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Mohsen S, Sadeghijam M, Talebian S, Pourbakht A. Use of Some Relevant Parameters for Primary Prediction of Brain Activity in Idiopathic Tinnitus Based on a Machine Learning Application. Audiol Neurootol 2023; 28:446-457. [PMID: 37331332 DOI: 10.1159/000530811] [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: 08/08/2022] [Accepted: 04/17/2023] [Indexed: 06/20/2023] Open
Abstract
INTRODUCTION Tinnitus is one of the most common complaints, distressing about 15-24% of the adult population. Because of its pathophysiology heterogeneity, no curable treatment has been attained yet. Even though a neuromodulation management technique based on the tinnitus network model is currently being developed, it has not yet worked because the most involved brain areas still remain unpredictable from the patient's individual clinical and functional profile. A remarkable correlation between tinnitus network activity and the subjective measures of tinnitus like perceived loudness and annoyance and functional handicap is well established. Therefore, this study aimed to develop software for predicting the involved brain areas in the tinnitus network based on the subjective characteristics and clinical profile of patients using a supervised machine-learning method. METHODS The involved brain areas of 30 tinnitus patients ranging from 6 to 80 months in duration were recognized by using QEEG and sLORETA software. There was a correlation between subjective information and those areas of activities in all rhythms by which we wrote our software. RESULTS For verification and validation of the software, we compared and analyzed the results with SPSS data and the receiver operating characteristic (ROC) curves. CONCLUSIONS The findings of this study confirmed the effectiveness of the software in predicting the brain activity in tinnitus subjects; however, some other important parameters can be added to the model to strengthen its reliability and feasibility in clinical use.
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Affiliation(s)
- Samer Mohsen
- Department of Otolaryngology, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
- Department of Audiology, Faculty of Health Sciences, Damascus University, Damascus, Syrian Arab Republic
| | - Maryam Sadeghijam
- Rehabilitation Research Center, Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talebian
- Motor Control Laboratory, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Alonso-Valerdi LM, Ibarra-Zárate DI, Torres-Torres AS, Zolezzi DM, Naal-Ruiz NE, Argüello-García J. Comparative analysis of acoustic therapies for tinnitus treatment based on auditory event-related potentials. Front Neurosci 2023; 17:1059096. [PMID: 37081936 PMCID: PMC10111057 DOI: 10.3389/fnins.2023.1059096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/06/2023] [Indexed: 04/07/2023] Open
Abstract
IntroductionSo far, Auditory Event-Related Potential (AERP) features have been used to characterize neural activity of patients with tinnitus. However, these EEG patterns could be used to evaluate tinnitus evolution as well. The aim of the present study is to propose a methodology based on AERPs to evaluate the effectiveness of four acoustic therapies for tinnitus treatment.MethodsThe acoustic therapies were: (1) Tinnitus Retraining Therapy (TRT), (2) Auditory Discrimination Therapy (ADT), (3) Therapy for Enriched Acoustic Environment (TEAE), and (4) Binaural Beats Therapy (BBT). In addition, relaxing music was included as a placebo for both: tinnitus sufferers and healthy individuals. To meet this aim, 103 participants were recruited, 53% were females and 47% were males. All the participants were treated for 8 weeks with one of these five sounds, which were moreover tuned in accordance with the acoustic features of their tinnitus (if applied) and hearing loss. They were electroencephalographically monitored before and after their acoustic therapy, and wherefrom AERPs were estimated. The sound effect of acoustic therapies was evaluated by examining the area under the curve of those AERPs. Two parameters were obtained: (1) amplitude and (2) topographical distribution.ResultsThe findings of the investigation showed that after an 8-week treatment, TRT and ADT, respectively achieved significant neurophysiological changes over somatosensory and occipital regions. On one hand, TRT increased the tinnitus perception. On the other hand, ADT redirected the tinnitus attention, what in turn diminished the tinnitus perception. Tinnitus handicapped inventory outcomes verified these neurophysiological findings, revealing that 31% of patients in each group reported that TRT increased tinnitus perception, but ADT diminished it.DiscussionTinnitus has been identified as a multifactorial condition highly associated with hearing loss, age, sex, marital status, education, and even, employment. However, no conclusive evidence has been found yet. In this study, a significant (but low) correlation was found between tinnitus intensity and right ear hearing loss, left ear hearing loss, heart rate, area under the curve of AERPs, and acoustic therapy. This study raises the possibility to assign acoustic therapies by neurophysiological response of patient.
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Affiliation(s)
- Luz M. Alonso-Valerdi
- Tecnológico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Mexico
- *Correspondence: Luz M. Alonso-Valerdi,
| | | | | | - Daniela M. Zolezzi
- Tecnológico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Mexico
| | | | - Janet Argüello-García
- Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas, Instituto Politécnico Nacional, Mexico City, Mexico
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Using prism adaptation to alleviate perception of unilateral tinnitus: A case study. Cortex 2022; 157:197-210. [PMID: 36335820 DOI: 10.1016/j.cortex.2022.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 12/10/2021] [Accepted: 08/10/2022] [Indexed: 12/15/2022]
Abstract
Tinnitus is described as an uncomfortable sound or noise heard by an individual in the absence of an external sound source. Treating this phantom perception remains difficult even if drug and nondrug therapies are used to alleviate symptoms. The present case study aimed to investigate whether prism adaptation could induce beneficial aftereffects in a tinnitus sufferer. A 75-year-old man, R. B., with chronic unilateral tinnitus in the left ear reported a self-estimation of parameters of his tinnitus-discomfort, pitch and loudness-and performed a manual line-bisection task to study the consequences of lateralized auditory disorder on spatial representation. Aftereffects of prism adaptation were assessed using a sensorimotor open-loop pointing task. In parallel, a control group completed the line-bisection task and the open-loop pointing task before and after lens exposure, under the same experimental condition as those of R. B. Throughout the pretests, the patient assessed his tinnitus at a constant medium pitch (around 3000 Hz), and he was biased toward the affected ear in both the sensorimotor task and the estimation of the subjective center in the manual line-bisection task. Although both optical deviations were effective, an exposure to prism adaptation to a rightward optical deviation (i.e., toward the unaffected ear) produced stronger aftereffects. In posttests, the tinnitus pitch decreased to 50 Hz and the subjective center was shifted toward the right side (i.e., unaffected ear side). Furthermore, the line-bisection task seemed to reflect the changes in the tinnitus perception, and spatial representation could be a new tool to assess tinnitus indirectly. Our findings suggest that prism adaptation may have benefits on unilateral tinnitus and open a new avenue for its treatment.
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Boecking B, Biehl R, Brueggemann P, Mazurek B. Health-Related Quality of Life, Depressive Symptoms, Anxiety, and Somatization Symptoms in Male and Female Patients with Chronic Tinnitus. J Clin Med 2021; 10:jcm10132798. [PMID: 34202097 PMCID: PMC8267833 DOI: 10.3390/jcm10132798] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: To investigate the joint impact of tinnitus-related distress (TRD), anxiety, depressive symptoms, and other somatization symptoms on health-related quality of life (HRQoL) in female vs. male patients with chronic tinnitus. Method: Three-hundred-and-fifty-two patients with chronic tinnitus completed audiological testing and a psychological assessment battery that comprised—among other measures—German versions of the Tinnitus Questionnaire, Hospital Anxiety and Depression Scale, Somatic Symptom Scale-8, and Health-Related Quality of Life scale. Descriptive analyses examined associations as well as within- and between-gender differences of the measured variables. Gender-specific serial indirect effects analyses aimed to explain the impact of TRD on HRQoL through psychological processes, notably anxiety, depressive symptoms, and somatization symptoms. Results: Both female and male patients yielded lower mental than physical HRQoL and negative associations between the measured psychological variables and HRQoL. Compared to male patients, female patients reported higher levels of tinnitus-related- and wider psychological distress, other somatization symptoms (e.g., headaches), and impairments in mental and physical HRQoL. For each gender, depressive symptoms, anxiety, and somatization symptoms fully mediated the effect of TRD on mental and physical HRQoL. A double-dissociation revealed an interaction of somatization symptoms and depression on the TRD-HRQoL association in women, and of somatization symptoms and anxiety in men. Conclusions: In patients with chronic tinnitus, psychological constructs account for reported impairments in both mental and physical HRQoL. To improve patients’ HRQoL, treatment conceptualizations should consider gender-specific psychological expressions of low mood or anxiety.
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Affiliation(s)
| | | | | | - Birgit Mazurek
- Correspondence: ; Tel.: +49-30-450-009; Fax: +49-30-450-555-907
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Gos E, Rajchel JJ, Dziendziel B, Kutyba J, Bienkowska K, Swierniak W, Gocel M, Raj-Koziak D, Skarzynski PH, Skarzynski H. How to Interpret Tinnitus Functional Index Scores: A Proposal for a Grading System Based on a Large Sample of Tinnitus Patients. Ear Hear 2020; 42:654-661. [PMID: 33156124 DOI: 10.1097/aud.0000000000000967] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The Tinnitus Functional Index (TFI) is considered the gold standard in measuring tinnitus severity. The aim of the study was to establish reference values to improve the interpretability of TFI scores. DESIGN Results from 1114 patients with tinnitus were retrospectively analyzed. The participants were consecutive patients who attended our tertiary referral Ear, Nose, and Throat Center. The eligibility criteria were: at least 18 years old, persistent tinnitus, completed pure-tone audiometry, and answered all 25 items on the TFI. Hearing status (normal hearing vs. hearing impairment) was established according to the recommendation of the Bureau International d'Audiophonologie. Means (M) and SD on the TFI were the basis for grading tinnitus severity on four levels: low, lower moderate, upper moderate, and high. To gauge individual scores in clinical practice, percentiles are also proposed. RESULTS All 1114 patients (586 women and 528 men) were Caucasian and aged from 19 to 87 years (M = 50.96; SD = 13.10 years). Tinnitus duration ranged from 0.5 to 50 years (M = 7.17; SD = 7.71 years). There were 258 patients with normal hearing and 856 patients with hearing loss. A score of above 65 points on TFI was established as the cutoff point for diagnosing high tinnitus severity. A regression model associating tinnitus severity with gender, age, tinnitus duration, and hearing loss was statistically significant: F(4,1109) = 8.99; p < 0.001, but the effect was very small (R2adj = 0.028) and only gender and age were associated with TFI global score, while tinnitus severity was not related to tinnitus duration or hearing loss. CONCLUSIONS The reference values proposed here support those reported previously by Meikle et al. They are empirically based and can be used as benchmarks in clinical practice and scientific research. They make it possible to assess tinnitus severity, evaluate individual scores, and categorize individuals with tinnitus. This allows researchers to set inclusion or exclusion criteria when assigning patients to specific groups during clinical trials involving tinnitus intervention strategies.
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Affiliation(s)
- Elzbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Joanna J Rajchel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Beata Dziendziel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Justyna Kutyba
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Katarzyna Bienkowska
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Weronika Swierniak
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Maria Gocel
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Danuta Raj-Koziak
- Department of Audiology and Phoniatrics, Tinnitus Clinic, Institute of Physiology and Pathology of Hearing, Warsaw
| | - Piotr H Skarzynski
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw.,Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, Warsaw.,Institute of Sensory Organs, Nadarzyn/Kajetany
| | - Henryk Skarzynski
- Department of Otorhinolaryngosurgery, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw
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Abstract
OBJECTIVE To investigate how tinnitus affects the processing of speech and non-speech stimuli at the subcortical level. STUDY DESIGN Cross-sectional analytical study. SETTING Academic, tertiary referral center. PATIENTS Eighteen individuals with tinnitus and 20 controls without tinnitus matched based on their age and sex. All subjects had normal hearing sensitivity. INTERVENTION Diagnostic. MAIN OUTCOME MEASURES The effect of tinnitus on the parameters of auditory brainstem responses (ABR) to non-speech (click-ABR), and speech (sABR) stimuli was investigated. RESULTS Latencies of click ABR in waves III, V, and Vn, as well as inter-peak latency (IPL) of I to V were significantly longer in individuals with tinnitus compared with the controls. Individuals with tinnitus demonstrated significantly longer latencies of all sABR waves than the control group. The tinnitus patients also exhibited a significant decrease in the slope of the V-A complex and reduced encoding of the first and higher formants. A significant difference was observed between the two groups in the spectral magnitudes, the first formant frequency range (F1) and a higher frequency region (HF). CONCLUSIONS Our findings suggest that maladaptive neural plasticity resulting from tinnitus can be subcortically measured and affects timing processing of both speech and non-speech stimuli. The findings have been discussed based on models of maladaptive plasticity and the interference of tinnitus as an internal noise in synthesizing speech auditory stimuli.
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Mohsen S, Mahmoudian S, Talbian S, Pourbakht A. Correlation Analysis of the Tinnitus Handicap Inventory and Distress Network in Chronic Tinnitus: An EEG Study. Basic Clin Neurosci 2019; 10:499-514. [PMID: 32284839 PMCID: PMC7149958 DOI: 10.32598/bcn.9.10.215] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/10/2019] [Accepted: 07/17/2019] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Tinnitus is a common disorder with a considerable amount of distress that affects the patient's daily life. No objective tools were approved for measuring tinnitus distress. It can be estimated only by subjective scales and questionnaires, albeit, the Electroencephalography (EEG) studies have reported some alterations regarding tinnitus distress network. This study aimed to investigate the correlation between Tinnitus Handicap Inventory (THI) and the recorded EEG data. METHODS A total of 33 chronic tinnitus cases (9 females) with the mean age of 42.67 years were recruited. Their THI scores were collected, and a 3-minute EEG recorded with eye closed at resting-state. The correlation analysis was performed on THI scores and the current density in the selected Region of Interests (ROIs) concerning the distress network for the eight frequency bands. The patients grouped depending on the THI cutoff point of 56 into low and high THI groups, and then the groups were compared for source analysis and functional connectivity between ROIs using standardized low-resolution brain electromagnetic tomography. RESULTS A significant positive correlation was seen between THI scores and the electrical activity in the Anterior Cingulate Cortex (ACC), the prefrontal cortex, and the parahippocampus for an alpha band (P<0.05) and in the ACC for beta (P<0.01). Source analysis showed significant differences with increased activity in the high THI group for alpha, beta and gamma bands. Functional connectivity was also elevated in the high THI group between the ROIs in alpha and beta bands. CONCLUSION THI can be a useful tool for measuring tinnitus distress, and it has a high correlation with EEG data.
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Affiliation(s)
- Samer Mohsen
- Department of Otolaryngology, School of Medicine, Damascus University, Damascus, Syria
| | - Saeid Mahmoudian
- ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeed Talbian
- School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Pourbakht
- Department of Audiology, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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