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Jahn KN, Kashiwagura ST, Yousuf MS. Clinical phenotype and management of sound-induced pain: Insights from adults with pain hyperacusis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.06.19.24309185. [PMID: 38946957 PMCID: PMC11213080 DOI: 10.1101/2024.06.19.24309185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
Pain hyperacusis, also known as noxacusis, causes physical pain in response to everyday sounds that do not bother most people. How sound causes excruciating pain that can last for weeks or months in otherwise healthy individuals is not well understood, resulting in a lack of effective treatments. To address this gap, we identified the most salient physical and psychosocial consequences of debilitating sound-induced pain and reviewed the interventions that sufferers have sought for pain relief to gain insights into the underlying mechanisms of the condition. Adults (n = 32) with pain hyperacusis attended a virtual focus group to describe their sound-induced pain. They completed three surveys to identify common symptoms and themes that defined their condition and to describe their use of pharmaceutical and non-pharmaceutical therapies for pain relief. All participants endorsed negative effects of pain hyperacusis on psychosocial and physical function. Most reported sound-induced burning (80.77%), stabbing (76.92%), throbbing (73.08%), and pinching (53.85%) that occurs either in the ear or elsewhere in the body (i.e., referred pain). Participants reported using numerous pharmaceutical and non-pharmaceutical interventions to alleviate their pain with varying degrees of pain relief. Benzodiazepines and nerve blockers emerged as the most effective analgesic options while non-pharmaceutical therapies were largely ineffective. Symptoms of pain hyperacusis and therapeutic approaches are largely consistent with peripheral mechanistic theories of pain hyperacusis (e.g., trigeminal nerve involvement). An interdisciplinary approach to clinical studies and the development of animal models is needed to identify, validate, and treat the pathological mechanisms of pain hyperacusis.
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Affiliation(s)
- Kelly N Jahn
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Richardson, TX, USA
- Callier Center for Communication Disorders, The University of Texas at Dallas, Dallas, TX, USA
| | - Sean Takamoto Kashiwagura
- Department of Speech, Language, and Hearing, The University of Texas at Dallas, Richardson, TX, USA
- Callier Center for Communication Disorders, The University of Texas at Dallas, Dallas, TX, USA
| | - Muhammad Saad Yousuf
- Department of Neuroscience and Center for Advanced Pain Studies, The University of Texas at Dallas, Richardson, TX, USA
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Perin P, Cossellu D, Vivado E, Batti L, Gantar I, Voigt FF, Pizzala R. Temporal bone marrow of the rat and its connections to the inner ear. Front Neurol 2024; 15:1386654. [PMID: 38817550 PMCID: PMC11137668 DOI: 10.3389/fneur.2024.1386654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 04/10/2024] [Indexed: 06/01/2024] Open
Abstract
Calvarial bone marrow has been found to be central in the brain immune response, being connected to the dura through channels which allow leukocyte trafficking. Temporal bone marrow is thought to play important roles in relation to the inner ear, but is still largely uncharacterized, given this bone complex anatomy. We characterized the geometry and connectivity of rat temporal bone marrow using lightsheet imaging of cleared samples and microCT. Bone marrow was identified in cleared tissue by cellular content (and in particular by the presence of megakaryocytes); since air-filled cavities are absent in rodents, marrow clusters could be recognized in microCT scans by their geometry. In cleared petrosal bone, autofluorescence allowed delineation of the otic capsule layers. Within the endochondral layer, bone marrow was observed in association to the cochlear base and vestibule, and to the cochlear apex. Cochlear apex endochondral marrow (CAEM) was a separated cluster from the remaining endochondral marrow, which was therefore defined as "vestibular endochondral marrow" (VEM). A much larger marrow island (petrosal non-endochondral marrow, PNEM) extended outside the otic capsule surrounding semicircular canal arms. PNEM was mainly connected to the dura, through bone channels similar to those of calvarial bone, and only a few channels were directed toward the canal periosteum. On the contrary, endochondral bone marrow was well connected to the labyrinth through vascular loops (directed to the spiral ligament for CAEM and to the bony labyrinth periosteum for VEM), and to dural sinuses. In addition, CAEM was also connected to the tensor tympani fossa of the middle ear and VEM to the endolymphatic sac. Endochondral marrow was made up of small lobules connected to each other and to other structures by channels lined by elongated macrophages, whereas PNEM displayed larger lobules connected by channels with a sparse macrophage population. Our data suggest that the rat inner ear is surrounded by bone marrow at the junctions with middle ear and brain, most likely with "customs" role, restricting pathogen spread; a second marrow network with different structural features is found within the endochondral bone layer of the otic capsule and may play different functional roles.
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Affiliation(s)
- Paola Perin
- Department of Brain and Behaviour Sciences, University of Pavia, Pavia, Italy
| | - Daniele Cossellu
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Elisa Vivado
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Laura Batti
- Wyss Center for Bio and Neuro Engineering, Geneva, Switzerland
| | - Ivana Gantar
- Wyss Center for Bio and Neuro Engineering, Geneva, Switzerland
| | - Fabian F. Voigt
- Department of Molecular and Cellular Biology, Harvard University, Cambridge, MA, United States
| | - Roberto Pizzala
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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Gao J, Tan P, Liu Y, Chen S, Liu J. Association Between Sleep Apnea and Tinnitus: A Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241226853. [PMID: 38321723 DOI: 10.1177/01455613241226853] [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: 02/08/2024] Open
Abstract
Objective: It remains unclear whether sleep apnea (SA) is associated with tinnitus in adults. Based on a systematic review and meta-analysis of observational studies, we investigated the association between SA and tinnitus in adult population. Methods: Observational studies relevant to our research were identified by searching PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Results: Eight case-control or cross-sectional studies, including 132,292 adults were included, and 1556 of them had SA. It was shown that SA was related to a higher prevalence of tinnitus (odds ratio [OR]: 1.65, 95% confidence interval: 1.14-2.39, P < .001) with moderate heterogeneity (P for Cochrane Q test = 0.04, I2 = 53%). Seven studies reported the association between obstructive SA and tinnitus, while the other one study reported the association between overall SA and tinnitus. Subgroup analyses showed that the association was not significant for mild (OR: 1.80, P = .17) or moderate (OR: 1.25, P = .53), but significant for severe SA (OR: 2.25, P = .008). In addition, the association between SA and tinnitus seemed to be stronger in studies from Italy or United States as compared to those from China (OR: 2.91 vs 1.35, P for subgroup difference = .02). The association was not significantly affected by study design, mean age, proportion of men, methods for diagnosis of SA, and controlling of age and sex (P for subgroup difference all > .05). Conclusion: Severe SA may be related to tinnitus in adults.
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Affiliation(s)
- Jing Gao
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Ping Tan
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Yunliang Liu
- Department of Otolaryngology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Shoujian Chen
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Jianqing Liu
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
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Montemurro N, Trilli I, Bordea IR, Ferrara E, Francesco MD, Caccamo F, Malcangi G, Rapone B. Are Whiplash-Associated Disorders and Temporomandibular Disorders in a Trauma Related Cause and Effect Relationship? A Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1482. [PMID: 37629772 PMCID: PMC10456620 DOI: 10.3390/medicina59081482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background: Whiplash is associated with a wide variety of clinical manifestations, including headache, neck pain, cervical rigidity, shoulder and back pain, paresthesia, vertigo, and temporomandibular disorders (TMDs). Previous studies reported that TMDs are more common in individuals with chronic whiplash-associated disorders (WAD) than in the general population; however, the pathophysiology and mechanism of this relationship are still not well understood. Methods: A PubMed and Ovid EMBASE review was performed to identify all studies addressing the trauma related cause and effect relationship between WAD and TMDs from January 2003 to March 2023. Results: After screening for eligibility and inclusion criteria, a total of 16 articles met the selection criteria. The various included studies discussed different aspects of the association between WDA and TMDs, including changes in the coordination and amplitude of jaw opening, the severity of the associated symptoms/signs in cases of WAD, the degree of fatigue and psychological stress, difficulty in feeding, cervical and myofascial pain, changes in the MRI signal at various muscle points, muscle tenderness, and quality of life. Conclusions: In this review, we summarized the clinical evidence of any trauma related cause and effect relationship between whiplash and TMDs. An accurate screening of the previous literature showed that, in conclusion, the relationship between whiplash and TMDs is still unclear.
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Affiliation(s)
- Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy;
| | - Irma Trilli
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Ioana Roxana Bordea
- Department of Oral Rehabilitation, Faculty of Dental Medicine, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, 400012 Cluj-Napoca, Romania
| | - Elisabetta Ferrara
- Department of Medical, Oral and Biotechnological Sciences, University G. d’Annunzio, 66100 Chieti, Italy;
| | - Maurizio De Francesco
- Department of Neurosciences, Institute of Clinical Dentistry, University of Padua, 35128 Padua, Italy;
| | | | - Giuseppina Malcangi
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
| | - Biagio Rapone
- Interdisciplinary Department of Medicine, “Aldo Moro” University of Bari, 70121 Bari, Italy; (I.T.); (G.M.); (B.R.)
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Makani P, Koops EA, Pyott SJ, van Dijk P, Thioux M. Hyperacusis is associated with smaller gray matter volumes in the supplementary motor area. Neuroimage Clin 2023; 38:103425. [PMID: 37137255 PMCID: PMC10176058 DOI: 10.1016/j.nicl.2023.103425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/05/2023]
Abstract
Hyperacusis is a disorder in loudness perception characterized by increased sensitivity to ordinary environmental sounds and associated with otologic conditions, including hearing loss and tinnitus (the phantom perception of sound) as well as neurologic and neuropsychiatric conditions. Hyperacusis is believed to arise centrally in the brain; however, the underlying causes are unknown. To gain insight into differences in brain morphology associated with hyperacusis, we undertook a retrospective case-control study comparing whole-brain gray matter morphology in participants with sensorineural hearing loss and tinnitus who either scored above or below the threshold for hyperacusis based on a standard questionnaire. We found that participants reporting hyperacusis had smaller gray matter volumes and cortical sheet thicknesses in the right supplementary motor area (SMA), independent of anxiety, depression, tinnitus burden, or sex. In fact, the right SMA volumes extracted from an independently defined volume of interest could accurately classify participants. Finally, in a subset of participants where functional data were also available, we found that individuals with hyperacusis showed increased sound-evoked responses in the right SMA compared to individuals without hyperacusis. Given the role of the SMA in initiating motion, these results suggest that in hyperacusis the SMA is involved in a motor response to sounds.
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Affiliation(s)
- Punitkumar Makani
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands.
| | - Elouise A Koops
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Department of Radiology, Massachusetts General Hospital-Harvard Medical School, Boston, USA
| | - Sonja J Pyott
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Pim van Dijk
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
| | - Marc Thioux
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Groningen, University Medical Centre Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands; Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, FA30, P.O. Box 196, 9700 AD Groningen, the Netherlands
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Singh K, Gude A, Kour A, Guthikonda MR, Mishra AK, Gupta A. A Prospective Study to Elucidate the Efficacy of 4 Oral Prednisolone Regimens in Acute Acoustic Trauma. Indian J Otolaryngol Head Neck Surg 2022; 74:3692-3699. [PMID: 36742739 PMCID: PMC9895518 DOI: 10.1007/s12070-021-02437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 02/07/2023] Open
Abstract
Noise induced hearing loss affects around 5% of the population and acoustic trauma to military personnel accounts for 30% of all injuries inflicted during active service. Initial treatment for acoustic trauma involves administration of steroids, however there are no studies regarding oral steroid regimens for best outcomes. Comparing and elucidating the benefits of four oral steroid regimens on hearing gain in patients with acute acoustic trauma. A prospective study of 4 different steroid regimens was done in 200 soldiers from July 2014 - July 2020. In the first group, oral Prednisolone 60 mg was administered for 6 days, in the second group for 8 days, in the third group for 10 days and in the fourth group for 12 days. Medication was tapered over the next 5 days in all the groups. Data analysed included demographics, Pure Tone Audiograms at admission and at 4 weeks, time of reporting to hospital, onset of treatment and type of treatment given. Multivariate linear regression model was done to consider the risk factors responsible for average hearing gain at all pure tones. Box-and-whisker plot, Mann-Whitney-Wilcoxon test, Kruskal Wallis test, Reciever Operating Characteristic curve were used to analyse the independent samples. p value of < 0.05 was considered statistically significant. Age, time of onset of prednisolone therapy and acoustic trauma due to blast or gunshot injury did not show correlation (R2 = 0.01, 0.01 and 0.35 respectively and p = 0.09, 0.71, 0.80 respectively). Prednisolone therapy, average initial hearing at pure tones were considered as factors responsible for hearing gain as they showed correlation (R2 = 0.22, and 0.34 respectively and p < 0.001 and < 0.01 respectively). Significant hearing gain was found in all groups. The hearing gain was statistically better in group 3 and 4 as compared to group 1 and 2. There was no statistically significant difference in hearing gain between groups 3 and 4. So there was no additional advantage of giving 60 mg oral prednisolone for more than 10 days. The best oral prednisolone regimen recommended is 60 mg/day for 10 days which is tapered over the next 5 days.
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Affiliation(s)
- Kamalpreet Singh
- Dept of Otorhinolaryngology-Head & Neck Surgery, Armed Forces Medical College, Pune, Maharashtra India 411040
| | - Aswini Gude
- Department of Pathology, Gayatri Institute of Health Care &Medical Technology, GVP Medical College, Maridi Valley, Marikavalasa, Visakhapatnam, Andhra Pradesh 530048 India
| | - Amrindarjeet Kour
- Medical Officer, Armed Forced Medical College, Pune, Maharashtra 411040 India
| | - Mohan Raghav Guthikonda
- Dept of Otorhinolaryngology- Head & Neck Surgery, 166 Military Hospital, Satwari Cantonment, Jammu and Kashmir, Jammu, 180003 India
| | - Awadhesh Kumar Mishra
- Dept of Otorhinolaryngology-Head & Neck Surgery, Army College of Medical Sciences &Base Hospital, Delhi Cantt, New Delhi, India
| | - Arun Gupta
- Dept of PSM, AFMC, Pune, Maharashtra India
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Fournier P, Paleressompoulle D, Esteve Fraysse MJ, Paolino F, Devèze A, Venail F, Noreña A. Exploring the middle ear function in patients with a cluster of symptoms including tinnitus, hyperacusis, ear fullness and/or pain. Hear Res 2022; 422:108519. [PMID: 35644108 DOI: 10.1016/j.heares.2022.108519] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/06/2022] [Accepted: 05/10/2022] [Indexed: 11/04/2022]
Abstract
Middle ear muscle (MEM) abnormalities have been proposed to be involved in the development of ear-related symptoms such as tinnitus, hyperacusis, ear fullness, dizziness and/or otalgia. This cluster of symptoms have been called the Tonic Tensor Tympani Syndrome (TTTS) because of the supposed involvement of the tensor tympani muscle (TTM). However, the putative link between MEM dysfunction and the symptoms has not been proven yet and the detailed mechanisms (the causal chain) of TTTS are still elusive. It has been speculated that sudden loud sound (acoustic shock) may impair the functioning of the MEM, specifically the TTM, after an excessive contraction. This would result in inflammatory processes, activation of the trigeminal nerve and a change of the MEMs state into a hypersensitive one, that may be associated to the cluster of symptoms listed above. The goal of this study is to provide further insights into the mechanisms of TTTS. The middle ear function of 11 patients who reported TTTS symptoms has been investigated using either admittancemetry and/or measurement of air pressure in the sealed external auditory canal. While the former method measured the middle ear stiffness the latter provides an estimate of the tympanic membrane displacement. Most patients displayed results consistent with phasic contractions of the TTM (n = 9) and/or Eustachian Tube (ET) dysfunction (n = 6). The MEM contraction or ET dysfunction could be evoked by acoustic stimulation (n = 3), somatic maneuvers (n = 3), or pressure changes in the ear canal (n = 3). Spontaneous TTM contraction (n = 1) or ET opening (n = 1) could also be observed. Finally, voluntary contraction of MEM was also reported (n = 5). On the other hand, tonic contraction of the TTM could not be observed in any patient. The implications of these results for the mechanisms of TTTS are discussed.
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Affiliation(s)
- Philippe Fournier
- Centre National de la Recherche Scientifique (CNRS), Université d'Aix-Marseille, Centre St-Charles-Pôle 3C, Marseille, France; School of Rehabilitation, Faculty of Medecine, Université Laval, Québec, QC, Canada
| | - Dany Paleressompoulle
- Centre National de la Recherche Scientifique (CNRS), Université d'Aix-Marseille, Centre St-Charles-Pôle 3C, Marseille, France
| | - Marie-José Esteve Fraysse
- Service d'Oto-Rhino-Laryngologie, d'Oto-Neurologie et d'ORL Pédiatrique, Centre Hospitalier Universitaire de Toulouse, Place du Dr Baylac, France
| | - Fabien Paolino
- ORL and Skull Base Surgery, Clairval Hospital, Ramsay GDS Health Care, Marseille, France
| | - Arnaud Devèze
- ORL and Skull Base Surgery, Clairval Hospital, Ramsay GDS Health Care, Marseille, France; Laboratory of Biomechanism, IFSTTAR UMR T24, Faculty of Medicine Nord, Aix Marseille University, Marseille, France
| | - Frédéric Venail
- Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Arnaud Noreña
- Centre National de la Recherche Scientifique (CNRS), Université d'Aix-Marseille, Centre St-Charles-Pôle 3C, Marseille, France.
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Fournier P, Paquette S, Paleressompoulle D, Paolino F, Devèze A, Noreña A. An exploratory multi-method investigation of middle ear muscle contraction. Hear Res 2022; 420:108509. [DOI: 10.1016/j.heares.2022.108509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/18/2022] [Accepted: 04/20/2022] [Indexed: 11/04/2022]
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Williams ZJ, Suzman E, Woynaroski TG. A Phenotypic Comparison of Loudness and Pain Hyperacusis: Symptoms, Comorbidity, and Associated Features in a Multinational Patient Registry. Am J Audiol 2021; 30:341-358. [PMID: 33877881 DOI: 10.1044/2021_aja-20-00209] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose Hyperacusis is a complex and poorly understood auditory disorder characterized by decreased tolerance to sound at levels that would not trouble most individuals. Recently, it has been suggested that individuals who experience otalgia in response to everyday sounds (termed pain hyperacusis) may differ clinically from those whose primary symptom is the perception of everyday sounds as excessively loud (termed loudness hyperacusis). Despite this theoretical distinction, there have been no empirical studies directly comparing these two populations of hyperacusis patients. Method Using data from a multinational patient registry (the Coordination of Rare Diseases at Sanford Registry), we examined self-reported demographics, symptoms, comorbidity, and response to treatment in a sample of 243 adults with hyperacusis, 152 of whom were classified as having pain hyperacusis based on reported symptoms. Bayesian statistical tests were used to investigate both the presence and absence of group differences between patients with loudness and pain hyperacusis. Results Individuals with pain hyperacusis presented with a more severe clinical phenotype, reporting a higher frequency of temporary symptom exacerbations (i.e., "setbacks"), less perceived symptom improvement over time, more severe comorbid headache disorders, and reduced benefit from sound therapy. However, the two hypothesized hyperacusis subtypes exhibited more similarities than differences, with the majority of symptoms and comorbidities being equally prevalent across groups. Multiple comorbidities were commonly observed, including tinnitus, primary headache disorders, psychiatric disorders, and functional somatic syndromes. Intolerance of sensory stimuli in other modalities was also frequently reported. Conclusion Although this study provides little evidence that loudness and pain hyperacusis are pathophysiologically distinct conditions, our findings indicate that a pain-predominant phenotype may be a meaningful prognostic marker in patients with hyperacusis.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
| | - Evan Suzman
- Graduate Program in Biomedical Sciences, Vanderbilt University, Nashville, TN
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN
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Simoes JP, Daoud E, Shabbir M, Amanat S, Assouly K, Biswas R, Casolani C, Dode A, Enzler F, Jacquemin L, Joergensen M, Kok T, Liyanage N, Lourenco M, Makani P, Mehdi M, Ramadhani AL, Riha C, Santacruz JL, Schiller A, Schoisswohl S, Trpchevska N, Genitsaridi E. Multidisciplinary Tinnitus Research: Challenges and Future Directions From the Perspective of Early Stage Researchers. Front Aging Neurosci 2021; 13:647285. [PMID: 34177549 PMCID: PMC8225955 DOI: 10.3389/fnagi.2021.647285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 03/19/2021] [Indexed: 12/15/2022] Open
Abstract
Tinnitus can be a burdensome condition on both individual and societal levels. Many aspects of this condition remain elusive, including its underlying mechanisms, ultimately hindering the development of a cure. Interdisciplinary approaches are required to overcome long-established research challenges. This review summarizes current knowledge in various tinnitus-relevant research fields including tinnitus generating mechanisms, heterogeneity, epidemiology, assessment, and treatment development, in an effort to highlight the main challenges and provide suggestions for future research to overcome them. Four common themes across different areas were identified as future research direction: (1) Further establishment of multicenter and multidisciplinary collaborations; (2) Systematic reviews and syntheses of existing knowledge; (3) Standardization of research methods including tinnitus assessment, data acquisition, and data analysis protocols; (4) The design of studies with large sample sizes and the creation of large tinnitus-specific databases that would allow in-depth exploration of tinnitus heterogeneity.
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Affiliation(s)
- Jorge Piano Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Elza Daoud
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Maryam Shabbir
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sana Amanat
- Otology & Neurotology Group CTS 495, Department of Genomic Medicine, GENYO - Centre for Genomics and Oncological Research Pfizer/University of Granada/Junta de Andalucía, PTS, Granada, Spain
| | - Kelly Assouly
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
- Department of Clinical and Experimental Neuroscience, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, Netherlands
- Cochlear Technology Centre, Mechelen, Belgium
| | - Roshni Biswas
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Chiara Casolani
- Hearing Systems, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
- Oticon A/S, Smoerum, Denmark
- Interacoustics Research Unit, Lyngby, Denmark
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Falco Enzler
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Laure Jacquemin
- Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Mie Joergensen
- Hearing Systems, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
- WS Audiology, Lynge, Denmark
| | - Tori Kok
- Ear Institute, University College London, London, United Kingdom
| | - Nuwan Liyanage
- University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Matheus Lourenco
- Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
- Health Psychology Research Group, Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Punitkumar Makani
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands
| | - Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Anissa L. Ramadhani
- Radiological Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Constanze Riha
- Chair of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Jose Lopez Santacruz
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands
| | - Axel Schiller
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Natalia Trpchevska
- Department of Physiology and Pharmacology, Experimental Audiology Laboratory, Karolinska Institutet, Stockholm, Sweden
| | - Eleni Genitsaridi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Nottingham Biomedical Research Centre, National Institute for Health Research, Nottingham, United Kingdom
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11
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Fournier P, Hébert S. The gap prepulse inhibition of the acoustic startle (GPIAS) paradigm to assess auditory temporal processing: Monaural versus binaural presentation. Psychophysiology 2020; 58:e13755. [PMID: 33355931 DOI: 10.1111/psyp.13755] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 10/08/2020] [Accepted: 10/09/2020] [Indexed: 01/20/2023]
Abstract
The Gap Prepulse Inhibition of the Acoustic Startle Reflex (GPIAS) is a paradigm used to assess auditory temporal processing in both animals and humans. It consists of the presentation of a silent gap embedded in noise and presented a few milliseconds before a startle sound. The silent gap produces the inhibition of the startle reflex, a phenomenon called gap-prepulse inhibition (GPI). This paradigm is also used to detect tinnitus in animal models. The lack of inhibition by the silent gaps is suggested to be indicative of the presence of tinnitus "filling-in" the gaps. The current research aims at improving the GPIAS technique by comparing the GPI produced by monaural versus binaural silent gaps in 29 normal-hearing subjects. Two gap durations (5 or 50 ms), each embedded in two different frequency backgrounds (centered around 500 or 4 kHz). Both low- and high- frequency narrowband noises had a bandwidth of half an octave. Overall, the startle magnitude was greater for the binaural versus the monaural presentation, which might reflect binaural loudness summation. In addition, the GPI was similar between the monaural and the binaural presentations for the high-frequency background noise. However, the GPI was greater for the low-frequency background noise for the binaural, compared to the monaural, presentation. These findings suggest that monaural GPIAS might be more suited to detect tinnitus compared to the binaural presentation.
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Affiliation(s)
- Philippe Fournier
- École d'orthophonie et d'audiologie, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,BRAMS, International Laboratory for Brain, Music, and Sound Research, Université de Montréal and McGill University, Montréal, QC, Canada.,Centre national de la recherche scientifique (CNRS), Université d'Aix-Marseille, Centre St-Charles-Pôle 3C, Marseille, France
| | - Sylvie Hébert
- École d'orthophonie et d'audiologie, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,BRAMS, International Laboratory for Brain, Music, and Sound Research, Université de Montréal and McGill University, Montréal, QC, Canada
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12
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Manohar S, Adler HJ, Radziwon K, Salvi R. Interaction of auditory and pain pathways: Effects of stimulus intensity, hearing loss and opioid signaling. Hear Res 2020; 393:108012. [PMID: 32554129 DOI: 10.1016/j.heares.2020.108012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/24/2020] [Accepted: 05/29/2020] [Indexed: 11/19/2022]
Abstract
Moderate intensity sounds can reduce pain sensitivity (i.e., audio-analgesia) whereas intense sounds can induce aural pain, evidence of multisensory interaction between auditory and pain pathways. To explore auditory-pain pathway interactions, we used the tail-flick (TF) test to assess thermal tail-pain sensitivity by measuring the latency of a rat to remove its tail from 52 °C water. In Experiment 1, TF latencies were measured in ambient noise and broadband noise (BBN) presented from 80 to 120 dB SPL. TF latencies gradually increased from ambient to 90 dB SPL (audio-analgesia), but then declined. At 120 dB, TF latencies were significantly shorter than normal, evidence for audio-hyperalgesia near the aural threshold for pain. In Experiment II, the opioid pain pathway was modified by treating rats with a high dose of fentanyl known to induce post-treatment hyperalgesia. TF latencies in ambient noise were normal 10-days post-fentanyl. However, TF latencies became shorter than normal from 90 to 110 dB indicating that fentanyl pre-treatment had converted audio-analgesia to audio-hyperalgesia. In Experiment III, we tested the hypothesis that hearing loss could alter pain sensitivity by unilaterally exposing rats to an intense noise that induced a significant hearing loss. TF latencies in ambient noise gradually declined from 1- to 4-weeks post-exposure indicating that noise-induced hearing loss had increased pain sensitivity. Our results suggest that auditory and pain pathways interact in ways that depend on intensity, hearing loss and opioid pain signaling, results potentially relevant to pain hyperacusis.
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Affiliation(s)
- Senthilvelan Manohar
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Henry J Adler
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Kelly Radziwon
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA
| | - Richard Salvi
- Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, 14214, USA.
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13
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Boedts MJO. Tympanic Resonance Hypothesis. Front Neurol 2020; 11:14. [PMID: 32117001 PMCID: PMC7008469 DOI: 10.3389/fneur.2020.00014] [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: 09/08/2019] [Accepted: 01/07/2020] [Indexed: 11/13/2022] Open
Abstract
Seemingly unrelated symptoms in the head and neck region are eliminated when a patch is applied on specific locations on the Tympanic Membrane. Clinically, two distinct patient populations can be distinguished; cervical and masticatory muscle tensions are involved, and mental moods of anxiety or need. Clinical observations lead to the hypothesis of a “Tympanic Resonance Regulating System.” Its controller, the Trigeminocervical complex, integrates external auditory, somatosensory, and central impulses. It modulates auditory attention, and directs it toward unpredictable external or expected domestic and internal sounds: peripherally by shifting the resonance frequencies of the Tympanic Membrane; centrally by influencing the throughput of auditory information to the neural attention networks that toggle between scanning and focusing; and thus altering the perception of auditory information. The hypothesis leads to the assumption that the Trigeminocervical complex is composed of a dorsal component, and a ventral one which may overlap with the concept of “Trigeminovagal complex.” “Tympanic Dissonance” results in a host of local and distant symptoms, most of which can be attributed to activation of the Trigeminocervical complex. Diagnostic and therapeutic measures for this “Tympanic Dissonance Syndrome” are suggested.
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Affiliation(s)
- Michael J O Boedts
- Brai3n, Ghent, Belgium.,ENT Department, AZ Maria Middelares, Ghent, Belgium
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14
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Xie P, Peng Y, Hu J, Yi S. A study on the effect of ligament and tendon detachment on human middle ear sound transfer using mathematic model. Proc Inst Mech Eng H 2019; 233:784-792. [PMID: 31165672 DOI: 10.1177/0954411919853364] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The objective of this study is to investigate the effects of ligament and tendon detachment on human middle ear sound transfer. For this purpose, a geometric human middle ear model was reconstructed based on the computed tomography scanning data of the temporal bones from healthy adult volunteers. For the ear model, pars tensa was assumed to be fit for a 5-parameter Maxwell model and inverse method was used to obtain the necessary coefficients. Furthermore, frequency response method was implemented to investigate the vibration behaviors of tympanic membrane umbo and stapes footplate under an acoustic stimulus of 90 dB within 0.2-8 kHz. Meanwhile, nine patterns of fractured ligaments and tendons, whose effects on the middle ear sound transfer function were simulated by setting free the nodes of the ligaments and tendons of interest. The results indicate that the displacement of tympanic membrane umbo and stapes footplate as well as the velocity transfer function lies within the bounds of the published experimental data. The detachments of ligaments or tendons except for lateral mallear ligament may incur both gains as much as 15 dB and losses of -8 dB in the velocity of stapes footplate at low frequencies (f≤ 1 kHz), while no significant changes were observed at high frequencies (f > 1 kHz). However, detachment of the ligaments or tendons induces tiny changes in the displacement of stapes footplate at the frequencies of 0.2-8 kHz.
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Affiliation(s)
- Pengpeng Xie
- 1 Key Laboratory of Traffic Safety on Track (Central South University), Ministry of Education, School of Traffic & Transportation Engineering, Central South University, Changsha, China.,2 Joint International Research Laboratory of Key Technology for Rail Traffic Safety, Central South University, Changsha, China
| | - Yong Peng
- 1 Key Laboratory of Traffic Safety on Track (Central South University), Ministry of Education, School of Traffic & Transportation Engineering, Central South University, Changsha, China.,3 National & Local Joint Engineering Research Center of Safety Technology for Rail Vehicle, Central South University, Changsha, China
| | - Junjiao Hu
- 4 Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shengen Yi
- 5 Research Laboratory of Hepatobiliary Diseases General Surgical Department, The Second Xiangya Hospital, Central South University, Changsha, China
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