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Lee KH, Kim MH, Kim J, Nam HJ. Acupuncture for Tinnitus: A Scoping Review of Clinical Studies. Complement Med Res 2024; 31:292-301. [PMID: 38531340 PMCID: PMC11177893 DOI: 10.1159/000538236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/05/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Acupuncture treatment for tinnitus has received attention owing to its potential as an alternative to conventional treatment modalities. We conducted a scoping review to identify detailed information on acupuncture treatment methods used in clinical studies and to provide useful information for practitioners, patients, and researchers. METHODS MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Oriental Medicine Advanced Searching Integrated System (OASIS), Korean Research Information Sharing Service (RISS), DataBase Periodical Information Academic (DBPIA), and the China National Knowledge Infrastructure (CNKI) were searched from their inception to December 2023. This review included single-arm trials, open-label randomized controlled trials (RCTs), and double-blind RCTs using needle-type acupuncture to treat tinnitus in English, Chinese, and Korean. We investigated basic and detailed information on the acupuncture treatment methods, assessment methods, and study outcomes. Network analysis was also conducted to evaluate the centrality between acupoints in the double-blind RCTs. RESULTS We included 106 articles. There were 11 single-arm trials, 90 open-label RCTs, and 5 double-blind RCTs. Most (89.6%) of these studies were conducted in China. Manual acupuncture was the most common type of acupuncture in treatment group. A total of 119 acupuncture points were used 1,138 times. The most frequently used acupoints were local points around the ear (TE17, GB2, SI19, and TE21). Both local and distant acupoints were used simultaneously in these studies. The treatment duration of 20-39 days, 10 to 19 sessions of treatment, the mean acupuncture duration of 30 min, needle diameter of 0.30 mm × 40 mm, and needling depth over 30 mm and less than 50 mm were confirmed as the most common. CONCLUSION These study outcomes will enable future acupuncture studies on tinnitus to perform more effective and standardized acupuncture treatments in selecting acupoints and procedures. Furthermore, the study has implications for informing clinicians and students about more impactful acupuncture strategies for addressing tinnitus. Hintergrund Die Anwendung von Akupunktur bei Tinnitus erhält seit einiger Zeit Aufmerksamkeit als potenzielle Alternative zu konventionellen Behandlungsmodalitäten. Wir führten einen Scoping-Review durch, um detaillierte Informationen zu den in klinischen Studien angewandten Akupunktur-Behandlungsmethoden zu sammeln und nützliche Informationen für Praktiker, Patienten und Forscher bereitzustellen. Methoden MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, Oriental Medicine Advanced Searching Integrated System (OASIS), Korean Research Information Sharing Service (RISS), DataBase Periodical Information Academic (DBPIA) und die China National Knowledge Infrastructure (CNKI) wurden von ihrem jeweiligen Beginn bis Dezember 2023 durchsucht. In diese Übersichtsarbeit wurden einarmige Studien, offene, randomisierte, kontrollierte Studien (RCTs) sowie doppelt verblindete RCTs zu Nadel-Akupunktur zur Behandlung von Tinnitus in englischer, chinesischer und koreanischer Sprache einbezogen. Wir untersuchten grundlegende und detaillierte Informationen zu den Akupunktur-Behandlungsmethoden, Untersuchungsmethoden und Studienergebnissen. Außerdem wurden Netzwerkanalysen zur Beurteilung der Zentralität zwischen Akupunkten in den doppelt verblindeten RCTs durchgeführt. Ergebnisse 106 Artikel wurden eingeschlossen. Sie behandelten 11 einarmige Studien, 90 offene RCTs und 5 doppelt verblindete RCTs. Die meisten (89,6%) dieser Studien waren in China durchgeführt worden. Manuelle Akupunktur war die häufigste Form der Akupunktur in den Behandlungsgruppen. 119 Akupunkturpunkte wurden insgesamt 1’138 Mal verwendet. Die am häufigsten verwendeten Akupunkte waren lokale Punkte im Bereich des Ohrs (TE17, GB2, SI19 und TE21). Jedoch wurden in den Studien lokale und entfernte Akupunkte gleichzeitig angewendet. Außerdem wurde festgestellt, dass die Behandlungsdauer am häufigsten 20 bis 39 Tage betrug, die Zahl der Sitzungen 10 bis 19, die mittlere Akupunkturdauer 30 Minuten, die Nadelgröße 0.30 mm × 40 mm und die Einstichtiefe zwischen 30 mm und weniger als 50 mm. Schlussfolgerung Diese Studienergebnisse bieten eine Grundlage für künftige Studien zu Akupunktur bei Tinnitus, um durch die Auswahl der Akupunkte und Verfahren wirksamere und standardisierte Akupunkturbehandlungen durchzuführen. Darüber hinaus hat die Studie Implikationen für die Aufklärung von Praktikern und Schülern über wirkungsvollere Akupunkturstrategien zur Behandlung von Tinnitus.
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Affiliation(s)
- Keun Hee Lee
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
- Kapsan Oriental Medicine Clinic, Gyeongju, Republic of Korea
| | - Min Hee Kim
- Department of Ophthalmology, Otolaryngology, and Dermatology, Kyung Hee University College of Korean Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Jaeho Kim
- Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Hae Jeong Nam
- Department of Ophthalmology, Otolaryngology, and Dermatology, Kyung Hee University College of Korean Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
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Shahin AJ, Gonzales MG, Dimitrijevic A. Cross-Modal Tinnitus Remediation: A Tentative Theoretical Framework. Brain Sci 2024; 14:95. [PMID: 38275515 PMCID: PMC10813772 DOI: 10.3390/brainsci14010095] [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: 12/23/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/27/2024] Open
Abstract
Tinnitus is a prevalent hearing-loss deficit manifested as a phantom (internally generated by the brain) sound that is heard as a high-frequency tone in the majority of afflicted persons. Chronic tinnitus is debilitating, leading to distress, sleep deprivation, anxiety, and even suicidal thoughts. It has been theorized that, in the majority of afflicted persons, tinnitus can be attributed to the loss of high-frequency input from the cochlea to the auditory cortex, known as deafferentation. Deafferentation due to hearing loss develops with aging, which progressively causes tonotopic regions coding for the lost high-frequency coding to synchronize, leading to a phantom high-frequency sound sensation. Approaches to tinnitus remediation that demonstrated promise include inhibitory drugs, the use of tinnitus-specific frequency notching to increase lateral inhibition to the deafferented neurons, and multisensory approaches (auditory-motor and audiovisual) that work by coupling multisensory stimulation to the deafferented neural populations. The goal of this review is to put forward a theoretical framework of a multisensory approach to remedy tinnitus. Our theoretical framework posits that due to vision's modulatory (inhibitory, excitatory) influence on the auditory pathway, a prolonged engagement in audiovisual activity, especially during daily discourse, as opposed to auditory-only activity/discourse, can progressively reorganize deafferented neural populations, resulting in the reduced synchrony of the deafferented neurons and a reduction in tinnitus severity over time.
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Affiliation(s)
- Antoine J. Shahin
- Department of Cognitive and Information Sciences, University of California, Merced, CA 95343, USA;
- Health Science Research Institute, University of California, Merced, CA 95343, USA
| | - Mariel G. Gonzales
- Department of Cognitive and Information Sciences, University of California, Merced, CA 95343, USA;
| | - Andrew Dimitrijevic
- Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada;
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Barros ACMPD, Lopes RV, Gil D, Carmo ACFD, Onishi ET, Branco-Barreiro FCA. Auditory training for tinnitus treatment: a scoping review. Braz J Otorhinolaryngol 2024; 90:101361. [PMID: 38006725 PMCID: PMC10709205 DOI: 10.1016/j.bjorl.2023.101361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 11/05/2023] [Indexed: 11/27/2023] Open
Abstract
OBJECTIVES Our study aimed to verify the evidence of auditory training employed in the audiological treatment of tinnitus in adults and older adults. METHODS Scoping review based on a search for articles in journals available in MEDLINE (PubMed), Embase (Elsevier), LILACS (BVS), and Cochrane Library. Titles and abstracts of the retrieved articles were assessed by peers, following the eligibility criteria; they were afterward read in full text, and the references were hand searched in the results found. Studies' level of evidence was classified into very high (Level A+), high (Level A), moderate (Level B), limited (Level C), low (Level D), or very low (Level D-) based on the Critically Appraised Topics. RESULTS 2160 records were identified in the searching stage and 15 studies were eligible for data extraction. Study design, sample characterization, auditory training tasks, sound stimuli, outcome measures, and results were extracted. Frequency discrimination training was the most frequent strategy, followed by auditory attentional skills training and multisensory training. Almost all studies with daily auditory training sessions reported significant benefits demonstrated in at least one outcome measure. Studies that used auditory discrimination training and attentional auditory skill stimulation to treat tinnitus obtained quality evidence levels ranging from limited to high (C‒A) and studies that applied multisensory training or attentional training combined with counseling and passive listening in tinnitus patients reached a high-quality evidence level (A). CONCLUSION Recent studies had higher levels of evidence and considered attentional factors and multisensory pathways in auditory training strategies.
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Affiliation(s)
| | - Rhayane Vitória Lopes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fonoaudiologia, São Paulo, SP, Brazil
| | - Daniela Gil
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Departamento de Fonoaudiologia, São Paulo, SP, Brazil
| | | | - Ektor Tsuneo Onishi
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina, Clínica de Zumbido - Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil.
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Hsiao CJ, Galazyuk AV. Depolarization shift in the resting membrane potential of inferior colliculus neurons explains their hyperactivity induced by an acoustic trauma. Front Neurosci 2023; 17:1258349. [PMID: 37732309 PMCID: PMC10508343 DOI: 10.3389/fnins.2023.1258349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Neuronal hyperactivity has been associated with many brain diseases. In the auditory system, hyperactivity has been linked to hyperacusis and tinnitus. Previous research demonstrated the development of hyperactivity in inferior colliculus (IC) neurons after sound overexposure, but the underlying mechanism of this hyperactivity remains unclear. The main goal of this study was to determine the mechanism of this hyperactivity. Methods Experiments were performed on CBA/CaJ mice in a restrained, unanesthetized condition using intracellular recordings with sharp microelectrodes. Recordings were obtained from control (unexposed) and unilaterally sound overexposed groups of mice. Results Our data suggest that sound exposure-induced hyperactivity was due to a depolarizing shift of the resting membrane potential (RMP) in the hyperactive neurons. The half width of action potentials in these neurons was also decreased after sound exposure. Surprisingly, we also found an RMP gradient in which neurons have more hyperpolarized RMPs with increasing depth in the IC. This gradient was altered in the overexposed animals.
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Affiliation(s)
| | - Alexander V. Galazyuk
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, United States
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Chen YJ, Hsu AY, Lin CJ, Hsia NY, Meng PP, Liao PL, Hsu MY, Tien PT, Lai CT, Chen HS, Chiang CC, Tsai YY. Tinnitus as a Potential Risk Factor for Uveitis: A 14-Year Nationwide Population-Based Cohort Study in Taiwan. Ocul Immunol Inflamm 2023:1-7. [PMID: 37437268 DOI: 10.1080/09273948.2023.2232444] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/15/2023] [Accepted: 06/28/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Tinnitus and uveitis have shared commonality in pathophysiology in terms of autoimmunity. However, no studies that have linked any association between the conditions of tinnitus and uveitis. METHODS This is a retrospective study conducted from the Taiwan National Health Insurance database in order to investigate whether tinnitus patients are at increased risk of uveitis. Patients newly diagnosed with tinnitus between 2001 and 2014 were recruited and followed up until 2018. The endpoint of interest was a diagnosis of uveitis. RESULTS A total of 31,034 tinnitus patients and 124,136 matched comparisons were analyzed. Tinnitus patients were found to have a significantly higher cumulative incidence for uveitis than those without the diagnosis of tinnitus with incidence rate of 1.68 (95% CI 1.55-1.82) per 10 000 person-months for tinnitus group and 1.48 (95% CI 1.42-1.54) per 10 000 person-months for non-tinnitus group. CONCLUSION Tinnitus patients were found to have increased risk of developing uveitis.
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Affiliation(s)
- Yi-Jye Chen
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Alan Y Hsu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of General Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Ju Lin
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Ning-Yi Hsia
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ping-Ping Meng
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Pei-Lun Liao
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Min-Yen Hsu
- Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Peng-Tai Tien
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chun-Ting Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Huan-Sheng Chen
- An-Shin Dialysis Center, NephroCare Ltd., Fresenius Medical Care, Taichung, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Optometry, Asia University, Taichung, Taiwan
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Tang D, Wang J, Yu X, Yu H. The clinical effects of modified tinnitus relieving sound (MTRS) for chronic tinnitus: protocol for a randomized controlled trial. Trials 2023; 24:372. [PMID: 37268971 DOI: 10.1186/s13063-023-07389-8] [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: 12/16/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
INTRODUCTION Chronic subjective tinnitus has become an increasingly serious hazard that affects the health-related quality of life for millions of people. Due to the lack of curative treatment strategies, this study aims to introduce a novel acoustic therapy named the modified tinnitus relieving sound (MTRS) for tinnitus and to evaluate the efficacy of MTRS in comparison with unmodified music (UM) which served as a control. METHODS AND ANALYSIS A randomized, double-blinded, controlled, clinical trial will be carried out. Sixty-eight patients with subjective tinnitus will be recruited and randomly allocated into two groups in 1:1 ratio. The primary outcome is Tinnitus Handicapped Inventory (THI); the secondary outcomes are the Hospital Anxiety and Distress Scale (HADS; HADS subscales for Anxiety (HADS-A) and Depression (HADS-D)), Athens Insomnia Scale (AIS), the visual analog scale (VAS) for tinnitus, and tinnitus loudness matched by sensation level (SL). Assessment will be performed at baseline and at 1, 3, 9, and 12 months post-randomization. The sound stimulus will be persistent until 9 months after randomization, and be interdictory in the last three months. Data collected during the intervention process will be analyzed and compared to baseline. ETHICS AND DISSEMINATION This trial received ethical approval from the Institutional Review Board (IRB) of Eye & ENT Hospital of Fudan University (No. 2017048). The study results will be disseminated via academic journals and conferences. FUNDING This study is supported by the Shanghai Shenkang Development Program (SHDC12019119), the Excellent Doctors-Excellent Clinical Researchers Program (SYB202008), the Shanghai Rising-Star Program (23QC1401200), the Shanghai Rising Stars of Medical Talent Youth Development Program (2021-99), the National Natural Science Foundation of China (81800912), and the National Natural Science Foundation of Shanghai (21ZR1411800). TRIAL REGISTRATION ClinicalTrials.gov NCT04026932. Registered on 18 July 2019.
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Affiliation(s)
- Dongmei Tang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, People's Republic of China.
| | - Jinghan Wang
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, People's Republic of China
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, People's Republic of China
| | - Xiaopei Yu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, People's Republic of China
| | - Huiqian Yu
- ENT Institute and Otorhinolaryngology Department of Eye & ENT Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Fudan University, Shanghai, 200031, People's Republic of China.
- NHC Key Laboratory of Hearing Medicine, Fudan University, Shanghai, 200031, People's Republic of China.
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A clinical trial of a patient-customized virtual reality intervention for tinnitus. Sci Rep 2022; 12:12441. [PMID: 35859044 PMCID: PMC9300604 DOI: 10.1038/s41598-022-16764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 07/14/2022] [Indexed: 11/14/2022] Open
Abstract
Virtual reality (VR) has recently been used as a clinical treatment because it can efficiently simulate situations that are difficult to control in real-world settings. In our study, we assessed the potential of VR in patients with chronic subjective tinnitus. An evaluation of its clinical benefits was performed based on analyses of patient electroencephalograms (EEGs) and by questionnaire responses after 6–8 weeks of patient involvement in our VR-based alleviation program. Clinical trials were performed at a tertiary academic hospital. Nineteen patients (aged 33–64 years) who visited our hospital with chronic subjective tinnitus over 3 months were enrolled in the study. The intervention consisted of trashing the tinnitus avatar in VR. We expected that the patients would have the subjective feeling of controlling tinnitus through our intervention. The VR environment comprised four different sessions in four different settings: a bedroom, a living room, a restaurant, and a city street. We analyzed changes in the source activities of the prefrontal regions related to tinnitus in these patients using standardized low-resolution brain electromagnetic tomography. The Tinnitus Handicap Inventory (THI), the total score (from 50.11 to 44.21, P = 0.046) and the grade (from 3.16 to 2.79, P = 0.035) were significantly improved after the VR-based tinnitus treatment program (P < 0.05). The Pittsburgh Sleep Quality Index also showed improved outcomes (P = 0.025). On the other hand, a Tinnitus Handicap Questionnaire, Quality of Life Assessment (WHO-QOL), Hospital Anxiety and Depression Scale, Profile of Mood States revealed no significant change after the intervention. The baseline EEG data showed that brain activity in the orbitofrontal cortex significantly increased in the alpha and theta frequency bands. Furthermore, patients who showed a THI score improvement after the intervention showed specific increases in brain activity for the theta and high beta bands in the orbitofrontal cortex. Our findings suggest that the virtual reality-based program, as in parts of cognitive behavioral treatment, may help to alleviate tinnitus-related distress in patients with chronic subjective tinnitus.
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Clifford RE, Ryan AF. The Interrelationship of Tinnitus and Hearing Loss Secondary to Age, Noise Exposure, and Traumatic Brain Injury. Ear Hear 2022; 43:1114-1124. [PMID: 35612496 PMCID: PMC11193335 DOI: 10.1097/aud.0000000000001222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Tinnitus has been the No. 1 disability at the Veteran Administration for the last 15 years, yet its interaction with hearing loss secondary to etiologies such as age, noise trauma, and traumatic brain injuries remains poorly characterized. Our objective was to analyze hearing loss and tinnitus, including audiogram data, of the Million Veteran Program within the context of military exposures in an aging population. DESIGN Health records, questionnaires, audiograms, and military data were aggregated for 758,005 Veteran participants in the Million Veteran Program 2011 to 2020, with relative risks (RR) calculated for ancestries, sex, hearing loss and military exposures such as combat, blast, and military era served. A multivariate model with significant demographic measures and exposures was then analyzed. Next, audiogram data stratified by sex were compared for those with and without tinnitus by two methods: first, mean thresholds at standard frequencies were compared to thresholds adjusted per ISO 7029:2000E age and sex formulae. Second, levels for those ≤40 years of age were compared with those 41 and older. Finally, a proportional hazards model was examined to ascertain the timing between the onset of tinnitus and hearing loss, calculated separately for electronic health record diagnoses (ICD) and self-report. RESULTS Tinnitus was either self-reported, diagnosed, or both in 37.5% (95% CI, 37.4 to 37.6), mean age 61.5 (95% CI, 61.4 to 61.5), range 18 to 112 years. Those with hearing loss were 4.15 times (95% CI, 4.12 to 4.15) as likely to have tinnitus. Americans of African descent were less likely to manifest tinnitus (RR 0.61, 95% CI, 0.60 to 0.61), as were women (RR 0.65, 95% CI, 0.64 to 0.65). A multivariate model indicated a higher RR of 1.73 for traumatic brain injury (95% CI, 1.71 to 1.73) and daily combat noise exposure (1.17, 95% CI, 1.14 to 1.17) than age (0.998, 95% CI, 0.997 to 0.998). Subjects ≤40 years of age had small but significantly elevated hearing thresholds through all standard frequencies compared to Veterans without tinnitus, and the effect of tinnitus on hearing thresholds diminished with age. In the hazard model, those >40 with new onset of tinnitus were at risk for hearing loss sooner and with greater incidence than those who were younger. The rate of hearing loss following tinnitus approached 100%. In contrast, only approximately 50% of those who self-reported hearing loss initially were at risk for later hearing loss, in contrast to ICD comparison, where those with ICD of hearing loss were more likely to sustain an ICD of tinnitus subsequently. CONCLUSIONS Evidence suggests that the occurrence of tinnitus in the military is more closely related to environmental exposures than to aging. The finding that tinnitus affects hearing frequencies across the audiogram spectrum suggests an acoustic injury independent of tonotopicity. Particularly for males >40, tinnitus may be a harbinger of audiologic damage predictive of later hearing loss.
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Affiliation(s)
- Royce Ellen Clifford
- Research Department, VA Healthcare San Diego, La Jolla, CA
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California San Diego School of Medicine, La Jolla, CA
- Visiting Scientist, Harvard University School of Public Health, Boston, MA
| | - Allen F. Ryan
- Research Department, VA Healthcare San Diego, La Jolla, CA
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of California San Diego School of Medicine, La Jolla, CA
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Vasudevan H, Ganapathy K, Palaniswamy HP, Searchfield G, Rajashekhar B. Systematic review and meta-analysis on the effect of continuous subjective tinnitus on attention and habituation. PeerJ 2021; 9:e12340. [PMID: 34900408 PMCID: PMC8628620 DOI: 10.7717/peerj.12340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Attention and habituation are two domains known to play key roles in the perception and maintenance of tinnitus. The heterogeneous nature of tinnitus and the methodologies adopted by various studies make it difficult to generalize findings. The current review aims at assessing and synthesizing evidence on the possible roles of attention and habituation in continuous subjective tinnitus. Methodology The literature search included five databases (PubMed, Scopus, Web of Sciences, CINAHL and ProQuest) that resulted in 1,293 articles, published by July 2019. Studies on attention and/or habituation in individuals with tinnitus using either behavioural or electrophysiological tests were included in the review after a quality assessment. Results Seventeen studies on attention in tinnitus were included in the narrative synthesis. Two meta-analyses were performed to assess the role of attention in tinnitus using a behavioural methodology (z = 4.06; p < 0.0001) and P300 amplitude (z = 2.70; p = 0.007) with 531 participants. With respect to habituation, the review indicates the lack of quality articles for habituation inclusion in the narrative synthesis. Conclusions The review highlights that selective domains of attention were consistently impaired in individuals with tinnitus. Habituation, on the other hand, needs further exploration.
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Affiliation(s)
- Harini Vasudevan
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Kanaka Ganapathy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Grant Searchfield
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
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Hsiao CJ, Galazyuk AV. Effect of Unilateral Acoustic Trauma on Neuronal Firing Activity in the Inferior Colliculus of Mice. Front Synaptic Neurosci 2021; 13:684141. [PMID: 34239435 PMCID: PMC8258394 DOI: 10.3389/fnsyn.2021.684141] [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: 03/22/2021] [Accepted: 05/18/2021] [Indexed: 12/01/2022] Open
Abstract
Neural hyperactivity induced by sound exposure often correlates with the development of hyperacusis and/or tinnitus. In laboratory animals, hyperactivity is typically induced by unilateral sound exposure to preserve one ear for further testing of hearing performance. Most ascending fibers in the auditory system cross into the superior olivary complex and then ascend contralaterally. Therefore, unilateral exposure should be expected to mostly affect the contralateral side above the auditory brain stem. On the other hand, it is well known that a significant number of neurons have crossing fibers at every level of the auditory pathway, which may spread the effect of unilateral exposure onto the ipsilateral side. Here we demonstrate that unilateral sound exposure causes development of hyperactivity in both the contra and ipsilateral inferior colliculus in mice. We found that both the spontaneous firing rate and bursting activity were increased significantly compared to unexposed mice. The neurons with characteristic frequencies at or above the center frequency of exposure showed the greatest increase. Surprisingly, this increase was more pronounced in the ipsilateral inferior colliculus. This study highlights the importance of considering both ipsi- and contralateral effects in future studies utilizing unilateral sound exposure.
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Affiliation(s)
- Chun-Jen Hsiao
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, United States
| | - Alexander V Galazyuk
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, OH, United States
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Zimmerman BJ, Schmidt SA, Khan RA, Tai Y, Shahsavarani S, Husain FT. Decreased resting perfusion in precuneus and posterior cingulate cortex predicts tinnitus severity. CURRENT RESEARCH IN NEUROBIOLOGY 2021; 2:100010. [PMID: 36246506 PMCID: PMC9559103 DOI: 10.1016/j.crneur.2021.100010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/23/2021] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
Functional magnetic resonance imaging has been increasingly used to understand the mechanisms involved in subjective tinnitus; however, researchers have struggled to reach a consensus about a primary mechanistic model to explain tinnitus. While many studies have used functional connectivity of the BOLD signal to understand how patterns of activity change with tinnitus severity, there is much less research on whether there are differences in more fundamental physiology, including cerebral blood flow, which may help inform the BOLD measures. Here, arterial spin labeling was used to measure perfusion in four regions-of-interest, guided by current models of tinnitus, in a sample of 60 tinnitus patients and 31 control subjects. We found global reductions in cerebral perfusion in tinnitus compared with controls. Additionally, we observed a significant negative correlation between tinnitus severity and perfusion. These results demonstrate that examining perfusion from the whole brain may present a complementary tool for studying tinnitus. More research will help better understand the physiology underlying these differences in perfusion. Global cerebral blood flow is reduced in tinnitus. Tinnitus severity is negatively correlated with cerebral blood flow globally. Tinnitus severity is negatively correlated with cerebral blood flow in the precuneus and posterior cingulate cortex. Hearing loss predicted reduced cerebral blood flow in the precuneus in participants without tinnitus. The presence or absence of hearing loss did not affect the correlation between tinnitus severity and cerebral blood flow.
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Affiliation(s)
- Benjamin J. Zimmerman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sara A. Schmidt
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rafay A. Khan
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
| | - Somayeh Shahsavarani
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Institute for Mind Brain and Behavior, Columbia University, New York, NY, USA
| | - Fatima T. Husain
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Corresponding author. Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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Efficacy of caloric vestibular stimulation for the treatment of idiopathic tinnitus. JOURNAL OF SURGERY AND MEDICINE 2020. [DOI: 10.28982/josam.809898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bakhla AK, Dayal M, Bala R, Toppo A. Auditory sensation with affective agnosia: A prevalence of alexithymia among tinnitus patients. Ind Psychiatry J 2020; 29:149-154. [PMID: 33776288 PMCID: PMC7989460 DOI: 10.4103/ipj.ipj_40_18] [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: 09/28/2018] [Revised: 04/26/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The aim of the present study was to determine the prevalence and association of alexithymia, depression, and anxiety in patients affected by tinnitus. METHODS The study was conducted among the patients referred for audiometric evaluation for tinnitus. They were further evaluated with the Hospital Anxiety and Depression Scale, the Tinnitus Handicap Inventory, and the Toronto Alexithymia Scale. Analysis was done for prevalence and the sample was categorized as high and low tinnitus handicap subgroups, and mean scores of alexithymia, anxiety, and depression were compared. RESULTS A total of 70 patients (55.7% - male and 44.3% - female) with a mean age of 33.17 ± 12.24 years were finally analyzed. The severity of tinnitus was most severe (34.3%), followed by moderate (20%), catastrophic (18.6%), mild (17.1%), and slight (10%). The prevalence of alexithymia, anxiety, and depression among patients of tinnitus was found to be 65.7%, 37.1%, and 20%, respectively. The high tinnitus handicap group showed higher scoring on total alexithymia score, anxiety, and depression and higher scoring with describing emotion and identification of emotion, but there was no difference for the subscale of externally oriented thinking. CONCLUSIONS The study found a prevalence of alexithymia, anxiety, and depression as 65.7%, 37.1%, and 20%, respectively, among patients of tinnitus, and problem of describing and identification of emotion are associated with higher tinnitus handicap.
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Affiliation(s)
- Ajay Kumar Bakhla
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Meenakshi Dayal
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Rajni Bala
- Department of Psychiatry, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
| | - Ashit Toppo
- Department of ENT, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India
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Xu JJ, Cui J, Feng Y, Yong W, Chen H, Chen YC, Yin X, Wu Y. Chronic Tinnitus Exhibits Bidirectional Functional Dysconnectivity in Frontostriatal Circuit. Front Neurosci 2019; 13:1299. [PMID: 31866810 PMCID: PMC6909243 DOI: 10.3389/fnins.2019.01299] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/20/2019] [Indexed: 12/28/2022] Open
Abstract
Purpose The phantom sound of tinnitus is considered to be associated with abnormal functional coupling between the nucleus accumbens (NAc) and the prefrontal cortex, which may form a frontostriatal top-down gating system to evaluate and modulate sensory signals. Resting-state functional magnetic resonance imaging (fMRI) was used to recognize the aberrant directional connectivity of the NAc in chronic tinnitus and to ascertain the relationship between this connectivity and tinnitus characteristics. Methods Participants included chronic tinnitus patients (n = 50) and healthy controls (n = 55), matched for age, sex, education, and hearing thresholds. The hearing status of both groups was comparable. On the basis of the NAc as a seed region, a Granger causality analysis (GCA) study was conducted to investigate the directional connectivity and the relationship with tinnitus duration or distress. Results Compared with healthy controls, tinnitus patients exhibited abnormal directional connectivity between the NAc and the prefrontal cortex, principally the middle frontal gyrus (MFG), orbitofrontal cortex (OFC), and inferior frontal gyrus (IFG). Additionally, positive correlations between tinnitus handicap questionnaire (THQ) scores and increased directional connectivity from the right NAc to the left MFG (r = 0.357, p = 0.015) and from the right MFG to the left NAc (r = 0.626, p < 0.001) were observed. Furthermore, the enhanced directional connectivity from the right NAc to the right OFC was positively associated with the duration of tinnitus (r = 0.599, p < 0.001). Conclusion In concurrence with expectations, tinnitus distress was correlated with enhanced directional connectivity between the NAc and the prefrontal cortex. The current study not only helps illuminate the neural basis of the frontostriatal gating control of tinnitus sensation but also contributes to deciphering the neuropathological features of tinnitus.
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Affiliation(s)
- Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jinluan Cui
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Feng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Wei Yong
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuanqing Wu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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15
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Maladaptive alterations of resting state cortical network in Tinnitus: A directed functional connectivity analysis of a larger MEG data set. Sci Rep 2019; 9:15452. [PMID: 31664058 PMCID: PMC6820754 DOI: 10.1038/s41598-019-51747-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/02/2019] [Indexed: 12/29/2022] Open
Abstract
The present study used resting state MEG whole-head recordings to identify how chronic tonal tinnitus relates to altered functional connectivity of brain's intrinsic cortical networks. Resting state MEG activity of 40 chronic tinnitus patients and 40 matched human controls was compared identifying significant alterations in intrinsic networks of the tinnitus population. Directed functional connectivity of the resting brain, at a whole cortex level, was estimated by means of a statistical comparison of the estimated phase Transfer Entropy (pTE) between the time-series of cortical activations, as reconstructed by LORETA. As pTE identifies the direction of the information flow, a detailed analysis of the connectivity differences between tinnitus patients and controls was possible. Results indicate that the group of tinnitus patients show increased connectivity from right dorsal prefrontal to right medial temporal areas. Our results go beyond previous findings by indicating that the role of the left para-hippocampal area is dictated by a modulation from dmPFC; a region that is part of the dorsal attention network (DAN), as well as implicated in the regulation of emotional processing. Additionally, this whole cortex analysis showed a crucial role of the left inferior parietal cortex, which modulated the activity of the right superior temporal gyrus, providing new hypotheses for the role of this area within the context of current tinnitus models. Overall, these maladaptive alterations of the structure of intrinsic cortical networks show a decrease in efficiency and small worldness of the resting state network of tinnitus patients, which is correlated to tinnitus distress.
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Galazyuk A, Longenecker R, Voytenko S, Kristaponyte I, Nelson G. Residual inhibition: From the putative mechanisms to potential tinnitus treatment. Hear Res 2019; 375:1-13. [DOI: 10.1016/j.heares.2019.01.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 01/23/2019] [Accepted: 01/30/2019] [Indexed: 01/04/2023]
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Möhrle D, Hofmeier B, Amend M, Wolpert S, Ni K, Bing D, Klose U, Pichler B, Knipper M, Rüttiger L. Enhanced Central Neural Gain Compensates Acoustic Trauma-induced Cochlear Impairment, but Unlikely Correlates with Tinnitus and Hyperacusis. Neuroscience 2018; 407:146-169. [PMID: 30599268 DOI: 10.1016/j.neuroscience.2018.12.038] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 12/18/2018] [Accepted: 12/20/2018] [Indexed: 01/09/2023]
Abstract
For successful future therapeutic strategies for tinnitus and hyperacusis, a subcategorization of both conditions on the basis of differentiated neural correlates would be of invaluable advantage. In the present study, we used our refined operant conditioning animal model to divide equally noise-exposed rats into groups with either tinnitus or hyperacusis, with neither condition, or with both conditions co-occurring simultaneously. Using click stimulus and noise burst-evoked Auditory Brainstem Responses (ABR) and Distortion Product Otoacoustic Emissions, no hearing threshold difference was observed between any of the groups. However, animals with neither tinnitus nor hyperacusis responded to noise trauma with shortened ABR wave I and IV latencies and elevated central neuronal gain (increased ABR wave IV/I amplitude ratio), which was previously assumed in most of the literature to be a neural correlate for tinnitus. In contrast, animals with tinnitus had reduced neural response gain and delayed ABR wave I and IV latencies, while animals with hyperacusis showed none of these changes. Preliminary studies, aimed at establishing comparable non-invasive objective tools for identifying tinnitus in humans and animals, confirmed reduced central gain and delayed response latency in human and animals. Moreover, the first ever resting state functional Magnetic Resonance Imaging (rs-fMRI) analyses comparing humans and rats with and without tinnitus showed reduced rs-fMRI activities in the auditory cortex in both patients and animals with tinnitus. These findings encourage further efforts to establish non-invasive diagnostic tools that can be used in humans and animals alike and give hope for differentiated classification of tinnitus and hyperacusis.
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Affiliation(s)
- Dorit Möhrle
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
| | - Benedikt Hofmeier
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
| | - Mario Amend
- University of Tübingen, Department of Preclinical Imaging and Radiopharmacy, University Hospital Tübingen, Röntgenweg 13, 72076 Tübingen, Germany.
| | - Stephan Wolpert
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
| | - Kun Ni
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany; Shanghai Jiao Tong University, Department of Otolaryngology, Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Luding Road, NO. 355. Putuo District, 200062 Shanghai, China.
| | - Dan Bing
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
| | - Uwe Klose
- University Hospital Tübingen, Department of Diagnostic and Interventional Neuroradiology, Hoppe-Seyler-Str. 3, 72076 Tübingen, Germany.
| | - Bernd Pichler
- University of Tübingen, Department of Preclinical Imaging and Radiopharmacy, University Hospital Tübingen, Röntgenweg 13, 72076 Tübingen, Germany.
| | - Marlies Knipper
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
| | - Lukas Rüttiger
- University of Tübingen, Department of Otolaryngology, Head & Neck Surgery, Tübingen Hearing Research Centre (THRC), Molecular Physiology of Hearing, Elfriede-Aulhorn-Straße 5, 72076 Tübingen, Germany.
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18
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Fan X, Chen Y, Li L, Wang Y, Zhang Y, Lu S, Zhu D, Sheng M. Efficacy of Chinese herb Cistanche Yishen granules in treatment of tinnitus for patients with chronic nephritis. J Cell Biochem 2018; 120:5505-5509. [PMID: 30474893 DOI: 10.1002/jcb.27833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 09/14/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of Chinese herb Cistanche Yishen granules (CYG) in the treatment of tinnitus for patients with chronic nephritis. METHODS A total of 89 adult patients were diagnosed with chronic glomerulonephritis from January 2016 to December 2017. All the patients were randomly divided into two groups, such as the control group and the CYG group. The efficacy of tinnitus was determined using tinnitus handicap inventory (THI), Pittsburgh sleep quality index (PSQI), pure tone audiometry (PTA), speech reception threshold (SRT), and visual analog scale (VAS) for tinnitus loudness and annoyance. RESULTS In both these two groups of patients, values of THI, PSQI, PTA, SRT, and VAS for tinnitus loudness and annoyance were significantly decreased after the treatment compared with those before treatment. However, all values in CYG group after the treatment were significantly lower than those in the control group. CONCLUSION CYG could apparently release the tinnitus symptoms in the patients with chronic nephritis. This study might give more clinical evidence for Cistanche in the treatment of tinnitus and give a new treatment method for the patients with tinnitus.
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Affiliation(s)
- Xiaoli Fan
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Chen
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Li Li
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Wang
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Lu
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Danyang Zhu
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Meixiao Sheng
- Department of Nephrology, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Rammo R, Ali R, Pabaney A, Seidman M, Schwalb J. Surgical Neuromodulation of Tinnitus: A Review of Current Therapies and Future Applications. Neuromodulation 2018; 22:380-387. [DOI: 10.1111/ner.12793] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/16/2018] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Richard Rammo
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
| | - Rushna Ali
- Department of Neurological SurgeryVanderbilt UniversityNashville TN USA
| | - Aqueel Pabaney
- Department of Neurosurgery, Grandview Medical CenterKettering Health NetworkDayton OH USA
| | - Michael Seidman
- Department of OtolaryngologyFlorida Hospital Celebration HealthCelebration FL USA
| | - Jason Schwalb
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
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20
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Impact of Tinnitus on Cognitive Function in Forensic Neuropsychology Context. PSYCHOLOGICAL INJURY & LAW 2018. [DOI: 10.1007/s12207-018-9321-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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21
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Chen JC, Koo M, Hwang JH. Tinnitus Is Associated with a Higher Risk of Benign Brain Tumors: A Nationwide, Population-Based Secondary Cohort Study of Young and Middle-Aged Adults. Neuroepidemiology 2017; 49:174-178. [PMID: 29190632 DOI: 10.1159/000481991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 10/01/2017] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND It remains unclear whether tinnitus is associated with a higher risk of benign or malignant brain tumors in humans. Therefore, the aim of this secondary study was to investigate the risk of brain tumors in adult with tinnitus using data from a nationwide health claims research database. METHODS Patients aged 20-50 years who were newly diagnosed with tinnitus were identified from the Taiwan's National Health Insurance Research Database and they served as the study cohort. A comparison cohort was formed by using patients without tinnitus from the same database with frequency matching (4: 1) by 10-year age interval and gender to the patients in the tinnitus cohort. Cox proportional hazards models were used to calculate the adjusted hazard ratios (AHR) for benign and malignant brain tumors in patients with tinnitus, adjusting for age, gender, and comorbidities. RESULTS There were 15,819 patients in the tinnitus cohort and 63,276 in the comparison cohort. A significantly higher proportion of patients with tinnitus had benign brain tumor (p = 0.003) and all 11 comorbid conditions (p < 0.001) compared to those without tinnitus. Cox proportional hazards regression analysis performed on the basis of age, gender, and the 11 comorbidities revealed that tinnitus was independently associated with a higher risk for benign brain tumor (AHR 1.65, 95% CI 1.24-2.20, p = 0.001) and but not with malignant brain tumors (AHR 1.66, 95% CI 0.93-2.94, p = 0.085). CONCLUSIONS Findings from this secondary cohort analysis indicated that tinnitus is associated with a higher risk of benign brain tumors.
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Affiliation(s)
- Jin-Cherng Chen
- Department of Neurosurgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Malcolm Koo
- Department of Medical Research, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Juen-Haur Hwang
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Otolaryngology, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
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22
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Shih CP, Lin HC, Chung CH, Hsiao PJ, Wang CH, Lee JC, Chien WC. Increased risk of tinnitus in patients with chronic kidney disease: A nationwide, population-based cohort study. PLoS One 2017; 12:e0183192. [PMID: 28813508 PMCID: PMC5557597 DOI: 10.1371/journal.pone.0183192] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/31/2017] [Indexed: 12/27/2022] Open
Abstract
Tinnitus mostly results from central and peripheral auditory pathology. Chronic kidney disease (CKD) is a major risk factor for cerebrovascular disease. However, no studies have evaluated the association between tinnitus and CKD. The aim of this study is to investigate the risk of tinnitus in patients with CKD. This retrospective cohort study was conducted using Taiwan National Health Insurance Research Database from 2000 to 2010. We established a CKD group (n = 185,430) and a non-CKD comparison group (n = 556,290) to investigate the incidence of tinnitus. Cox proportional hazard regression analysis was used to evaluate the effects of CKD on tinnitus risk. The results showed CKD significantly increased the risk of tinnitus (adjusted hazard ratio, 3.02; 95% CI, 2.655-3.456, P<0.001). A subgroup analysis revealed the increase in risk of tinnitus is more in CKD patients with heart failure (adjusted hazard ratio, 9.975; 95% CI, 5.001-18.752) and diabetes mellitus (adjusted hazard ratio, 3.712; 95% CI, 2.856-5.007). Furthermore, compared to non-CKD patients, the risk of tinnitus was increased 4.586-fold (95% CI, 2.399-6.7) in CKD patients with dialysis and 2.461-fold (95% CI, 1.033-3.454) in CKD patients without dialysis. This study is the first to report that CKD is associated with an increased risk of tinnitus. Among CKD cohort, patients with dialysis are at a higher risk of tinnitus than those without dialysis.
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Affiliation(s)
- Cheng-Ping Shih
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC
| | - Po-Jen Hsiao
- Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
- Division of Nephrology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan City, Taiwan, ROC
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jih-Chin Lee
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC
- Department of Medical Research, Tri-Service General Hospital, Taipei, Taiwan, ROC
- * E-mail:
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Ivansic D, Dobel C, Volk GF, Reinhardt D, Müller B, Smolenski UC, Guntinas-Lichius O. Results of an Interdisciplinary Day Care Approach for Chronic Tinnitus Treatment: A Prospective Study Introducing the Jena Interdisciplinary Treatment for Tinnitus. Front Aging Neurosci 2017; 9:192. [PMID: 28670275 PMCID: PMC5472663 DOI: 10.3389/fnagi.2017.00192] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 05/29/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: Considering the heterogeneity of the symptoms shown by patients suffering from chronic tinnitus, there are surprisingly few interdisciplinary treatments available, and mostly available only for inpatients. In order to provide an interdisciplinary treatment, we developed a day care concept in which each patient was treated by an ENT doctor, a cognitive behavioral therapist, a specialist for medical rehabilitation and an audiologist (Jena Interdisciplinary Treatment for Tinnitus, JITT). The aim of this study was to observe the changes of tinnitus related distress due to interdisciplinary day care treatment and to determine which factors mediate this change. Subjects and Methods: Tinnitus annoyance was measured using the Tinnitus Questionnaire on 308 patients with chronic tinnitus. They were treated in the day care unit over five consecutive days between July 2013 and December 2014. Data were collected before treatment when screened (T0), at the beginning (T1) and at the end of the 5 day treatment (T2), as well as 20 days (T3) and 6 months after treatment (T4). Results: Overall, tinnitus annoyance improved significantly from the screening day to the beginning of treatment, and to a much larger degree from the beginning to the end of treatment. The treatment outcome remained stable 6 months after treatment. Patients with the following symptoms displayed higher tinnitus annoyance at T0: dizziness at tinnitus onset, tinnitus sound could not be masked with background noise, tinnitus worsening during physical stress, comorbid psychiatric diagnosis, higher age and higher hearing loss. Loudness of tinnitus perceived in the right ear correlated with tinnitus annoyance significantly. Demographic, tinnitus and strain variables could only explain 12.8% of the variance of the change in tinnitus annoyance from T0 to T4. Out of 39 predictors, the only significant ones were “sick leave 6 months before treatment” and “tinnitus annoyance at T0.” Conclusion: The newly developed JITT represents a valuable treatment for chronic tinnitus patients with improvement remaining stable for at least 6 months after treatment. Using a large number of variables did not allow predicting treatment outcome which underlines the heterogeneity of tinnitus.
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Affiliation(s)
- Daniela Ivansic
- Tinnitus-Centre, Department of Otorhinolaryngology, Jena University HospitalJena, Germany
| | - Christian Dobel
- Tinnitus-Centre, Department of Otorhinolaryngology, Jena University HospitalJena, Germany
| | - Gerd F Volk
- Tinnitus-Centre, Department of Otorhinolaryngology, Jena University HospitalJena, Germany
| | - Daniel Reinhardt
- Tinnitus-Centre, Department of Otorhinolaryngology, Jena University HospitalJena, Germany
| | - Boris Müller
- Tinnitus-Centre, Department of Otorhinolaryngology, Jena University HospitalJena, Germany
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Galazyuk AV, Voytenko SV, Longenecker RJ. Long-Lasting forward Suppression of Spontaneous Firing in Auditory Neurons: Implication to the Residual Inhibition of Tinnitus. J Assoc Res Otolaryngol 2017; 18:343-353. [PMID: 27832500 PMCID: PMC5352609 DOI: 10.1007/s10162-016-0601-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022] Open
Abstract
Tinnitus is the perception of a sound that has no external source. Sound stimuli can suppress spontaneous firing in auditory neurons long after stimulus offset. It is unknown how changes in sound stimulus parameters affect this forward suppression. Using in vivo extracellular recording in awake mice, we found that about 40 % of spontaneously active inferior colliculus (IC) neurons exhibited forward suppression of spontaneous activity after sound offset. The duration of this suppression increased with sound duration and lasted about 40 s following a 30-s stimulus offset. Pure tones presented at the neuron's characteristic frequency (CF) were more effective in triggering suppression compared to non-CF or wideband noise stimuli. In contrast, non-CF stimuli often induced forward facilitation. About one third of IC neurons exhibited shorter suppression durations with each subsequent sound presentation. These characteristics of forward suppression are similar to the psychoacoustic properties of residual inhibition of tinnitus: a phenomenon of brief (about 30 s) suppression of tinnitus observed in tinnitus patients after sound presentations. Because elevated spontaneous firing in central auditory neurons has been linked to tinnitus, forward suppression of this firing with sound might be an underlying mechanism of residual inhibition.
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Affiliation(s)
- A V Galazyuk
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA.
| | - S V Voytenko
- Department of Neuronal Networks Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences of Ukraine, Kiev, Ukraine
| | - R J Longenecker
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
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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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Zenner HP, Delb W, Kröner-Herwig B, Jäger B, Peroz I, Hesse G, Mazurek B, Goebel G, Gerloff C, Trollmann R, Biesinger E, Seidler H, Langguth B. A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus. Eur Arch Otorhinolaryngol 2016; 274:2079-2091. [DOI: 10.1007/s00405-016-4401-y] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 11/19/2016] [Indexed: 01/17/2023]
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Omidvar S, Jafari Z, Mahmoudian S, Khabazkhoob M, Ahadi M, Yazdani N. The relationship between ultra-high frequency thresholds and transient evoked otoacoustic emissions in adults with tinnitus. Med J Islam Repub Iran 2016; 30:449. [PMID: 28210614 PMCID: PMC5307623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 07/16/2016] [Indexed: 11/03/2022] Open
Abstract
Background: The possible role of cochlear function in tinnitus generation is still a matter of debate. To assess the role of outer hair cell dysfunction in tinnitus and its possible relationship with ultra-high frequency (UHF) hearing sensitivity, transient evoked otoacoustic emissions (TEOAE) and UHF hearing thresholds were investigated in normal hearing individuals with and without tinnitus. Methods: Eighteen individuals with tinnitus and 22 without tinnitus participated in this study. TEOAE was recorded with click stimulus at 80 dBpeSPL. UHF pure tone audiometry was performed at 10, 12.5, 16, and 18 kHz. Results: TEOAE was significantly abnormal in 72.2% of the tinnitus, and 18.2% of the control groups (p=0.001). The individuals with tinnitus had significantly poorer UHF hearing sensitivity compared to the control group at 12.5 and 18 kHz (p≤0.048). There was a stronger correlation between increasing UHFs hearing threshold and decreasing SNRs of TEOAEs in the tinnitus group compared to the controls. Conclusion: Our study revealed poorer UHF hearing thresholds and more TEOAE abnormalities in normal hearing individuals with tinnitus compared to the controls. Perhaps the alterations in the basal cochlea, following a decrease in UHF hearing sensitivity, affect OAEs that are originated from more apical cochlear parts in tinnitus ears more than non-tinnitus ears.
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Affiliation(s)
- Shaghayegh Omidvar
- 1 PhD Candidate, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. ;
| | - Zahra Jafari
- 2 PhD, Associate Professor, Department of Rehabilitation Basic Science, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. ,(Corresponding author) PhD, Associate Professor, Department of Rehabilitation Basic Science, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Saeid Mahmoudian
- 3 PhD, Assistant Professor, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran. ;
| | - Mehdi Khabazkhoob
- 4 PhD, Assistant Professor, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Mohsen Ahadi
- 5 PhD, Assistant Professor, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran. Address: Shahnazari St, Mirdamad Blvd, Tehran, Iran.
| | - Nasrin Yazdani
- 6 Associate Professor, Otorhinolaryngology Research Centre, AmirAlam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Lin CH, Kuo CE, Yu HC, Lai YK, Huang YC, Tsai MY. Efficacy of adjuvant Chinese herbal formula treatment for chronic tinnitus: A retrospective observational study. Complement Ther Med 2015; 23:226-32. [DOI: 10.1016/j.ctim.2015.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 10/17/2014] [Accepted: 01/01/2015] [Indexed: 10/24/2022] Open
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Krick CM, Grapp M, Daneshvar-Talebi J, Reith W, Plinkert PK, Bolay HV. Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy. Front Neurosci 2015; 9:49. [PMID: 25745385 PMCID: PMC4333796 DOI: 10.3389/fnins.2015.00049] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/04/2015] [Indexed: 12/19/2022] Open
Abstract
Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-min sessions of individualized therapy implemented over 1 week. Clinical improvement and long-term effects over several years have previously been published. However, the underlying neural basis of the therapy's success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG) and healthy active controls (AC). Non-treated patients were also included as passive controls (PTC). As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (Two-Way ANOVA) revealed structural gray matter (GM) increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG vs. AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be assumed.
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Affiliation(s)
- Christoph M Krick
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Miriam Grapp
- German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
| | | | - Wolfgang Reith
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital for Ear, Nose, and Throat, University of Heidelberg Heidelberg, Germany
| | - Hans Volker Bolay
- Music Therapy Tinnitus Outpatient Department, German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
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Offutt SJ, Ryan KJ, Konop AE, Lim HH. Suppression and facilitation of auditory neurons through coordinated acoustic and midbrain stimulation: investigating a deep brain stimulator for tinnitus. J Neural Eng 2014; 11:066001. [PMID: 25307351 PMCID: PMC4244264 DOI: 10.1088/1741-2560/11/6/066001] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The inferior colliculus (IC) is the primary processing center of auditory information in the midbrain and is one site of tinnitus-related activity. One potential option for suppressing the tinnitus percept is through deep brain stimulation via the auditory midbrain implant (AMI), which is designed for hearing restoration and is already being implanted in deaf patients who also have tinnitus. However, to assess the feasibility of AMI stimulation for tinnitus treatment we first need to characterize the functional connectivity within the IC. Previous studies have suggested modulatory projections from the dorsal cortex of the IC (ICD) to the central nucleus of the IC (ICC), though the functional properties of these projections need to be determined. APPROACH In this study, we investigated the effects of electrical stimulation of the ICD on acoustic-driven activity within the ICC in ketamine-anesthetized guinea pigs. MAIN RESULTS We observed ICD stimulation induces both suppressive and facilitatory changes across ICC that can occur immediately during stimulation and remain after stimulation. Additionally, ICD stimulation paired with broadband noise stimulation at a specific delay can induce greater suppressive than facilitatory effects, especially when stimulating in more rostral and medial ICD locations. SIGNIFICANCE These findings demonstrate that ICD stimulation can induce specific types of plastic changes in ICC activity, which may be relevant for treating tinnitus. By using the AMI with electrode sites positioned with the ICD and the ICC, the modulatory effects of ICD stimulation can be tested directly in tinnitus patients.
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Affiliation(s)
- Sarah J. Offutt
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
| | - Kellie J. Ryan
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
| | - Alexander E. Konop
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
| | - Hubert H. Lim
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, USA
- Institute for Translational Neuroscience, University of Minnesota, Minneapolis, USA
- Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, USA
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Thabit MN, Fouad N, Shahat B, Youssif M. Combined Central and Peripheral Stimulation for Treatment of Chronic Tinnitus. Neurorehabil Neural Repair 2014; 29:224-33. [DOI: 10.1177/1545968314542616] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background. Tinnitus is a common untreatable condition that originates from central maladaptive plasticity initiated by peripheral injury. Repetitive transcranial magnetic stimulation (rTMS), direct cochlear low-level laser therapy (LLLT), and acupuncture were tried for tinnitus treatment, but the results of these methods were clinically unsatisfactory. Objective. This study aimed to test the combined effect of the 3 methods targeting both peripheral and central auditory areas as a new therapeutic strategy for tinnitus. Methods. For this, 30 patients were randomized to 3 equal groups receiving 3 different interventions: inhibitory rTMS to the left auditory cortex, LLLT (which includes a combination of direct cochlear LLLT and laser acupuncture) to the affected ear(s), and finally, a combination of rTMS and LLLT. The Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were assessed before, immediately after, and at 2 weeks and 4 weeks after 10 consecutive every-other-day sessions for each intervention type. Results. We found that combined stimulation was effective in tinnitus treatment. This effect remained for 4 weeks after the end of the treatment. However, each of rTMS and LLLT alone had no significant effect. Repeated-measures ANOVA showed a significant effect of Time and Time × Intervention interaction for THI and VAS scores. The post hoc t test for different time points per intervention revealed a significant difference between baseline and all postintervention measurements of both THI and VAS for the combination intervention. Conclusion. Combined central rTMS and peripheral LLLT is more beneficial as a new method for management of tinnitus rather than these two used separately.
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Knipper M, Van Dijk P, Nunes I, Rüttiger L, Zimmermann U. Advances in the neurobiology of hearing disorders: Recent developments regarding the basis of tinnitus and hyperacusis. Prog Neurobiol 2013; 111:17-33. [DOI: 10.1016/j.pneurobio.2013.08.002] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 08/20/2013] [Accepted: 08/20/2013] [Indexed: 10/26/2022]
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