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Devolder P, Keppler H, Keshishzadeh S, Taghon B, Dhooge I, Verhulst S. The role of hidden hearing loss in tinnitus: Insights from early markers of peripheral hearing damage. Hear Res 2024; 450:109050. [PMID: 38852534 DOI: 10.1016/j.heares.2024.109050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
Since the presence of tinnitus is not always associated with audiometric hearing loss, it has been hypothesized that hidden hearing loss may act as a potential trigger for increased central gain along the neural pathway leading to tinnitus perception. In recent years, the study of hidden hearing loss has improved with the discovery of cochlear synaptopathy and several objective diagnostic markers. This study investigated three potential markers of peripheral hidden hearing loss in subjects with tinnitus: extended high-frequency audiometric thresholds, the auditory brainstem response, and the envelope following response. In addition, speech intelligibility was measured as a functional outcome measurement of hidden hearing loss. To account for age-related hidden hearing loss, participants were grouped according to age, presence of tinnitus, and audiometric thresholds. Group comparisons were conducted to differentiate between age- and tinnitus-related effects of hidden hearing loss. All three markers revealed age-related differences, whereas no differences were observed between the tinnitus and non-tinnitus groups. However, the older tinnitus group showed improved performance on low-pass filtered speech in noise tests compared to the older non-tinnitus group. These low-pass speech in noise scores were significantly correlated with tinnitus distress, as indicated using questionnaires, and could be related to the presence of hyperacusis. Based on our observations, cochlear synaptopathy does not appear to be the underlying cause of tinnitus. The improvement in low-pass speech-in-noise could be explained by enhanced temporal fine structure encoding or hyperacusis. Therefore, we recommend that future tinnitus research takes into account age-related factors, explores low-frequency encoding, and thoroughly assesses hyperacusis.
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Affiliation(s)
- Pauline Devolder
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium; Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
| | - Hannah Keppler
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium; Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium
| | - Sarineh Keshishzadeh
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Baziel Taghon
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
| | - Ingeborg Dhooge
- Department of Ear, Nose and Throat, Ghent University Hospital, Ghent, Belgium; Department of Head and Skin, Ghent University, Ghent, Belgium
| | - Sarah Verhulst
- Hearing Technology @ WAVES, Department of Information Technology, Ghent University, Zwijnaarde, Belgium
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2
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Bhatt IS, Washnik NJ, Kingsbury S, Deshpande AK, Kingsbury H, Bhagavan SG, Michel K, Dias R, Torkamani A. Identifying Health-Related Conditions Associated with Tinnitus in Young Adults. Audiol Res 2023; 13:546-562. [PMID: 37489384 PMCID: PMC10366783 DOI: 10.3390/audiolres13040048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/10/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023] Open
Abstract
OBJECTIVE The present study investigated the epidemic of tinnitus in college-aged young adults. Our first objective was to identify health conditions associated with tinnitus in young adults. The second objective was to evaluate the predictive utility of some known risk factors. STUDY DESIGN A cross-sectional design was used to investigate the prevalence and risk factors for tinnitus. SETTING A questionnaire was distributed, reaching out to a large college-aged population. A total of 2258 young adults aged 18-30 years were recruited from April 2021 to February 2022. INTERVENTIONS A questionnaire was administered to investigate the epidemiology of tinnitus in a population of college-aged young adults. RESULTS About 17.7% of young adults reported bothersome tinnitus perception lasting for ≥5 min in the last 12 months. The prevalence of chronic tinnitus (bothersome tinnitus for ≥1 year) and acute tinnitus (bothersome tinnitus for <1 year) was 10.6% and 7.1%, respectively. About 19% of the study sample reported at least one health condition. Individuals reporting head injury, hypertension, heart disease, scarlet fever, and malaria showed significantly higher odds of reporting chronic tinnitus. Meningitis and self-reported hearing loss showed significant associations with bothersome tinnitus. The prevalence of chronic tinnitus was significantly higher in males reporting high noise exposure, a positive history of reoccurring ear infections, European ethnic background, and a positive health history. Risk modeling showed that noise exposure was the most important risk factor for chronic tinnitus, followed by sex, reoccurring ear infections, and a history of any health condition. A positive history of COVID-19 and self-reported severity showed no association with tinnitus. Individuals reporting reoccurring ear infections showed a significantly higher prevalence of COVID-19. CONCLUSIONS While young adults with health conditions are at a higher risk of reporting tinnitus, the predictive utility of a positive health history remains relatively low, possibly due to weak associations between health conditions and tinnitus. Noise, male sex, reoccurring ear infections, European ethnicity, and a positive health history revealed higher odds of reporting chronic tinnitus than their counterparts. These risk factors collectively explained about 16% variability in chronic tinnitus, which highlights the need for identifying other risk factors for chronic tinnitus in young adults.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Nilesh J Washnik
- Department of Hearing Speech and Language Sciences, Ohio University, Athens, OH 45701, USA
| | - Sarah Kingsbury
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Aniruddha K Deshpande
- Department of Speech-Language-Hearing Sciences, Hofstra University, Hempstead, NY 11549, USA
| | - Hailey Kingsbury
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Srividya Grama Bhagavan
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Klayre Michel
- Department of Communication Sciences and Disorders, University of Iowa, Iowa City, IA 52242, USA
| | - Raquel Dias
- Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32603, USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology, Scripps Science Institute, La Jolla, CA 92037, USA
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3
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Rademaker MM, Meijers SM, Smit AL, Stegeman I. Prediction Models for Tinnitus Presence and the Impact of Tinnitus on Daily Life: A Systematic Review. J Clin Med 2023; 12:jcm12020695. [PMID: 36675624 PMCID: PMC9861218 DOI: 10.3390/jcm12020695] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023] Open
Abstract
The presence of tinnitus does not necessarily imply associated suffering. Prediction models on the impact of tinnitus on daily life could aid medical professionals to direct specific medical resources to those (groups of) tinnitus patients with specific levels of impact. Models of tinnitus presence could possibly identify risk factors for tinnitus. We systematically searched the PubMed and EMBASE databases for articles published up to January 2021. We included all studies that reported on multivariable prediction models for tinnitus presence or the impact of tinnitus on daily life. Twenty-one development studies were included, with a total of 31 prediction models. Seventeen studies made a prediction model for the impact of tinnitus on daily life, three studies made a prediction model for tinnitus presence and one study made models for both. The risk of bias was high and reporting was poor in all studies. The most used predictors in the final impact on daily life models were depression- or anxiety-associated questionnaire scores. Demographic predictors were most common in final presence models. No models were internally or externally validated. All published prediction models were poorly reported and had a high risk of bias. This hinders the usability of the current prediction models. Methodological guidance is available for the development and validation of prediction models. Researchers should consider the importance and clinical relevance of the models they develop and should consider validation of existing models before developing new ones.
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Affiliation(s)
- Maaike M. Rademaker
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Sebastiaan M. Meijers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Correspondence:
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4
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Chen S, Shen X, Yuan J, Wu Y, Li Y, Tong B, Qiu J, Wu F, Liu Y. Characteristics of tinnitus and factors influencing its severity. Ther Adv Chronic Dis 2022; 13:20406223221109656. [PMID: 35847479 PMCID: PMC9280848 DOI: 10.1177/20406223221109656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/08/2022] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives There is a wealth of information regarding the treatment methods for tinnitus; however, the treatment available is unsatisfactory because of the following reasons: first, tinnitus has various etiologies and second, it has distinct heterogeneity among different individuals. Numerous studies have focused on understanding the causes of tinnitus severity, but the conclusions have been inconsistent. The purpose of the present study was to define factors that differentially influence subjectively perceived tinnitus severity. Methods Clinical data of patients with chronic tinnitus who visited our outpatient clinic from April 2020 to April 2021 were collected. Tinnitus Handicap Inventory (THI) and Tinnitus Evaluation Questionnaire (TEQ) were used to evaluate tinnitus severity among patients, and the independent factors influencing the severity of tinnitus were investigated by performing univariate and multivariate stepwise regression analyses. Results Eleven variables were associated with THI and TEQ scores, of which nine were identical. Multiple regression analyses results revealed that five variables had a significantly unique predictive effect on tinnitus severity based on THI and the TEQ scores. Three factors including Self-Rating Scale of Sleep (SRSS), change in loudness, and Self-Rating Anxiety Scale (SAS) were identical. Conclusion Sleep status, anxiety level, and change in loudness in patients with chronic tinnitus were significantly correlated with severity of tinnitus. Follow-up studies should investigate the causal relationship between these factors and tinnitus severity.
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Affiliation(s)
- Shanwen Chen
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Xueqin Shen
- Anhui University of Chinese Medicine, Hefei, P.R. China
| | - Jinjin Yuan
- Department of Otorhinolaryngology, Head and Neck Surgery, Jiujiang University Affiliated Hospital, Jiujiang, P.R. China
| | - Yu Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Yifan Li
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Busheng Tong
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Jianxin Qiu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China
| | - Feihu Wu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, P.R. China
| | - Yehai Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, The First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Hefei 230032, Anhui, P.R. China
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5
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Husain FT, Chappell J, Tai Y. An online survey study of the association between tinnitus and hyperacusis using validated questionnaires. Int J Audiol 2021; 61:655-662. [PMID: 34353201 DOI: 10.1080/14992027.2021.1953712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To investigate the association between the highly comorbid tinnitus and hyperacusis conditions using standard questionnaires. DESIGN A cross-sectional internet-based survey consisted of general demographic questions, questions about hearing and emotional status, Tinnitus Primary Function Questionnaire (TPFQ), and Hyperacusis Questionnaire (HQ). STUDY SAMPLE Six hundred sixteen completed surveys were obtained primarily from students and staff in a large university. RESULTS About 6% of the respondents could be classified as having hyperacusis based on the criterion of HQ scores ≥ 28 and had significantly increased odds of reporting having tinnitus (OR 10.11; 95% CI 3.76-35.3). Tinnitus severity (TPFQ) and HQ scores were correlated regardless of the hearing loss status. When predicting TPFQ scores, after controlling for demographic factors and affective states, hyperacusis status became an insignificant predictor. In contrast, both affirmative answers to having anxiety and depression, together with hearing loss status and tinnitus were significant predictors of HQ scores. CONCLUSIONS Having hyperacusis did not appear to contribute significantly to tinnitus severity, but having tinnitus contributed to the likelihood of having hyperacusis. Our findings provide a nuanced view of how tinnitus and hyperacusis conditions co-occur and influence each other, which may be valuable to clinicians and researchers.
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Affiliation(s)
- Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jenise Chappell
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Champaign, IL, USA.,Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
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6
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Kikidis D, Vassou E, Schlee W, Iliadou E, Markatos N, Triantafyllou A, Langguth B. Methodological Aspects of Randomized Controlled Trials for Tinnitus: A Systematic Review and How a Decision Support System Could Overcome Barriers. J Clin Med 2021; 10:1737. [PMID: 33923778 PMCID: PMC8074073 DOI: 10.3390/jcm10081737] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 12/05/2022] Open
Abstract
Although a wide range of tinnitus management interventions is currently under research and a variety of therapeutic interventions have already been applied in clinical practice, no optimal and universal tinnitus treatment has been reached yet. This fact is to some extent a consequence of the high heterogeneity of the methodologies used in tinnitus related clinical studies. In this manuscript, we have identified, summarized, and critically appraised tinnitus-related randomized clinical trials since 2010, aiming at systematically mapping the research conducted in this area. The results of our analysis of the 73 included randomized clinical trials provide important insight on the identification of limitations of previous works, methodological pitfalls or gaps in current knowledge, a prerequisite for the adequate interpretation of current literature and execution of future studies.
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Affiliation(s)
- Dimitrios Kikidis
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Evgenia Vassou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
| | - Eleftheria Iliadou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Nikolaos Markatos
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Aikaterini Triantafyllou
- First Department of Otorhinolaryngology, Head and Neck Surgery, Hippokration General Hospital, National and Kapodistrian University of Athens, 15772 Athens, Greece; (E.V.); (E.I.); (N.M.); (A.T.)
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Universität Regensburg, 93053 Regensburg, Germany; (W.S.); (B.L.)
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7
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Vozel D, Steiner N, Božanić Urbančič N, Mladenov D, Battelino S. Slovenian Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12), Vertigo (DHI, NVI) and TINNITUS (THI). Zdr Varst 2020; 59:120-127. [PMID: 32952712 PMCID: PMC7478096 DOI: 10.2478/sjph-2020-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/02/2020] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To provide physicians and patients with the tools needed to evaluate patients' problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI). MATERIALS AND METHODS COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire. RESULTS Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p>0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden's index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively. CONCLUSION Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.
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Affiliation(s)
- Domen Vozel
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Nejc Steiner
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
| | - Nina Božanić Urbančič
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
| | - Dejan Mladenov
- Železniški zdravstveni dom Ljubljana, Celovška cesta 4, 1000Ljubljana, Slovenia
| | - Saba Battelino
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, Zaloška 2, 1000Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Department of Otorhinolaringology, Vrazov trg 2, 1000Ljubljana, Slovenia
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8
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Evaluation of a Cognitive Behavioral Model of Tinnitus Distress: A Cross-Sectional Study Using Structural Equation Modeling. Ear Hear 2020; 41:1028-1039. [DOI: 10.1097/aud.0000000000000826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Pearson SE, Taylor J, Patel P, Baguley DM. Cancer survivors treated with platinum-based chemotherapy affected by ototoxicity and the impact on quality of life: a narrative synthesis systematic review. Int J Audiol 2019; 58:685-695. [PMID: 31545660 DOI: 10.1080/14992027.2019.1660918] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective: To identify any change in quality of life (QoL) caused by chemotherapy-induced toxicities, such as hearing loss and tinnitus, to provide information in order to improve services and aid clinicians in their decision-making. Design: This systematic review followed the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. The search terms were cancer, platinum-based chemotherapy, ototoxicity and "quality of life". Titles and abstracts, followed by full texts, were screened by two independent researchers. The relevant data were extracted and quality analysis was performed using the NIH Quality Assessment Tool. Study sample: About 308 titles and abstracts were screened, and 27 full-text articles were screened. Ten articles representing 11 studies were included in the review. Study design included cross-sectional studies, randomised control trials and longitudinal studies. Results: Diagnostic criteria consisted of audiograms, questionnaires and patient complaints. The study quality ranged from 21.43% to 85.71%. Overall results found that those treated with cisplatin had more hearing loss and tinnitus than those treated with other therapies. Furthermore, those with hearing loss and tinnitus were more likely to have a lower QoL. Conclusions: There is an urgent need to standardise diagnostics when investigating ototoxicity and its effect on QoL, particularly for research into risk factors, prevention and management.
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Affiliation(s)
- Stephanie E Pearson
- NIHR Nottingham Biomedical Research Centre , Nottingham , UK.,Department of Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK
| | - John Taylor
- NIHR Nottingham Biomedical Research Centre , Nottingham , UK.,Department of Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK
| | - Poulam Patel
- Nottingham University Hospitals NHS Trust , Nottingham , UK.,Division of Cancer and Stem Cells, Academic Unit of Oncology, School of Medicine, University of Nottingham , Nottingham , UK
| | - David M Baguley
- NIHR Nottingham Biomedical Research Centre , Nottingham , UK.,Department of Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK.,Nottingham University Hospitals NHS Trust , Nottingham , UK
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10
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Deklerck AN, Degeest S, Dhooge IJM, Keppler H. Test-Retest Reproducibility of Response Duration in Tinnitus Patients With Positive Residual Inhibition. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:3531-3544. [PMID: 31433704 DOI: 10.1044/2019_jslhr-h-18-0514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose Functional imaging is often used to try to elucidate the pathophysiological mechanism of tinnitus. Residual inhibition, the temporary suppression of tinnitus after application of a masking noise, could be an interesting technique to modulate tinnitus perception in functional imaging paradigms. The purposes of this study were to primarily assess reproducibility of the (partial) positive residual inhibition response duration in patients with tinnitus and to explore its utility in experimental designs. Method Patients with tinnitus exhibiting a (partial) positive residual inhibition response or tinnitus reduction after a 1-min white noise presentation were selected from a broad consulting tinnitus population. In 27 patients, this response was tested 4 times: twice during initial testing and twice during a retest of the psychoacoustic tinnitus measures, 4-8 weeks after initial consultation. In 17 patients with stable residual inhibition responses, reproducibility of response duration, the duration of tinnitus reduction up to pretesting state, was analyzed. Results Initial testing showed a residual inhibition duration of 29.5 s on average. Test-retest reproducibility of response duration was shown to be reliable with an ICC(3, 4) of .871 (95% CI [0.733, 0.948]) and a standard error of measurement of 6.64 s. Conclusions This study indicates the good test-retest reproducibility of residual inhibition duration in our subset of 17 patients with stable (partial) positive residual inhibition. Residual inhibition is, therefore, a technique that can potentially be used for temporary tinnitus manipulation in experimental paradigms to unravel tinnitus pathophysiology.
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Affiliation(s)
- Ann N Deklerck
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent University, Belgium
| | - Sofie Degeest
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Belgium
| | - Ingeborg J M Dhooge
- Faculty of Medicine and Health Sciences, Department of Head and Skin, Ghent University, Belgium
- Department of Otorhinolaryngology, Ghent University Hospital, Belgium
| | - Hannah Keppler
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences, Ghent University, Belgium
- Department of Otorhinolaryngology, Ghent University Hospital, Belgium
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11
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Deklerck AN, Marechal C, Pérez Fernández AM, Keppler H, Van Roost D, Dhooge IJM. Invasive Neuromodulation as a Treatment for Tinnitus: A Systematic Review. Neuromodulation 2019; 23:451-462. [DOI: 10.1111/ner.13042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 07/09/2019] [Accepted: 07/31/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Ann N. Deklerck
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
| | - Celine Marechal
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
| | | | - Hannah Keppler
- Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences Ghent University Ghent Belgium
- Department of Otorhinolaryngology Ghent University Hospital Ghent Belgium
| | - Dirk Van Roost
- Department of Neurosurgery Ghent University Hospital Ghent Belgium
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair Ghent University Ghent Belgium
| | - Ingeborg J. M. Dhooge
- Faculty of Medicine and Health Sciences, Department of Head and Skin Gent University Ghent Belgium
- Department of Otorhinolaryngology Ghent University Hospital Ghent Belgium
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Bureš Z, Profant O, Svobodová V, Tóthová D, Vencovský V, Syka J. Speech Comprehension and Its Relation to Other Auditory Parameters in Elderly Patients With Tinnitus. Front Aging Neurosci 2019; 11:219. [PMID: 31496946 PMCID: PMC6713070 DOI: 10.3389/fnagi.2019.00219] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022] Open
Abstract
Deteriorated speech comprehension is a common manifestation of the age-related decline of auditory functions (presbycusis). It could be assumed that when presbycusis is accompanied by tinnitus, general hearing functions, and particularly comprehension of speech in quiet and speech in noise (SIN), will be significantly affected. In this study, speech comprehension ability and other parameters of auditory function were assessed in elderly subjects with (T, n = 25) and without (NT, n = 26) tinnitus, aiming for examination of both peripheral and central auditory processing. Apart from high-frequency audiograms in quiet and in background noise, speech recognition thresholds in silence or in competitive babble noise, and the ability to understand temporally gated speech (GS), we measured also sensitivity to frequency modulation (FM) and interaural delay, gap detection thresholds (GDT), or the difference limens of intensity. The results show that in elderly participants matched by age (mean ages around 68 years), cognitive status (median MoCA scores around 27), and hearing thresholds [median pure-tone averages (PTA) around 16 dB hearing loss (HL)], tinnitus per se has little influence on speech comprehension. The tinnitus patients also show similar GDT, sensitivity to interaural intensity difference, and sensitivity to FM as the NT subjects. Despite these similarities, nevertheless, significant differences in auditory processing have been found in the tinnitus participants: a worse ability to detect tones in noise, a higher sensitivity to intensity changes, and a higher sensitivity to interaural time differences. Additional correlation analyses further revealed that speech comprehension in the T subjects is dependent on the sensitivity to temporal modulation and interaural time delay (ITD), while these correlations are weak and non-significant in the NT subjects. Therefore, despite similarities in average speech comprehension and several other parameters of auditory function, elderly people with tinnitus exhibit different auditory processing, particularly at a suprathreshold level. The results also suggest that speech comprehension ability of elderly tinnitus patients relies more on temporal features of the sound stimuli, especially under difficult conditions, compared to elderly people without tinnitus.
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Affiliation(s)
- Zbyněk Bureš
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.,Department of Technical Studies, College of Polytechnics, Jihlava, Czechia
| | - Oliver Profant
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.,Department of Otorhinolaryngology of Faculty Hospital Královské Vinohrady and 3rd Faculty of Medicine, Charles University, Prague, Czechia
| | - Veronika Svobodová
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.,Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czechia
| | - Diana Tóthová
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.,Department of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague, University Hospital Motol, Prague, Czechia
| | - Václav Vencovský
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia.,Department of Radioelectronics, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czechia
| | - Josef Syka
- Department of Auditory Neuroscience, Institute of Experimental Medicine of the Czech Academy of Sciences, Prague, Czechia
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Abstract
Background Hyperacusis is a troublesome symptom that can have a marked negative impact on quality of life. Objectives To identify major research questions in hyperacusis. Materials and methods Review of gaps in knowledge regarding hyperacusis, and where opportunities may lie to address these. Results Eight major research questions were identified as priorities for future research. These were: What is the prevalence of hyperacusis in adults and children? What are the risk factors associated with hyperacusis? What is the natural history of hyperacusis? How is ‘pain hyperacusis’ perceived? What mechanisms are involved in hyperacusis? What is the relationship between hyperacusis and tinnitus? Can a questionnaire be developed that accurately measures the impact of hyperacusis and can be used as a treatment outcome measure? What treatments, alone or in combination, are effective for hyperacusis? Conclusion This clinical/researcher-led project identified major research questions in hyperacusis. A further development to identify patient-prioritized research will follow.
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The Incidence of Cranial Arteriovenous Shunts in Patients With Pulsatile Tinnitus: A Prospective Observational Study. Otol Neurotol 2018; 39:648-653. [PMID: 29561378 DOI: 10.1097/mao.0000000000001767] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES Finding the underlying cause for pulsatile tinnitus can be challenging. We aimed to determine the incidence of arteriovenous shunts, i.e., arteriovenous malformations (AVMs) or dural arteriovenous fistulas (dAVFs), in patients referred for catheter angiography (digital subtraction angiography [DSA]). Furthermore, we assessed which clinical features were predictive for the presence of such a lesion. STUDY DESIGN AND METHODS Fifty-one patients with pulsatile tinnitus, who were referred to us for DSA to exclude an arteriovenous shunt, were enrolled, prospectively. MAIN OUTCOME MEASURES DSA determined the presence of a dAVF or AVM. Clinical characteristics were recorded systematically and all patients underwent a physical examination. RESULTS Fifty patients were included in the final analyses. While no AVMs were found, a dAVF was found in 12 cases (24%). Three of these demonstrated cortical venous reflux, thus requiring treatment due to the risk of hemorrhage. In three cases (6%), DSA demonstrated a non-arteriovenous-shunt abnormality, likely causing the tinnitus. The odds of having a dAVF were significantly raised by unilaterality, objective bruit, and the ability to influence the tinnitus with compression. Unilaterality even had a negative predictive value of 1 and, if used as selection criterion, would have raised dAVF prevalence from 24 to 32%. CONCLUSION In a tertiary care setting, the prevalence of dAVFs in patients with pulsatile tinnitus is not negligible. Thus, patients with unilateral pulsatile tinnitus should be offered dynamic vascular imaging to rule out a dAVF. Especially, since some of these patients are at risk of intracranial hemorrhage and treatment options exist.
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The relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. The Journal of Laryngology & Otology 2017; 131:1017-1025. [DOI: 10.1017/s0022215117001803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AbstractObjectives:Chronic tinnitus is associated with reduced auditory input, which results in changes in the central auditory system. This study aimed to examine the relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. For audiometry, the parameters represented the edge frequency of hearing loss, the frequency of maximum hearing loss and the frequency range of hearing loss. For distortion product otoacoustic emissions, the parameters were the frequency of lowest distortion product otoacoustic emission amplitudes and the frequency range of reduced distortion product otoacoustic emissions.Method:Sixty-seven patients (45 males, 22 females) with subjective chronic tinnitus, aged 18 to 73 years, were included.Results:No correlation was found between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. However, tinnitus pitch fell mostly within the frequency range of hearing loss.Conclusion:The current study seems to confirm the relationship between tinnitus pitch and the frequency range of hearing loss, thus supporting the homeostatic plasticity model.
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Degeest S, Keppler H, Corthals P. The Effect of Tinnitus on Listening Effort in Normal-Hearing Young Adults: A Preliminary Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1036-1045. [PMID: 28282482 DOI: 10.1044/2016_jslhr-h-16-0090] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 09/12/2016] [Indexed: 06/06/2023]
Abstract
PURPOSE The objective of this study was to investigate the effect of chronic tinnitus on listening effort. METHOD Thirteen normal-hearing young adults with chronic tinnitus were matched with a control group for age, gender, hearing thresholds, and educational level. A dual-task paradigm was used to evaluate listening effort in different listening conditions. A primary speech-recognition task and a secondary memory task were performed both separately and simultaneously. Furthermore, subjective listening effort was questioned for various listening situations. The Tinnitus Handicap Inventory was used to control for tinnitus handicap. RESULTS Listening effort significantly increased in the tinnitus group across listening conditions. There was no significant difference in listening effort between listening conditions, nor was there an interaction between groups and listening conditions. Subjective listening effort did not significantly differ between both groups. CONCLUSIONS This study is a first exploration of listening effort in normal-hearing participants with chronic tinnitus showing that listening effort is increased as compared with a control group. There is a need to further investigate the cognitive functions important for speech understanding and their possible relation with the presence of tinnitus and listening effort.
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Affiliation(s)
- Sofie Degeest
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Hannah Keppler
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, Belgium
| | - Paul Corthals
- Department of Speech, Language and Hearing Sciences, Ghent University, Ghent, BelgiumFaculty of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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Gauvin DV, Yoder JD, Tapp RL, Baird TJ. Small Compartment Toxicity: CN VIII and Quality of Life: Hearing Loss, Tinnitus, and Balance Disorders. Int J Toxicol 2017; 36:8-20. [PMID: 27194512 DOI: 10.1177/1091581816648905] [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: 11/16/2022]
Abstract
Life experiences, industrial/environmental exposures, and administration of Food and Drug Administration (FDA)-approved drugs may have unintended but detrimental effects on peripheral and central auditory pathways. Most relevant to the readership of this journal is the role that drug treatments approved by the FDA as safe and effective appear to interact with 3 independent modes of toxicity within the small compartment of the ear. What may seem to be trivial drug-induced toxicity has the potential to change important measures of quality of life and functional capacity of mid- to late-life patients. Drugs meant to treat can become the source of interference in the activities of daily living, and as a result, treatment compliance may be jeopardized. Ototoxicity has been defined as the tendency of certain therapeutic agents and other chemical substances to cause functional impairments and cellular degeneration of the tissues of the inner ear resulting in hearing loss. However, one of the largest contributors to hospitalizations is fall-related injuries in the elderly patients associated with disorders of vestibular function linked to progressive and drug-induced toxicities. Tinnitus affects 35 to 50 million adults representing approximately 25% of the US population, with 12 million seeking medical care and 2 to 3 million reporting symptoms that were severely debilitating. This review is intended to highlight these targets of neurotoxicity that threaten the usefulness of drug treatments deemed safe and effective prior to access by the general public.
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Affiliation(s)
- David V Gauvin
- Neurobehavioral Sciences, MPI Research Inc, Mattawan, MI, USA
| | - Joshua D Yoder
- Neurobehavioral Sciences, MPI Research Inc, Mattawan, MI, USA
| | - Rachel L Tapp
- Neurobehavioral Sciences, MPI Research Inc, Mattawan, MI, USA
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