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Kang YJ, Zheng Y. Current understanding of subjective tinnitus in adults. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08633-w. [PMID: 38632112 DOI: 10.1007/s00405-024-08633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 03/14/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE An up-to-date overview of epidemiology, etiology and pathophysiological mechanisms, diagnostic and evaluation methods, current treatment status and future directions of subjective tinnitus in adults. METHODS Review of current evidence-based literature on subjective tinnitus in adults. RESULTS The prevalence of subjective tinnitus in the adult population is estimated to be around 14%, and it tends to increase with age. Subjective tinnitus is a complex condition with multiple factors contributing to its origin. However, the exact causes and underlying mechanisms remain unknown. Potential causes may include hearing loss, dysfunction in the somatosensory system, and auditory cortical dysfunction, although severe underlying pathology is rare. Currently, diagnosis primarily relies on patient self-reported medical history and physician-based clinical assessment due to the lack of objective testing. Various treatment and management options have been proposed, but their effectiveness varies, and there is no universally agreed-upon treatment option. CONCLUSIONS Tinnitus is a complex and heterogeneous disease with a high incidence rate and a tendency to increase with age. A holistic perspective is needed to understand the generation, perception, and emotional responses to tinnitus. Diagnosis requires a comprehensive assessment based on medical history and relevant examinations, identification of concurrent psychosomatic comorbidities, and active pursuit of objective diagnostic methods. At the same time, on the basis of existing treatment plans and combining emerging technologies, we will develop new personalized, precise, and combined treatment plans.
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Affiliation(s)
- Yao-Jie Kang
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China
- Department of Otolaryngology-Head and Neck Surgery, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi Tujia and Miao Autonomous Prefecture, China
| | - Yun Zheng
- Hearing Center, Department of Otolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu, China.
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Lai H, Gao M, Yang H. The potassium channels: Neurobiology and pharmacology of tinnitus. J Neurosci Res 2024; 102:e25281. [PMID: 38284861 DOI: 10.1002/jnr.25281] [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: 04/23/2023] [Revised: 10/27/2023] [Accepted: 11/16/2023] [Indexed: 01/30/2024]
Abstract
Tinnitus is a widespread public health issue that imposes a significant social burden. The occurrence and maintenance of tinnitus have been shown to be associated with abnormal neuronal activity in the auditory pathway. Based on this view, neurobiological and pharmacological developments in tinnitus focus on ion channels and synaptic neurotransmitter receptors in neurons in the auditory pathway. With major breakthroughs in the pathophysiology and research methodology of tinnitus in recent years, the role of the largest family of ion channels, potassium ion channels, in modulating the excitability of neurons involved in tinnitus has been increasingly demonstrated. More and more potassium channels involved in the neural mechanism of tinnitus have been discovered, and corresponding drugs have been developed. In this article, we review animal (mouse, rat, hamster, and guinea-pig), human, and genetic studies on the different potassium channels involved in tinnitus, analyze the limitations of current clinical research on potassium channels, and propose future prospects. The aim of this review is to promote the understanding of the role of potassium ion channels in tinnitus and to advance the development of drugs targeting potassium ion channels for tinnitus.
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Affiliation(s)
- Haohong Lai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Minqian Gao
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Hearing and Speech-Language Science, Guangzhou Xinhua University, Guangzhou, China
| | - Haidi Yang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Hearing and Speech-Language Science, Guangzhou Xinhua University, Guangzhou, China
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Matarèse BFE, Rusin A, Seymour C, Mothersill C. Quantum Biology and the Potential Role of Entanglement and Tunneling in Non-Targeted Effects of Ionizing Radiation: A Review and Proposed Model. Int J Mol Sci 2023; 24:16464. [PMID: 38003655 PMCID: PMC10671017 DOI: 10.3390/ijms242216464] [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: 09/20/2023] [Revised: 11/01/2023] [Accepted: 11/13/2023] [Indexed: 11/26/2023] Open
Abstract
It is well established that cells, tissues, and organisms exposed to low doses of ionizing radiation can induce effects in non-irradiated neighbors (non-targeted effects or NTE), but the mechanisms remain unclear. This is especially true of the initial steps leading to the release of signaling molecules contained in exosomes. Voltage-gated ion channels, photon emissions, and calcium fluxes are all involved but the precise sequence of events is not yet known. We identified what may be a quantum entanglement type of effect and this prompted us to consider whether aspects of quantum biology such as tunneling and entanglement may underlie the initial events leading to NTE. We review the field where it may be relevant to ionizing radiation processes. These include NTE, low-dose hyper-radiosensitivity, hormesis, and the adaptive response. Finally, we present a possible quantum biological-based model for NTE.
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Affiliation(s)
- Bruno F. E. Matarèse
- Department of Haematology, University of Cambridge, Cambridge CB2 1TN, UK;
- Department of Physics, University of Cambridge, Cambridge CB2 1TN, UK
| | - Andrej Rusin
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (A.R.); (C.S.)
| | - Colin Seymour
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (A.R.); (C.S.)
| | - Carmel Mothersill
- Department of Biology, McMaster University, Hamilton, ON L8S 4L8, Canada; (A.R.); (C.S.)
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Cuesta M, Cobo P. A Heterogeneous Sample of a Spanish Tinnitus Cohort. Brain Sci 2023; 13:brainsci13040652. [PMID: 37190617 DOI: 10.3390/brainsci13040652] [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: 03/13/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Taking into account heterogeneity has been highly recommended in tinnitus studies both to disentangle all diverse factors that can contribute to their complexity and to design personalized treatments. To this aim, a heterogeneous sample of 270 tinnitus subjects is analyzed considering the gender (male/female), hearing condition (hearing-impaired/normal-hearing), and tinnitus severity (compensated/decompensated) subgroups. Two categorical variables (tinnitus laterality and tinnitus sound type) and four quantitative variables (average auditory threshold, age of tinnitus onset, tinnitus frequency, and tinnitus severity) are used. The percentages (for categorical variables) and mean values (for quantitative variables) of the whole sample are compared with these of each subgroup. Furthermore, correlational and hypothesis testing is applied to calculate the correlation coefficients and statistical significance, respectively. The results show that the male and female subgroups contrast in the sound type and frequency of their tinnitus, hearing-impaired and normal-hearing individuals differ, in addition, in their average auditory threshold, and the compensated/decompensated tinnitus subgroup provides significantly distinct values in tinnitus laterality and tinnitus sound.
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Affiliation(s)
- María Cuesta
- Institute for Physical and Information Technologies (ITEFI), Spanish National Research Council (CSIC), 28006 Madrid, Spain
| | - Pedro Cobo
- Institute for Physical and Information Technologies (ITEFI), Spanish National Research Council (CSIC), 28006 Madrid, Spain
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Special Issue "New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus". Brain Sci 2022; 12:brainsci12101330. [PMID: 36291264 PMCID: PMC9599459 DOI: 10.3390/brainsci12101330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 11/29/2022] Open
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Nawafleh S, Qaswal AB, Alali O, Zayed FM, Al-Azzam AM, Al-Kharouf K, Ali MB, Albliwi MA, Al-Hamarsheh R, Iswaid M, Albanna A, Enjadat A, Al-Adwan MAO, Dibbeh K, Shareah EAA, Hamdan A, Suleiman A. Quantum Mechanical Aspects in the Pathophysiology of Neuropathic Pain. Brain Sci 2022; 12:brainsci12050658. [PMID: 35625044 PMCID: PMC9140023 DOI: 10.3390/brainsci12050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/08/2022] [Accepted: 05/12/2022] [Indexed: 11/17/2022] Open
Abstract
Neuropathic pain is a challenging complaint for patients and clinicians since there are no effective agents available to get satisfactory outcomes even though the pharmacological agents target reasonable pathophysiological mechanisms. This may indicate that other aspects in these mechanisms should be unveiled to comprehend the pathogenesis of neuropathic pain and thus find more effective treatments. Therefore, in the present study, several mechanisms are chosen to be reconsidered in the pathophysiology of neuropathic pain from a quantum mechanical perspective. The mathematical model of the ions quantum tunneling model is used to provide quantum aspects in the pathophysiology of neuropathic pain. Three major pathophysiological mechanisms are revisited in the context of the quantum tunneling model. These include: (1) the depolarized membrane potential of neurons; (2) the cross-talk or the ephaptic coupling between the neurons; and (3) the spontaneous neuronal activity and the emergence of ectopic action potentials. We will show mathematically that the quantum tunneling model can predict the occurrence of neuronal membrane depolarization attributed to the quantum tunneling current of sodium ions. Moreover, the probability of inducing an ectopic action potential in the axons of neurons will be calculated and will be shown to be significant and influential. These ectopic action potentials are generated due to the formation of quantum synapses which are assumed to be the mechanism behind the ephaptic transmission. Furthermore, the spontaneous neuronal activity and the emergence of ectopic action potentials independently from any adjacent stimulated neurons are predicted to occur according to the quantum tunneling model. All these quantum mechanical aspects contribute to the overall hyperexcitability of the neurons and to the pathogenesis of neuropathic pain. Additionally, providing a new perspective in the pathophysiology of neuropathic pain may improve our understanding of how the neuropathic pain is generated and maintained and may offer new effective agents that can improve the overall clinical outcomes of the patients.
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Affiliation(s)
- Sager Nawafleh
- Department of Anesthesia and Intensive Care Unit, The Hashemite University, Zarqa 13115, Jordan;
| | - Abdallah Barjas Qaswal
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
- Correspondence:
| | - Obada Alali
- Department of Anesthesia and Intensive Care, Alabdali Clemenceau Hospital, Amman 11190, Jordan;
| | - Fuad Mohammed Zayed
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | | | - Khaled Al-Kharouf
- Southampton Orthopedics: Centre for Arthroplasty and Revision Surgery, University Hospital Southampton, Tremona Road, Southampton SO16 6YD, UK;
| | - Mo’ath Bani Ali
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Moath Ahmad Albliwi
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Rawan Al-Hamarsheh
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Mohammad Iswaid
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Ahmad Albanna
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Ahmad Enjadat
- Department of Internship Program, Jordan University Hospital, Amman 11942, Jordan;
| | - Mohammad Abu Orabi Al-Adwan
- School of Medicine, The University of Jordan, Amman 11942, Jordan; (F.M.Z.); (M.B.A.); (M.A.A.); (R.A.-H.); (M.I.); (A.A.); (M.A.O.A.-A.)
| | - Khaled Dibbeh
- Leicester University Hospitals, P.O. Box 7853, Leicester LE1 9WW, UK;
| | - Ez-Aldeen Abu Shareah
- Accident and Emergency Department, The Princess Alexandra Hospital NHS Trust, Hamstel Road, Harlow CM20 1QX, UK;
| | - Anas Hamdan
- Department of Anesthesia and Intensive Care Unit, Istishari Hospital, Amman 11184, Jordan;
| | - Aiman Suleiman
- Department of Anesthesia, Intensive Care and Pain Management, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
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