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Ying R, Hamlette L, Nikoobakht L, Balaji R, Miko N, Caras ML. Organization of orbitofrontal-auditory pathways in the Mongolian gerbil. J Comp Neurol 2023; 531:1459-1481. [PMID: 37477903 PMCID: PMC10529810 DOI: 10.1002/cne.25525] [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: 04/25/2023] [Revised: 06/11/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023]
Abstract
Sound perception is highly malleable, rapidly adjusting to the acoustic environment and behavioral demands. This flexibility is the result of ongoing changes in auditory cortical activity driven by fluctuations in attention, arousal, or prior expectations. Recent work suggests that the orbitofrontal cortex (OFC) may mediate some of these rapid changes, but the anatomical connections between the OFC and the auditory system are not well characterized. Here, we used virally mediated fluorescent tracers to map the projection from OFC to the auditory midbrain, thalamus, and cortex in a classic animal model for auditory research, the Mongolian gerbil (Meriones unguiculatus). We observed no connectivity between the OFC and the auditory midbrain, and an extremely sparse connection between the dorsolateral OFC and higher order auditory thalamic regions. In contrast, we observed a robust connection between the ventral and medial subdivisions of the OFC and the auditory cortex, with a clear bias for secondary auditory cortical regions. OFC axon terminals were found in all auditory cortical lamina but were significantly more concentrated in the infragranular layers. Tissue-clearing and lightsheet microscopy further revealed that auditory cortical-projecting OFC neurons send extensive axon collaterals throughout the brain, targeting both sensory and non-sensory regions involved in learning, decision-making, and memory. These findings provide a more detailed map of orbitofrontal-auditory connections and shed light on the possible role of the OFC in supporting auditory cognition.
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Affiliation(s)
- Rose Ying
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, Maryland, 20742
- Department of Biology, University of Maryland, College Park, Maryland, 20742
- Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park, Maryland, 20742
| | - Lashaka Hamlette
- Department of Biology, University of Maryland, College Park, Maryland, 20742
| | - Laudan Nikoobakht
- Department of Biology, University of Maryland, College Park, Maryland, 20742
| | - Rakshita Balaji
- Department of Biology, University of Maryland, College Park, Maryland, 20742
| | - Nicole Miko
- Department of Biology, University of Maryland, College Park, Maryland, 20742
| | - Melissa L. Caras
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, Maryland, 20742
- Department of Biology, University of Maryland, College Park, Maryland, 20742
- Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park, Maryland, 20742
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Xia Q, Yang S, Ji F. The characteristics of hearing loss in outpatients with tinnitus over the age of 60: a 11-year cross-sectional study. Acta Otolaryngol 2023; 143:753-758. [PMID: 37772756 DOI: 10.1080/00016489.2023.2259952] [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: 07/20/2023] [Accepted: 09/07/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND Presbycusis with tinnitus has a significant impact on the quality of life of elderly patients, becoming a serious socioeconomic problem. OBJECTIVES We conducted an 11-year cross-sectional analysis of the audiometry results of elderly patients with tinnitus from 2011 to 2021. METHODS 9642 patients aged 60 and over were divided into three groups: young-old (YO) (60-74), old-old (OO) (75-89), and longevous (LON) (90 and over). Pure-tone audiometry results of all patients were analyzed. RESULTS Among 9642 patients, the cases of female with tinnitus were more than male in all years. The hearing curve showed a typical age-related decline. Hearing level of air conduction in female declined significantly at low frequencies while that of male was worse at high frequencies in YO and OO groups. Compared with right, left hearing level of air conduction was significantly decreased at all frequencies except 0.125 kHz. CONCLUSIONS When the chief complaint was tinnitus, women were likely to experience more distress than men. However, men suffered from more hearing loss than women, at least in high frequencies. The influence weight of presbycusis and tinnitus on the auditory cortices might be a possible reason for the lateral distinction of hearing loss at different ages.
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Affiliation(s)
- Qingqing Xia
- College of Medicine, Nankai University, Tianjin, China
| | - Shiming Yang
- College of Medicine, Nankai University, Tianjin, China
- Department of Otolaryngology Head and Neck Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
| | - Fei Ji
- Department of Otolaryngology Head and Neck Surgery, the First Medical Centre, Chinese PLA General Hospital, Beijing, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing, China
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Yuan H, Lu PH, Chen JW, Ma PW, Wang WL, Ding XR, Lun YQ, Gao W, Lu LJ. Correlation between clinical characteristics and tinnitus severity in tinnitus patients of different sexes: an analytic retrospective study. Eur Arch Otorhinolaryngol 2023; 280:167-173. [PMID: 35701540 DOI: 10.1007/s00405-022-07480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/30/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE This study aimed to explore whether sex is influences tinnitus severity and whether the risk factors for tinnitus severity are the same in tinnitus patients of different sexes. METHODS This was a retrospective study of data from 1427 patients complaining of tinnitus in a local hospital otolaryngology clinic from November 2019 to January 2022. All patients were interviewed and assessed by otoscopy, pure-tone audiometry, tinnitus handicap inventory (THI), visual analogue scale (VAS), and tinnitus refinement test. RESULTS THI values were higher in females than in males (P = 0.00). Types of tinnitus sounds (OR 0.667, P = 0.000) and degree of hearing loss (OR 1.318, P = 0.000) were risk factors for tinnitus severity in males. Types of tinnitus sounds (OR 0.789, P = 0.005), sensation level (OR 1.023, P = 0.037), tinnitus types (OR 1.163, P = 0.041), tinnitus location (OR 1.198, P = 0.026), and the degree of hearing loss (OR 1.303, P = 0.000) were risk factors for tinnitus severity in females. Sex was an influencing factor for tinnitus severity. There were different risk factors for the tinnitus severity in different sexes. CONCLUSION The risk factors for tinnitus severity differed according to sex in tinnitus patients, and the risk factors for tinnitus severity were greater in women than in men. These findings add to the literature on sex differences in tinnitus and suggest that medical and psychological screening of affected individuals and customized tinnitus treatment for each individual with tinnitus are needed. TRIAL REGISTRATION NUMBER/DATE OF REGISTRATION ChiCTR2200057958, 2022/3/24 (retrospectively registered trials).
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Affiliation(s)
- Hao Yuan
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Pei-Heng Lu
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Jia-Wei Chen
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Peng-Wei Ma
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei-Long Wang
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Xue-Rui Ding
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Yu-Qiang Lun
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Wei Gao
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China
| | - Lian-Jun Lu
- Department of Otolaryngology Head and Neck Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, China.
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Hearing Aid Use Time Is Causally Influenced by Psychological Parameters in Mildly Distressed Patients with Chronic Tinnitus and Mild-to-Moderate Hearing Loss. J Clin Med 2022; 11:jcm11195869. [PMID: 36233736 PMCID: PMC9573609 DOI: 10.3390/jcm11195869] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/30/2022] [Accepted: 10/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Hearing aids (HAs) can improve tinnitus-related distress (TRD) and speech-comprehension (SC) in silence or at 55 dB level of noise-interference (SC_55 dB) in patients with chronic tinnitus and mild-to-moderate hearing loss. However, the role of HA use time in relation to psychological, audiological, or self-reported tinnitus characteristics is an under-investigated area. Methods: We examine 177 gender-stratified patients before (t1) and after an intervention comprising binaural DSLchild algorithm-based HA fitting and auditory training (t2) and at a 70-day follow up [t3]. HA use time was retrospectively retrieved (at t2) for the pre-post- and (at t3) post-follow up periods. General linear models investigated HA use time in relation to (1) general audiological, (2) tinnitus-related audiological, (3) tinnitus-related self-report, and (4) distress-related self-report indices before and after treatment, where applicable. Receiver operator characteristic analyses identified optimal HA use time for hereby-mediated treatment changes. Results: At t1 and t2, psychological, but not audiological indices causally influenced prospective HA use time—except for SC_55 dB at t1, which, however, correlated with patients’ anxiety, depressivity, and psychological distress levels. Correlations did not differ between patient subgroups defined by categorical tinnitus-related audiological or self-report indices. HA use time partly mediated treatment-related improvement in TRD, but not SC. Optimal use amounted to 9.5–10.5 h/day. Conclusions: An awareness of psychological influences may help clinicians facilitate HA use and, thereby, TRD improvement with hearing amplification.
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Allgaier J, Schlee W, Langguth B, Probst T, Pryss R. Predicting the gender of individuals with tinnitus based on daily life data of the TrackYourTinnitus mHealth platform. Sci Rep 2021; 11:18375. [PMID: 34526553 PMCID: PMC8443560 DOI: 10.1038/s41598-021-96731-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 08/12/2021] [Indexed: 02/08/2023] Open
Abstract
Tinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data of the TrackYourTinnitus platform (TYT) were analyzed to investigate whether the gender of users can be predicted. In general, the TYT mobile Health crowdsensing platform was developed to demystify the daily and momentary variations of tinnitus symptoms over time. The goal of the presented investigation is a better understanding of gender-related differences in the symptom profiles of users from TYT. Based on two questionnaires of TYT, four machine learning based classifiers were trained and analyzed. With respect to the provided daily answers, the gender of TYT users can be predicted with an accuracy of 81.7%. In this context, worries, difficulties in concentration, and irritability towards the family are the three most important characteristics for predicting the gender. Note that in contrast to existing studies on TYT, daily answers to the worst symptom question were firstly investigated in more detail. It was found that results of this question significantly contribute to the prediction of the gender of TYT users. Overall, our findings indicate gender-related differences in tinnitus and tinnitus-related symptoms. Based on evidence that gender impacts the development of tinnitus, the gathered insights can be considered relevant and justify further investigations in this direction.
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Affiliation(s)
- Johannes Allgaier
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany.
| | - Winfried Schlee
- Department for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department for Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau , Austria
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
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6
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Song JJ, Park J, Koo JW, Lee SY, Vanneste S, De Ridder D, Hong S, Lim S. The balance between Bayesian inference and default mode determines the generation of tinnitus from decreased auditory input: A volume entropy-based study. Hum Brain Mapp 2021; 42:4059-4073. [PMID: 34076316 PMCID: PMC8288089 DOI: 10.1002/hbm.25539] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/15/2022] Open
Abstract
Along with phantom pain, tinnitus, a phantom auditory perception occurring in the absence of an external acoustic stimulus, is one of the most representative phantom perceptions that develops in subjects with decreased peripheral sensory input. Although tinnitus is closely associated with peripheral hearing loss (HL), it remains unclear why only some individuals with HL develop tinnitus. In this study, we investigated the differences between 65 HL with tinnitus (HL‐T) and 104 HL with no tinnitus (HL‐NT) using a resting‐state electroencephalography data‐based volume entropy model of the brain network, by comparing the afferent node capacities, that quantify the contribution of each node to the spread of information, of all Brodmann areas. While the HL‐T group showed increased information flow in areas involved in Bayesian inference (the left orbitofrontal cortex, the left subgenual anterior cingulate cortex, and the left ventrolateral prefrontal cortex) and auditory memory storage (the right hippocampus/parahippocampus), the HL‐NT group showed increased afferent node capacity in hub areas of the default mode network (DMN; the right posterior cingulate cortex and the right medial temporal gyrus). These results suggest that the balance of activity between the Bayesian inferential network (updating missing auditory information by retrieving auditory memories from the hippocampus/parahippocampus) and DMN (maintaining the “silent status quo”) determines whether phantom auditory perception occurs in a brain with decreased peripheral auditory input.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jaemin Park
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Soonki Hong
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
| | - Seonhee Lim
- Department of Mathematical Sciences, Seoul National University, Seoul, South Korea
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7
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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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8
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Watson S, Taavola H, Attalla M, Kaminsky E, Yue Q. Characterization of VigiBase reports on tinnitus associated with bisoprolol—An exploratory and descriptive study. Pharmacol Res Perspect 2021. [PMCID: PMC8101611 DOI: 10.1002/prp2.780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The aim of this descriptive and explorative study was to assess individual case safety reports of bisoprolol associated with tinnitus and investigate their added value in information about adverse drug reactions (ADRs) in relation to information provided in medicine labels. The global reports from VigiBase, the WHO database of individual case safety reports, as of May 3, 2020, were analyzed for information about bisoprolol associated with tinnitus as an ADR affecting the quality of life of the patients. There were 123 reports of the ADR tinnitus reported with intake of bisoprolol in VigiBase. These described experiences of tinnitus and how this impacted on patients’ daily life, for example, it could be long‐lasting and may have negative impact on sleeping, and even ability to work and keep a job. There were also reports describing the management of the reaction, for example, recovery upon stopping the treatment, and improvement of the symptoms following a decreased dose or change of medicine batch. Based on reports in VigiBase, the ADR tinnitus associated with bisoprolol suggests vigilance for the onset of the event and that, if it occurs, a dose reduction or stopping the treatment could be necessary. The information provided in the reports shows the value of individual case safety reports collected post marketing, in providing descriptive information of the experience and management of the ADR.
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Affiliation(s)
| | | | | | - Elenor Kaminsky
- Uppsala Monitoring Centre Uppsala Sweden
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
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Chen Q, Lv H, Wang Z, Wei X, Zhao P, Yang Z, Gong S, Wang Z. Lateralization effects in brain white matter reorganization in patients with unilateral idiopathic tinnitus: a preliminary study. Brain Imaging Behav 2021; 16:11-21. [PMID: 33830430 DOI: 10.1007/s11682-021-00472-1] [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: 10/23/2020] [Accepted: 03/14/2021] [Indexed: 12/01/2022]
Abstract
Idiopathic tinnitus can cause significant auditory-related brain structural and functional changes in patients. However, changes in patterns of the lateralization effects in idiopathic tinnitus have yet to be established, especially on white matter (WM) reorganization. In this study, we studied 19 left-sided and 19 right-sided idiopathic tinnitus (LSIT, RSIT) patients and 19 healthy controls (HCs). We combined applied voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analyses to investigate altered features of the auditory-related brain WM. We also conducted correlation analyses between the clinical variables and WM changes in the patients. Compared with the HCs, both sided tinnitus patients showed significant auditory-related brain WM alterations. More interestingly, the LSIT patients demonstrated a greater decrease in white matter volume (WMV) in the right medial superior frontal gyrus (SFG) than the RSIT; meanwhile, we also found that compared with the RSIT group, the LSIT group showed significantly increased fractional anisotropy (FA) in the body of the corpus callosum (CC), left cingulum, and right superior longitudinal fasciculus (SLF) and decreased mean diffusivity (MD) in the body of CC. Moreover, relative to the RSIT group, the LSIT group also exhibited increases in WM axial diffusivity (AD) in the left SLF, left cingulum, right middle cerebellar peduncle (MCP), left thalamus, and bilateral forceps major (FM) and decreases in radial diffusivity (RD) in the genu of CC. Additionally, the FA value of the right SLF was closely associated with tinnitus severity in the LSIT. Our study suggests that lateralization has a significant effect on WM reorganization in patients with idiopathic tinnitus; in particular, LSIT patients may experience more severe and widespread alterations in WMV and WM microstructure than the RSIT group, and all these changes are indirectly auditory related. These findings provide new useful information that can lead to a better understanding of the tinnitus mechanisms.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Xuan Wei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, 95 Yongan Road, Xicheng District, Beijing, People's Republic of China.
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Amanat S, Gallego-Martinez A, Sollini J, Perez-Carpena P, Espinosa-Sanchez JM, Aran I, Soto-Varela A, Batuecas-Caletrio A, Canlon B, May P, Cederroth CR, Lopez-Escamez JA. Burden of rare variants in synaptic genes in patients with severe tinnitus: An exome based extreme phenotype study. EBioMedicine 2021; 66:103309. [PMID: 33813136 PMCID: PMC8047463 DOI: 10.1016/j.ebiom.2021.103309] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/22/2021] [Accepted: 03/12/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND tinnitus is a heterogeneous condition associated with audiological and/or mental disorders. Chronic, severe tinnitus is reported in 1% of the population and it shows a relevant heritability, according to twins, adoptees and familial aggregation studies. The genetic contribution to severe tinnitus is unknown since large genomic studies include individuals with self-reported tinnitus and large heterogeneity in the phenotype. The aim of this study was to identify genes for severe tinnitus in patients with extreme phenotype. METHODS for this extreme phenotype study, we used three different cohorts with European ancestry (Spanish with Meniere disease (MD), Swedes tinnitus and European generalized epilepsy). In addition, four independent control datasets were also used for comparisons. Whole-exome sequencing was performed for the MD and epilepsy cohorts and whole-genome sequencing was carried out in Swedes with tinnitus. FINDINGS we found an enrichment of rare missense variants in 24 synaptic genes in a Spanish cohort, the most significant being PRUNE2, AKAP9, SORBS1, ITGAX, ANK2, KIF20B and TSC2 (p < 2E-04), when they were compared with reference datasets. This burden was replicated for ANK2 gene in a Swedish cohort with 97 tinnitus individuals, and in a subset of 34 Swedish patients with severe tinnitus for ANK2, AKAP9 and TSC2 genes (p < 2E-02). However, these associations were not significant in a third cohort of 701 generalized epilepsy individuals without tinnitus. Gene ontology (GO) and gene-set enrichment analyses revealed several pathways and biological processes involved in severe tinnitus, including membrane trafficking and cytoskeletal protein binding in neurons. INTERPRETATION a burden of rare variants in ANK2, AKAP9 and TSC2 is associated with severe tinnitus. ANK2, encodes a cytoskeleton scaffolding protein that coordinates the assembly of several proteins, drives axonal branching and influences connectivity in neurons.
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Affiliation(s)
- Sana Amanat
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer/University of Granada/ Junta de Andalucía, PTS, Granada, Spain
| | - Alvaro Gallego-Martinez
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer/University of Granada/ Junta de Andalucía, PTS, Granada, Spain
| | - Joseph Sollini
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Patricia Perez-Carpena
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer/University of Granada/ Junta de Andalucía, PTS, Granada, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Juan M Espinosa-Sanchez
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer/University of Granada/ Junta de Andalucía, PTS, Granada, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain
| | - Ismael Aran
- Department of Otolaryngology, Complexo Hospitalario de Pontevedra, Pontevedra, Spain
| | - Andres Soto-Varela
- Division of Otoneurology, Department of Otorhinolaryngology, Complexo Hospitalario Universitario, Santiago de Compostela, Spain
| | | | - Barbara Canlon
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden
| | - Patrick May
- Bioinformatics Core, Luxembourg Centre for System Biomedicine, University of Luxemburg, Esch-sur-Alzette, Luxembourg
| | - Christopher R Cederroth
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institute, Stockholm, Sweden; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust, Ropewalk House, Nottingham, UK
| | - Jose A Lopez-Escamez
- Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO-Centre for Genomics and Oncological Research-Pfizer/University of Granada/ Junta de Andalucía, PTS, Granada, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria, ibs.Granada, Hospital Universitario Virgen de las Nieves, Granada, Spain; Department of Surgery, Division of Otolaryngology, University of Granada, Granada, Spain.
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Insomnia Associated with Tinnitus and Gender Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063209. [PMID: 33808865 PMCID: PMC8003647 DOI: 10.3390/ijerph18063209] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/10/2021] [Accepted: 03/12/2021] [Indexed: 11/16/2022]
Abstract
Chronic tinnitus causes a decrease in well-being and can negatively affect sleep quality. It has further been indicated that there are clinically relevant gender differences, which may also have an impact on sleep quality. By conducting a retrospective and explorative data analysis for differences in patients with tinnitus and patients diagnosed with tinnitus and insomnia, hypothesized differences were explored in the summed test scores and on item-level of the validated psychometric instruments. A cross-sectional study was conducted collecting data from a sample of tinnitus patients (n = 76). Insomnia was diagnosed in 49 patients. Gender differences were found on aggregated test scores of the MADRS and BDI with men scoring higher than women, indicating higher depressive symptoms in men. Women stated to suffer more from headaches (p < 0.003), neck pain (p < 0.006) and nervousness as well as restlessness (p < 0.02). Women also reported an increase in tinnitus loudness in response to stress compared to men (p < 0.03). Male individuals with tinnitus and insomnia have higher depression scores and more clinically relevant depressive symptoms than women, who suffer more from psychosomatic symptoms. The results indicate a need for a targeted therapy of depressive symptoms in male patients and targeted treatment of psychosomatic symptoms, stress-related worsening of insomnia and tinnitus in women.
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Jacquemin L, Mertens G, Shekhawat GS, Van de Heyning P, Vanderveken OM, Topsakal V, De Hertogh W, Michiels S, Beyers J, Moyaert J, Van Rompaey V, Gilles A. High Definition transcranial Direct Current Stimulation (HD-tDCS) for chronic tinnitus: Outcomes from a prospective longitudinal large cohort study. PROGRESS IN BRAIN RESEARCH 2021; 263:137-152. [PMID: 34243886 DOI: 10.1016/bs.pbr.2020.09.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Transcranial Direct Current Stimulation (tDCS) aims to induce cortical plasticity by modulating the activity of brain structures. The broad stimulation pattern, which is one of the main limitations of tDCS, can be overcome with the recently developed technique called High-Definition tDCS (HD-tDCS). OBJECTIVE Investigation of the effect of HD-tDCS on tinnitus in a large patient cohort. METHODS This prospective study included 117 patients with chronic, subjective, non-pulsatile tinnitus who received six sessions of anodal HD-tDCS of the right Dorsolateral Prefrontal Cortex (DLPFC). Therapy effects were assessed by use of a set of standardized tinnitus questionnaires filled out at the pre-therapy (Tpre), post-therapy (T3w) and follow-up visit (T10w). Besides collecting the questionnaire data, the perceived effect (i.e., self-report) was also documented at T10w. RESULTS The Tinnitus Functional Index (TFI) and Tinnitus Questionnaire (TQ) total scores improved significantly over time (pTFI<0.01; pTQ<0.01), with the following significant post hoc comparisons: Tpre vs. T10w (pTFI<0.05; pTQ<0.05) and T3w vs. T10w (pTFI<0.01; pTQ<0.01). The percentage of patients reporting an improvement of their tinnitus at T10w was 47%. Further analysis revealed a significant effect of gender with female patients showing a larger improvement on the TFI and TQ (pTFI<0.01; pTQ<0.05). CONCLUSIONS The current study reported the effects of HD-tDCS in a large tinnitus population. HD-tDCS of the right DLPFC resulted in a significant improvement of the tinnitus perception, with a larger improvement for the female tinnitus patients.
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Affiliation(s)
- Laure Jacquemin
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium.
| | - Griet Mertens
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Giriraj Singh Shekhawat
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia; Ear Institute, University College London, London, United Kingdom; Tinnitus Research Initiative, Regensburg, Germany
| | - Paul Van de Heyning
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Olivier M Vanderveken
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Vedat Topsakal
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Sarah Michiels
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Jolien Beyers
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Julie Moyaert
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium
| | - Annick Gilles
- University Department of Otorhinolaryngology and Head & Neck surgery, Antwerp University Hospital, Edegem, Belgium; Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Antwerp University, Wilrijk, Belgium; Department of Education, Health & Social Work, University College Ghent, Ghent, Belgium
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Vanneste S, Mohan A, De Ridder D, To WT. The BDNF Val 66Met polymorphism regulates vulnerability to chronic stress and phantom perception. PROGRESS IN BRAIN RESEARCH 2021; 260:301-326. [PMID: 33637225 DOI: 10.1016/bs.pbr.2020.08.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Auditory phantom percepts, such as tinnitus, are a heterogeneous condition with great interindividual variations regarding both the percept itself and its concomitants. Tinnitus causes a considerable amount of distress, with as many as 25% of affected people reporting that it interferes with their daily lives. Although previous research gives an idea about the neural correlates of tinnitus-related distress, it cannot explain why some tinnitus patients develop distress and while others are not bothered by their tinnitus. BDNF Val66Met polymorphism (rs6265) is a known risk factor for affective disorders due to its common frequency and established functionality. To elucidate, we explore the neural activation pattern of tinnitus associated with the BDNF Val66Met polymorphism using electrophysiological data to assess activity and connectivity changes. A total of 110 participants (55 tinnitus and 55 matched control subjects) were included. In this study, we validate that the BDNF Val66Met polymorphism plays an important role in the susceptibility to the clinical manifestation of tinnitus-related distress. We demonstrate that Val/Met carriers have increased alpha power in the subgenual anterior cingulate cortex that correlates with distress levels. Furthermore, distress mediates the relationship between BDNF Val66Met polymorphism and tinnitus loudness. In other words, for Val/Met carriers, the subgenual anterior cingulate cortex sends distress-related information to the parahippocampus, which likely integrates the loudness and distress of the tinnitus percept.
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Affiliation(s)
- Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Global Brain Health Institute, Trinity College Institute of Neuroscience, Trinity College Dublin, Ireland; Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States.
| | - Anusha Mohan
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Wing Ting To
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, United States
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14
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Spontaneous brain activity underlying auditory hallucinations in the hearing-impaired. Cortex 2021; 136:1-13. [PMID: 33450598 DOI: 10.1016/j.cortex.2020.12.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/09/2020] [Accepted: 12/05/2020] [Indexed: 11/22/2022]
Abstract
Auditory hallucinations, the perception of a sound without a corresponding source, are common in people with hearing impairment. Two forms can be distinguished: simple (i.e., tinnitus) and complex hallucinations (speech and music). Little is known about the precise mechanisms underlying these types of hallucinations. Here we tested the assumption that spontaneous activity in the auditory pathways, following deafferentation, underlies these hallucinations and is related to their phenomenology. By extracting (fractional) Amplitude of Low Frequency Fluctuation [(f)ALFF] scores from resting state fMRI of 18 hearing impaired patients with complex hallucinations (voices or music), 18 hearing impaired patients with simple hallucinations (tinnitus or murmuring), and 20 controls with normal hearing, we investigated differences in spontaneous brain activity between these groups. Spontaneous activity in the anterior and posterior cingulate cortex of hearing-impaired groups was significantly higher than in the controls. The group with complex hallucinations showed elevated activity in the bilateral temporal cortex including Wernicke's area, while spontaneous activity of the group with simple hallucinations was mainly located in the cerebellum. These results suggest a decrease in error monitoring in both hearing-impaired groups. Spontaneous activity of language-related areas only in complex hallucinations suggests that the manifestation of the spontaneous activity represents the phenomenology of the hallucination. The link between cerebellar activity and simple hallucinations, such as tinnitus, is new and may have consequences for treatment.
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Abstract
This volume has highlighted the many recent advances in tinnitus theory, models, diagnostics, therapies, and therapeutics. But tinnitus knowledge is far from complete. In this chapter, contributors to the Behavioral Neuroscience of Tinnitus consider emerging topics and areas of research needed in light of recent findings. New research avenues and methods to explore are discussed. Issues pertaining to current assessment, treatment, and research methods are outlined, along with recommendations on new avenues to explore with research.
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Lefebvre-Demers M, Doyon N, Fecteau S. Non-invasive neuromodulation for tinnitus: A meta-analysis and modeling studies. Brain Stimul 2020; 14:113-128. [PMID: 33276156 DOI: 10.1016/j.brs.2020.11.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/07/2020] [Accepted: 11/15/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Patients with tinnitus often have poor quality of life, as well as severe anxiety and depression. New approaches to treat tinnitus are needed. OBJECTIVE Evaluate the effects of non-invasive neuromodulation on tinnitus through a metaanalysis and modeling study. The main hypothesis was that real as compared to sham neuromodulation that decreases tinnitus will modulate regions in line with the neurobiological models of tinnitus. METHODS AND RESULTS The systematic review, conducted from Pubmed, Cochrane and PsycINFO databases, showed that active as compared to sham repetitive transcranial magnetic stimulation (rTMS) reduced tinnitus, but active and sham transcranial direct current stimulation did not significantly differ. Further, rTMS over the auditory cortex was the most effective protocol. The modeling results indicate that this rTMS protocol elicited the strongest electric fields in the insula. Also, rTMS was particularly beneficial in women. Finally, the placebo effects were highly variable, highlighting the importance of conducting sham-controlled trials. CONCLUSION In sum, neuromodulation protocols that target the auditory cortex and the insula may hold clinical potential to treat tinnitus.
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Affiliation(s)
- Mathilde Lefebvre-Demers
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Canada
| | - Nicolas Doyon
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Faculty of Science and Engineering, Université Laval, Canada
| | - Shirley Fecteau
- CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Canada.
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Lee SY, Choi BY, Koo JW, De Ridder D, Song JJ. Cortical Oscillatory Signatures Reveal the Prerequisites for Tinnitus Perception: A Comparison of Subjects With Sudden Sensorineural Hearing Loss With and Without Tinnitus. Front Neurosci 2020; 14:596647. [PMID: 33328868 PMCID: PMC7731637 DOI: 10.3389/fnins.2020.596647] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/06/2020] [Indexed: 12/18/2022] Open
Abstract
Just as the human brain works in a Bayesian manner to minimize uncertainty regarding external stimuli, a deafferented brain due to hearing loss attempts to obtain or "fill in" the missing auditory information, resulting in auditory phantom percepts (i.e., tinnitus). Among various types of hearing loss, sudden sensorineural hearing loss (SSNHL) has been extensively reported to be associated with tinnitus. However, the reason that tinnitus develops selectively in some patients with SSNHL remains elusive, which led us to hypothesize that patients with SSNHL with tinnitus (SSNHL-T) and those without tinnitus (SSNHL-NT) may exhibit different cortical activity patterns. In the current study, we compared resting-state quantitative electroencephalography findings between 13 SSNHL-T and 13 SSNHL-NT subjects strictly matched for demographic characteristics and hearing thresholds. By performing whole-brain source localization analysis complemented by functional connectivity analysis, we aimed to determine the as-yet-unidentified cortical oscillatory signatures that may reveal potential prerequisites for the perception of tinnitus in patients with SSNHL. Compared with the SSNHL-NT group, the SSNHL-T group showed significantly higher cortical activity in Bayesian inferential network areas such as the frontopolar cortex, orbitofrontal cortex (OFC), and pregenual anterior cingulate cortex (pgACC) for the beta 3 and gamma frequency bands. This suggests that tinnitus develops in a brain with sudden auditory deafferentation only if the Bayesian inferential network updates the missing auditory information and the pgACC-based top-down gatekeeper system is actively involved. Additionally, significantly increased connectivity between the OFC and precuneus for the gamma frequency band was observed in the SSNHL-T group, further suggesting that tinnitus derived from Bayesian inference may be linked to the default mode network so that tinnitus is regarded as normal. Taken together, our preliminary results suggest a possible mechanism for the selective development of tinnitus in patients with SSNHL. Also, these areas could serve as the potential targets of neuromodulatory approaches to preventing the development or prolonged perception of tinnitus in subjects with SSNHL.
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Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, South Korea
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18
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Differences in Clinical Characteristics and Brain Activity between Patients with Low- and High-Frequency Tinnitus. Neural Plast 2020; 2020:5285362. [PMID: 32774356 PMCID: PMC7399790 DOI: 10.1155/2020/5285362] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 06/23/2020] [Indexed: 11/17/2022] Open
Abstract
This study was aimed at delineating and comparing differences in clinical characteristics and brain activity between patients with low- and high-frequency tinnitus (LFT and HFT, respectively) using high-density electroencephalography (EEG). This study enrolled 3217 patients with subjective tinnitus who were divided into LFT (frequency < 4000 Hz) and HFT (≥4000 Hz) groups. Data regarding medical history, Tinnitus Handicap Inventory, tinnitus matching, and hearing threshold were collected from all patients. Twenty tinnitus patients and 20 volunteers were subjected to 256-channel EEG, and neurophysiological differences were evaluated using standardized low-resolution brain electromagnetic tomography (sLORETA) source-localized EEG recordings. Significant differences in sex (p < 0.001), age (p = 0.022), laterality (p < 0.001), intensity (p < 0.001), tinnitus type (p < 0.001), persistent tinnitus (p = 0.04), average threshold (p < 0.001), and hearing loss (p = 0.028) were observed between LFT and HFT groups. The tinnitus pitch only appeared to be correlated with the threshold of the worst hearing loss in the HFT group. Compared with the controls, the LFT group exhibited increased gamma power (p < 0.05), predominantly in the posterior cingulate cortex (PCC, BA31), whereas the HFT group had significantly decreased alpha1 power (p < 0.05) in the angular gyrus (BA39) and auditory association cortex (BA22). Higher gamma linear connectivity between right BA39 and right BA41 was observed in the HFT group relative to controls (t = 3.637, p = 0.027). Significant changes associated with increased gamma in the LFT group and decreased alpha1 in the HFT group indicate that tinnitus pitch is crucial for matching between the tinnitus and control groups. Differences of band frequency energy in brain activity levels may contribute to the clinical characteristics and internal tinnitus “spectrum” differences.
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19
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Single nucleotide polymorphisms in tinnitus patients exhibiting severe distress. Sci Rep 2020; 10:13023. [PMID: 32747715 PMCID: PMC7398919 DOI: 10.1038/s41598-020-69467-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/01/2020] [Indexed: 11/08/2022] Open
Abstract
The association between distress caused by tinnitus and psychological factors such as depression and anxiety has been examined and reported. However, prognostic factors remain poorly understood because there are only a few reports on genetic associations. We theorized there might be an association between the grade of tinnitus distress and the genetic background related to psychological factors which might lead us to identify prognostic markers. We enrolled 138 patients who had suffered from tinnitus for over 3 months. Using Tinnitus Handicap Inventory (THI) scores, we examined the association between tinnitus distress and a genetic background related to depression or anxiety. A significant association between single nucleotide polymorphism rs131702 of the Breakpoint Cluster Region (BCR) gene and the severe THI score was identified. In addition, there was an association with the severity of the State-Trait Anxiety Inventory, an index of state anxiety severity. No association was found with the Self-Rating Depression Scale, an index of depression severity. It is reported that rs131702 of BCR in Japanese patients are related to bipolar II depression characterized by fluctuation between abnormal mood states of mania and depression. Our results indicate that rs131702 of BCR is independent of depression in this study and is, therefore, a prognostic factor unique to tinnitus. We conclude that the severity of tinnitus is associated with genes related to depression.
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Hu S, Anschuetz L, Huth ME, Sznitman R, Blaser D, Kompis M, Hall DA, Caversaccio M, Wimmer W. Association Between Residual Inhibition and Neural Activity in Patients with Tinnitus: Protocol for a Controlled Within- and Between-Subject Comparison Study. JMIR Res Protoc 2019; 8:e12270. [PMID: 30626571 PMCID: PMC6329433 DOI: 10.2196/12270] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 01/19/2023] Open
Abstract
Background Electroencephalography (EEG) studies indicate possible associations between tinnitus and changes in the neural activity. However, inconsistent results require further investigation to better understand such heterogeneity and inform the interpretation of previous findings. Objective This study aims to investigate the feasibility of EEG measurements as an objective indicator for the identification of tinnitus-associated neural activities. Methods To reduce heterogeneity, participants served as their own control using residual inhibition (RI) to modulate the tinnitus perception in a within-subject EEG study design with a tinnitus group. In addition, comparison with a nontinnitus control group allowed for a between-subjects comparison. We will apply RI stimulation to generate tinnitus and nontinnitus conditions in the same subject. Furthermore, high-frequency audiometry (up to 13 kHz) and tinnitometry will be performed. Results This work was funded by the Infrastructure Grant of the University of Bern, Bern, Switzerland and Bernafon AG, Bern, Switzerland. Enrollment for the study described in this protocol commenced in February 2018. Data analysis is currently under way and the first results are expected to be submitted for publication in 2019. Conclusions This study design helps in comparing the neural activity between conditions in the same individual, thereby addressing a notable limitation of previous EEG tinnitus studies. In addition, the high-frequency assessment will help to analyze and classify tinnitus symptoms beyond the conventional clinical standard. International Registered Report Identifier (IRRID) RR1-10.2196/12270
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Affiliation(s)
- Suyi Hu
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lukas Anschuetz
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Markus E Huth
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Sznitman
- Ophthalmic Technology Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Daniela Blaser
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Martin Kompis
- Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Deborah A Hall
- National Institute for Health Research Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, United Kingdom.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Nottingham University Hospitals National Health Service Trust, Queens Medical Centre, Nottingham, United Kingdom.,Malaysia Campus, University of Nottingham, Semeniyh, Malaysia
| | - Marco Caversaccio
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Wilhelm Wimmer
- Hearing Research Laboratory, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.,Department of Ears, Nose, Throat, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Rammo R, Ali R, Pabaney A, Seidman M, Schwalb J. Surgical Neuromodulation of Tinnitus: A Review of Current Therapies and Future Applications. Neuromodulation 2018; 22:380-387. [DOI: 10.1111/ner.12793] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/16/2018] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Richard Rammo
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
| | - Rushna Ali
- Department of Neurological SurgeryVanderbilt UniversityNashville TN USA
| | - Aqueel Pabaney
- Department of Neurosurgery, Grandview Medical CenterKettering Health NetworkDayton OH USA
| | - Michael Seidman
- Department of OtolaryngologyFlorida Hospital Celebration HealthCelebration FL USA
| | - Jason Schwalb
- Department of NeurosurgeryHenry Ford HospitalDetroit MI USA
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22
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Pattyn T, Vanneste S, De Ridder D, Van Rompaey V, Veltman DJ, Van de Heyning P, Sabbe B, Van Den Eede F. Differential electrophysiological correlates of panic disorder in non-pulsatile tinnitus. J Psychosom Res 2018; 109:57-62. [PMID: 29773153 DOI: 10.1016/j.jpsychores.2018.03.168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 12/25/2022]
Abstract
AIMS The prevalence of panic disorder (PD) reportedly is up to fivefold higher in people with tinnitus than it is in the general population. The brain networks in the two conditions overlap but the pathophysiological link remains unclear. In this study the electrophysiological brain activity is investigated in adults with non-pulsatile tinnitus with and without concurrent PD. METHODS Resting-state EEGs of 16 participants with non-pulsatile tinnitus and PD were compared with those of 16 peers with non-pulsatile tinnitus without PD and as many healthy controls. The sLORETA technique was used to identify group-specific electrophysiological frequencies in the brain and to approximate the brain regions where differences occurred. The influence of distress was investigated and functional connectivity charted using the Region-of-Interest (ROI) approach (amygdala, anterior cingulate cortex (ACC), insula, precuneus). RESULTS The comorbid group showed significantly diminished theta activity (p < 0.05) in the precuneus (BA7) compared to the tinnitus group without PD as well as in another region of the precuneus (BA31) as compared to the controls. Higher levels of distress influenced results in the tinnitus group without PD, while in those with PD a diminished connectivity was observed between the dorsal ACC and the other three ROIs as contrasted to the controls. CONCLUSIONS Adults with non-pulsatile tinnitus and concurrent PD show differential brain activity patterns to tinnitus only sufferers and healthy controls. Higher levels of distress may modulate brain activity in the absence of PD. Screening for distress is recommended in both clinical and research settings.
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Affiliation(s)
- T Pattyn
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Department of Psychiatry, Campus Antwerp University Hospital, Antwerp, Belgium.
| | - S Vanneste
- University of Texas at Dallas, School of Behavioral and Brain Sciences, Dallas, Richardson, TX, United States.
| | - D De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - V Van Rompaey
- Department of Translational Neuroscience, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
| | - D J Veltman
- Amsterdam Public Health research institute, Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
| | - P Van de Heyning
- Department of Translational Neuroscience, University of Antwerp, Antwerp, Belgium; Department of Otorhinolaryngology and Head & Neck Surgery, Antwerp University Hospital, Antwerp, Belgium.
| | - Bcg Sabbe
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium; University Department of Psychiatry, Campus Psychiatric Hospital Duffel, Duffel, Belgium.
| | - F Van Den Eede
- University Department of Psychiatry, Campus Antwerp University Hospital, Antwerp, Belgium; Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium.
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Lee DY, Kim YH. Urine Cotinine Should Be Involved in Initial Evaluation of Tinnitus in Adolescents. Clin Exp Otorhinolaryngol 2018; 11:242-249. [PMID: 29631390 PMCID: PMC6222183 DOI: 10.21053/ceo.2017.01641] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 02/04/2018] [Indexed: 12/01/2022] Open
Abstract
Objectives Smoking is associated with hearing loss, while the correlation between tinnitus and smoking is not fully elucidated. This study aimed to evaluate risk factors of tinnitus in adolescents in terms of smoking, and we identified a rectifiable parameter that can be serially monitored. Methods A cross-sectional study was conducted using data from the Korea National Health and Nutrition Examination Survey, with 2,782 participants aged 12 to 18 years, from 2008 through 2011. Participants with history of ear disease, hearing loss, and inadequate responses to questionnaires were excluded. We investigated the prevalence of tinnitus and tinnitus-related annoyance by questionnaire and sought potential risk factors in blood and urine tests and smoking history. Results The prevalence of tinnitus in the 12- to 18-year-old population was 17.5%, with 3.3% reporting tinnitus-related annoyance. On univariate analysis, the prevalence of tinnitus increased with age (P<0.001) and was higher among girls (P=0.012). Blood tests and urinalysis showed significant correlation between tinnitus and red blood cell count, alkaline phosphatase levels, and urine cotinine (P=0.002, P<0.001, P=0.018, respectively). In multivariate analysis, the urine cotinine level was the only parameter associated with tinnitus (odds ratio, 1.000; 95% confidence interval, 0.999 to 1.000; P=0.038). Smoking was also significantly correlated with tinnitus (P=0.043), and amount of smoking with tinnitus-related annoyance (P=0.045). However, current smoking and past smoking were not correlated with tinnitus. Conclusion Urine cotinine may be a rectifiable marker for management of tinnitus in adolescents. This suggests that smoking cessation should be incorporated in the management of tinnitus in adolescents.
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Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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Güntensperger D, Thüring C, Meyer M, Neff P, Kleinjung T. Neurofeedback for Tinnitus Treatment - Review and Current Concepts. Front Aging Neurosci 2017; 9:386. [PMID: 29249959 PMCID: PMC5717031 DOI: 10.3389/fnagi.2017.00386] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/09/2017] [Indexed: 12/18/2022] Open
Abstract
An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.
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Affiliation(s)
- Dominik Güntensperger
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Christian Thüring
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Department of Psychology, University of Zurich, Zurich, Switzerland.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital of Zurich, Zurich, Switzerland
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25
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Lee DY, Kim YH. Risk factors of pediatric tinnitus: Systematic review and meta‐analysis. Laryngoscope 2017; 128:1462-1468. [DOI: 10.1002/lary.26924] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/21/2017] [Accepted: 08/28/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Doh Young Lee
- Department of Otorhinolaryngology–Head and Neck SurgeryKorea University Anam HospitalSeoul South Korea
| | - Young Ho Kim
- Department of Otorhinolaryngology–Head and Neck SurgerySeoul National University Boramae Medical Center, Seoul National University College of MedicineSeoul South Korea
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Noroozian M, Jafari Z, Shahmiri E, Omidvar S, Zendehbad A, Amini N, Radmehr M, Bagherian M, Yoonessi A. Effect of Age, Gender and Hearing Loss on the Degree of Discomfort Due to Tinnitus. Basic Clin Neurosci 2017; 8:435-442. [PMID: 29942427 PMCID: PMC6010657 DOI: 10.29252/nirp.bcn.8.6.435] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Tinnitus is one of the complex symptoms of hearing described as a phantom auditory sensation without any external stimulation. Due to the subjective nature of tinnitus, perception and discomfort of tinnitus vary among the patients. The main aim of this study is to investigate the effects of gender, age and the degree of hearing loss on discomfort due to tinnitus. Methods: Eighteen patients with tinnitus, aged 21–72 years, (9 males and 9 females) were recruited. Tinnitus discomfort was investigated by Tinnitus Handicap Inventory (THI) questionnaire. Psychoacoustic assessments of tinnitus and auditory threshold assessments were evaluated using a 2-channel clinical audiometer. Results: The results showed no significant correlation between THI scores with loudness matching (P=0.187), mean of auditory threshold (P=0.304), gender (P=0.93) and age (P=0.200). Also, no significant correlation was found between maximal level of hearing loss and pitch matching (P=0.208). Conclusion: The study findings suggests that tinnitus is not correlated with age, gender and hearing loss. Overall, tinnitus is a complicated clinical condition which its real impact and degree of discomfort are unclear. More investigation is needed to clarify the factors involving in tinnitus annoyance.
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Affiliation(s)
- Maryam Noroozian
- Department of Memory and Behavioral Neurology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Jafari
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Basic Sciences, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Elaheh Shahmiri
- Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran.,Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shaghayegh Omidvar
- Department of Audiology, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azadeh Zendehbad
- Department of Geriatric Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Amini
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahsa Radmehr
- Department of Audiology, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Masoud Bagherian
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Yoonessi
- Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Ahn MH, Hong SK, Min BK. The absence of resting-state high-gamma cross-frequency coupling in patients with tinnitus. Hear Res 2017; 356:63-73. [PMID: 29097049 DOI: 10.1016/j.heares.2017.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 10/17/2017] [Accepted: 10/23/2017] [Indexed: 12/17/2022]
Abstract
Tinnitus is a psychoacoustic phantom perception of currently unknown neuropathology. Despite a growing number of post-stimulus tinnitus studies, uncertainty still exists regarding the neural signature of tinnitus in the resting-state brain. In the present study, we used high-gamma cross-frequency coupling and a Granger causality analysis to evaluate resting-state electroencephalographic (EEG) data in healthy participants and patients with tinnitus. Patients with tinnitus lacked robust frontal delta-phase/central high-gamma-amplitude coupling that was otherwise clearly observed in healthy participants. Since low-frequency phase and high-frequency amplitude coupling reflects inter-regional communication during cognitive processing, and given the absence of frontal modulation in patients with tinnitus, we hypothesized that tinnitus might be related to impaired prefrontal top-down inhibitory control. A Granger causality analysis consistently showed abnormally pronounced functional connectivity of low-frequency activity in patients with tinnitus, possibly reflecting a deficiency in large-scale communication during the resting state. Moreover, different causal neurodynamics were characterized across two subgroups of patients with tinnitus; the T1 group (with higher P300 amplitudes) showed abnormal frontal-to-auditory cortical information flow, whereas the T2 group (with lower P300 amplitudes) exhibited abnormal auditory-to-frontal cortical information control. This dissociation in resting-state low-frequency causal connectivity is consistent with recent post-stimulus observations. Taken together, our findings suggest that maladaptive neuroplasticity or abnormal reorganization occurs in the auditory default mode network of patients with tinnitus. Additionally, our data highlight the utility of resting-state EEG for the quantitative diagnosis of tinnitus symptoms and the further characterization of tinnitus subtypes.
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Affiliation(s)
- Min-Hee Ahn
- Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea
| | - Sung Kwang Hong
- Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea; Department of Otolaryngology, Hallym University College of Medicine, Anyang 14068, South Korea
| | - Byoung-Kyong Min
- Department of Brain and Cognitive Engineering, Korea University, Seoul 02841, South Korea.
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A methodological assessment of studies that use voxel-based morphometry to study neural changes in tinnitus patients. Hear Res 2017; 355:23-32. [PMID: 28951023 DOI: 10.1016/j.heares.2017.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/29/2017] [Accepted: 09/08/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The scientific understanding of tinnitus and its etiology has transitioned from thinking of tinnitus as solely a peripheral auditory problem to an increasing awareness that cortical networks may play a critical role in tinnitus percept or bother. With this change, studies that seek to use structural brain imaging techniques to better characterize tinnitus patients have become more common. These studies include using voxel-based morphometry (VBM) to determine if there are differences in regional gray matter volume in individuals who suffer from tinnitus and those who do not. However, studies using VBM in patients with tinnitus have produced inconsistent and sometimes contradictory results. OBJECTIVE This paper is a systematic review of all of the studies to date that have used VBM to study regional gray matter volume in people with tinnitus, and explores ways in which methodological differences in these studies may account for their heterogeneous results. We also aim to provide guidance on how to conduct future studies using VBM to produce more reproducible results to further our understanding of disease processes such as tinnitus. METHODS Studies about tinnitus and VBM were searched for using PubMed and Embase. These returned 15 and 25 results respectively. Of these, nine met the study criteria and were included for review. An additional 5 studies were identified in the literature as pertinent to the topic at hand and were added to the review, for a total of 13 studies. RESULTS There was significant heterogeneity among the studies in several areas, including inclusion and exclusion criteria, software programs, and statistical analysis. We were not able to find publicly shared data or code for any study. DISCUSSION The differences in study design, software analysis, and statistical methodology make direct comparisons between the different studies difficult. Especially problematic are the differences in the inclusion and exclusion criteria of the study, and the statistical design of the studies, both of which could radically alter findings. Thus, heterogeneity has complicated efforts to explore the etiology of tinnitus using structural MRI. CONCLUSION There is a pressing need to standardize the use of VBM when evaluating tinnitus patients. While some heterogeneity is expected given the rapid advances in the field, more can be done to ensure that there is internal validity between studies.
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Durai M, O'Keeffe MG, Searchfield GD. Examining the short term effects of emotion under an Adaptation Level Theory model of tinnitus perception. Hear Res 2016; 345:23-29. [PMID: 28027920 DOI: 10.1016/j.heares.2016.12.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/11/2016] [Accepted: 12/16/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Existing evidence suggests a strong relationship between tinnitus and emotion. The objective of this study was to examine the effects of short-term emotional changes along valence and arousal dimensions on tinnitus outcomes. Emotional stimuli were presented in two different modalities: auditory and visual. The authors hypothesized that (1) negative valence (unpleasant) stimuli and/or high arousal stimuli will lead to greater tinnitus loudness and annoyance than positive valence and/or low arousal stimuli, and (2) auditory emotional stimuli, which are in the same modality as the tinnitus, will exhibit a greater effect on tinnitus outcome measures than visual stimuli. STUDY DESIGN Auditory and visual emotive stimuli were administered to 22 participants (12 females and 10 males) with chronic tinnitus, recruited via email invitations send out to the University of Auckland Tinnitus Research Volunteer Database. Emotional stimuli used were taken from the International Affective Digital Sounds- Version 2 (IADS-2) and the International Affective Picture System (IAPS) (Bradley and Lang, 2007a, 2007b). The Emotion Regulation Questionnaire (Gross and John, 2003) was administered alongside subjective ratings of tinnitus loudness and annoyance, and psychoacoustic sensation level matches to external sounds. RESULTS Males had significantly different emotional regulation scores than females. Negative valence emotional auditory stimuli led to higher tinnitus loudness ratings in males and females and higher annoyance ratings in males only; loudness matches of tinnitus remained unchanged. The visual stimuli did not have an effect on tinnitus ratings. The results are discussed relative to the Adaptation Level Theory Model of Tinnitus. CONCLUSIONS The results indicate that the negative valence dimension of emotion is associated with increased tinnitus magnitude judgements and gender effects may also be present, but only when the emotional stimulus is in the auditory modality. Sounds with emotional associations may be used for sound therapy for tinnitus relief; it is of interest to determine whether the emotional component of sound treatments can play a role in reversing the negative responses discussed in this paper.
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Affiliation(s)
- Mithila Durai
- Department of Audiology, University of Auckland, Auckland, New Zealand; Center for Brain Research, University of Auckland, Auckland, New Zealand
| | - Mary G O'Keeffe
- Department of Audiology, University of Auckland, Auckland, New Zealand
| | - Grant D Searchfield
- Department of Audiology, University of Auckland, Auckland, New Zealand; Center for Brain Research, University of Auckland, Auckland, New Zealand.
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30
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Influencing connectivity and cross-frequency coupling by real-time source localized neurofeedback of the posterior cingulate cortex reduces tinnitus related distress. Neurobiol Stress 2016; 8:211-224. [PMID: 29888315 PMCID: PMC5991329 DOI: 10.1016/j.ynstr.2016.11.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 11/15/2016] [Accepted: 11/19/2016] [Indexed: 12/20/2022] Open
Abstract
Background In this study we are using source localized neurofeedback to moderate tinnitus related distress by influencing neural activity of the target region as well as the connectivity within the default network. Hypothesis We hypothesize that up-training alpha and down-training beta and gamma activity in the posterior cingulate cortex has a moderating effect on tinnitus related distress by influencing neural activity of the target region as well as the connectivity within the default network and other functionally connected brain areas. Methods Fifty-eight patients with chronic tinnitus were included in the study. Twenty-three tinnitus patients received neurofeedback training of the posterior cingulate cortex with the aim of up-training alpha and down-training beta and gamma activity, while 17 patients underwent training of the lingual gyrus as a control situation. A second control group consisted of 18 tinnitus patients on a waiting list for future tinnitus treatment. Results This study revealed that neurofeedback training of the posterior cingulate cortex results in a significant decrease of tinnitus related distress. No significant effect on neural activity of the target region could be obtained. However, functional and effectivity connectivity changes were demonstrated between remote brain regions or functional networks as well as by altering cross frequency coupling of the posterior cingulate cortex. Conclusion This suggests that neurofeedback could remove the information, processed in beta and gamma, from the carrier wave, alpha, which transports the high frequency information and influences the salience attributed to the tinnitus sound. Based on the observation that much pathology is the result of an abnormal functional connectivity within and between neural networks various pathologies should be considered eligible candidates for the application of source localized EEG based neurofeedback training.
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Lv H, Zhao P, Liu Z, Li R, Zhang L, Wang P, Yan F, Liu L, Wang G, Zeng R, Li T, Dong C, Gong S, Wang Z. Abnormal resting-state functional connectivity study in unilateral pulsatile tinnitus patients with single etiology: A seed-based functional connectivity study. Eur J Radiol 2016; 85:2023-2029. [PMID: 27776655 DOI: 10.1016/j.ejrad.2016.09.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 08/31/2016] [Accepted: 09/13/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Previous studies demonstrated altered regional neural activations in several brain areas in patients with pulsatile tinnitus (PT), especially indicating an important role of posterior cingulate cortex (PCC). However, few studies focused on the degree of functional connectivity (FC) of this area in PT patients. In this study, we will compare the FC of PCC in patients affected with this condition and normal controls by using resting-state functional magnetic resonance imaging (fMRI). METHODS Structural and functional MRI data were obtained from 36 unilateral PT patients with single etiology and 36 matched healthy controls. FC feature of the region of interest (PCC) were characterized using a seed-based correlation method with the voxels in the whole-brain. RESULTS Compared with healthy controls, patients showed significant decreased FC to the right middle temporal gyrus (MTG), right thalamus and bilateral insula. By contrast, PCC demonstrated increased functional connectivity between the precuneus, bilateral inferior parietal lobule and middle occipital gyrus. We also found correlations between the disease duration of PT and FC of PCC-right MTG (r=-0.616, p<0.001). CONCLUSIONS Unilateral PT patients could have abnormal FC to the PCC bilaterally in the brain. PCC, as a highly integrated brain area, is an example of nucleus that was involved in mediation between different neural networks. It might be a modulation core between visual network and auditory network. The decreased FC of MTG to PCC may indicate a down regulation of activity between PCC and auditory associated brain cortex. Decreased FC between limbic system (bilateral AI) and PCC may reflect the emotional message control in patient group. This study facilitated understanding of the underlying neuropathological process in patients with pulsatile tinnitus.
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Affiliation(s)
- Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China; Neuroradiology Division, Department of Radiology, Stanford University, CA, 94305, USA
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaohui Liu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Rui Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Ling Zhang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Peng Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Fei Yan
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Liheng Liu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Guopeng Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Rong Zeng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Ting Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Cheng Dong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Beebe Palumbo D, Joos K, De Ridder D, Vanneste S. The Management and Outcomes of Pharmacological Treatments for Tinnitus. Curr Neuropharmacol 2016; 13:692-700. [PMID: 26467416 PMCID: PMC4761638 DOI: 10.2174/1570159x13666150415002743] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/12/2015] [Accepted: 04/09/2015] [Indexed: 01/28/2023] Open
Abstract
Tinnitus, a phantom sensation experienced by people around the world, currently is endured
without a known cure. Some find the condition tolerable, while others are tortured on a daily basis
from the incessant phantom noises. For those who seek treatment, oftentimes, they have a comorbid
condition (e.g., depression, anxiety, insomnia), which is treated pharmaceutically. These products aim
to reduce the comorbities associated with tinnitus thereby minimizing the overall burden present.
Because of the phantom nature of tinnitus, it is often compared to neurologic pain. Since pain can be managed with
pharmaceutical options, it is reasonable to assume that similar agents might work to alleviate tinnitus. The effects of
antidepressants, benzodiazepines, anticonvulsants, and glutamate antagonists are reviewed in this paper. Table 1 summarizes
the pharmaceutical products discussed. Due to the variety of comorbid factors and potential causes of tinnitus, there may
not be one pharmaceutical treatment that will combat every type of tinnitus. Nevertheless, a product that finally addresses
the true cause of tinnitus, and not just its comorbidities, will benefit millions of people worldwide.
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Affiliation(s)
| | | | | | - Sven Vanneste
- Lab for Auditory & Integrative Neuroscience, School of Behavioral & Brain Science, University of Texas at Dallas, W 1966 Inwood Rd, Dallas, Texas 75235, USA
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Chen YC, Feng Y, Xu JJ, Mao CN, Xia W, Ren J, Yin X. Disrupted Brain Functional Network Architecture in Chronic Tinnitus Patients. Front Aging Neurosci 2016; 8:174. [PMID: 27458377 PMCID: PMC4937025 DOI: 10.3389/fnagi.2016.00174] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 06/28/2016] [Indexed: 12/16/2022] Open
Abstract
Purpose: Resting-state functional magnetic resonance imaging (fMRI) studies have demonstrated the disruptions of multiple brain networks in tinnitus patients. Nonetheless, several studies found no differences in network processing between tinnitus patients and healthy controls (HCs). Its neural bases are poorly understood. To identify aberrant brain network architecture involved in chronic tinnitus, we compared the resting-state fMRI (rs-fMRI) patterns of tinnitus patients and HCs. Materials and Methods: Chronic tinnitus patients (n = 24) with normal hearing thresholds and age-, sex-, education- and hearing threshold-matched HCs (n = 22) participated in the current study and underwent the rs-fMRI scanning. We used degree centrality (DC) to investigate functional connectivity (FC) strength of the whole-brain network and Granger causality to analyze effective connectivity in order to explore directional aspects involved in tinnitus. Results: Compared to HCs, we found significantly increased network centrality in bilateral superior frontal gyrus (SFG). Unidirectionally, the left SFG revealed increased effective connectivity to the left middle orbitofrontal cortex (OFC), left posterior lobe of cerebellum (PLC), left postcentral gyrus, and right middle occipital gyrus (MOG) while the right SFG exhibited enhanced effective connectivity to the right supplementary motor area (SMA). In addition, the effective connectivity from the bilateral SFG to the OFC and SMA showed positive correlations with tinnitus distress. Conclusions: Rs-fMRI provides a new and novel method for identifying aberrant brain network architecture. Chronic tinnitus patients have disrupted FC strength and causal connectivity mostly in non-auditory regions, especially the prefrontal cortex (PFC). The current findings will provide a new perspective for understanding the neuropathophysiological mechanisms in chronic tinnitus.
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Affiliation(s)
- Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Yuan Feng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Cun-Nan Mao
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Wenqing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Jun Ren
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University Nanjing, China
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35
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Seimetz BM, Teixeira AR, Rosito LPS, Flores LS, Pappen CH, Dall'igna C. Pitch and Loudness Tinnitus in Individuals with Presbycusis. Int Arch Otorhinolaryngol 2016; 20:321-326. [PMID: 27746834 PMCID: PMC5063743 DOI: 10.1055/s-0035-1570311] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 10/04/2015] [Indexed: 10/25/2022] Open
Abstract
Introduction Tinnitus is a symptom that is often associated with presbycusis. Objective This study aims to analyze the existence of association among hearing thresholds, pitch, and loudness of tinnitus in individuals with presbycusis, considering the gender variable. Methods Cross-sectional, descriptive, and prospective study, whose sample consisted of individuals with tinnitus and diagnosis of presbycusis. For the evaluation, we performed anamnesis along with otoscopy, pure tone audiometry, and acuphenometry to analyze the psychoacoustic characteristics of tinnitus individuals. Results The sample consisted of 49 subjects, with a mean age of 69.57 ± 6.53 years, who presented unilateral and bilateral tinnitus, therefore, a sample of 80 ears. In analyzing the results, as for acuphenometry, the loudness of tinnitus was more present at 0dB and the pitch was 6HKz and 8HKz. Regarding the analysis of the association between the frequency of greater hearing threshold and tinnitus pitch, no statistical significance (p = 0.862) was found. As for the association between the intensity of greater hearing threshold and tinnitus loudness, no statistical significance (p = 0.115) was found. Conclusion There is no significant association between the hearing loss of patients with presbycusis and the pitch and loudness of tinnitus.
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Affiliation(s)
- Bruna Macangnin Seimetz
- Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Adriane Ribeiro Teixeira
- Department of Developmental Psychology and Personality, Universidade Federal do Rio Grande do Sul, Instituto de Psicologia da UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - Leticia Petersen Schmidt Rosito
- Department of Otolaryngology - Head and Neck Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Carlos Henrique Pappen
- Medical School, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Celso Dall'igna
- Department of Otolaryngology - Head and Neck Surgery, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Lv H, Zhao P, Liu Z, Wang G, Zeng R, Yan F, Dong C, Zhang L, Li R, Wang P, Li T, Gong S, Wang Z. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus. Neural Plast 2016; 2016:4918186. [PMID: 27413554 PMCID: PMC4931090 DOI: 10.1155/2016/4918186] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Accepted: 05/09/2016] [Indexed: 02/07/2023] Open
Abstract
Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027-0.073 Hz, and slow-5, 0.010-0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp.) were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule), left IFG (inferior frontal gyrus), and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future.
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Affiliation(s)
- Han Lv
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- 2Neuroradiology Division, Department of Radiology, Stanford University, Stanford, CA 94305, USA
| | - Pengfei Zhao
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaohui Liu
- 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Guopeng Wang
- 4Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Rong Zeng
- 4Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Fei Yan
- 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Cheng Dong
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Ling Zhang
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Rui Li
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Peng Wang
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Ting Li
- 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Shusheng Gong
- 4Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- *Shusheng Gong: and
| | - Zhenchang Wang
- 1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- *Zhenchang Wang:
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Han L, Pengfei Z, Zhaohui L, Fei Y, Ting L, Cheng D, Zhenchang W. Resting-state functional connectivity density mapping of etiology confirmed unilateral pulsatile tinnitus patients: Altered functional hubs in the early stage of disease. Neuroscience 2015; 310:27-37. [PMID: 26384961 DOI: 10.1016/j.neuroscience.2015.09.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Revised: 08/25/2015] [Accepted: 09/11/2015] [Indexed: 02/07/2023]
Abstract
Functional magnetic resonance imaging (fMRI) has been widely used to identify altered intrinsic local neural activities and global networks of tinnitus patients. In this study, functional connectivity density (FCD) mapping, a newly developed voxelwise data-driven method based on fMRI, was applied for the first time to measure the functional reorganization pattern in thirty-two unilateral pulsatile tinnitus (PT) patients in the early stage of disease (less than 48 months). FCD analysis was employed to compute short-range and long-range FCD values. A correlation analysis with clinical variables was also performed. Compared with normal controls, PT patients showed significantly increased short-range FCD, mainly in the precuneus (PCu), bilateral inferior frontal gyrus (IFG) and middle occipital gyrus (MOG), and increased long-range FCD in the PCu, posterior cingulate cortex (PCC), and bilateral middle frontal gyrus (MFG). In addition, correlation analysis showed positive correlations between PT duration and short-range FCD values in the right MOG. Positive correlations were also found between the disease duration and the long-range FCD value in the PCC. The increased short-/long-range FCD in bilateral dorsal visual areas indicated that the enhanced pathway between the auditory cortex and bilateral dorsal visual areas may have activated the "auditory occipital activations" (AOAs) pathway. The bilaterally altered FCD values in the dorsal visual areas reflected the cooperation of different brain areas. This study is a foundation of the connectivity research in PT patients. Our work may advance the understanding of the disrupted neural network of patients with PT.
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Affiliation(s)
- L Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Z Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - L Zhaohui
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Y Fei
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - L Ting
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - D Cheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - W Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Chen YC, Xia W, Luo B, Muthaiah VPK, Xiong Z, Zhang J, Wang J, Salvi R, Teng GJ. Frequency-specific alternations in the amplitude of low-frequency fluctuations in chronic tinnitus. Front Neural Circuits 2015; 9:67. [PMID: 26578894 PMCID: PMC4624866 DOI: 10.3389/fncir.2015.00067] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/15/2015] [Indexed: 12/13/2022] Open
Abstract
Tinnitus, a phantom ringing, buzzing, or hissing sensation with potentially debilitating consequences, is thought to arise from aberrant spontaneous neural activity at one or more sites within the central nervous system; however, the location and specific features of these oscillations are poorly understood with respect to specific tinnitus features. Recent resting-state functional magnetic resonance imaging (fMRI) studies suggest that aberrant fluctuations in spontaneous low-frequency oscillations (LFO) of the blood oxygen level-dependent (BOLD) signal may be an important factor in chronic tinnitus; however, the role that frequency-specific components of LFO play in subjective tinnitus remains unclear. A total of 39 chronic tinnitus patients and 41 well-matched healthy controls participated in the resting-state fMRI scans. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) in two different frequency bands (slow-4: 0.027–0.073 Hz and slow-5: 0.01–0.027 Hz). We observed significant differences between tinnitus patients and normal controls in ALFF/fALFF in the two bands (slow-4 and slow-5) in several brain regions including the superior frontal gyrus (SFG), inferior frontal gyrus, middle temporal gyrus, angular gyrus, supramarginal gyrus, and middle occipital gyrus. Across the entire subject pool, significant differences in ALFF/fALFF between the two bands were found in the midbrain, basal ganglia, hippocampus and cerebellum (Slow 4 > Slow 5), and in the middle frontal gyrus, supramarginal gyrus, posterior cingulate cortex, and precuneus (Slow 5 > Slow 4). We also observed significant interaction between frequency bands and patient groups in the orbitofrontal gyrus. Furthermore, tinnitus distress was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-4 band in left SFG, whereas tinnitus duration was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-5 band in left SFG. Resting-state fMRI provides an unbiased method for identifying aberrant spontaneous LFO occurring throughout the central nervous system. Chronic tinnitus patients have widespread abnormalities in ALFF and fALFF slow-4 and slow-5 band which are correlated with tinnitus distress and duration. These results provide new insights on the neuropathophysiology of chronic tinnitus; therapies capable of reversing these aberrant patterns may reduce tinnitus distress.
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Affiliation(s)
- Yu-Chen Chen
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China ; Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Wenqing Xia
- Medical School, Southeast University Nanjing, China
| | - Bin Luo
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Vijaya P K Muthaiah
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Zhenyu Xiong
- Toshiba Stroke and Vascular Research Center, State University of New York at Buffalo, Buffalo NY, USA
| | - Jian Zhang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China
| | - Jian Wang
- Department of Physiology, Southeast University Nanjing, China ; School of Human Communication Disorders, Dalhousie University, Halifax NS, Canada
| | - Richard Salvi
- Center for Hearing and Deafness, State University of New York at Buffalo, Buffalo NY, USA
| | - Gao-Jun Teng
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University Nanjing, China
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Elgoyhen AB, Langguth B, De Ridder D, Vanneste S. Tinnitus: perspectives from human neuroimaging. Nat Rev Neurosci 2015; 16:632-42. [DOI: 10.1038/nrn4003] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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De Ridder D, Vanneste S, Langguth B, Llinas R. Thalamocortical Dysrhythmia: A Theoretical Update in Tinnitus. Front Neurol 2015; 6:124. [PMID: 26106362 PMCID: PMC4460809 DOI: 10.3389/fneur.2015.00124] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/14/2015] [Indexed: 01/06/2023] Open
Abstract
Tinnitus is the perception of a sound in the absence of a corresponding external sound source. Pathophysiologically it has been attributed to bottom-up deafferentation and/or top-down noise-cancelling deficit. Both mechanisms are proposed to alter auditory thalamocortical signal transmission, resulting in thalamocortical dysrhythmia (TCD). In deafferentation, TCD is characterized by a slowing down of resting state alpha to theta activity associated with an increase in surrounding gamma activity, resulting in persisting cross-frequency coupling between theta and gamma activity. Theta burst-firing increases network synchrony and recruitment, a mechanism, which might enable long-range synchrony, which in turn could represent a means for finding the missing thalamocortical information and for gaining access to consciousness. Theta oscillations could function as a carrier wave to integrate the tinnitus-related focal auditory gamma activity in a consciousness enabling network, as envisioned by the global workspace model. This model suggests that focal activity in the brain does not reach consciousness, except if the focal activity becomes functionally coupled to a consciousness enabling network, aka the global workspace. In limited deafferentation, the missing information can be retrieved from the auditory cortical neighborhood, decreasing surround inhibition, resulting in TCD. When the deafferentation is too wide in bandwidth, it is hypothesized that the missing information is retrieved from theta-mediated parahippocampal auditory memory. This suggests that based on the amount of deafferentation TCD might change to parahippocampocortical persisting and thus pathological theta–gamma rhythm. From a Bayesian point of view, in which the brain is conceived as a prediction machine that updates its memory-based predictions through sensory updating, tinnitus is the result of a prediction error between the predicted and sensed auditory input. The decrease in sensory updating is reflected by decreased alpha activity and the prediction error results in theta–gamma and beta–gamma coupling. Thus, TCD can be considered as an adaptive mechanism to retrieve missing auditory input in tinnitus.
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Affiliation(s)
- Dirk De Ridder
- BRAI2N, Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago , Dunedin , New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, University of Texas at Dallas , Richardson, TX , USA
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg , Regensburg , Germany
| | - Rodolfo Llinas
- Department of Neuroscience and Physiology, New York University School of Medicine , New York, NY , USA
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Vanneste S, Van De Heyning P, De Ridder D. Tinnitus: a large VBM-EEG correlational study. PLoS One 2015; 10:e0115122. [PMID: 25781934 PMCID: PMC4364116 DOI: 10.1371/journal.pone.0115122] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Accepted: 11/18/2014] [Indexed: 11/29/2022] Open
Abstract
A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography) was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum) that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus.
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Affiliation(s)
- Sven Vanneste
- Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- School for Behavioral & Brain Sciences, University of Texas at Dallas, Dallas, Texas, United States of America
| | - Paul Van De Heyning
- Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
- ENT Department, University Hospital Antwerp, Antwerp, Belgium
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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De Ridder D, Vanneste S, Weisz N, Londero A, Schlee W, Elgoyhen AB, Langguth B. An integrative model of auditory phantom perception: Tinnitus as a unified percept of interacting separable subnetworks. Neurosci Biobehav Rev 2014; 44:16-32. [PMID: 23597755 DOI: 10.1016/j.neubiorev.2013.03.021] [Citation(s) in RCA: 254] [Impact Index Per Article: 25.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 03/19/2013] [Accepted: 03/27/2013] [Indexed: 01/30/2023]
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A brain centred view of psychiatric comorbidity in tinnitus: from otology to hodology. Neural Plast 2014; 2014:817852. [PMID: 25018882 PMCID: PMC4074975 DOI: 10.1155/2014/817852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/18/2014] [Accepted: 05/05/2014] [Indexed: 11/17/2022] Open
Abstract
Introduction. Comorbid psychiatric disorders are frequent among patients affected by tinnitus. There are mutual clinical influences between tinnitus and psychiatric disorders, as well as neurobiological relations based on partially overlapping hodological and neuroplastic phenomena. The aim of the present paper is to review the evidence of alterations in brain networks underlying tinnitus physiopathology and to discuss them in light of the current knowledge of the neurobiology of psychiatric disorders. Methods. Relevant literature was identified through a search on Medline and PubMed; search terms included tinnitus, brain, plasticity, cortex, network, and pathways. Results. Tinnitus phenomenon results from systemic-neurootological triggers followed by neuronal remapping within several auditory and nonauditory pathways. Plastic reorganization and white matter alterations within limbic system, arcuate fasciculus, insula, salience network, dorsolateral prefrontal cortex, auditory pathways, ffrontocortical, and thalamocortical networks are discussed. Discussion. Several overlapping brain network alterations do exist between tinnitus and psychiatric disorders. Tinnitus, initially related to a clinicoanatomical approach based on a cortical localizationism, could be better explained by an holistic or associationist approach considering psychic functions and tinnitus as emergent properties of partially overlapping large-scale neural networks.
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Schlee W, Schecklmann M, Lehner A, Kreuzer PM, Vielsmeier V, Poeppl TB, Langguth B. Reduced variability of auditory alpha activity in chronic tinnitus. Neural Plast 2014; 2014:436146. [PMID: 24967106 PMCID: PMC4055153 DOI: 10.1155/2014/436146] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/19/2014] [Accepted: 04/22/2014] [Indexed: 01/27/2023] Open
Abstract
Subjective tinnitus is characterized by the conscious perception of a phantom sound which is usually more prominent under silence. Resting state recordings without any auditory stimulation demonstrated a decrease of cortical alpha activity in temporal areas of subjects with an ongoing tinnitus perception. This is often interpreted as an indicator for enhanced excitability of the auditory cortex in tinnitus. In this study we want to further investigate this effect by analysing the moment-to-moment variability of the alpha activity in temporal areas. Magnetoencephalographic resting state recordings of 21 tinnitus subjects and 21 healthy controls were analysed with respect to the mean and the variability of spectral power in the alpha frequency band over temporal areas. A significant decrease of auditory alpha activity was detected for the low alpha frequency band (8-10 Hz) but not for the upper alpha band (10-12 Hz). Furthermore, we found a significant decrease of alpha variability for the tinnitus group. This result was significant for the lower alpha frequency range and not significant for the upper alpha frequencies. Tinnitus subjects with a longer history of tinnitus showed less variability of their auditory alpha activity which might be an indicator for reduced adaptability of the auditory cortex in chronic tinnitus.
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Affiliation(s)
- Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Veronika Vielsmeier
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Timm B. Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
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De Ridder D, Vanneste S. Targeting the parahippocampal area by auditory cortex stimulation in tinnitus. Brain Stimul 2014; 7:709-17. [PMID: 25129400 DOI: 10.1016/j.brs.2014.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The final common pathway in tinnitus generation is considered to be synchronized auditory oscillatory hyperactivity. Intracranial auditory cortex stimulation (iACS) via implanted electrodes has been developed to treat severe cases of intractable tinnitus targeting this final common pathway, in the hope of being a panacea for tinnitus. However, not everybody responds to this treatment. OBJECTIVE The electrical brain activity and functional connectivity at rest might determine who is going to respond or not to iACS and might shed light on the pathophysiology of auditory phantom sound generation. METHOD The resting state electrical brain activity of 5 patients who responded and 5 patients who did not respond to auditory cortex implantation are compared using source localized spectral activity (Z-score of log transformed current density) and lagged phase synchronization. RESULTS sLORETA source localization reveals significant differences between responders vs non-responders for beta3 in left posterior parahippocampal, hippocampal and amygdala area extending into left insula. Gamma band differences exist in the posterior parahippocampal areas and BA10. Functional connectivity between the auditory cortex and the hippocampal area is increased for beta2, delta and theta2 in responders, as well as between the parahippocampal area and auditory cortex for beta3. CONCLUSION The resting state functional connectivity and activity between the auditory cortex and parahippocampus might determine whether a tinnitus patient will respond to a cortical implant. The auditory cortex may only be a functional entrance into a larger parahippocampal based tinnitus network.
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Affiliation(s)
- Dirk De Ridder
- Brai²n, Sint Augustinus Hospital, Antwerp, Belgium; Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, New Zealand.
| | - Sven Vanneste
- School for Behavioral & Brain Sciences, University of Texas at Dallas, Dallas, USA; Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Belgium
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Han L, Zhaohui L, Fei Y, Ting L, Pengfei Z, Wang D, Cheng D, Pengde G, Xiaoyi H, Xiao W, Rui L, Zhenchang W. Abnormal baseline brain activity in patients with pulsatile tinnitus: a resting-state FMRI study. Neural Plast 2014; 2014:549162. [PMID: 24872895 PMCID: PMC4020302 DOI: 10.1155/2014/549162] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2014] [Revised: 03/10/2014] [Accepted: 04/06/2014] [Indexed: 02/07/2023] Open
Abstract
Numerous investigations studying the brain functional activity of the tinnitus patients have indicated that neurological changes are important findings of this kind of disease. However, the pulsatile tinnitus (PT) patients were excluded in previous studies because of the totally different mechanisms of the two subtype tinnitus. The aim of this study is to investigate whether altered baseline brain activity presents in patients with PT using resting-state functional magnetic resonance imaging (rs-fMRI) technique. The present study used unilateral PT patients (n = 42) and age-, sex-, and education-matched normal control subjects (n = 42) to investigate the changes in structural and amplitude of low-frequency (ALFF) of the brain. Also, we analyzed the relationships between these changes with clinical data of the PT patients. Compared with normal controls, PT patients did not show any structural changes. PT patients showed significant increased ALFF in the bilateral precuneus, and bilateral inferior frontal gyrus (IFG) and decreased ALFF in multiple occipital areas. Moreover, the increased THI score and PT duration was correlated with increased ALFF in precuneus and bilateral IFG. The abnormalities of spontaneous brain activity reflected by ALFF measurements in the absence of structural changes may provide insights into the neural reorganization in PT patients.
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Affiliation(s)
- Lv Han
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Liu Zhaohui
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Yan Fei
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Li Ting
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Zhao Pengfei
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Du Wang
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Dong Cheng
- 2Department of Radiology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Guo Pengde
- 1Department of Radiology Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Han Xiaoyi
- 2Department of Radiology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Wang Xiao
- 2Department of Radiology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li Rui
- 2Department of Radiology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Wang Zhenchang
- 2Department of Radiology Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
- *Wang Zhenchang:
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Milerová J, Anders M, Dvořák T, Sand PG, Königer S, Langguth B. The influence of psychological factors on tinnitus severity. Gen Hosp Psychiatry 2013; 35:412-6. [PMID: 23602606 DOI: 10.1016/j.genhosppsych.2013.02.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2012] [Revised: 02/17/2013] [Accepted: 02/26/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Subjective tinnitus is a frequent symptom characterized by perception of sound in the absence of a corresponding external stimulus. Although many people learn to live with tinnitus, some find it severely debilitating. Why tinnitus is debilitating in some patients, but not in others, is still incompletely understood. We aimed to assess the influence of different aspects of psychological distress on perceived tinnitus severity. METHODS Three hundred seventeen patients diagnosed with chronic subjective tinnitus at two university clinics completed the Tinnitus Handicap Inventory (THI), the Tinnitus Questionnaire (TQ) and the Symptom Check List-90-Revised. The influence of the different dimensions of psychological distress on perceived tinnitus severity was statistically evaluated. RESULTS Both THI and TQ scores were significantly influenced by gender, site and the dimension "depression". In addition, TQ scores were significantly influenced by age and "somatization," whereas "hostility" had an impact on THI scores only. CONCLUSION Psychological aspects as well as sociodemographic variables had a significant influence on both TQ scores. However, our results indicate, that these scales reflect emotional distress of tinnitus sufferers differently. This should be taken into consideration in the use of these scales as screening tools for assessment of tinnitus handicap.
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Affiliation(s)
- Jana Milerová
- Department of Psychiatry, First Faculty of Medicine, Charles University in Prague, Ke Karlovu 11, Praha 2, 120 00, Czech Republic
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Michikawa T, Nishiwaki Y, Saito H, Mizutari K, Takebayashi T. Tinnitus preceded depressive symptoms in community-dwelling older Japanese: a prospective cohort study. Prev Med 2013; 56:333-6. [PMID: 23384472 DOI: 10.1016/j.ypmed.2013.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 01/09/2013] [Accepted: 01/26/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Most studies of the association between tinnitus and depression have been cross-sectional, making it difficult to draw any conclusions about the directionality of the association. This study aimed to clarify whether tinnitus precedes the development of depressive symptoms in a general older population. METHODS Residents of Kurabuchi Town, Gunma Prefecture, Japan (239 men, 296 women: ≥65years) without depressive symptoms were given health examinations in 2005-2006. Information on tinnitus was obtained via a questionnaire. Depressive symptoms were then assessed in a face-to-face home visit interviews carried out once in 2007 and once in 2008 according to the Geriatric Depression Scale 15-item version (GDS15). RESULTS Among the men, the 2.5-year incidence of depressive symptoms (GDS15≥6) was higher in those with tinnitus than in those without (20.5% vs. 9.5%). In the multi-adjusted model, tinnitus was significantly associated with an increased risk of depressive symptoms (relative risk=2.07; 95% confidence interval=1.01-4.25). Among the women, no associations were found. CONCLUSION In the present study, tinnitus was independently associated with the risk of depressive symptoms developing in men, but not in women. We believe primary care providers and public health staff should recognize tinnitus as a risk factor for depressive symptoms.
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Affiliation(s)
- Takehiro Michikawa
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki, Japan.
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Hyperacusis-associated pathological resting-state brain oscillations in the tinnitus brain: a hyperresponsiveness network with paradoxically inactive auditory cortex. Brain Struct Funct 2013; 219:1113-28. [PMID: 23609486 DOI: 10.1007/s00429-013-0555-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 04/11/2013] [Indexed: 10/26/2022]
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Silchenko AN, Adamchic I, Hauptmann C, Tass PA. Impact of acoustic coordinated reset neuromodulation on effective connectivity in a neural network of phantom sound. Neuroimage 2013; 77:133-47. [PMID: 23528923 DOI: 10.1016/j.neuroimage.2013.03.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Revised: 01/28/2013] [Accepted: 03/06/2013] [Indexed: 01/29/2023] Open
Abstract
Chronic subjective tinnitus is an auditory phantom phenomenon characterized by abnormal neuronal synchrony in the central auditory system. As recently shown in a proof of concept clinical trial, acoustic coordinated reset (CR) neuromodulation causes a significant relief of tinnitus symptoms combined with a significant decrease of pathological oscillatory activity in a network comprising auditory and non-auditory brain areas. The objective of the present study was to analyze whether CR therapy caused an alteration of the effective connectivity in a tinnitus related network of localized EEG brain sources. To determine which connections matter, in a first step, we considered a larger network of brain sources previously associated with tinnitus. To that network we applied a data-driven approach, combining empirical mode decomposition and partial directed coherence analysis, in patients with bilateral tinnitus before and after 12 weeks of CR therapy as well as in healthy controls. To increase the signal-to-noise ratio, we focused on the good responders, classified by a reliable-change-index (RCI). Prior to CR therapy and compared to the healthy controls, the good responders showed a significantly increased connectivity between the left primary cortex auditory cortex and the posterior cingulate cortex in the gamma and delta bands together with a significantly decreased effective connectivity between the right primary auditory cortex and the dorsolateral prefrontal cortex in the alpha band. Intriguingly, after 12 weeks of CR therapy most of the pathological interactions were gone, so that the connectivity patterns of good responders and healthy controls became statistically indistinguishable. In addition, we used dynamic causal modeling (DCM) to examine the types of interactions which were altered by CR therapy. Our DCM results show that CR therapy specifically counteracted the imbalance of excitation and inhibition. CR significantly weakened the excitatory connection between posterior cingulate cortex and primary auditory cortex and significantly strengthened inhibitory connections between auditory cortices and the dorsolateral prefrontal cortex. The overall impact of CR therapy on the entire tinnitus-related network showed up as a qualitative transformation of its spectral response, in terms of a drastic change of the shape of its averaged transfer function. Based on our findings we hypothesize that CR therapy restores a silence based cognitive auditory comparator function of the posterior cingulate cortex.
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Affiliation(s)
- Alexander N Silchenko
- Institute of Neuroscience and Medicine, Neuromodulation, Research Center Juelich, Juelich, Germany.
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