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Sendesen E, Turkyilmaz D. Can Residual Inhibition Predict the Success of Sound Enrichment Treatment for Tinnitus? Brain Behav 2024; 14:e70083. [PMID: 39378282 PMCID: PMC11460611 DOI: 10.1002/brb3.70083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/28/2024] [Accepted: 09/08/2024] [Indexed: 10/10/2024] Open
Abstract
OBJECTIVES The objective of this study was to investigate whether residual inhibition (RI), which provides information on the relationship between tinnitus and increased spontaneous activity in the auditory system, is a predictor for the success of sound enrichment treatment. DESIGN Tinnitus patients were divided into two groups based on whether RI was achieved (RI+) or not (RI-). All participants underwent sound enrichment. Psychosomatic measures (for tinnitus severity, discomfort, attention deficit and sleep difficulties), Tinnitus Handicap Inventory (THI), minimum masking level (MML), and tinnitus loudness level (TLL) results were compared before and at 1, 3, and 6 months after treatment. STUDY SAMPLE Sixty-seven chronic tinnitus patients were divided into two groups based on whether RI was achieved (RI+) or not (RI-). There were 38 patients in the RI+ group and 29 in the RI- group. RESULTS There was a statistically significant difference between the groups in psychosomatic measures, THI, MML and TLL scores at the post-treatment 6 months after treatment (p <.05). There was a statistically significant decrease in psychosomatic measures, THI, MML and TLL scores during the treatment period in the RI+ group, but not in the RI- group. CONCLUSION RI may predict the prognosis of tinnitus treatments used in clinics to reduce the spontaneous firing rate of neurons in the central auditory system, and that RI positivity may be a predictor of treatment success in sound enrichment.
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Affiliation(s)
- Eser Sendesen
- Department of AudiologyHacettepe UniversityAnkaraTurkey
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Jørgensen ML, Hyvärinen P, Caporali S, Dau T. Effect of sound therapy on whole scalp oscillatory brain activity and distress in chronic tinnitus patients. Front Neurosci 2023; 17:1212558. [PMID: 37706157 PMCID: PMC10495592 DOI: 10.3389/fnins.2023.1212558] [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: 04/26/2023] [Accepted: 08/14/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction Sound therapy is a common tinnitus treatment, where the tinnitus percept is either fully or partially masked by an external sound. Some tinnitus patients experience a decrease in tinnitus related distress after the use of sound therapy. Differences in the neural response to sound therapy may form a basis for classifying tinnitus patients. Methods In this study, the long-term (2 months) effects of sound therapy on the oscillatory brain activity and tinnitus related distress were investigated in chronic tinnitus patients. Baseline oscillatory activity in the group of tinnitus participants was also compared to a matched control group. Results No differences were found in the oscillatory activity when comparing the tinnitus group to the control group. Differences were found for the frequency range between 27.5 and 41.5 Hz corresponding to high beta and gamma power when comparing the tinnitus group before and after the use of sound therapy. Furthermore, a reduction of the tinnitus-related distress was found after the long-term use of sound therapy. However, there was no correlation between the changes in the oscillatory activity and the reductions of the tinnitus-related distress. Discussion Overall, the lack of correlation between the changes in tinnitus-related distress and changes in power activity hampers the interpretability of the findings and undermines the utility of using oscillatory activity as a biomarker for the effect of sound therapy treatment.
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Affiliation(s)
- Mie Lærkegård Jørgensen
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- WS Audiology, Lynge, Denmark
- Copenhagen Hearing and Balance Center, Department of Oto-Rhino-Laryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Petteri Hyvärinen
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- Department of lnformation and Communications Engineering, School of Electrical Engineering, Aalto University, Espoo, Finland
| | | | - Torsten Dau
- Hearing Systems Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- Copenhagen Hearing and Balance Center, Department of Oto-Rhino-Laryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Cuevas-Romero AR, Alonso-Valerdi LM, Intriago-Campos LA, Ibarra-Zárate DI. An Electroencephalography-based Database for studying the Effects of Acoustic Therapies for Tinnitus Treatment. Sci Data 2022; 9:500. [PMID: 35977951 PMCID: PMC9385645 DOI: 10.1038/s41597-022-01622-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 07/21/2022] [Indexed: 11/08/2022] Open
Abstract
The present database provides demographic (age and sex), clinical (hearing loss and acoustic properties of tinnitus), psychometric (based on Tinnitus Handicapped Inventory and Hospital Anxiety and Depression Scale) and electroencephalographic information of 89 tinnitus sufferers who were semi-randomly treated for eight weeks with one of five acoustic therapies. These were (1) placebo (relaxing music), (2) tinnitus retraining therapy, (3) auditory discrimination therapy, (4) enriched acoustic environment, and (5) binaural beats therapy. Fourteen healthy volunteers who were exposed to relaxing music and followed the same experimental procedure as tinnitus sufferers were additionally included in the study (control group). The database is available at https://doi.org/10.17632/kj443jc4yc.1 . Acoustic therapies were monitored one week after, three weeks after, five weeks after, and eight weeks after the acoustic therapy. This study was previously approved by the local Ethical Committee (CONBIOETICA19CEI00820130520), it was registered as a clinical trial (ISRCTN14553550) in BioMed Central (Springer Nature), the protocol was published in 2016, it attracted L'Oréal-UNESCO Organization as a sponsor, and six journal publications have resulted from the analysis of this database.
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Tziridis K, Brunner S, Schilling A, Krauss P, Schulze H. Spectrally Matched Near-Threshold Noise for Subjective Tinnitus Loudness Attenuation Based on Stochastic Resonance. Front Neurosci 2022; 16:831581. [PMID: 35431789 PMCID: PMC9005796 DOI: 10.3389/fnins.2022.831581] [Citation(s) in RCA: 4] [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: 12/09/2021] [Accepted: 02/23/2022] [Indexed: 12/29/2022] Open
Abstract
Recently, we proposed a model of tinnitus development based on a physiological mechanism of permanent optimization of information transfer from the auditory periphery to the central nervous system by means of neuronal stochastic resonance utilizing neuronal noise to be added to the cochlear input, thereby improving hearing thresholds. In this view, tinnitus is a byproduct of this added neuronal activity. Interestingly, in healthy subjects auditory thresholds can also be improved by adding external, near-threshold acoustic noise. Based on these two findings and a pilot study we hypostatized that tinnitus loudness (TL) might be reduced, if the internally generated neuronal noise is substituted by externally provided individually adapted acoustic noise. In the present study, we extended the data base of the first pilot and further optimized our approach using a more fine-grained adaptation of the presented noise to the patients' audiometric data. We presented different spectrally filtered near-threshold noises (-2 dB to +6 dB HL, 2 dB steps) for 40 s each to 24 patients with tonal tinnitus and a hearing deficit not exceeding 40 dB. After each presentation, the effect of the noise on the perceived TL was obtained by patient's response to a 5-scale question. In 21 out of 24 patients (13 women) TL was successfully subjectively attenuated during acoustic near-threshold stimulation using noise spectrally centered half an octave below the individual's tinnitus pitch (TP). Six patients reported complete subjective silencing of their tinnitus percept during stimulation. Acoustic noise is able to reduce TL, but the TP has to be taken into account. Based on our findings, we speculate about a possible future treatment of tinnitus by near-threshold bandpass filtered acoustic noise stimulation, which could be implemented in hearing aids with noise generators.
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Affiliation(s)
| | | | | | | | - Holger Schulze
- Experimental Otolaryngology, University of Erlangen-Nuremberg, Erlangen, Germany
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Heading for Personalized rTMS in Tinnitus: Reliability of Individualized Stimulation Protocols in Behavioral and Electrophysiological Responses. J Pers Med 2021; 11:jpm11060536. [PMID: 34207847 PMCID: PMC8226921 DOI: 10.3390/jpm11060536] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/02/2021] [Accepted: 06/05/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation tool potentially modulating pathological brain activity. Its clinical effectiveness is hampered by varying results and characterized by inter-individual variability in treatment responses. RTMS individualization might constitute a useful strategy to overcome this variability. A precondition for this approach would be that repeatedly applied protocols result in reliable effects. The condition tinnitus provides the advantage of immediate behavioral consequences (tinnitus loudness changes) after interventions and thus offers an excellent model to exemplify TMS personalization. Objective: The aim was to investigate the test–retest reliability of short rTMS stimulations in modifying tinnitus loudness and oscillatory brain activity as well as to examine the feasibility of rTMS individualization in tinnitus. Methods: Three short verum (1, 10, 20 Hz; 200 pulses) and one sham (0.1 Hz; 20 pulses) rTMS protocol were administered on two different days in 22 tinnitus patients. Before and after each protocol, oscillatory brain activity was recorded with electroencephalography (EEG), together with behavioral tinnitus loudness ratings. RTMS individualization was executed on the basis of behavioral and electrophysiological responses. Stimulation responders were identified via consistent sham-superior increases in tinnitus loudness (behavioral responders) and alpha power increases or gamma power decreases (alpha responders/gamma responders) in accordance with the prevalent neurophysiological models for tinnitus. Results: It was feasible to identify individualized rTMS protocols featuring reliable tinnitus loudness changes (55% behavioral responder), alpha increases (91% alpha responder) and gamma decreases (100% gamma responder), respectively. Alpha responses primary occurred over parieto-occipital areas, whereas gamma responses mainly appeared over frontal regions. On the contrary, test–retest correlation analyses per protocol at a group level were not significant neither for behavioral nor for electrophysiological effects. No associations between behavioral and EEG responses were found. Conclusion: RTMS individualization via behavioral and electrophysiological data in tinnitus can be considered as a feasible approach to overcome low reliability at the group level. The present results open the discussion favoring personalization utilizing neurophysiological markers rather than behavioral responses. These insights are not only useful for the rTMS treatment of tinnitus but also for neuromodulation interventions in other pathologies, as our results suggest that the individualization of stimulation protocols is feasible despite absent group-level reliability.
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Neurophysiological correlates of residual inhibition in tinnitus: Hints for trait-like EEG power spectra. Clin Neurophysiol 2021; 132:1694-1707. [PMID: 34038848 DOI: 10.1016/j.clinph.2021.03.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate oscillatory brain activity changes following acoustic stimulation in tinnitus and whether these changes are associated with behavioral measures of tinnitus loudness. Moreover, differences in ongoing brain activity between individuals with and without residual inhibition (RI) are examined (responders vs. non-responders). METHODS Three different types of noise stimuli were administered for acoustic stimulation in 45 tinnitus patients. Subjects resting state brain activity was recorded before and after stimulation via EEG alongside with subjective measurements of tinnitus loudness. RESULTS Delta, theta and gamma band power increased, whereas alpha and beta power decreased from pre to post stimulation. Acoustic stimulation responders exhibited reduced gamma and a trend for enhanced alpha activity with the latter localized in the right inferior temporal gyrus. Post stimulation, individuals experiencing RI showed higher theta, alpha and beta power with a peak power difference in the alpha band localized in the right superior temporal gyrus. Neither correlations with behavioral tinnitus measures nor stimulus-specific changes in EEG activity were present. CONCLUSIONS Our observations might be indicative of trait-specific forms of oscillatory signatures in different subsets of the tinnitus population related to acoustic tinnitus suppression. SIGNIFICANCE Results and insights are not only useful to understand basic neural mechanisms behind RI but are also valuable for general neural models of tinnitus.
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Sanders PJ, Doborjeh ZG, Doborjeh MG, Kasabov NK, Searchfield GD. Prediction of Acoustic Residual Inhibition of Tinnitus Using a Brain-Inspired Spiking Neural Network Model. Brain Sci 2021; 11:52. [PMID: 33466500 PMCID: PMC7824871 DOI: 10.3390/brainsci11010052] [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: 12/03/2020] [Revised: 12/23/2020] [Accepted: 01/02/2021] [Indexed: 02/07/2023] Open
Abstract
Auditory Residual Inhibition (ARI) is a temporary suppression of tinnitus that occurs in some people following the presentation of masking sounds. Differences in neural response to ARI stimuli may enable classification of tinnitus and a tailored approach to intervention in the future. In an exploratory study, we investigated the use of a brain-inspired artificial neural network to examine the effects of ARI on electroencephalographic function, as well as the predictive ability of the model. Ten tinnitus patients underwent two auditory stimulation conditions (constant and amplitude modulated broadband noise) at two time points and were then characterised as responders or non-responders, based on whether they experienced ARI or not. Using a spiking neural network model, we evaluated concurrent neural patterns generated across space and time from features of electroencephalographic data, capturing the neural dynamic changes before and after stimulation. Results indicated that the model may be used to predict the effect of auditory stimulation on tinnitus on an individual basis. This approach may aid in the development of predictive models for treatment selection.
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Affiliation(s)
- Philip J. Sanders
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Zohreh G. Doborjeh
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Maryam G. Doborjeh
- Information Technology and Software Engineering Department, Auckland University of Technology, Auckland 1010, New Zealand;
| | - Nikola K. Kasabov
- School of Engineering, Computer and Mathematical Sciences, Auckland University of Technology, Auckland 1010, New Zealand;
- Intelligent Systems Research Centre, Ulster University, Derry/Londonderry BT48 7JL, UK
- Auckland Bioengineering Institute, The University of Auckland, Auckland 1010, New Zealand
| | - Grant D. Searchfield
- Section of Audiology, The University of Auckland, Auckland 1023, New Zealand; (P.J.S.); (Z.G.D.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
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Sense and Sensibility: A Review of the Behavioral Neuroscience of Tinnitus Sound Therapy and a New Typology. Curr Top Behav Neurosci 2020; 51:213-247. [PMID: 33547596 DOI: 10.1007/7854_2020_183] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Tinnitus Sound Therapy is not a single strategy. It consists of many different sound types, targeting many different mechanisms. Therapies that use sound to cover, reduce attention to, or facilitate habituation of tinnitus are among the most common tinnitus treatment paradigms. Recent history has seen a proliferation of sound therapies, but they have each been criticized for having limited empirical support. In this review, Sound Therapy's modern history will be described, and a typology will be introduced and discussed in light of current behavioral neuroscience research. It will be argued that contributing factors to the limited evidence for the efficacy of Sound Therapy are its diversity, plural modes of action, and absence of a clear typology. Despite gaps in understanding the efficacy of sound's effects on tinnitus, there is compelling evidence for its multiple, but related, neurophysiological mechanisms. Evidence suggests that sound may reduce tinnitus through its presence, context, reaction, and potentially adaptation. This review provides insights into the neurocognitive basis of these tinnitus Sound Therapy modes. It concludes that a unifying classification is needed to secure and advance arguments in favor of Sound Therapy.
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