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Wertz J, Rüttiger L, Bender B, Klose U, Stark RS, Dapper K, Saemisch J, Braun C, Singer W, Dalhoff E, Bader K, Wolpert SM, Knipper M, Munk MHJ. Differential cortical activation patterns: pioneering sub-classification of tinnitus with and without hyperacusis by combining audiometry, gamma oscillations, and hemodynamics. Front Neurosci 2024; 17:1232446. [PMID: 38239827 PMCID: PMC10794389 DOI: 10.3389/fnins.2023.1232446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 10/16/2023] [Indexed: 01/22/2024] Open
Abstract
The ongoing controversies about the neural basis of tinnitus, whether linked with central neural gain or not, may hamper efforts to develop therapies. We asked to what extent measurable audiometric characteristics of tinnitus without (T) or with co-occurrence of hyperacusis (TH) are distinguishable on the level of cortical responses. To accomplish this, electroencephalography (EEG) and concurrent functional near-infrared spectroscopy (fNIRS) were measured while patients performed an attentionally demanding auditory discrimination task using stimuli within the individual tinnitus frequency (fTin) and a reference frequency (fRef). Resting-state-fMRI-based functional connectivity (rs-fMRI-bfc) in ascending auditory nuclei (AAN), the primary auditory cortex (AC-I), and four other regions relevant for directing attention or regulating distress in temporal, parietal, and prefrontal cortex was compiled and compared to EEG and concurrent fNIRS activity in the same brain areas. We observed no group differences in pure-tone audiometry (PTA) between 10 and 16 kHz. However, the PTA threshold around the tinnitus pitch was positively correlated with the self-rated tinnitus loudness and also correlated with distress in T-groups, while TH experienced their tinnitus loudness at minimal loudness levels already with maximal suffering scores. The T-group exhibited prolonged auditory brain stem (ABR) wave I latency and reduced ABR wave V amplitudes (indicating reduced neural synchrony in the brainstem), which were associated with lower rs-fMRI-bfc between AAN and the AC-I, as observed in previous studies. In T-subjects, these features were linked with elevated spontaneous and reduced evoked gamma oscillations and with reduced deoxygenated hemoglobin (deoxy-Hb) concentrations in response to stimulation with lower frequencies in temporal cortex (Brodmann area (BA) 41, 42, 22), implying less synchronous auditory responses during active auditory discrimination of reference frequencies. In contrast, in the TH-group gamma oscillations and hemodynamic responses in temporoparietal regions were reversed during active discrimination of tinnitus frequencies. Our findings suggest that T and TH differ in auditory discrimination and memory-dependent directed attention during active discrimination at either tinnitus or reference frequencies, offering a test paradigm that may allow for more precise sub-classification of tinnitus and future improved treatment approaches.
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Affiliation(s)
- Jakob Wertz
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Lukas Rüttiger
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Benjamin Bender
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Robert S. Stark
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Konrad Dapper
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
| | - Jörg Saemisch
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | | | - Wibke Singer
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Ernst Dalhoff
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Katharina Bader
- Section of Physiological Acoustics and Communication, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Stephan M. Wolpert
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Marlies Knipper
- Department of Otolaryngology, Head and Neck Surgery, Tübingen Hearing Research Centre, University of Tübingen, Tübingen, Germany
| | - Matthias H. J. Munk
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
- Department of Biology, Technical University Darmstadt, Darmstadt, Germany
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Bramhall NF, Theodoroff SM, McMillan GP, Kampel SD, Buran BN. Associations Between Physiological Correlates of Cochlear Synaptopathy and Tinnitus in a Veteran Population. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:4635-4652. [PMID: 37889209 DOI: 10.1044/2023_jslhr-23-00234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
PURPOSE Animal models and human temporal bones indicate that noise exposure is a risk factor for cochlear synaptopathy, a possible etiology of tinnitus. Veterans are exposed to high levels of noise during military service. Therefore, synaptopathy may explain the high rates of noise-induced tinnitus among Veterans. Although synaptopathy cannot be directly evaluated in living humans, animal models indicate that several physiological measures are sensitive to synapse loss, including the auditory brainstem response (ABR), the middle ear muscle reflex (MEMR), and the envelope following response (EFR). The purpose of this study was to determine whether tinnitus is associated with reductions in physiological correlates of synaptopathy that parallel animal studies. METHOD Participants with normal audiograms were grouped according to Veteran status and tinnitus report (Veterans with tinnitus, Veterans without tinnitus, and non-Veteran controls). The effects of being a Veteran with tinnitus on ABR, MEMR, and EFR measurements were independently modeled using Bayesian regression analysis. RESULTS Modeled point estimates of MEMR and EFR magnitude showed reductions for Veterans with tinnitus compared with non-Veterans, with the most evident reduction observed for the EFR. Two different approaches were used to provide context for the Veteran tinnitus effect on the EFR by comparing to age-related reductions in EFR magnitude and synapse numbers observed in previous studies. These analyses suggested that EFR magnitude/synapse counts were reduced in Veterans with tinnitus by roughly the same amount as over 20 years of aging. CONCLUSION These findings suggest that cochlear synaptopathy may contribute to tinnitus perception in noise-exposed Veterans. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24347761.
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Affiliation(s)
- Naomi F Bramhall
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Sarah M Theodoroff
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
| | - Garnett P McMillan
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
| | - Sean D Kampel
- VA RR&D National Center for Rehabilitative Auditory Research, Veterans Affairs Portland Health Care System, OR
| | - Brad N Buran
- Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland
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Jeong YJ, Oh KH, Lim SJ, Park DH, Rah YC, Choi J. Analysis of auditory brain stem response and otoacoustic emission in unilateral tinnitus patients with normal hearing. Auris Nasus Larynx 2022:S0385-8146(22)00228-0. [DOI: 10.1016/j.anl.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/13/2022] [Accepted: 11/28/2022] [Indexed: 12/14/2022]
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A Systematic Review and Meta-Analysis of Extended High-Frequency Hearing Thresholds in Tinnitus With a Normal Audiogram. Ear Hear 2022; 43:1643-1652. [PMID: 35612517 DOI: 10.1097/aud.0000000000001229] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Current evidence supports the growing application of extended high-frequency (EHF: 9 to 20 kHz) audiometry in hearing research, which likely results from the high vulnerability of this frequency region to damage induced by known auditory risk factors. The present systematic review and meta-analysis were performed to investigate whether adults with a normal audiogram and tinnitus show increased EHF hearing thresholds relative to control peers. DESIGN A comprehensive search was undertaken on electronic databases consisting of PubMed, ScienceDirect, Wiley, and Google Scholar using combined keywords: "tinnitus," "extended high frequency," "normal audiogram," and "hidden hearing loss." RESULTS From 261 articles found by searching databases, nine studies met the inclusion criteria for the meta-analysis. A significant difference was observed between tinnitus and control groups in the effect size analysis of hearing thresholds at 10, 12.5, 14, 16, and 18 kHz ( p ≤ 0.001), and the I-square heterogeneity analysis was below 50% in all studies ( p ≥ 0.131). Visual inspection by the Funnel plot and Egger's regression test ( p ≥ 0.211) also exhibited no publication bias in the meta-analyses. CONCLUSIONS Our findings are in support of the idea that in most cases, tinnitus is associated with some degree of cochlear mechanical dysfunction, which may not be detected by conventional audiometry alone. This finding underscores the significance of EHF audiometry in clinical practice, which may help both early identification of individuals susceptible to developing tinnitus and reduce the number of new cases through preventive counseling programs.
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Jacxsens L, De Pauw J, Cardon E, van der Wal A, Jacquemin L, Gilles A, Michiels S, Van Rompaey V, Lammers MJW, De Hertogh W. Brainstem evoked auditory potentials in tinnitus: A best-evidence synthesis and meta-analysis. Front Neurol 2022; 13:941876. [PMID: 36071905 PMCID: PMC9441610 DOI: 10.3389/fneur.2022.941876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction Accumulating evidence suggests a role of the brainstem in tinnitus generation and modulation. Several studies in chronic tinnitus patients have reported latency and amplitude changes of the different peaks of the auditory brainstem response, possibly reflecting neural changes or altered activity. The aim of the systematic review was to assess if alterations within the brainstem of chronic tinnitus patients are reflected in short- and middle-latency auditory evoked potentials (AEPs). Methods A systematic review was performed and reported according to the PRISMA guidelines. Studies evaluating short- and middle-latency AEPs in tinnitus patients and controls were included. Two independent reviewers conducted the study selection, data extraction, and risk of bias assessment. Meta-analysis was performed using a multivariate meta-analytic model. Results Twenty-seven cross-sectional studies were included. Multivariate meta-analysis revealed that in tinnitus patients with normal hearing, significantly longer latencies of auditory brainstem response (ABR) waves I (SMD = 0.66 ms, p < 0.001), III (SMD = 0.43 ms, p < 0.001), and V (SMD = 0.47 ms, p < 0.01) are present. The results regarding possible changes in middle-latency responses (MLRs) and frequency-following responses (FFRs) were inconclusive. Discussion The discovered changes in short-latency AEPs reflect alterations at brainstem level in tinnitus patients. More specifically, the prolonged ABR latencies could possibly be explained by high frequency sensorineural hearing loss, or other modulating factors such as cochlear synaptopathy or somatosensory tinnitus generators. The question whether middle-latency AEP changes, representing subcortical level of the auditory pathway, are present in tinnitus still remains unanswered. Future studies should identify and correctly deal with confounding factors, such as age, gender and the presence of somatosensory tinnitus components. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021243687, PROSPERO [CRD42021243687].
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Affiliation(s)
- Laura Jacxsens
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- *Correspondence: Laura Jacxsens
| | - Joke De Pauw
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Emilie Cardon
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Annemarie van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Orofacial Pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam, Amsterdam, Netherlands
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| | - Sarah Michiels
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Faculty of Rehabilitation Sciences, REVAL, University of Hasselt, Hasselt, Belgium
| | - Vincent Van Rompaey
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Marc J. W. Lammers
- Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital (UZA), Edegem, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Objective Detection of Tinnitus Based on Electrophysiology. Brain Sci 2022; 12:brainsci12081086. [PMID: 36009149 PMCID: PMC9406100 DOI: 10.3390/brainsci12081086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Abstract
Tinnitus, a common disease in the clinic, is associated with persistent pain and high costs to society. Several aspects of tinnitus, such as the pathophysiology mechanism, effective treatment, objective detection, etc., have not been elucidated. Any change in the auditory pathway can lead to tinnitus. At present, there is no clear and unified mechanism to explain tinnitus, and the hypotheses regarding its mechanism include auditory plasticity theory, cortical reorganization theory, dorsal cochlear nucleus hypothesis, etc. Current theories on the mechanism of tinnitus mainly focus on the abnormal activity of the central nervous system. Unfortunately, there is currently a lack of objective diagnostic methods for tinnitus. Developing a method that can detect tinnitus objectively is crucial, only in this way can we identify whether the patient really suffers from tinnitus in the case of cognitive impairment or medical disputes and the therapeutic effect of tinnitus. Electrophysiological investigations have prompted the development of an objective detection of tinnitus by potentials recorded in the auditory pathway. However, there is no objective indicator with sufficient sensitivity and specificity to diagnose tinnitus at present. Based on recent findings of studies with various methods, possible electrophysiological approaches to detect the presence of tinnitus have been summarized. We analyze the change of neural activity throughout the auditory pathway in tinnitus subjects and in patients with tinnitus of varying severity to find available parameters in these methods, which is helpful to further explore the feasibility of using electrophysiological methods for the objective detection of tinnitus.
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Chen F, Zhao F, Mahafza N, Lu W. Detecting Noise-Induced Cochlear Synaptopathy by Auditory Brainstem Response in Tinnitus Patients With Normal Hearing Thresholds: A Meta-Analysis. Front Neurosci 2021; 15:778197. [PMID: 34987358 PMCID: PMC8721093 DOI: 10.3389/fnins.2021.778197] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/15/2021] [Indexed: 01/10/2023] Open
Abstract
Noise-induced cochlear synaptopathy (CS) is defined as a permanent loss of synapses in the auditory nerve pathway following noise exposure. Several studies using auditory brainstem response (ABR) have indicated the presence of CS and increased central gain in tinnitus patients with normal hearing thresholds (TNHT), but the results were inconsistent. This meta-analysis aimed to review the evidence of CS and its pathological changes in the central auditory system in TNHT. Published studies using ABR to study TNHT were reviewed. PubMed, EMBASE, and Scopus databases were selected to search for relevant literature. Studies (489) were retrieved, and 11 were included for meta-analysis. The results supported significantly reduced wave I amplitude in TNHT, whereas the alternations in wave V amplitude were inconsistent among the studies. Consistently increased V/I ratio indicated noise-induced central gain enhancement. The results indicated the evidence of noise-induced cochlear synaptopathy in tinnitus patients with normal hearing. However, inconsistent changes in wave V amplitude may be explained by that the failure of central gain that triggers the pathological neural changes in the central auditory system and/or that increased central gain may be necessary to generate tinnitus but not to maintain tinnitus.
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Affiliation(s)
- Feifan Chen
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Fei Zhao
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
- Department of Hearing and Speech Science, Guangzhou Xinhua College, Guangzhou, China
| | - Nadeem Mahafza
- Centre for Speech and Language Therapy and Hearing Science, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom
| | - Wei Lu
- Department of Otolaryngology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Current topics in hearing research: Deafferentation and threshold independent hearing loss. Hear Res 2021; 419:108408. [PMID: 34955321 DOI: 10.1016/j.heares.2021.108408] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/28/2021] [Accepted: 11/30/2021] [Indexed: 11/20/2022]
Abstract
Hearing research findings in recent years have begun to change how we think about hearing loss and how we consider the risk of auditory damage from noise exposure. These findings include evidence of noise-induced cochlear damage in the absence of corresponding permanent threshold elevation or evidence of hair cell loss. Animal studies in several species have shown that noise exposures that produce robust but only temporary threshold shifts can permanently damage inner hair cell synaptic ribbons. This type of synaptic degeneration has also been shown to occur as a result of aging in animals and humans. The emergence of these data has motivated a number of clinical studies aimed at identifying the perceptual correlates associated with synaptopathy. The deficits believed to arise from synaptopathy include poorer hearing in background noise, tinnitus and hyperacusis (loudness intolerance). However, the findings from human studies have been mixed. Key questions remain as to whether synaptopathy reliably produces suprathreshold perceptual deficits or whether it serves as an early indicator of auditory damage with suprathreshold deficits emerging later as a function of further cochlear damage. Here, we provide an overview of both human and animal studies that explore the relationship among inner hair cell damage, including loss of afferent synapses, auditory thresholds, and suprathreshold measures of hearing.
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Salvi R, Radziwon K, Manohar S, Auerbach B, Ding D, Liu X, Lau C, Chen YC, Chen GD. Review: Neural Mechanisms of Tinnitus and Hyperacusis in Acute Drug-Induced Ototoxicity. Am J Audiol 2021; 30:901-915. [PMID: 33465315 DOI: 10.1044/2020_aja-20-00023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Purpose Tinnitus and hyperacusis are debilitating conditions often associated with age-, noise-, and drug-induced hearing loss. Because of their subjective nature, the neural mechanisms that give rise to tinnitus and hyperacusis are poorly understood. Over the past few decades, considerable progress has been made in deciphering the biological bases for these disorders using animal models. Method Important advances in understanding the biological bases of tinnitus and hyperacusis have come from studies in which tinnitus and hyperacusis are consistently induced with a high dose of salicylate, the active ingredient in aspirin. Results Salicylate induced a transient hearing loss characterized by a reduction in otoacoustic emissions, a moderate cochlear threshold shift, and a large reduction in the neural output of the cochlea. As the weak cochlear neural signals were relayed up the auditory pathway, they were progressively amplified so that the suprathreshold neural responses in the auditory cortex were much larger than normal. Excessive central gain (neural amplification), presumably resulting from diminished inhibition, is believed to contribute to hyperacusis and tinnitus. Salicylate also increased corticosterone stress hormone levels. Functional imaging studies indicated that salicylate increased spontaneous activity and enhanced functional connectivity between structures in the central auditory pathway and regions of the brain associated with arousal (reticular formation), emotion (amygdala), memory/spatial navigation (hippocampus), motor planning (cerebellum), and motor control (caudate/putamen). Conclusion These results suggest that tinnitus and hyperacusis arise from aberrant neural signaling in a complex neural network that includes both auditory and nonauditory structures.
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Affiliation(s)
- Richard Salvi
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Kelly Radziwon
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Senthilvelan Manohar
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Ben Auerbach
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Dalian Ding
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Xiaopeng Liu
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
| | - Condon Lau
- Department of Physics, City University of Hong Kong
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, China
| | - Guang-Di Chen
- Center for Hearing & Deafness, Department of Communicative Disorders and Sciences, The State University of New York at Buffalo
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Han MS, Jeong YJ, Im GJ, Song JJ, Chae SW, Chan Rah Y, Choi J. Auditory brainstem response test results in normal hearing adolescents with subjective tinnitus. Int J Pediatr Otorhinolaryngol 2021; 146:110775. [PMID: 34022656 DOI: 10.1016/j.ijporl.2021.110775] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/30/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The objective of the study was to analyze the auditory brainstem response (ABR) test results of adolescents with normal hearing threshold who have subjective tinnitus in an effort to determine the probable site of origin of tinnitus. METHODS Among the patients who visited the outpatient clinic of the Department of Otolaryngology at our tertiary hospital from January 2016 to December 2019, adolescents aged 13-18 years with the chief complaint of unilateral subjective tinnitus and pure tone audiometry (PTA) within 25 dB HL were enrolled and retrospectively reviewed. The ABR test parameters (amplitudes and latencies of waves I, III, and V and interpeak latencies [IPLs] of waves I-III, III-V, and I-V) were analyzed and compared between tinnitus ears and contralateral ears without tinnitus. Study participants were divided into the chronic tinnitus (tinnitus duration ≥6 months) and non-chronic tinnitus (tinnitus duration <6 months) groups, and the difference between the two groups was analyzed. RESULTS Ten adolescents were included in the study, and their ABR test results were reviewed. IPL III-V was significantly prolonged in tinnitus ears compared to non-tinnitus ears (p = 0.035). Although other parameters were found to be statistically non-significant, there was preponderance in ABR wave I amplitude; it was smaller in tinnitus ears of chronic tinnitus adolescents than in those of non-chronic tinnitus adolescents (p = 0.114). CONCLUSION The probable site of origin of tinnitus in adolescents with normal hearing might be in the upper brainstem of the auditory pathway. Further analysis of ABR test results in adolescents with tinnitus and normal hearing can help clarify the pathophysiology of tinnitus in adolescents.
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Affiliation(s)
- Mun Soo Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Yong Jun Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - Gi Jung Im
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Jae-Jun Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Sung-Won Chae
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea
| | - June Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Medicine, Korea University Ansan Hospital, Ansan, South Korea.
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Joo JW, Jeong YJ, Han MS, Chang YS, Rah YC, Choi J. Analysis of Auditory Brainstem Response Change, according to Tinnitus Duration, in Patients with Tinnitus with Normal Hearing. J Int Adv Otol 2021; 16:190-196. [PMID: 32784156 DOI: 10.5152/iao.2020.7951] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES The purpose of this study was to analyze auditory brainstem response (ABR) waveforms of patients with tinnitus with normal hearing, according to tinnitus duration, and demonstrate the possible pathophysiological mechanisms of tinnitus. MATERIALS AND METHODS From January 2016 to December 2017, patients who presented to our hospital with tinnitus as their chief complaint were enrolled and reviewed retrospectively. Pure tone audiometry and ABR tests were performed. The patients were classified into three groups according to tinnitus duration: acute (<1 month), subacute (1-6 months), and chronic (>6 months). The amplitudes of waves I and V and the latencies of waves I, III, and V were evaluated. In this study, 177 ears of 128 patients with tinnitus with normal hearing were evaluated. RESULTS Wave V amplitude was significantly lower during the subacute phase than during the acute phase. The absolute latency value of wave V was greater during the subacute phase than during the acute phase. The interpeak latency I-V was significantly prolonged during the subacute phase compared with the acute and chronic phases. Wave V amplitude, wave V absolute latency, and interpeak latency I-V varied significantly between cases with a 1-month and 6-month tinnitus history. CONCLUSION The compensatory response to tinnitus decreased sharply after 1 month of symptoms. Early tinnitus identification and treatment initiation are recommended.
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Affiliation(s)
- Jae Woo Joo
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yong Jun Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Mun Soo Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Young-Soo Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yoon Chan Rah
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
| | - June Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University, Seoul, Republic of Korea
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Johannesen PT, Lopez-Poveda EA. Age-related central gain compensation for reduced auditory nerve output for people with normal audiograms, with and without tinnitus. iScience 2021; 24:102658. [PMID: 34151241 PMCID: PMC8192693 DOI: 10.1016/j.isci.2021.102658] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/24/2021] [Accepted: 05/25/2021] [Indexed: 11/30/2022] Open
Abstract
Central gain compensation for reduced auditory nerve output has been hypothesized as a mechanism for tinnitus with a normal audiogram. Here, we investigate if gain compensation occurs with aging. For 94 people (aged 12-68 years, 64 women, 7 tinnitus) with normal or close-to-normal audiograms, the amplitude of wave I of the auditory brainstem response decreased with increasing age but was not correlated with wave V amplitude after accounting for age-related subclinical hearing loss and cochlear damage, a result indicative of age-related gain compensation. The correlations between age and wave I/III or III/V amplitude ratios suggested that compensation occurs at the wave III generator site. For each one of the seven participants with non-pulsatile tinnitus, the amplitude of wave I, wave V, and the wave I/V amplitude ratio were well within the confidence limits of the non-tinnitus participants. We conclude that increased central gain occurs with aging and is not specific to tinnitus.
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Affiliation(s)
- Peter T Johannesen
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, 37007 Salamanca, Spain.,Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, 37007 Salamanca, Spain
| | - Enrique A Lopez-Poveda
- Instituto de Neurociencias de Castilla y León, Universidad de Salamanca, Calle Pintor Fernando Gallego 1, 37007 Salamanca, Spain.,Instituto de Investigación Biomédica de Salamanca, Universidad de Salamanca, 37007 Salamanca, Spain.,Departamento de Cirugía, Facultad de Medicina, Universidad de Salamanca, 37007 Salamanca, Spain
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13
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Henton A, Tzounopoulos T. What's the buzz? The neuroscience and the treatment of tinnitus. Physiol Rev 2021; 101:1609-1632. [PMID: 33769102 DOI: 10.1152/physrev.00029.2020] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Tinnitus is a pervasive public health issue that affects ∼15% of the United States population. Similar estimates have also been shown on a global scale, with similar prevalence found in Europe, Asia, and Africa. The severity of tinnitus is heterogeneous, ranging from mildly bothersome to extremely disruptive. In the United States, ∼10-20% of individuals who experience tinnitus report symptoms that severely reduce their quality of life. Due to the huge personal and societal burden, in the last 20 yr a concerted effort on basic and clinical research has significantly advanced our understanding and treatment of this disorder. Yet, neither full understanding, nor cure exists. We know that tinnitus is the persistent involuntary phantom percept of internally generated nonverbal indistinct noises and tones, which in most cases is initiated by acquired hearing loss and maintained only when this loss is coupled with distinct neuronal changes in auditory and extra-auditory brain networks. Yet, the exact mechanisms and patterns of neural activity that are necessary and sufficient for the perceptual generation and maintenance of tinnitus remain incompletely understood. Combinations of animal model and human research will be essential in filling these gaps. Nevertheless, the existing progress in investigating the neurophysiological mechanisms has improved current treatment and highlighted novel targets for drug development and clinical trials. The aim of this review is to thoroughly discuss the current state of human and animal tinnitus research, outline current challenges, and highlight new and exciting research opportunities.
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Affiliation(s)
- A Henton
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - T Tzounopoulos
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
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14
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Domarecka E, Olze H, Szczepek AJ. Auditory Brainstem Responses (ABR) of Rats during Experimentally Induced Tinnitus: Literature Review. Brain Sci 2020; 10:brainsci10120901. [PMID: 33255266 PMCID: PMC7760291 DOI: 10.3390/brainsci10120901] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 12/31/2022] Open
Abstract
Tinnitus is a subjective phantom sound perceived only by the affected person and a symptom of various auditory and non-auditory conditions. The majority of methods used in clinical and basic research for tinnitus diagnosis are subjective. To better understand tinnitus-associated changes in the auditory system, an objective technique measuring auditory sensitivity-the auditory brainstem responses (ABR)-has been suggested. Therefore, the present review aimed to summarize ABR's features in a rat model during experimentally induced tinnitus. PubMed, Web of Science, Science Direct, and Scopus databanks were searched using Medical Subject Heading (MeSH) terms: auditory brainstem response, tinnitus, rat. The search identified 344 articles, and 36 of them were selected for the full-text analyses. The experimental protocols and results were evaluated, and the gained knowledge was synthesized. A high level of heterogeneity between the studies was found regarding all assessed areas. The most consistent finding of all studies was a reduction in the ABR wave I amplitude following exposure to noise and salicylate. Simultaneously, animals with salicylate-induced but not noise-induced tinnitus had an increased amplitude of wave IV. Furthermore, the present study identified a need to develop a consensus experimental ABR protocol applied in future tinnitus studies using the rat model.
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Affiliation(s)
- Ewa Domarecka
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (E.D.); (H.O.)
| | - Heidi Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (E.D.); (H.O.)
| | - Agnieszka J. Szczepek
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (E.D.); (H.O.)
- Faculty of Medicine and Health Sciences, University of Zielona Gora, 65-046 Zielona Gora, Poland
- Correspondence:
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15
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Abstract
Tinnitus is a phantom auditory sensation in the absence of external sounds, while hyperacusis is an atypical sensitivity to external sounds that leads them to be perceived as abnormally loud or even painful. Both conditions may reflect the brain's over-compensation for reduced input from the ear. The present work differentiates between two compensation models: The additive central noise compensates for hearing loss and is likely to generate tinnitus, whereas the multiplicative central gain compensates for hidden hearing loss and is likely to generate hyperacusis. Importantly, both models predict increased variance in central representations of sounds, especially a nonlinear increase in variance by the central gain. The increased central variance limits the amount of central compensation and reduces temporal synchrony, which can explain the insufficient central gain reported in the literature. Future studies need to collect trial-by-trial firing variance data so that the present variance-based model can be falsified.
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Affiliation(s)
- Fan-Gang Zeng
- Departments of Anatomy and Neurobiology, Biomedical Engineering, Cognitive Sciences, and Otolaryngology - Head and Neck Surgery, Center for Hearing Research, University of California Irvine
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16
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Within-Subject Comparisons of the Auditory Brainstem Response and Uncomfortable Loudness Levels in Ears With and Without Tinnitus in Unilateral Tinnitus Subjects With Normal Audiograms. Otol Neurotol 2020; 42:10-17. [PMID: 33177407 DOI: 10.1097/mao.0000000000002867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate whether cochlear synaptopathy is a common pathophysiologic cause of tinnitus in individuals with normal audiograms. STUDY DESIGN Prospective study. SETTING Tertiary referral center. METHODS We enrolled 27 subjects with unilateral tinnitus and normal symmetric hearing thresholds, and 27 age- and sex-matched control subjects with normal symmetric hearing thresholds. We measured 1) the amplitudes of waves I and V with 90 dB nHL click stimuli in quiet conditions; 2) the latency shift of wave V with 80 dB nHL click stimuli in background noise, varying from 40 dB HL to 70 dB HL; and 3) uncomfortable loudness levels (UCLs) at 500 Hz and 3000 Hz pure tones. RESULTS There were no significant differences in the wave V/I amplitude ratio or the latency shift in wave V with increasing noise levels among the tinnitus ears (TEs), nontinnitus ears (NTEs), and control ears. There were no significant differences in UCLs at 500 Hz or 3000 Hz between TEs and NTEs, but the UCLs were lower in TEs (mean 111.3 dB or 104.1 dB) and NTEs (mean 109.4 dB or 100.6 dB) than in control ears (mean 117.9 dB or 114.1 dB, p < 0.017). No subject met our criteria for cochlear synaptopathy or increased central gain in terms of all three parameters. CONCLUSION Based on these results for UCL, increased central gain is a major mechanism of tinnitus in humans with normal audiograms. However, this compensatory mechanism for reduced auditory input may originate from other pathophysiologic factors rather than from cochlear synaptopathy.
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Sengul Y, Bal N, Louis ED. Evidence of central involvement in essential tremor: a detailed study of auditory pathway physiology. J Neural Transm (Vienna) 2020; 127:1153-1159. [PMID: 32507996 DOI: 10.1007/s00702-020-02215-w] [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: 04/05/2020] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
Essential tremor (ET) is a common tremor disorder that is likely neurodegenerative. The pathophysiology of ET involves the cerebellum and its connections in the brainstem and thalamus. Hearing dysfunction has been shown to be a non-motor finding in ET patients. A limited number of studies have suggested that cochlear pathology is the cause, but studies have not evaluated the integrity of the primary auditory pathway in ET. The main aim of this study is to investigate the integrity of the auditory pathway via auditory brainstem response (ABR) and auditory middle latency response (AMLR), thereby allowing us to evaluate the auditory pathway from the 8th cranial nerve to the cerebral cortex. Sixteen ET patients and sixteen age- and gender-matched controls (64 ears) were evaluated. In the ABR study, we detected prolongation of wave V peak latencies (ms) in ET (p = 0.02). In the AMLR study, P0 (p = 0.03), Pa (p = 0.008), Na (p = 0.03), and Nb (p = 0.01) waves differed between the two groups. Eleven ET patients and four control subjects had abnormal electrophysiological findings (ABR or AMLR or both) (68.8% vs. 25%, p = 0.01). Tremor duration was greater in ET patients with abnormal electrophysiological findings (p = 0.01). Finally, we observed prolongation of latencies after the ABR III wave, indicating that abnormalities exist within the superior olivary complex. For the first time, our research provides evidence that ET-related pathology is present at the subcortical and cortical levels of the auditory pathway.
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Affiliation(s)
- Yildizhan Sengul
- Department of Neurology, Faculty of Medicine, Bezmialem Foundation University, Fatih, Istanbul, Turkey. .,Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.
| | - Nilufer Bal
- Department of Audiology, Faculty of Medical Sciences, Bezmialem Foundation University, Fatih, Istanbul, Turkey
| | - Elan D Louis
- Division of Movement Disorders, Department of Neurology, Yale School of Medicine, Yale University, New Haven, CT, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, CT, USA.,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, USA
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18
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Bora A, Durmuş K, Terzi H, Altuntaş EE. Examining the Early Period Effect of Nilotinib on Hearing: An Experimental Study. J Int Adv Otol 2020; 16:77-86. [PMID: 31287435 PMCID: PMC7224425 DOI: 10.5152/iao.2019.5908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 03/11/2019] [Accepted: 03/13/2019] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Nilotinib has very few side effects, including neutropenia, thrombocytopenia, cardiotoxicity, high pancreatic lipase, ischemia, and vascular occlusion. We aimed to investigate whether short-term administration of nilotinib had ototoxic effects in rats. MATERIALS AND METHODS Wistar-albino rats were categorized into three groups: group C (administered 0.25 mL of distilled water, no nilotinib), group N-20 (administered 20 mg/kg/day of nilotinib dissolved in distilled water), and group N-50 (administered 50 mg/kg/day of nilotinib dissolved in distilled water). A single dose was administered once per day, at the same hour, over 21 days. Auditory brainstem response (ABR) thresholds were recorded on day 0 and day 21. RESULTS There were no changes in ABR threshold values obtained on day 0 (baseline) and on day 21 across all three groups. A statistically significant difference was not found in terms of the mean latency of waves V and III, interpeak latency values of waves III-V, and amplitude ratios of waves III-V and V/Va at baseline and on day 21 across all three groups on within-group or between-group evaluation. CONCLUSION Consequently, further studies are needed that involve different drug doses, prolonged administration of drugs, as well as distortion otoacoustic emission test for the evaluation of cochlear activation and ABR. Furthermore, histopathological studies are needed to indicate whether the cochlea is affected to prove that nilotinib has definitively no ototoxic effect.
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Affiliation(s)
- Adem Bora
- Department of Otolaryngology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Kasım Durmuş
- Department of Otolaryngology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Hatice Terzi
- Department of Internal Medicine, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Emine Elif Altuntaş
- Department of Otolaryngology, Cumhuriyet University School of Medicine, Sivas, Turkey
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19
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Kikidis D, Vardonikolaki A, Zachou Z, Razou A, Pantos P, Bibas A. ABR findings in musicians with normal audiogram and otoacoustic emissions: evidence of cochlear synaptopathy? HEARING, BALANCE AND COMMUNICATION 2020. [DOI: 10.1080/21695717.2019.1663054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Dimitrios Kikidis
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Aikaterini Vardonikolaki
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Zoe Zachou
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Andriana Razou
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Pavlos Pantos
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Bibas
- 1st Department of Otolaryngology – Head & Neck Surgery, National & Kapodistrian University of Athens, Athens, Greece
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20
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Dewey RS, Francis ST, Guest H, Prendergast G, Millman RE, Plack CJ, Hall DA. The association between subcortical and cortical fMRI and lifetime noise exposure in listeners with normal hearing thresholds. Neuroimage 2020; 204:116239. [PMID: 31586673 PMCID: PMC6905154 DOI: 10.1016/j.neuroimage.2019.116239] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 09/07/2019] [Accepted: 09/30/2019] [Indexed: 10/26/2022] Open
Abstract
In animal models, exposure to high noise levels can cause permanent damage to hair-cell synapses (cochlear synaptopathy) for high-threshold auditory nerve fibers without affecting sensitivity to quiet sounds. This has been confirmed in several mammalian species, but the hypothesis that lifetime noise exposure affects auditory function in humans with normal audiometric thresholds remains unconfirmed and current evidence from human electrophysiology is contradictory. Here we report the auditory brainstem response (ABR), and both transient (stimulus onset and offset) and sustained functional magnetic resonance imaging (fMRI) responses throughout the human central auditory pathway across lifetime noise exposure. Healthy young individuals aged 25-40 years were recruited into high (n = 32) and low (n = 30) lifetime noise exposure groups, stratified for age, and balanced for audiometric threshold up to 16 kHz fMRI demonstrated robust broadband noise-related activity throughout the auditory pathway (cochlear nucleus, superior olivary complex, nucleus of the lateral lemniscus, inferior colliculus, medial geniculate body and auditory cortex). fMRI responses in the auditory pathway to broadband noise onset were significantly enhanced in the high noise exposure group relative to the low exposure group, differences in sustained fMRI responses did not reach significance, and no significant group differences were found in the click-evoked ABR. Exploratory analyses found no significant relationships between the neural responses and self-reported tinnitus or reduced sound-level tolerance (symptoms associated with synaptopathy). In summary, although a small effect, these fMRI results suggest that lifetime noise exposure may be associated with central hyperactivity in young adults with normal hearing thresholds.
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Affiliation(s)
- Rebecca S Dewey
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, NG7 2RD, UK; National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, NG7 2UH, UK.
| | - Susan T Francis
- Sir Peter Mansfield Imaging Centre, School of Physics and Astronomy, University of Nottingham, NG7 2RD, UK.
| | - Hannah Guest
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester Academic Health Science Centre, M13 9PL, UK.
| | - Garreth Prendergast
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester Academic Health Science Centre, M13 9PL, UK.
| | - Rebecca E Millman
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester Academic Health Science Centre, M13 9PL, UK; National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK.
| | - Christopher J Plack
- Manchester Centre for Audiology and Deafness (ManCAD), University of Manchester, Manchester Academic Health Science Centre, M13 9PL, UK; National Institute for Health Research (NIHR) Manchester Biomedical Research Centre, Central Manchester University Hospitals NHS Foundation Trust, Manchester, M13 9WL, UK; Department of Psychology, Lancaster University, LA1 4YF, UK.
| | - Deborah A Hall
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, NG7 2UH, UK; University of Nottingham Malaysia, Jalan Broga, 43500, Semeniyh, Selangor Darul Ehsan, Malaysia.
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21
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Chen PY, Liu TC. Within-Subject Analysis of Auditory Brain Stem Responses in Adults With Unilateral Tinnitus. EAR, NOSE & THROAT JOURNAL 2019; 100:592S-596S. [PMID: 31875693 DOI: 10.1177/0145561319893847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Tinnitus affects about 10% of population worldwide. Most patients present with some degrees of hearing impairment, while others remain normal. The aim of this study was to analyze the latency and amplitude of auditory brain stem response (ABR) waveforms in patients with unilateral tinnitus. The tinnitus ears and non-tinnitus ears were compared for each patient. Sixty-seven patients with single-sided tinnitus were enrolled, including 26 male and 41 female patients with a mean age of 54.4 (age ranged from 22 to 79). Eighteen patients had bilateral normal hearing, while 49 patients had some degree of sensorineural hearing. The ABR waveforms were retrospectively analyzed in terms of waves I, III, and V absolute latency, as well as waves I-III, waves II-V, and waves I-V latency intervals, amplitude, and amplitude ratio (III/I, V/I). Statistical analyses were performed within patients. There was no significant ABR difference between the tinnitus and non-tinnitus ears with regard to all the wave latencies and amplitudes in our patients (all P values >0.1). Our result that ABR changes were not found between tinnitus and non-tinnitus ears implies that tinnitus does not simply originate from the defect of the peripheral auditory system. It conforms to the contemporary theory that a higher level of the brain is involved in the generation of tinnitus.
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Affiliation(s)
- Pey-Yu Chen
- Department of Otolaryngology, 36897MacKay Memorial Hospital, Taipei, Taiwan.,Department of Otolaryngology, 38006National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Chen Liu
- Department of Otolaryngology, 38006National Taiwan University Hospital, Taipei, Taiwan
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22
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Bramhall NF, McMillan GP, Gallun FJ, Konrad-Martin D. Auditory brainstem response demonstrates that reduced peripheral auditory input is associated with self-report of tinnitus. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3849. [PMID: 31795660 DOI: 10.1121/1.5132708] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Tinnitus is one of the predicted perceptual consequences of cochlear synaptopathy, a type of age-, noise-, or drug-induced auditory damage that has been demonstrated in animal models to cause homeostatic changes in central auditory gain. Although synaptopathy has been observed in human temporal bones, assessment of this condition in living humans is limited to indirect non-invasive measures such as the auditory brainstem response (ABR). In animal models, synaptopathy is associated with a reduction in ABR wave I amplitude at suprathreshold stimulus levels. Several human studies have explored the relationship between wave I amplitude and tinnitus, with conflicting results. This study investigates the hypothesis that reduced peripheral auditory input due to synaptic/neuronal loss is associated with tinnitus. Wave I amplitude data from 193 individuals [43 with tinnitus (22%), 150 without tinnitus (78%)], who participated in up to 3 out of 4 different studies, were included in a logistic regression analysis to estimate the relationship between wave I amplitude and tinnitus at a variety of stimulus levels and frequencies. Statistical adjustment for sex and distortion product otoacoustic emissions (DPOAEs) was included. The results suggest that smaller wave I amplitudes and/or lower DPOAE levels are associated with an increased probability of tinnitus.
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Affiliation(s)
- Naomi F Bramhall
- Department of Veterans Affairs (VA) Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
| | - Garnett P McMillan
- Department of Veterans Affairs (VA) Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
| | - Frederick J Gallun
- Department of Veterans Affairs (VA) Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
| | - Dawn Konrad-Martin
- Department of Veterans Affairs (VA) Rehabilitation Research and Development Service (RR&D), National Center for Rehabilitative Auditory Research (NCRAR), VA Portland Health Care System, Portland, Oregon 97239, USA
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23
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Bramhall N, Beach EF, Epp B, Le Prell CG, Lopez-Poveda EA, Plack CJ, Schaette R, Verhulst S, Canlon B. The search for noise-induced cochlear synaptopathy in humans: Mission impossible? Hear Res 2019; 377:88-103. [DOI: 10.1016/j.heares.2019.02.016] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/25/2019] [Accepted: 02/28/2019] [Indexed: 10/27/2022]
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24
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Guest H, Munro KJ, Plack CJ. Acoustic Middle-Ear-Muscle-Reflex Thresholds in Humans with Normal Audiograms: No Relations to Tinnitus, Speech Perception in Noise, or Noise Exposure. Neuroscience 2019; 407:75-82. [DOI: 10.1016/j.neuroscience.2018.12.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 12/23/2022]
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25
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Sedley W. Tinnitus: Does Gain Explain? Neuroscience 2019; 407:213-228. [DOI: 10.1016/j.neuroscience.2019.01.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/01/2023]
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26
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Campbell J, LaBrec A, Bean C, Nielsen M, So W. Auditory Gating and Extended High-Frequency Thresholds in Normal-Hearing Adults With Minimal Tinnitus. Am J Audiol 2019; 28:209-224. [PMID: 31022362 DOI: 10.1044/2019_aja-ttr17-18-0036] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Purpose The goal of this study was to assess whether peripheral auditory sensitivity in frequency regions above 8 kHz is related to central inhibitory function, as measured through a sensory gating paradigm, in normal-hearing adults with tinnitus (TINN) and without tinnitus (NTINN). The contribution of gating processes and peripheral sensitivity in extended high frequencies to tinnitus severity was evaluated via a hierarchical multiple regression method. Method Cortical auditory evoked potentials (CAEPs) were recorded in response to pairs of tones in normal-hearing adults without tinnitus, NTINN ( n = 45), and adults with tinnitus, TINN ( n = 21). CAEP peak component amplitude, latency, and gating indices were compared and correlated with extended high-frequency (EHF) pure-tone averages (PTAs) across groups and with tinnitus severity. An exploratory analysis was performed to investigate gating variability within the TINN group. Based on Tinnitus Handicap Inventory (Newman, Jacobson, & Spitzer, 1996) median scores, the TINN group was categorized into low- and high-median subgroups, and gating indices were compared between these subgroups. A hierarchical multiple regression analysis was performed to determine the amount of variance accounted for in the TINN group. Results Decreased gating via the CAEP Pa component and increased gating via the N1 component correlated with increased tinnitus severity, even in individuals who would traditionally be classified as having no tinnitus handicap. In the TINN group, lower EHF PTA thresholds correlated with tinnitus severity and decreased Pa gating. Individuals with a greater severity of tinnitus demonstrated atypical gating function reflected in both Pa and N1 components. Gating function and EHF PTA accounted for significant variance regarding tinnitus severity. Conclusions A trade-off between lower and higher level gating function was observed in adults with normal hearing and tinnitus, indicative of higher order compensatory mechanisms. Better cochlear sensitivity in extended high frequencies was related to decreased lower level gating processes and increased tinnitus THI scores, suggestive of an interaction between decreased gating and heightened auditory awareness. We are currently exploring whether gating processes in this population are compensatory, and the role of gating in auditory awareness.
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Affiliation(s)
- Julia Campbell
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Alison LaBrec
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Connor Bean
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Mashhood Nielsen
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
| | - Won So
- Department of Communication Sciences and Disorders, The University of Texas at Austin
- Central Sensory Processes Laboratory, The University of Texas at Austin
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