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Sun T, Li W, Shi K, Zhao Y, Guo D, Wang D. The Role of Connexin26 and Connexin30 in the Mouse Cochlea of Noise-Induced Hearing Loss. Otolaryngol Head Neck Surg 2024. [PMID: 39369436 DOI: 10.1002/ohn.1002] [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: 01/03/2024] [Revised: 08/15/2024] [Accepted: 09/14/2024] [Indexed: 10/08/2024]
Abstract
OBJECTIVE We aimed to explore the role of connexin26 (Cx26) and connexin30 (Cx30) in the cochlea in noise-induced permanent threshold shifts (PTS) and temporary threshold shift (TTS). STUDY DESIGN Prospective, controlled. SETTING Laboratory. METHODS A mouse model of noise-induced PTS and TTS was constructed. Western blots were used to detect the expression of Cx26 and Cx30 in the cochlea. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to assess the potential biological pathways. RESULTS Both the expression of Cx26 and Cx30 showed a trend of first rising and then falling in noise-induced PTS. The expression of Cx26 increased greatly in the 24 hours noise exposure (P < .05) and reached the highest level in the 4 hours after noise exposure (P < .05), then decreased gradually and returned to the control level on the seventh day after the noise exposure, when compared with the control group. The expression of Cx30 showed a similar trend in noise-induced PTS. However, both the expression of Cx26 and Cx30 showed a trend of first falling and then rising in noise induced TTS. The expression of Cx26/Cx30 reached its lowest level in the 4 hours after noise exposure (P < .05), and then increased to the control level on the second day after noise exposure (P > .05), compared with the control group. The first KEGG and GO pathway may be related with oxidative phosphorylation. CONCLUSION Cx26 and Cx30 may have an effect in noise induced PTS and TTS. Future studies are needed to confirm the results.
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Affiliation(s)
- Tao Sun
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, Henan, China
- Henan Provincial Health and Wellness Commission Key Laboratory of Hearing Loss Mechanism Research, Zhengzhou, Henan, China
| | - Wenzhen Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
- Shenzhen Research Institute of the Chinese University of Hong Kong, Shenzhen, China
| | - Ke Shi
- Henan Provincial Health and Wellness Commission Key Laboratory of Hearing Loss Mechanism Research, Zhengzhou, Henan, China
- Department of Biochemistry and Molecular Biology, Henan Medical College, Zhengzhou, Henan, China
| | - Yue Zhao
- Precision Medicine Center, Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan, China
| | - Dan Guo
- Department of Clinical Medicine, Henan Medical College, Zhengzhou, Henan, China
- Henan Provincial Health and Wellness Commission Key Laboratory of Hearing Loss Mechanism Research, Zhengzhou, Henan, China
- The Second Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou, Henan, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Key Laboratory of Environment and Health, Ministry of Education and Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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2
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Safavi-Naeini SM, Nasehi M, Zarrindast MR, Safavi-Naeini SA. Exploring the effects of naringenin on cell functioning and energy synthesis in the hippocampus of male Wistar rats with chronic tinnitus, by examining genetic indicators such as Bax, Bcl-2, Tfam, and Pgc-1α. Gene 2024; 933:148980. [PMID: 39368787 DOI: 10.1016/j.gene.2024.148980] [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: 06/21/2024] [Revised: 09/25/2024] [Accepted: 10/02/2024] [Indexed: 10/07/2024]
Abstract
BACKGROUND The pivotal factors, including neural plasticity, oxidative stress, neuronal inflammation, and apoptosis, play a significant role in the pathogenesis of tinnitus. The balance between Bax/Bcl-2 genes is an important factor in determining the rate of apoptosis. Pgc-1α and Tfam genes are fundamental regulators of mitochondrial biogenesis. Naringenin possesses significant antioxidant, neuroprotective, anti-inflammatory, anti-apoptotic, and antiviral properties, and its compounds are effective on cell signaling pathways. AIMS In light of the aforementioned information, we endeavored to evaluate the impact of naringenin on the expression levels of Bax, Bcl-2, Pgc-1α, and Tfam genes in the hippocampus of male Wistar rats with chronic tinnitus. MATERIAL AND METHODS To demonstrate the existence of tinnitus, all rats were instructed to complete an "active avoidance test" utilizing a conditioning box. The expression levels of genes mentioned above were assessed using real-time PCR. RESULTS The sodium salicylate at a dosage of 350 mg/kg showed an upregulation in the expression level of Bax and a downregulation in the expression level of the Bcl-2 gene (p < 0.001). Furthermore, the sodium salicylate displayed significantly higher expression levels of Tfam and Pgc-1α (p < 0.001) genes. The naringenin, at a dose of 100 mg/kg, led to a decrease in Bax gene expression (p < 0.05) and an increase in Bcl-2 gene expression (p < 0.05). On the other hand, naringenin restored the expression level of both Tfam (p < 0.001) and Pgc-1α (p < 0.01) genes. CONCLUSIONS Our research findings demonstrate that sodium salicylate-induced tinnitus leads to enhanced apoptosis and mitochondrial biogenesis within the hippocampus. Additionally, our evidence recommends that naringenin can reduce apoptosis effectively and maintain a balanced mitochondrial state.
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Affiliation(s)
| | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Amir-Almomenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed-Abbas Safavi-Naeini
- Department of ENT, Taleghani Hospital, Shaheed Beheshti University of Medical Sciences and Health Services, Tehran, Iran
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Kang YJ, Zheng Y. Current understanding of subjective tinnitus in adults. Eur Arch Otorhinolaryngol 2024; 281:4507-4517. [PMID: 38632112 DOI: 10.1007/s00405-024-08633-w] [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] [Received: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults. METHODS Review of current evidence-based literature on subjective tinnitus in adults. RESULTS The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option. CONCLUSIONS Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
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Affiliation(s)
- Yao-Jie Kang
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China
| | - Yun Zheng
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
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4
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Fabrizio-Stover EM, Oliver DL, Burghard AL. Tinnitus mechanisms and the need for an objective electrophysiological tinnitus test. Hear Res 2024; 449:109046. [PMID: 38810373 DOI: 10.1016/j.heares.2024.109046] [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: 02/29/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
Tinnitus, the perception of sound with no external auditory stimulus, is a complex, multifaceted, and potentially devastating disorder. Despite recent advances in our understanding of tinnitus, there are limited options for effective treatment. Tinnitus treatments are made more complicated by the lack of a test for tinnitus based on objectively measured physiological characteristics. Such an objective test would enable a greater understanding of tinnitus mechanisms and may lead to faster treatment development in both animal and human research. This review makes the argument that an objective tinnitus test, such as a non-invasive electrophysiological measure, is desperately needed. We review the current tinnitus assessment methods, the underlying neural correlates of tinnitus, the multiple tinnitus generation theories, and the previously investigated electrophysiological measurements of tinnitus. Finally, we propose an alternate objective test for tinnitus that may be valid in both animal and human subjects.
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Affiliation(s)
- Emily M Fabrizio-Stover
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA; Department of Otolaryngology-Head and Neck Surgery, Medical University South Carolina, Charleston, SC, USA
| | - Douglas L Oliver
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alice L Burghard
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA.
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5
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Cai R, Ling L, Ghimire M, Brownell KA, Caspary DM. Tinnitus-related increases in single-unit activity in awake rat auditory cortex correlate with tinnitus behavior. Hear Res 2024; 445:108993. [PMID: 38518392 DOI: 10.1016/j.heares.2024.108993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/04/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
Tinnitus is known to affect 10-15 % of the population, severely impacting 1-2 % of those afflicted. Canonically, tinnitus is generally a consequence of peripheral auditory damage resulting in maladaptive plastic changes in excitatory/inhibitory homeostasis at multiple levels of the central auditory pathway as well as changes in diverse nonauditory structures. Animal studies of primary auditory cortex (A1) generally find tinnitus-related changes in excitability across A1 layers and differences between inhibitory neuronal subtypes. Changes due to sound-exposure include changes in spontaneous activity, cross-columnar synchrony, bursting and tonotopic organization. Few studies in A1 directly correlate tinnitus-related changes in neural activity to an individual animal's behavioral evidence of tinnitus. The present study used an established condition-suppression sound-exposure model of chronic tinnitus and recorded spontaneous and driven single-unit responses from A1 layers 5 and 6 of awake Long-Evans rats. A1 units recorded from animals with behavioral evidence of tinnitus showed significant increases in spontaneous and sound-evoked activity which directly correlated to the animal's tinnitus score. Significant increases in the number of bursting units, the number of bursts/minute and burst duration were seen for A1 units recorded from animals with behavioral evidence of tinnitus. The present A1 findings support prior unit recording studies in auditory thalamus and recent in vitro findings in this same animal model. The present findings are consistent with sensory cortical studies showing tinnitus- and neuropathic pain-related down-regulation of inhibition and increased excitation based on plastic neurotransmitter and potassium channel changes. Reducing A1 deep-layer tinnitus-related hyperactivity is a potential target for tinnitus pharmacotherapy.
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Affiliation(s)
- Rui Cai
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Lynne Ling
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Madan Ghimire
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Kevin A Brownell
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States
| | - Donald M Caspary
- Department of Pharmacology, Southern Illinois University School of Medicine, PO Box 19629, Springfield, IL 62794-9629, United States.
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6
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Cacace AT, Berri B. Blast Overpressures as a Military and Occupational Health Concern. Am J Audiol 2023; 32:779-792. [PMID: 37713532 DOI: 10.1044/2023_aja-23-00125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
PURPOSE This tutorial reviews effects of environmental stressors like blast overpressures and other well-known acoustic contaminants (continuous, intermittent, and impulsive noise) on hearing, tinnitus, vestibular, and balance-related functions. Based on the overall outcome of these effects, detailed consideration is given to the health and well-being of individuals. METHOD Because hearing loss and tinnitus are consequential in affecting quality of life, novel neuromodulation paradigms are reviewed for their positive abatement and treatment-related effects. Examples of clinical data, research strategies, and methodological approaches focus on repetitive transcranial magnetic stimulation (rTMS) and electrical stimulation of the vagus nerve paired with tones (VNSt) for their unique contributions to this area. RESULTS Acoustic toxicants transmitted through the atmosphere are noteworthy for their propensity to induce hearing loss and tinnitus. Mounting evidence also indicates that high-level rapid onset changes in atmospheric sound pressure can significantly impact vestibular and balance function. Indeed, the risk of falling secondary to loss of, or damage to, sensory receptor cells in otolith organs (utricle and saccule) is a primary reason for this concern. As part of the complexities involved in VNSt treatment strategies, vocal dysfunction may also manifest. In addition, evaluation of temporospatial gait parameters is worthy of consideration based on their ability to detect and monitor incipient neurological disease, cognitive decline, and mortality. CONCLUSION Highlighting these respective areas underscores the need to enhance information exchange among scientists, clinicians, and caregivers on the benefits and complications of these outcomes.
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Affiliation(s)
- Anthony T Cacace
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
| | - Batoul Berri
- Department of Communication Sciences & Disorders, Wayne State University, Detroit, MI
- Department of Otolaryngology, University of Michigan, Ann Arbor
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7
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Zhang Y, Janssen MLF, Gommer ED, Zhang Q, van de Berg R. Typewriter tinnitus with time-locked vestibular paroxysmia in a patient with cerebellopontine angle meningioma. J Neurol 2023; 270:5645-5648. [PMID: 37477833 PMCID: PMC10576677 DOI: 10.1007/s00415-023-11869-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Affiliation(s)
- Yuzhong Zhang
- Department of Otorhinolaryngology and Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Otorhinolaryngology, Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Marcus L F Janssen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Erik D Gommer
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Qing Zhang
- Department of Otorhinolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Raymond van de Berg
- Department of Otorhinolaryngology and Head & Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
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8
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Abd-Elhakim YM, Abdel-Motal SM, Malhat SM, Mostafa HI, Ibrahim WM, Beheiry RR, Moselhy AAA, Said EN. Curcumin attenuates gentamicin and sodium salicylate ototoxic effects by modulating the nuclear factor-kappaB and apoptotic pathways in rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:89954-89968. [PMID: 35859240 PMCID: PMC9722864 DOI: 10.1007/s11356-022-21932-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/05/2022] [Indexed: 05/24/2023]
Abstract
This study aimed to investigate the effectiveness of curcumin (CCM) against gentamicin (GEN) and sodium salicylates (NaS)-induced ototoxic effects in rats. For 15 consecutive days, seven rat groups were given 1 mL/rat physiological saline orally, 1 mL/rat olive oil orally, 50 mg/kg bwt CCM orally, 120 mg/kg bwt GEN intraperitoneally, 300 mg/kg bwt NaS intraperitoneally, CCM+GEN, or CCM+NaS. The distortion product otoacoustic emission measurements were conducted. The rats' hearing function and balance have been behaviorally assessed using auditory startle response, Preyer reflex, and beam balance scale tests. The serum lipid peroxidation and oxidative stress biomarkers have been measured. Immunohistochemical investigations of the apoptotic marker caspase-3 and the inflammatory indicator nuclear factor kappa (NF-κB) in cochlear tissues were conducted. GEN and NaS exposure resulted in deficit hearing and impaired ability to retain balance. GEN and NaS exposure significantly decreased the reduced glutathione level and catalase activity but increased malondialdehyde content. GEN and NaS exposure evoked pathological alterations in cochlear and vestibular tissues and increased caspase-3 and NF-κB immunoexpression. CCM significantly counteracted the GEN and NaS injurious effects. These outcomes concluded that CCM could be a naturally efficient therapeutic agent against GEN and NaS-associated ototoxic side effects.
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Affiliation(s)
- Yasmina M Abd-Elhakim
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
| | - Sabry M Abdel-Motal
- Department of Pharmacology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Seham M Malhat
- Department of Pharmacology, Animal health research institute, Zagazig, Egypt
| | - Hend I Mostafa
- Department of Pharmacology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Walied M Ibrahim
- Audiology unit, Otorhinolaryngology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Rasha R Beheiry
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Attia A A Moselhy
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Enas N Said
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
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9
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Shi L, Palmer K, Wang H, Xu-Friedman MA, Sun W. Low Intensity Noise Exposure Enhanced Auditory Loudness and Temporal Processing by Increasing Excitability of DCN. Neural Plast 2022; 2022:6463355. [PMID: 36452876 PMCID: PMC9705115 DOI: 10.1155/2022/6463355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 08/12/2022] [Accepted: 10/21/2022] [Indexed: 11/23/2022] Open
Abstract
Sound stimulation is generally used for tinnitus and hyperacusis treatment. Recent studies found that long-term noise exposure can change synaptic and firing properties in the central auditory system, which will be detected by the acoustic startle reflex. However, the perceptual consequences of long-term low-intensity sound exposure are indistinct. This study will detect the effects of moderate-level noise exposure (83 dB SPL) on auditory loudness, and temporal processing was evaluated using CBA/CaJ mice. C-Fos staining was used to detect neural activity changes in the central auditory pathway. With two weeks of 83 dB SPL noise exposure (8 hours per day), no persistent threshold shift of the auditory brainstem response (ABR) was identified. On the other hand, noise exposure enhanced the acoustic startle response (ASR) and gap-induced prepulse inhibition significantly (gap-PPI). Low-level noise exposure, according to the findings, can alter temporal acuity. Noise exposure increased the number of c-Fos labeled neurons in the dorsal cochlear nucleus (DCN) and caudal pontine reticular nucleus (PnC) but not at a higher level in the central auditory nuclei. Our results suggested that noise stimulation can change acoustical temporal processing presumably by increasing the excitability of auditory brainstem neurons.
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Affiliation(s)
- Lin Shi
- Department of Otorhinolaryngology, The First Hospital of Dalian Medical University, Dalian, China
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, NY, USA
| | - Katie Palmer
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, NY, USA
| | - Haolin Wang
- Department of Otorhinolaryngology, The First Hospital of Dalian Medical University, Dalian, China
- Department of General Surgery, The First Hospital of Dalian Medical University, Dalian, China
| | - Matthew A. Xu-Friedman
- Department of Biological Sciences, State University of New York at Buffalo, Buffalo, NY, USA
| | - Wei Sun
- Department of Communicative Disorders and Sciences, Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo, NY, USA
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10
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Ma X, Chen N, Wang F, Zhang C, Dai J, Ding H, Yan C, Shen W, Yang S. Surface-based functional metrics and auditory cortex characteristics in chronic tinnitus. Heliyon 2022; 8:e10989. [PMID: 36276740 PMCID: PMC9582700 DOI: 10.1016/j.heliyon.2022.e10989] [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: 01/05/2022] [Revised: 06/11/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Abnormal auditory cortex (AC) neuronal activity is thought to be a primary cause of the auditory disturbances perceived by individuals suffering from tinnitus. The present study was designed to test that possibility by evaluating auditory cortical characteristics (volume, curvature, surface area, thickness) and surface-based functional metrics in chronic tinnitus patients. In total, 63 chronic tinnitus patients and 36 age-, sex- and education level-matched healthy control (HC) patients were enrolled in this study. Hearing levels in these two groups were comparable, and following magnetic resonance imaging (MRI) of these individuals, the DPABISurf software was used to compute cerebral cortex curvature, thickness, and surface area as well as surface-based functional metrics. The Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionary (THQ), and Visual Analogue Scales (VAS) were used to gauge participant tinnitus severity, while correlation analyses were conducted to evaluate associations between these different analyzed parameters. A significant increase in the regional homogeneity (ReHo) of the right secondary AC was detected in the tinnitus group relative to the HC group. There were also significant reductions in the cortical volume and surface area of the right secondary AC in the tinnitus group relative to the HC group (all P < 0.05). In addition, significant negative correlations between tinnitus pitch and the cortical area and volume of the right secondary AC were observed in the tinnitus group.
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Affiliation(s)
- Xiaoyan Ma
- The First Affiliated Hospital of Xi'an, Jiaotong University, Shanxi, China,Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Ningxuan Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Center for Cognitive Science of Language, Beijing Language and Culture University, Beijing, China
| | - Fangyuan Wang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Chi Zhang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Jing Dai
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Haina Ding
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Chaogan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Center for Cognitive Science of Language, Beijing Language and Culture University, Beijing, China,Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA,Corresponding author.
| | - Weidong Shen
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China,Corresponding author.
| | - Shiming Yang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China,Corresponding author.
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11
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Haider HF, Ribeiro D, Ribeiro SF, Trigueiros N, Caria H, Borrego L, Pinto I, Papoila AL, Hoare DJ, Paço J. Audiological biomarkers of tinnitus in an older Portuguese population. Front Aging Neurosci 2022; 14:933117. [PMID: 36092804 PMCID: PMC9449802 DOI: 10.3389/fnagi.2022.933117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 07/28/2022] [Indexed: 11/13/2022] Open
Abstract
Tinnitus is a phantom sound perceived in the absence of external acoustic stimulation. It is described in a variety of ways (e.g., buzzing, ringing, and roaring) and can be a single sound or a combination of different sounds. Our study evaluated associations between audiological parameters and the presence or severity of tinnitus, to improve tinnitus diagnosis, treatment, and prognosis. Our sample included 122 older participants (63 women and 59 men), aged 55–75 years from the Portuguese population, with or without sensory presbycusis and with or without tinnitus. All participants underwent a clinical evaluation through a structured interview, Ear, Nose, and Throat observation, and audiological evaluation (standard and extended audiometry, psychoacoustic tinnitus evaluation, auditory brainstem responses, and distortion product otoacoustic emissions). The Tinnitus Handicap Inventory was used to measure tinnitus symptom severity. Our data confirmed that the odds of developing tinnitus were significantly higher in the presence of noise exposure and hearing loss. Also, participants who had abrupt tinnitus onset and moderate or severe hyperacusis featured higher odds of at least moderate tinnitus. However, it was in the ABR that we obtained the most exciting and promising results, namely, in wave I, which was the common denominator in all findings. The increase in wave I amplitude is a protective factor to the odds of having tinnitus. Concerning the severity of tinnitus, the logistic regression model showed that for each unit of increase in the mean ratio V/I of ABR, the likelihood of having at least moderate tinnitus was 10% higher. Advancing knowledge concerning potential tinnitus audiological biomarkers can be crucial for the adequate diagnosis and treatment of tinnitus.
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Affiliation(s)
- Haúla F. Haider
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- Comprehensive Health Research Centre, NOVA Medical School, Faculty of Medical Sciences, Lisbon, Portugal
| | - Diogo Ribeiro
- Comprehensive Health Research Centre, NOVA Medical School, Faculty of Medical Sciences, Lisbon, Portugal
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- *Correspondence: Diogo Ribeiro,
| | - Sara F. Ribeiro
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
| | - Nuno Trigueiros
- ENT Department, Hospital Pedro Híspano, Matosinhos, Portugal
| | - Helena Caria
- BTR Unit, Deafness Research Group, BioISI, Faculty of Sciences, University of Lisbon (FCUL), Lisbon, Portugal
- ESS/IPS – Biomedical Sciences Department, School of Health, Polytechnic Institute of Setubal, Setúbal, Portugal
| | - Luís Borrego
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
- Department of Immunoallergy, CUF Descobertas Hospital, Lisbon, Portugal
| | - Iola Pinto
- Instituto Superior de Engenharia de Lisboa, Lisbon, Portugal
- Centro de Matemática e Aplicações, NOVA School of Science and Technology, FCT NOVA, Costa da Caparica, Portugal
| | - Ana L. Papoila
- NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
| | - Derek J. Hoare
- School of Medicine, NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, United Kingdom
| | - João Paço
- ENT Department, CUF Tejo Hospital – NOVA Medical School, Faculty of Medical Sciences, NOVA University Lisbon, Lisbon, Portugal
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12
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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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13
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The blinking eye as a window into tinnitus: A new animal model of tinnitus in the macaque. Hear Res 2022; 420:108517. [DOI: 10.1016/j.heares.2022.108517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/16/2022] [Accepted: 05/10/2022] [Indexed: 11/22/2022]
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14
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Behavioral and Immunohistochemical Evidence for Suppressive Effects of Goshajinkigan on Salicylate-Induced Tinnitus in Rats. Brain Sci 2022; 12:brainsci12050587. [PMID: 35624974 PMCID: PMC9139011 DOI: 10.3390/brainsci12050587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 02/04/2023] Open
Abstract
Many people are affected by tinnitus, a sensation of ringing in the ear despite the absence of external sound. Goshajinkigan (GJG) is one of the formulations of Japanese traditional herbal medicine and is prescribed for the palliative treatment of patients with tinnitus. Although GJG is clinically effective in these patients, its behavioral effects and the underlying neuroanatomical substrate have not been modeled in animals. We modeled tinnitus using salicylate-treated rats, demonstrated the effectiveness of GJG on tinnitus, and examined the underlying neuronal substrate with c-Fos expression. Intraperitoneal injection of sodium salicylate (400 mg/kg) into rats for three consecutive days significantly increased false positive scores, which were used to assess tinnitus behavior. When GJG was orally administered one hour after each salicylate injection, the increase in tinnitus behavior was suppressed. The analysis of c-Fos expression in auditory-related brain areas revealed that GJG significantly reduced the salicylate-induced increase in the number of c-Fos-expressing cells in the auditory cortices, inferior colliculus, and dorsal cochlear nucleus. These results suggest a suppressive effect of GJG on salicylate-induced tinnitus in animal models.
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15
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Lara RA, Breitzler L, Lau IH, Gordillo-Martinez F, Chen F, Fonseca PJ, Bass AH, Vasconcelos RO. Noise-induced hearing loss correlates with inner ear hair cell decrease in larval zebrafish. J Exp Biol 2022; 225:274643. [PMID: 35258623 DOI: 10.1242/jeb.243743] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/27/2022] [Indexed: 11/20/2022]
Abstract
Anthropogenic noise can be hazardous for the auditory system and wellbeing of animals, including humans. However, very limited information is known on how this global environmental pollutant affects auditory function and inner ear sensory receptors in early ontogeny. The zebrafish (Danio rerio) is a valuable model in hearing research, including to investigate developmental processes of the vertebrate inner ear. We tested the effects of chronic exposure to white noise in larval zebrafish on inner ear saccular sensitivity and morphology at 3 and 5 days post fertilization (dpf), as well as on auditory-evoked swimming responses using the prepulse inhibition paradigm (PPI) at 5 dpf. Noise-exposed larvae showed significant increase in microphonic potential thresholds at low frequencies, 100 and 200 Hz, while PPI revealed a hypersensitisation effect and similar threshold shift at 200 Hz. Auditory sensitivity changes were accompanied by a decrease in saccular hair cell number and epithelium area. In aggregate, the results reveal noise-induced effects on inner ear structure-function in a larval fish paralleled by a decrease in auditory-evoked sensorimotor responses. More broadly, this study highlights the importance of investigating the impact of environmental noise on early development of sensory and behavioural responsiveness to acoustic stimuli.
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Affiliation(s)
- Rafael A Lara
- Institute of Science and Environment, University of Saint Joseph, Macao S.A.R., China.,Departamento de Biología, Universidad de Sevilla, Spain
| | - Lukas Breitzler
- Institute of Science and Environment, University of Saint Joseph, Macao S.A.R., China
| | - Ieng Hou Lau
- Institute of Science and Environment, University of Saint Joseph, Macao S.A.R., China
| | | | - Fangyi Chen
- Department of Biomedical Engineering, South University of Science and Technology of China, Guangdong, China
| | - Paulo J Fonseca
- Departamento de Biologia Animal and cE3c - Centre for Ecology, Evolution and Environmental Changes, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Andrew H Bass
- Department of Neurobiology and Behavior, Cornell University, NY, USA
| | - Raquel O Vasconcelos
- Institute of Science and Environment, University of Saint Joseph, Macao S.A.R., China
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16
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Huang B, Wang X, Wei F, Sun Q, Sun J, Liang Y, Chen H, Zhuang H, Xiong G. Notched Sound Alleviates Tinnitus by Reorganization Emotional Center. Front Hum Neurosci 2022; 15:762492. [PMID: 35153700 PMCID: PMC8832119 DOI: 10.3389/fnhum.2021.762492] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundTinnitus is a common disease, and sound therapy is an effective method to alleviate it. Previous studies have shown that notched sound not only changes levels of cortical blood oxygen, but affects blood oxygen in specific cerebral cortical areas, such as Brodmann area 46 (BA46), which is associated with emotion. Extensive evidence has confirmed that tinnitus is closely related to emotion. Whether notched sound plays a role in regulating the emotional center is still unclear.MethodsThis study included 29 patients with newly diagnosed chronic tinnitus who were treated with notched sound. Functional near-infrared spectroscopy (fNIRS) was conducted before and after treatment to observe bilateral changes in cortical blood oxygen in the cerebral hemispheres. We compared the changes in connectivity between the two regions of interest (the superior temporal gyrus and BA46), as wells as other cortical regions before and after treatment.ResultsThe results showed (1) That global connectivity between the bilateral auditory cortex of the superior temporal sulcus and the ipsilateral cortex did not change significantly between baseline and the completion of treatment, and (2) That the connectivity between channel 14 and the right superior temporal sulcus decreased after treatment. The overall connectivity between the right BA46 region and the right cortex decreased after treatment, and decreases in connectivity after treatment were specifically found for channels 10 and 14 in the right parietal lobe and channels 16, 20, 21, and 22 in the frontal lobe, while there was no significant change on the left side. There were no significant changes in the questionnaire measures of tinnitus, anxiety, or depression before and after treatment.ConclusionThe results of the study indicate that cerebral cortex reorganization occurs in tinnitus patients after submitted to treatment with notched sound for 1 month, and that notched sound decreases the connectivity between the auditory cortex and specific brain regions.SignificanceNotched sound not only regulates the auditory center through lateral inhibition, but also alleviates tinnitus by reorganizing the emotional control center.
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Affiliation(s)
- Bixue Huang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Xianren Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Xianren Wang,
| | - Fanqing Wei
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Qiyang Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Jincangjian Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Yue Liang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Huiting Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Huiwen Zhuang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Guanxia Xiong
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
- Guanxia Xiong,
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17
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Parameshwarappa V, Pezard L, Norena AJ. Changes in the spatiotemporal pattern of spontaneous activity across a cortical column after noise trauma. J Neurophysiol 2021; 127:239-254. [PMID: 34936500 DOI: 10.1152/jn.00262.2021] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In the auditory modality, noise trauma has often been used to investigate cortical plasticity as it causes cochlear hearing loss. One limitation of these past studies, however, is that the effects of noise trauma have been mostly documented at the granular layer, which is the main cortical recipient of thalamic inputs. Importantly, the cortex is composed of six different layers each having its own pattern of connectivity and specific role in sensory processing. The present study aims at investigating the effects of acute and chronic noise trauma on the laminar pattern of spontaneous activity in primary auditory cortex of the anesthetized guinea pig. We show that spontaneous activity is dramatically altered across cortical layers after acute and chronic noise-induced hearing loss. First, spontaneous activity was globally enhanced across cortical layers, both in terms of firing rate and amplitude of spike-triggered average of local field potentials. Second, current source density on (spontaneous) spike-triggered average of local field potentials indicates that current sinks develop in the supra- and infragranular layers. These latter results suggest that supragranular layers become a major input recipient and that the propagation of spontaneous activity over a cortical column is greatly enhanced after acute and chronic noise-induced hearing loss. We discuss the possible mechanisms and functional implications of these changes.
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Affiliation(s)
- Vinay Parameshwarappa
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Laurent Pezard
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Arnaud Jean Norena
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
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18
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Chen F, Zhao F, Mahafza N, Lu W. Detecting Noise-Induced Cochlear Synaptopathy by Auditory Brainstem Response in Tinnitus Patients With Normal Hearing Thresholds: A Meta-Analysis. Front Neurosci 2021; 15:778197. [PMID: 34987358 PMCID: PMC8721093 DOI: 10.3389/fnins.2021.778197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023] Open
Abstract
Noise-induced cochlear synaptopathy (CS) is defined as a permanent loss of synapses in the auditory nerve pathway following noise exposure. Several studies using auditory brainstem response (ABR) have indicated the presence of CS and increased central gain in tinnitus patients with normal hearing thresholds (TNHT), but the results were inconsistent. This meta-analysis aimed to review the evidence of CS and its pathological changes in the central auditory system in TNHT. Published studies using ABR to study TNHT were reviewed. PubMed, EMBASE, and Scopus databases were selected to search for relevant literature. Studies (489) were retrieved, and 11 were included for meta-analysis. The results supported significantly reduced wave I amplitude in TNHT, whereas the alternations in wave V amplitude were inconsistent among the studies. Consistently increased V/I ratio indicated noise-induced central gain enhancement. The results indicated the evidence of noise-induced cochlear synaptopathy in tinnitus patients with normal hearing. However, inconsistent changes in wave V amplitude may be explained by that the failure of central gain that triggers the pathological neural changes in the central auditory system and/or that increased central gain may be necessary to generate tinnitus but not to maintain tinnitus.
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Affiliation(s)
- Feifan Chen
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Department of Hearing and Speech Science, Guangzhou Xinhua College, Guangzhou, China
| | - Nadeem Mahafza
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Wei Lu
- Department of Otolaryngology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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19
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Ludwig M, Wienke C, Betts MJ, Zaehle T, Hämmerer D. Current challenges in reliably targeting the noradrenergic locus coeruleus using transcutaneous auricular vagus nerve stimulation (taVNS). Auton Neurosci 2021; 236:102900. [PMID: 34781120 DOI: 10.1016/j.autneu.2021.102900] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 09/03/2021] [Accepted: 10/15/2021] [Indexed: 12/11/2022]
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS), as a non-invasive brain stimulation technique may influence the locus coeruleus-norepinephrine system (LC-NE system) via modulation of the Vagus Nerve (VN) which projects to the LC. Few human studies exist examining the effects of taVNS on the LC-NE system and studies to date assessing the ability of taVNS to target the LC yield heterogeneous results. The aim of this review is to present an overview of the current challenges in assessing effects of taVNS on LC function and how translational approaches spanning animal and human research can help in this regard. A particular emphasis of the review discusses how the effects of taVNS may be influenced by changes in structure and function of the LC-NE system across the human lifespan and in disease.
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Affiliation(s)
- Mareike Ludwig
- Institute for Cognitive Neurology and Dementia Research, Faculty of Medicine, University Hospital Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, Magdeburg, Germany.
| | - Christian Wienke
- Department of Neurology, Section of Neuropsychology, Otto-v.-Guericke University, Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Matthew J Betts
- Institute for Cognitive Neurology and Dementia Research, Faculty of Medicine, University Hospital Magdeburg, Germany; German Center for Neurodegenerative Diseases (DZNE), Otto-von-Guericke University Magdeburg, Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Section of Neuropsychology, Otto-v.-Guericke University, Magdeburg, Germany; CBBS Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Dorothea Hämmerer
- Institute for Cognitive Neurology and Dementia Research, Faculty of Medicine, University Hospital Magdeburg, Germany; Institute of Cognitive Neuroscience, University College London, London, UK; Department of Psychology, University of Innsbruck; CBBS Center for Behavioral Brain Sciences, Magdeburg, Germany
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20
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Henton A, Tzounopoulos T. What's the buzz? The neuroscience and the treatment of tinnitus. Physiol Rev 2021; 101:1609-1632. [PMID: 33769102 DOI: 10.1152/physrev.00029.2020] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Tinnitus is a pervasive public health issue that affects ∼15% of the United States population. Similar estimates have also been shown on a global scale, with similar prevalence found in Europe, Asia, and Africa. The severity of tinnitus is heterogeneous, ranging from mildly bothersome to extremely disruptive. In the United States, ∼10-20% of individuals who experience tinnitus report symptoms that severely reduce their quality of life. Due to the huge personal and societal burden, in the last 20 yr a concerted effort on basic and clinical research has significantly advanced our understanding and treatment of this disorder. Yet, neither full understanding, nor cure exists. We know that tinnitus is the persistent involuntary phantom percept of internally generated nonverbal indistinct noises and tones, which in most cases is initiated by acquired hearing loss and maintained only when this loss is coupled with distinct neuronal changes in auditory and extra-auditory brain networks. Yet, the exact mechanisms and patterns of neural activity that are necessary and sufficient for the perceptual generation and maintenance of tinnitus remain incompletely understood. Combinations of animal model and human research will be essential in filling these gaps. Nevertheless, the existing progress in investigating the neurophysiological mechanisms has improved current treatment and highlighted novel targets for drug development and clinical trials. The aim of this review is to thoroughly discuss the current state of human and animal tinnitus research, outline current challenges, and highlight new and exciting research opportunities.
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Affiliation(s)
- A Henton
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - T Tzounopoulos
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
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21
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Zhang J, Firestone E, Elattma A. Animal Models of Tinnitus Treatment: Cochlear and Brain Stimulation. Curr Top Behav Neurosci 2021; 51:83-129. [PMID: 34282563 DOI: 10.1007/7854_2021_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromodulation, via stimulation of a variety of peripheral and central structures, is used to suppress tinnitus. However, investigative limitations in humans due to ethical reasons have made it difficult to decipher the mechanisms underlying treatment-induced tinnitus relief, so a number of animal models have arisen to address these unknowns. This chapter reviews animal models of cochlear and brain stimulation and assesses their modulatory effects on behavioral evidence of tinnitus and its related neural correlates. When a structure is stimulated, localized modulation, often presenting as downregulation of spontaneous neuronal spike firing rate, bursting and neurosynchrony, occurs within the brain area. Through anatomical projections and transmitter pathways, the interventions activate both auditory- and non-auditory structures by taking bottom-up ascending and top-down descending modes to influence their target brain structures. Furthermore, it is the brain oscillations that cochlear or brain stimulation evoke and connect the prefrontal cortex, striatal systems, and other limbic structures to refresh neural networks and relieve auditory, attentive, conscious, as well as emotional reactive aspects of tinnitus. This oscillatory neural network connectivity is achieved via the thalamocorticothalamic circuitry including the lemniscal and non-lemniscal auditory brain structures. Beyond existing technologies, the review also reveals opportunities for developing advanced animal models using new modalities to achieve precision neuromodulation and tinnitus abatement, such as optogenetic cochlear and/or brain stimulation.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Communication Sciences and Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, USA.
| | - Ethan Firestone
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ahmed Elattma
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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22
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Abd-Elhakim YM, Abdel-Motal SM, Malhat SM, Mostafa HI, Moselhy AAA, Beheiry RR, Said EN. Curcumin mitigates neurotoxic and neurobehavioral changes of gentamicin and sodium salicylate in rats by adjusting oxidative stress and apoptosis. Life Sci 2020; 265:118824. [PMID: 33278387 DOI: 10.1016/j.lfs.2020.118824] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 11/10/2020] [Accepted: 11/24/2020] [Indexed: 02/08/2023]
Abstract
Currently, antibiotics and salicylates are the most highly consumed medications worldwide. The side effects of these pharmaceuticals on the nervous system have been little investigated. Thus, this study aimed to examine the influence of the gentamicin (GM) and sodium salicylates (SS) on neurobehavioral functions, including locomotors function, memory, and sensorimotor functions together with gamma-aminobutyric acid (GABA) neurotransmitter levels. Also, oxidative stress, lipid peroxidation, and apoptotic indicators of brain tissue were assessed. Additionally, the histopathological architecture of brain tissues was investigated. This study also evaluated the curcumin (CUR) efficacy to counteract the GM or SS induced neurotoxic impacts in rats. For this purpose, seven groups were administered physiological saline (1 ml/rat; orally), olive oil (1 ml/rat; orally), CUR (50 mg/kg bwt; orally), GM (120 mg/kg bwt; intraperitoneally), SS (300 mg /kg bwt; intraperitoneally), CUR + GM, or CUR + SS for consecutive 15 days. The results revealed that GM and SS exposure evoked impaired memory, sensorimotor deficit functions, and depressive-like behavior together with the depletion of GABA. GM and SS exposure elevated malondialdehyde and Caspase-3 levels, but total antioxidant capacity and Bcl-2 levels were reduced. Besides, GM and SS exposure induced distinct pathological perturbations in cerebral cortices and hippocampus tissues. CUR significantly reversed the GM and SS harmful impacts. In conclusion, these findings verified that CUR could be a biologically efficient protective intervention against GM and SS induced neurotoxic impacts and neurobehavioral aberrations.
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Affiliation(s)
- Yasmina M Abd-Elhakim
- Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
| | - Sabry M Abdel-Motal
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | | | - Hend I Mostafa
- Department of Pharmacology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Attia A A Moselhy
- Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Zagazig University, Egypt
| | - Rasha R Beheiry
- Department of Histology and Cytology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Enas N Said
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
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Lefebvre-Demers M, Doyon N, Fecteau S. Non-invasive neuromodulation for tinnitus: A meta-analysis and modeling studies. Brain Stimul 2020; 14:113-128. [PMID: 33276156 DOI: 10.1016/j.brs.2020.11.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/07/2020] [Accepted: 11/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with tinnitus often have poor quality of life, as well as severe anxiety and depression. New approaches to treat tinnitus are needed. OBJECTIVE Evaluate the effects of non-invasive neuromodulation on tinnitus through a metaanalysis and modeling study. The main hypothesis was that real as compared to sham neuromodulation that decreases tinnitus will modulate regions in line with the neurobiological models of tinnitus. METHODS AND RESULTS The systematic review, conducted from Pubmed, Cochrane and PsycINFO databases, showed that active as compared to sham repetitive transcranial magnetic stimulation (rTMS) reduced tinnitus, but active and sham transcranial direct current stimulation did not significantly differ. Further, rTMS over the auditory cortex was the most effective protocol. The modeling results indicate that this rTMS protocol elicited the strongest electric fields in the insula. Also, rTMS was particularly beneficial in women. Finally, the placebo effects were highly variable, highlighting the importance of conducting sham-controlled trials. CONCLUSION In sum, neuromodulation protocols that target the auditory cortex and the insula may hold clinical potential to treat tinnitus.
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Affiliation(s)
- Mathilde Lefebvre-Demers
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Canada
| | - Nicolas Doyon
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Faculty of Science and Engineering, Université Laval, Canada
| | - Shirley Fecteau
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Canada.
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Manohar S, Adler HJ, Chen GD, Salvi R. Blast-induced hearing loss suppresses hippocampal neurogenesis and disrupts long term spatial memory. Hear Res 2020; 395:108022. [PMID: 32663733 PMCID: PMC9063718 DOI: 10.1016/j.heares.2020.108022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/07/2020] [Accepted: 06/11/2020] [Indexed: 12/16/2022]
Abstract
Acoustic information transduced by cochlear hair cells is continuously relayed from the auditory pathway to other sensory, motor, emotional and cognitive centers in the central nervous system. Human epidemiological studies have suggested that hearing loss is a risk factor for dementia and cognitive decline, but the mechanisms contributing to these memory and cognitive impairments are poorly understood. To explore these issues in a controlled experimental setting, we exposed adult rats to a series of intense blast wave exposures that significantly reduced the neural output of the cochlea. Several weeks later, we used the Morris Water Maze test, a hippocampal-dependent memory task, to assess the ability of Blast Wave and Control rats to learn a spatial navigation task (memory acquisition) and to remember what they had learned (spatial memory retention) several weeks earlier. The elevated plus maze and open field arena were used to test for anxiety-like behaviors. Afterwards, hippocampal cell proliferation and neurogenesis were evaluated using bromodeoxyuridine (BrdU), doublecortin (DCX), and Neuronal Nuclei (NeuN) immunolabeling. The Blast Wave and Control rats learned the spatial navigation task equally well and showed no differences on tests of anxiety. However, the Blast Wave rats performed significantly worse on the spatial memory retention task, i.e., remembering where they had been two weeks earlier. Deficits on the spatial memory retention task were associated with significant decreases in hippocampal cell proliferation and neurogenesis. Our blast wave results are consistent with other experimental manipulations that link spatial memory retention deficits (long term memory) with decreased cell proliferation and neurogenesis in the hippocampus. These results add to the growing body of knowledge linking blast-induced cochlear hearing loss with the cognitive deficits often seen in combat personnel and provide mechanistic insights into these extra auditory disorders that could lead to therapeutic interventions.
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Affiliation(s)
- Senthilvelan Manohar
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY, 14214, USA
| | - Henry J Adler
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY, 14214, USA
| | - Guang-Di Chen
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY, 14214, USA
| | - Richard Salvi
- Center for Hearing and Deafness, State University of New York at Buffalo, 137 Cary Hall, 3435 Main Street, Buffalo, NY, 14214, USA.
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Hayes SH, Schormans AL, Sigel G, Beh K, Herrmann B, Allman BL. Uncovering the contribution of enhanced central gain and altered cortical oscillations to tinnitus generation. Prog Neurobiol 2020; 196:101893. [PMID: 32783988 DOI: 10.1016/j.pneurobio.2020.101893] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/20/2020] [Accepted: 08/02/2020] [Indexed: 12/22/2022]
Abstract
Various theories and their associated mechanisms have been proposed as the neural basis of phantom sound perception (tinnitus), including central gain enhancement and altered cortical oscillations. However, it remains unknown whether these cortical changes directly cause tinnitus, or simply coexist with the phantom percept. Using chronically-implanted electrodes and drug delivery cannulae in rats, we examined whether enhanced central gain and cortical oscillations are consistent across different tinnitus induction methods (noise exposure; salicylate), and if directly-inducing enhanced central gain or altered cortical oscillations via pharmacologic manipulation of inhibition along the auditory pathway would cause behavioral evidence of tinnitus. We show that, while there appeared to be no clear link between tinnitus and the presence of enhanced sound-evoked cortical activity or altered spontaneous cortical oscillations, pharmacologic impairment of GABAergic neurotransmission in the auditory cortex was sufficient to cause tinnitus; collective findings which further advance our understanding of the neural basis of tinnitus.
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Affiliation(s)
- Sarah H Hayes
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 3K7, Canada.
| | - Ashley L Schormans
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Gregory Sigel
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Krystal Beh
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Björn Herrmann
- Department of Psychology, Brain and Mind Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Brian L Allman
- Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, N6A 3K7, Canada
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26
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Milner R, Lewandowska M, Ganc M, Nikadon J, Niedziałek I, Jędrzejczak WW, Skarżyński H. Electrophysiological correlates of focused attention on low- and high-distressed tinnitus. PLoS One 2020; 15:e0236521. [PMID: 32756593 PMCID: PMC7406215 DOI: 10.1371/journal.pone.0236521] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/07/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The study aimed at determining the EEG correlates of concentration on either low or high-distressed tinnitus. METHODS Sixty-seven patients (36 women, mean age = 50.34 ± 12.94 years) with chronic tinnitus were assigned to either a high (HD) or low (LD) tinnitus-related distress group based on THI results. All participants took part in the EEG study comprising two 3-4 min blocks of focusing on either tinnitus (Tinnitus Focus Condition, TFC) or the sensations from one's own body (Body Focus Condition, BFC). The absolute power and current density of 8 frequency bands in 7 clusters were compared between conditions and groups. RESULTS The most pronounced differences were found in the HD patients in the TFC, relative to the BFC, i.e. reduced power of frontally distributed low alpha (8-10 Hz) and posterior high alpha (10-12 Hz) as well as lower current density of 8-10 Hz rhythm over the right frontal/anterior cingulate cortex and higher middle beta (15-18 Hz) density in the precuneus. The HD, relative to LD patients, in both conditions, exhibited increased low beta (12-15 Hz) power over the left middle area and greater higher beta (15-25 Hz) power in the left posterior region. CONCLUSIONS The present study contrasted bioelectrical activity, acquired when concentrating on tinnitus with EEG data collected whilst patients focused on their body. Decreased alpha power and current density in the frontal/cingulate cortex when listening to bothersome tinnitus might reflect greater cortical arousal whereas increased beta power and density in the precuneus/posterior cingulate activity in this condition could be indicative for elevated tension or augmented cognitive/emotional processing of tinnitus sound. Enhanced beta rhythm in patients with high versus low tinnitus distress, observed independently of the study condition, may be due to greater self-focused attention or more active processing of sensations derived from the own body.
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Affiliation(s)
- Rafał Milner
- Department of Experimental Audiology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| | - Monika Lewandowska
- Institute of Psychology, Faculty of Philosophy and Social Sciences, Nicolaus Copernicus University, Toruń, Poland
| | - Małgorzata Ganc
- Department of Experimental Audiology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| | - Jan Nikadon
- Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Iwona Niedziałek
- Audiology and Phoniatrics Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| | - Wiesław Wiktor Jędrzejczak
- Department of Experimental Audiology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
| | - Henryk Skarżyński
- Oto-Rhino-Laryngology Surgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, Kajetany/Warsaw, Poland
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Abstract
Tinnitus is a common symptom. Standard therapies aim at improving the quality of life and reducing the psychological stress associated with tinnitus. Most interventions have little or no effect on the main symptom. Those affected subjects, however, want such a change and prefer a specific solution, such as pharmacologic therapy to other modalities. Scientific efforts have not yet led to significant improvement in the range of therapies. This article outlines existing efforts and develops ideas on how research for improved tinnitus therapy might look in the future.
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Affiliation(s)
- Tobias Kleinjung
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, Zurich CH 8091, Switzerland.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Interdisciplinary Tinnitus Center, University of Regensburg, Universitätsstrasse 84, Regensburg D 93053, Germany
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Abstract
Cochlear damage is often thought to result in hearing thresholds shift, whether permanent or temporary. The report of tinnitus in the absence of any clear deficit in cochlear function was believed to indicate that hearing loss and tinnitus, while comorbid, could arise independently from each other. In all likelihood, tinnitus that is not of central nervous system origin is associated with hearing loss. As a correlate, although a treatment of most forms of tinnitus will likely emerge in the years to come, curing tinnitus will first require curing hearing loss.
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Affiliation(s)
- Ronna Hertzano
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; Anatomy and Neurobiology, University of Maryland School of Medicine, Baltimore, MD, USA; Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Erika L Lipford
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Didier Depireux
- Department of Otorhinolaryngology Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, MD, USA; R&D OtolithLabs, Washington, DC, USA.
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Kochilas HL, Cacace AT, Arnold A, Seidman MD, Tarver WB. Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing. Laryngoscope Investig Otolaryngol 2020; 5:286-296. [PMID: 32337360 PMCID: PMC7178458 DOI: 10.1002/lio2.364] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 01/23/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE In individuals with chronic tinnitus, our interest was to determine whether daily low-level electrical stimulation of the vagus nerve paired with tones (paired-VNSt) for tinnitus suppression had any adverse effects on motor-speech production and physiological acoustics of sustained vowels. Similarly, we were also interested in evaluating for changes in pure-tone thresholds, word-recognition performance, and minimum-masking levels. Both voice and hearing functions were measured repeatedly over a period of 1 year. STUDY DESIGN Longitudinal with repeated-measures. METHODS Digitized samples of sustained frontal, midline, and back vowels (/e/, /o/, /ah/) were analyzed with computer software to quantify the degree of jitter, shimmer, and harmonic-to-noise ratio contained in these waveforms. Pure-tone thresholds, monosyllabic word-recognition performance, and MMLs were also evaluated for VNS alterations. Linear-regression analysis was the benchmark statistic used to document change over time in voice and hearing status from a baseline condition. RESULTS Most of the regression functions for the vocal samples and audiometric variables had slope values that were not significantly different from zero. Four of the nine vocal functions showed a significant improvement over time, whereas three of the pure tone regression functions at 2-4 kHz showed some degree of decline; all changes observed were for the left ear, all were at adjacent frequencies, and all were ipsilateral to the side of VNS. However, mean pure-tone threshold changes did not exceed 4.29 dB from baseline and therefore, would not be considered clinically significant. In some individuals, larger threshold shifts were observed. No significant regression/slope effects were observed for word-recognition or MMLs. CONCLUSION Quantitative voice analysis and assessment of audiometric variables showed minimal if any evidence of adverse effects using paired-VNSt over a treatment period of 1 year. Therefore, we conclude that paired-VNSt is a safe tool for tinnitus abatement in humans without significant side effects. LEVEL OF EVIDENCE Level IV.
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Affiliation(s)
- Helen L. Kochilas
- North Atlanta Ears, Nose, Throat & Allergy, AlpharettaGeorgia
- Present address:
North Atlanta Ears, Nose, Throat & AllergyAlpharettaGeorgia
| | - Anthony T. Cacace
- Department of Communication Sciences & Disorders, Wayne State University, DetroitMichigan
| | - Amy Arnold
- The Hearing Clinic, BrightonMichigan
- Present address:
The Hearing ClinicBrightonMichigan
| | - Michael D. Seidman
- Florida ENT Surgical Specialists, Florida Hospital Medical Group, Head & Neck Surgery Center of Florida, CelebrationFlorida
- Present address:
Florida Hospital Medical GroupHead & Neck Surgery Center of FloridaCelebrationFlorida
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Duan Q, Ma F, Zhang J. Salicylate increased ascorbic acid levels and neuronal activity in the rat auditory cortex. Pediatr Investig 2019; 3:146-152. [PMID: 32851309 PMCID: PMC7331419 DOI: 10.1002/ped4.12143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 08/14/2019] [Indexed: 11/10/2022] Open
Abstract
IMPORTANCE Clinical observations have implied a central origin for tinnitus and potential therapeutic effects of ascorbic acid (AA); however, the detailed mechanisms remain undetermined. OBJECTIVE To investigate changes in the AA levels and neural activity in the auditory cortex (AC) during salicylate-induced tinnitus. METHODS Rats were randomly divided into 3 groups: (1) saline group, which received an intraperitoneal saline injection; (2) SS group, which received an intraperitoneal sodium salicylate (SS) injection (350 mg/kg); and (3) SS+Lido group, which received an intraperitoneal SS injection (350 mg/kg) and lidocaine delivered to the AC by microdialysis. For each group, we firstly used an in vivo microdialysis technique to investigate the concentrations of AA in the AC; and secondly, we recorded the neural activity in the AC using a single-unit recording technique. RESULTS The AA concentration in the SS group significantly increased after SS injection, whereas that of the saline group did not change. The AA concentration in the SS+Lido group also showed an increasing trend but was significantly lower than that in the SS group. In the electrophysiological study, the spontaneous firing rate of the SS group was significantly higher than that of the saline group. In addition, the proportion of short interval discharges was also higher in the SS group than in the saline group. Both differences were reversed by lidocaine treatment. INTERPRETATION Our data suggest that the elevation of AA levels in the AC may be related to increased neuronal activity, which may represent the mechanism underlying salicylate-induced tinnitus.
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Affiliation(s)
- Qingchuan Duan
- Department of Otolaryngology Head and Neck SurgeryPeking University Third HospitalBeijingChina
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children's HospitalNational Center for Children's HealthBeijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck SurgeryBeijingChina
| | - Furong Ma
- Department of Otolaryngology Head and Neck SurgeryPeking University Third HospitalBeijingChina
| | - Jie Zhang
- Department of Otorhinolaryngology Head and Neck SurgeryBeijing Children's HospitalNational Center for Children's HealthBeijing Key Laboratory for Pediatric Diseases of Otolaryngology Head and Neck SurgeryBeijingChina
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Xiong S, Song Y, Liu J, Du Y, Ding Y, Wei H, Bryan K, Ma F, Mao L. Neuroprotective effects of MK-801 on auditory cortex in salicylate-induced tinnitus: Involvement of neural activity, glutamate and ascorbate. Hear Res 2019; 375:44-52. [PMID: 30795964 DOI: 10.1016/j.heares.2019.01.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 01/17/2019] [Accepted: 01/30/2019] [Indexed: 12/14/2022]
Abstract
Tinnitus may cause anxiety, depression, insomnia, which impair the quality of life of millions worldwide. However, the mechanism of tinnitus remains to be understood, it has been previously hypothesized that the activation of N-methyl-D-aspartate (NMDA) receptor is involved in the tinnitus processes and blockade of the NMDA receptor is regarded as a therapeutic strategy for tinnitus treatment even if the rescue treatment is still proved invalid in some cases. To demonstrate the therapeutic effect of the NMDA receptor blocker on tinnitus, we examined here the spontaneous firing rate (SFR) and the neurochemical dynamics in the auditory cortex (AC) of rats after sodium salicylate (SS) injection, which is a widely used model for tinnitus research. We also recorded their responses to MK-801 treatment. Electrophysiological studies showed that MK-801 significantly suppresses SFR in AC of rats with SS-induced tinnitus. In addition, by using a technique that combining in vivo microdialysis with an online electrochemical system (OECS) and a high-performance liquid chromatography (HPLC), we found that the levels of both glutamate and ascorbate in AC dramatically increased after SS injection and that MK-801 administration attenuated those response. Further studies found that MK-801 given at a time point of 30 min pre- or post-injection of SS were more effective than that given at a time point of 60 min post-SS injection, indicating that the time point of MK-801 intervention has a critical impact on the therapeutic effect. These findings suggest that MK-801 plays a neuroprotective role against hyperactivity during tinnitus induced by SS and that the therapeutic effect depends on the time point of MK-801 intervention, which would advance the studies on understanding of the therapeutic potential of NMDA receptor antagonist in tinnitus therapy.
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Affiliation(s)
- Shan Xiong
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Yu Song
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Junxiu Liu
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Yali Du
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Yujing Ding
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China
| | - Huan Wei
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, The Chinese Academy of Sciences, Beijing, 100190, China
| | - Kevin Bryan
- Junipero Serra High School, San Mateo, CA, USA
| | - Furong Ma
- Department of Otolaryngology Head and Neck Surgery, Peking University Third Hospital, Beijing, 100191, China.
| | - Lanqun Mao
- Beijing National Laboratory for Molecular Sciences, Key Laboratory of Analytical Chemistry for Living Biosystems, Institute of Chemistry, The Chinese Academy of Sciences, Beijing, 100190, China.
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Haider HF, Bojić T, Ribeiro SF, Paço J, Hall DA, Szczepek AJ. Pathophysiology of Subjective Tinnitus: Triggers and Maintenance. Front Neurosci 2018; 12:866. [PMID: 30538616 PMCID: PMC6277522 DOI: 10.3389/fnins.2018.00866] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/06/2018] [Indexed: 01/07/2023] Open
Abstract
Tinnitus is the conscious perception of a sound without a corresponding external acoustic stimulus, usually described as a phantom perception. One of the major challenges for tinnitus research is to understand the pathophysiological mechanisms triggering and maintaining the symptoms, especially for subjective chronic tinnitus. Our objective was to synthesize the published literature in order to provide a comprehensive update on theoretical and experimental advances and to identify further research and clinical directions. We performed literature searches in three electronic databases, complemented by scanning reference lists from relevant reviews in our included records, citation searching of the included articles using Web of Science, and manual searching of the last 6 months of principal otology journals. One-hundred and thirty-two records were included in the review and the information related to peripheral and central mechanisms of tinnitus pathophysiology was collected in order to update on theories and models. A narrative synthesis examined the main themes arising from this information. Tinnitus pathophysiology is complex and multifactorial, involving the auditory and non-auditory systems. Recent theories assume the necessary involvement of extra-auditory brain regions for tinnitus to reach consciousness. Tinnitus engages multiple active dynamic and overlapping networks. We conclude that advancing knowledge concerning the origin and maintenance of specific tinnitus subtypes origin and maintenance mechanisms is of paramount importance for identifying adequate treatment.
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Affiliation(s)
- Haúla Faruk Haider
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Tijana Bojić
- Laboratory of Radiobiology and Molecular Genetics, Vinča Institute of Nuclear Sciences, University of Belgrade, Belgrade, Serbia
| | - Sara F Ribeiro
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - João Paço
- ENT Department, Hospital Cuf Infante Santo - NOVA Medical School, Lisbon, Portugal
| | - Deborah A Hall
- NIHR Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom.,University of Nottingham Malaysia, Semeniyh, Malaysia
| | - Agnieszka J Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Attarha M, Bigelow J, Merzenich MM. Unintended Consequences of White Noise Therapy for Tinnitus—Otolaryngology's Cobra Effect. JAMA Otolaryngol Head Neck Surg 2018; 144:938-943. [DOI: 10.1001/jamaoto.2018.1856] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Mouna Attarha
- Posit Science Corporation, San Francisco, California
| | - James Bigelow
- Coleman Memorial Laboratory, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco
| | - Michael M. Merzenich
- Posit Science Corporation, San Francisco, California
- Coleman Memorial Laboratory, Department of Otolaryngology–Head and Neck Surgery, University of California, San Francisco
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34
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Diseases and targets for local drug delivery to the inner ear. Hear Res 2018; 368:3-9. [PMID: 29778289 DOI: 10.1016/j.heares.2018.05.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/06/2018] [Accepted: 05/09/2018] [Indexed: 01/09/2023]
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The Characteristic and Short-Term Prognosis of Tinnitus Associated with Sudden Sensorineural Hearing Loss. Neural Plast 2018; 2018:6059697. [PMID: 29861716 PMCID: PMC5971248 DOI: 10.1155/2018/6059697] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/18/2018] [Indexed: 11/18/2022] Open
Abstract
Tinnitus is believed to result from the maladaptive plasticity of the auditory nervous system; reports regarding its severity and prognosis are conflicting. We evaluated the characteristic and short-term prognosis of tinnitus associated with sudden sensorineural hearing loss (SSNHL). A total of 230 cases were enrolled. The severity and 1-month prognosis of tinnitus (according to the Tinnitus Handicap Inventory (THI)) were assessed in terms of the patients' sex, age, level of hearing loss, type of audiogram results, and so on. According to our statistical analysis, the degree of handicap due to tinnitus was not related to sex, age, or level of hearing loss; the Tinnitus Handicap Inventory indicated that the low-frequency-audiogram group had a low tinnitus handicap (F = 7.516, P = 0.000). Furthermore, we found that the prognosis of tinnitus was not related to the type of audiogram or level of hearing loss. Recovery from a severe level of hearing loss was, however, found to be associated with a poor tinnitus prognosis (F = 5.203, P = 0.006). In summary, our study indicates that the association between tinnitus and SSNHL is extremely high. Tinnitus can be ameliorated by the successful treatment of hearing loss. The study was registered in the Chinese Clinical Trial Registry (ChiCTR1800014797).
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RIGA M, KOMIS A, MARAGOUDAKIS P, KORRES G, FEREKIDIS E, DANIELIDES V. Objective assessment of subjective tinnitus through contralateral suppression of otoacoustic emissions by white noise: effects of frequency, gender, tinnitus bilaterality and age. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2018; 38:131-137. [PMID: 29967558 PMCID: PMC6028813 DOI: 10.14639/0392-100x-1465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 05/07/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY Accumulating evidence seems to support an association between tinnitus and medial olivocochlear bundle (MOCB) dysfunction. Most studies use patient/control comparisons to support this correlation. The aim of this study was to investigate the hypothesis in a substantially different way and evaluate the roles of gender, age, frequency and tinnitus bilaterality as possible confounding factors. The population consisted of 78 normal hearing patients with chronic tinnitus, 28 normal hearing controls, 19 presbycousic tinnitus patients and 13 presbycousic controls (n = 276 ears). Mean suppression amplitudes of transient evoked otoacoustic emissions (TEOAEs) and distortion product OAEs (DPOAEs) by contralateral white noise (50 dB SPL) were computed. Mean suppression values < 1 dB SPL or < 2 dB SPL were validated as positive test results. Overall suppression (OS) values < 1 dB SPL were qualified as a diagnostic test of moderate positive predictive value for both DPOAEs and TEOAEs, while OS values < 2 dB SPL were found to be of large negative predictive value for DPOAEs and moderate for TEOAEs. Mean suppression values (for all frequencies, OS) are of higher diagnostic value than suppression values corresponding to either lower (1-2 kHz) or higher frequencies (2.8-4 kHz for TEOAEs and 2.8-6 kHz for DPOAEs). After excluding patients with unilateral tinnitus from the analysis, correlations were found to be stronger. Useful correlations were also attributed for all age groups < 61 years. In females, OAE suppression seems to have a stronger positive predictive value, while in males it seems to have a stronger negative predictive value. OAE-based assays of MOCB function as an objective diagnostic tool for subjective tinnitus might deserve further investigation. Tinnitus uni- or bi-laterality is a confounding factor, which probably confirms the observation that defective function of the MOCB usually applies to the contralateral ear as well. Gender is an additional confounding factor, while correlations can be verified for all age groups < 61 years old.
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Affiliation(s)
- M. RIGA
- Democritus University of Thrace, Alexandroupolis, Greece
| | - A. KOMIS
- University ENT Dept, Hippoktation General Hospital of Athens, Greece
| | - P. MARAGOUDAKIS
- University ENT Dept, Attikon University Hospital, Athens, Greece
| | - G. KORRES
- University ENT Dept, Attikon University Hospital, Athens, Greece
| | - E. FEREKIDIS
- University ENT Dept, Hippoktation General Hospital of Athens, Greece
| | - V. DANIELIDES
- Democritus University of Thrace, Alexandroupolis, Greece
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37
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Güntensperger D, Thüring C, Meyer M, Neff P, Kleinjung T. Neurofeedback for Tinnitus Treatment - Review and Current Concepts. Front Aging Neurosci 2017; 9:386. [PMID: 29249959 PMCID: PMC5717031 DOI: 10.3389/fnagi.2017.00386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022] Open
Abstract
An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.
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Affiliation(s)
- Dominik Güntensperger
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Christian Thüring
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
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Kleinjung T, Thüring C, Güntensperger D, Neff P, Meyer M. [Neurofeedback for the treatment of chronic tinnitus : Review and future perspectives]. HNO 2017; 66:198-204. [PMID: 29143096 DOI: 10.1007/s00106-017-0432-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Neurofeedback is a noninvasive neuromodulation technique employing real-time display of brain activity in terms of electroencephalography (EEG) signals to teach self-regulation of distinct patterns of brain activity or influence brain activity in a targeted manner. The benefit of this approach for control of symptoms in attention deficit disorders, hyperactivity, depression, and migraine has been proven. Studies in recent years have also repeatedly shown this treatment to improve tinnitus symptoms, although it has not become established as routine therapy. The primary focus of this review is the rational of EEG neurofeedback for tinnitus treatment and the currently available data from published studies. Furthermore, alternative neurofeedback protocols using real-time functional magnetic resonance imaging (fMRI) measurements for tinnitus control are considered. Finally, this article highlights how modern EEG analysis (source localization, connectivity) and the improving understanding of tinnitus pathology can contribute to development of more focused neurofeedback protocols for more sustainable control of tinnitus.
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Affiliation(s)
- T Kleinjung
- Klinik für Ohren‑, Nasen‑, Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz.
| | - C Thüring
- Klinik für Ohren‑, Nasen‑, Hals- und Gesichtschirurgie, UniversitätsSpital Zürich, Frauenklinikstraße 24, 8091, Zürich, Schweiz
| | - D Güntensperger
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
| | - P Neff
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
| | - M Meyer
- Psychologisches Institut, Universität Zürich, Zürich, Schweiz
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39
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Emmert K, Kopel R, Koush Y, Maire R, Senn P, Van De Ville D, Haller S. Continuous vs. intermittent neurofeedback to regulate auditory cortex activity of tinnitus patients using real-time fMRI - A pilot study. NEUROIMAGE-CLINICAL 2017; 14:97-104. [PMID: 28154796 PMCID: PMC5278116 DOI: 10.1016/j.nicl.2016.12.023] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 11/20/2022]
Abstract
The emerging technique of real-time fMRI neurofeedback trains individuals to regulate their own brain activity via feedback from an fMRI measure of neural activity. Optimum feedback presentation has yet to be determined, particularly when working with clinical populations. To this end, we compared continuous against intermittent feedback in subjects with tinnitus. Fourteen participants with tinnitus completed the whole experiment consisting of nine runs (3 runs × 3 days). Prior to the neurofeedback, the target region was localized within the auditory cortex using auditory stimulation (1 kHz tone pulsating at 6 Hz) in an ON-OFF block design. During neurofeedback runs, participants received either continuous (n = 7, age 46.84 ± 12.01, Tinnitus Functional Index (TFI) 49.43 ± 15.70) or intermittent feedback (only after the regulation block) (n = 7, age 47.42 ± 12.39, TFI 49.82 ± 20.28). Participants were asked to decrease auditory cortex activity that was presented to them by a moving bar. In the first and the last session, participants also underwent arterial spin labeling (ASL) and resting-state fMRI imaging. We assessed tinnitus severity using the TFI questionnaire before all sessions, directly after all sessions and six weeks after all sessions. We then compared neuroimaging results from neurofeedback using a general linear model (GLM) and region-of-interest analysis as well as behavior measures employing a repeated-measures ANOVA. In addition, we looked at the seed-based connectivity of the auditory cortex using resting-state data and the cerebral blood flow using ASL data. GLM group analysis revealed that a considerable part of the target region within the auditory cortex was significantly deactivated during neurofeedback. When comparing continuous and intermittent feedback groups, the continuous group showed a stronger deactivation of parts of the target region, specifically the secondary auditory cortex. This result was confirmed in the region-of-interest analysis that showed a significant down-regulation effect for the continuous but not the intermittent group. Additionally, continuous feedback led to a slightly stronger effect over time while intermittent feedback showed best results in the first session. Behaviorally, there was no significant effect on the total TFI score, though on a descriptive level TFI scores tended to decrease after all sessions and in the six weeks follow up in the continuous group. Seed-based connectivity with a fixed-effects analysis revealed that functional connectivity increased over sessions in the posterior cingulate cortex, premotor area and part of the insula when looking at all patients while cerebral blood flow did not change significantly over time. Overall, these results show that continuous feedback is suitable for long-term neurofeedback experiments while intermittent feedback presentation promises good results for single session experiments when using the auditory cortex as a target region. In particular, the down-regulation effect is more pronounced in the secondary auditory cortex, which might be more susceptible to voluntary modulation in comparison to a primary sensory region. Comparison of continuous and intermittent fMRI neurofeedback in tinnitus patients Both groups attempted down-regulation of the auditory cortex. The continuous feedback group seemed to improve after multiple sessions. Intermittent feedback worked best for a single session. Down-regulation effect seems more pronounced in the secondary auditory cortex.
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Affiliation(s)
- Kirsten Emmert
- Department of Radiology and Medical Informatics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, Chemin des Mines 9, Case postale 60, 1211 Geneva 20, Switzerland
| | - Rotem Kopel
- Department of Radiology and Medical Informatics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, Chemin des Mines 9, Case postale 60, 1211 Geneva 20, Switzerland
| | - Yury Koush
- Department of Radiology and Medical Informatics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, Chemin des Mines 9, Case postale 60, 1211 Geneva 20, Switzerland
- Department of Radiology and Biomedical Imaging, Yale University, 300 Cedar Street, New Haven, CT 06519, USA
| | - Raphael Maire
- Department of ENT, Head & Neck Surgery, Neurotology and Audiology Unit, University Hospital of Lausanne, Rue du Bugnon 21, 1011 Lausanne, Switzerland
| | - Pascal Senn
- Department of Clinical Neurosciences, Service of ORL and HNS, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
| | - Dimitri Van De Ville
- Department of Radiology and Medical Informatics, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
- Medical Image Processing Laboratory, Institute of Bioengineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), Campus Biotech, Chemin des Mines 9, Case postale 60, 1211 Geneva 20, Switzerland
| | - Sven Haller
- Affidea CDRC - Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
- Department of Neuroradiology, University Hospital Freiburg, Germany
- Faculty of Medicine of the University of Geneva, Switzerland
- Corresponding author at: Affidea CDRC - Centre Diagnostique Radiologique de Carouge, Clos de la Fonderie 1, 1227 Carouge, Switzerland.Affidea CDRC - Centre Diagnostique Radiologique de CarougeClos de la Fonderie 1Carouge1227Switzerland
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40
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Sekiya K, Takahashi M, Murakami S, Kakigi R, Okamoto H. Broadened population-level frequency tuning in the auditory cortex of tinnitus patients. J Neurophysiol 2017; 117:1379-1384. [PMID: 28053240 PMCID: PMC5350267 DOI: 10.1152/jn.00385.2016] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 12/29/2016] [Accepted: 12/31/2016] [Indexed: 11/22/2022] Open
Abstract
Although subjective tinnitus is one of the most common public health concerns that impair the quality of life of many individuals, no standard treatment or objective diagnostic method currently exists. We herein revealed that population-level frequency tuning was significantly broader in the tinnitus ear than in the nontinnitus ear. The results of the present study provide an insight into the development of an objective diagnostic method for subjective tinnitus. Tinnitus is a phantom auditory perception without an external sound source and is one of the most common public health concerns that impair the quality of life of many individuals. However, its neural mechanisms remain unclear. We herein examined population-level frequency tuning in the auditory cortex of unilateral tinnitus patients with similar hearing levels in both ears using magnetoencephalography. We compared auditory-evoked neural activities elicited by a stimulation to the tinnitus and nontinnitus ears. Objective magnetoencephalographic data suggested that population-level frequency tuning corresponding to the tinnitus ear was significantly broader than that corresponding to the nontinnitus ear in the human auditory cortex. The results obtained support the hypothesis that pathological alterations in inhibitory neural networks play an important role in the perception of subjective tinnitus. NEW & NOTEWORTHY Although subjective tinnitus is one of the most common public health concerns that impair the quality of life of many individuals, no standard treatment or objective diagnostic method currently exists. We herein revealed that population-level frequency tuning was significantly broader in the tinnitus ear than in the nontinnitus ear. The results of the present study provide an insight into the development of an objective diagnostic method for subjective tinnitus.
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Affiliation(s)
- Kenichi Sekiya
- Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan.,Department of Otolaryngology, Head, and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan; and
| | - Mariko Takahashi
- Department of Otolaryngology, Head, and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan; and
| | - Shingo Murakami
- Department of Otolaryngology, Head, and Neck Surgery, Nagoya City University Graduate School of Medical Sciences and Medical School, Nagoya, Japan; and
| | - Ryusuke Kakigi
- Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan.,The Graduate University for Advanced Studies (SOKENDAI), Hayama, Japan
| | - Hidehiko Okamoto
- Department of Integrative Physiology, National Institute for Physiological Sciences, Okazaki, Japan; .,The Graduate University for Advanced Studies (SOKENDAI), Hayama, Japan
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41
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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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42
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Yi B, Hu S, Zuo C, Jiao F, Lv J, Chen D, Ma Y, Chen J, Mei L, Wang X, Huang Z, Wu H. Effects of long-term salicylate administration on synaptic ultrastructure and metabolic activity in the rat CNS. Sci Rep 2016; 6:24428. [PMID: 27068004 PMCID: PMC4828705 DOI: 10.1038/srep24428] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 03/30/2016] [Indexed: 11/17/2022] Open
Abstract
Tinnitus is associated with neural hyperactivity in the central nervous system (CNS). Salicylate is a well-known ototoxic drug, and we induced tinnitus in rats using a model of long-term salicylate administration. The gap pre-pulse inhibition of acoustic startle test was used to infer tinnitus perception, and only rats in the chronic salicylate-treatment (14 days) group showed evidence of experiencing tinnitus. After small animal positron emission tomography scans were performed, we found that the metabolic activity of the inferior colliculus (IC), the auditory cortex (AC), and the hippocampus (HP) were significantly higher in the chronic treatment group compared with saline group (treated for 14 days), which was further supported by ultrastructural changes at the synapses. The alterations all returned to baseline 14 days after the cessation of salicylate-treatment (wash-out group), indicating that these changes were reversible. These findings indicate that long-term salicylate administration induces tinnitus, enhanced neural activity and synaptic ultrastructural changes in the IC, AC, and HP of rats due to neuroplasticity. Thus, an increased metabolic rate and synaptic transmission in specific areas of the CNS may contribute to the development of tinnitus.
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Affiliation(s)
- Bin Yi
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai China
| | - Shousen Hu
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province China
| | - Chuantao Zuo
- PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai China
| | - Fangyang Jiao
- PET Center, Department of Nuclear Medicine, Huashan Hospital, Fudan University, Shanghai China
| | - Jingrong Lv
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China
| | - Dongye Chen
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai China
| | - Yufei Ma
- Department of Nuclear Medicine, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China
| | - Jianyong Chen
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China
| | - Ling Mei
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China
| | - Xueling Wang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai China
| | - Zhiwu Huang
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai China
| | - Hao Wu
- Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai China.,Laboratory of Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai China.,Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai China
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43
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Novák O, Zelenka O, Hromádka T, Syka J. Immediate manifestation of acoustic trauma in the auditory cortex is layer specific and cell type dependent. J Neurophysiol 2016; 115:1860-74. [PMID: 26823513 DOI: 10.1152/jn.00810.2015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/28/2016] [Indexed: 02/02/2023] Open
Abstract
Exposure to loud sounds damages the auditory periphery and induces maladaptive changes in central parts of the auditory system. Diminished peripheral afferentation and altered inhibition influence the processing of sounds in the auditory cortex. It is unclear, however, which types of inhibitory interneurons are affected by acoustic trauma. Here we used single-unit electrophysiological recording and two-photon calcium imaging in anesthetized mice to evaluate the effects of acute acoustic trauma (125 dB SPL, white noise, 5 min) on the response properties of neurons in the core auditory cortex. Electrophysiological measurements suggested the selective impact of acoustic trauma on inhibitory interneurons in the auditory cortex. To further investigate which interneuronal types were affected, we used two-photon calcium imaging to record the activity of neurons in cortical layers 2/3 and 4, specifically focusing on parvalbumin-positive (PV+) and somatostatin-positive (SST+) interneurons. Spontaneous and pure-tone-evoked firing rates of SST+ interneurons increased in layer 4 immediately after acoustic trauma and remained almost unchanged in layer 2/3. Furthermore, PV+ interneurons with high best frequencies increased their evoked-to-spontaneous firing rate ratios only in layer 2/3 and did not change in layer 4. Finally, acoustic trauma unmasked low-frequency excitatory inputs only in layer 2/3. Our results demonstrate layer-specific changes in the activity of auditory cortical inhibitory interneurons within minutes after acoustic trauma.
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Affiliation(s)
- Ondřej Novák
- Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Ondřej Zelenka
- Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Tomáš Hromádka
- Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
| | - Josef Syka
- Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Prague, Czech Republic
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