The Effects of Yoga in Patients Suffering from Subjective Tinnitus

Usefulness of Yoga in the management of tinnitus during COVID-19: A narrative review

The emergence of Coronavirus disease 2019 (COVID- 19) has resulted in an unprecedented global health crisis. Tinnitus is the most commonly reported symptom when the COVID-19 impacts the auditory-vestibular system. There are a variety of management strategies for amelioration of tinnitus including Yoga. The present review deals with three issues: one, occurrence of tinnitus in persons affected by COVID-19; two, the impact of COVID-19 situation on tinnitus severity; and three, the potential of Yoga as an intervention strategy. Literature search was carried out through search engines like PubMed, Cochrane, Web of Science and Google scholar using keywords like 'tinnitus', 'COVID-19' and 'Yoga'. The relevant studies were identified and the findings summarized in a narrative manner. Based on the evidence obtained in the present review, the authors propose that yoga can be used as an effective strategy in overcoming the psychosocial factors associated with COVID-19 particularly in this pandemic and related lockdown situation. It is also proposed here that teleyoga can serve as a practical, feasible and safe mode for providing therapeutic services for tinnitus-related issues particularly in the present pandemic situation.

Migrainous Vertigo, Tinnitus, and Ear Symptoms and Alternatives

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

Higher Peripheral Inflammation Is Associated With Lower Orbitofrontal Gamma Power in Chronic Tinnitus

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.

The efficacy of acoustic therapy versus oral medication for chronic tinnitus: A meta-analysis

PURPOSE

To compare the efficacy of acoustic therapy (AT) and drug therapy (DT) for chronic tinnitus.

METHODS

We searched Pubmed, ScienceDirect, Chinese Journal Full-text Database (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), Embase, and Cochrane Library from the establishment of the database to December 2019. Meta-analysis was performed on the Tinnitus Handicap Inventory (THI) score and Visual Analogue Scale (VAS) with included literature using Revman 5.3 software.

RESULTS

A total of 18 documents were included, including 16 Chinese documents and 2 English documents, with 1774 patients (including 962 patients treated with AT and 812 patients treated with DT). The effect of AT (by the number of cases or ears) is better than that of DT (P < 0.05). After treatment, the THI value of AT was more evident than that of DT (WMD = -4.25, (-13.24, -5.29)). And the VAS value of AT was significantly lower than that of DT (WMD = -0.73, (-1.31, -0.15)).

CONCLUSION

Compared with DT, AT can significantly improve the efficacy of tinnitus and reduce the symptoms of tinnitus patients. Clinically, it can vigorously promote the application value of treating tinnitus by sound.

The Role of Manganese, Cadmium, Chromium and Selenium on Subjective Tinnitus

Elevated levels of heavy metals like cadmium (Cd) and manganese (Mn) are known to lead to oxidative damage-related oto-toxicity and decreased levels of chromium (Cr) and selenium (Se) are known to lead to oto-toxicity due to reduced anti-oxidant activity. The aim of the present study was to evaluate serum levels of Cd, Mn, Cr, and Se and their relationship with tinnitus. A total of 48 patients with tinnitus (Group 1) and 40 healthy controls (Group 2) were included in the study. All participants were applied audiology tests. Severity of tinnitus was measured with Tinnitus Severity Index Questionnaire (TSIQ) in group 1. Serum Mn, Cd, Cr, and Se measurements were done by using The Agilent ICP-MS system consisted of a 7700 coupled plasma mass spectrometry (ICP-MS). Serum Cd, Mn, and Cr levels were higher in group 1 and Se level was lower in group 1 than that of group 2. We may conclude that Cd, Mn, Cr, and Se levels could play an important role in etio-pathogenesis of tinnitus, and thereby supplementation or reduction of these elements could be considered as novel therapeutic goals.

Effectiveness of Yoga Nidra in reducing stress in school going adolescents: An experimental study

BACKGROUND AND OBJECTIVES

Academic stress can exert severe stress in adolescents answering their career deciding board exams. The present study attempted to understand the efficacy of Yoga Nidra (YN) in mitigating psychosocial stress.

DESIGN

and Methods: This study was carried on 10th-grade students (ages 14 to 16) and had two arms, one performing YN (experimental) and the other without YN (control) for 21 consecutive days. Modified Adolescent Stress Questionnaire (ASQ-I) was used to assess the stress in the students before and after the intervention.

RESULTS

The results indicate that performing YN was effective and significantly decreased the total stress (P < 0.001) and vital domains like the stress of home life (P < 0.005), school performance (P < 0.026), teacher interaction (P < 0.024), future uncertainty (P < 0.001), school and leisure conflict (P < 0.001). Also, at the end of the study in control, low and moderate stress was observed in 58.06% and 41.93%, while in the YN group, it was 96.15% and 3.85% and was statistically significant (p < 0.001).

CONCLUSIONS

This study shows that YN effectively reduced psychosocial stress in adolescents and could be useful in school curriculum.

Effect of yoga and meditation on tinnitus: a systematic review

OBJECTIVE

The present systematic review aimed to explore the published literature on the application of yoga and meditation for tinnitus.

METHOD

A systematic search was carried out to identify the eligible studies exploring the effect of yoga and meditation on tinnitus in PubMed, Scopus and Cochrane Library electronic databases. Studies on the application of yoga and meditation on tinnitus were identified following a three-step screening process by both the authors independently. A mixed-methods appraisal tool was used to perform the quality appraisal of the included studies.

RESULTS

Five studies were shortlisted and included in the present review. Four studies had used different types of yoga and pranayama, while one used relaxation therapy. Three studies concluded that there were positive effects of yoga on tinnitus, such as a reduction in severity, stress, anxiety and irritability associated with tinnitus and improved quality of life.

CONCLUSION

This review highlights the application of yoga and meditation in management of tinnitus along with regular otological and audiological treatment options. Furthermore, there is a need to have more randomised controlled trials in this area to evidence the effect of yoga and meditation on tinnitus empirically.

Tinnitus and stress in adults: a scoping review

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.