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Hoare DJ, Smith H, Kennedy V, Fackrell K. Tinnitus in Children. J Assoc Res Otolaryngol 2024; 25:239-247. [PMID: 38709437 PMCID: PMC11150219 DOI: 10.1007/s10162-024-00944-3] [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: 12/31/2023] [Accepted: 03/04/2024] [Indexed: 05/07/2024] Open
Abstract
This perspective reviews the current state of the art and literature on tinnitus in children, prevalence and risk factors, clinical management, and future priorities for healthcare provision and research. Most research in the field to date appears to be prevalence studies, which have reached dramatically different estimates; this reflects the lack of a standard language when asking about the presence of tinnitus, or how bothersome, distressing, or negatively impacting it is for the child. Estimates are also likely affected by a lack of awareness of tinnitus amongst children and parents. Children are less likely to spontaneously report tinnitus than adults, and parents are often unaware their child could even develop tinnitus, considering it a disease of older age for example. It is critical that children are asked and learn about tinnitus. In hearing clinics, clinicians should routinely ask about all children about tinnitus and offer tinnitus care and settings that are child- and family-friendly. As well as asking directly, clinicians should be alert to soft signs of tinnitus such as unexplained listening, speech perception, concentration difficulties, worry or anxiety, or difficulties completing hearing tests or using hearing aids. The recently developed impact of Tinnitus in Children Questionnaire (iTICQ) can then be used to assess problems that are most commonly core to children's experience of tinnitus. Clinical guidelines for tinnitus in children are few but provide recommendations for additional paediatric questionnaires and alternative assessments and for a range of treatment options. Of note, however, is the lack of clinical trials and, therefore, evidence of the effectiveness of any treatment for tinnitus in children. Significant and concerted work is therefore needed to raise awareness of tinnitus in children, understand the scale of clinical need, and standardise and evaluate clinical management options.
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Affiliation(s)
- Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
- School of Clinical Therapies, College of Medicine and Health, University College Cork, Cork, T12 EK59, Republic of Ireland.
| | - Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- National Institute for Health and Care Research (NIHR) Coordinating Centre, School of Healthcare Enterprise and Innovation, University of Southampton, Southampton, UK
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Hall DA, Xiong B, Li W, Wang Y, Zhang X, Zhao F. Why is tinnitus a problem? A large-scale qualitative evaluation of problems reported by tinnitus patients in mainland China. Int J Audiol 2024; 63:334-341. [PMID: 37093086 DOI: 10.1080/14992027.2023.2199441] [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: 10/18/2022] [Accepted: 03/30/2023] [Indexed: 04/25/2023]
Abstract
OBJECTIVES The lived experience of tinnitus has biopsychosocial characteristics which are influenced by sociocultural factors. The main purpose of this study is to investigate how tinnitus affects people in their everyday life in China. A deductive qualitative analysis examined whether an a priori Western-centric conceptual framework could extend to an Asian context. DESIGN A large-scale prospective survey collected patient-reported problems associated with tinnitus in 485 adults attending four major ENT clinics in Eastern and Southern mainland China. RESULTS The evidence suggests that patients in China express a narrower range of problem domains associated with the lived experience of tinnitus. While 13 tinnitus-related problem domains were confirmed, culture-specific adaptations included the addition uncomfortable (a novel concept not previously reported), and the potential exclusion of concepts such as intrusiveness, loss of control, loss of peace and loss of sense of self. CONCLUSIONS The sociocultural context of patients across China plays an important role in defining the vocabulary used to describe the patient-centred impacts of tinnitus. Possible explanatory factors include cultural differences in the meaning and relevance of certain concepts relating to self and in help-seeking behaviour, low health literacy and a different lexicon in Chinese compared to English to describe tinnitus-related problems.
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Affiliation(s)
- Deborah A Hall
- School of Social Sciences, Heriot-Watt University, Putrajaya, Malaysia
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Binbin Xiong
- Center for Hearing and Balance of Zhuhai, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Affiliated Hospital of the Faculty of Chinese Medicine, Zhuhai Hospital Affiliated to Southern Medical University Macao University of Science and Technology, Zhuhai, People's Republic of China
| | - Wenyan Li
- Department of Otolaryngology, Affiliated Eye and Ear, Nose and Throat (ENT) Hospital of Fudan University, Shanghai, People's Republic of China
| | - Yaowen Wang
- Department of Otolaryngology, Ningbo First Hospital, Ningbo, People's Republic of China
| | - Xiaoli Zhang
- Department of Otolaryngology Head and Neck Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, People's Republic of China
- Research Institute of Otolaryngology, Nanjing, People's Republic of China
| | - Fei Zhao
- Cardiff School of Health Sciences, Cardiff Metropolitan University, Cardiff, UK
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Jacquemin L, van der Poel N, Biot L, Schollaert J, Bonné F, Vanderveken OM, Lammers MJW, Van Rompaey V, Gilles A. Prevalence of tinnitus and hyperacusis in 9-12-year-old children. Eur Arch Otorhinolaryngol 2023; 280:4819-4825. [PMID: 37133498 PMCID: PMC10155651 DOI: 10.1007/s00405-023-07995-x] [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: 10/29/2022] [Accepted: 04/24/2023] [Indexed: 05/04/2023]
Abstract
OBJECTIVES To estimate the prevalence of tinnitus and hyperacusis in children aged 9-12 years in Flanders, as well as to explore the associations with hearing abilities and listening behaviours. DESIGN A cross-sectional survey was undertaken in four different Flemish schools. The questionnaire was distributed among 415 children, with a response rate of 97.3%. RESULTS The prevalence of permanent tinnitus was 10.5% and of hyperacusis was 3.3%. The hyperacusis prevalence was higher in girls (p < .05). Some children reported effects of tinnitus in terms of anxiety (20.1%), sleep (36.5%), and concentration (24.8%). When listening to personal listening devices, 33.5% of the children reported to listen for at least 1 h at 60% or higher of the volume range. Moreover, 54.9% of children stated to never wear hearing protection. CONCLUSIONS Tinnitus and hyperacusis are prevalent in children aged 9-12 years. Some of these children might be overlooked and, as such, not receiving the required follow-up or counselling. Development of guidelines for the assessment of these auditory symptoms in children would help to determine the prevalence numbers with greater accuracy. Sensibility campaigns for safe listening are warranted, as more than half of the children never use hearing protection.
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Affiliation(s)
- Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium.
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium.
| | - Nicolien van der Poel
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Lana Biot
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Joris Schollaert
- Medicine, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
| | - Fien Bonné
- Audiology, University College Ghent, Ghent, Belgium
| | - Olivier M Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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Bourez PH, Vallet GT, Fournier P. Improving Audiology Student Training by Clinical Simulation of Tinnitus: A Glimpse of the Lived Experience of Tinnitus. Brain Sci 2023; 13:1338. [PMID: 37759939 PMCID: PMC10526917 DOI: 10.3390/brainsci13091338] [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: 08/24/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
PURPOSE Student audiology training in tinnitus evaluation and management is heterogeneous and has been found to be insufficient. We designed a new clinical simulation laboratory for training students on psychoacoustic measurements of tinnitus: one student plays the role of the tinnitus patient, wearing a device producing a sound like tinnitus on one ear, while another student plays the role of the audiologist, evaluating their condition. The objective of the study was to test this new clinical simulation laboratory of tinnitus from the perspective of the students. METHOD This study reports the findings from twenty-one audiology students (20 female and 1 male, mean age = 29, SD = 7.7) who participated in this laboratory for a mandatory audiology class at the Laval University of Quebec. Three students had hearing loss (one mild, two moderate). All students played the role of both the clinician and the patient, alternately. They also had to fill out a questionnaire about their overall experience of the laboratory. RESULTS The qualitative analysis revealed three main themes: "Benefits of the laboratory on future practice", "Barriers and facilitators of the psychoacoustic assessment", and "Awareness of living with tinnitus". The participants reported that this experience would have a positive impact on their ability to manage tinnitus patients in their future career. CONCLUSION This fast, cheap, and effective clinical simulation method could be used by audiology and other healthcare educators to strengthen students' skills and confidence in tinnitus evaluation and management. The protocol is made available to all interested parties.
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Affiliation(s)
- Pierre H. Bourez
- Department of Rehabilitation, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
| | - Guillaume T. Vallet
- Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada;
- Centre de Recherche de L’institut Universitaire de Gériatrie de Montréal, Montreal, QC H3W 1W4, Canada
| | - Philippe Fournier
- Department of Rehabilitation, Laval University, Quebec City, QC G1V 0A6, Canada
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de La Capitale-Nationale (CIUSSS-CN), Quebec City, QC G1M 2S8, Canada
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Norena AJ. The Analogy between Tinnitus and Chronic Pain: A Phenomenological Approach. Brain Sci 2023; 13:1129. [PMID: 37626486 PMCID: PMC10452332 DOI: 10.3390/brainsci13081129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Tinnitus is an auditory sensation without external acoustic stimulation or significance, which may be lived as an unpleasant experience and impact the subject's quality of life. Tinnitus loudness, which is generally low, bears no relation to distress. Factors other than psychoacoustic (such as psychological factors) are therefore implicated in the way tinnitus is experienced. The aim of this article is to attempt to understand how tinnitus can, like chronic pain, generate a 'crisis' in the process of existence, which may go as far as the collapse of the subject. The main idea put forward in the present article is that tinnitus may be compared to the phenomenon of pain from the point of view of the way it is experienced. Although the analogy between tinnitus and pain has often been made in the literature, it has been limited to a parallel concerning putative physiopathological mechanisms and has never really been explored in depth from the phenomenological point of view. Tinnitus is comparable to pain inasmuch as it is felt, not perceived: it springs up (without intention or exploration), abolishes the distance between the subject and the sensation (there is only a subject and no object), and has nothing to say about the world. Like pain, tinnitus is formless and abnormal and can alter the normal order of the world with maximum intensity. Finally, tinnitus and pain enclose the subject within the limits of the body, which then becomes in excess. Tinnitus may be a source of suffering, which affects not only the body but a person's very existence and, in particular, its deployment in time. Plans are thus abolished, so time is no longer 'secreted', it is enclosed in an eternal present. If the crisis triggered by tinnitus is not resolved, the subject may buckle and collapse (depression) when their resources for resisting are depleted. The path may be long and winding from the moment when tinnitus emerges to when it assaults existence and its eventual integration into a new existential norm where tinnitus is no longer a source of disturbance.
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Affiliation(s)
- Arnaud J Norena
- Laboratoire de Neurosciences Sensorielles et Cognitives, CNRS, Aix-Marseille University, 13003 Marseille, France
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Wang X, Guo L, Tian R, Fei Y, Ji J, Diao C, Zuo L, Zeng Y, Guo Q, Chen K, Zheng Y. Hearing Aids Combined With Educational Counseling Versus Educational Counseling Alone for Tinnitus Treatment in Patients With Hearing Loss: A Longitudinal Follow-Up Study. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-13. [PMID: 37267442 DOI: 10.1044/2023_jslhr-22-00493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE The effect of hearing aids (HAs) and educational counseling (EC) or their combination on tinnitus is ambiguous. This study aimed to investigate whether the combined use of HAs and EC is more effective than EC alone on tinnitus relief. METHOD A total of 72 adults with chronic, bothersome tinnitus and coexisting sensorineural hearing loss completed at least 1-month and 3-month follow-up. After receiving EC and HA prescriptions, 21 participants selected to purchase HAs (i.e., the HA + EC group), whereas the remaining 51 refused to use HAs despite recommendations (i.e., the EC group). Tinnitus severity was measured by Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), and Visual Analog Scale (VAS) for loudness. The primary outcome measure was THI, and tinnitus relief was defined as a 20-point or more reduction in THI. A generalized linear mixed model was used to confirm that the heterogeneity in baseline characteristics between groups did not interfere with the results. RESULTS The THI, TEQ, and VAS scores decreased significantly after treatments, and both groups yielded a similar trend of reduction. There were no significant differences in the incidence of tinnitus relief and time-to-event curves between the two groups. In addition, the length of follow-up did not affect treatment effectiveness. CONCLUSION There was insufficient evidence to support the superiority of the combined use of HA and EC for tinnitus over EC with no device.
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Affiliation(s)
- Xunyi Wang
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Lanxin Guo
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Run Tian
- State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu
- Department of Dermatology, West China Hospital, Sichuan University, Chengdu
| | - Yingping Fei
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Jinfeng Ji
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Cong Diao
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Lin Zuo
- West China Medical School, Sichuan University, Chengdu
| | - Yuxiao Zeng
- West China Medical School, Sichuan University, Chengdu
| | - Qingxin Guo
- West China Medical School, Sichuan University, Chengdu
| | - Ke Chen
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
| | - Yun Zheng
- Hearing Center/Hearing & Speech Laboratory, Department of Otorhinolaryngology-Head & Neck Surgery, West China Hospital, Sichuan University, Chengdu
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Chauhan B, Arya S, Chauhan K. Ginkgo biloba Administered Singly and Combined With Antioxidants in Tinnitus Patients. J Audiol Otol 2023; 27:37-44. [PMID: 36710418 PMCID: PMC9884989 DOI: 10.7874/jao.2022.00395] [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: 09/18/2022] [Accepted: 11/24/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Tinnitus, or ear ringing, involves impulsive and spontaneous activity in the auditory neurons. Its prevalence is high in the elderly, but 10%-15% of adults suffer from tinnitus, affecting their quality of life. Therefore, this study aimed to evaluate the efficacy of Ginkgo biloba administered singly and in combination with antioxidants in tinnitus patients. Subjects and. METHODS Patients were randomly allocated to Placebo (T0, n=22), Treatment 1 (T1, n=24), and Treatment 2 (T2, n=23) groups. The patients were educated on the study's methodology and were instructed to visit at 0, 4, 8, 12, and 14 weeks. The placebo group received starch capsule supplements. Conversely, the treatment groups received Ginkgo biloba (60 mg twice a day) singly and in combination with antioxidants. We enrolled 69 patients aged 40-70 years (41 men, 28 women). The Tinnitus Handicap Index (THI), Visual Analogue Score (VAS), and Short Form 36 (SF-36) Health Scores were determined pre- and post-treatment at each visit. RESULTS Supplementation of Ginkgo biloba, along with antioxidants, provided marked improvement (p<0.05) in post-treatment THI and VAS scores in the T2 group compared to those in the T1 and T0 groups. The greatest (p<0.05) percent difference was observed in the pre- and post-treatment THI (-36%) and VAS scores (-22.6%) of T2 patients. Likewise, the SF-36 scores improved significantly (p<0.05) in the T2 group in varied parameters. CONCLUSIONS Ginkgo biloba, along with antioxidants, can be a promising therapy for tinnitus patients, providing marked improvement in THI, VAS, and SF-36 scores.
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Affiliation(s)
- Bhushan Chauhan
- Department of ENT, M. M. Institute of Medical Sciences and Research, MMDU, Mullana, Ambala, Haryana, India,Address for correspondence Bhushan Chauhan, MS Department of ENT, M. M. Institute of Medical Sciences & Research, MMDU, Mullana, Ambala, Haryana, India Tel +91-9357097074 E-mail
| | - Shantanu Arya
- Department of ENT, M. M. Institute of Medical Sciences and Research, MMDU, Mullana, Ambala, Haryana, India
| | - Komal Chauhan
- National Institute of Food Technology Entrepreneurship and Management, Kundli, Sonipat, Haryana, India
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Fernández M, Cuesta M, Sanz R, Cobo P. Comparison of Tinnitus Handicap Inventory and Tinnitus Functional Index as Treatment Outcomes. Audiol Res 2022; 13:23-31. [PMID: 36648924 PMCID: PMC9844388 DOI: 10.3390/audiolres13010003] [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: 10/27/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Tinnitus is an audiological disorder for which there are no objective measuring tools. Thus, many self-report questionnaires have been proposed to assess its severity. These questionnaires have been judged for their capacity to assess the tinnitus severity at baseline, their sensitivity to treatment-related changes (responsiveness), and their resolution. METHODS The most widely used questionnaires for clinical and research studies are the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). While both questionnaires have been recognized as good evaluators of the baseline tinnitus severity, the latter is considered to be more responsive to changes following treatments. OBJECTIVES The aim of this work is to provide a preliminary comparison of the performance of both questionnaires in the initial and final tinnitus severity assessment of a cohort of patients undergoing a four-month Enriched Acoustic Environment (EAE) therapy. RESULTS The EAE therapy provided a 30 and 26 point reduction in THI and TFI, respectively. A good correlation is obtained between the THI and TFI questionnaires at baseline and after the treatment. CONCLUSION At baseline, the THI provided a higher score than the TFI for a higher degree of tinnitus but a lower score for lower tinnitus severity. Both THI and TFI were good questionnaires for baseline assessment and for treatment-related changes. The THI provided a slightly higher score drop than the TFI following the treatment, although the TFI had better resolution.
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Affiliation(s)
- Marta Fernández
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - María Cuesta
- Institute of Physical and Information Technologies (ITEFI), CSIC, Serrano 144, 28006 Madrid, Spain
| | - Ricardo Sanz
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Pedro Cobo
- Institute of Physical and Information Technologies (ITEFI), CSIC, Serrano 144, 28006 Madrid, Spain
- Correspondence: ; Tel.: +34-915618806
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Labree B, Hoare DJ, Fackrell K, Hall DA, Gascoyne LE, Sereda M. Establishing a Core Domain Set for early-phase clinical trials of electrical stimulation interventions for tinnitus in adults: protocol for an online Delphi study. Trials 2022; 23:1039. [PMID: 36539777 PMCID: PMC9769048 DOI: 10.1186/s13063-022-07020-2] [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: 11/12/2021] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Tinnitus is the awareness of a sound in the ear or head in the absence of an external source. It affects around 10-15% of people and current treatment options are limited. Experimental treatments include various forms of electrical stimulation of the brain. Currently, there is no consensus on the outcomes that should be measured when investigating the efficacy of this type of intervention for tinnitus. This study seeks to address this by establishing a Core Domain Set: a common standard of what specific tinnitus-related complaints are critical and important to assess in all clinical trials of electrical stimulation-based interventions for tinnitus. METHODS A two-round online survey will be conducted, followed by a stakeholder consensus meeting to identify a Core Domain Set. Participants will belong to one of two stakeholder groups: healthcare users with lived experience of tinnitus, and professionals with relevant clinical, commercial, or research experience. DISCUSSION This study will establish a Core Domain Set for the evaluation of electrical stimulation-based interventions for tinnitus via an e-Delphi study. The resulting Core Domain Set will act as a minimum standard for reporting in future clinical trials of electrical stimulation interventions for tinnitus. Standardisation will facilitate comparability of research findings.
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Affiliation(s)
- Bas Labree
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Derek J. Hoare
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Kathryn Fackrell
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK ,grid.5491.90000 0004 1936 9297Wessex Institute, University of Southampton, Southampton, UK
| | - Deborah A. Hall
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.472615.30000 0004 4684 7370Department of Psychology, School of Social Sciences, Heriot-Watt University, Putrajaya, Malaysia
| | - Lauren E. Gascoyne
- grid.4563.40000 0004 1936 8868Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, Nottingham, UK
| | - Magdalena Sereda
- grid.511312.50000 0004 9032 5393NIHR Nottingham Biomedical Research Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Hearing Sciences, Mental Health and Clinical Neuroscience, University of Nottingham, Nottingham, UK
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Gu H, Diao C, Tang J, Yang B, Ji J, Zhou M, Meng Z. Minimal clinically important difference for the Mandarin version of the Tinnitus Questionnaire determined via anchor-based and distribution-based methods. Health Qual Life Outcomes 2022; 20:157. [PMID: 36451205 PMCID: PMC9710156 DOI: 10.1186/s12955-022-02072-z] [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: 08/13/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The previous study showed that the Mandarin Tinnitus Questionnaire (MTQ) has satisfactory reliability and validity. We have also completed the classification of the severity of tinnitus based on MTQ scores. In clinical studies, efficacy is often judged by whether results are statistically significant; however, statistical significance does not necessarily equate to clinical significance, whereas the minimum clinically important difference (MCID) of the scale does. In the following project, we will explore the MCID of the MTQ. METHODS We recruited participants aged 18 years and above who sought treatment for primary or secondary tinnitus at the Otorhinolaryngology Department of the Hearing Center of West China Hospital, Sichuan University from September 2020 to September 2021. The participants had to undergo the following four assessments of tinnitus severity: doctor evaluation, self-report, the MTQ, and the visual analog scale (VAS), all at baseline and at the follow-up. The MCIDs of the MTQ were established via anchor-based and distribution-based methods. The anchor method used the VAS and self-reported clinical impression as anchors and defined the treatment effectiveness by mean/median and receiver operating characteristic (ROC) curve, while methods of effect size (ES), standard error of measurement (SEM), and reliability change index (RCI) were used in distribution-based methods. RESULTS A total of 115 patients were investigated in this study, 57.4% of whom were women. The average age was 43.2 ± 13.20 years. The average MTQ and VAS scores at baseline were 31.3 ± 14.90 and 5.03 ± 2.24, respectively, while the average MTQ and VAS scores at follow-up were 15.9 ± 11.70 and 3.58 ± 2.48, respectively. Moreover, in terms of self-reported clinical impressions, 19 patients indicated that they were cured (16.5%), 24 that it was much better (20.9%), 63 that there was no change (54.8%), and 9 that it was much worse (7.8%). The MCIDs for the change in total MTQ ranged from 6.29 to 19.00, those for improvement from 1.09 to 22.75, and those for deterioration from 3.50 to 7.64. CONCLUSION We selected an absolute value of 7.5 as the MCID for the MTQ score. An increase in MTQ score more than 7.5 was considered aggravation of tinnitus, and a decrease in MTQ score more than 7.5 was considered a reduction in tinnitus.
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Affiliation(s)
- Hailing Gu
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Cong Diao
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Jiatong Tang
- grid.13291.380000 0001 0807 1581West China Hospital/West China Medical School, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Bo Yang
- grid.13291.380000 0001 0807 1581West China Hospital/West China Medical School, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Jinfeng Ji
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
| | - Mengyun Zhou
- grid.13291.380000 0001 0807 1581West China Hospital/West China Medical School, Sichuan University, Chengdu, Sichuan People’s Republic of China
| | - Zhaoli Meng
- grid.412901.f0000 0004 1770 1022Department of Otolaryngology-Head and Neck Surgery, Hearing Center/Hearing and Speech Science Laboratory, West China Hospital of Sichuan University, 37 Guo Xue Lane, Chengdu, 610041 Sichuan People’s Republic of China
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11
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Abstract
BACKGROUND Tinnitus is a symptom defined as the perception of sound in the absence of an external source. In England alone there are an estimated ¾ million general practice consultations every year where the primary complaint is tinnitus, equating to a major burden on healthcare services. Clinical management strategies include education and advice, relaxation therapy, tinnitus retraining therapy (TRT), cognitive behavioural therapy (CBT), sound enrichment using ear-level sound generators or hearing aids, and drug therapies to manage co-morbid symptoms such as insomnia, anxiety or depression. OBJECTIVES: To assess the effects of Ginkgo biloba for tinnitus in adults and children. SEARCH METHODS The Cochrane ENT Information Specialist searched the Cochrane ENT Register; CENTRAL (2022, Issue 6); Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 7 June 2022. SELECTION CRITERIA Randomised controlled trials (RCTs) recruiting adults and children with acute or chronic subjective tinnitus. We included studies where the intervention involved Ginkgo biloba and this was compared to placebo, no intervention, or education and information. Concurrent use of other medication or other treatment was acceptable if used equally in each group. Where an additional intervention was used equally in both groups, we analysed this as a separate comparison. The review included all courses of Ginkgo biloba, regardless of dose regimens or formulations, and for any duration of treatment. DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcomes were tinnitus symptom severity measured as a global score on a multi-item tinnitus questionnaire and serious adverse effects (bleeding, seizures). Our secondary outcomes were tinnitus loudness (change in subjective perception), tinnitus intrusiveness, generalised depression, generalised anxiety, health-related quality of life and other adverse effects (gastrointestinal upset, headache, allergic reaction). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS This review included 12 studies (with a total of 1915 participants). Eleven studies compared the effects of Ginkgo biloba with placebo and one study compared the effects of Ginkgo biloba with hearing aids to hearing aids alone. All included studies were parallel-group RCTs. In general, risk of bias was high or unclear due to selection bias and poor reporting of allocation concealment and blinding of participants, personnel and outcome assessments. Due to heterogeneity in the outcomes measured and measurement methods used, only limited data pooling was possible. Ginkgo biloba versus placebo When we pooled data from two studies for the primary outcome tinnitus symptom severity, we found that Ginkgo biloba may have little to no effect (Tinnitus Handicap Inventory scores) at three to six months compared to placebo, but the evidence is very uncertain (mean difference (MD) -1.35 (scale 0 to 100), 95% confidence interval (CI) -8.26 to 5.55; 2 studies; 85 participants) (very low-certainty). Ginkgo biloba may result in little to no difference in the risk of bleeding or seizures, with no serious adverse effects reported in either group (4 studies; 1154 participants; low-certainty). For the secondary outcomes, one study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on tinnitus loudness measured with audiometric loudness matching at 12 weeks, but the evidence is very uncertain (MD -4.00 (scale -10 to 140 dB), 95% CI -13.33 to 5.33; 1 study; 73 participants) (very low-certainty). One study found that there may be little to no difference between the effects of Ginkgo biloba and placebo on health-related quality of life measured with the Glasgow Health Status Inventory at three months (MD -0.58 (scale 0 to 100), 95% CI -4.67 to 3.51; 1 study; 60 participants) (low-certainty). Ginkgo biloba may not increase the frequency of other adverse effects (gastrointestinal upset, headache, allergic reaction) at three months compared to placebo (risk ratio 0.91, 95% CI 0.52 to 1.60; 4 studies; 1175 participants) (low-certainty). None of the studies reported the other secondary outcomes of tinnitus intrusiveness or changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety. Gingko biloba with concurrent intervention versus concurrent intervention only One study compared Ginkgo biloba with hearing aids to hearing aids only. It assessed the mean difference in the change in Tinnitus Handicap Inventory scores and tinnitus loudness using a 10-point visual analogue scale (VAS) at three months. The study did not report adverse effects, tinnitus intrusiveness, changes in depressive symptoms or depression, anxiety symptoms or generalised anxiety, or health-related quality of life. This was a single, very small study (22 participants) and for all outcomes the certainty of the evidence was very low. We were unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS There is uncertainty about the benefits and harms of Ginkgo biloba for the treatment of tinnitus when compared to placebo. We were unable to draw meaningful conclusions regarding the benefits and harms of Ginkgo biloba when used with concurrent intervention (hearing aids). The certainty of the evidence for the reported outcomes, assessed using GRADE, ranged from low to very low. Future research into the effectiveness of Ginkgo biloba in patients with tinnitus should use rigorous methodology. Randomisation and blinding should be of the highest quality, given the subjective nature of tinnitus and the strong likelihood of a placebo response. The CONSORT statement should be used in the design and reporting of future studies. We also recommend the use of validated, patient-centred outcome measures for research in the field of tinnitus.
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Affiliation(s)
- Magdalena Sereda
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Jun Xia
- Nottingham China Health Institute, The University of Nottingham Ningbo, Ningbo, China
| | - Polly Scutt
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Amr El Refaie
- Department of Speech and Hearing Sciences, University College Cork, Cork, Ireland
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
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12
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van der Wal A, Michiels S, De Pauw J, Jacxsens L, Chalimourdas A, Gilles A, Braem M, van Rompaey V, Van de Heyning P, De Hertogh W. ICF domains covered by the Tinnitus Questionnaire and Tinnitus Functional Index. Disabil Rehabil 2022; 44:6851-6860. [PMID: 34523370 DOI: 10.1080/09638288.2021.1972172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE Tinnitus frequently causes disability as it affects daily living, which is objectified using several tinnitus questionnaires. To what extent they cover domains of the International Classification of Functioning, Disability and Health (ICF) is currently unknown. Therefore, this study aims to investigate which ICF domains are measured by two questionnaires and to describe the health status of somatic tinnitus patients in ICF terms. MATERIALS AND METHODS All questions of the Tinnitus Questionnaire (TQ) and Tinnitus Functional Index (TFI) were linked to the ICF using linking rules. A count-based method was used to link all individual answers of 80 tinnitus patients, to the ICF categories. RESULTS Most of the linked questions concerned "body functions". TFI covered more categories of "activity and participation" than TQ. Patients reported severe impairments in "mental functions", "sensory functions and pain", and "sleep functions". Additionally, severe limitations were scored in "focusing attention". CONCLUSIONS The TFI and TQ measure distinct domains but can be used complementary or solely, depending on the research question. The TFI identifies a broad spectrum of problems, where the TQ focuses on the psychological impact of tinnitus. Somatic patients in our study reported impairments and disabilities in all covered domains, especially in "onset of sleep" and "sound detection".Implications for RehabilitationThe Tinnitus Functional Index (TFI) and the Tinnitus Questionnaire (TQ) cover different domains of the International Classification of Functioning, Disability and Health.The TFI identifies problems in "body functions" and "activity and participation".The TQ focuses on the psychological impact of tinnitus.
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Affiliation(s)
- Annemarie van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium.,Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Sarah Michiels
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,Faculty of Rehabilitation Sciences, REVAL, University of Hasselt, Hasselt, Belgium
| | - Joke De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Laura Jacxsens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Antonios Chalimourdas
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium.,Faculty of Rehabilitation Sciences, REVAL, University of Hasselt, Hasselt, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Marc Braem
- Lab Dental Materials, University of Antwerp, Edegem, Belgium.,Special Care Dentistry, University Hospital Antwerp, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Vincent van Rompaey
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Faculty of Medicine and Health Sciences, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Edegem, Belgium
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13
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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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14
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Waechter S, Jönsson A. Hearing Aids Mitigate Tinnitus, But Does It Matter if the Patient Receives Amplification in Accordance With Their Hearing Impairment or Not? A Meta-Analysis. Am J Audiol 2022; 31:789-818. [PMID: 35973434 DOI: 10.1044/2022_aja-22-00004] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of the present meta-analysis is to explore the potential effects of objective verification of hearing aid amplification on tinnitus-related outcomes. METHOD Twenty-seven studies reporting tinnitus outcomes pre and post hearing aid fitting were identified through a systematic literature search. From these studies, data from 1,400 participants were included in the present meta-analysis. Studies were divided into subgroups based on whether they had reported performing objective verification of the participants' hearing aid amplification or not. Outcome measures were tinnitus distress and tinnitus loudness. RESULTS Meta-analyses of all included studies indicated verified amplification to result in significantly enhanced reduction of tinnitus loudness (p < .00001), while the enhanced reduction of tinnitus distress only approached statistical significance (p = .07). However, when excluding an outlier from the subgroup of studies using unverified amplification, individuals receiving verified amplification showed significantly greater reduction of tinnitus distress (p = .02). In addition, analyses of longitudinal effects revealed that the reductions of tinnitus distress decreased over time among individuals receiving unverified amplification but increased over time among individuals receiving verified amplification. CONCLUSIONS The present meta-analysis indicates verified hearing aid amplification to be superior to unverified amplification in terms of reduction of tinnitus loudness and distress. The longitudinal increase of mitigation of tinnitus distress with verified amplification only may reflect improved neural reorganization and/or better adherence to hearing aid use, with verified compared to unverified amplification. Due to the low cost of hearing aid verification compared to the high societal cost of tinnitus, objective verification of hearing aid amplification for tinnitus patients is recommended.
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Affiliation(s)
- Sebastian Waechter
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden
| | - Anders Jönsson
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden
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15
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Riha C, Güntensperger D, Kleinjung T, Meyer M. Recovering Hidden Responder Groups in Individuals Receiving Neurofeedback for Tinnitus. Front Neurosci 2022; 16:867704. [PMID: 35812211 PMCID: PMC9261875 DOI: 10.3389/fnins.2022.867704] [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: 02/01/2022] [Accepted: 05/23/2022] [Indexed: 11/29/2022] Open
Abstract
The widespread understanding that chronic tinnitus is a heterogeneous phenomenon with various neural oscillatory profiles has spurred investigations into individualized approaches in its treatment. Neurofeedback, as a non-invasive tool for altering neural activity, has become increasingly popular in the personalized treatment of a wide range of neuropsychological disorders. Despite the success of neurofeedback on the group level, the variability in the treatment efficacy on the individual level is high, and evidence from recent studies shows that only a small number of people can effectively modulate the desired aspects of neural activity. To reveal who may be more suitable, and hence benefit most from neurofeedback treatment, we classified individuals into unobserved subgroups with similar oscillatory trajectories during the treatment and investigated how subgroup membership was predicted by a series of characteristics. Growth mixture modeling was used to identify distinct latent subgroups with similar oscillatory trajectories among 50 individuals suffering from chronic subjective tinnitus (38 male, 12 female, mean age = 47.1 ± 12.84) across 15 neurofeedback training sessions. Further, the impact of characteristics and how they predicted the affiliation in the identified subgroups was evaluated by including measures of demographics, tinnitus-specific (Tinnitus Handicap Inventory) and depression variables, as well as subjective quality of life subscales (World Health Organization—Quality of Life Questionnaire), and health-related quality of life subscales (Short Form-36) in a logistic regression analysis. A latent class model could be fitted to the longitudinal data with a high probability of correctly classifying distinct oscillatory patterns into 3 different groups: non-responder (80%), responder (16%), and decliner (4%). Further, our results show that the health-related wellbeing subscale of the Short Form-36 questionnaire was differentially associated with the groups. However, due to the small sample size in the Responder group, we are not able to provide sufficient evidence for a distinct responder profile. Nevertheless, the identification of oscillatory change-rate differences across distinct groups of individuals provides the groundwork from which to tease apart the complex and heterogeneous oscillatory processes underlying tinnitus and the attempts to modify these through neurofeedback. While more research is needed, our results and the analytical approach presented may bring clarity to contradictory past findings in the field of tinnitus research, and eventually influence clinical practice.
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Affiliation(s)
- Constanze Riha
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Research Priority Program “ESIT—European School of Interdisciplinary Tinnitus Research,” Zurich, Switzerland
- *Correspondence: Constanze Riha, , orcid.org/0000-0002-6006-7018
| | | | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), ETH Zürich, Zurich, Switzerland
| | - Martin Meyer
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), ETH Zürich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging,” University of Zurich, Zurich, Switzerland
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16
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Beukes EW, Manchaiah V, Andersson G, Maidment DW. Application of the Behavior Change Wheel Within the Context of Internet-Based Cognitive Behavioral Therapy for Tinnitus Management. Am J Audiol 2022; 31:433-444. [PMID: 35436419 DOI: 10.1044/2022_aja-21-00160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Although experiencing tinnitus can lead to many difficulties, these can be reduced by using techniques derived from cognitive behavioral therapy. Internet-based cognitive behavioral therapy (ICBT) has been developed to provide an accessible intervention. The aim of this study was to describe how ICBT can facilitate tinnitus management by identifying the active ingredients of the intervention from the perspective of health behavior change. METHOD The ICBT intervention was evaluated using the Behavior Change Wheel in eight steps across the following three stages: (1) understanding the behavior, (2) identifying intervention options, and (3) identifying content and implementation options. RESULTS Target behaviors identified to reduce tinnitus distress, as well as additional problems associated with tinnitus, included goal setting, an increased understanding of tinnitus, encouraging deep breathing and progressive muscle relaxation, identifying and restructuring unhelpful thoughts, engaging in positive imagery, and reducing avoidance behaviors. ICBT provided the required components for individuals to be physically and psychologically capable of adapting to tinnitus, providing social and environmental opportunities to manage hearing loss through practice and training, and facilitated automatic and reflective motivation. CONCLUSION Understanding ICBT in the context of the Behavior Change Wheel has helped identify how its effectiveness can be improved and can be used for future tinnitus intervention planning. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19555213.
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Affiliation(s)
- Eldré W. Beukes
- Vision and Hearing Sciences Research Group, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora
| | - Vinaya Manchaiah
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - David W. Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, United Kingdom
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17
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Manchaiah V, Londero A, Deshpande AK, Revel M, Palacios G, Boyd RL, Ratinaud P. Online Discussions About Tinnitus: What Can We Learn From Natural Language Processing of Reddit Posts? Am J Audiol 2022; 31:993-1002. [PMID: 35130042 DOI: 10.1044/2021_aja-21-00158] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study was aimed at identifying key topics in online discussions about tinnitus by examining a large data set extracted from Reddit social media using a natural language processing technique. METHOD A corpus of 113,215 posts about tinnitus was extracted from Reddit's application programming interface. After cleaning the data for duplications and posts without any text information, the sample was reduced to 101,905 posts, which was subjected to cluster analysis using the open-source IRaMuTeQ software to identify main topics based on the co-occurrence of texts. These clusters were named by a panel of tinnitus experts (n = 9) by reading typical text segments within each cluster. RESULTS The cluster analysis identified 16 unique clusters that belong to two topics, which were named "tinnitus causes and consequences" and "tinnitus management and coping." Based on their characteristics, the clusters were named: tinnitus timeline (10%), tinnitus perception (9.7%), medical triggers and modulators (8.8%), hearing research (8.8%), attention and silence (8.6%), social media posts about tinnitus (7.4%), hearing protection (7.3%), interaction with hearing health care providers (6.7%), mental health and coping (5.8%), music listening (5.7%), hope for a cure (5.6%), interactions with people without tinnitus (5.4%), dietary supplements and alternative therapies (3.2%), sleep (3.9%), dietary effects (1.7%), and writing about tinnitus and being thankful to online community (1.4%). CONCLUSIONS Despite some limitations, tinnitus posts on Reddit provide rich real-world data to identify various issues and complaints that tinnitus patients and their significant others discuss in online communities. Some of the clusters identified here are novel (e.g., tinnitus timeline, interactions with people without tinnitus) and have not been much discussed in the tinnitus literature. The results suggest that individuals with tinnitus relay on social media for support and highlight the service delivery needs in providing social support through other means (e.g., support groups).
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Affiliation(s)
- Vinaya Manchaiah
- Department of Otolaryngology–Head and Neck Surgery, University of Colorado School of Medicine, Aurora
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora
- Virtual Hearing Lab, Collaborative Initiative between University of Colorado School of Medicine and University of Pretoria, Aurora, CO
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, India
| | - Alain Londero
- Hôpital Européen Georges Pompidou, Assistance Publique – Hôpitaux de Paris; Faculté de Médecine Paris Descartes – Université de Paris, France
| | - Aniruddha K. Deshpande
- Department of Speech-Language-Hearing Sciences, Hofstra University, Long Island, NY
- Long Island Doctor of Audiology Consortium, Garden City, NY
| | - Manon Revel
- Institute for Data, Systems and Society, Massachusetts Institute of Technology, Cambridge
| | | | - Ryan L. Boyd
- Department of Psychology, Lancaster University, United Kingdom
- Security Lancaster, Lancaster University, United Kingdom
- Data Science Institute, Lancaster University, United Kingdom
| | - Pierre Ratinaud
- Laboratory of Applied Studies and Research in Social Sciences, University of Toulouse, France
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18
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Manchaiah V, Nisha KV, Prabhu P, Granberg S, Karlsson E, Andersson G, Beukes EW. Examining the consequences of tinnitus using the multidimensional perspective. Acta Otolaryngol 2022; 142:67-72. [PMID: 34964683 DOI: 10.1080/00016489.2021.2019307] [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: 10/19/2022]
Abstract
BACKGROUND Tinnitus is one of the most frequent chronic conditions in adults with wide range of consequences. AIMS/OBJECTIVES The aim of the current study was to determine the problems and life effects reported by individuals with tinnitus using the International Classification of Functioning, Disability and Health (ICF) framework. MATERIAL AND METHODS The study used a cross-sectional survey design. A total of 344 individuals with tinnitus completed a series of questionnaires. The responses to open-ended questions were linked to ICF categories. RESULTS Activity limitations and participation restrictions were most dominant consequence of tinnitus followed by effect on the body function with limited emphasis on the contextual factors. Frequently reported responses to body function involved emotional functions (b152), attention function (b140), and sleep functions (b134). Commonly reported responses to activity limitations and participation restrictions were recreation and leisure (d920), conversation (d350), communicating with-receiving-spoken messages (d310), listening (d115), and remunerative employment (d850). Sound intensity (e2500) and sound quality (e2501) were the frequently reported responses to environmental factors. Coping styles, past and present experiences, and lifestyle were the most frequently occurring personal factors. CONCLUSIONS AND SIGNIFICANCE The study highlighted some key influencing factors of tinnitus in different ICF domains which can be helpful in rehabilitation planning.
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Affiliation(s)
- Vinaya Manchaiah
- Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, Colorado, USA
- UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, Colorado, USA
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA
- Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria, Beaumont, USA
- Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
| | - K. V. Nisha
- All India Institute of Speech and Hearing, Mysore, India
| | | | - Sarah Granberg
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Elin Karlsson
- Faculty of Medicine and Health, Örebro University, Sweden
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
| | - Eldré W. Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, Texas, USA
- Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria, Beaumont, USA
- Vision and Hearing Sciences Research Group, School of Psychology and Sport Science, Anglia Ruskin University, Cambridge, United Kingdom
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19
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Beukes EW, Maidment DW, Andersson G, Fagleson MA, Heffernan E, Manchaiah V. Development and psychometric validation of a questionnaire assessing the impact of tinnitus on significant others. JOURNAL OF COMMUNICATION DISORDERS 2022; 95:106159. [PMID: 34894419 DOI: 10.1016/j.jcomdis.2021.106159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/27/2021] [Accepted: 10/13/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite evidence showing that tinnitus can have a detrimental impact on significant others (SOs), no standardized self-reported measure is currently available that specifically assesses the presence of third-party disability for tinnitus. The aim of this study was to develop and assess the psychometric properties of a newly developed self-reported measure for SOs of tinnitus and assess how scores could be meaningfully interpreted. METHODS The research consisted of two phases. During Phase I, the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ) was developed using the The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Phase II included the assessment of psychometric properties of the CTSOQ including the construct validity, internal consistency, interpretability, and responsiveness. Pairs of 194 individuals with tinnitus and their SOs completed a series of online questionnaires. SOs completed the CTSOQ measure while individuals with tinnitus completed measures related to tinnitus distress, anxiety, depression, insomnia, and quality of life. RESULTS A 25 item CTSOQ was developed using a formative model. The questionnaire validation process indicated good psychometric properties with an internal consistency of 0.93 and inter-item correlation of 0.60. Support was found for the construct and discriminative validity of the measure. Floor and ceiling effects were negligible. Scores can be meaningfully interpreted to indicate mild, significant, or severe effect of tinnitus on SOs. The questionnaire was also found to be responsive to treatment-related changes. CONCLUSIONS The CTSOQ was found to have sufficient measurement properties suggesting that it is a suitable measure of third-party disability for SOs of individuals with tinnitus. Further research should be initiated to measure face validity and what scores reflect clinically meaningful change.
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Affiliation(s)
- Eldré W Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States of America; Vision and Hearing Sciences Research Group, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom of Great Britain NL NT Ireland; Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa.
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Marc A Fagleson
- Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, Tennessee, United States of America; Audiological Rehabilitation Laboratory, Veterans Affairs Medical Center, Mountain Home, Tennessee, United States of America
| | - Eithne Heffernan
- Discipline of General Practice, Clinical Science Institute, School of Medicine, National University of Ireland, Galway, H91 TK33, Ireland
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States of America; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India; Virtual Hearing Lab, Collaborative initiative between Lamar University and University of Pretoria Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa; Department of Speech-Language Pathology and Audiology, University of Pretoria, Gauteng, South Africa
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20
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Biswas R, Lugo A, Akeroyd M, Schlee W, Gallus S, Hall D. Tinnitus prevalence in Europe: a multi-country cross-sectional population study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 12:100250. [PMID: 34950918 PMCID: PMC8671623 DOI: 10.1016/j.lanepe.2021.100250] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare resource use and hearing difficulty with tinnitus symptoms. METHODS Between 2017-2018, a cross-sectional European Tinnitus Survey (ETS) was conducted in 12 European Union nations (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain), using a standardised set of tinnitus-related questions and response options in country-specific languages. We recruited 11,427 adults aged ≥18 years. FINDINGS Prevalence of any tinnitus was 14·7% (14·0% in men and 15·2% in women), ranging from 8·7% in Ireland to 28·3% in Bulgaria. Severe tinnitus was found in 1·2% participants (1·0% in men and 1·4% in women), ranging from 0·6% in Ireland to 4·2% in Romania. Tinnitus prevalence significantly increased with increasing age and worsening of hearing status. Healthcare resource use for tinnitus increased with increasing tinnitus symptom severity. INTERPRETATION This is the first multinational report of Pan-European tinnitus prevalence using standardised questions. The overall prevalence estimates refine previous findings, although widespread inter-country heterogeneity was noted. The results indicate that more than 1 in 7 adults in the EU have tinnitus. Extrapolating to the overall population, approximately 65 million adults in EU28 have tinnitus, 26 million have bothersome tinnitus and 4 million have severe tinnitus. FUNDING National Institute for Health Research, European Union's Horizon 2020, Medical Research Council, and GENDER-Net Co-Plus Fund.
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Affiliation(s)
- R. Biswas
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - A. Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - M.A. Akeroyd
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
| | - W. Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - S. Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - D.A. Hall
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
- School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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21
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Hedayati R, Hekmat S, Mahmoudian S, Teimourinejad F, Malek H, Yaghoobi N, Rastgoo F, Firuzabadi H, Kalantari F. Alterations in brain single-photon emission computed tomography perfusion pattern pre- and post-transcranial magnetic stimulation in tinnitus participants. INDIAN JOURNAL OF OTOLOGY 2022. [DOI: 10.4103/indianjotol.indianjotol_4_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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22
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Jacquemin L, Gilles A, Shekhawat GS. Hearing more to hear less: a scoping review of hearing aids for tinnitus relief. Int J Audiol 2021; 61:887-895. [PMID: 34865589 DOI: 10.1080/14992027.2021.2007423] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE As tinnitus is often associated with hearing loss, hearing aids have been proposed for tinnitus relief in literature for more than 70 years. There is a need for recent literature to be reviewed and guide decision making in tinnitus management. This scoping review aims to provide an update of the available evidence on hearing aids for tinnitus, focussing on the effect of sound amplification or combination devices (i.e. amplification and sound generation within one device). DESIGN Research studies were included if they investigated hearing aids or combination devices for tinnitus and were published after 2011. STUDY SAMPLE A total of 28 primary research studies were selected. RESULTS Positive results of hearing aids in tinnitus patients were shown in 68% of the studies, whereas 14% demonstrated no change in tinnitus distress. However, the quality of the evidence across studies was variable. CONCLUSIONS Scientific support for hearing aids and combination devices for tinnitus relief was found. The standalone effect of sound amplification and the added value of sound generators and adjustment of sound processing strategies needs further investigation. Stronger methodology in future studies is needed to reach consensus on how to optimise hearing solutions in a multidisciplinary approach.
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Affiliation(s)
- Laure Jacquemin
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, Department of Translational Neurosciences, Antwerp University, Wilrijk, Belgium
| | - Annick Gilles
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, Department of Translational Neurosciences, Antwerp University, Wilrijk, Belgium.,Department of Education, Health & Social Work, University College Ghent, Ghent, Belgium
| | - Giriraj Singh Shekhawat
- College of Nursing and Health Sciences, Flinders University, Bedford Park, Australia.,Tinnitus Research Initiative, Regensburg, Germany.,Ear Institute, University College London, London, UK
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23
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Dullaart MJ, Kip M, Smit AL, Stegeman I. Treatment of Tinnitus in Children-A Systematic Review. Front Neurol 2021; 12:726803. [PMID: 34566871 PMCID: PMC8460757 DOI: 10.3389/fneur.2021.726803] [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: 06/17/2021] [Accepted: 08/09/2021] [Indexed: 12/03/2022] Open
Abstract
Objectives: To systematically review studies on the effect of treatment of subjective tinnitus in children. Data Sources: We searched for studies in MEDLINE and EMBASE databases, after which additional studies were hand searched using Scopus databases. The methods are described in the study protocol, which has been registered in the PROSPERO register. PRISMA guidelines were followed in the reporting of this study. Eligibility Criteria: We considered for inclusion randomized controlled trials (RCTs), observational studies, case reports, and case series, with tinnitus as primary outcome in children (0–18 years old) with acute or chronic subjective tinnitus. We excluded studies in which both children and adults participated but outcomes were not specifically reported for children, as well as animal studies, studies with a non-original study design and studies about children with pulsatile or objective tinnitus. Data Selection: Two reviewers independently assessed studies for eligibility and quality, collected and extracted data. Statistical analyses were performed in case of homogeneous outcomes. Results: The search yielded a total of 4,447 studies. Of these, 147 eligible studies were selected. One case report and five observational studies met the eligibility criteria. Three studies applied counseling and (simplified-)TRT and reported improvement in tinnitus outcome in 68 out of 82 children after 3–6 months of treatment. Two studies used pharmacological treatments and reported improvement in 74 out of 86 patients after 10 days to 3 months of treatment. One study reported the outcome of biofeedback therapy, describing an improvement in tinnitus loudness and annoyance after 2 months of treatment. Conclusion: Due to the high risk of bias of the included studies, we cannot determine the effectiveness of the treatment of subjective tinnitus in children. Also, owing to brief follow-up periods, it is not possible to draw conclusions regarding long-term effects. Randomized controlled trials with longer follow-up periods are necessary to provide substantial evidence of the effects of therapies for children affected by tinnitus. https://www.crd.york.ac.uk/prospero/ Systematic Review Registration:https://www.crd.york.ac.uk/prospero/, identifier [CRD42020178134].
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Affiliation(s)
- Max J Dullaart
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marijn Kip
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Epidemiology and Data Science, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,University Medical Center Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
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24
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Quality of Life and Psychological Distress in Portuguese Older Individuals with Tinnitus. Brain Sci 2021; 11:brainsci11070953. [PMID: 34356187 PMCID: PMC8306429 DOI: 10.3390/brainsci11070953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 11/24/2022] Open
Abstract
Tinnitus is the perception of a sound without an external source, often associated with adverse psychological and emotional effects leading to impaired quality of life (QoL). The present study investigated QoL and psychological distress in tinnitus patients and analysed the effects of associated comorbidities. Tonal and speech audiometry, tinnitus assessment, and clinical interviews were obtained from 122 Portuguese individuals (aged from 55 to 75). Portuguese versions of the Brief Symptoms Inventory (BSI), the Medical Outcomes Study Short Form Health Survey (MOS SF-36) and Tinnitus Handicap Inventory (THI) were used to evaluate psychological distress, health-related QoL, social difficulties and tinnitus severity. The presence of tinnitus was significantly associated with hearing loss. The increases in tinnitus severity were associated with decreases in QoL, particularly regarding MOS SF-36 subscales “perception of health”, “social functioning”, and “mental health”. Regarding BSI, patients with greater tinnitus severity had more severe psychopathology symptoms, measured with scales “Obsessive–compulsive”, “Depression”, “Anxiety”, “Hostility” and “Phobic Anxiety”. Our study supports the notion of the negative impact of increased tinnitus severity on QoL and psychological distress in older adults. Presented data strengthen the importance of a multidisciplinary approach to tinnitus assessment and treatment.
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25
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Beukes EW, Lourenco MPCG, Biot L, Andersson G, Kaldo V, Manchaiah V, Jacquemin L. Suggestions for shaping tinnitus service provision in Western Europe: Lessons from the COVID-19 pandemic. Int J Clin Pract 2021; 75:e14196. [PMID: 33837639 PMCID: PMC8250123 DOI: 10.1111/ijcp.14196] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/27/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Tinnitus severity has been exacerbated because of the COVID-19 pandemic and those with tinnitus require additional support. Such support should be informed by patient preferences and needs. The objective of this study was to gather information from individuals with tinnitus living in Europe to inform stakeholders of the (a) support they needed in relation to changes associated with the COVID-19 pandemic and (b) suggestions regarding tinnitus care for the future. METHODS A cross-sectional mixed method study design was used using closed and open-ended questions via an online survey. Data were gathered from 710 adults experiencing tinnitus in Western Europe, with the majority living in The Netherlands, Belgium and Sweden. Data were analysed using qualitative content analysis and descriptive statistics. RESULTS Those with tinnitus indicated the following support needs during the pandemic (a) support for tinnitus, (b) support for hearing-related difficulties, (c) social support and (d) pandemic-related support. Five directions for future tinnitus care were provided, namely, (a) need for understanding professional support and access to multidisciplinary experts, (b) greater range of therapies and resources, (c) access to more information about tinnitus, (d) prioritising tinnitus research and (e) more support for hearing protection and hearing loss prevention. CONCLUSIONS The findings point to the need for accessible (remote), patient-centred, suitable and evidence-based tinnitus care. Insights from the current study can be used by various stakeholders including clinical practitioners and tinnitus support services to ensure those with tinnitus have access to the help and support required in order to reduce service provision insufficiencies.
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Affiliation(s)
- Eldré W. Beukes
- Department of Speech and Hearing SciencesLamar UniversityBeaumontTXUSA
- Department of Vision and Hearing SciencesAnglia Ruskin UniversityCambridgeUK
| | - Matheus P. C. G. Lourenco
- Experimental Health PsychologyMaastricht UniversityMaastrichtThe Netherlands
- Research Group Health PsychologyKU Leuven UniversityLeuvenBelgium
| | - Lana Biot
- Faculty of BiomedicalPharmaceuticals and Veterinary SciencesUniversity of AntwerpAntwerpBelgium
| | - Gerhard Andersson
- Department of Behavioral Sciences and LearningDepartment of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
| | - Viktor Kaldo
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of PsychologyFaculty of Health and Life SciencesLinnaeus UniversityVäxjöSweden
| | - Vinaya Manchaiah
- Department of Speech and Hearing SciencesLamar UniversityBeaumontTXUSA
- Department of Speech and HearingSchool of Allied Health SciencesManipal UniversityManipalKarnatakaIndia
| | - Laure Jacquemin
- Department of Translational NeurosciencesFaculty of Medicine and Health SciencesUniversity of AntwerpWilrijkBelgium
- Department of Otorhinolaryngology and Head and Neck SurgeryAntwerp University HospitalEdegemBelgium
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26
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Genitsaridi E, Dode A, Qirjazi B, Mehdi M, Pryss R, Probst T, Reichert M, Hauck F, Hall DA. An Albanian translation of a questionnaire for self-reported tinnitus assessment. Int J Audiol 2021; 61:515-519. [PMID: 34182868 DOI: 10.1080/14992027.2021.1933221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To our knowledge, there is no published study investigating the characteristics of people experiencing tinnitus in Albania. Such a study would be important, providing the basis for further research in this region and contributing to a wider understanding of tinnitus heterogeneity across different geographic locations. The main objective of this study was to develop an Albanian translation of a standardised questionnaire for tinnitus research, namely the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire (ESIT-SQ). A secondary objective was to assess its applicability and usefulness by conducting an exploratory survey on a small sample of the Albanian tinnitus population. DESIGN AND STUDY SAMPLE Three translators were recruited to create the Albanian ESIT-SQ translation following good practice guidelines. Using this questionnaire, data from 107 patients attending otolaryngology clinics in Albania were collected. RESULTS Participants reporting various degrees of tinnitus symptom severity had distinct phenotypic characteristics. Application of a random forest approach on this preliminary dataset showed that self-reported hearing difficulty, and tinnitus duration, pitch and temporal manifestation were important variables for predicting tinnitus symptom severity. CONCLUSIONS Our study provided an Albanian translation of the ESIT-SQ and demonstrated that it is a useful tool for tinnitus profiling and subgrouping.
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Affiliation(s)
- Eleni Genitsaridi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Birkena Qirjazi
- Department of ENT, Faculty of Medicine, University of Tirana, Tirana, Albania
| | - Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Franz Hauck
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Deborah Ann Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK.,Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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27
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Greenwell K, Sereda M, Bradbury K, Geraghty AWA, Coulson NS, Hoare DJ. Intervention Planning for the Tinnitus E-Programme 2.0, an Internet-Based Cognitive Behavioral Intervention for Tinnitus. Am J Audiol 2021; 30:241-254. [PMID: 34038162 DOI: 10.1044/2021_aja-20-00131] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Purpose The purpose of this study is to comprehensively describe the intervention planning process for the Tinnitus E-Programme 2.0, an Internet-based cognitive behavioral intervention for tinnitus. Method Theory-, evidence-, and person-based approaches to intervention development were used. In Phase 1, quantitative systematic reviews were used to identify potentially effective intervention techniques and design features. Primary mixed-methods research involving adults with tinnitus explored the acceptability of the first version of the intervention. In Phase 2, person-based guiding principles highlighted key intervention design objectives and features to address needs of the intervention's target group (identified in Phase 1) to maximize its acceptability, feasibility of delivery, and effectiveness. Theory-based "behavioral analysis" and "logic modeling" comprehensively described intervention content and potential mechanisms of action. From this planning work, a prototype intervention was developed. Results The intervention design objectives outlined in the guiding principles were to (a) normalize tinnitus, (b) support users to maintain a regular relaxation practice, (c) minimize the worsening of users' tinnitus sensation, and (d) ensure the intervention is accessible to those with hearing loss. Behavioral analysis and logic modeling identified intervention processes (e.g., illness perceptions, beliefs about consequences, skills, goals) and purported mediators (acceptance of tinnitus, negative thinking, use of the cognitive skills tools for managing negative thoughts, and practicing regular relaxation) hypothesized to facilitate reductions in tinnitus symptom severity. Conclusions The guiding principles highlight key design objectives and features to consider when developing interventions for tinnitus. The logic model offers hypothesized mechanisms of action that can be tested in future process analyses.
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Affiliation(s)
- Kate Greenwell
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, United Kingdom
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
| | - Magdalena Sereda
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
| | - Katherine Bradbury
- Centre for Clinical and Community Applications of Health Psychology, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, United Kingdom
| | - Adam W. A. Geraghty
- School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, United Kingdom
| | - Neil S. Coulson
- Division of Rehabilitation, Ageing and Wellbeing, School of Medicine, University of Nottingham, United Kingdom
| | - Derek J. Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Hearing Sciences group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, United Kingdom
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28
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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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Biswas R, Lugo A, Genitsaridi E, Trpchevska N, Akeroyd MA, Cederroth CR, Liu X, Schlee W, Garavello W, Gallus S, Hall DA. Modifiable lifestyle-related risk factors for tinnitus in the general population: An overview of smoking, alcohol, body mass index and caffeine intake. PROGRESS IN BRAIN RESEARCH 2021; 263:1-24. [PMID: 34243884 DOI: 10.1016/bs.pbr.2021.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Tinnitus is a symptom and not a disease in its own right. A number of medical conditions are known to increase the risk of developing tinnitus. Most known risk factors are otological or neurological, but general health and lifestyle can also precipitate the condition. Understanding these modifiable risk factors can help to identify vulnerable groups and can inform preventive actions to reduce likelihood of developing tinnitus. Smoking, alcohol consumption, body mass index (BMI) and caffeine intake are all lifestyle risk factors hypothesized to be related to tinnitus. Nonetheless, research findings in support of those relationships are somewhat mixed. METHODS A systematic review was conducted to identify all relevant studies on the specific risk factors. Findings were summarized using a narrative synthesis and meta-analysis, where possible. RESULTS Overall 384 studies were included, mostly using cross-sectional designs. Findings indicated significantly increased risk of tinnitus among current (based on 26 studies) and ever smokers (based on 16 studies) and among obese people (based on seven studies), but no effect of alcohol consumption (based on 11 studies). With respect to caffeine intake or coffee drinking, only three studies examined this risk factor and so we were unable to draw conclusions. CONCLUSION Our results contribute to quantifying the relationship between tinnitus and specific lifestyle-related risk factors, and we highlight some of the gaps and inconsistencies across published studies.
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Affiliation(s)
- Roshni Biswas
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Eleni Genitsaridi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Natalia Trpchevska
- Experimental Audiology, Department of Physiology and Pharmacology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Michael A Akeroyd
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Christopher R Cederroth
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom; Experimental Audiology, Department of Physiology and Pharmacology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Xiaoqiu Liu
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Werner Garavello
- Department of Otorhinolaryngology, School of Medicine and Surgery, Università degli Studi di Milano-Bicocca, Monza, Italy
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
| | - Deborah A Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, United Kingdom; Heriot-Watt University Malaysia, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia
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Lourenco MPCG, Cima RFF, Vlaeyen JWS. Effects of ecological momentary assessment (EMA) induced monitoring on tinnitus experience: A multiple-baseline single-case experiment. PROGRESS IN BRAIN RESEARCH 2021; 263:153-170. [PMID: 34243887 DOI: 10.1016/bs.pbr.2021.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Ecological momentary assessment (EMA) is a method capable of assessing tinnitus experience throughout the day, enabling the exploration of daily dynamic changes of tinnitus expression. However, the effects on patients' tinnitus experience itself are still largely unknown. This study seeks to test the hypothesis that the use of EMA negatively influences tinnitus experience in participants with severe tinnitus. METHOD A multiple-baseline single-case experimental design included four severely affected tinnitus volunteers who were recruited online and randomized into different phasing schedules. Baseline phase (A) ranged from 11 to 24 days, followed by an EMA phase (B) for the remainder of the 33-day schedule. End-of-day diary assessments of tinnitus experience (e.g., annoyance, intrusiveness, mood) were visually inspected, and complemented with inferential statistics (randomization tests and Tau-U). RESULTS End-of-day diary data revealed no change in broadened median between phases. Nevertheless, tinnitus experience scores improved as variability decreased and a significant improvement in stress was observed through weighted Tau-U statistics. CONCLUSION Findings of this study corroborate that EMA assessment does not negatively affect tinnitus experience. On the contrary, participants may have improved. The underlying mechanism of improvements are still to be uncovered. Findings are limited to severely affected tinnitus sufferers at present.
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Affiliation(s)
- Matheus P C G Lourenco
- Experimental Health Psychology, Maastricht University, Maastricht, Netherlands; Research Group Health Psychology, KU Leuven University, Leuven, Belgium.
| | - Rilana F F Cima
- Experimental Health Psychology, Maastricht University, Maastricht, Netherlands; Adelante, Centre for Expertise in Rehabilitation & Audiology, Hoensbroek, Netherlands; Research Group Health Psychology, KU Leuven University, Leuven, Belgium
| | - Johan W S Vlaeyen
- Experimental Health Psychology, Maastricht University, Maastricht, Netherlands; Research Group Health Psychology, KU Leuven University, Leuven, Belgium
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31
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Partyka M, Neff P, Bacri T, Michels J, Weisz N, Schlee W. Gender differentiates effects of acoustic stimulation in patients with tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 263:25-57. [PMID: 34243890 DOI: 10.1016/bs.pbr.2021.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Gender constitutes a major factor to consider when tailoring subtype-based therapies for tinnitus. Previous reports showed important differences between men and women concerning basic perceptual tinnitus characteristics (i.e., laterality, frequency, tinnitus loudness) as well as psychological reactions linked to this condition. Therapeutic approaches based on acoustic stimulation involve processes beyond a pure masking effect and consist of sound presentation temporarily altering or alleviating tinnitus perception via residual and/or lateral inhibition mechanisms. Presented stimuli may include pure tones, noise, and music adjusted to or modulated to filter out tinnitus pitch and therefore trigger reparative functional and structural changes in the auditory system. Furthermore, recent findings suggest that in tonal tinnitus, the presentation of pitch-adjusted sounds which were altered by a 10Hz modulation of amplitude was more efficient than unmodulated stimulation. In this paper, we investigate sex differences in the outcome of different variants of acoustic stimulation, looking for factors revealing predictive value in the efficiency of tinnitus relief.
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Affiliation(s)
- Marta Partyka
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Patrick Neff
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria; University of Zurich, Zurich, Switzerland
| | - Timothée Bacri
- Department of Mathematics, University of Bergen, Bergen, Norway
| | - Jakob Michels
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Nathan Weisz
- Centre for Cognitive Neuroscience and Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Winfried Schlee
- Clinic and Policlinic for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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Noreña AJ, Lacher-Fougère S, Fraysse MJ, Bizaguet E, Grevin P, Thai-Van H, Moati L, Le Pajolec C, Fournier P, Ohresser M. A contribution to the debate on tinnitus definition. PROGRESS IN BRAIN RESEARCH 2021; 262:469-485. [PMID: 33931192 DOI: 10.1016/bs.pbr.2021.01.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Tinnitus is generally defined as an auditory perception in the absence of environmental sound stimulation. However, this definition is quite incomplete as it omits an essential aspect, the patient's point of view. This point of view constitutes, first and foremost, a global and unified lived experience, which is not only sensory (localization, loudness, pitch and tone), but also cognitive (thoughts, attentiveness, behaviors) and emotional (discomfort, suffering). This experience can be lived in a very unpleasant way and consequently have a very negative impact on quality of life. This article proposes and justifies a new definition for tinnitus elaborated by a group of French clinicians and researchers, which is more in line with its phenomenology. It also provides a minimum knowledge base, including possibilities for clinical care, hoping to eradicate all misinformation, misconceptions and inappropriate attitudes or practices toward this condition. Here is the short version of our definition: Tinnitus is an auditory sensation without an external sound stimulation or meaning, which can be lived as an unpleasant experience, possibly impacting quality of life.
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Affiliation(s)
- Arnaud J Noreña
- Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France.
| | | | | | | | | | - Hung Thai-Van
- Hôpital Edouard Herriot, Pavillon U, Place d'Arsonval, Lyon, France
| | | | | | - Philippe Fournier
- Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
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Shabbir M, Akeroyd MA, Hall DA. A comprehensive literature search to identify existing measures assessing "concentration" as a core outcome domain for sound-based interventions for chronic subjective tinnitus in adults. PROGRESS IN BRAIN RESEARCH 2021; 262:209-224. [PMID: 33931180 DOI: 10.1016/bs.pbr.2021.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The Core Outcome Measures in Tinnitus (COMiT) initiative has recommended a minimum standard of five outcomes when designing a clinical trial to assess the efficacy of sound-based interventions. These are: ability to ignore, concentration, quality of sleep, sense of control and tinnitus intrusiveness. The next stage is to consider what measurement instruments might be appropriate for assessing these constructs. The current study aimed to systematically gather existing instruments used to assess concentration. A total of 6240 potentially relevant records were identified. Duplicates and non-published works were removed, leaving a total of 3599 records. A procedure was developed to sample a subset of records, in order to identify relevant instruments without exhaustively reading all 3599 texts. Initially 559 records were identified by screening 1000 articles; 500 of which were randomly selected, and 500 were the most recent publications identified from the PubMed database. Using predefined criteria for data saturation, information about measures of concentration was extracted from the 559 full texts. However, data saturation was reached by 240. Thirteen candidate instruments were identified. The next step will be to assess content validity and feasibility of administration for all these candidate instruments. Findings will inform future recommendations for how to measure concentration in clinical trials to ensure results of trials can be easily compared, contrasted, and synthesized.
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Affiliation(s)
- Maryam Shabbir
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
| | - Michael A Akeroyd
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Deborah A Hall
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, United Kingdom; University of Nottingham Malaysia, Semenyih, Selangor Darul Ehsan, Malaysia
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Fournier P, Bigras C, Lehmann A, Noreña AJ, Hébert S. Modulation of hyperacusis and tinnitus loudness in tinnitus patients with and without hearing loss following 3 weeks of acoustic stimulation: A proof-of-concept study. PROGRESS IN BRAIN RESEARCH 2021; 262:57-91. [PMID: 33931195 DOI: 10.1016/bs.pbr.2021.01.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Tinnitus and hyperacusis are two debilitating conditions that are highly comorbid. It has been postulated that they may originate from similar pathophysiological mechanisms such as an increase in central gain. Interestingly, sound stimulation has been shown to reduce central gain and is currently used for the treatment of both conditions. This study investigates the effect of sound stimulation on both tinnitus and hyperacusis in the same patients. Two distinct series of tinnitus participants were tested: one with normal or near-normal hearing (n=16) and one with hearing loss (n=14). A broadband noise shaped to cover most of the tinnitus frequency spectrum was delivered through hearing aids using the noise generator feature (no amplification) and verified through real-ear measurements. Participants received sound stimulation for 3 weeks and were tested before (at baseline), then after 1 week and at the end of the 3 weeks of sound stimulation. There was also a 1-month follow-up after the end of the stimulation protocol. The measurements included self-reported measures of tinnitus and hyperacusis (VAS), validated questionnaires (THI, HQ) and psychoacoustic measurements (tinnitus battery and loudness functions). On both self-assessment (VAS of sound tolerance and tinnitus loudness) and psychoacoustic measures (loudness function and tinnitus loudness in dB), about 50% of tinnitus participants had a synchronous (either a decrease or an increase) modulation of hyperacusis and tinnitus loudness after 1 week and 3 weeks of acoustic stimulation and up to about 70% of participants at 1-M follow-up. The decrease of hyperacusis and tinnitus loudness was more prevalent in normal-hearing participants. There was a significant increase in tinnitus loudness during and following the stimulation in the group with hearing loss. Hyperacusis improvement as assessed by loudness function was significantly correlated with the intensity level of the acoustic stimulation (dB level of the noise produced by the noise generator) in tinnitus participants with normal/near-normal hearing thresholds. Our study partly supports the central gain hypothesis by showing synchronous modulation of hyperacusis and tinnitus loudness. It also shows beneficial effects of acoustic stimulation in some tinnitus individuals, in particular those with normal or near-normal hearing, while highlighting the importance of a careful fitting of sound generators to prevent increase. Since the amplification feature was not turned on in our study, future work should determine whether amplification alone, or in addition to acoustic stimulation (sound generators), would benefit to those with hearing loss.
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Affiliation(s)
- Philippe Fournier
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, QC, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, QC, Canada; Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Charlotte Bigras
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, QC, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, QC, Canada
| | - Alexandre Lehmann
- International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, QC, Canada; Royal Victoria Hospital, ENT Department, McGill University, Montreal, QC, Canada
| | - Arnaud J Noreña
- Laboratoire de Neurosciences Cognitives, UMR 7291, Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Sylvie Hébert
- School of Speech Pathology and Audiology, Université de Montréal, Montréal, QC, Canada; International Laboratory for Research on Brain, Music, and Sound (BRAMS), Université de Montréal, Montréal, QC, Canada.
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Ausland JHL, Engdahl B, Oftedal B, Steingrímsdóttir ÓA, Nielsen CS, Hopstock LA, Johnsen M, Friborg O, Rosenvinge JH, Eggen AE, Krog NH. Tinnitus and associations with chronic pain: The population-based Tromsø Study (2015-2016). PLoS One 2021; 16:e0247880. [PMID: 33651844 PMCID: PMC7924755 DOI: 10.1371/journal.pone.0247880] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 02/16/2021] [Indexed: 11/18/2022] Open
Abstract
Tinnitus and pain have many similarities. Both are subjective sensations that may turn chronic, they are often accompanied by hypersensitivity in their respective sensory system, and overlapping brain changes have been observed. Since no population study has examined the empirical association between chronic pain and tinnitus, the present study aimed to explore the relationship in a general adult population. We used data from the seventh survey of the Tromsø Study (2015–2016). Participants (aged ≥40) responded to questions about pain and tinnitus. Using multiple logistic regression, we analysed the adjusted relationship between chronic pain and tinnitus in the full sample (n = 19,039), using several tinnitus definitions ranging from tinnitus >5 minutes within the past 12 months (broadest definition) to at least weekly and highly bothersome tinnitus (strictest definition). We also analysed relationships between number of body regions with pain, pain intensity and bothering, and tinnitus >5 minutes, among participants with chronic pain (n = 11,589). We found an association between chronic pain and tinnitus that was present irrespective of tinnitus definition, but was stronger with more bothersome tinnitus. With chronic pain, the odds of tinnitus >5 minutes was 64% higher, while odds of at least weekly, highly bothersome tinnitus was 144% higher than without chronic pain. Among participants with chronic pain, the number of pain regions was the pain variable most strongly associated with tinnitus >5 minutes (OR = 1.17 (95% CI: 1.14–1.20) for an increase of one region), whereas the other pain variables (intensity and bothering) showed weaker associations. All chronic pain variables had significant interactions with age, with the strongest associations for the youngest individuals (40–54 years). Our findings support the existence of an association between chronic pain and tinnitus and emphasises the importance of examining for comorbid pain in tinnitus patients to provide a more comprehensive treatment of tinnitus.
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Affiliation(s)
- Jannike H-L Ausland
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- * E-mail:
| | - Bo Engdahl
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Bente Oftedal
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Ólöf A. Steingrímsdóttir
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
| | - Christopher S. Nielsen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
- Department of Pain Management and Research, Oslo University Hospital, Nydalen, Oslo, Norway
| | - Laila A. Hopstock
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Magnar Johnsen
- Department of Occupational and Environmental Medicine, University Hospital of North Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Jan H. Rosenvinge
- Department of Psychology, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Anne E. Eggen
- Department of Community Medicine, UiT The Arctic University of Norway, Langnes, Tromsø, Norway
| | - Norun H. Krog
- Department of Environmental Health, Norwegian Institute of Public Health, Skøyen, Oslo, Norway
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Web-based discussion forums reveal the person-centered relevance and importance of tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 260:205-221. [PMID: 33637218 DOI: 10.1016/bs.pbr.2020.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
An increasing number of health researchers are recognizing the benefits of crowdsourcing. Web-based discussion forums are well suited for collecting qualitative research data with tinnitus participants and forum posts can be evaluated using thematic analysis. The present study reports an innovative use of such qualitative data contributed by a group of 148 people with tinnitus and tinnitus professionals through the crowdsourcing platform Tinnitus Talk. While the primary research question was focused on defining symptom concepts, discussions were broad-ranging and extended far beyond this topic. Thematic analysis of the discussion conducted by two analysts identified three novel emerging themes and these were not pre-planned according to the moderator's script. These were (i) the lived experience of tinnitus, (ii) perspectives on interventions for tinnitus, and (iii) the experience of participating in a web discussion forum. These unexpected themes contribute to a richer and more in-depth understanding of tinnitus seen through the eyes of those who experience it on a daily basis. Findings are important since spontaneous themes presumably reflect issues that are of personal relevance and importance to the participants. They therefore give insights into future research directions and have implications for patient-centered counseling strategies that could be effective in clinic.
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Raj-Koziak D, Gos E, Swierniak W, Skarzynski H, Skarzynski PH. Prevalence of tinnitus in a sample of 43,064 children in Warsaw, Poland. Int J Audiol 2020; 60:614-620. [PMID: 33315487 DOI: 10.1080/14992027.2020.1849829] [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] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Tinnitus affects both adults and children. Children rarely complain spontaneously of tinnitus, and their parents are not aware of the condition. The prevalence of tinnitus in children differs considerably between studies, and large studies are needed to reliably estimate how many children experience tinnitus symptoms. The goal of the study was to estimate the prevalence of tinnitus in a large sample of schoolchildren. DESIGN This study was population-based, epidemiological research, conducted in the general, paediatric population of school-age children in Warsaw, Poland. Pure-tone audiometric testing was done, and hearing thresholds were determined from 0.5 to 8 kHz. Both the children and parents answered questions about the presence of tinnitus in the child. STUDY SAMPLE Results from 43,064 children aged 11 to 13 years old, as well as their parents, were collected. RESULTS The study showed that tinnitus affected 3.1% of the children, but it was significantly more frequent (9%) in children with hearing loss. We found that 1.4% of the parents were aware of the presence of tinnitus in their children. CONCLUSIONS Children should be routinely asked whether they experience tinnitus and if so, they should be included in the thorough assessment and management of the condition.
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Affiliation(s)
- Danuta Raj-Koziak
- Department of Audiology and Phoniatrics, Tinnitus Clinic, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Elzbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Weronika Swierniak
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Henryk Skarzynski
- Department of Otorhinolaryngosurgery, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland
| | - Piotr H Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw/Kajetany, Poland.,Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland.,Institute of Sensory Organs, Warsaw/Kajetany, Poland
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Genitsaridi E, Hoare DJ, Kypraios T, Hall DA. A Review and a Framework of Variables for Defining and Characterizing Tinnitus Subphenotypes. Brain Sci 2020; 10:E938. [PMID: 33291859 PMCID: PMC7762072 DOI: 10.3390/brainsci10120938] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/26/2020] [Accepted: 12/01/2020] [Indexed: 02/07/2023] Open
Abstract
Tinnitus patients can present with various characteristics, such as those related to the tinnitus perception, symptom severity, and pattern of comorbidities. It is speculated that this phenotypic heterogeneity is associated with differences in the underlying pathophysiology and personal reaction to the condition. However, there is as yet no established protocol for tinnitus profiling or subtyping, hindering progress in treatment development. This review summarizes data on variables that have been used in studies investigating phenotypic differences in subgroups of tinnitus, including variables used to both define and compare subgroups. A PubMed search led to the identification of 64 eligible articles. In most studies, variables for subgrouping were chosen by the researchers (hypothesis-driven approach). Other approaches included application of unsupervised machine-learning techniques for the definition of subgroups (data-driven), and subgroup definition based on the response to a tinnitus treatment (treatment response). A framework of 94 variable concepts was created to summarize variables used across all studies. Frequency statistics for the use of each variable concept are presented, demonstrating those most and least commonly assessed. This review highlights the high dimensionality of tinnitus heterogeneity. The framework of variables can contribute to the design of future studies, helping to decide on tinnitus assessment and subgrouping.
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Affiliation(s)
- Eleni Genitsaridi
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; (D.J.H.); (D.A.H.)
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
| | - Derek J. Hoare
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; (D.J.H.); (D.A.H.)
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
| | - Theodore Kypraios
- School of Mathematical Sciences, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Deborah A. Hall
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK; (D.J.H.); (D.A.H.)
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham NG1 5DU, UK
- Queens Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK
- University of Nottingham Malaysia, Semenyih 43500, Selangor Darul Ehsan, Malaysia
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Clarke NA, Henshaw H, Akeroyd MA, Adams B, Hoare DJ. Associations Between Subjective Tinnitus and Cognitive Performance: Systematic Review and Meta-Analyses. Trends Hear 2020; 24:2331216520918416. [PMID: 32436477 PMCID: PMC7243410 DOI: 10.1177/2331216520918416] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Tinnitus is the perception of sound in the absence of a corresponding external sound source, and bothersome tinnitus has been linked to poorer cognitive performance. This review comprehensively quantifies the association between tinnitus and different domains of cognitive performance. The review protocol was preregistered and published in a peer-reviewed journal. The review and analyses were reported according to Preferred Reporting Items for Systematic Review and Meta-analysis guidelines. Peer-reviewed literature was searched using electronic databases to find studies featuring participants with tinnitus who had undertaken measures of cognitive performance. Studies were assessed for quality and categorized according to an established cognitive framework. Random-effects meta-analyses were performed on various cognitive domains with potential moderator variables assessed where possible. Thirty-eight records were included in the analysis from a total of 1,863 participants. Analyses showed that tinnitus is associated with poorer executive function, processing speed, general short-term memory, and general learning and retrieval. Narrow cognitive domains of Inhibition and Shifting (within executive function) and learning and retrieval (within general learning and retrieval) were also associated with tinnitus.
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Affiliation(s)
- Nathan A Clarke
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Helen Henshaw
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Michael A Akeroyd
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Bethany Adams
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre.,Division of Clinical Neuroscience, School of Medicine, University of Nottingham
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Elarbed A, Fackrell K, Baguley DM, Hoare DJ. Tinnitus and stress in adults: a scoping review. Int J Audiol 2020; 60:171-182. [PMID: 33000672 DOI: 10.1080/14992027.2020.1827306] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Tinnitus and stress are recurrently reported together. The strength and direction of this relationship is not clear. The aim of this review is to catalogue the evidence of this relationship, how it has been described in adults and which instruments were used. DESIGN Five-stage framework was followed. An online search of databases and published journals were conducted. The main inclusion criteria were original studies published in English and conducted in an adult human population, in which both tinnitus and stress were measured using different instruments. STUDY SAMPLES 5699 records were identified in the searching stage and 50 studies were eligible for data extraction. RESULTS Measurements of perceived stress were most frequently used. Tinnitus patients tend to report louder and more bothersome tinnitus when they are stressed, but not all tinnitus patients associated stress with the onset or the severity of their tinnitus. Any positive correlation reported between stress and tinnitus levels varied in strength according to the used instrument. Post-intervention changes in stress and tinnitus levels showed inconsistency. CONCLUSION There is considerable room for further research to study the relationship between stress and tinnitus. We highlight principal issues that should be considered in future studies.
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Affiliation(s)
- Asma Elarbed
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - David M Baguley
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
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Waechter S, Wilson WJ, Brännström JK. The impact of tinnitus on working memory capacity. Int J Audiol 2020; 60:274-281. [PMID: 33000654 DOI: 10.1080/14992027.2020.1822550] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE To determine if tinnitus was related to working memory (WM) in adults and if tinnitus handicap was related to WM in adults with tinnitus. DESIGN Two groups, cross-sectional design. STUDY SAMPLES 76 adults forming a tinnitus group (n = 38) and a control group (n = 38). Each group included 19 adults with normal hearing and 19 adults with hearing loss matched for age, sex and educational backgrounds. All participants completed the visual n-back test; pure tone audiometry (0.125-16 kHz); and the Hospital Anxiety and Depression Scale (HADS). Tinnitus sufferers also completed the Tinnitus Handicap Inventory (THI). RESULTS For all participants, tinnitus was not related to WM scores when corrected for hearing thresholds, anxiety, and depression. The corrections for best ear high-frequency pure-tone average hearing threshold (BEHFPTA: 10, 12.5, 14 and 16 kHz) were significant. For tinnitus sufferers, THI was related to WM scores in the easiest n-back condition, and BEHFPTA was related to WM scores in the easiest and the hardest n-back condition. CONCLUSION Tinnitus was not related to WM scores. Tinnitus handicap was related to some WM scores in tinnitus sufferers. Further investigation of the possible relationship between high-frequency hearing and WM is warranted.
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Affiliation(s)
- Sebastian Waechter
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
| | - Wayne J Wilson
- Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Australia
| | - Jonas K Brännström
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Lund, Sweden
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Cimino R, Bucci R, Ambrosio A, Carrabba L, Corrado B, Simeon V, Michelotti A. Temporomandibular disorders, neck disability, and oral parafunctions in tinnitus patients: A cross-sectional epidemiological study from Southern Italy. Cranio 2020; 40:485-493. [PMID: 32559128 DOI: 10.1080/08869634.2020.1781499] [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: 10/24/2022]
Abstract
OBJECTIVE To assess the prevalence of temporomandibular disorders (TMD) in a sample of tinnitus patients and to determine the association between tinnitus, TMD, neck disability, and oral parafunctions. METHODS Seventy-nine tinnitus patients were enrolled and underwent standardized clinical examination for TMD. The tinnitus severity was measured with the Tinnitus Handicap Inventory (THI). The oral parafunctions were self-reported with the Oral Behavior Checklist (OBC). The neck disability was recorded with the Neck Disability Index (NDI). RESULTS More than half of the sample presented TMD, and the most frequent diagnosis was TMD pain. Higher THI was observed in TMD-pain individuals, compared to TMD-free (β 18.4; 95%CI 6.7, 30.1; p = 0.002). The OBC showed a significant low-to-moderate positive correlation with the THI (rho= 0.368, p = 0.001), while the NDI did not. DISCUSSION Standardized assessment of TMD and oral behaviors should be integrated into the routine diagnostic evaluations of tinnitus patients.
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Affiliation(s)
- Roberta Cimino
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Rosaria Bucci
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy.,Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Andrea Ambrosio
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
| | - Laura Carrabba
- Department of Neurosciences, Reproductive Sciences and Oral Science, Audiology Unit, University of Naples Federico II, Naples, Italy
| | - Bruno Corrado
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Vittorio Simeon
- Department of Public, Clinical and Preventive Medicine, Medical Statistics Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ambrosina Michelotti
- Department of Neurosciences, Reproductive Sciences and Oral Science, School of Orthodontics and Temporomandibular Disorders, University of Naples Federico II, Naples, Italy
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Abstract
OBJECTIVE Determine the prevalence of clinical insomnia and its associations with anxiety, depression, and tinnitus in adult cochlear implant (CI) users. DESIGN Self-reported information on tinnitus, sleep, and demographic variables was collected from adult CI users (n = 127). Tinnitus presence, its persistence, related emotional distress, and difficulties with sleep were assessed using questions from the UK Biobank study (www.ukbiobank.ac.uk). Tinnitus-related handicap was assessed using the Tinnitus Handicap Inventory. Clinical insomnia symptoms were characterized using the Insomnia Severity Index (ISI), and clinical anxiety and depression symptoms using the Hospital Anxiety and Depression Scale (HADS). Regression models were used to compare the data from CI users with and without tinnitus, and to test the associations between clinical insomnia, anxiety, depression and tinnitus handicap. RESULTS About a half (53%) of CI users reported tinnitus, of whom 54% described it as persistent, 41% as emotionally distressing and 73% reported having difficulties with sleep based on the UK Biobank questions. The ISI suggested that clinically abnormal insomnia symptoms were more likely to occur with tinnitus (odds ratio [OR] = 2.60, 95% confidence interval 1.04 to 6.45; p = 0.040) and were found in 41% of CI users with tinnitus. Post-hoc exploratory analyses on the ISI suggested that CI users with tinnitus experienced greater levels of difficulty falling asleep, lower satisfaction with sleep patterns, greater interference of sleep problems with daily activities, and a greater impact on their quality of life. The HADS scores suggested that those with tinnitus were also more likely to have clinically abnormal anxiety (42%; OR = 3.50, 95% confidence interval 1.49 to 8.22; p = 0.004) and depression symptoms (14%; OR = 6.18, 95% confidence interval 1.17 to 32.82; p = 0.032). The clinical insomnia observed in CI users with tinnitus was associated with tinnitus handicap (p = 0.028), and the levels of clinical anxiety (p = 0.012) and depression (p < 0.001). CONCLUSIONS Clinically abnormal insomnia symptoms are prevalent, potentially affecting over 40% of CI users with tinnitus. The associations between clinical insomnia, anxiety, and depression symptoms, and tinnitus-related handicap suggest that all of these symptoms should be considered when assessing the tinnitus-related burden and its impact on the quality of life after cochlear implantation. The present findings also have potential implications for the clinical management of CI recipients with tinnitus, in whom it may be advisable to monitor sleep problems so that they can be addressed where appropriate. Further research is needed to investigate the mechanisms and causal links behind insomnia and tinnitus-related symptoms in this population. Future studies should also investigate the feasibility and effectiveness of night time use of CIs to alleviate tinnitus-related insomnia. The potential impact of insomnia on the quality of life of CI users with tinnitus highlights the importance of including sleep measures in future evaluations of the effectiveness of cochlear implantation for the alleviation of tinnitus.
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Smith H, Fackrell K, Kennedy V, Barry JG, Broomhead E, Hoare DJ. An evaluation of paediatric tinnitus services in UK National Health Service audiology departments. BMC Health Serv Res 2020; 20:214. [PMID: 32171314 PMCID: PMC7071756 DOI: 10.1186/s12913-020-5040-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 02/26/2020] [Indexed: 01/25/2023] Open
Abstract
Background Whilst evidence indicates many children experience troublesome tinnitus, specialist services for children are far less established than those available for adults. To date, there is limited understanding of how paediatric tinnitus is managed in the UK, and to what extent current practice reflects what is recommended. This service evaluation aimed to 1) profile how tinnitus in children is managed in UK clinical practice, and assess to what extent care provided by services reflects advice included in the British Society of Audiology (BSA) Tinnitus in Children Practice Guidance, 2) collate clinician opinions on how services may be optimised, and 3) identify common problems experienced by children who present with bothersome tinnitus in clinic. Methods As part of a larger survey, eight questions regarding services for paediatric tinnitus were distributed to UK NHS audiology services via email and social media. Representatives from eighty-seven services responded between July and September 2017. Results Fifty-three percent of respondents reported that their department provided a paediatric tinnitus service. Among these services, there was widespread use of most BSA recommended assessments and treatments. Less widely used practices were the assessment of mental health (42%), and the use of psychological treatment approaches; cognitive behavioural therapy (CBT) (28%), mindfulness (28%), and narrative therapy (14%). There was varied use of measurement tools to assess tinnitus in children, and a minority of respondents reported using adult tinnitus questionnaires with children. Frequently reported tinnitus-related problems presented by children were sleep difficulties, concentration difficulties at school, situation-specific concentration difficulties, and emotional distress. Conclusions Approaches used to manage children with troublesome tinnitus in UK NHS services are largely consistent and reflective of the current practice guidance. However, findings from this study indicate specialist staff training, access to child-specific tools, and the treatment and referral of children with tinnitus-related psychological problems represent key areas in need of optimisation.
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Affiliation(s)
- Harriet Smith
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Kathryn Fackrell
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, UK
| | | | - Johanna G Barry
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK.,Nottingham University Hospitals NHS Trust, Nottingham, UK
| | | | - Derek J Hoare
- NIHR Nottingham Biomedical Research Centre, Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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Palacios G, Noreña A, Londero A. Assessing the Heterogeneity of Complaints Related to Tinnitus and Hyperacusis from an Unsupervised Machine Learning Approach: An Exploratory Study. Audiol Neurootol 2020; 25:174-189. [DOI: 10.1159/000504741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022] Open
Abstract
Introduction: Subjective tinnitus (ST) and hyperacusis (HA) are common auditory symptoms that may become incapacitating in a subgroup of patients who thereby seek medical advice. Both conditions can result from many different mechanisms, and as a consequence, patients may report a vast repertoire of associated symptoms and comorbidities that can reduce dramatically the quality of life and even lead to suicide attempts in the most severe cases. The present exploratory study is aimed at investigating patients’ symptoms and complaints using an in-depth statistical analysis of patients’ natural narratives in a real-life environment in which, thanks to the anonymization of contributions and the peer-to-peer interaction, it is supposed that the wording used is totally free of any self-limitation and self-censorship. Methods: We applied a purely statistical, non-supervised machine learning approach to the analysis of patients’ verbatim exchanged on an Internet forum. After automated data extraction, the dataset has been preprocessed in order to make it suitable for statistical analysis. We used a variant of the Latent Dirichlet Allocation (LDA) algorithm to reveal clusters of symptoms and complaints of HA patients (topics). The probability of distribution of words within a topic uniquely characterizes it. The convergence of the log-likelihood of the LDA-model has been reached after 2,000 iterations. Several statistical parameters have been tested for topic modeling and word relevance factor within each topic. Results: Despite a rather small dataset, this exploratory study demonstrates that patients’ free speeches available on the Internet constitute a valuable material for machine learning and statistical analysis aimed at categorizing ST/HA complaints. The LDA model with K = 15 topics seems to be the most relevant in terms of relative weights and correlations with the capability to individualizing subgroups of patients displaying specific characteristics. The study of the relevance factor may be useful to unveil weak but important signals that are present in patients’ narratives. Discussion/Conclusion: We claim that the LDA non-supervised approach would permit to gain knowledge on the patterns of ST- and HA-related complaints and on patients’ centered domains of interest. The merits and limitations of the LDA algorithms are compared with other natural language processing methods and with more conventional methods of qualitative analysis of patients’ output. Future directions and research topics emerging from this innovative algorithmic analysis are proposed.
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Hibbert A, Vesala M, Kerr M, Fackrell K, Harrison S, Smith H, Hall DA. Defining Symptom Concepts in Chronic Subjective Tinnitus: Web-Based Discussion Forum Study. Interact J Med Res 2020; 9:e14446. [PMID: 31909716 PMCID: PMC6996772 DOI: 10.2196/14446] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/24/2019] [Accepted: 09/28/2019] [Indexed: 11/19/2022] Open
Abstract
Background A minimum standard based upon consensus decision making recommends a core set of tinnitus-specific health complaints (outcome domains) that should be assessed and reported in all clinical trials as this enables comparisons to be made across studies as well as data pooling for meta-analysis. Objective This study aimed to further clarify how the outcome domain concepts should be defined for 5 of the core set: tinnitus intrusiveness, sense of control, acceptance of tinnitus, concentration, and ability to ignore. This step requires a clear and fully elaborated definition for each outcome domain, moving from an abstract or a vague concept to an operationalized and measurable health-related construct, so that a suitable measurement instrument can then be identified. Methods A series of 5 focus group–style semistructured discussions were conducted via a Web-based discussion forum, each open for 2 weeks and ending with a vote. The participants included 148 tinnitus experts who completed a preceding e-Delphi survey that had generated the original set of minimum standards. The participants were health care users living with tinnitus, health care professionals, clinical researchers, commercial representatives, and funders. Results The Web discussions led to a revision of all 5 original plain language definitions that had been used in the preceding e-Delphi survey. Each revised definition was voted by 8 to 53 participants and reached the prespecified threshold of 70% consensus for all except tinnitus intrusiveness. Although a single definition was not agreed upon for tinnitus intrusiveness, the majority of participants shared the view that the concept should be sufficiently broad to encapsulate a range of subdomains. The examples included tinnitus awareness, unpleasantness, and impact on different aspects of everyday life. Thematic analysis of the 5 Web-based discussion threads gave important insights into expert interpretations of each core outcome domain, generating an operationalized and measurable health construct in each case. Conclusions The qualitative data gathered during the Web-based discussion forum provided an important in-depth understanding of the health concepts that had raised a debate during earlier face-to-face meetings. The descriptive summaries and definitions provide sufficient operationalization of those concepts to proceed to the second stage of core outcome set development that is to identify and evaluate suitable measurement instruments. This study supports the use of Web-based peer discussion forums in defining health concepts.
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Affiliation(s)
- Alice Hibbert
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | | | - Micky Kerr
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Kathryn Fackrell
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | | | - Harriet Smith
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom
| | - Deborah Ann Hall
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, United Kingdom.,University of Nottingham Malaysia, Semenyih, Malaysia
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Abstract
How many people are affected by tinnitus? Is the risk of developing tinnitus on the rise or has it been declining over time? What modifiable lifestyle factors could help to prevent tinnitus? These population-based questions can be addressed through epidemiological research. Epidemiology refers to the underlying and basic science of public health. It describes the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems. There are two key concepts in epidemiology: (1) measures of frequency and (2) measures of effect. In this chapter, we introduce the two main measures of frequency, prevalence and incidence. We also introduce the notion of risk factors, critical for understanding measures of effect concerning the risk of developing a health condition. In both sections, we provide illustrative examples from the published literature on tinnitus. We end by offering a critical evaluation of the current status of epidemiological research on tinnitus and point to some promising future directions.
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Xiang T, Zhong J, Lu T, Pu JM, Liu L, Xiao Y, Lai D. Effect of educational counseling alone on people with tinnitus: Meta-analysis of randomized controlled trials. PATIENT EDUCATION AND COUNSELING 2020; 103:44-54. [PMID: 31378310 DOI: 10.1016/j.pec.2019.07.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 07/22/2019] [Accepted: 07/25/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To review and meta-analyze the efficacy of educational counseling alone in tinnitus. METHODS We collected randomized controlled trials (RCTs) adhered to PRISMA guidelines. Analyzed the effect of educational counseling alone versus other forms of therapy (psychological or combination) with RevMan 5.3. RESULTS In nine trials, 582 patients receiving educational counseling alone and 759 patients receiving other psychological or combination therapies. During the 3-6 months follow-up, there was no significant difference in the tinnitus recovery rate between these two groups (OR 0.62, 95% CI 0.34-1.16, P = 0.14; I2 = 71%, P = 0.00, random-effects model). The tinnitus symptom severity rates were also similar during 1-12 months follow-up (mean difference, 3.59, 95% CI -0.56-7.74, P = 0.09) with heterogeneity among studies (I2 = 74%, P = 0.00; random-effects model). Sensitivity analysis indicated that a single trial containing almost 40% of the patients was the cause of heterogeneity. There was no significant change in tinnitus loudness at the 3 months follow-up (OR 0.84, 95% CI 0.42-1.66, P = 0.61), with no significant heterogeneity (I2 = 0%, P = 0.60). CONCLUSION Educational counseling alone helps to improve tinnitus and related problems, and has the same effect as other psychological or combination therapies. PRACTICE IMPLICATIONS The results of the current analysis may help to develop evidence-based cost-effective treatment(s) for tinnitus, which will be minimally burdensome for the patients.
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Affiliation(s)
- Tao Xiang
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Juan Zhong
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tao Lu
- Hearing Center/Hearing and Speech Science Laboratory, Department of Otolaryngology Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
| | - Jun-Mei Pu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Lu Liu
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Yan Xiao
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Dan Lai
- Department of Otolaryngology Head and Neck Surgery, The Affiliated Hospital of Southwest Medical University, Luzhou, China.
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Sereda M, Xia J, Scutt P, Hilton MP, El Refaie A, Hoare DJ. Ginkgo biloba for tinnitus. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2019. [DOI: 10.1002/14651858.cd013514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Magdalena Sereda
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham; NIHR Nottingham Biomedical Research Centre; Ropewalk House, 113 The Ropewalk Nottingham UK NG1 5DU
| | - Jun Xia
- The University of Nottingham Ningbo; Nottingham China Health Institute; 199 Taikang E Rd Yinzhou Qu Ningbo Zhejiang Sheng China 315000
| | - Polly Scutt
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham; NIHR Nottingham Biomedical Research Centre; Ropewalk House, 113 The Ropewalk Nottingham UK NG1 5DU
| | - Malcolm P Hilton
- Royal Devon and Exeter NHS Trust; ENT Department; Barrack Road Exeter Devon UK EX2 5DW
| | - Amr El Refaie
- University College Cork; Department of Speech and Hearing Sciences; Cork Ireland
| | - Derek J Hoare
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham; NIHR Nottingham Biomedical Research Centre; Ropewalk House, 113 The Ropewalk Nottingham UK NG1 5DU
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Jacquemin L, Mertens G, Van de Heyning P, Vanderveken OM, Topsakal V, De Hertogh W, Michiels S, Van Rompaey V, Gilles A. Sensitivity to change and convergent validity of the Tinnitus Functional Index (TFI) and the Tinnitus Questionnaire (TQ): Clinical and research perspectives. Hear Res 2019; 382:107796. [DOI: 10.1016/j.heares.2019.107796] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 08/06/2019] [Accepted: 09/01/2019] [Indexed: 10/26/2022]
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