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Cho YS, Park S, Kim GY, Jo M, Hong SH, Moon IJ. Effects of Transcutaneous Trigeminal Electrical Stimulation and Sound Therapy in Patients with Tinnitus. Yonsei Med J 2023; 64:618-624. [PMID: 37727921 PMCID: PMC10522882 DOI: 10.3349/ymj.2022.0611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/28/2023] [Accepted: 07/24/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE Tinnitus is one of the most common health conditions worldwide. Although various methods of treatment have been used, the condition is still difficult to manage or cure. This study aimed to evaluate the therapeutic effects of transcutaneous trigeminal electrical stimulation (TTES) combined with notched sound therapy (NST) on patients with tinnitus. MATERIALS AND METHODS A clinical trial was conducted prospectively from September 2020 to September 2021 at a single center in South Korea. In total, 14 patients took part in this trial. Periodic visits and tele-monitoring were used to assess treatment compliance and collect data, including electroencephalography (EEG), photoplethysmography (PPG), tinnitus handicap inventory (THI), tinnitus magnitude index, Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and 36-item short-form survey (SF-36) results. RESULTS Changes after intervention were analyzed with paired t-test. This study showed that alpha waves in the left hemisphere measured by EEG (p=0.024), autonomic nervous system balance (p=0.007), and stress level (p=0.022) measured by PPG significantly changed after intervention. Also, THI scores especially emotional symptoms (p=0.029) and catastrophic symptoms (p=0.043) decreased after treatment. The SF-36 score, both mental component summary and physical component summary score (each p<0.001), increased significantly, whereas the PSQI score (p<0.001) and BDI score (p<0.001) decreased after TTES and NST. CONCLUSION Based on the results of our study, we could confirm that TTES combined with NST can significantly improve tinnitus, catastrophic symptoms, and the overall quality of life of patients.
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Affiliation(s)
- Young Sang Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Sungwon Park
- Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ga-Young Kim
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Mini Jo
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea
| | - Sung Hwa Hong
- Department of Otorhinolaryngology, Myongji Hospital, Hanyang University Medical Center, Goyang, Korea
| | - Il Joon Moon
- Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
- Hearing Research Laboratory, Samsung Medical Center, Seoul, Korea.
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2
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Zare A, van Zwieten G, Kotz SA, Temel Y, Almasabi F, Schultz BG, Schwartze M, Janssen MLF. Sensory gating functions of the auditory thalamus: adaptation and modulations through noise-exposure and high-frequency stimulation in rats. Behav Brain Res 2023; 450:114498. [PMID: 37201892 DOI: 10.1016/j.bbr.2023.114498] [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: 02/28/2023] [Revised: 05/12/2023] [Accepted: 05/14/2023] [Indexed: 05/20/2023]
Abstract
The medial geniculate body (MGB) of the thalamus is an obligatory relay for auditory processing. A breakdown of adaptive filtering and sensory gating at this level may lead to multiple auditory dysfunctions, while high-frequency stimulation (HFS) of the MGB might mitigate aberrant sensory gating. To further investigate the sensory gating functions of the MGB, this study (i) recorded electrophysiological evoked potentials in response to continuous auditory stimulation, and (ii) assessed the effect of MGB HFS on these responses in noise-exposed and control animals. Pure-tone sequences were presented to assess differential sensory gating functions associated with stimulus pitch, grouping (pairing), and temporal regularity. Evoked potentials were recorded from the MGB and acquired before and after HFS (100Hz). All animals (unexposed and noise-exposed, pre- and post-HFS) showed gating for pitch and grouping. Unexposed animals also showed gating for temporal regularity not found in noise-exposed animals. Moreover, only noise-exposed animals showed restoration comparable to the typical EP amplitude suppression pattern following MGB HFS. The current findings confirm adaptive thalamic sensory gating based on different sound characteristics and provide evidence that temporal regularity affects MGB auditory signaling.
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Affiliation(s)
- Aryo Zare
- School for Mental Health and Neuroscience, Faculty of Health Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Gusta van Zwieten
- School for Mental Health and Neuroscience, Faculty of Health Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Ear, Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Sonja A Kotz
- Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands; Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Yasin Temel
- School for Mental Health and Neuroscience, Faculty of Health Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Neurosurgery, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Faris Almasabi
- School for Mental Health and Neuroscience, Faculty of Health Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands; Physiology Department, Faculty of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Benjamin G Schultz
- Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands
| | - Michael Schwartze
- Department of Neuropsychology and Psychopharmacology, Maastricht University, the Netherlands.
| | - Marcus L F Janssen
- School for Mental Health and Neuroscience, Faculty of Health Medicine, and Life Sciences, Maastricht University, Maastricht, the Netherlands; Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, the Netherlands.
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3
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The Effect of Noise Trauma and Deep Brain Stimulation of the Medial Geniculate Body on Tissue Activity in the Auditory Pathway. Brain Sci 2022; 12:brainsci12081099. [PMID: 36009162 PMCID: PMC9405782 DOI: 10.3390/brainsci12081099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/08/2022] [Accepted: 08/15/2022] [Indexed: 11/17/2022] Open
Abstract
Tinnitus is defined as the phantom perception of sound. To date, there is no curative treatment, and contemporary treatments have failed to show beneficial outcomes. Deep brain stimulation has been suggested as a potential therapy for refractory tinnitus. However, the optimal target and stimulation regimens remain to be defined. Herein, we investigated metabolic and neuronal activity changes using cytochrome C oxidase histochemistry and c-Fos immunohistochemistry in a noise trauma-induced rat model of tinnitus. We also assessed changes in neuronal activity following medial geniculate body (MGB) high-frequency stimulation (HFS). Metabolic activity was reduced in the primary auditory cortex, MGB and CA1 region of the hippocampus in noise-exposed rats. Additionally, c-Fos expression was increased in the primary auditory cortex of those animals. Furthermore, MGB-HFS enhanced c-Fos expression in the thalamic reticular nucleus. We concluded that noise trauma alters tissue activity in multiple brain areas including the auditory and limbic regions. MGB-HFS resulted in higher neuronal activity in the thalamic reticular nucleus. Given the prominent role of the auditory thalamus in tinnitus, these data provide more rationales towards targeting the MGB with HFS as a symptom management tool in tinnitus.
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4
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The role of the medial geniculate body of the thalamus in the pathophysiology of tinnitus and implications for treatment. Brain Res 2022; 1779:147797. [DOI: 10.1016/j.brainres.2022.147797] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 11/25/2021] [Accepted: 01/13/2022] [Indexed: 01/12/2023]
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5
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van Zwieten G, Roberts MJ, Schaper FLVW, Smit JV, Temel Y, Janssen MLF. Noise-induced neurophysiological alterations in the rat medial geniculate body and thalamocortical desynchronization by deep brain stimulation. J Neurophysiol 2021; 125:661-671. [PMID: 33405997 DOI: 10.1152/jn.00752.2019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The thalamic medial geniculate body (MGB) is uniquely positioned within the neural tinnitus networks. Deep brain stimulation (DBS) of the MGB has been proposed as a possible novel treatment for tinnitus, yet mechanisms remain elusive. The aim of this study was to characterize neurophysiologic hallmarks in the MGB after noise exposure and to assess the neurophysiological effects of electrical stimulation of the MGB. Fourteen male Sprague-Dawley rats were included. Nine subjects were unilaterally exposed to a 16-kHz octave-band noise at 115 dB for 90 min, five received sham exposure. Single units were recorded from the contralateral MGB where spontaneous firing, coefficient of variation, response type, rate-level functions, and thresholds were determined. Local field potentials and electroencephalographical (EEG) recordings were performed before and after high-frequency DBS of the MGB. Thalamocortical synchronization and power were analyzed. In total, 214 single units were identified (n = 145 in noise-exposed group, n = 69 in control group). After noise exposure, fast-responding neurons become less responsive or nonresponsive without change to their spontaneous rate, whereas sustained- and suppressed-type neurons exhibit enhanced spontaneous activity without change to their stimulus-driven activity. MGB DBS suppressed thalamocortical synchronization in the β and γ bands, supporting suppression of thalamocortical synchronization as an underlying mechanism of tinnitus suppression by high frequency DBS. These findings contribute to our understanding of the neurophysiologic consequences of noise exposure and the mechanism of potential DBS therapy for tinnitus.NEW & NOTEWORTHY Separate functional classes of MGB neurons might have distinct roles in tinnitus pathophysiology. After noise exposure, fast-responding neurons become less responsive or nonresponsive without change to their spontaneous firing, whereas sustained and suppressed neurons exhibit enhanced spontaneous activity without change to their stimulus-driven activity. Furthermore, results suggest desynchronization of thalamocortical β and γ oscillations as a mechanism of tinnitus suppression by MGB DBS.
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Affiliation(s)
- Gusta van Zwieten
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mark J Roberts
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Frédéric L V W Schaper
- School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jasper V Smit
- School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Ear Nose and Throat/Head and Neck Surgery, Zuyderland Hospital, Heerlen, The Netherlands
| | - Yasin Temel
- School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus L F Janssen
- School of Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
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6
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Vajsakovic D, Maslin M, Searchfield GD. Principles and Methods for Psychoacoustic Evaluation of Tinnitus. Curr Top Behav Neurosci 2020; 51:419-459. [PMID: 33550568 DOI: 10.1007/7854_2020_211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Tinnitus, the perception of sound in the absence of a physical sound in the environment, is highly heterogeneous. It varies in its etiology, characteristics, and impact on an individual's life. The sound is commonly described as "ringing," "buzzing," "crickets," "hissing," "humming." Tinnitus can be acute or chronic, mild or disabling. It can be perceived unilaterally or, more commonly, bilaterally. The sound and its location differ from person to person and fluctuate in the same individual over a certain period of time. This heterogeneity in characterization has important implications for research and clinical practice. Identifying patterns in how tinnitus sounds and its relationship to hearing may aid in identifying different forms of tinnitus and revealing their underlying mechanisms. However, the subjective nature of characterizing tinnitus makes it difficult to reliably define and measure. This chapter will focus on reviewing the psychoacoustic assessment of tinnitus, its relationship to cognitive and behavioral aspects of tinnitus, and its neuropathophysiology. In particular, it will describe the heterogeneity of tinnitus and tinnitus matching, and how individual variability in measures may be used to guide treatment and as a prognostic factor.
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Affiliation(s)
- Dunja Vajsakovic
- Section of Audiology, The University of Auckland, Auckland, New Zealand.,Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, A Centre of Research Excellence, Auckland, New Zealand
| | - Michael Maslin
- Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand.,School of Psychology, Speech and Hearing, The University of Canterbury, Canterbury, New Zealand
| | - Grant D Searchfield
- Section of Audiology, The University of Auckland, Auckland, New Zealand. .,Eisdell Moore Centre, The University of Auckland, Auckland, New Zealand. .,Centre for Brain Research, The University of Auckland, Auckland, New Zealand. .,Brain Research New Zealand, A Centre of Research Excellence, Auckland, New Zealand.
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7
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van Zwieten G, Jahanshahi A, van Erp ML, Temel Y, Stokroos RJ, Janssen MLF, Smit JV. Alleviation of Tinnitus With High-Frequency Stimulation of the Dorsal Cochlear Nucleus: A Rodent Study. Trends Hear 2019; 23:2331216519835080. [PMID: 30868944 PMCID: PMC6419256 DOI: 10.1177/2331216519835080] [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] [Indexed: 02/03/2023] Open
Abstract
Deep brain stimulation of the central auditory pathway is emerging as a promising treatment modality for tinnitus. Within this pathway, the dorsal cochlear nucleus (DCN) plays a key role in the pathophysiology of tinnitus and is believed to be a tinnitus generator. We hypothesized that high-frequency stimulation (HFS) of the DCN would influence tinnitus-related abnormal neuronal activity within the auditory pathway and hereby suppress tinnitus. To this end, we assessed the effect of HFS of the DCN in a noise-induced rat model of tinnitus. The presence of tinnitus was verified using the gap prepulse inhibition of the acoustic startle response paradigm. Hearing thresholds were determined before and after noise trauma by measuring the auditory brainstem responses. In addition, changes in neuronal activity induced by noise trauma and HFS were assessed using c-Fos immunohistochemistry in related structures. Results showed tinnitus development after noise trauma and hearing loss ipsilateral to the side exposed to noise trauma. During HFS of the DCN, tinnitus was suppressed. There was no change in c-Fos expression within the central auditory pathway after HFS. These findings suggest that DCN-HFS changes patterns of activity and results in information lesioning within the network and hereby blocking the relay of abnormal tinnitus-related neuronal activity.
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Affiliation(s)
- Gusta van Zwieten
- 1 Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,2 School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Ali Jahanshahi
- 3 Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marlieke L van Erp
- 2 School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Yasin Temel
- 2 School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.,3 Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J Stokroos
- 4 Department of Ear Nose Throat/Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marcus L F Janssen
- 2 School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands.,5 Department of Neurophysiology and Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jasper V Smit
- 1 Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,2 School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
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8
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Abstract
Tinnitus is the sensation of hearing a sound with no external auditory stimulus present. It is a public health issue correlated with multiple comorbidities and precipitating factors such as noise exposure, military service, and traumatic brain injury, migraine, insomnia, small vessel disease, smoking history, stress exposure, anxiety, depression, and socioeconomic status. Clinical experience and a recent literature review point at tinnitus as a neuropsychiatric condition involving both auditory and nonauditory cortical areas of the brain and affecting brain-auditory circuitry. In fact, brain-ear connections have been highlighted in different models. Forward management of this disorder should take this body of research into consideration as tinnitus remains a challenging condition to evaluate and treat with current management protocols still symptomatic at best. With a better understanding of the etiologic factors and comorbidities of tinnitus, additional research trials and new therapeutic approaches could see the light to tackle this public health disability bringing hope to patients and doctors.
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Affiliation(s)
- Zeina Chemali
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| | - R Nehmé
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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9
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van Zwieten G, Janssen MLF, Smit JV, Janssen AML, Roet M, Jahanshahi A, Stokroos RJ, Temel Y. Inhibition of Experimental Tinnitus With High Frequency Stimulation of the Rat Medial Geniculate Body. Neuromodulation 2018; 22:416-424. [PMID: 30102446 PMCID: PMC6618158 DOI: 10.1111/ner.12795] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 03/28/2018] [Accepted: 05/02/2018] [Indexed: 12/24/2022]
Abstract
BACKGROUND Neuromodulation is a promising treatment modality for tinnitus, especially in chronic and severe cases. The auditory thalamus plays a key role in the pathophysiology of tinnitus, as it integrates and processes auditory and limbic information. OBJECTIVE The effect of high frequency stimulation and low frequency stimulation of the medial geniculate bodies on tinnitus in a noise-induced tinnitus rat model is assessed. MATERIALS AND METHODS Presence of tinnitus was verified using the gap-induced prepulse inhibition of the acoustic startle response paradigm. Hearing thresholds were determined before and after noise trauma with auditory brainstem responses. Anxiety-related side-effects were evaluated in the elevated zero maze and open field. RESULTS Results show tinnitus development after noise exposure and preserved hearing thresholds of the ear that was protected from noise trauma. We found that high frequency stimulation of the medial geniculate bodies suppressed tinnitus. This effect maintained directly after stimulation when the stimulator was turned off. Low frequency stimulation did not have any effects on the gap:no-gap ratio of the acoustic startle response. CONCLUSION High frequency stimulation of the MGB has a direct and residual suppressing effect on tinnitus in this animal model. Low frequency stimulation of the MGB did not inhibit tinnitus.
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Affiliation(s)
- Gusta van Zwieten
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Marcus L F Janssen
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurology and Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - A Miranda L Janssen
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Methodology and Statistics, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Milaine Roet
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Yasin Temel
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
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Is Presence of Vascular Loop in Magnetic Resonance Imaging Always Related to Tinnitus? J Craniofac Surg 2017; 28:e295-e298. [PMID: 28468227 DOI: 10.1097/scs.0000000000003546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION One of the most common otological complaints is tinnitus in adults. When there is a complaint of unilateral tinnitus and retrocochlear pathology is suspected, imaging methods are applied. However, the imaging findings obtained may not always be compatible with the severity and localization of the tinnitus. AIM The aim of the present study was to determine whether or not there was a significant correlation between the findings on magnetic resonance imaging (MRI) and the presence and severity of tinnitus in patients with the complaint of unilateral tinnitus. METHOD The study included 44 patients with no loss of hearing who presented with the complaint of unilateral tinnitus. The relationship between tinnitus severity and vascular loop presence was investigated. RESULTS Various types of vascular loop were determined in 14 patients. No statistically significant relationship was determined between the presence of vascular loop and the Tinnitus Handicap Inventory scores. CONCLUSION The results of this study showed no significant difference in respect of the presence of vascular loop on the MRI findings of symptomatic and healthy ears. The presence of vascular loop on MRI is not always a pathological event and should be considered only as an examination finding that could be an anatomic variation.
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11
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Smit JV, Janssen MLF, Engelhard M, de Bie RMA, Schuurman PR, Contarino MF, Mosch A, Temel Y, Stokroos RJ. The impact of deep brain stimulation on tinnitus. Surg Neurol Int 2016; 7:S848-S854. [PMID: 27994936 PMCID: PMC5134112 DOI: 10.4103/2152-7806.194156] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Accepted: 05/14/2016] [Indexed: 11/24/2022] Open
Abstract
Background: Tinnitus is a disorder of the nervous system that cannot be adequately treated with current therapies. The effect of neuromodulation induced by deep brain stimulation (DBS) on tinnitus has not been studied well. This study investigated the effect of DBS on tinnitus by use of a multicenter questionnaire study. Methods: Tinnitus was retrospectively assessed prior to DBS and at the current situation (with DBS). From the 685 questionnaires, 443 were returned. A control group was one-to-one matched to DBS patients who had tinnitus before DBS (n = 61). Tinnitus was assessed by the tinnitus handicap inventory (THI) and visual analog scales (VAS) of loudness and burden. Results: The THI decreased significantly during DBS compared to the situation prior to surgery (from 18.9 to 15.1, P < .001), which was only significant for DBS in the subthalamic nucleus (STN). The THI in the control group (36.9 to 35.5, P = 0.50) and other DBS targets did not change. The VAS loudness increased in the control group (5.4 to 6.0 P < .01). Conclusion: DBS might have a modulatory effect on tinnitus. Our study suggests that DBS of the STN may have a beneficial effect on tinnitus, but most likely other nuclei linked to the tinnitus circuitry might be even more effective.
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Affiliation(s)
- Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus L F Janssen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Malou Engelhard
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Rob M A de Bie
- Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands
| | - P Richard Schuurman
- Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands
| | - Maria F Contarino
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Arne Mosch
- Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
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