; 31:11-8. [PMID: 19816233 DOI: 10.1097/mao.0b013e3181bc3dd1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depression). MATERIALS AND METHODS Using a cross-sectional study design, 265 consecutive tinnitus patients were asked to complete the Hospital Anxiety and Depression Scale, the Maastricht Questionnaire, the Type D Scale (DS14), the Short-Form Health Survey 36, and the Tinnitus Reaction Questionnaire. RESULTS The prevalence of Type D was 35.5%. Type D patients were significantly more anxious, depressed, and vitally exhausted, and experienced more impaired HRQoL and increased tinnitus-related distress compared with non-Type D patients. Structural equation modeling showed that Type D personality directly increased symptoms of depression and anxiety, but not vital exhaustion. Type D was also a direct predictor of poor mental and physical HRQoL and increased tinnitus-related distress, although this influence was mainly mediated by symptoms of depression and anxiety. Anxiety, depression, and vital exhaustion had a direct influence on HRQoL and self-reported tinnitus-related distress, with a higher impact on mental HRQoL (R2 = 0.74) compared with physical HRQoL (R2 = 0.33). Vital exhaustion was a predictor of HRQoL and self-reported tinnitus-related distress; however, its influence was moderated by enhanced levels of anxiety and depression. CONCLUSION Tinnitus patients with a Type D personality were more likely to be anxious and depressed and to experience poor HRQoL and increased self-reported tinnitus-related distress, with the impact of Type D mainly being mediated by symptoms of anxiety and depression, although Type D also exerted a direct influence on these outcomes. These findings underline that to reduce the impact of tinnitus on HRQoL and self-reported tinnitus-related distress, treatment should be directed toward reducing anxiety and depression, especially in patients with a Type D personality.
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Low vagal tone is associated with impaired post stress recovery of cardiovascular, endocrine, and immune markers. Eur J Appl Physiol 2010; 109:201-11. [PMID: 20052593 DOI: 10.1007/s00421-009-1341-x] [Citation(s) in RCA: 170] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2009] [Indexed: 12/19/2022]
Abstract
Reduced heart rate variability (HRV) and delayed blood pressure recovery are associated with increased cardiovascular risk. Besides this evident link, the vagus is thought to play an inhibitory role in the regulation of other allostatic systems, including inflammation and the hypothalamic-pituitary-adrenal (HPA) axis. However, human evidence is scarce. To further explore these associations and with special regard to the postulated mediating role of the vagus, we hypothesised that subjects with low vagal tone as indexed by reduced resting HRV would show impaired post-stress recovery of cardiovascular, endocrine and immune system markers involved in cardiovascular pathology. 44 healthy men underwent a standardised mental stress test. Besides continuous measurement of systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and HRV serum cortisol, tumour necrosis factor-alpha (TNF-alpha), and interleukin-6 (IL-6) were measured before, after, 20, and 60 min after stress. Low versus high HRV groups was defined by median split on resting HRV (RMSSD). The task elicited significant time effects for SBP, DBP, HR, HRV, cortisol, and TNF-alpha. Subjects with low baseline HRV showed almost no modulation of HRV coupled with overall reduced HRV levels, and impaired recovery of DBP, cortisol, and TNF-alpha. Confirming our hypothesis, low vagal tone was associated with impaired recovery of cardiovascular, endocrine, and immune markers in healthy males. The data support an inhibitory role of the vagus in the regulation of allostatic systems as described in the neurovisceral integration model. We posit reduced resting HRV as a risk marker for future cardiovascular and other stress-related disease.
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Tariverdian N, Rücke M, Szekeres-Bartho J, Blois SM, Karpf EF, Sedlmayr P, Klapp BF, Kentenich H, Siedentopf F, Arck PC. Neuroendocrine circuitry and endometriosis: progesterone derivative dampens corticotropin-releasing hormone-induced inflammation by peritoneal cells in vitro. J Mol Med (Berl) 2009; 88:267-78. [PMID: 19898767 DOI: 10.1007/s00109-009-0559-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 10/21/2009] [Accepted: 10/22/2009] [Indexed: 12/11/2022]
Abstract
Clinical symptoms of endometriosis, such as pain and infertility, can be described as persistent stressors. Such continuous exposure to stress may severely affect the equilibrium and bidirectional communication of the endocrine and immune system, hereby further aggravating the progression of endometriosis. In the present study, we aimed to tease apart mediators that are involved in the stress response as well as in the progression of endometriosis. Women undergoing diagnostic laparoscopy due to infertility were recruited (n = 69). Within this cohort, early stage of endometriosis were diagnosed in n = 30 and advanced stage of endometriosis in n = 8. Levels of progesterone in serum were determined. Frequency of progesterone receptor (PR) expression on CD56(+) and CD8(+) peritoneal lymphocytes was analysed by flow cytometry. The production of tumour necrosis factor (TNF) and interleukin (IL)-10 by peritoneal leukocytes upon stimulation with the potent stress mediator corticotropin-releasing hormone (CRH) and the progesterone derivative dydrogesterone, or both, were evaluated. Furthermore, the production of progesterone-induced blocking factor (PIBF) by peritoneal leukocytes and the expression of PR in endometriotic tissue were investigated. Levels of progesterone in serum were decreased in women with endometriosis and inversely correlated to pain scores. Furthermore, an increased frequency of CD56(+)PR(+) and CD8(+)PR(+) peritoneal lymphocytes was present in advanced endometriosis. The TNF/IL-10 ratio, reflecting cytokine secretion by peritoneal cells, was higher in cells derived from endometriosis patients and could be further heightened by CRH stimulation, whereas stimulation with dydrogesterone abrogated the CRH-mediated inflammation. Finally, the expression of PIBF by peritoneal leukocytes was increased in endometriosis. Low levels of progesterone in the follicular phase could be responsible for the progression of endometriosis and related pain. Peripheral CRH, increasing upon high psychological stress, might contribute to the peritoneal inflammation present in endometriosis. The therapeutic application of progesterone derivatives, CRH blocking agents as well as improvement of stress coping may disrupt the vicious circle between the chronic peritoneal inflammation and high perception of psychological stress in endometriosis.
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Affiliation(s)
- Nadja Tariverdian
- Center of Internal Medicine and Dermatology, Division of PsychoNeuroImmunology, Charité, Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, Berlin, Germany
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Holmes S, Padgham ND. Review paper: more than ringing in the ears: a review of tinnitus and its psychosocial impact. J Clin Nurs 2009; 18:2927-37. [DOI: 10.1111/j.1365-2702.2009.02909.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Bushell WC. Longevity: potential life span and health span enhancement through practice of the basic yoga meditation regimen. Ann N Y Acad Sci 2009; 1172:20-7. [PMID: 19735236 DOI: 10.1111/j.1749-6632.2009.04538.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This chapter briefly reviews recent psychological, physiological, molecular biological, and anthropological research which has important implications, both direct and indirect, for the recognition and understanding of the potential life span and health span enhancing effects of the basic yoga meditational regimen. This regimen consists of meditation, yogic breath control practices, physical exercises (of both a postural- and movement-based, including aerobic nature), and dietary practices. While each of these component categories exhibit variations in different schools, lineages, traditions, and cultures, the focus of this chapter is primarily on basic forms of relaxation meditation and breath control, as well as postural and aerobic physical exercises (e.g., yogic prostration regimens, see below), and a standard form of yogic or ascetic diet, all of which constitute a basic form of regimen found in many if not most cultures, though with variations.
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Affiliation(s)
- William C Bushell
- Anthropology Program, Massachusetts Institute of Technology, Cambridge, Massachusetts 02139, USA.
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Loizzo J. Optimizing learning and quality of life throughout the lifespan: a global framework for research and application. Ann N Y Acad Sci 2009; 1172:186-98. [PMID: 19743554 DOI: 10.1196/annals.1393.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This overview surveys the new optimism about the aging mind/brain, focusing on the potential for self-regulation practices to advance research in stress-protection and optimal health. It reviews recent findings and offers a research framework. The review links the age-related biology of stress and regeneration to the variability of mind/brain function found under a range of conditions from trauma to enrichment. The framework maps this variation along a biphasic continuum from atrophic dysfunction to peak performance. It adopts the concept of allostatic load as a measure of the wear-and-tear caused by stress, and environmental enrichment as a measure of the use-dependent enhancement caused by positive reinforcement. It frames the dissociation, aversive affect and stereotyped reactions linked with stress as cognitive, affective and behavioral forms of allostatic drag; and the association, positive affect, and creative responses in enrichment as forms of allostatic lift. It views the human mind/brain as a heterarchy of higher intelligence systems that shift between a conservative, egocentric mode heightening self-preservation and memory and a generative, altruistic mode heightening self-correction and learning. Cultural practices like meditation and psychotherapy work by teaching the self-regulation of shifts from the conservative to the generative mode. This involves a systems shift from allostatic drag to allostatic lift, minimizing wear-and-tear and optimizing plasticity and learning. For cultural practices to speed research and application, a universal typology is needed. This framework includes a typology aligning current brain models of stress and learning with traditional Indo-Tibetan models of meditative stress-cessation and learning enrichment.
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Affiliation(s)
- Joseph Loizzo
- Weill Cornell Center for Complementary and Integrative Medicine, Columbia University Center for Buddhist Studies, New York, New York, USA.
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