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Braite N, da Cruz Fernandes L, Rissatto Lago MR, de Aragão Dantas Alves C. Effects of type 1 diabetes mellitus on efferent auditory system in children and adolescents. Int J Pediatr Otorhinolaryngol 2019; 127:109660. [PMID: 31487561 DOI: 10.1016/j.ijporl.2019.109660] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 10/26/2022]
Abstract
AIM To investigate whether type 1 diabetes mellitus (T1DM) could affect the efferent auditory system by analyzing the relationship between the activation of the medial olivocochlear reflex with disease duration, metabolic control and age at time of diagnosis. METHOD A total of 101 children and adolescents were evaluated. They were divided into two groups: 50 with T1DM and 51 without the disease. The participants answered a structured questionnaire containing questions about auditory complaints and were evaluated for tonal audiometry, tympanometry, acoustic reflex, otoacoustic emission by distortion product to evaluate the inhibitory effect of medial olivocochlear reflex (MOC). RESULTS The participants with T1DM presented changed AR (increased or absent) at all the frequencies in both ears (p < 0.05) when compared with the group without the disease. No differences were found between the DPOAE amplitudes of the individuals with and without T1DM, in both ears at all the frequencies. There were significant differences in the activation of the MOC reflex between the groups with and without T1DM, the participants with T1DM presented the absence of the inhibitory effect of the DPOAE in the right and left ears, in the frequencies of 4000 Hz (p = 0.035/0.002respectively) and 6000 Hz (p = 0.033/0.031 respectively) and 8000 Hz (p = 0.007/0.001 respectively) when compared to the healthy group. Significant differences were also observed between the groups with and without T1DM (p < 0.05) for self-reported complaints of tinitus, difficulties with the perception of speech when there was noise and distraction with noise. No association was found between the hearing complaints and the audiological measurements obtained and disease time, metabolic control and age at the time of diagnosis. CONCLUSION The findings suggest the presence of early auditory dysfunction of the efferent pathway in patients with T1DM.
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Affiliation(s)
- Nadja Braite
- Department of Life Science, State University of Bahia, Salvador, Bahia, Brazil.
| | - Luciene da Cruz Fernandes
- Department of Speech Therapy, Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | | | - Crésio de Aragão Dantas Alves
- Pediatric Endocrinology Unit. University Hospital Prof. Edgard Santos, Faculty of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
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Takeuti AA, Fávero ML, Zaia EH, Ganança FF. Auditory brainstem function in women with vestibular migraine: a controlled study. BMC Neurol 2019; 19:144. [PMID: 31248379 PMCID: PMC6595618 DOI: 10.1186/s12883-019-1368-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/17/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Vestibular migraine (VM) has been recognized as a diagnostic entity over the past three decades. It affects up to 1% of the general population and 7% of patients seen in dizziness clinics. It is still underdiagnosed; consequently, it is important to conduct clinical studies that address diagnostic indicators of VM. The aim of this study was to assess auditory brainstem function in women with vestibular migraine using electrophysiological testing, contralateral acoustic reflex and loudness discomfort level. METHODS The study group consisted of 29 women with vestibular migraine in the interictal period, and the control group comprised 25 healthy women. Auditory brainstem response, frequency following response, binaural interaction component and assessment of contralateral efferent suppression were performed. The threshold of loudness discomfort and the contralateral acoustic reflex were also investigated. The results were compared between the groups. RESULTS There was a statistically significant difference between the groups in the frequency following response and the loudness discomfort level. CONCLUSIONS The current study suggested that temporal auditory processing and loudness discomfort levels are altered in VM patients during the interictal period, indicating that these measures may be useful as diagnostic criteria.
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Affiliation(s)
- Alice A. Takeuti
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mariana L. Fávero
- Divisão de Educação e Reabilitação dos Distúrbios da Comunicação (DERDIC), Pontíficia Universidade Catolica de São Paulo, São Paulo, Brazil
| | | | - Fernando F. Ganança
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Universidade Federal de São Paulo, São Paulo, Brazil
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Tzounopoulos T, Balaban C, Zitelli L, Palmer C. Towards a Mechanistic-Driven Precision Medicine Approach for Tinnitus. J Assoc Res Otolaryngol 2019; 20:115-131. [PMID: 30825037 PMCID: PMC6453992 DOI: 10.1007/s10162-018-00709-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
In this position review, we propose to establish a path for replacing the empirical classification of tinnitus with a taxonomy from precision medicine. The goal of a classification system is to understand the inherent heterogeneity of individuals experiencing and suffering from tinnitus and to identify what differentiates potential subgroups. Identification of different patient subgroups with distinct audiological, psychophysical, and neurophysiological characteristics will facilitate the management of patients with tinnitus as well as the design and execution of drug development and clinical trials, which, for the most part, have not yielded conclusive results. An alternative outcome of a precision medicine approach in tinnitus would be that additional mechanistic phenotyping might not lead to the identification of distinct drivers in each individual, but instead, it might reveal that each individual may display a quantitative blend of causal factors. Therefore, a precision medicine approach towards identifying these causal factors might not lead to subtyping these patients but may instead highlight causal pathways that can be manipulated for therapeutic gain. These two outcomes are not mutually exclusive, and no matter what the final outcome is, a mechanistic-driven precision medicine approach is a win-win approach for advancing tinnitus research and treatment. Although there are several controversies and inconsistencies in the tinnitus field, which will not be discussed here, we will give a few examples, as to how the field can move forward by exploring the major neurophysiological tinnitus models, mostly by taking advantage of the common features supported by all of the models. Our position stems from the central concept that, as a field, we can and must do more to bring studies of mechanisms into the realm of neuroscience.
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Affiliation(s)
- Thanos Tzounopoulos
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.
| | - Carey Balaban
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Lori Zitelli
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Catherine Palmer
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, 15261, USA
- Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, PA, 15213, USA
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RIGA M, KOMIS A, MARAGOUDAKIS P, KORRES G, FEREKIDIS E, DANIELIDES V. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise: effects of frequency, gender, tinnitus bilaterality and age. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2018; 38:131-137. [PMID: 29967558 PMCID: PMC6028813 DOI: 10.14639/0392-100x-1465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/07/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY Accumulating evidence seems to support an association between tinnitus and medial olivocochlear bundle (MOCB) dysfunction. Most studies use patient/control comparisons to support this correlation. The aim of this study was to investigate the hypothesis in a substantially different way and evaluate the roles of gender, age, frequency and tinnitus bilaterality as possible confounding factors. The population consisted of 78 normal hearing patients with chronic tinnitus, 28 normal hearing controls, 19 presbycousic tinnitus patients and 13 presbycousic controls (n = 276 ears). Mean suppression amplitudes of transient evoked otoacoustic emissions (TEOAEs) and distortion product OAEs (DPOAEs) by contralateral white noise (50 dB SPL) were computed. Mean suppression values < 1 dB SPL or < 2 dB SPL were validated as positive test results. Overall suppression (OS) values < 1 dB SPL were qualified as a diagnostic test of moderate positive predictive value for both DPOAEs and TEOAEs, while OS values < 2 dB SPL were found to be of large negative predictive value for DPOAEs and moderate for TEOAEs. Mean suppression values (for all frequencies, OS) are of higher diagnostic value than suppression values corresponding to either lower (1-2 kHz) or higher frequencies (2.8-4 kHz for TEOAEs and 2.8-6 kHz for DPOAEs). After excluding patients with unilateral tinnitus from the analysis, correlations were found to be stronger. Useful correlations were also attributed for all age groups < 61 years. In females, OAE suppression seems to have a stronger positive predictive value, while in males it seems to have a stronger negative predictive value. OAE-based assays of MOCB function as an objective diagnostic tool for subjective tinnitus might deserve further investigation. Tinnitus uni- or bi-laterality is a confounding factor, which probably confirms the observation that defective function of the MOCB usually applies to the contralateral ear as well. Gender is an additional confounding factor, while correlations can be verified for all age groups < 61 years old.
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Affiliation(s)
- M. RIGA
- Democritus University of Thrace, Alexandroupolis, Greece
| | - A. KOMIS
- University ENT Dept, Hippoktation General Hospital of Athens, Greece
| | - P. MARAGOUDAKIS
- University ENT Dept, Attikon University Hospital, Athens, Greece
| | - G. KORRES
- University ENT Dept, Attikon University Hospital, Athens, Greece
| | - E. FEREKIDIS
- University ENT Dept, Hippoktation General Hospital of Athens, Greece
| | - V. DANIELIDES
- Democritus University of Thrace, Alexandroupolis, Greece
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Onishi ET, Coelho CCDB, Oiticica J, Figueiredo RR, Guimarães RDCC, Sanchez TG, Gürtler AL, Venosa AR, Sampaio ALL, Azevedo AA, Pires APBDÁ, Barros BBDC, Oliveira CACPD, Saba C, Yonamine FK, Medeiros ÍRTD, Rosito LPS, Rates MJA, Kii MA, Fávero ML, Santos MADO, Person OC, Ciminelli P, Marcondes RDA, Moreira RKDP, Torres SDMS. Tinnitus and sound intolerance: evidence and experience of a Brazilian group. Braz J Otorhinolaryngol 2018; 84:135-149. [PMID: 29339026 PMCID: PMC9449167 DOI: 10.1016/j.bjorl.2017.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Accepted: 12/07/2017] [Indexed: 12/13/2022] Open
Abstract
Introduction Tinnitus and sound intolerance are frequent and subjective complaints that may have an impact on a patient's quality of life. Objective To present a review of the salient points including concepts, pathophysiology, diagnosis and approach of the patient with tinnitus and sensitivity to sounds. Methods Literature review with bibliographic survey in LILACS, SciELO, Pubmed and MEDLINE database. Articles and book chapters on tinnitus and sound sensitivity were selected. The several topics were discussed by a group of Brazilian professionals and the conclusions were described. Results The prevalence of tinnitus has increased over the years, often associated with hearing loss, metabolic factors and inadequate diet. Medical evaluation should be performed carefully to guide the request of subsidiary exams. Currently available treatments range from medications to the use of sounds with specific characteristics and meditation techniques, with variable results. Conclusion A review on tinnitus and auditory sensitivity was presented, allowing the reader a broad view of the approach to these patients, based on scientific evidence and national experience.
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Riga M, Komis A, Marangoudakis P, Naxakis S, Ferekidis E, Kandiloros D, Danielides V. Differences in the suppression of distortion product otoacoustic emissions by contralateral white noise between patients with acute or chronic tinnitus. Int J Audiol 2017; 56:589-595. [DOI: 10.1080/14992027.2017.1305516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maria Riga
- University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece,
| | - Agis Komis
- Attikon University Hospital, National University of Athens, Athens, Greece,
| | | | - Stefanos Naxakis
- University Hospital of Patras, University of Patras, Patras, Greece, and
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Riga M, Komis A, Maragkoudakis P, Korres G, Danielides V. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise; suggested cut-off points. Int J Audiol 2016; 55:775-781. [DOI: 10.1080/14992027.2016.1219778] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- M. Riga
- University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece,
| | - A. Komis
- Attikon University Hospital, National University of Athens, Greece, and
| | - P. Maragkoudakis
- Attikon University Hospital, National University of Athens, Greece, and
| | - G. Korres
- Attikon University Hospital, National University of Athens, Greece, and
| | - V. Danielides
- University Hospital of Patras, University of Patras, Greece
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Fang L, Fu Y, Zhang TY. Salicylate-Induced Hearing Loss Trigger Structural Synaptic Modifications in the Ventral Cochlear Nucleus of Rats via Medial Olivocochlear (MOC) Feedback Circuit. Neurochem Res 2016; 41:1343-53. [PMID: 26886762 DOI: 10.1007/s11064-016-1836-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 04/13/2015] [Accepted: 04/21/2015] [Indexed: 12/24/2022]
Abstract
Lesion-induced cochlear damage can result in synaptic outgrowth in the ventral cochlear nucleus (VCN). Tinnitus may be associated with the synaptic outgrowth and hyperactivity in the VCN. However, it remains unclear how hearing loss triggers structural synaptic modifications in the VCN of rats subjected to salicylate-induced tinnitus. To address this issue, we evaluated tinnitus-like behavior in rats after salicylate treatment and compared the amplitude of the distortion product evoked otoacoustic emission (DPOAE) and auditory brainstem response (ABR) between control and treated rats. Moreover, we observed the changes in the synaptic ultrastructure and in the expression levels of growth-associated protein (GAP-43), brain-derived neurotrophic factor (BDNF), the microglial marker Iba-1 and glial fibrillary acidic protein (GFAP) in the VCN. After salicylate treatment (300 mg/kg/day for 4 and 8 days), analysis of the gap prepulse inhibition of the acoustic startle showed that the rats were experiencing tinnitus. The changes in the DPOAE and ABR amplitude indicated an improvement in cochlear sensitivity and a reduction in auditory input following salicylate treatment. The treated rats displayed more synaptic vesicles and longer postsynaptic density in the VCN than the control rats. We observed that the GAP-43 expression, predominantly from medial olivocochlear (MOC) neurons, was significantly up-regulated, and that BDNF- and Iba-1-immunoreactive cells were persistently decreased after salicylate administration. Furthermore, GFAP-immunoreactive astrocytes, which is associated with synaptic regrowth, was significantly increased in the treated groups. Our study revealed that reduced auditory nerve activity triggers synaptic outgrowth and hyperactivity in the VCN via a MOC neural feedback circuit. Structural synaptic modifications may be a reflexive process that compensates for the reduced auditory input after salicylate administration. However, massive increases in excitatory synapses in the VCN may represent a detrimental process that causes central hyperactivity, leading to tinnitus.
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Affiliation(s)
- Lian Fang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
- Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of WenZhou Medical University, Wenzhou, 325000, Zhejiang, China
| | - YaoYao Fu
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China
| | - Tian-Yu Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Eye and ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Xuhui District, Shanghai, 200031, China.
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Serra L, Novanta G, Sampaio AL, Augusto Oliveira C, Granjeiro R, Braga SC. The study of otoacoustic emissions and the suppression of otoacoustic emissions in subjects with tinnitus and normal hearing: an insight to tinnitus etiology. Int Arch Otorhinolaryngol 2015; 19:171-5. [PMID: 25992175 PMCID: PMC4399173 DOI: 10.1055/s-0034-1374648] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 03/06/2014] [Indexed: 11/20/2022] Open
Abstract
Introduction Analysis of the suppression effect is a simple method to evaluate cochlear status and central auditory mechanisms and, more specifically, the medial olivocochlear system. This structure may be involved in the generation of mechanisms that cause tinnitus and in the pathophysiology of tinnitus in patients with tinnitus and normal hearing. Objective To review the literature of the etiology of tinnitus on the lights of otoacoustic emissions in patients with normal hearing. Data Synthesis Individuals with tinnitus and normal hearing have a higher prevalence of alterations in transient-evoked otoacoustic emissions and distortion-product otoacoustic emissions than normal subjects. This fact suggests that dysfunctions of the outer hair cells (OHCs) might be important in the generation of the tinnitus; however, this feature is not always present in those who have the symptoms of tinnitus. Final Comments These findings suggest that OHC dysfunction is not necessary for tinnitus development-that is, there might be mechanisms other than OHC damage in the tinnitus development. On the other hand, OHC dysfunction alone is not sufficient to cause the symptom, because a great many individuals with OHC dysfunction did not complain about tinnitus.
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Affiliation(s)
- Lucieny Serra
- Department of Otolaryngology, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Gabriela Novanta
- Department of Otolaryngology, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | - Andre Lopes Sampaio
- Department of Otolaryngology, Universidade de Brasília, Brasília, Distrito Federal, Brazil
| | | | - Ronaldo Granjeiro
- Secretaria de Saúde–Hospital de Base, Brasília, Distrito Federal, Brazil
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Knudson IM, Shera CA, Melcher JR. Increased contralateral suppression of otoacoustic emissions indicates a hyperresponsive medial olivocochlear system in humans with tinnitus and hyperacusis. J Neurophysiol 2014; 112:3197-208. [PMID: 25231612 PMCID: PMC4269714 DOI: 10.1152/jn.00576.2014] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 09/15/2014] [Indexed: 12/24/2022] Open
Abstract
Atypical medial olivocochlear (MOC) feedback from brain stem to cochlea has been proposed to play a role in tinnitus, but even well-constructed tests of this idea have yielded inconsistent results. In the present study, it was hypothesized that low sound tolerance (mild to moderate hyperacusis), which can accompany tinnitus or occur on its own, might contribute to the inconsistency. Sound-level tolerance (SLT) was assessed in subjects (all men) with clinically normal or near-normal thresholds to form threshold-, age-, and sex-matched groups: 1) no tinnitus/high SLT, 2) no tinnitus/low SLT, 3) tinnitus/high SLT, and 4) tinnitus/low SLT. MOC function was measured from the ear canal as the change in magnitude of distortion-product otoacoustic emissions (DPOAE) elicited by broadband noise presented to the contralateral ear. The noise reduced DPOAE magnitude in all groups ("contralateral suppression"), but significantly more reduction occurred in groups with tinnitus and/or low SLT, indicating hyperresponsiveness of the MOC system compared with the group with no tinnitus/high SLT. The results suggest hyperresponsiveness of the interneurons of the MOC system residing in the cochlear nucleus and/or MOC neurons themselves. The present data, combined with previous human and animal data, indicate that neural pathways involving every major division of the cochlear nucleus manifest hyperactivity and/or hyperresponsiveness in tinnitus and/or low SLT. The overactivation may develop in each pathway separately. However, a more parsimonious hypothesis is that top-down neuromodulation is the driving force behind ubiquitous overactivation of the auditory brain stem and may correspond to attentional spotlighting on the auditory domain in tinnitus and hyperacusis.
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Affiliation(s)
- Inge M Knudson
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and
| | - Christopher A Shera
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and Speech and Hearing Bioscience and Technology Program, Harvard Division of Medical Sciences, Boston, Massachusetts
| | - Jennifer R Melcher
- Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts; Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts; and Speech and Hearing Bioscience and Technology Program, Harvard Division of Medical Sciences, Boston, Massachusetts
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Urnau D, Tochetto TM. Occurrence and suppression effect of otoacoustic emissions in normal hearing adults with tinnitus and hyperacusis. Braz J Otorhinolaryngol 2012; 78:87-94. [PMID: 22392244 PMCID: PMC9443871 DOI: 10.1590/s1808-86942012000100014] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2011] [Accepted: 06/04/2011] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED The association between tinnitus and hyperacusis is common according to the literature. AIM To verify the occurrence and the suppression effect of transient otoacoustic emissions (TEOAE), the existence of association between tinnitus degrees and hyperacusis degrees, and between the suppressive effect of TEOAE and laterality, tinnitus and hyperacusis degrees in normal hearing adults with complaints of tinnitus and hyperacusis. MATERIALS AND METHODS 25 normal hearing subjects with complaints of hyperacusis and tinnitus were studied in this cross-sectional study. The Tinnitus Handicap Inventory (THI) was used for the classification of tinnitus degrees, and the Loudness Discomfort Level (LDL) for the hyperacusis classification. RESULTS The occurrence of TEOAE ranged from 33 to 88%. We observed the presence of TEOAE suppression effect on 63.7% in the right ear and 81.7% in the left ear. There was no significant correlation between the degrees of tinnitus and hyperacusis in both ears. No statistically significant associations between the TEOAE suppression effect and laterality, tinnitus degrees and hyperacusis degrees were found. CONCLUSION The occurrence of TEOAE was lower than that found in normal hearing adults. A higher percentage of the presence of TEOAE suppression effect has been found in both ears. No association between the variables was observed.
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Affiliation(s)
- Daila Urnau
- Speech Therapy Department, UFSM, Santa Maria, RS
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Kraus KS, Ding D, Jiang H, Lobarinas E, Sun W, Salvi RJ. Relationship between noise-induced hearing-loss, persistent tinnitus and growth-associated protein-43 expression in the rat cochlear nucleus: does synaptic plasticity in ventral cochlear nucleus suppress tinnitus? Neuroscience 2011; 194:309-25. [PMID: 21821100 PMCID: PMC3390756 DOI: 10.1016/j.neuroscience.2011.07.056] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 07/22/2011] [Accepted: 07/23/2011] [Indexed: 10/17/2022]
Abstract
Aberrant, lesion-induced neuroplastic changes in the auditory pathway are believed to give rise to the phantom sound of tinnitus. Noise-induced cochlear damage can induce extensive fiber growth and synaptogenesis in the cochlear nucleus, but it is currently unclear if these changes are linked to tinnitus. To address this issue, we unilaterally exposed nine rats to narrow-band noise centered at 12 kHz at 126 dB sound pressure level (SPL) for 2 h and sacrificed them 10 weeks later for evaluation of synaptic plasticity (growth-associated protein 43 [GAP-43] expression) in the cochlear nucleus. Noise-exposed rats along with three age-matched controls were screened for tinnitus-like behavior with gap prepulse inhibition of the acoustic startle (GPIAS) before, 1-10 days after, and 8-10 weeks after the noise exposure. All nine noise-exposed rats showed similar patterns of severe hair cell loss at high- and mid-frequency regions in the exposed ear. Eight of the nine showed strong up-regulation of GAP-43 in auditory nerve fibers and pronounced shrinkage of the ventral cochlear nucleus (VCN) on the noise-exposed side, and strong up-regulation of GAP-43 in the medial ventral VCN, but not in the lateral VCN or the dorsal cochlear nucleus. GAP-43 up-regulation in VCN was significantly greater in Noise-No-Tinnitus rats than in Noise-Tinnitus rats. One Noise-No-Tinnitus rat showed no up-regulation of GAP-43 in auditory nerve fibers and only little VCN shrinkage, suggesting that auditory nerve degeneration plays a role in tinnitus generation. Our results suggest that noise-induced tinnitus is suppressed by strong up-regulation of GAP-43 in the medial VCN. GAP-43 up-regulation most likely originates from medial olivocochlear neurons. Their increased excitatory input on inhibitory neurons in VCN may possibly reduce central hyperactivity and tinnitus.
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Affiliation(s)
- Kari Suzanne Kraus
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
| | - Dalian Ding
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
| | - Haiyan Jiang
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
| | - Ed Lobarinas
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
| | - Wei Sun
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
| | - Richard J Salvi
- Center for Hearing and Deafness, SUNY at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY 14214, United States
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