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Sample records for chronic tinnitus patients

  1. Altered Interhemispheric Functional Coordination in Chronic Tinnitus Patients

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    Yu-Chen Chen

    2015-01-01

    Full Text Available Purpose. Recent studies suggest that tinnitus may be due in part to aberrant callosal structure and interhemispheric interaction. To explore this hypothesis we use a novel method, voxel-mirrored homotopic connectivity (VMHC, to examine the resting-state interhemispheric functional connectivity and its relationships with clinical characteristics in chronic tinnitus patients. Materials and Methods. Twenty-eight chronic tinnitus patients with normal hearing thresholds and 30 age-, sex-, education-, and hearing threshold-matched healthy controls were included in this study and underwent the resting-state fMRI scanning. We computed the VMHC to analyze the interhemispheric functional coordination between homotopic points of the brain in both groups. Results. Compared to the controls, tinnitus patients showed significantly increased VMHC in the middle temporal gyrus, middle frontal gyrus, and superior occipital gyrus. In tinnitus patients, a positive correlation was found between tinnitus duration and VMHC of the uncus. Moreover, correlations between VMHC changes and tinnitus distress were observed in the transverse temporal gyrus, superior temporal pole, precentral gyrus, and calcarine cortex. Conclusions. These results show altered interhemispheric functional connectivity linked with specific tinnitus characteristics in chronic tinnitus patients, which may be implicated in the neuropathophysiology of tinnitus.

  2. The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus

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    David Riedl

    2015-01-01

    Full Text Available Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97. Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC curves were used to calculate a cutoff score for the German "Tinnitus Acceptance Questionnaire" (CTAQ-G and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with "low-to-mild tinnitus acceptance" and "moderate-to-high tinnitus acceptance." Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress.

  3. Aberrant spontaneous brain activity in chronic tinnitus patients revealed by resting-state functional MRI

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    Yu-Chen Chen

    2014-01-01

    Conclusions: The present study confirms that chronic tinnitus patients have aberrant ALFF in many brain regions, which is associated with specific clinical tinnitus characteristics. ALFF disturbance in specific brain regions might be used to identify the neuro-pathophysiological mechanisms in chronic tinnitus patients.

  4. Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

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    Weisz Nathan; Michels Lars; Moazami-Goudarzi Morteza; Jeanmonod Daniel

    2010-01-01

    Abstract Background The physiopathological mechanism underlying the tinnitus phenomenon is still the subject of an ongoing debate. Since oscillatory EEG activity is increasingly recognized as a fundamental hallmark of cortical integrative functions, this study investigates deviations from the norm of different resting EEG parameters in patients suffering from chronic tinnitus. Results Spectral parameters of resting EEG of male tinnitus patients (n = 8, mean age 54 years) were compared to thos...

  5. Coexistence of anxiety sensitivity and psychiatric comorbidities in patients with chronic tinnitus

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    Gül Aİ

    2015-02-01

    Full Text Available Ali İrfan Gül,1 Mahmut Özkiris,2 Reha Aydin,2 Gülnihal Şimşek,3 Levent Saydam2 1Department of Psychiatry, 2Department of Otolaryngology, Head and Neck Surgery, Bozok University Medical Faculty, 3Department of Psychiatry, Government Hospital, Yozgat, Turkey Background: Tinnitus refers to the objective or subjective perception of a series of sounds most frequently described as ringing in the ear or within the head itself. Anxiety and depressive disorders frequently accompany this complaint. In this study, we aimed to investigate the presence of psychiatric symptoms and the degree of anxiety sensitivity in patients with chronic tinnitus. Methods: Fifty patients with chronic tinnitus who had been followed up for at least 6 months or longer were enrolled in this study. All subjects completed the Anxiety Sensitivity Index-3 (ASI-3, Stait-Trait Anxiety Inventory (STAI, and Symptom Check List-90-Revised (SCL-90-R questionnaires. Fifty healthy volunteers were given the same tests and a statistical comparison of the psychometric outcome data was done for subjects with and without chronic tinnitus. Results: Patients with chronic tinnitus demonstrated higher statistically meaningful scores than the healthy group. Comparison between chronic tinnitus group and control group scores showed that patient group has a high rate of statistically significant results than controls; ASI-3, STAI-2, SCL-90-R GSI, SCL-90-R Somatization, SCL-90-R Depression, SCL-90-R Anxiety (z=-8.00, P<0.01, SCL-90-R Phobic Anxiety. Conclusion: Higher scores for anxiety sensitivity and other psychiatric symptoms in patients with chronic tinnitus reflects the prevalence of psychiatric disorders such as depression, anxiety, somatoform disorder, and chronic tinnitus. The finding of more psychiatric comorbidity in patients with chronic tinnitus indicates that planning and follow-up in both otolaryngology and psychiatry is necessary to improve the overall results of treatment. Keywords

  6. Somatoform disorders in patients with chronic subjective tinnitus.

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    Sahin, Caner; Aras, Hatice İmer; Yilmaz, Mahmut Sinan

    2016-11-01

    This study aimed to investigate the correlation of psychiatric disorders with tinnitus and tinnitus handicap scores. A total of 30 patients and 30 otherwise healthy people were enrolled for the study. Somatoform disorder questionnaire SDQ-20 was filled in by both the study and the control group. Tinnitus handicap scores were filled in study group. Tinnitus handicap scores were 28.1 ± 19.8, and somatoform disorder questionnaire scores were 30.5 ± 7.3 in the tinnitus group. In the control group the somatoform disorder questionnaire scores were 25.4 ± 4.6. (1) We found a statistically significant difference between somatoform disorder questionnaire scores between groups (p tinnitus handicap scores and somatoform disorder questionnaire scores in study group (p = 0.0). The correlation between these tests was positively strong (R = 0.782). (3) There was no statistical difference between genders. We recommend investigating patients with long-lasting tinnitus for psychiatric comorbidity in relation to somatoform disorders in cooperation with psychiatric clinics.

  7. Three years later: report on the state of well-being of patients with chronic tinnitus who underwent modified tinnitus retraining therapy.

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    Seydel, Claudia; Haupt, Heidemarie; Szczepek, Agnieszka J; Hartmann, Anne; Rose, Matthias; Mazurek, Birgit

    2015-01-01

    Successful management of patients with chronic tinnitus is an important health issue. One of the tinnitus management strategies used at our Tinnitus Center is a combination of tinnitus retraining therapy (TRT) with physiotherapy and psychological management [called modified TRT (MTRT)]. We have used this type of management for over a decade and have described the protocol in detail elsewhere. In the present study, we wanted to determine the effect of MTRT on the well-being of tinnitus patients 3 years after treatment onset. One hundred and thirty patients with chronic tinnitus were assessed using psychometric instruments immediately before 7-day MTRT, immediately after the therapy and 3 years later. Patients with very severe tinnitus-related distress associated with major depression and a risk of suicide were excluded from this study. MTRT resulted in a sustained reduction of tinnitus-related distress. Moreover, the quality of life of patients had increased, as assessed by a separate questionnaire. The effect of MTRT was influenced by the degree of tinnitus-related distress and by the patients' age, the latter being gender dependent. Hearing loss and tinnitus duration had only a minor influence on the therapeutic effect. Taken together, we report a positive change in the state of well-being of patients with chronic tinnitus measurable with various psychometric instruments 3 years after the onset of MTRT.

  8. Impairments of thalamic resting-state functional connectivity in patients with chronic tinnitus

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    Zhang, Jian [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Chen, Yu-Chen [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Center for Hearing and Deafness, University at Buffalo, State University of New York, Buffalo, NY (United States); Feng, Xu [Department of Otolaryngology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Yang, Ming; Liu, Bin; Qian, Cheng [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China); Wang, Jian [Department of Physiology, Southeast University, Nanjing (China); School of Human Communication Disorders, Dalhousie University, Halifax, NS (Canada); Salvi, Richard [Center for Hearing and Deafness, University at Buffalo, State University of New York, Buffalo, NY (United States); Teng, Gao-Jun, E-mail: gjteng@vip.sina.com [Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, Medical School, Southeast University, Nanjing (China)

    2015-07-15

    Highlights: • Tinnitus patients have aberrant thalamic connectivity to many brain regions. • Decreased thalamic connectivity is linked with tinnitus characteristics. • Thalamocortical connectivity disturbances can reflect tinnitus-related networks. - Abstract: Purpose: The phantom sound of tinnitus is believed to arise from abnormal functional coupling between the thalamus and cerebral cortex. To explore this hypothesis, we used resting-state functional magnetic resonance imaging (fMRI) to compare the degree of thalamocortical functional connectivity in chronic tinnitus patients and controls. Materials and methods: Resting-state fMRI scans were obtained from 31 chronic tinnitus patients and 33 well-matched healthy controls. Thalamocortical functional connectivity was characterized using a seed-based whole-brain correlation method. The resulting thalamic functional connectivity measures were correlated with other clinical data. Results: We found decreased functional connectivity between the seed region in left thalamus and right middle temporal gyrus (MTG), right middle orbitofrontal cortex, left middle frontal gyrus, right precentral gyrus, and bilateral calcarine cortex. Decreased functional connectivity was detected between the seed in the right thalamus and the left superior temporal gyrus (STG), left amygdala, right superior frontal gyrus, left precentral gyrus, and left middle occipital gyrus. Tinnitus distress correlated negatively with thalamic functional connectivity in right MTG; tinnitus duration correlated negatively with thalamic functional connectivity in left STG. Increased functional connectivity between the bilateral thalamus and a set of regions were also observed. Conclusions: Chronic tinnitus patients have disrupted thalamocortical functional connectivity to selected brain regions which is associated with specific tinnitus characteristics. Resting-state thalamic functional connectivity disturbances may play an important role in

  9. The role of fear-avoidance cognitions and behaviors in patients with chronic tinnitus.

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    Kleinstäuber, Maria; Jasper, Kristine; Schweda, Isabell; Hiller, Wolfgang; Andersson, Gerhard; Weise, Cornelia

    2013-01-01

    The current study investigated the role of fear-avoidance-a concept from chronic pain research-in chronic tinnitus. A self-report measure the "Tinnitus Fear-Avoidance Cognitions and Behaviors Scale (T-FAS)" was developed and validated. Furthermore, the role of fear-avoidance behavior as mediator of the relationship between anxiety sensitivity and tinnitus handicap was investigated. From a clinical setting, N = 373 patients with chronic tinnitus completed questionnaires assessing tinnitus handicap (Tinnitus Handicap Inventory), anxiety, depression (Hospital Anxiety and Depression Scale), anxiety sensitivity (Anxiety Sensitivity Index-3), personality factors (Big Five Inventory-10), and fear-avoidance. To analyze the psychometric properties, principal component analysis with parallel component extraction and correlational analyses were used. To examine a possible mediating effect, hierarchical regression analysis was applied. The principal component analysis resulted in a three-factor solution: Fear-avoidance Cognitions, Tinnitus-related Fear-Avoidance Behavior, and Ear-related Fear-Avoidance Behavior. Internal consistency was satisfactory for the total scale and all subscales. High correlations between tinnitus-related handicap scales, depressive and anxiety symptoms, and the T-FAS were found, whereas associations with personality factors were low. Moreover, results indicate a significant partial mediation of fear-avoidance behaviors in the relationship between anxiety sensitivity and the cognitive dimension of tinnitus handicap. Results show that fear-avoidance behavior plays an important role in tinnitus handicap. More attention should be paid to this concept in research and clinical practice of psychotherapy for chronic tinnitus.

  10. Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

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    Weisz Nathan

    2010-03-01

    Full Text Available Abstract Background The physiopathological mechanism underlying the tinnitus phenomenon is still the subject of an ongoing debate. Since oscillatory EEG activity is increasingly recognized as a fundamental hallmark of cortical integrative functions, this study investigates deviations from the norm of different resting EEG parameters in patients suffering from chronic tinnitus. Results Spectral parameters of resting EEG of male tinnitus patients (n = 8, mean age 54 years were compared to those of age-matched healthy males (n = 15, mean age 58.8 years. On average, the patient group exhibited higher spectral power over the frequency range of 2-100 Hz. Using LORETA source analysis, the generators of delta, theta, alpha and beta power increases were localized dominantly to left auditory (Brodmann Areas (BA 41,42, 22, temporo-parietal, insular posterior, cingulate anterior and parahippocampal cortical areas. Conclusions Tinnitus patients show a deviation from the norm of different resting EEG parameters, characterized by an overproduction of resting state delta, theta and beta brain activities, providing further support for the microphysiological and magnetoencephalographic evidence pointing to a thalamocortical dysrhythmic process at the source of tinnitus. These results also provide further confirmation that reciprocal involvements of both auditory and associative/paralimbic areas are essential in the generation of tinnitus.

  11. Acoustic Coordinated Reset Neuromodulation in a Real Life Patient Population with Chronic Tonal Tinnitus

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    Christian Hauptmann

    2015-01-01

    Full Text Available Purpose. Primary tinnitus has a severe negative influence on the quality of life of a significant portion of the general population. Acoustic coordinated reset neuromodulation is designed to induce a long-lasting reduction of tinnitus symptoms. To test acoustic coordinated reset neuromodulation as a treatment for chronic, tonal tinnitus under real life conditions, an outpatient study “RESET Real Life” was commissioned by ANM GmbH. Herein we present the results of this study. Methods. In a prospective, open-label, nonrandomized, noncontrolled multicenter clinical study with 200 chronic tinnitus patients, tinnitus questionnaire TBF-12 and Global Clinical Improvement-Impression Scale (CGI-I7 are used to study the safety and efficacy of acoustic coordinated reset neuromodulation. 189 patients completed the last 12-month visit, 11 patients dropped out (8 because of nontreatment related reasons; 2 because tinnitus did not change; and 1 because tinnitus got louder. Results. Acoustic coordinated reset neuromodulation caused a statistically and clinically significant decrease in TBF-12 scores as well as in CGI-I7 after 12 months of therapy under real life conditions. There were no persistent adverse events reported that were related to the therapy. Conclusion. The field study “RESET Real Life” provides evidence for safety and efficacy of acoustic coordinated reset neuromodulation in a prospective, open-label, real life setting.

  12. Efficacy and Safety of Repeated Courses of rTMS Treatment in Patients with Chronic Subjective Tinnitus

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    Astrid Lehner

    2015-01-01

    Full Text Available Background. Repetitive transcranial magnetic stimulation (rTMS has shown promising effects in the treatment of chronic subjective tinnitus. However, little is known about maintenance treatment in order to achieve long-lasting improvements. Objective. This study addresses the questions whether the repeated application of rTMS treatment can contribute to the maintenance or enhancement of treatment effects and if so in which cases repetitive treatment courses are beneficial. Methods. 55 patients with chronic tinnitus were treated with two rTMS treatment courses with ten treatment sessions each. The mean intertreatment interval was 20.65 ± 18.56 months. Tinnitus severity was assessed before and after each treatment course. Results. Both treatments were well tolerated and caused significant improvement of tinnitus severity. The main predictor for the outcome of the second treatment was the development of tinnitus distress in the phase between both treatment courses: the more patients worsened in this interval, the more they improved during the second treatment course. Conclusion. Repeated application of rTMS seems to be useful in tinnitus management and should preferentially be offered to patients who experience a worsening of their tinnitus during the intertreatment interval, irrespective of their response to the first treatment course.

  13. Efficacy and Safety of Repeated Courses of rTMS Treatment in Patients with Chronic Subjective Tinnitus

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    Lehner, Astrid; Schecklmann, Martin; Poeppl, Timm B.; Kreuzer, Peter M.; Peytard, Juliette; Frank, Elmar; Langguth, Berthold

    2015-01-01

    Background. Repetitive transcranial magnetic stimulation (rTMS) has shown promising effects in the treatment of chronic subjective tinnitus. However, little is known about maintenance treatment in order to achieve long-lasting improvements. Objective. This study addresses the questions whether the repeated application of rTMS treatment can contribute to the maintenance or enhancement of treatment effects and if so in which cases repetitive treatment courses are beneficial. Methods. 55 patients with chronic tinnitus were treated with two rTMS treatment courses with ten treatment sessions each. The mean intertreatment interval was 20.65 ± 18.56 months. Tinnitus severity was assessed before and after each treatment course. Results. Both treatments were well tolerated and caused significant improvement of tinnitus severity. The main predictor for the outcome of the second treatment was the development of tinnitus distress in the phase between both treatment courses: the more patients worsened in this interval, the more they improved during the second treatment course. Conclusion. Repeated application of rTMS seems to be useful in tinnitus management and should preferentially be offered to patients who experience a worsening of their tinnitus during the intertreatment interval, irrespective of their response to the first treatment course. PMID:26583152

  14. Role of worry in patients with chronic tinnitus and sensorineural hearing loss: a preliminary study.

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    Caldirola, Daniela; Teggi, Roberto; Daccò, Silvia; Sangiorgio, Erika; Bussi, Mario; Perna, Giampaolo

    2016-12-01

    Tinnitus-related distress appears to be more strongly associated with multiple psychological factors than with any perceptual properties of tinnitus. Prior studies have not investigated the role of worry in tinnitus sufferers. Worry is a dispositional cognitive trait that involves a pervasive, non-specific, future-oriented proneness to fretting, which can foster negative affective states and catastrophic thinking about a specific trouble when the trouble is actual and present. We examined the relationship between worry and self-perceived anxiety and depressive symptoms and handicap in 54 outpatients with chronic tinnitus and sensorineural hearing loss who had been previously recruited for a randomized double-blind study on the efficacy of transmeatal low-level laser therapy for tinnitus. We measured the current anxiety and depressive symptoms with the State-Trait Anxiety Inventory Form Y-1/Self-evaluation Depression Scale, the handicap with the Tinnitus Handicap Inventory, and the proneness to worry with the Penn State Worry Questionnaire. For the psychoacoustic tinnitus measures, we considered the loudness match and the minimum masking level. We found that tinnitus-related anxiety and depressive symptoms and handicap were significantly associated with proneness to worry (linear regression models, p tinnitus in clinical practice. Early therapeutic interventions for reducing proneness to worry may facilitate better adaptation to tinnitus.

  15. Psychophysiological Associations between Chronic Tinnitus and Sleep: A Cross Validation of Tinnitus and Insomnia Questionnaires

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    Martin Schecklmann

    2015-01-01

    Full Text Available Background. The aim of the present study was to assess the prevalence of insomnia in chronic tinnitus and the association of tinnitus distress and sleep disturbance. Methods. We retrospectively analysed data of 182 patients with chronic tinnitus who completed the Tinnitus Questionnaire (TQ and the Regensburg Insomnia Scale (RIS. Descriptive comparisons with the validation sample of the RIS including exclusively patients with primary/psychophysiological insomnia, correlation analyses of the RIS with TQ scales, and principal component analyses (PCA in the tinnitus sample were performed. TQ total score was corrected for the TQ sleep items. Results. Prevalence of insomnia was high in tinnitus patients (76% and tinnitus distress correlated with sleep disturbance (r=0.558. TQ sleep subscore correlated with the RIS sum score (r=0.690. PCA with all TQ and RIS items showed one sleep factor consisting of all RIS and the TQ sleep items. PCA with only TQ sleep and RIS items showed sleep- and tinnitus-specific factors. The sleep factors (only RIS items were sleep depth and fearful focusing. The TQ sleep items represented tinnitus-related sleep problems. Discussion. Chronic tinnitus and primary insomnia are highly related and might share similar psychological and neurophysiological mechanisms leading to impaired sleep quality.

  16. Tinnitus

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    Savage, Julian; Cook, Stephanie; Waddell, Angus

    2009-01-01

    Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, or depression.Tinnitus can last for many years, and can interfere with sleep and concentration.

  17. Tinnitus

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    Savage, Julian; Waddell, Angus

    2012-01-01

    Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, or depression.Tinnitus can last for many years, and can interfere with sleep and concentration.

  18. Tinnitus

    OpenAIRE

    Savage, Julian; Waddell, Angus

    2014-01-01

    Up to 18% of people in industrialised societies are mildly affected by chronic tinnitus, and 0.5% report tinnitus having a severe effect on their daily life. Tinnitus can be associated with hearing loss, acoustic neuromas, drug toxicity, ear diseases, or depression.Tinnitus can last for many years, and can interfere with sleep and concentration.

  19. Medium-Level Laser in Chronic Tinnitus Treatment

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    K. Dejakum

    2013-01-01

    Full Text Available The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue scales measuring the perceived loudness of tinnitus, the annoyance associated with tinnitus, and the degree of attention paid to tinnitus as well as psycho-acoustical matches of tinnitus pitch and loudness. The results did show only very moderate temporary improvement of tinnitus. Moreover, no statistically relevant differences between laser and placebo group could be found. We conclude that medium-level laser therapy cannot be regarded as an effective treatment of chronic tinnitus in our therapy regime considering the limited number of patients included in our study.

  20. Abnormal resting-state cortical coupling in chronic tinnitus

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    Langguth Berthold

    2009-02-01

    Full Text Available Abstract Background Subjective tinnitus is characterized by an auditory phantom perception in the absence of any physical sound source. Consequently, in a quiet environment, tinnitus patients differ from control participants because they constantly perceive a sound whereas controls do not. We hypothesized that this difference is expressed by differential activation of distributed cortical networks. Results The analysis was based on a sample of 41 participants: 21 patients with chronic tinnitus and 20 healthy control participants. To investigate the architecture of these networks, we used phase locking analysis in the 1–90 Hz frequency range of a minute of resting-state MEG recording. We found: 1 For tinnitus patients: A significant decrease of inter-areal coupling in the alpha (9–12 Hz band and an increase of inter-areal coupling in the 48–54 Hz gamma frequency range relative to the control group. 2 For both groups: an inverse relationship (r = -.71 of the alpha and gamma network coupling. 3 A discrimination of 83% between the patient and the control group based on the alpha and gamma networks. 4 An effect of manifestation on the distribution of the gamma network: In patients with a tinnitus history of less than 4 years, the left temporal cortex was predominant in the gamma network whereas in patients with tinnitus duration of more than 4 years, the gamma network was more widely distributed including more frontal and parietal regions. Conclusion In the here presented data set we found strong support for an alteration of long-range coupling in tinnitus. Long-range coupling in the alpha frequency band was decreased for tinnitus patients while long-range gamma coupling was increased. These changes discriminate well between tinnitus and control participants. We propose a tinnitus model that integrates this finding in the current knowledge about tinnitus. Furthermore we discuss the impact of this finding to tinnitus therapies using Transcranial

  1. Illness representations as mediators of the relationship between dispositional optimism and depression in patients with chronic tinnitus: A cross-sectional study.

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    Vollmann, Manja; Scharloo, Margreet; Langguth, Berthold; Kalkouskaya, Natallia; Salewski, Christel

    2014-01-01

    Objective: Both dispositional optimism and illness representations are related to psychological health in chronic patients. In a group of chronic tinnitus sufferers, the interplay between these two variables was examined. Specifically, it was tested to what extent the relationship between dispositio

  2. [Interdisciplinary management of chronic tinnitus (II)].

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    Rosanowski, F; Hoppe, U; Köllner, V; Weber, A; Eysholdt, U

    2001-06-01

    Tinnitus is defined as the perception of sound in the absence of any appropriate external stimulation. It is a common, bothersome and hard-to-evaluate symptom and in most cases it cannot be objectified. Its incidence in Germany and the western world is about 10%. About 1-2% of the population are severely disturbed by tinnitus and it may disrupt everyday activities and sleep. Recent theoretical developments favour a neurophysiological approach as an explanation for tinnitus in addition to a psychoacoustic model based on peripheral lesion in the cochlea or auditory nerve. In the neurophysiological model, the processing of the tinnitus signal plays a dominant role in its detection, perception and evaluation. Therefore, attention and other psychological factors become important in the understanding and treatment of tinnitus. Many treatments of chronic tinnitus have been proposed and implemented. Today, cognitive-behavioural treatment is regarded as an important part of an integrative therapy which may be compiled of counselling, relaxation therapy, instrumental (hearing aid, tinnitus masker, tinnitus instrument, tinnitus noiser) and pharmacological tools (lidocaine, neurotransmitters). In well-controlled studies the empirical support for other therapeutical approaches such as acupuncture is weak. This work gives a review of the current knowledge of the etiology, pathogenesis, epidemiology, the interdisciplinary diagnostic approach and treatment of tinnitus and especially focuses on insurance and medico-legal aspects.

  3. Chronic cervicogenic tinnitus rapidly resolved by intermittent use of cervical collar

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    Karl eBechter

    2016-03-01

    Full Text Available Introduction:Cervicogenic tinnitus is a not generally accepted pathogenetic subtype, which might be subsumed under the concept of somatosensory tinnitus. After the personal experience of therapy resistant tinnitus in context with a cervical pain syndrome (CS and successful add-on treatment with cervical collar (CC, the idea was persued in several individual treatments in patients.Patients and Methods:Reporting one particular case with chronic tinnitus considered untreatable, but rapidly improved with CC use. Thereafter tinnitus was experimentally replicated by head inclination, the respective neck-head angles and cerebral blood flow measured. Results:Chronic subjective tinnitus of a 20 years duration completely disappeared within 4 weeks with an intermittent short time application of CC. Thereafter, tinnitus was liberately again induced by head inclination, set on with anterior tilt of 14°, reaching maximum strength by 23°. Tinnitus stopped with return to neutral head position. Blood flow in the vertebral arteries on both sides was unchanged during head inclination with prevalent tinnitus, however blood flow was physiologically reduced with head rotation though not accompanied by tinnitus.Discussion:In a single case of chronic tinnitus, we found that treatment with CC rapidly led to full remission. Nevertheless, tinnitus could be resumed by constrained head postures. Experimental tinnitus replication by inclination points to an underscored role of upper posterior cervical muscle groups, matching with animal experiments, working in concert with other triggers including psychological factors. Blood flow reduction in vertebral arteries was unrelated to tinnitus.

  4. Chronic Tinnitus following Electroconvulsive Therapy

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    Robert L. Folmer

    2011-01-01

    Full Text Available A 43-year-old female with a 27-year history of obsessive-compulsive disorder and major depression had previously been treated with psychotherapy, antidepressant, and antipsychotic medications. Because these treatments were minimally effective and because the frequency and duration of her depressive episodes continued to increase, the patient was scheduled to undergo a series of electroconvulsive therapy (ECT procedures. The patient received four ECT treatments during one month. Stimulating current was delivered to the right frontotemporal region of the head. Electroencephalographic seizures occurred during each of the ECT procedures. After the patient recovered from anesthesia, she complained of headaches, muscle pain, amnesia, and, after the fourth ECT, she reported a ringing sound in her right ear. Audiometric testing the day after the fourth ECT revealed a slight increase in threshold for 8000 Hz tones in her right ear. It is likely that current delivered during the fourth ECT treatment triggered the perception of tinnitus for this patient. The unique organization of this patient's central nervous and auditory systems combined with her particular pharmacological history might have predisposed her to developing tinnitus.

  5. Tinnitus

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    Hoekstra, Carlijn; Venekamp, Roderick; van Zanten, Bert

    2015-01-01

    In this article, a number of common questions about the diagnosis and treatment of tinnitus are discussed, based on the first author’s PhD thesis. It is hoped that this will help general practitioners when deciding whether to refer a patient with tinnitus to an otorhinolaryngologist or an audiologic

  6. [Illness behavior and depression in tinnitus patients].

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    Schönweiler, R; Neuschulte, C; Paar, G H

    1989-05-01

    Tinnitus patients often complain of psychosomatic disorders and of problems in social life. We intended to prove the modulation of tinnitus perception by psychosocial factors. We examined 48 tinnitus patients, 35 with and 13 without hearing loss. A control group of 48 patients without tinnitus, without hearing disorder and without tumor disease was adapted to correspond to the tinnitus group in respect of age, sex and social factors. A quantitative assessment of complaints as well as of the intensity of depression was made via questionaires (Giessener Beschwerdebogen and Beck Depression Inventory). In tinnitus patients, we found a statistically significantly higher degree of complaints even for non-otological symptoms. They were statistically more depressive than the controls, but less than patients with endogenic depression usually are. Nevertheless, in tinnitus patients it seems to be reasonable to inquire after general symptoms of illness to assess whether cooperation with a psychiatrist is required before initiating somatic treatment.

  7. Validation of Screening Questions for Hyperacusis in Chronic Tinnitus

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    Martin Schecklmann

    2015-01-01

    Full Text Available Background. We investigated the validity of the two hyperacusis items of the TSCHQ (Tinnitus Sample Case History Questionnaire from the TRI (Tinnitus Research Initiative database by comparing them with the German hyperacusis questionnaire GÜF. Methods. We investigated the association of the GÜF with the TSCHQ screening questions for both the sum score and the single items with correlation, contrast, principal component, and discriminant analysis in a sample of 161 patients with chronic tinnitus. Results. TSCHQ items and the GÜF total score were significantly associated with a special focus on fear and pain related hyperacusis. Factor analysis of the GÜF revealed the three factors “fear and pain related hyperacusis,” “hearing related problems,” and “problems in quality of life.” A discriminant analysis showed a sensitivity of 64% and a specificity of 71% of the TSCHQ items for the establishment of tinnitus patient subgroups with and without hyperacusis. Discussion. Both hyperacusis TSCHQ items can serve as screening questions with respect to self-reported hyperacusis in chronic tinnitus with a specific focus on fear and pain related hyperacusis. However, the multiple dimensions of hyperacusis should be considered for diagnosis and treatment in both scientific and clinical contexts.

  8. Brainstem auditory evoked response characteristics in normal-hearing subjects with chronic tinnitus and in non-tinnitus group

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    Shadman Nemati

    2014-06-01

    Full Text Available Background and Aim: While most of the people with tinnitus have some degrees of hearing impairment, a small percent of patients admitted to ear, nose and throat clinics or hearing evaluation centers are those who complain of tinnitus despite having normal hearing thresholds. This study was performed to better understanding of the reasons of probable causes of tinnitus and to investigate possible changes in the auditory brainstem function in normal-hearing patients with chronic tinnitus.Methods: In this comparative cross-sectional, descriptive and analytic study, 52 ears (26 with and 26 without tinnitus were examined. Components of the auditory brainstem response (ABR including wave latencies and wave amplitudes were determined in the two groups and analyzed using appropriate statistical methods.Results: The mean differences between the absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that was not statistically significant. Also, the interpeak latency values of waves I-III, III-V and I-V in both groups had no significant difference. Only, the V/I amplitude ratio in the tinnitus group was significantly higher (p=0.04.Conclusion: The changes observed in amplitude of waves, especially in the latter ones, can be considered as an indication of plastic changes in neuronal activity and its possible role in generation of tinnitus in normal-hearing patients.

  9. Effectiveness of sound therapy in patients with tinnitus resistant to previous treatments: importance of adjustments

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    Flavia Alencar de Barros Suzuki

    Full Text Available ABSTRACT INTRODUCTION: The difficulty in choosing the appropriate therapy for chronic tinnitus relates to the variable impact on the quality of life of affected patients and, thus, requires individualization of treatment. OBJECTIVE: To evaluate the effectiveness of using sound generators with individual adjustments to relieve tinnitus in patients unresponsive to previous treatments. METHODS: A prospective study of 10 patients with chronic tinnitus who were unresponsive to previous drug treatments, five males and five females, with ages ranging from 41 to 78 years. Bilateral sound generators (Reach 62 or Mind 9 models were used daily for at least 6 h during 18 months. The patients were evaluated at the beginning, after 1 month and at each 3 months until 18 months through acuphenometry, minimum masking level, the Tinnitus Handicap Inventory, visual analog scale, and the Hospital Anxiety and Depression Scale. The sound generators were adjusted at each visit. RESULTS: There was a reduction of Tinnitus Handicap Inventory in nine patients using a protocol with a customized approach, independent of psychoacoustic characteristics of tinnitus. The best response to treatment occurred in those with whistle-type tinnitus. A correlation among the adjustments and tinnitus loudness and minimum masking level was found. Only one patient, who had indication of depression by Hospital Anxiety and Depression Scale, did not respond to sound therapy. CONCLUSION: There was improvement in quality of life (Tinnitus Handicap Inventory, with good response to sound therapy using customized settings in patients who did not respond to previous treatments for tinnitus.

  10. Spontaneous Otoacoustic Emissions in Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    SHI Yongbing; William Martin

    2006-01-01

    Otoacoustic emissions (OAEs) are believed to be the products of active cochlear mechanics. They are generally associated with relatively intact outer hair cell function. OAEs usually decrease or become undetectable when hearing loss of cochlear origin exceeds 40-50 dB HL. Subjective tinnitus is a perception of sound without detectable corresponding source. It is most often seen in patients with hearing loss. It is also frequently seen in patients with head injuries. Studies have suggested that the prevalence of spontaneous otoacoustic emissions(SOAEs) is lower in patients with hearing loss and tinnitus than in normal population. There have also been reports on association between tinnitus and SOAEs of unusually high amplitudes, which can be controlled by aspirin administration. The current paper is a preliminary review of clinical data collected from a group oftinnitus patients in an attempt to elucidate on the relationship between SOAEs and tinnitus from a clinical point of view. Audiometric, tinnitus and SOAE data from 59 patients seen at the Oregon Health & Science University Tinnitus Clinic were retrospectively studied. Fifty-four of these 59 patients showed sensorineural hearing loss of various degrees at the time of evaluation, mostly affecting high frequencies. SOAEs were detected in 26 ears (22%) of 1 8 patients(30.5%). There was no difference in SOAE prevalence between male and female patients. SOAEs were recorded in four of the five patients whose pure tone thresholds were within normal limits up to 8000 Hz. SOAEs appeared to be recorded at a higher rate in patients whose tinnitus started following motor vehicle accidents or head injuries(5/10) than in other patients.Time course of tinnitus did not appear to affect SOAE detection rate. There were no correlations between SOAE frequency and matched tinnitus pitch or frequency of maximum hearing loss. Significance of these findings is discussed.

  11. Tinnitus

    Science.gov (United States)

    ... tinnitus treatment are frequently advertised on the internet, television and radio. There is no evidence that any ... disturbance of tinnitus. If tinnitus is interfering with sleep, you should inform your doctor. Can children be ...

  12. Tinnitus

    Science.gov (United States)

    ... in the ears; Ear buzzing; Otitis media - tinnitus; Aneurysm - tinnitus; Ear infection - tinnitus; Meniere disease - ... MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. ...

  13. Tinnitus

    Science.gov (United States)

    Tinnitus is often described as a ringing in the ears. It also can sound like roaring, clicking, ... one or both ears. Millions of Americans have tinnitus. People with severe tinnitus may have trouble hearing, ...

  14. Real-time fMRI feedback training may improve chronic tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    Haller, Sven [University Hospital Basel, Institute of Radiology, Department of Neuroradiology, Basel (Switzerland); Department of Imaging and Medical Informatics, Geneva University Hospital, Institute of Neuroradiology, Geneva (Switzerland); Birbaumer, Niels [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany); Instituto di Ricovero e Cura a Carattere Scientifico, Ospedale San Camillo, Venezia (Italy); Veit, Ralf [University of Tuebingen, Institute of Medical Psychology and Behavioral Neurobiology, Tuebingen (Germany)

    2010-03-15

    Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms. Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation. Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants. These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results. (orig.)

  15. Frequency-Specific Alternations in the Amplitude of Low-Frequency Fluctuations in Chronic Tinnitus

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    Yu-Chen eChen

    2015-10-01

    Full Text Available Tinnitus, a phantom ringing, buzzing or hissing sensation with potentially debilitating consequences, is thought to arise from aberrant spontaneous neural activity at one or more sites within the central nervous system; however, the location and specific features of these oscillations are poorly understood with respect to specific tinnitus features. Recent resting-state functional magnetic resonance imaging (fMRI studies suggest that aberrant fluctuations in spontaneous low-frequency oscillations (LFO of the blood oxygen level-dependent (BOLD signal may be an important factor in chronic tinnitus; however, the role that frequency-specific components of LFO play in subjective tinnitus remains unclear. A total of 39 chronic tinnitus patients and 41 well-matched healthy controls participated in the resting-state fMRI scans. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF and fractional ALFF (fALFF in two different frequency bands (slow-4: 0.027-0.073 Hz and slow-5: 0.01-0.027 Hz. We observed significant differences between tinnitus patients and normal controls in ALFF/fALFF in the two bands (slow-4 and slow-5 in several brain regions including the superior frontal gyrus (SFG, inferior frontal gyrus, middle temporal gyrus, angular gyrus, supramarginal gyrus, and middle occipital gyrus. Across the entire subject pool, significant differences in ALFF/fALFF between the two bands were found in the midbrain, basal ganglia, hippocampus and cerebellum (Slow 4>Slow 5, and in the middle frontal gyrus, supramarginal gyrus, posterior cingulate cortex, and precuneus (Slow 5>Slow 4. We also observed significant interaction between frequency bands and patient groups in the orbitofrontal gyrus. Furthermore, tinnitus distress was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-4 band in left SFG, whereas tinnitus duration was positively correlated with the magnitude of ALFF in

  16. Frequency-specific alternations in the amplitude of low-frequency fluctuations in chronic tinnitus.

    Science.gov (United States)

    Chen, Yu-Chen; Xia, Wenqing; Luo, Bin; Muthaiah, Vijaya P K; Xiong, Zhenyu; Zhang, Jian; Wang, Jian; Salvi, Richard; Teng, Gao-Jun

    2015-01-01

    Tinnitus, a phantom ringing, buzzing, or hissing sensation with potentially debilitating consequences, is thought to arise from aberrant spontaneous neural activity at one or more sites within the central nervous system; however, the location and specific features of these oscillations are poorly understood with respect to specific tinnitus features. Recent resting-state functional magnetic resonance imaging (fMRI) studies suggest that aberrant fluctuations in spontaneous low-frequency oscillations (LFO) of the blood oxygen level-dependent (BOLD) signal may be an important factor in chronic tinnitus; however, the role that frequency-specific components of LFO play in subjective tinnitus remains unclear. A total of 39 chronic tinnitus patients and 41 well-matched healthy controls participated in the resting-state fMRI scans. The LFO amplitudes were investigated using the amplitude of low-frequency fluctuation (ALFF) and fractional ALFF (fALFF) in two different frequency bands (slow-4: 0.027-0.073 Hz and slow-5: 0.01-0.027 Hz). We observed significant differences between tinnitus patients and normal controls in ALFF/fALFF in the two bands (slow-4 and slow-5) in several brain regions including the superior frontal gyrus (SFG), inferior frontal gyrus, middle temporal gyrus, angular gyrus, supramarginal gyrus, and middle occipital gyrus. Across the entire subject pool, significant differences in ALFF/fALFF between the two bands were found in the midbrain, basal ganglia, hippocampus and cerebellum (Slow 4 > Slow 5), and in the middle frontal gyrus, supramarginal gyrus, posterior cingulate cortex, and precuneus (Slow 5 > Slow 4). We also observed significant interaction between frequency bands and patient groups in the orbitofrontal gyrus. Furthermore, tinnitus distress was positively correlated with the magnitude of ALFF in right SFG and the magnitude of fALFF slow-4 band in left SFG, whereas tinnitus duration was positively correlated with the magnitude of ALFF in right

  17. State- and trait-related alterations of motor cortex excitability in tinnitus patients.

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    Martin Schecklmann

    Full Text Available Chronic tinnitus is a brain network disorder with involvement of auditory and non-auditory areas. Repetitive transcranial magnetic stimulation (rTMS over the temporal cortex has been investigated for the treatment of tinnitus. Several small studies suggest that motor cortex excitability is altered in people with tinnitus. We retrospectively analysed data from 231 patients with chronic tinnitus and 120 healthy controls by pooling data from different studies. Variables of interest were resting motor threshold (RMT, short-interval intra-cortical inhibition (SICI, intra-cortical facilitation (ICF, and cortical silent period (CSP. 118 patients were tested twice - before and after ten rTMS treatment sessions over the left temporal cortex. In tinnitus patients SICI and ICF were increased and CSP was shortened as compared to healthy controls. There was no group difference in RMT. Treatment related amelioration of tinnitus symptoms were correlated with normalisations in SICI. These findings confirm earlier studies of abnormal motor cortex excitability in tinnitus patients. Moreover our longitudinal data suggest that altered SICI may reflect a state parameter, whereas CSP and ICF may rather mirror a trait-like predisposing factor of tinnitus. These findings are new and innovative as they enlarge the knowledge about basic physiologic and neuroplastic processes in tinnitus.

  18. Management of tinnitus in patients with presbycusis.

    Science.gov (United States)

    Zagólski, Olaf

    2006-01-01

    Sensorineural hearing loss in elderly patients (presbycusis) relatively often coexists with annoying tinnitus (termed presbytinnitus [PT] by Claussen). The purpose of this study was to verify the conditions of improvement in patients treated for PT. We fitted with hearing aids 33 PT patients (ages 60-89 years) and questioned them about subjective hearing results. Assessment tools included comprehensive audiology and a subjective self-assessment survey of tinnitus characteristics. All patients had very good tolerance of the hearing aids; 28 reported that they had considerable reduction in PT intensity. Fitting PT patients with hearing aids is usually effective. In patients with unilateral sensorineural hearing loss and tinnitus, fitting the impaired ear is sufficient. Individuals with bilateral complaints require bilateral fitting. Effectiveness of fitting in the affected group of patients depended on speech discrimination scores before fitting. The improvement scores were higher in patients with more aggravated symptoms and did not depend on history of prolonged exposure to excessive noise.

  19. Investigation of Tinnitus Patients in Italy: Clinical and Audiological Characteristics

    Directory of Open Access Journals (Sweden)

    Francesco Martines

    2010-01-01

    Full Text Available Objective. 312 tinnitus sufferers were studied in order to analyze: the clinical characteristics of tinnitus; the presence of tinnitus-age correlation and tinnitus-hearing loss correlation; the impact of tinnitus on subjects' life and where possible the etiological/predisposing factors of tinnitus. Results. There is a slight predominance of males. The highest percentage of tinnitus results in the decades 61–70. Of the tinnitus sufferers, 197 (63.14% have a hearing deficit (light hearing loss in 37.18% of cases. The hearing impairment results of sensorineural type in 74.62% and limited to the high frequencies in 58.50%. The tinnitus is referred as unilateral in 59.93%, a pure tone in 66.99% and 10 dB above the hearing threshold in 37.7%. It is limited to high frequencies in 72.10% of the patients with sensorineural hearing loss (SNHL while the 88.37% of the patients with high-frequency SNHL have a high-pitched tinnitus (2=66.26;<.005. Conclusion. Hearing status and age represent the principal tinnitus related factors; there is a statistically significant association between high-pitched tinnitus and high-frequency SNHL. There is no significant correlation between tinnitus severity and tinnitus loudness confirming the possibility that neural connection involved in evoking tinnitus-related negative reactions are governed by conditioned reflexes.

  20. Obsessive-compulsiveness in a population of tinnitus patients.

    Science.gov (United States)

    Folmer, Robert L; Griest, Susan E; Martin, William Hal

    2008-01-01

    The purpose of this study was to use the Maudsley Obsessional-Compulsive Inventory (MOCI) to assess obsessive-compulsiveness in a population of 196 tinnitus patients and to correlate MOCI scores with measures of anxiety, depression, and tinnitus severity. Tinnitus severity was positively correlated with measures of anxiety and depression. Depression was positively correlated with MOCI and anxiety scores. MOCI scores exhibited weaker positive correlations with tinnitus severity and anxiety. Effective management of tinnitus requires identification of psychological disorders or symptoms when they are present so that patients can receive appropriate treatment as soon as possible. The MOCI can be used to assess obsessive-compulsiveness in tinnitus patients.

  1. Evaluation of Anxiety and Depressive Levels in Tinnitus Patients

    OpenAIRE

    Cho, Chang Gun; Chi, Jun Hyuk; Song, Jae-Jun; Lee, Eun Kyeong; Kim, Bo Hae

    2013-01-01

    Background and Objectives The aims of this study were to evaluate the relationship between tinnitus and the level of anxiety and depression experienced by subjective tinnitus patients, and to determine the effect of the level of anxiety and depression to the results of tinnitus treatment. Subjects and Methods A total of 104 patients were included in this study. All the patients conducted Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), State Trait Anxiety Inventory 1, 2 (ST...

  2. Relationship between Audiometric slope and tinnitus pitch in tinnitus patients: insights into the mechanisms of tinnitus generation.

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    Martin Schecklmann

    Full Text Available BACKGROUND: Different mechanisms have been proposed to be involved in tinnitus generation, among them reduced lateral inhibition and homeostatic plasticity. On a perceptual level these different mechanisms should be reflected by the relationship between the individual audiometric slope and the perceived tinnitus pitch. Whereas some studies found the tinnitus pitch corresponding to the maximum hearing loss, others stressed the relevance of the edge frequency. This study investigates the relationship between tinnitus pitch and audiometric slope in a large sample. METHODOLOGY: This retrospective observational study analyzed 286 patients. The matched tinnitus pitch was compared to the frequency of maximum hearing loss and the edge of the audiogram (steepest hearing loss by t-tests and correlation coefficients. These analyses were performed for the whole group and for sub-groups (uni- vs. bilateral (117 vs. 338 ears, pure-tone vs. narrow-band (340 vs. 115 ears, and low and high audiometric slope (114 vs. 113 ears. FINDINGS: For the right ear, tinnitus pitch was in the same range and correlated significantly with the frequency of maximum hearing loss, but differed from and did not correlate with the edge frequency. For the left ear, similar results were found but the correlation between tinnitus pitch and maximum hearing loss did not reach significance. Sub-group analyses (bi- and unilateral, tinnitus character, slope steepness revealed identical results except for the sub-group with high audiometric slope which revealed a higher frequency of maximum hearing loss as compared to the tinnitus pitch. CONCLUSION: The study-results confirm a relationship between tinnitus pitch and maximum hearing loss but not to the edge frequency, suggesting that tinnitus is rather a fill-in-phenomenon resulting from homeostatic mechanisms, than the result of deficient lateral inhibition. Sub-group analyses suggest that audiometric steepness and the side of affected ear

  3. Cortico-limbic morphology separates tinnitus from tinnitus distress

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    Amber M Leaver

    2012-04-01

    Full Text Available Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing in the ear. Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with tinnitus. It remains unclear, however, whether these non-auditory anatomical markers of tinnitus are related to the tinnitus signal itself, or merely to negative emotional reactions to tinnitus (i.e., tinnitus distress. In the current study, we used anatomical MRI to identify neural markers of tinnitus, and measured their relationship to a variety of tinnitus characteristics and other factors often linked to tinnitus, such as hearing loss, depression, anxiety, and noise sensitivity. In a new cohort of participants, we confirmed that people with chronic tinnitus exhibit reduced grey matter in ventromedial prefrontal cortex (vmPFC compared to controls matched for age and hearing loss. This effect was driven by reduced cortical surface area, and was not related to tinnitus distress, symptoms of depression or anxiety, noise sensitivity, or other factors. Instead, tinnitus distress was positively correlated with cortical thickness in the anterior insula in tinnitus patients, while symptoms of anxiety and depression were negatively correlated with cortical thickness in subcallosal anterior cingulate cortex (scACC across all groups. Tinnitus patients also exhibited increased gyrification of dorsomedial prefrontal cortex (dmPFC, which was more severe in those patients with constant (vs. intermittent tinnitus. Our data suggest that the neural systems associated with chronic tinnitus are different from those involved in aversive or distressed reactions to tinnitus.

  4. Investigation of Tinnitus Characteristics in 36 Patients with Subjective Tinnitus with Unknown Etiology

    Directory of Open Access Journals (Sweden)

    Mahdi Bakhshaee

    2006-06-01

    Full Text Available Background and Aim: Tinnitus represents the perception of sound without an external stimulus. The prevalence of tinnitus ranges from 3% to 30%. In most cases its etiology is unknown. Tinnitus can be classified as pulsatile or nonpulsatile. Nonpulsatile form is the most common form and almost exclusively subjective in nature. There is a range of condition attributed to nonpulsatile high frequency tinnitus (acoustic neuroma, Meniere’s disease, ototoxic agents, and noise exposure, etc. There are many studies about form, site, loudness, and frequency of tinnitus and how it can affect the quality of patient life. Materials and methods: This was a descriptive and analytic study. Thirty-six patients (23 men and 13 women with mean age 53.1 year old with subjective tinnitus evaluated in Pezhvak audiometric clinic in Mashhad.The data consisting of age sex, loudness, frequency form and site of tinnitus. Evaluation of effects of tinnitus on the quality of life and habits was performed with a tinnitus questionnaire (TQ. Results: Tinnitus was unilateral in 64% of cases. The right site was more common. Mean pitch was 7.03 kHz and average loudness was 3.8 dB SPL. SDS was in normal range in all of patients. There was a high frequency sensory neural hearing loss (above the 4 kHz in most of the patients. The greatest score (60.3% of TQ related to intrusiveness aspect. Sleep disorder has the lowest score (39/3%. Global score was 52.4%. Conclusion: Nonpulsatile subjective tinnitus has a broad range of etiology with unknown mechanism in most cases and without any history of underlying disease in a large group of patients. This symptom mostly involves the patients` lifestyle that is intrusiveness aspect in comparison with the other aspects including sleep, hearing and somatic complaints. There is no cure for most patient and more studies are needed in the future.

  5. 声治疗结合心理咨询治疗慢性耳鸣%A Clinical Study of Sound Therapy and Psychological Counseling for Chronic Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    许轶; 王铭歆; 任飞; 周慧芳

    2015-01-01

    目的:分析声治疗结合心理咨询对慢性耳鸣的疗效。方法通过声治疗结合心理咨询治疗232例慢性耳鸣患者,其中,重度耳鸣178例(76.72%,178/232),轻度耳鸣54例(29.28%,54/232),疗程为12个月,于治疗前、治疗3、6、12个月后分别填写耳鸣评价量表,评估治疗效果。结果治疗后患者耳鸣症状明显改善,疗程结束后重度耳鸣患者为36例(15.52%,36/232),较治疗前的例数明显减少(P <0.01);治疗6个月后,总有效率为79.31%(184/232),治疗12个月后总有效率为86.21%(200/232)。结论声治疗结合心理咨询是治疗慢性耳鸣的有效方法,疗效稳定持久。%Objective To investigate the clinical effects of sound therapy and psychological counseling on chronic tinnitus .Methods Two hundred and thirty - two cases of chronic tinnitus patients were treated with sound therapy and psychological counseling in this study .The time course of treatment was 12 months .Tinnitus Evalua‐tion Questionnaire(TEQ) was filled out before sound therapy ,3 ,6 and 12 months after the therapy to evaluate the effects .Results After the therapy ,the patients had a significant improvement in tinnitus symptoms .Before the therapy ,178 patients had severe tinnitus ,while after the therapy ,this number decreased obviously .In the end of treatment there were only 36 cases ,with severe tinnitus(15 .52% ) .After the 6 months treatment ,the effective rate was 79 .31% ,after 12 months the effective rate was 86 .21% .Conclusion Sound therapy and psychological counse‐ling are effective treatments for chronic tinnitus ,and the effects are stable and durable .

  6. Neuroanatomical abnormalities in chronic tinnitus in the human brain

    Science.gov (United States)

    Adjamian, Peyman; Hall, Deborah A.; Palmer, Alan R.; Allan, Thomas W.; Langers, Dave R.M.

    2014-01-01

    In this paper, we review studies that have investigated brain morphology in chronic tinnitus in order to better understand the underlying pathophysiology of the disorder. Current consensus is that tinnitus is a disorder involving a distributed network of peripheral and central pathways in the nervous system. However, the precise mechanism remains elusive and it is unclear which structures are involved. Given that brain structure and function are highly related, identification of anatomical differences may shed light upon the mechanism of tinnitus generation and maintenance. We discuss anatomical changes in the auditory cortex, the limbic system, and prefrontal cortex, among others. Specifically, we discuss the gating mechanism of tinnitus and evaluate the evidence in support of the model from studies of brain anatomy. Although individual studies claim significant effects related to tinnitus, outcomes are divergent and even contradictory across studies. Moreover, results are often confounded by the presence of hearing loss. We conclude that, at present, the overall evidence for structural abnormalities specifically related to tinnitus is poor. As this area of research is expanding, we identify some key considerations for research design and propose strategies for future research. PMID:24892904

  7. Neuronal correlates of maladaptive coping: an EEG-study in tinnitus patients.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available Here we aimed to investigate the neuronal correlates of different coping styles in patients suffering from chronic tinnitus. Adaptive and maladaptive coping styles were determined in 85 tinnitus patients. Based on resting state EEG recordings, coping related differences in brain activity and connectivity were found. Maladaptive coping behavior was related to increases in subjective tinnitus loudness and distress, higher tinnitus severity and higher depression scores. EEG recordings demonstrated increased alpha activity over the left dorsolateral prefrontal cortex (DLPFC and subgenual anterior cingulate cortex (sgACC as well as increased connectivity in the default (i.e. resting state network in tinnitus patients with a maladaptive coping style. Correlation analysis revealed that the changes in the DLPFC correlate primarily with maladaptive coping behavior, whereas the changes in the sgACC correlate with tinnitus severity and depression. Our findings are in line with previous research in the field of depression that during resting state a alpha band hyperconnectivity exists within the default network for patients who use a maladaptive coping style, with the sgACC as the dysfunctional node and that the strength of the connectivity is related to focusing on negative mood and catastrophizing about the consequences of tinnitus.

  8. Neuronal correlates of maladaptive coping: an EEG-study in tinnitus patients.

    Science.gov (United States)

    Vanneste, Sven; Joos, Kathleen; Langguth, Berthold; To, Wing Ting; De Ridder, Dirk

    2014-01-01

    Here we aimed to investigate the neuronal correlates of different coping styles in patients suffering from chronic tinnitus. Adaptive and maladaptive coping styles were determined in 85 tinnitus patients. Based on resting state EEG recordings, coping related differences in brain activity and connectivity were found. Maladaptive coping behavior was related to increases in subjective tinnitus loudness and distress, higher tinnitus severity and higher depression scores. EEG recordings demonstrated increased alpha activity over the left dorsolateral prefrontal cortex (DLPFC) and subgenual anterior cingulate cortex (sgACC) as well as increased connectivity in the default (i.e. resting state) network in tinnitus patients with a maladaptive coping style. Correlation analysis revealed that the changes in the DLPFC correlate primarily with maladaptive coping behavior, whereas the changes in the sgACC correlate with tinnitus severity and depression. Our findings are in line with previous research in the field of depression that during resting state a alpha band hyperconnectivity exists within the default network for patients who use a maladaptive coping style, with the sgACC as the dysfunctional node and that the strength of the connectivity is related to focusing on negative mood and catastrophizing about the consequences of tinnitus.

  9. Tinnitus

    Science.gov (United States)

    ... circuits involved in tinnitus. Repetitive transcranial magnetic stimulation (rTMS). This technique, which uses a small device placed ... brains of people with epilepsy. Preliminary trials of rTMS in humans, funded by the NIDCD, are helping ...

  10. Learning tinnitus

    Science.gov (United States)

    van Hemmen, J. Leo

    Tinnitus, implying the perception of sound without the presence of any acoustical stimulus, is a chronic and serious problem for about 2% of the human population. In many cases, tinnitus is a pitch-like sensation associated with a hearing loss that confines the tinnitus frequency to an interval of the tonotopic axis. Even in patients with a normal audiogram the presence of tinnitus may be associated with damage of hair-cell function in this interval. It has been suggested that homeostatic regulation and, hence, increase of activity leads to the emergence of tinnitus. For patients with hearing loss, we present spike-timing-dependent Hebbian plasticity (STDP) in conjunction with homeostasis as a mechanism for ``learning'' tinnitus in a realistic neuronal network with tonotopically arranged synaptic excitation and inhibition. In so doing we use both dynamical scaling of the synaptic strengths and altering the resting potential of the cells. The corresponding simulations are robust to parameter changes. Understanding the mechanisms of tinnitus induction, such as here, may help improving therapy. Work done in collaboration with Julie Goulet and Michael Schneider. JLvH has been supported partially by BCCN - Munich.

  11. Individual Patient Factors Associated with Effective Tinnitus Treatment

    Science.gov (United States)

    Theodoroff, Sarah M.; Schuette, Andrew; Griest, Susan; Henry, James A.

    2017-01-01

    Background Little is known about patient factors that might influence outcomes of tinnitus interventions. Determining such factors would offer insights into why some individuals benefit from tinnitus intervention whereas others do not. Purpose The purpose of this study was to evaluate selected patient factors that may be associated with outcomes of tinnitus intervention. Factors studied include demographics, tinnitus characteristics, psychoacoustic tinnitus measures, audiometric data, and overall physical/emotional health status. Research Design A retrospective analysis was performed on data obtained from a controlled clinical study that compared factors associated with tinnitus relief after tinnitus masking and tinnitus retraining therapy. Study Sample A total of 126 military veterans participated in this controlled clinical study. Of these, 89 completed outcome measures at both baseline and 12 mo and were included in the present analysis. Data Collection and Analysis A “responder” to intervention was identified as having a decrease (improvement) of 20 or more points on the Tinnitus Handicap Inventory between baseline and 12 mo. A “nonresponder” did not achieve a 20-point improvement on the Tinnitus Handicap Inventory. Individual patient factors were examined using independent t-tests or χ2 analysis. A logistic regression model was used to determine how well each factor predicted treatment outcome (responder or nonresponder) while controlling for each of the other factors. Results Five patient factors were significantly different (p ≤ 0.05) between responders and nonresponders. Responders tended to (1) be younger in age; (2) have better low-frequency hearing sensitivity; (3) have greater problems with overall hearing; (4) be more likely to have tinnitus for shorter durations; and (5) perceive their tinnitus to be located “in the head” versus “in the ears.” A logistic regression was then performed to determine how well each factor predicted the

  12. Cognitive mechanisms in chronic tinnitus: Psychological markers of a failure to switch attention

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    Krysta Jannaya Trevis

    2016-08-01

    Full Text Available The cognitive mechanisms underpinning chronic tinnitus (phantom auditory perceptions are underexplored but may reflect a failure to switch attention away from a tinnitus sound. Here, we investigated a range of components that influence the ability to switch attention, including cognitive control, inhibition, working memory and mood, on the presence and severity of chronic tinnitus. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional wellbeing, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional wellbeing whereas complaints in healthy participants correlated with objective cognitive functioning. Combined, cognitive control and depressive symptoms correctly classified 67% of participants. These results demonstrate the core role of cognition in chronic tinnitus. They also provide the foundations for a neurocognitive account of the maintenance of tinnitus, involving impaired interactions between the neurocognitive networks underpinning attention-switching and mood.

  13. Personality Traits in Patients with Subjective Idiopathic Tinnitus

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    Mahboobeh Adami Dehkordi

    2015-09-01

    Full Text Available Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group.   Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex. A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software.   Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001 and extraversion (P=0.001 between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism.   Conclusion:  Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.

  14. Tinnitus: patients do not have to 'just live with it'.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A; Bea, Scott M; Cherian, Kay; Cherian, Neil; Kahn, Karyn M; Kaltenbach, James

    2011-05-01

    Tinnitus is distressing and affects the quality of life for many patients. Because primary care physicians may be the entry point for patients seeking help for tinnitus, we urge them to acknowledge this symptom and its potential negative impact on the patient's health and quality of life. Physicians should actively listen to the patient and provide hope and encouragement, but also provide realistic expectations about the course of treatment. The patient must also understand that there may be no singular "cure" for tinnitus and that management may involve multidisciplinary assessment and treatment.

  15. Cortical activity in tinnitus patients and its modification by phonostimulation

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    Katarzyna Pawlak-Osińska

    2013-04-01

    Full Text Available OBJECTIVE: The goal of this study was to observe spontaneous cortical activity and cortical activity modulated by tinnitus-matched sound in tinnitus patients and healthy subjects with no otoneurologic symptoms. METHOD: Data were prospectively collected from 50 tinnitus patients and 25 healthy subjects. Cortical activity was recorded in all subjects with eyes closed and open and during photostimulation, hyperventilation and acoustic stimulation using 19-channel quantitative electroencephalography. The sound applied in the tinnitus patients was individually matched with the ability to mask or equal the tinnitus. The maximal and mean amplitude of the delta, theta, alpha and beta waves and the type and amount of the pathologic EEG patterns were noted during each recording. Differences in cortical localization and the influence of sound stimuli on spontaneous cortical activity were evaluated between the groups. RESULTS: The tinnitus group exhibited decreased delta activity and increased alpha and beta activity. Hyperventilation increased the intensity of the differences. The tinnitus patients had more sharp-slow waves and increased slow wave amplitude. Sound stimuli modified the EEG recordings; the delta and beta wave amplitudes were increased, whereas the alpha-1 wave amplitude was decreased. Acoustic stimulation only slightly affected the temporal region. CONCLUSION: Cortical activity in the tinnitus patients clearly differed from that in healthy subjects, i.e., tinnitus is not a “phantom” sign. The changes in cortical activity included decreased delta wave amplitudes, increased alpha-1, beta-1 and beta-h wave amplitudes and pathologic patterns. Cortical activity modifications occurred predominantly in the temporal region. Acoustic stimulation affected spontaneous cortical activity only in tinnitus patients, and although the applied sound was individually matched, the pathologic changes were only slightly improved.

  16. SUPPRESSION OF TINNITUS IN PATIENTS UNDERGOING COCHLEAR IMPLANTATION

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    M. T. Khorsandi

    1999-07-01

    Full Text Available 7 'innitus is a frequent complaint in patients with sensorineural deafness. Different reports suggest that electrical stimulation caused by cochlear implant devices "upn"ises tinnitus to a considerable degree. In a longitudinal -.mdv we have evaluated the severity and duration of tinnitus in both ears of J 7 cochlear implant patients before and after operation. Severity of tinnitus was reduced in both implanted and not implanted ears after the implantation (P=0.003 and p - 0.00-1 respectively. Duration of tinnitus, however, was not affected significantly. No significant difference in tinnitus suppression was observed between the implanted and not implanted ears. This might be attributed to both the electrical stimulation caused by the device and the psychogenic stability provided by return to the world of sound.

  17. Evaluation of Depression and Anxiety in patients with tinnitus

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    S.A.A. Hosseininasab, M.D

    2008-01-01

    Full Text Available AbstractBackground and Purpose: Tinnitus is a troublesome disease that may cause several problems, including the following: insomnia decreased concentration and diminished quality of life. This study was designed in order to evaluate depression and anxiety in patients with tinnitus.Materials and Methods: This study was an experimental survey and carried out with case – control method. There were 50 persons in case and control groups, case group included patients with non-organic tinnitus. The patients in case and control group completed Beck and Spiel Berger questionnaire, in order to evaluate their level of depression and anxiety.Results: Age, sex, marital status and smoking of case and control groups were similar. Case groups included 50 patients in which 20 of those were smokers and their level of depression and anxiety were higher than non smokers and this difference was significant (P=0.03. Level of depression in patients with tinnitus was higher than control group (p=0.03, patients with tinnitus experienced more anxiety than control group.Conclusion: The patients with tinnitus suffered more depression and anxiety in comparison to patients without tinnitus.

  18. Acceptance of tinnitus: validation of the tinnitus acceptance questionnaire.

    Science.gov (United States)

    Weise, Cornelia; Kleinstäuber, Maria; Hesser, Hugo; Westin, Vendela Zetterqvist; Andersson, Gerhard

    2013-01-01

    The concept of acceptance has recently received growing attention within tinnitus research due to the fact that tinnitus acceptance is one of the major targets of psychotherapeutic treatments. Accordingly, acceptance-based treatments will most likely be increasingly offered to tinnitus patients and assessments of acceptance-related behaviours will thus be needed. The current study investigated the factorial structure of the Tinnitus Acceptance Questionnaire (TAQ) and the role of tinnitus acceptance as mediating link between sound perception (i.e. subjective loudness of tinnitus) and tinnitus distress. In total, 424 patients with chronic tinnitus completed the TAQ and validated measures of tinnitus distress, anxiety, and depression online. Confirmatory factor analysis provided support to a good fit of the data to the hypothesised bifactor model (root-mean-square-error of approximation = .065; Comparative Fit Index = .974; Tucker-Lewis Index = .958; standardised root mean square residual = .032). In addition, mediation analysis, using a non-parametric joint coefficient approach, revealed that tinnitus-specific acceptance partially mediated the relation between subjective tinnitus loudness and tinnitus distress (path ab = 5.96; 95% CI: 4.49, 7.69). In a multiple mediator model, tinnitus acceptance had a significantly stronger indirect effect than anxiety. The results confirm the factorial structure of the TAQ and suggest the importance of a general acceptance factor that contributes important unique variance beyond that of the first-order factors activity engagement and tinnitus suppression. Tinnitus acceptance as measured with the TAQ is proposed to be a key construct in tinnitus research and should be further implemented into treatment concepts to reduce tinnitus distress.

  19. Increased mean platelet volume in patients with idiopathic subjective tinnitus.

    Science.gov (United States)

    Sarıkaya, Yasin; Bayraktar, Cem; Karataş, Mehmet; Doğan, Sedat; Olt, Serdar; Kaskalan, Emin; Türkbeyler, İbrahim Halil

    2016-11-01

    Tinnitus is the perception of sound with no external stimulus and idiopathic subjective tinnitus is the most common type in adults. Mean platelet volume (MPV) alterations were shown in some inflammatory diseases and were evaluated as a clinically useful marker. Our aim was to investigate MPV alterations in idiopathic subjective tinnitus patients. A total of 101 patients and 54 age- and sex-matched healthy control subjects were enrolled in the study. Patients included in the study had complaints of tinnitus for at least 3 months. All patients underwent detailed otolaryngologic examination, blood sampling, pure tone audiometry, magnetic resonance imaging of ear, and vertebrobasilar artery Doppler ultrasonography to make the differential diagnosis of tinnitus. Blood sampling consisted of renal-liver-thyroid function tests, lipid profile, and complete blood count. All tests and examinations except the imaging modalities were also performed for the control group. There were no differences in age and sex distribution of groups. Mean platelet volume values were significantly increased in tinnitus patients when compared with controls (p = 0.001). We think that MPV can be qualified as a useful marker in tinnitus patients.

  20. Alterations of Regional Cerebral Blood Flow in Tinnitus Patients as Assessed Using Single-Photon Emission Computed Tomography.

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    Takashi Ueyama

    Full Text Available Tinnitus is the perception of phantom sound without an external auditory stimulus. Using neuroimaging techniques, such as positron emission tomography, electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI, many studies have demonstrated that abnormal functions of the central nervous system are closely associated with tinnitus. In our previous research, we reported using resting-state fMRI that several brain regions, including the rectus gyrus, cingulate gyrus, thalamus, hippocampus, caudate, inferior temporal gyrus, cerebellar hemisphere, and medial superior frontal gyrus, were associated with tinnitus distress and loudness. To reconfirm these results and probe target regions for repetitive transcranial magnetic stimulation (rTMS, we investigated the regional cerebral blood flow (rCBF between younger tinnitus patients (<60 years old and the age-matched controls using single-photon emission computed tomography and easy Z-score imaging system. Compared with that of controls, the rCBF of tinnitus patients was significantly lower in the bilateral medial superior frontal gyri, left middle occipital gyrus and significantly higher in the bilateral cerebellar hemispheres and vermis, bilateral middle temporal gyri, right fusiform gyrus. No clear differences were observed between tinnitus patients with normal and impaired hearing. Regardless of the assessment modality, similar brain regions were identified as characteristic in tinnitus patients. These regions are potentially involved in the pathophysiology of chronic subjective tinnitus.

  1. Local NMDA receptor blockade attenuates chronic tinnitus and associated brain activity in an animal model.

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    Thomas J Brozoski

    Full Text Available Chronic tinnitus has no broadly effective treatment. Identification of specific markers for tinnitus should facilitate the development of effective therapeutics. Recently it was shown that glutamatergic blockade in the cerebellar paraflocculus, using an antagonist cocktail was successful in reducing chronic tinnitus. The present experiment examined the effect of selective N-methyl d-aspartate (NMDA receptor blockade on tinnitus and associated spontaneous brain activity in a rat model. The NMDA antagonist, D(--2-amino-5-phosphonopentanoic acid (D-AP5 (0.5 mM, was continuously infused for 2 weeks directly to the ipsilateral paraflocculus of rats with tinnitus induced months prior by unilateral noise exposure. Treated rats were compared to untreated normal controls without tinnitus, and to untreated positive controls with tinnitus. D-AP5 significantly decreased tinnitus within three days of beginning treatment, and continued to significantly reduce tinnitus throughout the course of treatment and for 23 days thereafter, at which time testing was halted. At the conclusion of psychophysical testing, neural activity was assessed using manganese enhanced magnetic resonance imaging (MEMRI. In agreement with previous research, untreated animals with chronic tinnitus showed significantly elevated bilateral activity in their paraflocculus and brainstem cochlear nuclei, but not in mid or forebrain structures. In contrast, D-AP5-treated-tinnitus animals showed significantly less bilateral parafloccular and dorsal cochlear nucleus activity, as well as significantly less contralateral ventral cochlear nucleus activity. It was concluded that NMDA-mediated glutamatergic transmission in the paraflocculus appears to be a necessary component of chronic noise-induced tinnitus in a rat model. Additionally, it was confirmed that in this model, elevated spontaneous activity in the cerebellar paraflocculus and auditory brainstem is associated with tinnitus.

  2. Cortico-limbic morphology separates tinnitus from tinnitus distress

    OpenAIRE

    Leaver, Amber M.; Anna eSeydell-Greenwald; Ted eTuresky; Susan eMorgan; Kim, Hung J.; Rauschecker, Josef P.

    2012-01-01

    Tinnitus is a common auditory disorder characterized by a chronic ringing or buzzing “in the ear.”Despite the auditory-perceptual nature of this disorder, a growing number of studies have reported neuroanatomical differences in tinnitus patients outside the auditory-perceptual system. Some have used this evidence to characterize chronic tinnitus as dysregulation of the auditory system, either resulting from inefficient inhibitory control or through the formation of aversive associations with ...

  3. Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients.

    Science.gov (United States)

    Hilgenberg, P B; Saldanha, A D D; Cunha, C O; Rubo, J H; Conti, P C R

    2012-04-01

    The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) and otologic symptoms in patients with and without tinnitus. The influence of the level of depression was also addressed. The tinnitus group was comprised of 100 patients with tinnitus, and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to determine the presence of TMD and depression level. Chi-square, Spearman Correlation and Mann-Whitney tests were used in statistical analysis, with a 5% significance level. TMD signs and symptoms were detected in 85% of patients with tinnitus and in 55% of controls (P≤0·001). The severity of pain and higher depression levels were positively associated with tinnitus (P≤0·001). It was concluded that tinnitus is associated with TMD and with otalgia, dizziness/vertigo, stuffy sensations, hypoacusis sensation and hyperacusis, as well as with higher depression levels.

  4. Does enriched acoustic environment in humans abolish chronic tinnitus clinically and electrophysiologically? A double blind placebo controlled study.

    Science.gov (United States)

    Vanneste, Sven; van Dongen, Marijn; De Vree, Bjorn; Hiseni, Senad; van der Velden, Eddy; Strydis, Christos; Joos, Kathleen; Norena, Arnaud; Serdijn, Wouter; De Ridder, Dirk

    2013-02-01

    Animal research has shown that loss of normal acoustic stimulation can increase spontaneous firing in the central auditory system and induce cortical map plasticity. Enriched acoustic environment after noise trauma prevents map plasticity and abolishes neural signs of tinnitus. In humans, the tinnitus spectrum overlaps with the area of hearing loss. Based on these findings it can be hypothesized that stimulating the auditory system by presenting music compensating specifically for the hearing loss might also suppress chronic tinnitus. To verify this hypothesis, a study was conducted in three groups of tinnitus patients. One group listened just to unmodified music (i.e. active control group), one group listened to music spectrally tailored to compensate for their hearing loss, and a third group received music tailored to overcompensate for their hearing loss, associated with one (in presbycusis) or two notches (in audiometric dip) at the edge of hearing loss. Our data indicate that applying overcompensation to the hearing loss worsens the patients' tinnitus loudness, the tinnitus annoyance and their depressive feelings. No significant effects were obtained for the control group or for the compensation group. These clinical findings were associated with an increase in current density within the left dorsal anterior cingulate cortex in the alpha2 frequency band and within the left pregenual anterior cingulate cortex in beta1 and beta2 frequency band. In addition, a region of interest analysis also demonstrated an associated increase in gamma band activity in the auditory cortex after overcompensation in comparison to baseline measurements. This was, however, not the case for the control or the compensation groups. In conclusion, music therapy compensating for hearing loss is not beneficial in suppressing tinnitus, and overcompensating hearing loss actually worsens tinnitus, both clinically and electrophysiologically.

  5. PSYCHOLOGICAL MORBIDITY IN PATIENTS WITH TINNITUS : A HOSPITAL BASED CROSS SECTIONAL STUDY

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    Arti

    2015-08-01

    Full Text Available INTRODUCTION: Tinnitus is not a disease but a symptom of hearing sound when no external sound is present. Studies have shown that some people, the sound causes anxiety or interferes with concentration, incr eased awareness of depression and personality disorders. To this purpose we evaluated the prevalence of psychiatric morbidity in chronic tinnitus using MINI interview. METHODS: A sample of 53 male and female patients with tinnitus between the age of 13 and 50 years participated in the study. Patients with ear infections , disease of th e heart or blood vessels , Meniere's disease , brain tumors , exposure to certain medications, a previous head injury and earwax were excluded. The subjects so chosen, were explained the nature of the study. Da ta was collected from outpatient ENT Clinics regarding demographic and clinical profiles from these patients. Each subject was then administered Mini International Neuropsychaitric Interview (M.I.N.I RESULTS: More numbers of females were there than males and majority were in between 30 - 39 years. Both married and unmarried people were equally affected. Middle class and upper lower classes were most affected. The prevalence of psychiatric co morbidity in these tinnitus patients follows in descending order: M ajor depressive disorder>>Social Phobia > Suicide > Panic - disorder > Obsessive – compulsive – disorder > Agarophobia = Dysthymic - disorder=Generalized - anxiety. CONCLUSION : We observed that the prevalence of psychiatric morbidity in chronic tinnitus patients were as follows in descending order Major - depressive - disorder >> Social - Phobia > Suicide > Pani c - disorder > Obsessive - compulsive – disorder > Agarophobia = Dysthymic disorder=Generalized - anxiety . Treatment of this psychiatric morbidity with medications and psychotherapy may likely reduce the severity of tinnitus in many of these patients.

  6. The Comparison of Ginkgo biloba and Cinnarizine effectiveness in tinnitus intensity of patients with subjective tinnitus

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    Hamidreza Khazraei

    2015-01-01

    Conclusion: It was found that after two months of treatment with Ginkgo biloba (120-140 mg daily tinnitus severity and the adverse changes on quality of life significantly decreased in the patients, whereas Cinnarizine did not reduce the latter significantly. However, no significant difference was observed between the two groups (Cinnarizine & Ginko biloba.

  7. Consensus for tinnitus patient assessment and treatment outcome measurement : Tinnitus Research Initiative meeting, Regensburg, July 2006

    NARCIS (Netherlands)

    Langguth, B.; Goodey, R.; Azevedo, A.; Bjorne, A.; Cacace, A.; Crocetti, A.; Del Bo, L.; De Ridder, D.; Diges, I.; Elbert, T.; Flor, H.; Herraiz, C.; Ganz Sanchez, T.; Eichhammer, P.; Figueiredo, R.; Hajak, G.; Kleinjung, T.; Landgrebe, M.; Londero, A.; Lainez, M. J. A.; Mazzoli, M.; Meikle, M. B.; Melcher, J.; Rauschecker, J. P.; Sand, P. G.; Struve, M.; Van de Heyning, P.; Van Dijk, P.; Vergara, R.; Langguth, B; Hajak, G; Kleinjung, T; Cacace, A; Moller, AR

    2007-01-01

    There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinn

  8. Efficacy and safety of bilateral continuous theta burst stimulation (cTBS for the treatment of chronic tinnitus: design of a three-armed randomized controlled trial

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    Plontke Stefan K

    2009-08-01

    Full Text Available Abstract Background Tinnitus, the perception of sound and noise in absence of an auditory stimulus, has been shown to be associated with maladaptive neuronal reorganization and increased activity of the temporoparietal cortex. Transient modulation of tinnitus by repetitive transcranial magnetic stimulation (rTMS indicated that these areas are critically involved in the pathophysiology of tinnitus and suggested new treatment strategies. However, the therapeutic efficacy of rTMS in tinnitus is still unclear, individual response is variable, and the optimal stimulation area disputable. Recently, continuous theta burst stimulation (cTBS has been put forward as an effective rTMS protocol for the reduction of pathologically enhanced cortical excitability. Methods 48 patients with chronic subjective tinnitus will be included in this randomized, placebo controlled, three-arm trial. The treatment consists of two trains of cTBS applied bilaterally to the secondary auditory cortex, the temporoparietal associaction cortex, or to the lower occiput (sham condition every working day for four weeks. Primary outcome measure is the change of tinnitus distress as quantified by the Tinnitus Questionnaire (TQ. Secondary outcome measures are tinnitus loudness and annoyance as well as tinnitus change during and after treatment. Audiologic and speech audiometric measurements will be performed to assess potential side effects. The aim of the present trail is to investigate effectiveness and safety of a four weeks cTBS treatment on chronic tinnitus and to compare two areas of stimulation. The results will contribute to clarify the therapeutic capacity of rTMS in tinnitus. Trial registration The trial was registered with the clinical trials register of http://www.clinicaltrials.gov (NCT00518024.

  9. The impact of Type D personality on health-related quality of life in tinnitus patients is mainly mediated by anxiety and depression

    DEFF Research Database (Denmark)

    Bartels, Hilke; Pedersen, Susanne S.; van der Laan, Bernard F A M

    2010-01-01

    To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depression)....

  10. The Impact of Type D Personality on Health-Related Quality of Life in Tinnitus Patients Is Mainly Mediated by Anxiety and Depression

    NARCIS (Netherlands)

    Bartels, H.; Pedersen, S.S.; van der Laan, B.F.A.M.; Staal, M.J.; Albers, F.W.J.; Middel, B.

    2010-01-01

    Objective: To evaluate the impact of Type D personality on health-related quality of life (HRQoL) and self-reported tinnitus-related distress in chronic tinnitus patients and whether this relationship is mediated by indicators of psychological distress (i.e., vital exhaustion, anxiety, and depressio

  11. Auditory hallucinations in tinnitus patients: Emotional relationships and depression

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    Santos, Rosa Maria Rodrigues dos

    2012-01-01

    Full Text Available Introduction: Over the last few years, our Tinnitus Research Group has identified an increasing number of patients with tinnitus who also complained of repeated perception of complex sounds, such as music and voices. Such hallucinatory phenomena motivated us to study their possible relation to the patients' psyches. Aims: To assess whether hallucinatory phenomena were related to the patients' psychosis and/or depression, and clarify their content and function in the patients' psyches. Method: Ten subjects (8 women; mean age = 65.7 years were selected by otolaryngologists and evaluated by the same psychologists through semi-structured interviews, the Hamilton Depression Rating Scale, and psychoanalysis interviews. Results: We found no association between auditory hallucinations and psychosis; instead, this phenomenon was associated with depressive aspects. The patients' discourse revealed that hallucinatory phenomena played unconscious roles in their emotional life. In all cases, there was a remarkable and strong tendency to recall/repeat unpleasant facts/situations, which tended to exacerbate the distress caused by the tinnitus and hallucinatory phenomena and worsen depressive aspects. Conclusions: There is an important relationship between tinnitus, hallucinatory phenomena, and depression based on persistent recall of facts/situations leading to psychic distress. The knowledge of such findings represents a further step towards the need to adapt the treatment of this particular subgroup of tinnitus patients through interdisciplinary teamwork. Prospective.

  12. The Relevance of Interoception in Chronic Tinnitus: Analyzing Interoceptive Sensibility and Accuracy

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    Pia Lau

    2015-01-01

    Full Text Available In order to better understand tinnitus and distress associated with tinnitus, psychological variables such as emotional and cognitive processing are a central element in theoretical models of this debilitating condition. Interoception, that is, the perception of internal processes, may be such a psychological factor relevant to tinnitus. Against this background, 20 participants suffering from chronic tinnitus and 20 matched healthy controls were tested with questionnaires, assessing interoceptive sensibility, and participated in two tasks, assessing interoceptive accuracy: the Schandry task, a heartbeat estimation assignment, and a skin conductance fluctuations perception task assessing the participants’ ability to perceive phasic increases in sympathetic activation were used. To test stress reactivity, a construct tightly connected to tinnitus onset, we also included a stress induction. No differences between the groups were found for interoceptive accuracy and sensibility. However, the tinnitus group tended to overestimate the occurrence of phasic activation. Loudness of the tinnitus was associated with reduced interoceptive performance under stress. Our results indicate that interoceptive sensibility and accuracy do not play a significant role in tinnitus. However, tinnitus might be associated with a tendency to overestimate physical changes.

  13. Comparing single-site with multisite rTMS for the treatment of chronic tinnitus – clinical effects and neuroscientific insights: study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Several years ago, repetitive transcranial magnetic stimulation (rTMS) of the auditory cortex has been introduced as a treatment approach for chronic tinnitus. Even if this treatment is beneficial for a subgroup of patients, the overall effects are limited. This limitation may be due to the fact that the auditory cortex is only one of several brain areas involved in tinnitus. Whereas auditory areas are considered to code for tinnitus loudness, conscious perception of and attention allocation to tinnitus is supposed to be reflected by network activity involving frontal and parietal cortical areas. The aim of the present study is to influence this frontoparietal network more efficiently by perturbing the most important nodes with rTMS. Methods/design This is a randomized, double-blind, parallel-group study. Patients receive rTMS treatment on 10 consecutive working days using either the multisite rTMS protocol (left dorsolateral prefrontal, 1,000 stimuli, 20 Hz; left temporoparietal, 1,000 stimuli, 1 Hz; right temporoparietal stimulation, 1,000 stimuli, 1 Hz) or a single-site protocol (unilateral stimulation of the temporoparietal cortex, 3,000 stimuli, 1 Hz). Individuals aged 18 to 70 years with chronic tinnitus ≥6-month duration and a Tinnitus Handicap Inventory score ≥38 are recruited for the study. A total of 50 patients are needed to detect a clinical relevant change of tinnitus severity (α = 0.05; 1 – β = 0.80). Primary outcome measures are the change in the Tinnitus Questionnaire score from baseline to the end of treatment as well as the number of treatment responders as defined by a reduction in the Tinnitus Questionnaire score of ≥5 points. Furthermore, changes in brain structure and activity are assessed using (functional) magnetic resonance imaging and electroencephalography in the resting state. Those measurements are also performed in 25 healthy control subjects. Discussion This study is designed to reveal whether network

  14. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study

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    Kreuzer Peter M

    2012-11-01

    Full Text Available Abstract Background Tinnitus, the perception of sound in absence of an external acoustic source, impairs the quality of life in 2% of the population. Since in most cases causal treatment is not possible, the majority of therapeutic attempts aim at developing and strengthening individual coping and habituation strategies. Therapeutic interventions that incorporate training in mindfulness meditation have become increasingly popular in the treatment of stress-related disorders. Here we conducted a randomized, controlled clinical study to investigate the efficacy of a specific mindfulness- and body-psychotherapy based program in patients suffering from chronic tinnitus. Methods Thirty-six patients were enrolled in this pilot study. The treatment was specifically developed for tinnitus patients and is based on mindfulness and body psychotherapy. Treatment was performed as group therapy at two training weekends that were separated by an interval of 7 weeks (eleven hours/weekend and in four further two-hour sessions (week 2, 9, 18 and 22. Patients were randomized to receive treatment either immediately or after waiting time, which served as a control condition. The primary study outcome was the change in tinnitus complaints as measured by the German Version of the Tinnitus Questionnaire (TQ. Results ANOVA testing for the primary outcome showed a significant interaction effect time by group (F = 7.4; df = 1,33; p = 0.010. Post hoc t-tests indicated an amelioration of TQ scores from baseline to week 9 in both groups (intervention group: t = 6.2; df = 17; p  Conclusions Our results suggest that this mindfulness- and body-psychotherapy-based approach is feasible in the treatment of tinnitus and merits further evaluation in clinical studies with larger sample sizes. The study is registered with clinicaltrials.gov (NCT01540357.

  15. Tinnitus in Patients with Sensorineural Hearing Loss : Management, Quality of Life and Treatment Strategies

    OpenAIRE

    Zarenoe, Reza

    2016-01-01

    Approximately 15% of Swedish people experience tinnitus, but only 2.4% experience severe problems. Treatment modalities for tinnitus vary, but the most common treatment is counseling. The majority of patients with tinnitus report some degree of hearing loss, and hearing aids have been used for many years in patients who suffer from both tinnitus and hearing impairment. The aim of the present thesis was to investigate disease management, determine quality of life and identify treatment strateg...

  16. Relationship Between Chronic Tinnitus and Glial Cell Line-Derived Neurotrophic Factor Gene rs3812047, rs1110149, and rs884344 Polymorphisms in a Turkish Population.

    Science.gov (United States)

    Orenay-Boyacioglu, Seda; Coskunoglu, Aysun; Caki, Zerrin; Cam, Fethi Sirri

    2016-08-01

    Glial cell line-derived neurotrophic factor (GDNF) plays a key role in early development of central auditory pathway and the inner ear. However, the auditory pathway studies of GDNF gene polymorphisms are scarce in the literature, and the studies especially associated with tinnitus are limited. Our study aimed to identify whether GDNF gene polymorphisms play any roles in the pathophysiology of tinnitus by investigating the relationship between tinnitus and GDNF polymorphisms. A total of 52 patients with chronic tinnitus and ages ranging from 18 to 55 were admitted to the Ear-Nose-Throat outpatient clinic of Celal Bayar University Medical Faculty Hospital of Manisa, Turkey and constituted the study group. Another 42 patients of the same age range, without tinnitus symptoms and lacking any systemic disease, were also admitted to the clinic and formed the control group. The tympanometric, audiological, and psychoacoustic assessments of the subjects were performed. Deoxyribonucleic acid samples obtained using venous blood taken for routine inspections were used to investigate GDNF gene polymorphisms (rs884344, rs3812047, and rs1110149) by polymerase chain reaction-based restriction fragment length polymorphism method. No correlation could be detected between GDNF rs884344 and rs3812047 polymorphisms and subjects with tinnitus (p > 0.05). Heterozygosity was significantly lower for GDNF rs1110149 polymorphism in tinnitus subjects compared to the controls (p tinnitus and control groups (p > 0.05). Failure to detect correlations between tinnitus and GDNF gene polymorphisms suggests this may be due to the fact that the GDNF gene has a variable expression pattern in different tissues and pathologies. Therefore, the study should be improved and its scope should be expanded by including a larger group of patients and different tissues to investigate the expression pattern of GDNF.

  17. Autonomic Conditions in Tinnitus and Implications for Korean Medicine

    Directory of Open Access Journals (Sweden)

    Eun Ji Choi

    2013-01-01

    Full Text Available Tinnitus patients suffer from not only auditory sensations but also physical, mental, and social difficulties. Even though tinnitus is believed to be associated with the autonomic nervous system, changes in autonomic conditions in tinnitus patients are not receiving much research attention. The aims of this study were to investigate the autonomic condition of tinnitus patients and to consider Korean medicine in the treatment of tinnitus with an evidence-based approach. We performed a retrospective chart review and compared the heart rate variability (HRV parameters of 40 tinnitus patients (19 acute and 21 chronic and 40 healthy controls. In tinnitus patients, the power of the high frequency component and total power of the HRV significantly decreased (P<0.05, and the low frequency to high frequency ratio significantly increased (P<0.05. There was no significant difference between the acute and chronic patients. When comparing each group with the controls, there was a tendency that the longer the duration of tinnitus was, the larger the observed HRV change was. In conclusion, tinnitus patients have vagal withdrawal and sympathetic overactivity, and chronic tinnitus more strongly affects autonomic conditions than acute tinnitus. This study provides evidence for Korean medical treatments of tinnitus, such as acupuncture and Qi-training, that cause modulation of cardiac autonomic function.

  18. Autobiographical memory specificity in patients with tinnitus versus patients with depression and normal controls.

    Science.gov (United States)

    Andersson, Gerhard; Hesser, Hugo; Cima, Rilana F F; Weise, Cornelia

    2013-01-01

    Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, & Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.

  19. The effect of tympanoplasty on tinnitus and analysis of possible influencing factors in patients with chronic otitis media%慢性中耳炎患者鼓室成形术后耳鸣变化及影响因素

    Institute of Scientific and Technical Information of China (English)

    郭平; 王武庆

    2014-01-01

    目的:了解慢性中耳炎患者鼓室成形术后耳鸣改变情况,分析慢性中耳炎患者术后听力提高程度、中耳炎分型与术后耳鸣改变的关系。方法记录106例慢性中耳炎病人术前及术后6个月的耳鸣严重程度的变化及听力改变情况,分析耳鸣改变与中耳炎分型以及听力提高的关系。使用配对t检验、独立样本t检验、卡方检验和确切概率法进行统计分析。结果慢性中耳炎患者的耳鸣发生率为46%。术前伴有耳鸣的40例病人,术后有15例病人的耳鸣治愈;18例病人耳鸣治疗有效;7例耳鸣治疗无效,鼓室成形术对耳鸣治疗有效率为82%;术后有1例新发耳鸣。术后耳鸣改善明显组的气导听力提高较耳鸣改善不良组的明显(p0.05)。结论对慢性中耳炎伴耳鸣的患者,手术可使多数患者耳鸣缓解。其中低频气导听力的提高对其耳鸣的缓解作用较显著,鼓室成形术诱发新的耳鸣不常见。%Objective The purpose of this paper is to investigate the effect of tympanoplasty on tinnitus in patients with chronic otitis media(COM), and to determine the effect of audiologic outcome, different types of chronic otitis media influenc-ing on tinnitus changes. Methods Our study consisted of 106 patients who were operated between March 2012 and January 2013. Audiologic evaluation by pure tone audiometry and assessment of tinnitus scores were conducted 3 months before and after surgery. We analysed the data with Paired t test, Student’s t test and Fisher's exact test by stata software. Results The pre-operative incidence of tinnitus in patients with chronic otitis media was 46%. After tympanoplasty, tinnitus reduced in 82%of patients. There was a very significant difference between audiological gain and reduced tinnitus scores (p0.05). There was one patient having new tinnitus after surgery. Conclusions Following tympanoplasty, most patients experienced a reduction in

  20. Clinical signs and symptoms of tinnitus in temporomandibular joint disorders: A pilot study comparing patients and non-patients

    Directory of Open Access Journals (Sweden)

    Amisha Kanji

    2013-12-01

    Full Text Available Background: Tinnitus is one of the otologic symptoms commonly reported to be associated with temporomandibular disorder (TMD, and questions regarding its nature and cause continue to plague the clinical and research community.Objectives: The current pilot study aimed to investigate the clinical signs and symptoms of presenting tinnitus in a group of individuals with TMD (group A, and compare them with a group with tinnitus but without TMD (group B. Twenty participants were included in the study, 10 from each group.Methods: All participants underwent basic audiological as well as ear, nose and throat (ENT evaluations to establish group A and group B. For tinnitus assessment, all participants completed a tinnitus survey questionnaire, and their tinnitus was evaluated using tinnitus matching procedures.Results: Findings revealed clinically relevant differences in attributes of tinnitus in patients with and without TMD. Most of the participants in group A matched their tinnitus to a 6 000 Hz tone or noise, at lower intensity levels than participants in group B, although these results were not statistically significant. Participants in group A associated their tinnitus with a single sound whereas some participants in group B associated it with more than one sound. More participants in group B reported the duration of their tinnitus as constant.Conclusions: Tinnitus may occur in patients with TMD, and be of high frequency. This highlights the importance of thorough assessment for patients with tinnitus as this might have implications for diagnosis and management.

  1. [Prospective therapeutic trial of masking treatment in patients with tinnitus].

    Science.gov (United States)

    Hernández Moñiz, F; Barrio, A; Pérez, A; Pertierra, M A; Salafranca, J M; González, M

    1998-01-01

    We report the results of a therapeutic trial of patients with tinnitus of different characteristics that was unresponsive to other medical or surgical treatments. Treatment was based on a combination of biofeedback training designed to reduce stress and either pure masking therapy or masking therapy consisting of a hearing aid and masker. The results showed an improvement in subjective perceptions and in the audiometric parameter of pitch in a significant percentage of patients.

  2. Relation of distortion product otoacoustic emission and tinnitus in normal hearing patients: A pilot study

    Directory of Open Access Journals (Sweden)

    Datt Modh

    2014-01-01

    Full Text Available Introduction: Tinnitus, the perception of the sound in the absence of an external acoustic source, disrupts the daily life 1 out of every 200 adults, yet its physiological basis remains largely a mystery. The generation of tinnitus is commonly linked with the impaired functioning of the outer hair cells (OHC inside the cochlea. Otoacoustic emissions are the objective test used to assess their activity. Objective: The objective of the investigation was to study the features of Distortion product OtoAcoustic emissions (DPOAE in a group of tinnitus patients with normal hearing and to find out whether there is any difference in DPOAE findings in the tinnitus patients with normal hearing and in persons with normal hearing with no complaint of tinnitus. Materials and Methods: The participants consisted of two groups. The subject group consisted of 16 ears of patients, in which 6 subjects were having tinnitus in both ears while 4 subjects were having tinnitus only in one ear. All subjects were aged between 20 to 60 years with complaint of tinnitus with audiometrically normal hearing. Control group was comprised of 16 audiometrically normal hearing ears of persons who were age and gender matched with the subject groups and had no complaint of tinnitus. Both the subject group as well as control group was subjected for DPOAE test. Findings of both the groups were compared using the unpaired t test. Result and conclusion: It was observed that the amplitudes of DPOAE were significantly lower in tinnitus patients than that of persons without complaint of tinnitus, at a frequency of 1281-1560, 5120-6250, 7243-8837 Hz, which imply that decrease of DPOAEs amplitudes may be related to the presence of tinnitus. It can be concluded that there is association between tinnitus and reduced OHC activity which indicate the OHC of cochlea are involved in the generation of tinnitus.

  3. Intratympanic injection of dexamethasone for treatment of tinnitus in patients with sudden sensorineural hearing loss

    OpenAIRE

    Yoshida, Tadao; Teranishi, Masaaki; Iwata, Tomoyuki; Otake, Hironao; Nakashima, Tsutomu

    2012-01-01

    The purpose of this study is to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe tinnitus in idiopathic sudden sensorineural hearing loss (SNHL). We studied 37 patients who received intratympanic dexamethasone injections and 14 control patients who did not receive it, with severe tinnitus after onset of unilateral sudden SNHL. Hearing level did not change during this study in any patient. The relationship between the duration of tinnitus and effective...

  4. Betahistine in the treatment of tinnitus in patients with vestibular disorders

    OpenAIRE

    Ganança,Maurício Malavasi; Caovilla, Heloisa Helena [UNIFESP; Gazzola, Juliana Maria [UNIFESP; Ganança, Cristina Freitas; Ganança,Fernando Freitas

    2011-01-01

    Betahistine is a medicine used to treat vestibular disorders that has also been used to treat tinnitus. AIM: To assess the effects of betahistine on tinnitus in patients with vestibular disorders. MATERIAL AND METHOD: Retrospective data were collected from patient records for individuals presenting with vestibular dysfunction and tinnitus. Patients included had received betahistine 48 mg/day and clinical outcomes were compared with a control group comprising individuals who were unable to rec...

  5. [Psychometric instruments for the diagnosis of tinnitus].

    Science.gov (United States)

    Seydel, C; Zirke, N; Haupt, H; Szczepek, A; Olze, H; Mazurek, B

    2012-08-01

    Tinnitus is a very complex phenomenon with various mechanisms of origin. Multimodal and interdisciplinary treatment is the most effective form of treatment for patients with chronic tinnitus. In order to assess existing comorbidity in tinnitus patients as well as to treat the patients individually, a comprehensive and differentiated diagnosis is needed. Since standardized guidelines for the use of relevant instruments in the diagnosis of tinnitus have been lacking hitherto, we present here psychometric questionnaires which have already been used effectively in the research, diagnosis and therapy of tinnitus in the present article. The questionnaires measure the severity of tinnitus, depression and anxiety, the perceived stress, personal resources as well as the quality of life of patients.

  6. Assessing audiological, pathophysiological and psychological variables in tinnitus patients with or without hearing loss.

    Science.gov (United States)

    Martines, Francesco; Bentivegna, Daniela; Martines, Enrico; Sciacca, Vincenzo; Martinciglio, Gioacchino

    2010-11-01

    The aim of this work is to study the characteristics of tinnitus both in normal hearing subjects and in patients with hearing loss. The study considered tinnitus sufferers, ranging from 21 to 83 years of age, who were referred to the Audiology Section of Palermo University in the years 2006-2008. The following parameters were considered: age, sex, hearing threshold, tinnitus laterality, tinnitus duration, tinnitus measurements and subjective disturbance caused by tinnitus. The sample was divided into Group1 (G1), 115 subjects with normal hearing, and Group2 (G2), 197 subjects with hearing loss. Especially for G2, there was a predominance of males compared to females (P = 0.011); the highest percentage of tinnitus resulted in the decades 61-70 and >70 with a significant difference for G2 demonstrating that the hearing status and the elderly represent the principal tinnitus-related factors (P hearing loss (SNHL) type and was limited to the high frequencies; the 72.1% of the patients with SNHL had a high-pitched tinnitus, while the 88.4% of the patients with a high-frequency SNHL had a high-pitched tinnitus (P depression, irritability and phobias.

  7. Tinnitus in Normal-Hearing Participants after Exposure to Intense Low-Frequency Sound and in Ménière’s Disease Patients

    Science.gov (United States)

    Ueberfuhr, Margarete Anna; Wiegrebe, Lutz; Krause, Eike; Gürkov, Robert; Drexl, Markus

    2017-01-01

    Tinnitus is one of the three classical symptoms of Ménière’s disease (MD), an inner ear disease that is often accompanied by endolymphatic hydrops. Previous studies indicate that tinnitus in MD patients is dominated by low frequencies, whereas tinnitus in non-hydropic pathologies is typically higher in frequency. Tinnitus of rather low-frequency (LF) quality was also reported to occur for about 90 s in normal-hearing participants after presentation of intense, LF sound (120 dB SPL, 30 Hz, 90 s). LF sound has been demonstrated to also cause temporary endolymphatic hydrops in animal models. Here, we quantify tinnitus in two study groups with chronic (MD patients) and presumably transient endolymphatic hydrops (normal-hearing participants after LF exposure) with a psychophysical procedure. Participants matched their tinnitus either with a pure tone of adjustable frequency and level or with a noise of adjustable spectral shape and level. Sensation levels of matching stimuli were lower for MD patients (mean: 8 dB SL) than for normal-hearing participants (mean: 15 dB SL). Transient tinnitus after LF-exposure occurred in all normal-hearing participants (N = 28). About half of the normal-hearing participants matched noise to their tinnitus, the other half chose a pure tone with frequencies below 2 kHz. MD patients matched their tinnitus with either high-frequency pure tones, mainly above 3 kHz, or with a noise. Despite a significant proportion of MD patients matching low-pass (roaring) noises to their tinnitus, the range of matched stimuli was more heterogeneous than previous data suggested. We propose that in those participants with noise-like tinnitus, the percept is probably generated by increased spontaneous activity of auditory nerve fibers with a broad range of characteristic frequencies, due to an impaired ion balance in the cochlea. For tonal tinnitus, additional mechanisms are conceivable: focal hair cell loss can result in decreased

  8. Acoustic startle reflex and pre-pulse inhibition in tinnitus patients

    Institute of Scientific and Technical Information of China (English)

    Kelly Shadwick; Wei Sun

    2014-01-01

    Gap induced pre-pulse inhibition (Gap-PPI) of acoustic startle reflex has been used as a measurement of tinnitus in animal models. However, whether this test is sensitive to detect tinnitus in humans is still unclear. Based on the testing procedure used in animal studies, a human subject testing method was formulated and conducted to investigate if a similar result could be found in tinnitus patients. Audiologic and tinnitus assessments and acoustic startle reflex measurements were performed on seven tinnitus subjects and nine age matched subjects without tinnitus. There was no significant difference found between the control and tinnitus group on the Gap-PPI across the frequencies evaluated. The amplitude of the startle response in the tinnitus group with normal hearing thresholds was significantly higher than the control group and those with tinnitus and hearing loss. This preliminary result suggests that hyperexcitability in the central auditory system may be involved in tinnitus. There was no correlation between hearing thresholds and the increased amplitude of startle response.

  9. Combined rTMS treatment targeting the Anterior Cingulate and the Temporal Cortex for the Treatment of Chronic Tinnitus

    Science.gov (United States)

    Kreuzer, Peter M.; Lehner, Astrid; Schlee, Winfried; Vielsmeier, Veronika; Schecklmann, Martin; Poeppl, Timm B.; Landgrebe, Michael; Rupprecht, Rainer; Langguth, Berthold

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has been proposed as a tinnitus treatment option. Promising results have been obtained by consecutive stimulation of lateral frontal and auditory brain regions. We investigated a combined stimulation paradigm targeting the anterior cingulate cortex (ACC) with double cone coil rTMS, followed by stimulation of the temporo-parietal junction area with a figure-of-eight coil. The study was conducted as a randomized, double-blind pilot trial in 40 patients suffering from chronic tinnitus. We compared mediofrontal stimulation with double-cone-coil, (2000 stimuli, 10 Hz) followed by left temporo-parietal stimulation with figure-of-eight-coil (2000 stimuli, 1 Hz) to left dorsolateral-prefrontal-cortex stimulation with figure-of-eight-coil (2000 stimuli, 10 Hz) followed by temporo-parietal stimulation with figure-of-eight-coil (2000 stimuli, 1 Hz). The stimulation was feasible with comparable dropout rates in both study arms; no severe adverse events were registered. Responder rates did not differ in both study arms. There was a significant main effect of time for the change in the TQ score, but no significant time x group interaction. This pilot study demonstrated the feasibility of combined mediofrontal/temporoparietal-rTMS-stimulation with double cone coil in tinnitus patients but failed to show better outcome compared to an actively rTMS treated control group. PMID:26667790

  10. Laterality, frequency and replication of rTMS treatment for chronic tinnitus: pilot studies and a review of maintenance treatment

    Science.gov (United States)

    Mennemeier, M.; Munn, T.; Allensworth, M.; Lenow, J.K.; Brown, G.; Allen, S.; Dornhoffer, J.; Williams, D.K.

    2012-01-01

    This manuscript reports on findings of three open label, pilot studies and it reviews studies using rTMS as a maintenance treatment for any disorder. The first pilot study examined whether a patient’s original treatment response to 1 Hz rTMS over temporal cortex could be replicated by stimulating a homologous region of the opposite hemisphere. The second study examined whether a patient’s response to 1Hz rTMS could be replicated by applying 10 Hz rTMS over the same treatment site. The third study applied a 3-day course of maintenance rTMS, either at 1 or 10 Hz, when subjects indicated that the benefit of their last course of treatment was waning. Patients with bilateral subjective tinnitus of at least 6 months duration were recruited from a prior, sham controlled study with treatment crossover that applied 1Hz rTMS over temporal cortex. Both treatment responders and non-responders were recruited. Results indicated, first, that the original treatment response, both positive and negative, is replicated after stimulating a homologous region of the opposite hemisphere; second, patients respond similarly to 1 and 10 Hz stimulation of the same treatment site (an exception was one patient who initially failed 1 Hz stimulation but responded positively to 10 Hz stimulation); and, third, maintenance rTMS had a sustained and additive benefit for tinnitus among treatment responders. Conclusions are that rTMS-induced effects on tinnitus are neither hemisphere specific nor frequency dependent; although, different frequencies of rTMS may have greater potency for a given subject. Maintenance treatment is a well tolerated approach with demonstrated feasibility for managing chronic tinnitus in persons who respond positively to an initial course of treatment. PMID:22486989

  11. Systematic Screening of the Serotonin Receptor 1A (5-HT1A) Gene in Chronic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    Kleinjung T; Langguth B; Fischer B; Hajak G; Eichhammer P; Sand PG

    2006-01-01

    Objective Chronic tinnitus is a highly prevalent condition and has been hypothesized to result from an innate disturbance in central nervous serotonergic transmission. Given the frequent comorbidity with major depression and anxiety, we argue that candidate genes for these disorders are likely to overlap. The present study addresses the gene encoding for the 5-HT1A receptor as a putative risk factor for tinnitus. Methods In 88 subjects with a diagnosis of chronic subjective tinnitus who underwent a detailed neurootological examination, the entire 5-HT1A gene was amplified using overlapping PCR products. Amplicons were custom sequenced bidirectionally and were screened for variants in multiple alignments against the human genome reference. Results We identified a synonymous C > T exchange at residue 184 (Pro) in 7/88 subjects, but detected no missense variants in the population under study. Specifically, the following residues were fully conserved: 16 (Pro), 22 (Gly), 28 (Ile), 98 (Val), 220(Arg), 267 (Val), 273 (Gly), and 418 (Asn). Discussion The present data count against the causation of chronic tinnitus by a change in the 5-HT1A receptor's amino acid sequence. However, the allele frequency for the 184Pro minor allele (0.04) reached twice the frequency reported in control cohorts from the same ethnicity.Additional investigations are invited to clarify the role of the 5-HT1A polymorphism in larger samples, and to control for comorbid affective disorders.

  12. Anticonvulsants for tinnitus (Review)

    NARCIS (Netherlands)

    Hoekstra, C.E.; Rynja, S.P.; Zanten, G.A.; Rovers, M.M.

    2011-01-01

    BACKGROUND: Tinnitus is the perception of sound or noise in the absence of an external or internal acoustic stimulation. It is a common and potentially distressing symptom for which no adequate therapy exists. OBJECTIVES: To assess the effectiveness of anticonvulsants in patients with chronic tinnit

  13. [Tinnitus in patients with hemifacial spasm: a treatable combination?

    NARCIS (Netherlands)

    Verhagen, C.V.M.; Meulstee, J.; Boogaarts, H.D.; Verhagen, W.I.

    2016-01-01

    BACKGROUND: About 5-15% of people in the Western world will suffer from an extended period of tinnitus during their lifetime. This is often a non-treatable, disabling disorder. Tinnitus can be classified as pulsatile or non-pulsatile. Pulsatile tinnitus can be caused by a treatable neurovascular com

  14. When Your Child Has Tinnitus

    Science.gov (United States)

    ... ENT Doctor Near You When Your Child Has Tinnitus When Your Child Has Tinnitus Patient Health Information News media interested in covering ... and public relations staff at newsroom@entnet.org . Tinnitus is a condition where the patient hears a ...

  15. Asymmetry in primary auditory cortex activity in tinnitus patients and controls

    NARCIS (Netherlands)

    Geven, L. I.; de Kleine, E.; Willemsen, A. T. M.; van Dijk, P.

    2014-01-01

    Tinnitus is a bothersome phantom sound percept and its neural correlates are not yet disentangled. Previously published papers, using [(18)F]-fluoro-deoxyglucose positron emission tomography (FDG-PET), have suggested an increased metabolism in the left primary auditory cortex in tinnitus patients. T

  16. The Relevance of the High Frequency Audiometry in Tinnitus Patients with Normal Hearing in Conventional Pure-Tone Audiometry

    Directory of Open Access Journals (Sweden)

    Veronika Vielsmeier

    2015-01-01

    Full Text Available Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz. Here we explored whether the results of the high frequency audiometry (>8 kHz provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical characteristics. Subjects and Methods. From the database of the Tinnitus Clinic at Regensburg we identified 75 patients with normal hearing thresholds in the conventional pure-tone audiometry. We contrasted these patients with normal and pathological high-frequency audiogram and compared them with respect to gender, age, tinnitus severity, pitch, laterality and duration, comorbid symptoms and triggers for tinnitus onset. Results. Patients with pathological high frequency audiometry were significantly older and had higher scores on the tinnitus questionnaires in comparison to patients with normal high frequency audiometry. Furthermore, there was an association of high frequency audiometry with the laterality of tinnitus. Conclusion. In tinnitus patients with normal pure-tone audiometry the high frequency audiometry provides useful additional information. The association between tinnitus laterality and asymmetry of the high frequency audiometry suggests a potential causal role for the high frequency hearing loss in tinnitus etiopathogenesis.

  17. Broadened population-level frequency tuning in the auditory cortex of tinnitus patients

    Science.gov (United States)

    Sekiya, Kenichi; Takahashi, Mariko; Murakami, Shingo; Kakigi, Ryusuke

    2017-01-01

    Tinnitus is a phantom auditory perception without an external sound source and is one of the most common public health concerns that impair the quality of life of many individuals. However, its neural mechanisms remain unclear. We herein examined population-level frequency tuning in the auditory cortex of unilateral tinnitus patients with similar hearing levels in both ears using magnetoencephalography. We compared auditory-evoked neural activities elicited by a stimulation to the tinnitus and nontinnitus ears. Objective magnetoencephalographic data suggested that population-level frequency tuning corresponding to the tinnitus ear was significantly broader than that corresponding to the nontinnitus ear in the human auditory cortex. The results obtained support the hypothesis that pathological alterations in inhibitory neural networks play an important role in the perception of subjective tinnitus. NEW & NOTEWORTHY Although subjective tinnitus is one of the most common public health concerns that impair the quality of life of many individuals, no standard treatment or objective diagnostic method currently exists. We herein revealed that population-level frequency tuning was significantly broader in the tinnitus ear than in the nontinnitus ear. The results of the present study provide an insight into the development of an objective diagnostic method for subjective tinnitus. PMID:28053240

  18. Transcranial Direct Current Stimulation in Tinnitus Patients: A Systemic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jae-Jin Song

    2012-01-01

    Full Text Available Although transcranial direct current stimulation (tDCS has already been used to manage tinnitus patients, paucity of reports and variations in protocols preclude a comprehensive understanding. Hence, we conducted a meta-analysis based on systemic review to assess effectiveness of tDCS in tinnitus management and to compare stimulation parameters. PubMed was searched for tDCS studies in tinnitus. For randomized controlled trials (RCTs, a meta-analysis was performed. A total of 17 studies were identified and 6 of them were included in the systemic review and 2 RCTs were included in the meta-analysis. Overall 39.5% responded to active tDCS with a mean tinnitus intensity reduction of 13.5%. Additionally, left temporal area (LTA and bifrontal tDCS indicated comparable results. Active tDCS was found to be more effective than sham tDCS for tinnitus intensity reduction (Hedges' g=.77, 95% confidence interval 0.23–1.31. The efficacy of tDCS in tinnitus could not be fully confirmed by the current study because of the limited number of studies, but all studies included in the current systemic review and meta-analysis demonstrated significant tinnitus intensity improvement. Therefore, tDCS may be a promising tool for tinnitus management. Future RCTs in a large series regarding the efficacy as well as the comparison between LTA- and bifrontal tDCS are recommended.

  19. Analysis of Audiometric Differences of Patients with and without Tinnitus in a Large Clinical Database.

    Science.gov (United States)

    Gollnast, Dominik; Tziridis, Konstantin; Krauss, Patrick; Schilling, Achim; Hoppe, Ulrich; Schulze, Holger

    2017-01-01

    Human hearing loss (HL) and comorbidities like tinnitus pose serious problems for people's daily life, which in most severe cases may lead to social isolation, depression, and suicide. Here, we investigate the relationship between hearing deficits and tinnitus. To this end, we conducted a retrospective study on anonymized pure tone and speech audiometric data from patients of the ENT hospital Erlangen in which we compare audiometric data between patients with and without tinnitus. Overall data from 37,661 patients with sensorineural (SHL) or conductive HL (CHL) with (T, 9.5%) or without (NT, 90.5%) a tinnitus percept in different age groups and with different tinnitus pitches were included in this study. The results of the pure tone audiometry comparisons showed significant differences in T patients compared to NT patients. In young patients, we generally found lower hearing thresholds in T compared to NT patients. In adult patients, differences were more heterogeneous: hearing thresholds in T patients were lower in low frequency ranges, while they were higher at high frequencies. Furthermore, lower thresholds were more often found in CHL patients and could rarely be detected in SHL patients. In speech audiometry, only CHL patients with high-pitched tinnitus showed lower thresholds compared to NT patients' thresholds. The results of this study may point to a biologically plausible functional benefit on hearing thresholds in HL tinnitus patients. We hypothesize that the physiological mechanism of stochastic resonance counteracts HL by adding neuronal noise to the system. This neuronal noise may induce changes in the auditory pathway and finally-as a side effect of threshold improvement-lead to the development of a tinnitus percept. We propose a general model of changed hearing thresholds in T patients, being either decreased or increased compared to NT patients.

  20. Tinnitus and Headache

    Directory of Open Access Journals (Sweden)

    Berthold Langguth

    2015-01-01

    Full Text Available Background. Tinnitus and headache are frequent disorders. Here, we aimed to investigate whether the occurrence of headache among tinnitus patients is purely coincidental or whether tinnitus and headache are pathophysiologically linked. We investigated a large sample of patients with tinnitus and headache to estimate prevalence rates of different headache forms, to determine the relationship between tinnitus laterality and headache laterality, and to explore the relationship between tinnitus and headache over time. Method. Patients who presented at a tertiary referral center because of tinnitus and reported comorbid headache were asked to complete validated questionnaires to determine the prevalence of migraine and tension-type headache and to assess tinnitus severity. In addition, several questions about the relationship between headache and tinnitus were asked. Results. Datasets of 193 patients with tinnitus and headache were analysed. 44.6% suffered from migraine, 13% from tension-type headache, and 5.7% from both. Headache laterality was significantly related to tinnitus laterality and in the majority of patients fluctuations in symptom severity of tinnitus and headache were interrelated. Conclusion. These findings suggest a significant relationship between tinnitus and headache laterality and symptom interaction over time and argue against a purely coincidental cooccurrence of tinnitus and headache. Both disorders may be linked by common pathophysiological mechanisms.

  1. Analysis of Audiometric Differences of Patients with and without Tinnitus in a Large Clinical Database

    Science.gov (United States)

    Gollnast, Dominik; Tziridis, Konstantin; Krauss, Patrick; Schilling, Achim; Hoppe, Ulrich; Schulze, Holger

    2017-01-01

    Human hearing loss (HL) and comorbidities like tinnitus pose serious problems for people’s daily life, which in most severe cases may lead to social isolation, depression, and suicide. Here, we investigate the relationship between hearing deficits and tinnitus. To this end, we conducted a retrospective study on anonymized pure tone and speech audiometric data from patients of the ENT hospital Erlangen in which we compare audiometric data between patients with and without tinnitus. Overall data from 37,661 patients with sensorineural (SHL) or conductive HL (CHL) with (T, 9.5%) or without (NT, 90.5%) a tinnitus percept in different age groups and with different tinnitus pitches were included in this study. The results of the pure tone audiometry comparisons showed significant differences in T patients compared to NT patients. In young patients, we generally found lower hearing thresholds in T compared to NT patients. In adult patients, differences were more heterogeneous: hearing thresholds in T patients were lower in low frequency ranges, while they were higher at high frequencies. Furthermore, lower thresholds were more often found in CHL patients and could rarely be detected in SHL patients. In speech audiometry, only CHL patients with high-pitched tinnitus showed lower thresholds compared to NT patients’ thresholds. The results of this study may point to a biologically plausible functional benefit on hearing thresholds in HL tinnitus patients. We hypothesize that the physiological mechanism of stochastic resonance counteracts HL by adding neuronal noise to the system. This neuronal noise may induce changes in the auditory pathway and finally—as a side effect of threshold improvement—lead to the development of a tinnitus percept. We propose a general model of changed hearing thresholds in T patients, being either decreased or increased compared to NT patients. PMID:28232817

  2. Short and intense tailor-made notched music training against tinnitus: the tinnitus frequency matters.

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    Henning Teismann

    Full Text Available Tinnitus is one of the most common diseases in industrialized countries. Here, we developed and evaluated a short-term (5 subsequent days and intensive (6 hours/day tailor-made notched music training (TMNMT for patients suffering from chronic, tonal tinnitus. We evaluated (i the TMNMT efficacy in terms of behavioral and magnetoencephalographic outcome measures for two matched patient groups with either low (≤8 kHz, N = 10 or high (>8 kHz, N = 10 tinnitus frequencies, and the (ii persistency of the TMNMT effects over the course of a four weeks post-training phase. The results indicated that the short-term intensive TMNMT took effect in patients with tinnitus frequencies ≤8 kHz: subjective tinnitus loudness, tinnitus-related distress, and tinnitus-related auditory cortex evoked activity were significantly reduced after TMNMT completion. However, in the patients with tinnitus frequencies >8 kHz, significant changes were not observed. Interpreted in their entirety, the results also indicated that the induced changes in auditory cortex evoked neuronal activity and tinnitus loudness were not persistent, encouraging the application of the TMNMT as a longer-term training. The findings are essential in guiding the intended transfer of this neuro-scientific treatment approach into routine clinical practice.

  3. Short and intense tailor-made notched music training against tinnitus: the tinnitus frequency matters.

    Science.gov (United States)

    Teismann, Henning; Okamoto, Hidehiko; Pantev, Christo

    2011-01-01

    Tinnitus is one of the most common diseases in industrialized countries. Here, we developed and evaluated a short-term (5 subsequent days) and intensive (6 hours/day) tailor-made notched music training (TMNMT) for patients suffering from chronic, tonal tinnitus. We evaluated (i) the TMNMT efficacy in terms of behavioral and magnetoencephalographic outcome measures for two matched patient groups with either low (≤8 kHz, N = 10) or high (>8 kHz, N = 10) tinnitus frequencies, and the (ii) persistency of the TMNMT effects over the course of a four weeks post-training phase. The results indicated that the short-term intensive TMNMT took effect in patients with tinnitus frequencies ≤8 kHz: subjective tinnitus loudness, tinnitus-related distress, and tinnitus-related auditory cortex evoked activity were significantly reduced after TMNMT completion. However, in the patients with tinnitus frequencies >8 kHz, significant changes were not observed. Interpreted in their entirety, the results also indicated that the induced changes in auditory cortex evoked neuronal activity and tinnitus loudness were not persistent, encouraging the application of the TMNMT as a longer-term training. The findings are essential in guiding the intended transfer of this neuro-scientific treatment approach into routine clinical practice.

  4. Association between sleep quality and psychiatric disorders in patients with subjective tinnitus in China.

    Science.gov (United States)

    Xu, Yaping; Yao, Jie; Zhang, Zhili; Wang, Wenxuan

    2016-10-01

    The study aimed to investigate the relationship between quality of sleep and psychiatric disorders including anxiety and depression in patients with subjective tinnitus. Early intervention is associated with improved therapeutic outcomes. We used Pittsburgh sleep quality index (PSQI), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and tinnitus handicap inventory (THI) in 543 patients [224 male (41.3 %); 319 female (58.7 %)] with subjective tinnitus enrolled in the ENT outpatient clinic from 2013 to 2015. Tinnitus characteristics and hearing status were recorded. A binary step-wise logistic regression analysis was performed. Two hundred cases (36.8 %) including 65 men (32.5 %) and 135 women (67.5 %) were diagnosed with sleep disorders. The PSQI score was the highest in patients with anxiety plus depression. Prolonged sleep latency and daytime dysfunction were positively associated with anxiety and depression. Increased sleep latency score was associated with 1.521- and 1.667-fold increased risk of anxiety and depression. Increase in the daytime dysfunction score was associated with 1.941- and 1.477-fold increases in the risk of anxiety and depression, respectively. Psychiatric and sleep disorders are highly prevalent in patients with subjective tinnitus. The most severe sleep impairment was found in patients with anxiety plus depression, resulting from prolonged sleep latency and severe daytime dysfunction. Acute duration, young people, hearing loss, impaired sleep, and severity of tinnitus were the major risk factors for tinnitus accompanied with anxiety symptoms. Severity of tinnitus and sleep impairment appeared to be the major risk factors of tinnitus accompanied with depression symptoms.

  5. The impact of co-morbid factors on the psychological outcome of tinnitus patients.

    Science.gov (United States)

    Pajor, Anna Maria; Ormezowska, Elżbieta Agata; Jozefowicz-Korczynska, Magdalena

    2013-03-01

    The study was carried out to determine the impact of some co-morbid otological symptoms and demographic factors on the emotional distress and cognitive functioning in patients with tinnitus. One hundred consecutive patients, complaining of constant idiopathic tinnitus, were enrolled into the study. Four tests were administered: Beck Depression Inventory, Hospital Anxiety Depression Scale (HADS, A--anxiety, D--depression), Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). A multivariate stepwise linear regression analysis was performed to estimate the relationship between the results of each of the tests and following co-morbid factors: age, sex, tinnitus duration, tinnitus laterality, hearing status (normal hearing, unilateral hearing loss and bilateral hearing loss) and vertigo/dizziness. It was found that the scores of MMSE and TMT were negatively correlated with age and with hearing status and the scores of HADS-A were slightly correlated with sex. In regression analysis, in HADS-A, sex and to a lesser extent tinnitus duration, in MMSE and TMT age and to a lesser extent tinnitus laterality were the variables that were comprised in the final model. Demographic factors had contributed more than overlapping otological symptoms to the psychological outcome in tinnitus patients.

  6. Repetitive transcranial magnetic stimulation for the treatment of chronic tinnitus after traumatic brain injury: a case study.

    Science.gov (United States)

    Kreuzer, Peter Michael; Landgrebe, Michael; Frank, Elmar; Langguth, Berthold

    2013-01-01

    Tinnitus is a frequent symptom of traumatic brain injury, which is difficult to treat. Repetitive transcranial magnetic stimulation has shown beneficial effects in some forms of tinnitus. However, traumatic brain injury in the past has been considered as a relative contraindication for repetitive transcranial magnetic stimulation because of the increased risk of seizures. Here we present the case of a 53-year-old male patient suffering from severe tinnitus after traumatic brain injury with comorbid depression and alcohol abuse, who received 5 treatment series of repetitive transcranial magnetic stimulation (1 Hz stimulation protocol over left primary auditory cortex, 10 sessions of 2000 stimuli each, stimulation intensity 110% resting motor threshold). Repetitive transcranial magnetic stimulation was tolerated without any side effects and tinnitus complaints (measured by a validated tinnitus questionnaire and numeric rating scales) were improved in a replicable way throughout 5 courses of transcranial magnetic stimulation up to now.

  7. Characterization of tinnitus in different age groups: A retrospective review

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    Jamil Al-Swiahb

    2016-01-01

    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  8. Effects of selective serotonin reuptake inhibitor on treating tinnitus in patients stratified for presence of depression or anxiety.

    Science.gov (United States)

    Oishi, Naoki; Kanzaki, Sho; Shinden, Seiichi; Saito, Hideyuki; Inoue, Yasuhiro; Ogawa, Kaoru

    2010-01-01

    We evaluated the effects of a selective serotonin reuptake inhibitor, paroxetine, on treating tinnitus.Tinnitus patients stratified for the presence of depression and anxiety were studied retrospectively. Fifty-six patients were observed for more than 6 months. They were initially treated with paroxetine only at a dose of 10 mg/day for 2-4 weeks; thereafter, the dose was increased to 20 mg/day. Tinnitus distress was evaluated with the Tinnitus Handicap Inventory (THI) and with visual analog scales (VASs) for tinnitus loudness and annoyance. Depression and anxiety were measured with the Self-Rating Depression Scale (SDS) and the trait section of the State-Trait Anxiety Inventory (STAI). The patients were grouped according to their SDS and STAI scores, and each variable was compared at baseline and the 6-month follow-up. Changes among these variables were also examined to determine whether reduced tinnitus distress was related to the improvement of depression or anxiety. Patients with both depression and anxiety showed better results (decrease in THI, VASs, SDS and STAI scores) than patients with anxiety alone, or patients without depression and anxiety. In patients with depression and anxiety, changes in tinnitus variables and changes in depression and anxiety scores were strongly correlated. In other patients, however, changes in tinnitus variables and changes in depression and anxiety scores were not correlated. These results suggest that paroxetine is effective in treating distressed tinnitus patients with depression and anxiety by reducing their tinnitus severity as well as their depression and anxiety.

  9. New Trends in Tinnitus Management

    OpenAIRE

    Fioretti, Alessandra; Eibenstein, Alberto; Fusetti, Marco

    2011-01-01

    Tinnitus is a perception of sound in absence of sound stimulation. Tinnitus in many cases cannot be eliminated by conventional medical treatment with drugs or surgery. Some people who begin to notice tinnitus, whether spontaneous or induced by noise, trauma or other insult, will experience spontaneous resolution, but many patients will have persistent tinnitus. For some of them, tinnitus sensation will be joined by tinnitus suffering, with many adverse effects like anxiety, depression and sle...

  10. Clinical and audiologic characteristics of patients with sensorineural tinnitus and its association with psychological aspects: an analytic retrospective study.

    Science.gov (United States)

    Al-Swiahb, Jamil Nasser; Hwang, Eul Seung; Kong, Ji Sun; Kim, Woo Jin; Yeo, Sang Won; Park, Shi Nae

    2016-12-01

    This study was performed to analyze clinical and audiologic characteristics of sensorineural tinnitus and to investigate the associating factors reflecting psychological aspects of stress and depression of the patients. This is a retrospective analytical study conducted in a tinnitus clinic of a tertiary referral center of a university hospital. The medical records of 216 patients suffering from sensorineural tinnitus were thoroughly evaluated to determine correlations between clinical and audiological characteristics, including age, sex, predisposing or etiologic factors, hearing levels up to extended high frequencies, and tinnitus severity. Psychological aspects of stress and depression were also evaluated and analyzed to seek the associations with tinnitus severity. All data were stored in our database bank and were statistically analyzed. Our study subjects showed a slight male predominance. The highest percentage of tinnitus was found in patients of 60-80 years old. Only 32.5 % of tinnitus patients were subjectively aware of their hearing loss, whereas 73 % of subjects had hearing deficits in some frequencies in their audiogram. Hearing impairments were of the low-frequency sensorineural type in 18.2 % of patients and were limited to the high frequencies in 77.9 % of patients. Tinnitus was unilateral in 51 % of patients and had a tonal nature in 45 % of patients. In total, 45.8 % of patients with high-frequency sensorineural hearing loss had high-pitched tinnitus. There were significant correlations between tinnitus severity, loudness and annoyance. Correlations with THI (Tinnitus Handicap Inventory) and Beck depression index scores were also found. Sensorineural tinnitus was related with hearing loss in some frequencies nevertheless of patients' own awareness of hearing loss. Loudness and annoyance of tinnitus seems to be two important factors reflecting psychological problems of patients' stress and depression.

  11. Increased risk of tinnitus in patients with temporomandibular disorder: a retrospective population-based cohort study.

    Science.gov (United States)

    Lee, Chun-Feng; Lin, Ming-Chia; Lin, Hui-Tzu; Lin, Cheng-Li; Wang, Tang-Chuan; Kao, Chia-Hung

    2016-01-01

    This study determined whether there is an increased risk of tinnitus in patients with temporomandibular joint (TMJ). We used information from health insurance claims obtained from Taiwan National Health Insurance (TNHI). Patients aged 20 years and older who were newly diagnosed with TMJ disorder served as the study cohort. The demographic factors and comorbidities that may be associated with tinnitus were also identified, including age, sex, and comorbidities of hearing loss, noise effects on the inner ear, and degenerative and vascular ear disorders. A higher proportion of TMJ disorder patients suffered from hearing loss (5.30 vs. 2.11 %), and degenerative and vascular ear disorders (0.20 vs. 0.08 %) compared with the control patients. The crude hazard ratio (HR) of tinnitus in the TMJ disorder cohort was 2.73-fold higher than that in the control patients, with an adjusted HR of 2.62 (95 % CI = 2.29-3.00). The comorbidity-specific TMJ disorder cohort to the control patients' adjusted HR of tinnitus was higher for patients without comorbidity (adjusted HR = 2.75, 95 % CI = 2.39-3.17). We also observed a 3.22-fold significantly higher relative risk of developing tinnitus within the 3-year follow-up period (95 % CI = 2.67-3.89). Patients with TMJ disorder might be at increased risk of tinnitus.

  12. Evaluation of a tinnitus patient%耳鸣患者的检查与评估

    Institute of Scientific and Technical Information of China (English)

    石勇兵; 赵立东; 王秋菊

    2016-01-01

    Tinnitus is a common otologic complaint and can severely affect quality of life in some patients. Appropri-ate diagnosis and evaluation of tinnitus can impact treatment outcomes. Tinnitus diagnosis involves determination of etiolo-gy, tinnitus testing, evaluation of tinnitus severity and identifying other factors that may contribute to tinnitus. Identification of the cause of tinnitus is first step. Comprehensive tinnitus evaluation includes a thorough history and physical examina-tion, timely hearing and tinnitus tests, appropriate laboratory and imaging studies, and use of tinnitus evaluation and other questionnaires when indicated. In addition to tinnitus and the auditory system, identifying systemic disorders that may con-tribute to tinnitus and consulting relevant specialists are also important steps in tinnitus evaluation.%耳鸣是耳科常见主诉,可以严重影响少数病人的生活。耳鸣的诊断与评估直接影响对耳鸣患者的治疗效果。耳鸣诊断包括寻找病因、测量耳鸣、评价耳鸣对患者影响的严重程度,以及确定有无影响患者耳鸣感受的其他因素,其中寻找和排除可能导致耳鸣的重要病因是第一位的。全面的耳鸣诊断应包括详尽和有针对性的病史采集和身体检查,及时的听力和耳鸣测试,合理的实验室以及影像学检查,以及必要的耳鸣问卷和其他辅助问卷的使用。除耳鸣本身和听觉系统疾患外,排除可能导致耳鸣的全身性疾病和及时寻求相关专科专家会诊也是耳鸣诊断的重要部分。

  13. The Impact of Sound on Electroencephalographic Waves during Sleep in Patients Suffering from Tinnitus

    Directory of Open Access Journals (Sweden)

    Marisa Pedemonte

    2014-09-01

    The main results found were that the largest number of changes, considering both the power spectrum and wave׳s coherence, occurred in stages N2 and N3. The delta and theta bands were the most changed, with important changes also in coherence of spindles during N2. All changes were more frequent in temporal areas. The differences between the two hemispheres do not depend, at least exclusively, on the side where the tinnitus is perceived and, hence, of the stimulated side. These results demonstrate that sound stimulation during sleep in tinnitus patients׳ influences brain activity and open an avenue for investigating the mechanism underlying tinnitus and its treatment.

  14. Intratympanic injection of dexamethasone for treatment of tinnitus in patients with sudden sensorineural hearing loss

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    Tadao Yoshida

    2012-01-01

    Full Text Available The purpose of this study is to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe tinnitus in idiopathic sudden sensorineural hearing loss (SNHL. We studied 37 patients who received intratympanic dexamethasone injections and 14 control patients who did not receive it, with severe tinnitus after onset of unilateral sudden SNHL. Hearing level did not change during this study in any patient. The relationship between the duration of tinnitus and effectiveness of treatment was investigated in sudden SNHL. We used a visual analogue scale to evaluate 51 patients with severe tinnitus at the stage of stable hearing level after idiopathic sudden sensorineural hearing loss. Forty-one per cent of patients showed significant improvement after treatment. The average period between onset of sudden sensorineural hearing loss and initiation of intratympanic dexamethasone injection was significantly shorter (207 days in the improved group than in the unchanged group (482 days (P<0.001. In control group, one of 14 patients presented significant improvement spontaneously. Intratympanic dexamethasone treatment may be effective in treatment of severe tinnitus after sudden SNHL at the stage of stable hearing level, and the shorter the period from onset of sudden deafness to the start of intratympanic dexamethasone treatment, the greater the improvement in tinnitus that can be expected.

  15. Tinnitus-Related Distress and the Personality Characteristic Resilience

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    Elisabeth Wallhäusser-Franke

    2014-01-01

    Full Text Available It has been suggested that personality traits may be prognostic for the severity of suffering from tinnitus. Resilience as measured with the Wagnild and Young resilience scale represents a positive personality characteristic that promotes adaptation to adverse life conditions including chronic health conditions. Aim of the study was to explore the relation between resilience and tinnitus severity. In a cross-sectional study with a self-report questionnaire, information on tinnitus-related distress and subjective tinnitus loudness was recorded together with the personality characteristic resilience and emotional health, a measure generated from depression, anxiety, and somatic symptom severity scales. Data from 4705 individuals with tinnitus indicate that tinnitus-related distress and to a lesser extent the experienced loudness of the tinnitus show an inverse correlation with resilience. A mediation analysis revealed that the relationship between resilience and tinnitus-related distress is mediated by emotional health. This indirect effect indicates that high resilience is associated with better emotional health or less depression, anxiety, and somatic symptom severity, which in turn is associated with a less distressing tinnitus. Validity of resilience as a predictor for tinnitus-related distress is supported but needs to be explored further in longitudinal studies including acute tinnitus patients.

  16. Tonic tensor tympani syndrome in tinnitus and hyperacusis patients: A multi-clinic prevalence study

    Directory of Open Access Journals (Sweden)

    Myriam Westcott

    2013-01-01

    Full Text Available Tonic tensor tympani syndrome (TTTS is an involuntary, anxiety-based condition where the reflex threshold for tensor tympani muscle activity is reduced, causing a frequent spasm. This can trigger aural symptoms from tympanic membrane tension, middle ear ventilation alterations and trigeminal nerve irritability. TTTS is considered to cause the distinctive symptoms of acoustic shock (AS, which can develop after exposure to an unexpected loud sound perceived as highly threatening. Hyperacusis is a dominant AS symptom. Aural pain/blockage without underlying pathology has been noted in tinnitus and hyperacusis patients, without wide acknowledgment. This multiclinic study investigated the prevalence of TTTS symptoms and AS in tinnitus and hyperacusis patients. This study included consecutive patients with tinnitus and/or hyperacusis seen in multiple clinics. Data collected: Symptoms consistent with TTTS (pain/numbness/burning in and around the ear; aural "blockage"; mild vertigo/nausea; "muffled" hearing; tympanic flutter; headache; onset or exacerbation from exposure to loud/intolerable sounds; tinnitus/hyperacusis severity. All patients were medically cleared of underlying pathology, which could cause these symptoms. 60.0% of the total sample (345 patients, 40.6% of tinnitus only patients, 81.1% of hyperacusis patients had ≥1 symptoms (P < 0.001. 68% of severe tinnitus patients, 91.3% of severe hyperacusis patients had ≥1 symptoms (P < 0.001. 19.7% (68/345 of patients in the total sample had AS. 83.8% of AS patients had hyperacusis, 41.2% of non-AS patients had hyperacusis (P < 0.001. The high prevalence of TTTS symptoms suggests they readily develop in tinnitus patients, more particularly with hyperacusis. Along with AS, they should be routinely investigated in history-taking.

  17. The relevance of the high frequency audiometry in tinnitus patients with normal hearing in conventional pure-tone audiometry

    OpenAIRE

    Veronika Vielsmeier; Astrid Lehner; Jürgen Strutz; Thomas Steffens; Kreuzer, Peter M; Martin Schecklmann; Michael Landgrebe; Berthold Langguth; Tobias Kleinjung

    2015-01-01

    Objective. The majority of tinnitus patients suffer from hearing loss. But a subgroup of tinnitus patients show normal hearing thresholds in the conventional pure-tone audiometry (125 Hz–8 kHz). Here we explored whether the results of the high frequency audiometry (>8 kHz) provide relevant additional information in tinnitus patients with normal conventional audiometry by comparing those with normal and pathological high frequency audiometry with respect to their demographic and clinical chara...

  18. rTMS Induced Tinnitus Relief Is Related to an Increase in Auditory Cortical Alpha Activity

    Science.gov (United States)

    Müller, Nadia; Lorenz, Isabel; Langguth, Berthold; Weisz, Nathan

    2013-01-01

    Chronic tinnitus, the continuous perception of a phantom sound, is a highly prevalent audiological symptom. A promising approach for the treatment of tinnitus is repetitive transcranial magnetic stimulation (rTMS) as this directly affects tinnitus-related brain activity. Several studies indeed show tinnitus relief after rTMS, however effects are moderate and vary strongly across patients. This may be due to a lack of knowledge regarding how rTMS affects oscillatory activity in tinnitus sufferers and which modulations are associated with tinnitus relief. In the present study we examined the effects of five different stimulation protocols (including sham) by measuring tinnitus loudness and tinnitus-related brain activity with Magnetoencephalography before and after rTMS. Changes in oscillatory activity were analysed for the stimulated auditory cortex as well as for the entire brain regarding certain frequency bands of interest (delta, theta, alpha, gamma). In line with the literature the effects of rTMS on tinnitus loudness varied strongly across patients. This variability was also reflected in the rTMS effects on oscillatory activity. Importantly, strong reductions in tinnitus loudness were associated with increases in alpha power in the stimulated auditory cortex, while an unspecific decrease in gamma and alpha power, particularly in left frontal regions, was linked to an increase in tinnitus loudness. The identification of alpha power increase as main correlate for tinnitus reduction sheds further light on the pathophysiology of tinnitus. This will hopefully stimulate the development of more effective therapy approaches. PMID:23390539

  19. Regional homogeneity on resting state fMRI in patients with tinnitus

    Institute of Scientific and Technical Information of China (English)

    Haidi Yang; Yiqing Zheng; Yongkang Ou; Xiayin Huang

    2014-01-01

    Objective:To study central functional network connections and their alterations in tinnitus patients using fMRI. Methods: Regional homogeneity (ReHo) values on fMRI were obtained from 18 tinnitus patients and 20 age and gender-matched control subjects. ReHo values were compared between tinnitus patients and control subjects to evaluate functional network connection differences. Results:Tinnitus patients showed increased ReHo values in gyrus frontalis inferior and decreased ReHo values in the anterior lobe of cerebellum in comparison with the controls. Analysis of functional network connection from the gyrus frontalis interior shows stronger connections to the middle brain (FWE, P<0.001) and right ventral striatum (FEW, P<0.05, small volume correction). Conclusions: The fMRI results indicate that both auditory and non-auditory centers play important roles in tinnitus. Functional connections among the auditory cortex, thalamus, medial temporal gyrus, parahippocampal gyrus and insula may be an underlying cause for the development of tinnitus.

  20. Ondansetron in patients with tinnitus: randomized double-blind placebo-controlled study.

    Science.gov (United States)

    Taslimi, Shervin; Vahidi, Hamed; Pourvaziri, Ali; Modabbernia, Amirhossein; Fallah, Arezoo Yeke; Yazdani, Nasrin; Taslimi, Negin; Hosseini, Mostafa; Zarandi, Masoud Motesadi

    2013-05-01

    The aim of this study was to assess the effect of ondansetron on symptoms of patients with subjective tinnitus accompanied by sensorineural hearing loss or normal hearing. Sixty patients with a chief complaint of tinnitus (with duration of more than 3 months) were equally randomized to ondansetron or placebo for 4 weeks. The dose of ondansetron was gradually increased from 4 mg/day (one tablet) to 16 mg/day (4 tablets) during 12 days and then continued up to 4 weeks. The exact number of tablets was prescribed in the placebo group. Patients underwent audiologic examinations and filled questionnaires at baseline and after 4 weeks of treatment. Our primary outcomes were changes in Tinnitus Handicap Inventory questionnaire (THI), Tinnitus Severity Index (TSI) and visual analog scale (VAS) scores. Our secondary outcomes were the changes in depression and anxiety based on Hospital Anxiety and Depression (HADS) questionnaire, side effects, tinnitus loudness matching, tinnitus pitch matching, pure tone audiometry and speech recognition threshold (SRT). In the ondansetron and placebo groups, 27 and 26 patients completed the study, respectively. The changes in VAS (P = 0.934), THI (P = 0.776), anxiety (P = 0.313) and depression (P = 0.163) scores were not different between the groups. TSI score decreased significantly in the ondansetron compared with the placebo group (P = 0.004). Changes in tinnitus loudness matching (P = 0.75) and pitch matching (P = 0.56) did not differ between the two groups. Ondansetron, but not placebo, decreased the SRT threshold (right, P tinnitus hypothetically through cochlear amplification.

  1. Neuroscience of Tinnitus.

    Science.gov (United States)

    Ryan, Daniel; Bauer, Carol A

    2016-05-01

    Tinnitus is a consequence of changes in auditory and nonauditory neural networks following damage to the cochlea. Homeostatic compensatory mechanisms occur after hearing loss and these mechanisms alter the balance of excitatory and inhibitory neurotransmitters. In many individuals with hearing loss, chronic tinnitus and related phenomena emerge. Some people with tinnitus are disturbed by this subjective sensation. When auditory network dysfunction is coupled with limbic-gating dysfunction, an otherwise meaningless auditory percept such as tinnitus may acquire negative emotional features. The development of effective treatment options is enhanced by the understanding of the neural networks underpinning tinnitus.

  2. Depression, Anxiety and Stress Scale in patients with tinnitus and hearing loss.

    Science.gov (United States)

    Gomaa, Mohammed Abdel Motaal; Elmagd, Manal Hassan Abo; Elbadry, Mohammed Mohammed; Kader, Rafeek Mohammed Abdel

    2014-08-01

    The study was proposed to evaluate co-morbid depression, anxiety and stress associated with tinnitus patients. The study was done on 196 subjects: 100 patients suffering from subjective tinnitus associated with hearing loss (tinnitus group), 45 patients suffering from hearing loss only (hearing loss group) and 50 healthy subjects not suffering from tinnitus or hearing loss (control group); the age ranges from 20 to 60 years old. The studied sample was subjected to full ear, nose and throat examinations and audiological evaluation. Depression, Anxiety and Stress Scale (DASS) was developed by Levibond H and Levibond F to assess three self-report scales designed to measure the negative emotional status of depression, anxiety and stress. All patients and control group were evaluated by DASS. (1) Depression: males were affected more than females. All patients over 60 years were affected by depression. The duration of tinnitus seems correlating with the severity of depression. Only 2 patients (4.3 %) of the hearing loss group suffer from depression. (2) Anxiety: 90 % of males suffer from anxiety as compared to 83.3 % females. The age group 20-29 years old suffers more than other age groups. Only 4 patients (8.7 %) of hearing loss group suffer from anxiety. (3) Stress: females seem to be affected by the stress (76.7 %) more than males (67.5). Patients in age group 30-39 suffer the most from the disease. There is a direct correlation between duration of tinnitus and severity of stress. No one of the hearing loss group suffers from stress. In conclusion, depression, anxiety and stress should be taken into consideration in the treatment of patients suffering from tinnitus.

  3. Chronic tinnitus:a grading management mode study%慢性耳鸣分级治疗模式的初步探讨

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 龚树生; 李鹏; 李源

    2009-01-01

    目的 探讨针对不同程度慢性耳鸣患者的分级治疗模式,提高耳鸣治疗的成本一效益比.方法 根据患者对耳鸣的烦恼程度和治疗需求,对587例慢性耳鸣患者,进行分级治疗:一级,耳鸣的初步评估、咨询及治疗,筛选出需要临床干预者;二级,提供耳鸣相关知识的宣教;三级,对经过一、二级治疗后仍有治疗需求者,进行深入的听功能诊断、耳鸣评估,根据评估结果 制定并实施个体化的长期治疗方案.结果 75%(441/587)的患者仅需要通过咨询及耳鸣知识的宣教解除其对耳鸣的神秘感、恐惧感而实现耳鸣代偿,25%(146/587)需要长期综合的临床干预.结论 通过有效的分级诊疗可快速而准确地掌握患者耳鸣的程度及治疗需求,为不同患者提供从耳鸣知识的咨询到个体化的长期干预等不同层次的治疗,提高了耳鸣治疗的成本一效益比.%Objective To probe into grading management mode for chronic tinnitns victims, so as to improve the cost-effectiveness rate of tinnitus treatment. Methods According to the severity of patient's own feeling and the therapy demand, the authors managed 587 of chronic tinnitus victims using a progressive methods: Level 1 was primary evaluation, counseling and treatment for tinnitus victims, then determined if the victim require further clinical intervention . Level 2 was educational counseling about the knowledge of tinnitus. Level 3 was further evaluation for hearing function and the severity of tinnitus. Than the authors made and put in practice an individual integrative treatment project for every victim according to the assessment results. Results 75% (441/587) of the chronic tinnitus victims needed only educational counseling which can free them from the mystification and dread of tinnitus, the counseling helped them get habituation of tinnitus; the rest 25% ( 146/587 ) needed long-term integrative clinical treatment. Conclusion Effective grading

  4. SUBJECTIVE TINNITUS AS FIRST PRESENTATION IN A PATIENT WITH METASTATIC LUNG CANCER IN TEMPORAL BONE-A CASE REPORT

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jing; WANG Hongtian; JIA Jingjie; XIAO Yueyong; SHI Huaiyin; YANG Weiyan

    2013-01-01

    Metastasis of lung cancer to the temporal bone is a very rare disease and subjective tinnitus as the present-ing symptom in these patients is even rarer. Here we report a case in which a 42-year-old male presented with subjective tinnitus of three months, with no pulmonary disease symptoms. Pure tone audiometry indi-cated moderate conductive deafness in left ear with an air-bone gap of 21.3 dB. HRCT temporal bone scan-ning indicated high-density shadows in the left epitympanic cavity, sinus tympani and mastoid cavity. Chron-ic otitis media with cholesteatoma was suspected and surgical treatment recommended. However, preopera-tive chest x-ray revealed high-density millet lesions scattered widely in both lungs. HRCT lung scanning confirmed the lungs lesions and indicated lung cancer. In order to determine correlations between the tempo-ral bone and pulmonary lesions, a CT-guided trans-mastoid aspiration biopsy and immunohistochemical study were conducted, which confirmed that the temporal bone lesion was metastatic from the lungs. The pa-tient was given a series of chemotherapy immediately and his tinnitus significantly improved after three months of treatment, with full recovery of his hearing and complete resolution of shadows in the mastoid cavity. Unfortunately, he subsequently developed multiple bone metastases in the 9th month and cerebral metastasis in the 18th month. Multiple organ failure resulted in death in 2.5 years.

  5. Clinical treatment observation of chronic subjective tinnitus treated by masking therapy and tinnitus retraining therapy%掩蔽治疗和习服治疗对慢性主观性耳鸣的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    卢友琪

    2016-01-01

    Objective To observe the clinical curative effect in treating chronic subjective tinnitus with masking therapy and tinnitus retrain-ing therapy(TRT). Methods Subjective tinnitus patients from 2014 to 2015,total 116 cases(161 ears)were selected,who were tested for tinnitus (including matching tinnitus pitch,loudness,residual inhibition test,etc. ),among which masking test results turned out 89 positive cases and 27 negative cases. 48 cases were randomly selected from 89 positive cases,using masking therapy( masking treatment group),the remaining 41 patients and 27 negative cases received tinnitus retraining therapy(tinnitus retraining therapy group). After 6 months and 12 months of treatment,curative effect evaluation of the two groups were performed with the internationally accepted tinnitus disability scale,the THI score and the clinical curative effect were compared. Results Compared with patientsˊpre-treatment conditions,two groups after receiving 6 months and 12 months of treatment, had shown significantly decreased THI score,and the 12 months period score was considerably less than that of the 6 months treatment results,with significant difference( P ﹤0. 01). Retraining group returned the following THI score(35. 56 ± 4. 36 points,27. 01 ± 4. 21 points)when 6 months and 12 months in the treatment. The scores were clearly lower than those of the masking group(37. 56 ± 3. 19 points,33. 41 ± 4. 34 points)with sig-nificant difference( P ﹤0. 01). After 6 months and 12 months of treatment,tinnitus retraining therapy groupˊs total effective rate(73. 5%,80. 8%) was significantly higher than that of the masking group(54. 0%,60. 4%),and the difference was statistically significant( P ﹤0. 05). Conclusion Masking therapy and tinnitus retraining therapy are both effective for chronic patients with subjective tinnitus,with tinnitus retraining therapy show-ing more positive results than masking treatment in terms of THI score and the total effective rate.%目的

  6. Complementary Therapies for Significant Dysfunction from Tinnitus: Treatment Review and Potential for Integrative Medicine

    Directory of Open Access Journals (Sweden)

    Ruth Q. Wolever

    2015-01-01

    Full Text Available Tinnitus is a prevalent and costly chronic condition; no universally effective treatment exists. Only 20% of patients who report tinnitus actually seek treatment, and when treated, most patients commonly receive sound-based and educational (SBE therapy. Additional treatment options are necessary, however, for nonauditory aspects of tinnitus (e.g., anxiety, depression, and significant interference with daily life and when SBE therapy is inefficacious or inappropriate. This paper provides a comprehensive review of (1 conventional tinnitus treatments and (2 promising complementary therapies that have demonstrated some benefit for severe dysfunction from tinnitus. While there has been no systematic study of the benefits of an Integrative Medicine approach for severe tinnitus, the current paper reviews emerging evidence suggesting that synergistic combinations of complementary therapies provided within a whole-person framework may augment SBE therapy and empower patients to exert control over their tinnitus symptoms without the use of medications, expensive devices, or extended programs.

  7. Intratympanic injection of dexamethasone for treatment of tinnitus in patients with sudden sensorineural hearing loss.

    Science.gov (United States)

    Yoshida, Tadao; Teranishi, Masaaki; Iwata, Tomoyuki; Otake, Hironao; Nakashima, Tsutomu

    2012-01-09

    The purpose of this study is to test the effectiveness of intratympanic dexamethasone injections as a treatment for severe tinnitus in idiopathic sudden sensorineural hearing loss (SNHL). We studied 37 patients who received intratympanic dexamethasone injections and 14 control patients who did not receive it, with severe tinnitus after onset of unilateral sudden SNHL. Hearing level did not change during this study in any patient. The relationship between the duration of tinnitus and effectiveness of treatment was investigated in sudden SNHL. We used a visual analogue scale to evaluate 51 patients with severe tinnitus at the stage of stable hearing level after idiopathic sudden sensorineural hearing loss. Forty-one per cent of patients showed significant improvement after treatment. The average period between onset of sudden sensorineural hearing loss and initiation of intratympanic dexamethasone injection was significantly shorter (207 days) in the improved group than in the unchanged group (482 days) (Psudden SNHL at the stage of stable hearing level, and the shorter the period from onset of sudden deafness to the start of intratympanic dexamethasone treatment, the greater the improvement in tinnitus that can be expected.

  8. Lateralization of functional magnetic resonance imaging (fMRI) activation in the auditory pathway of patients with lateralized tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    Smits, Marion [Erasmus MC - University Medical Center Rotterdam, Department of Radiology, Hs 224, Rotterdam (Netherlands); Kovacs, Silvia; Peeters, Ronald R.; Hecke, Paul van; Sunaert, Stefan [University Hospitals of the Catholic University Leuven, Department of Radiology, Leuven (Belgium); Ridder, Dirk de [University of Antwerp, Department of Neurosurgery, Edegem (Belgium)

    2007-08-15

    Tinnitus is hypothesized to be an auditory phantom phenomenon resulting from spontaneous neuronal activity somewhere along the auditory pathway. We performed fMRI of the entire auditory pathway, including the inferior colliculus (IC), the medial geniculate body (MGB) and the auditory cortex (AC), in 42 patients with tinnitus and 10 healthy volunteers to assess lateralization of fMRI activation. Subjects were scanned on a 3T MRI scanner. A T2*-weighted EPI silent gap sequence was used during the stimulation paradigm, which consisted of a blocked design of 12 epochs in which music presented binaurally through headphones, which was switched on and off for periods of 50 s. Using SPM2 software, single subject and group statistical parametric maps were calculated. Lateralization of activation was assessed qualitatively and quantitatively. Tinnitus was lateralized in 35 patients (83%, 13 right-sided and 22 left-sided). Significant signal change (P{sub corrected} < 0.05) was found bilaterally in the primary and secondary AC, the IC and the MGB. Signal change was symmetrical in patients with bilateral tinnitus. In patients with lateralized tinnitus, fMRI activation was lateralized towards the side of perceived tinnitus in the primary AC and IC in patients with right-sided tinnitus, and in the MGB in patients with left-sided tinnitus. In healthy volunteers, activation in the primary AC was left-lateralized. Our paradigm adequately visualized the auditory pathways in tinnitus patients. In lateralized tinnitus fMRI activation was also lateralized, supporting the hypothesis that tinnitus is an auditory phantom phenomenon. (orig.)

  9. Suppression of Tinnitus in a Patient with Unilateral Sudden Hearing Loss: A Case Report

    Directory of Open Access Journals (Sweden)

    Alessandra Fioretti

    2012-01-01

    Full Text Available We describe a case of a 67-year-old woman with severe disabling right-sided tinnitus, mild hyperacusis, and headache. The tinnitus was associated with sudden right hearing loss and vertigo, which occurred about 18 months before. Magnetic resonance imaging (MRI resulted in normal anatomical structures of the cochlea and of the cranial nerves showing a partial empty sella syndrome with suprasellar cistern hernia. Angio-MR revealed a bilateral contact between the anterior-inferior cerebellar artery (AICA and the acoustic-facial nerve with a potential neurovascular conflict. Surgery was considered unnecessary after further evaluations. The right ear was successfully treated with a combination device (hearing aid plus sound generator. Shortly after a standard fitting procedure, the patient reported a reduction of tinnitus, hyperacusis, and headache which completely disappeared at the follow-up evaluation after 3, 6, and 12 months. This paper demonstrates that the combination device resulted in a complete tinnitus and hyperacusis suppression in a patient with unilateral sensorineural sudden hearing loss. Our paper further supports the restoration of peripheral sensory input for the treatment of tinnitus associated with hearing loss in selected patients.

  10. Cochlear and brainstem audiologic findings in normal hearing tinnitus subjects in comparison with non-tinnitus control group.

    Directory of Open Access Journals (Sweden)

    Shadman Nemati

    2014-11-01

    Full Text Available While most tinnitus cases have some degree of hearing impairment, a small percent of the patients admitted to Ear, Nose and Throat Clinics or Hearing Evaluation Centers are those who complain of tinnitus despite having normal hearing thresholds. Present study was performed in order to better understanding of the probable causes of tinnitus and to investigate possible changes in the cochlear and auditory brainstem function in normal hearing patients with chronic tinnitus. Altogether, 63 ears (31 ears with tinnitus and 32 ears without tinnitus were examined. The prevalence of transient evoked otoacoustic emissions and characteristics of the auditory brainstem response components including wave latencies and wave amplitudes was determined in the two groups and analyzed with appropriate statistical methods. There was no difference between the prevalence of transient evoked emissions in the two groups. The mean difference between absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that were not statistically significant. Also, the interpeak latency values of I-III, III-V and I-V in both groups had no significant difference. Only the V/I amplitude ratio in the tinnitus group was significantly larger than the other group (p =0.04. The changes observed in amplitude of waves, especially in the later ones, can be considered as an Audiologic finding in normal hearing tinnitus subjects and its possible role in generation of tinnitus in these patients must be investigated.

  11. Cochlear and brainstem audiologic findings in normal hearing tinnitus subjects in comparison with non-tinnitus control group.

    Science.gov (United States)

    Nemati, Shadman; Faghih Habibi, Ali; Panahi, Rasool; Pastadast, Masoomeh

    2014-01-01

    While most tinnitus cases have some degree of hearing impairment, a small percent of the patients admitted to Ear, Nose and Throat Clinics or Hearing Evaluation Centers are those who complain of tinnitus despite having normal hearing thresholds. Present study was performed in order to better understanding of the probable causes of tinnitus and to investigate possible changes in the cochlear and auditory brainstem function in normal hearing patients with chronic tinnitus. Altogether, 63 ears (31 ears with tinnitus and 32 ears without tinnitus) were examined. The prevalence of transient evoked otoacoustic emissions and characteristics of the auditory brainstem response components including wave latencies and wave amplitudes was determined in the two groups and analyzed with appropriate statistical methods. There was no difference between the prevalence of transient evoked emissions in the two groups. The mean difference between absolute latencies of waves I, III and V was less than 0.1 ms between the two groups that were not statistically significant. Also, the interpeak latency values of I-III, III-V and I-V in both groups had no significant difference. Only the V/I amplitude ratio in the tinnitus group was significantly larger than the other group (p =0.04). The changes observed in amplitude of waves, especially in the later ones, can be considered as an Audiologic finding in normal hearing tinnitus subjects and its possible role in generation of tinnitus in these patients must be investigated.

  12. Biofeedback-Based Behavioral Treatment for Chronic Tinnitus: Results of a Randomized Controlled Trial

    Science.gov (United States)

    Weise, Cornelia; Heinecke, Kristin; Rief, Winfried

    2008-01-01

    Many tinnitus sufferers believe that their tinnitus has an organic basis and thus seek medical rather than psychological treatments. Tinnitus has been found to be associated with negative appraisal, dysfunctional attention shift, and heightened psychophysiological arousal, so cognitive-behavioral interventions and biofeedback are commonly…

  13. 耳鸣患者听力分析%The Analysis of Hearing of Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    林春招; 隆琰; 黄秋平; 白俊志; 江远仕

    2011-01-01

    目的 探讨以耳鸣为首发症状的患者用纯音电测听进行听力检查的必要性.方法 对218例耳鸣患者的纯音电测听结果进行分析.结果 218例耳鸣患者中,共有123例听力不正常,95例听力正常的患者中,有50例除耳鸣外,无其他病因.结论 听力正常的耳鸣患者中,如果未查出明确病因,需进一步行脑干电反应测听、耳声发射等听力检测及其他必要检查,以明确耳鸣的原因或听觉系统发生异常的部位,对耳鸣的早期诊断及治疗有重要意义,但纯音电测听应作为耳鸣患者首次就诊时的常规检查项目.%Objective To investigate the necessity to test the hearing of patients whose initial symptom is tinnitus with pure tone audiometer. Methods To analyze the results of pure tone audiometer of 218 tinnitus patients.Results Among 218 cases of tinnitus patients,a total of 123 patients with abnormal hearing,among 95 cases of patients with normal hearing, except for 50 cases of tinnitus, no other cause of disease. Conclusion Among the normal hearing tinnitus patients, we should do further hearing test for them if they are not identified a clear cause of disease,such as auditory brainstem response,otoacoustic emission and other necessary checks to clear the reasons for tinnitus or the position of the unusual auditory system. It is important for early diagnosis and treatment of tinnitus. But the pure-tone audiometer should be a routine examination when tinnitus patients come for the first visit.

  14. Can the tinnitus spectrum identify tinnitus subgroups?

    Directory of Open Access Journals (Sweden)

    Karin M Heijneman

    2013-01-01

    Full Text Available The tinnitus spectrum is a psycho-acoustic metric of tinnitus. Previous work found a tight relation between the spectrum and the tone audiogram. This suggests that the spectrum and the audiogram provide essentially the same information, and the added value of the spectrum is limited. In order to test whether the spectrum shows tinnitus characteristics that cannot be inferred from the audiogram, we re-examined the relation between the tinnitus spectrum and the tone audiogram, in a group of 80 tinnitus patients. We defined three subgroups of patients, using the shape of their tinnitus spectrum: (1 patients with a spectrum, monotonously increasing with frequency (2 patients with a distinct peak in their spectrum, (3 all other patients. Patients in group 3 typically showed low frequency tinnitus spectra. In all three groups, the largest hearing loss was at high frequencies (>2 kHz. The mean audiograms of group 1 and 2 were remarkably similar; group 3 had an additional hearing loss for the lower frequencies (<2 kHz. The three groups did not differ with respect to age, sex, or tinnitus questionnaire outcomes. In subgroups 2 and 3, the shape of the spectrum clearly differed from that of the tone audiogram. In other words, the spectrum technique provided information that could not have been obtained by tone audiometry alone. Therefore, the spectrum measurement may develop into a technique that can differentiate between classes of tinnitus. This may eventually contribute to the effective management of tinnitus, as various classes of tinnitus may require different therapeutic interventions.

  15. A critical evaluation of Web sites offering patient information on tinnitus.

    Science.gov (United States)

    Kieran, Stephen M; Skinner, Liam J; Donnelly, Martin; Smyth, David A

    2010-01-01

    The Internet is a vast information resource for both patients and healthcare professionals. However, the quality and content often lack formal scrutiny, so we examined the quality of patient information regarding tinnitus on the Internet. Using the three most popular search engines (google.com, yahoo.com, and msn.com), we found pertinent Web sites using the search term tinnitus. Web sites' accountability and authorship were evaluated using previously published criteria. The quality of patient information about tinnitus was assessed using a new 10-point scale, the Tinnitus Information Value (TIV). Statistical analysis was performed using the independent sample t-test (p Tinnitus information available on the Internet is indeed variable, and care should be taken in recommending tinnitus Web sites to patients.

  16. A critical evaluation of Web sites offering patient information on tinnitus.

    LENUS (Irish Health Repository)

    Kieran, Stephen M

    2012-02-01

    The Internet is a vast information resource for both patients and healthcare professionals. However, the quality and content often lack formal scrutiny, so we examined the quality of patient information regarding tinnitus on the Internet. Using the three most popular search engines (google.com, yahoo.com, and msn.com), we found pertinent Web sites using the search term tinnitus. Web sites\\' accountability and authorship were evaluated using previously published criteria. The quality of patient information about tinnitus was assessed using a new 10-point scale, the Tinnitus Information Value (TIV). Statistical analysis was performed using the independent sample t-test (p Tinnitus information available on the Internet is indeed variable, and care should be taken in recommending tinnitus Web sites to patients.

  17. Effectiveness of combined counseling and low-level laser stimulation in the treatment of disturbing chronic tinnitus.

    Science.gov (United States)

    Cuda, Domenico; De Caria, Antonio

    2008-01-01

    We recruited 46 adult patients affected by disturbing tinnitus lasting for at least 3 years. All were treated with a combined counseling protocol constituting hypnotherapeutic and muscle relaxation techniques. We randomly assigned 26 patients to the group receiving low-level laser stimulation treatment and 20 to the placebo group. The laser power was 5 mV and the wavelength 650 nm. The irradiation lasted 20 minutes daily for 3 months. The Tinnitus Handicap Inventory (THI) questionnaire was submitted at the beginning and at the end of treatment. The THI scores improved in the entire sample after treatment but more significantly in the group receiving low-level laser stimulation. From the point of view of clinical classification, approximately 61% of irradiated patients had tinnitus severity decreased by one class, in comparison to 35% of the placebo group.

  18. Hearing and tinnitus in head and neck cancer patients after chemoradiotherapy.

    Science.gov (United States)

    Niemensivu, Riina; Saarilahti, K; Ylikoski, J; Aarnisalo, A; Mäkitie, A A

    2016-09-01

    Head and neck cancer patients treated with high-dose cisplatin and radiotherapy will suffer from hearing deficits. The current low-dose regimen seldom causes hearing threshold decrease. Tinnitus in this patient population has not been investigated earlier. We aimed to evaluate the possible ototoxicity of low-dose (40 mg/m(2)) weekly administered cisplatin with concomitant radiotherapy. Twenty-two patients with locally advanced head and neck cancer were prospectively recruited to participate the study after treatment recommendation for chemoradiotherapy with low-dose cisplatin and intensity-modulated radiotherapy. They filled in a Tinnitus Handicap Inventory and undertook audiologic evaluations before and after treatment. Ototoxicity was determined by >10 dB threshold shift at frequencies 4 and 8 kHz or in pure tone average. A historical cohort of nine patients treated with high-dose (100 mg/m(2)) cisplatin and radiotherapy was used for comparison. After treatment, study patients demonstrated no significant changes in their hearing over frequencies 0.5-4 kHz, and the threshold shifts were minor at 4 and 8 kHz. More than 50 % of patients reported no tinnitus after treatment and the remainder only had slight to moderate tinnitus causing no interference with their daily activities. In contrast, five of the nine patients having received high-dose cisplatin reported disturbing tinnitus. Further, changes in pure tone averages were exhibited in three of these patients and six had significant threshold shifts at 4 and 8 kHz. Head and neck cancer patients treated with concomitant intensity-modulated radiotherapy and low-dose cisplatin seem to experience only minor audiological sequelae and therefore, these patients appear to require no routine audiological monitoring. Such evaluation could be performed only when needed.

  19. Does Chronic Tinnitus Alter the Emotional Response Function of the Amygdala?: A Sound-Evoked fMRI Study

    Science.gov (United States)

    Davies, Jeff E.; Gander, Phillip E.; Hall, Deborah A.

    2017-01-01

    Tinnitus is often associated with strong negative thoughts and emotions which can contribute to a distressing and chronic long-term condition. The amygdala, the “feeling and reacting” part of the brain, may play a key role in this process. Although implicated in several theoretical models of tinnitus, quantification of activity in the human amygdala has only been made possible more recently through neuroimaging methods such as functional magnetic resonance imaging (fMRI) but benefits from modified scanning parameters using a double-echo acquisition for improved BOLD sensitivity. This study thus examined the role of the amygdala in emotional sound processing in people with tinnitus using a novel double-echo imaging sequence for optimal detectability of subcortical activity. Our hypotheses were: (1) emotionally evocative sound clips rated as pleasant or unpleasant would elicit stronger amygdalar activation than sound clips rated as neutral, (2) people with tinnitus have greater amygdalar activation in response to emotionally evocative sounds (relative to neutral sounds) compared to controls. Methods: Twelve participants all with chronic, constant tinnitus took part. We also recruited 11 age and hearing-matched controls. Participants listened to a range of emotionally evocative sound clips; rated as pleasant, unpleasant or neutral. A region-of-interest analysis was chosen to test our a priori hypotheses. Results: Both groups displayed a robust and similar overall response to sounds vs. silence in the following ascending auditory pathways; inferior colliculus, medial geniculate body and the primary auditory cortex. In support of our first hypothesis, the amygdala's response to pleasant and unpleasant sound clips was significantly greater than neutral sounds. Opposing our second hypothesis, we found that the amygdala's overall response to pleasant and unpleasant sounds (compared to neutral sounds) was actually lower in the tinnitus group as compared to the controls

  20. The use of fractal tones in tinnitus patient management

    Directory of Open Access Journals (Sweden)

    Robert W Sweetow

    2013-01-01

    Full Text Available A variety of noises have been employed for decades in an effort to facilitate habituation, mask, or suppress tinnitus. Many of these sounds have reportedly provided benefit, but success has not been universal. More recently, musical stimuli have been added as a sound therapy component. The potential advantages of using such stimuli, in particular fractal tones, in combination with amplification are discussed in this paper.

  1. Radiologic diagnostic and therapeutic options in patients with pulsatile tinnitus; Radiologische Diagnostik des Ohrgeraeuschs und therapeutische Optionen

    Energy Technology Data Exchange (ETDEWEB)

    Wanke, Isabel [Klinik Hirslanden, Zuerich (Switzerland). Abt. fuer Neuroradiologie; Universitaetsklinikum Essen (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie und Neuroradiologie; Forsting, Michael [Universitaetsklinikum Essen (Germany). Inst. fuer Radiologie und Neuroradiolgoie

    2010-03-15

    A pulse synchronous tinnitus is characterized by a rhythmic sound that is in sync with the patient heartbeat or respiration and can be perceived by the patient as a bruit. Different from the more common classic and continuous ear sound, with pulse synchronous tinnitus one may often discover a pathological neovascular condition that can be diagnosed with medical imaging. This review covers the different conditions leading to pulse synchronous tinnitus and provides indications requiring preventive and active treatment to avoid potential but serious sequela for the patient. (orig.)

  2. Emerging pharmacotherapy of tinnitus.

    Science.gov (United States)

    Langguth, Berthold; Salvi, Richard; Elgoyhen, Ana Belén

    2009-12-01

    Tinnitus, the perception of sound in the absence of an auditory stimulus, is perceived by about 1 in 10 adults, and for at least 1 in 100, tinnitus severely affects their quality of life. Because tinnitus is frequently associated with irritability, agitation, stress, insomnia, anxiety and depression, the social and economic burdens of tinnitus can be enormous. No curative treatments are available. However, tinnitus symptoms can be alleviated to some extent. The most widespread management therapies consist of auditory stimulation and cognitive behavioral treatment, aiming at improving habituation and coping strategies. Available clinical trials vary in methodological rigor and have been performed for a considerable number of different drugs. None of the investigated drugs have demonstrated providing replicable long-term reduction of tinnitus impact in the majority of patients in excess of placebo effects. Accordingly, there are no FDA or European Medicines Agency approved drugs for the treatment of tinnitus. However, in spite of the lack of evidence, a large variety of different compounds are prescribed off-label. Therefore, more effective pharmacotherapies for this huge and still growing market are desperately needed and even a drug that produces only a small but significant effect would have an enormous therapeutic impact. This review describes current and emerging pharmacotherapies with current difficulties and limitations. In addition, it provides an estimate of the tinnitus market. Finally, it describes recent advances in the tinnitus field which may help overcome obstacles faced in the pharmacological treatment of tinnitus. These include incomplete knowledge of tinnitus pathophysiology, lack of well-established animal models, heterogeneity of different forms of tinnitus, difficulties in tinnitus assessment and outcome measurement and variability in clinical trial methodology.

  3. Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy

    Directory of Open Access Journals (Sweden)

    Christoph Maria Krick

    2015-02-01

    Full Text Available Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-minutes sessions of individualized therapy implemented over one week. Clinical improvement and long-term effects over several years have previously been published. However the underlying neural basis of the therapy’s success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG and healthy active controls (AC. Non-treated patients were also included as passive controls (PTC. As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (two-way ANOVA revealed structural gray matter (GM increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG versus AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be

  4. Clinical Evaluation of Tinnitus.

    Science.gov (United States)

    Hertzano, Ronna; Teplitzky, Taylor B; Eisenman, David J

    2016-05-01

    The clinical evaluation of patients with tinnitus differs based on whether the tinnitus is subjective or objective. Subjective tinnitus is usually associated with a hearing loss, and therefore, the clinical evaluation is focused on an otologic and audiologic evaluation with adjunct imaging/tests as necessary. Objective tinnitus is divided into perception of an abnormal somatosound or abnormal perception of a normal somatosound. The distinction between these categories is usually possible based on a history, physical examination, and audiogram, leading to directed imaging to identify the underlying abnormality.

  5. The More the Worse: the Grade of Noise-Induced Hearing Loss Associates with the Severity of Tinnitus

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    Agnieszka J. Szczepek

    2010-08-01

    Full Text Available Tinnitus disturbs lives and negatively affects the quality of life of about 2% of the adult world population. Research has shown that the main cause of tinnitus is hearing loss. To analyze a possible association of the degree of hearing loss with the severity of tinnitus, we have performed a retrospective study using admission data on 531 patients suffering from chronic tinnitus. We have found that 83% of our tinnitus patients had a high frequency hearing loss corresponding to a noise-induced hearing loss (NIHL. There was a significant correlation between the mean hearing loss and the tinnitus loudness (p < 0.0001. Interestingly, patients suffering from decompensated chronic tinnitus had a greater degree of hearing loss than the patients with compensated form of tinnitus. In addition, we demonstrate that the degree of hearing loss positively correlates with the two subscales (“intrusiveness” and “auditory perceptional difficulties” of the Tinnitus Questionnaire. Our retrospective study provides indirect evidence supporting the hypothesis that the degree of noise-induced hearing loss influences the severity of tinnitus.

  6. The radiologic evaluation of tinnitus

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    Branstetter, Barton F. [University of Pittsburgh Medical Center, Departments of Radiology and Otolaryngology, Pittsburgh, PA (United States); Weissman, Jane L. [Oregon Health Sciences University, Departments of Radiology, Ophthalmology, and Otolaryngology, Portland, OR (United States)

    2006-12-15

    Tinnitus (''ringing in the ears'') is a prevalent symptom in the general population, and often brings patients to medical attention. Many causes of tinnitus are evident radiographically. The most frequently-encountered causes of tinnitus are discussed, and imaging recommendations are provided. (orig.)

  7. Tinnitus-Induced Suicide

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    Serhan Derin

    2015-04-01

    Full Text Available Tinnitus is one of the most common complaints in otolaryngology practice. Tinnitus may often be accompanied with hearing loss and vertigo. Tinnitus may impair the quality of life in advanced degrees. In very rare cases, it may cause suicide. In this report, we presented the case of a 61-year-old female patient who attempted suicide due to tinnitus. She suffered from constant tinnitus in both ears since she had undergone serous otitis media two months ago. Despite medical treatment, tinnitus did not improve, and lately, she suffered from severe insomnia. Due to severe tinnitus and insomnia, she drank hydrochloric acid. She was consequently admitted to our emergency department by her family. On physical examination, the patient’s vital signs were stable and floor of the mouth mucosa, gingiva, and hard and soft palate had widely ulcerated areas. Severe laryngeal edema and ulceration was observed on laryngoscopic examination. The eardrum was myringosclerotic on otoscopic examination. The patient was closely followed for respiratory distress; however, tracheostomy was not required. The abovementioned case suggests that patients admitted with complaints of tinnitus should be questioned for severity of depressive symptoms, considering that the presence of depressive symptoms in these patients may result in an attempt of suicide. These patients should be evaluated not only in otolaryngology clinics but also in psychiatric clinics, and subsequently receive appropriate support.

  8. Acupuncture Treatment of Tinnitus

    Institute of Scientific and Technical Information of China (English)

    胡金生

    2004-01-01

    @@ Case History Mr. Bakir Hossain, a 49-year-old engineer of a company in Decca, the capital of the People's Republic of Bangladesh, paid his first visit on May8, 2002, with the chief complaint of tinnitus for more than a year. The patient stated that the tinnitus appeared a year before, accompanied with hypoacusis,which disturbed his work and sleep.

  9. Polarity Specific Suppression Effects of Transcranial Direct Current Stimulation for Tinnitus

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    Kathleen Joos

    2014-01-01

    Full Text Available Tinnitus is the perception of a sound in the absence of an external auditory stimulus and affects 10–15% of the Western population. Previous studies have demonstrated the therapeutic effect of anodal transcranial direct current stimulation (tDCS over the left auditory cortex on tinnitus loudness, but the effect of this presumed excitatory stimulation contradicts with the underlying pathophysiological model of tinnitus. Therefore, we included 175 patients with chronic tinnitus to study polarity specific effects of a single tDCS session over the auditory cortex (39 anodal, 136 cathodal. To assess the effect of treatment, we used the numeric rating scale for tinnitus loudness and annoyance. Statistical analysis demonstrated a significant main effect for tinnitus loudness and annoyance, but for tinnitus annoyance anodal stimulation has a significantly more pronounced effect than cathodal stimulation. We hypothesize that the suppressive effect of tDCS on tinnitus loudness may be attributed to a disrupting effect of ongoing neural hyperactivity, independent of the inhibitory or excitatory effects and that the reduction of annoyance may be induced by influencing adjacent or functionally connected brain areas involved in the tinnitus related distress network. Further research is required to explain why only anodal stimulation has a suppressive effect on tinnitus annoyance.

  10. Prefrontal cortex based sex differences in tinnitus perception: same tinnitus intensity, same tinnitus distress, different mood.

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    Sven Vanneste

    Full Text Available BACKGROUND: Tinnitus refers to auditory phantom sensation. It is estimated that for 2% of the population this auditory phantom percept severely affects the quality of life, due to tinnitus related distress. Although the overall distress levels do not differ between sexes in tinnitus, females are more influenced by distress than males. Typically, pain, sleep, and depression are perceived as significantly more severe by female tinnitus patients. Studies on gender differences in emotional regulation indicate that females with high depressive symptoms show greater attention to emotion, and use less anti-rumination emotional repair strategies than males. METHODOLOGY: The objective of this study was to verify whether the activity and connectivity of the resting brain is different for male and female tinnitus patients using resting-state EEG. CONCLUSIONS: Females had a higher mean score than male tinnitus patients on the BDI-II. Female tinnitus patients differ from male tinnitus patients in the orbitofrontal cortex (OFC extending to the frontopolar cortex in beta1 and beta2. The OFC is important for emotional processing of sounds. Increased functional alpha connectivity is found between the OFC, insula, subgenual anterior cingulate (sgACC, parahippocampal (PHC areas and the auditory cortex in females. Our data suggest increased functional connectivity that binds tinnitus-related auditory cortex activity to auditory emotion-related areas via the PHC-sgACC connections resulting in a more depressive state even though the tinnitus intensity and tinnitus-related distress are not different from men. Comparing male tinnitus patients to a control group of males significant differences could be found for beta3 in the posterior cingulate cortex (PCC. The PCC might be related to cognitive and memory-related aspects of the tinnitus percept. Our results propose that sex influences in tinnitus research cannot be ignored and should be taken into account in functional

  11. Deep Brain Stimulation——A new treatment for tinnitus

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Intractable tinnitus can lead to serious consequences. Study evidence indicates that the central nervous system is involved in generation and maintenance of chronic tinnitus and that tinnitus and other neurologic symptoms such as chronic pain may share similar mechanisms. Brain ablation and stimulation are used to treat chronic pain with success. Recent studies showed that ablation and stimulation in non-auditory areas resulted in tinnitus improvement. Deep brain stimulation (DBS) may be an alternative treatment for intractable tinnitus and deserves further study.

  12. Playing and listening to tailor-made notched music: cortical plasticity induced by unimodal and multimodal training in tinnitus patients.

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    Pape, Janna; Paraskevopoulos, Evangelos; Bruchmann, Maximilian; Wollbrink, Andreas; Rudack, Claudia; Pantev, Christo

    2014-01-01

    BACKGROUND. The generation and maintenance of tinnitus are assumed to be based on maladaptive functional cortical reorganization. Listening to modified music, which contains no energy in the range of the individual tinnitus frequency, can inhibit the corresponding neuronal activity in the auditory cortex. Music making has been shown to be a powerful stimulator for brain plasticity, inducing changes in multiple sensory systems. Using magnetoencephalographic (MEG) and behavioral measurements we evaluated the cortical plasticity effects of two months of (a) active listening to (unisensory) versus (b) learning to play (multisensory) tailor-made notched music in nonmusician tinnitus patients. Taking into account the fact that uni- and multisensory trainings induce different patterns of cortical plasticity we hypothesized that these two protocols will have different affects. RESULTS. Only the active listening (unisensory) group showed significant reduction of tinnitus related activity of the middle temporal cortex and an increase in the activity of a tinnitus-coping related posterior parietal area. CONCLUSIONS. These findings indicate that active listening to tailor-made notched music induces greater neuroplastic changes in the maladaptively reorganized cortical network of tinnitus patients while additional integration of other sensory modalities during training reduces these neuroplastic effects.

  13. Playing and Listening to Tailor-Made Notched Music: Cortical Plasticity Induced by Unimodal and Multimodal Training in Tinnitus Patients

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    Janna Pape

    2014-01-01

    Full Text Available Background. The generation and maintenance of tinnitus are assumed to be based on maladaptive functional cortical reorganization. Listening to modified music, which contains no energy in the range of the individual tinnitus frequency, can inhibit the corresponding neuronal activity in the auditory cortex. Music making has been shown to be a powerful stimulator for brain plasticity, inducing changes in multiple sensory systems. Using magnetoencephalographic (MEG and behavioral measurements we evaluated the cortical plasticity effects of two months of (a active listening to (unisensory versus (b learning to play (multisensory tailor-made notched music in nonmusician tinnitus patients. Taking into account the fact that uni- and multisensory trainings induce different patterns of cortical plasticity we hypothesized that these two protocols will have different affects. Results. Only the active listening (unisensory group showed significant reduction of tinnitus related activity of the middle temporal cortex and an increase in the activity of a tinnitus-coping related posterior parietal area. Conclusions. These findings indicate that active listening to tailor-made notched music induces greater neuroplastic changes in the maladaptively reorganized cortical network of tinnitus patients while additional integration of other sensory modalities during training reduces these neuroplastic effects.

  14. Influence of tinnitus percentage index of speech recognition in patients with normal hearing

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    Urnau, Daila

    2010-12-01

    Full Text Available Introduction: The understanding of speech is one of the most important measurable aspects of human auditory function. Tinnitus affects the quality of life, impairing communication. Objective: To investigate possible changes in the Percentage Index of Speech Recognition (SDT in individuals with tinnitus have normal hearing and examining the relationship between tinnitus, gender and age. Methods:A retrospective study by analyzing the records of 82 individuals of both genders, aged 21-70 years, totaling 128 ears with normal hearing. The ears were analyzed separately, and divided into control group, no complaints of tinnitus and group study, with complaints of tinnitus. The variables gender and age groups and examined the influence of tinnitus in the SDT. It was considered normal, the percentage of 100% correct and changed, and the value between 88-96%. These criteria were adopted, since the percentage below 88% correct is found in individuals with sensorineural hearing loss. Results:There was no statistically significant difference between the variables age and tinnitus, and tinnitus SDT, only gender and tinnitus. The prevalence of tinnitus in females (56%, higher incidence of tinnitus in the age group 31-40 years (41.67% and fewer from 41 to 50 years (18.75% and on the SDT there was a greater percentage change in individuals with tinnitus (61.11%. Conclusion: The buzz does not interfere with SDT and there is no relationship between tinnitus and age, only between tinnitus and gender.

  15. The characteristic and changes of the event-related potentials (ERP and brain topographic maps before and after treatment with rTMS in subjective tinnitus patients.

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    Haidi Yang

    Full Text Available OBJECTIVES: To compare the event-related potentials (ERPs and brain topographic maps characteristic and change in normal controls and subjective tinnitus patients before and after repetitive transcranial magnetic stimulation (rTMS treatment. METHODS AND PARTICIPANTS: The ERPs and brain topographic maps elicited by target stimulus were compared before and after 1-week treatment with rTMS in 20 subjective tinnitus patients and 16 healthy controls. RESULTS: Before rTMS, target stimulus elicited a larger N1 component than the standard stimuli (repeating soundsin control group but not in tinnitus patients. Instead, the tinnitus group pre-treatment exhibited larger amplitude of N1 in response to standard stimuli than to deviant stimuli. Furthermore tinnitus patients had smaller mismatch negativity (MMN and late discriminative negativity (LDNcomponent at Fz compared with the control group. After rTMS treatment, tinnitus patients showed increased N1 response to deviant stimuli and larger MMN and LDN compared with pre-treatment. The topographic maps for the tinnitus group before rTMS -treatment demonstrated global asymmetry between the left and right cerebral hemispheres with more negative activities in left side and more positive activities in right side. In contrast, the brain topographic maps for patients after rTMS-treatment and controls seem roughly symmetrical. The ERP amplitudes and brain topographic maps in post-treatment patient group showed no significant difference with those in controls. CONCLUSIONS: The characterical changes in ERP and brain topographic maps in tinnitus patients maybe related with the electrophysiological mechanism of tinnitus induction and development. It can be used as an objective biomarker for the evaluation of auditory central in subjective tinnitus patients. These findings support the notion that rTMS treatment in tinnitus patients may exert a beneficial effect.

  16. The Characteristic and Changes of the Event-Related Potentials (ERP) and Brain Topographic Maps before and after Treatment with rTMS in Subjective Tinnitus Patients

    Science.gov (United States)

    Wang, Changming; Zheng, Yiqing; Zhang, Xueyuan

    2013-01-01

    Objectives To compare the event-related potentials (ERPs) and brain topographic maps characteristic and change in normal controls and subjective tinnitus patients before and after repetitive transcranial magnetic stimulation (rTMS) treatment. Methods and Participants The ERPs and brain topographic maps elicited by target stimulus were compared before and after 1-week treatment with rTMS in 20 subjective tinnitus patients and 16 healthy controls. Results Before rTMS, target stimulus elicited a larger N1 component than the standard stimuli (repeating sounds)in control group but not in tinnitus patients. Instead, the tinnitus group pre-treatment exhibited larger amplitude of N1 in response to standard stimuli than to deviant stimuli. Furthermore tinnitus patients had smaller mismatch negativity (MMN) and late discriminative negativity (LDN)component at Fz compared with the control group. After rTMS treatment, tinnitus patients showed increased N1 response to deviant stimuli and larger MMN and LDN compared with pre-treatment. The topographic maps for the tinnitus group before rTMS -treatment demonstrated global asymmetry between the left and right cerebral hemispheres with more negative activities in left side and more positive activities in right side. In contrast, the brain topographic maps for patients after rTMS-treatment and controls seem roughly symmetrical. The ERP amplitudes and brain topographic maps in post-treatment patient group showed no significant difference with those in controls. Conclusions The characterical changes in ERP and brain topographic maps in tinnitus patients maybe related with the electrophysiological mechanism of tinnitus induction and development. It can be used as an objective biomarker for the evaluation of auditory central in subjective tinnitus patients. These findings support the notion that rTMS treatment in tinnitus patients may exert a beneficial effect. PMID:23951019

  17. Differences in resting state regional cerebral blood flow assessed with 99mTc-HMPAO SPECT and brain atlas matching between depressed patients with and without tinnitus.

    Science.gov (United States)

    Gardner, A; Pagani, M; Jacobsson, H; Lindberg, G; Larsson, S A; Wägner, A; Hällstrom, T

    2002-05-01

    An increased occurrence of major depressive disorder has been reported in tinnitus patients, and of tinnitus in depressive patients. Involvement of several Brodmann areas (BAs) has been reported in tinnitus perception. The aim of this study was to assess the regional cerebral blood flow (rCBF) changes in depressed patients with and without tinnitus. The rCBF distribution at rest was compared among 45 patients with a lifetime prevalence of major depressive disorder, of whom 27 had severe tinnitus, and 26 normal healthy subjects. 99mTc-hexamethylenepropylene amine oxime (99mTc-HMPAO) single photon emission computed tomography (SPECT), using a three-headed gamma camera, was performed and the uptake in 34 functional sub-volumes of the brain bilaterally was assessed by a computerized brain atlas. Decreased rCBF in right frontal lobe BA 45 (Ptinnitus patients compared with non-tinnitus patients. The proportion of tinnitus patients with pronounced rCBF alterations in one or more of the temporal lobe BAs 41+21+22 was increased compared to gender matched controls (Ptinnitus (Ptinnitus patients only in three limbic BAs (Ptinnitus patients only in five BAs subserving auditory perception and processing (Pdepressed patients with and without tinnitus were found in this study. The rCBF alterations were distributed in the cortex and were particularly specific in the auditory cortex. These findings suggest that taking audiological symptoms into account may yield more consistent results between rCBF studies of depression.

  18. Structural Brain Changes Following Left Temporal Low-Frequency rTMS in Patients with Subjective Tinnitus

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    Langguth, Berthold; Poeppl, Timm B.; Rupprecht, Rainer; Hajak, Göran; Landgrebe, Michael; Schecklmann, Martin

    2014-01-01

    Repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been used to treat patients with subjective tinnitus. While rTMS is known to induce morphological changes in healthy subjects, no study has investigated yet whether rTMS treatment induces grey matter (GM) changes in tinnitus patients as well, whether these changes are correlated with treatment success, and whether GM at baseline is a useful predictor for treatment outcome. Therefore, we examined magnetic resonance images of 77 tinnitus patients who were treated with rTMS of the left temporal cortex (10 days, 2000 stimuli/day, 1 Hz). At baseline and after the last treatment session high-resolution structural images of the brain were acquired and tinnitus severity was assessed. For a subgroup of 41 patients, additional brain scans were done after a follow-up period of 90 days. GM changes were analysed by means of voxel based morphometry. Transient GM decreases were detectable in several brain regions, especially in the insula and the inferior frontal cortex. These changes were not related to treatment outcome though. Baseline images correlated with change in tinnitus severity in the frontal cortex and the lingual gyrus, suggesting that GM at baseline might hold potential as a possible predictor for treatment outcome. PMID:24991438

  19. A central nervous system approach to tinnitus

    NARCIS (Netherlands)

    Hoekstra, C.E.L

    2013-01-01

    Chronic tinnitus is a phantom auditory perception of meaningless sound. It is a highly prevalent symptom with potential severe morbidity. In this thesis diagnostic and therapeutic aspects of tinnitus are assessed, based on the notion that tinnitus most probably arises from hyperactivity in the centr

  20. Auditory Cortex tACS and tRNS for Tinnitus: Single versus Multiple Sessions

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    Laura Claes

    2014-01-01

    Full Text Available Tinnitus is the perception of a sound in the absence of an external acoustic source, which often exerts a significant impact on the quality of life. Currently there is evidence that neuroplastic changes in both neural pathways are involved in the generation and maintaining of tinnitus. Neuromodulation has been suggested to interfere with these neuroplastic alterations. In this study we aimed to compare the effect of two upcoming forms of transcranial electrical neuromodulation: alternating current stimulation (tACS and random noise stimulation (tRNS, both applied on the auditory cortex. A database with 228 patients with chronic tinnitus who underwent noninvasive neuromodulation was retrospectively analyzed. The results of this study show that a single session of tRNS induces a significant suppressive effect on tinnitus loudness and distress, in contrast to tACS. Multiple sessions of tRNS augment the suppressive effect on tinnitus loudness but have no effect on tinnitus distress. In conclusion this preliminary study shows a possibly beneficial effect of tRNS on tinnitus and can be a motivation for future randomized placebo-controlled clinical studies with auditory tRNS for tinnitus. Auditory alpha-modulated tACS does not seem to be contributing to the treatment of tinnitus.

  1. Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development

    Science.gov (United States)

    Lopez-Escamez, Jose A.; Bibas, Thanos; Cima, Rilana F. F.; Van de Heyning, Paul; Knipper, Marlies; Mazurek, Birgit; Szczepek, Agnieszka J.; Cederroth, Christopher R.

    2016-01-01

    Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorders, and temporomandibular joint (TMJ) dysfunction, have been suggested to contribute to the onset or progression of tinnitus; however, the precise molecular mechanisms of tinnitus are not well understood and the contribution of genetic and epigenetic factors remains unknown. Human genetic studies could enable the identification of novel molecular therapeutic targets, possibly leading to the development of novel pharmaceutical therapeutics. In this article, we briefly discuss the available evidence for a role of genetics in tinnitus and consider potential hurdles in designing genetic studies for tinnitus. Since multiple diseases have tinnitus as a symptom and the supporting genetic evidence is sparse, we propose various strategies to investigate the genetic underpinnings of tinnitus, first by showing evidence of heritability using concordance studies in twins, and second by improving patient selection according to phenotype and/or etiology in order to control potential biases and optimize genetic data output. The increased knowledge resulting from this endeavor could ultimately improve the drug development process and lead to the preventive or curative treatment of tinnitus. PMID:27594824

  2. Genetics of tinnitus: an emerging area for molecular diagnosis and drug development

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    Jose Antonio Lopez-Escamez

    2016-08-01

    Full Text Available Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorders and temporomandibular joint dysfunction, have been suggested to contribute to the onset or progression of tinnitus, however the precise molecular mechanisms of tinnitus are not well understood and the contribution of genetic and epigenetic factors remains unknown. Human genetic studies could enable the identification of novel molecular therapeutic targets, possibly leading to the development of novel pharmaceutical therapeutics. In this article, we briefly discuss the available evidence for a role of genetics in tinnitus and consider potential hurdles in designing genetic studies for tinnitus. Since multiple diseases have tinnitus as a symptom and the supporting genetic evidence is sparse, we propose various strategies to investigate the genetic underpinnings of tinnitus, first by showing evidence of heritability using concordance studies in twins, and second by improving patient selection according to phenotype and/or etiology in order to control potential biases and optimize genetic data output. The increased knowledge resulting from this endeavor could ultimately improve the drug development process and lead to the preventive or curative treatment of tinnitus.

  3. Imaging Interpretation of Temporal Bone Studies in a Patient with Tinnitus: A Systematic Approach.

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    Stanton, Christian L; Fatterpekar, Girish M

    2016-05-01

    Tinnitus is an auditory perception of internal origin. Tinnitus is not a diagnosis but a symptom with many possible causes and correspondingly divergent pathophysiologic, anatomic, diagnostic, and therapeutic considerations. This article provides a summary of the imaging findings of structural causes of tinnitus.

  4. Effects of Deqi on Autonomic Balance in Adult Tinnitus Patients: Study Design of a Randomized Controlled Trial

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    Qian-Qian Li

    2013-01-01

    Full Text Available Background. Recent reports suggest that a proportion of tinnitus patients suffer from mental illness. Autonomic nervous system plays a useful role in tinnitus therapy since electrical vagal nerve stimulation (VNS has been frequently used to alleviate tinnitus-induced depression in clinic. heart rate variability (HRV, which is reflective of autonomic nervous system function, has been proved to be modulated by acupuncture. In the present study, we aim to compare the effect of deqi sensation on heart rate variability in adult tinnitus patients. Methods. Thirty participants are randomly assigned to verum acupuncture (creating deqi or shallow acupuncture (not creating deqi at Baihui (Du-20, Shenting (Du-24, Tinghui (GB-2, Waiguan (SJ-5, and Zulinqi (GB-41 for 3 weeks. The primary outcome measure is heart rate variability, which is measured at the first acupuncture, as well as the last acupuncture. Discussion. Completion of this trial will help to identify the role of deqi sensation in acupuncture effect for tinnitus and reveal an autonomic modulation mechanism for acupuncture effect. Trial Registration. This trial is registered with International Standard Randomised Controlled Trial Number ISRCTN58013563.

  5. A case of tinnitus induced by chlorpromazine in a pediatric patient

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    Carla Carnovale

    2014-01-01

    Full Text Available Chlorpromazine is a well-known antipsychotic agent that binds with a variety of receptors in the central nervous system. To date, chlorpromazine has never been associated with onset of hearing disorders and tinnitus. We report on an unexpected suspect adverse reaction to chlorpromazine that occurred in a 12-year-old boy, affected by severe generalized anxiety disorder. After treatment with chlorpromazine, the patient experienced an enhanced sensitivity to sounds accompanied by perception of noises of the buzzing or ringing type. This clinical case is of great clinical interest as chlorpromazine is not currently included among potentially ototoxic drugs.

  6. Clinical feature analysis on 217 patients with subjective tinnitus%217例主观性耳鸣的临床特征分析

    Institute of Scientific and Technical Information of China (English)

    陈玲; 杨海弟; 区永康

    2011-01-01

    目的 研究分析耳鸣患者的临床特征及听力学特点,比较不同类型耳鸣的掩蔽试验效果,探索耳鸣的个性化治疗.方法 对我科门诊及住院的主观性耳鸣患者217例,常规病史调查,同时行纯音测听、耳声发射、耳鸣检测及掩蔽,分析耳鸣患者的临床特征,评估各类耳鸣掩蔽试验的情况.结果 耳鸣在人群高发年龄段为36~ 55岁,占24%.男女比例分别为48%及52%,耳鸣发生侧别以左侧最常见(42%),双侧耳鸣次之(30%),右侧耳鸣最少(28%).城市人口及脑力劳动者居多,分别占77%和68%.病程中以慢性耳鸣患者(病程>1年)最多(占46%).耳鸣高频及低频耳鸣患者掩蔽最为有效,有效率分别为71.6%及73.6%,而中频耳鸣掩蔽有效率仅有52.2%,夫特曼曲线类型与掩蔽试验阳性率明显相关,由Ⅰ型掩蔽阳性率为89%降至Ⅴ型掩蔽阳性率为11.7%.结论 耳鸣患者各项特征与掩蔽试验、耳鸣频率等有较大相关性,可作为耳鸣治疗效果的预测指标.Feldman曲线类型在耳鸣诊断和治疗方面有很大应用价值及指导意义,是预测耳鸣掩蔽是否有效的一个重要指标,也是选择耳鸣个体化治疗的一个重要参考依据.%Objective To analysis the clinical feature and audiology feature of patients with subjective tinnitus,compare masking,screening effectiveness of various kinds tinnitus,and search for the individual treatment ways for subjective tinnitus.Methods 217 patients in our hospistor were performed pure tone test,DPOAE,tinnitus determination,and tinnitus masking including pitch matching,intensity matching,Feldmann masking curve,and residual inhibition test with TinniTestTM.Results The prevalence rate is higher in female (52%).Tinnitts occur to the left side more common (42%),followed by bilateral ears (30%) and the right side (28%).The urban population ( 77% ) and mental worker ( 68% ) were primary in patients.The patients

  7. Differential auditory-oculomotor interactions in patients with right versus left sided subjective tinnitus: A saccade study

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    Alexandre eLang

    2013-02-01

    Full Text Available Subjective tinnitus (ST is a frequent but poorly understood medical condition. Recent studies demonstrated abnormalities in several types of eye movements (smooth pursuit, optokinetic nystagmus, fixation and vergence in ST patients. The present study investigates horizontal and vertical saccades in patients with tinnitus lateralized predominantly to the left or to the right side. Compared to left sided ST, tinnitus perceived on the right side impaired almost all the parameters of saccades (latency, amplitude, velocity, etc. and noticeably the upward saccades. Relative to controls, saccades from both groups were more dysmetric and were characterized by increased saccade disconjugacy (i.e. poor binocular coordination. Although the precise mechanisms linking ST and saccadic control remain unexplained, these data suggest that ST can lead to detrimental auditory, visuomotor and perhaps vestibular interactions.

  8. Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy

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    Sarah Heinrich

    2016-05-01

    Conclusion: There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results.

  9. Therapy of unspecific tinnitus without organic cause

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    Seiler, Gerda

    2006-08-01

    training and structured group psychotherapy. Ad 4: Tinnitus Retraining Therapy (TRT: Unfortunately, the published results of the TRT are methodically frequently bad and scientific of a poor value. Many of the studies presented until now regarding tinnitus retraining therapy are not informative in their scientific context. In a study with 95 patients with a chronic tinnitus TRT could show a significant, more than six months lasting stable success by comparison to a combination of TET with group behaviour therapy (improvement be achieved around at least ten points in the tinnitus questionnaire (TF. Ad 5: Pharmacological therapies: Rheological drugs (medicines for hemodilution could not show any statistically significant effect in the treatment of tinnitus. Studies to the medical treatment with tocainides (lidocaine showed repeatable positive effects on tinnitus in higher dosages (as of 1.2 mg/day. Lamotrigine as a medicine had an effect positively only at with a small fraction of patients. Two studies with GABA receptor agonists could not prove therapeutic effects for tinnitus. Undesired side-effects were observed. Injections with Carvoverine (a glutamate antagonist achieved significantly successes with a special form of tinnitus, the “Cochlear-synaptic tinnitus (CST". A tricyclic antidepressant (Amitriptilin could prove superiority against placebo. This effect could be confirmed in another study. However Clonazepame (a benzodiazepine, could not achieve any improvement. Short-term improvements were achieved with other benzodiazepines (Clonazepame, Diazepam, Flurazepame, Oxacepame and Alprazolame. A German retrospective study suggests a graded pharmacological therapy by means of rheological infusion therapy, applications of neurotransmitters, and injections of lidocaine. This method achieved a disappearance or a recovery of the complaints at 95.3% of the acute and 26.7% of the chronic cases. Ad 6: Surgical procedures: The effects of the operative excision of the stapes

  10. Imaging in pulsatile tinnitus

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    Madani, G. [Radiology Department, St Mary' s Hospital, London (United Kingdom)], E-mail: gittamadani@yahoo.com; Connor, S.E.J. [Neuroradiology Department, King' s College Hospital, London (United Kingdom)

    2009-03-15

    Tinnitus may be continuous or pulsatile. Vascular lesions are the most frequent radiologically demonstrable cause of pulsatile tinnitus. These include congenital vascular anomalies (which may be arterial or venous), vascular tumours, and a variety of acquired vasculopathies. The choice of imaging depends on the clinical findings. If a mass is present at otoscopy, thin-section computed tomography (CT) is indicated. In the otoscopically normal patient, there is a range of possible imaging approaches. However, combined CT angiography and venography is particularly useful.

  11. Trauma-associated tinnitus: audiological, demographic and clinical characteristics.

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    Peter M Kreuzer

    Full Text Available BACKGROUND: Tinnitus can result from different etiologies. Frequently, patients report the development of tinnitus after traumatic injuries. However, to which extent this specific etiologic factor plays a role for the phenomenology of tinnitus is still incompletely understood. Additionally, it remains a matter of debate whether the etiology of tinnitus constitutes a relevant criterion for defining tinnitus subtypes. OBJECTIVE: By investigating a worldwide sample of tinnitus patients derived from the Tinnitus Research Initiative (TRI Database, we aimed to identify differences in demographic, clinical and audiological characteristics between tinnitus patients with and without preceding trauma. MATERIALS: A total of 1,604 patients were investigated. Assessment included demographic data, tinnitus related clinical data, audiological data, the Tinnitus Handicap Inventory, the Tinnitus Questionnaire, the Beck Depression Inventory, various numeric tinnitus rating scales, and the World Health Organisation Quality of Life Scale (WHOQoL. RESULTS: Our data clearly indicate differences between tinnitus patients with and without trauma at tinnitus onset. Patients suffering from trauma-associated tinnitus suffer from a higher mental burden than tinnitus patients presenting with phantom perceptions based on other or unknown etiologic factors. This is especially the case for patients with whiplash and head trauma. Patients with posttraumatic noise-related tinnitus experience more frequently hyperacousis, were younger, had longer tinnitus duration, and were more frequently of male gender. CONCLUSIONS: Trauma before tinnitus onset seems to represent a relevant criterion for subtypization of tinnitus. Patients with posttraumatic tinnitus may require specific diagnostic and therapeutic management. A more systematic and - at best - standardized assessment for hearing related sequelae of trauma is needed for a better understanding of the underlying pathophysiology and

  12. Long-term reductions in tinnitus severity

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    Folmer Robert L

    2002-09-01

    Full Text Available Abstract Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Health & Science University Tinnitus Clinic. All patients were then evaluated and treated within a comprehensive tinnitus management program. Follow-up questionnaires were mailed to the same 300 patients 6 to 36 months after their initial tinnitus clinic appointment. Results One hundred ninety patients (133 males, 57 females; mean age 57 years returned follow-up questionnaires 6 to 36 months (mean = 22 months after their initial tinnitus clinic appointment. This group of patients exhibited significant long-term reductions in self-rated tinnitus loudness, Tinnitus Severity Index scores, tinnitus-related anxiety and prevalence of current depression. Patients who improved their sleep patterns or Beck Depression Inventory scores exhibited greater reductions of tinnitus severity scores than patients who continued to experience insomnia and depression at follow-up. Conclusions Individualized tinnitus management programs that were designed for each patient contributed to overall reductions in tinnitus severity exhibited on follow-up questionnaires. Identification and treatment of patients experiencing anxiety, insomnia or depression are vital components of an effective tinnitus management program. Utilization of acoustic therapy also contributed to improvements exhibited by these patients.

  13. Tinnitus and arterial hypertension: a systematic review.

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    Figueiredo, Ricardo Rodrigues; de Azevedo, Andréia Aparecida; Penido, Norma de Oliveira

    2015-11-01

    Tinnitus is considered a multi-factorial symptom. Arterial hypertension has been cited as a tinnitus etiological factor. To assess the scientific evidence on the associations between arterial hypertension and tinnitus. A systematic review was performed using PubMed, ISI Web, Lilacs and SciELO scientific databases. This review included articles published in Portuguese, Spanish, French and English correlating tinnitus with hypertension. Letters to editors and case reports were excluded. A total of 424 articles were identified, of which only 20 met the inclusion criteria. Studies that analyzed the incidence of hypertension in tinnitus patients tended to show an association, while those that evaluated the incidence of tinnitus in hypertensive patients did not. There is evidence of an association between tinnitus and hypertension, although a cause and effect relationship is uncertain. Changes in the cochlear microcirculation, resulting in hearing loss, may be an adjuvant factor in tinnitus pathophysiology.

  14. Phenotypic characteristics of hyperacusis in tinnitus.

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    Martin Schecklmann

    Full Text Available BACKGROUND: Many people with tinnitus also suffer from hyperacusis. Both clinical and basic scientific data indicate an overlap in pathophysiologic mechanisms. In order to further elucidate the interplay between tinnitus and hyperacusis we compared clinical and demographic characteristics of tinnitus patients with and without hyperacusis by analyzing a large sample from an international tinnitus patient database. MATERIALS: The default dataset import [November 1(st, 2012] from the Tinnitus Research Initiative [TRI] Database was used for analyses. Hyperacusis was defined by the question "Do sounds cause you pain or physical discomfort?" of the Tinnitus Sample Case History Questionnaire. Patients who answered this question with "yes" were contrasted with "no"-responders with respect to 41 variables. RESULTS: 935 [55%] out of 1713 patients were characterized as hyperacusis patients. Hyperacusis in tinnitus was associated with younger age, higher tinnitus-related, mental and general distress; and higher rates of pain disorders and vertigo. In relation to objective audiological assessment patients with hyperacusis rated their subjective hearing function worse than those without hyperacusis. Similarly the tinnitus pitch was rated higher by hyperacusis patients in relation to the audiometrically determined tinnitus pitch. Among patients with tinnitus and hyperacusis the tinnitus was more frequently modulated by external noise and somatic maneuvers, i.e., exposure to environmental sounds and head and neck movements change the tinnitus percept. CONCLUSIONS: Our findings suggest that the comorbidity of hyperacusis is a useful criterion for defining a sub-type of tinnitus which is characterized by greater need of treatment. The higher sensitivity to auditory, somatosensory and vestibular input confirms the notion of an overactivation of an unspecific hypervigilance network in tinnitus patients with hyperacusis.

  15. Does a single session of theta-burst transcranial magnetic stimulation of inferior temporal cortex affect tinnitus perception?

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    Moser Tobias

    2009-05-01

    Full Text Available Abstract Background Cortical excitability changes as well as imbalances in excitatory and inhibitory circuits play a distinct pathophysiological role in chronic tinnitus. Repetitive transcranial magnetic stimulation (rTMS over the temporoparietal cortex was recently introduced to modulate tinnitus perception. In the current study, the effect of theta-burst stimulation (TBS, a novel rTMS paradigm was investigated in chronic tinnitus. Twenty patients with chronic tinnitus completed the study. Tinnitus severity and loudness were monitored using a tinnitus questionnaire (TQ and a visual analogue scale (VAS before each session. Patients received 600 pulses of continuous TBS (cTBS, intermittent TBS (iTBS and intermediate TBS (imTBS over left inferior temporal cortex with an intensity of 80% of the individual active or resting motor threshold. Changes in subjective tinnitus perception were measured with a numerical rating scale (NRS. Results TBS applied to inferior temporal cortex appeared to be safe. Although half of the patients reported a slight attenuation of tinnitus perception, group analysis resulted in no significant difference when comparing the three specific types of TBS. Converting the NRS into the VAS allowed us to compare the time-course of aftereffects. Only cTBS resulted in a significant short-lasting improvement of the symptoms. In addition there was no significant difference when comparing the responder and non-responder groups regarding their anamnestic and audiological data. The TQ score correlated significantly with the VAS, lower loudness indicating less tinnitus distress. Conclusion TBS does not offer a promising outcome for patients with tinnitus in the presented study.

  16. Tinnitus treatment with sound stimulation during sleep.

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    M, Pedemonte; D, Drexler; S, Rodio; D, Geisinger; A, Bianco; D, Pol-Fernandes; V, Bernhardt

    2010-01-01

    A new strategy for idiopathic subjective tinnitus treatment - sound stimulation during sleep - has been applied. It was based on the acknowledgement that the auditory system also works during sleep, processing the incoming information. Eleven patients were stimulated every night during 6 months. The stimulus was a sound that mimetized the tinnitus and was fixed at the same tinnitus intensity, applied through an iPod. All patients decreased their tinnitus intensity in the first month of treatment (statistically significant), most of them in the first week. Tinnitus intensity continued decreasing in the following weeks; three patients presented periods of total silence.

  17. Temporomandibular joint disorder complaints in tinnitus: further hints for a putative tinnitus subtype.

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    Veronika Vielsmeier

    Full Text Available OBJECTIVE: Tinnitus is considered to be highly heterogeneous with respect to its etiology, its comorbidities and the response to specific interventions. Subtyping is recommended, but it remains to be determined which criteria are useful, since it has not yet been clearly demonstrated whether and to which extent etiologic factors, comorbid states and interventional response are related to each other and are thus applicable for subtyping tinnitus. Analyzing the Tinnitus Research Initiative Database we differentiated patients according to presence or absence of comorbid temporomandibular joint (TMJ disorder complaints and compared the two groups with respect to etiologic factors. METHODS: 1204 Tinnitus patients from the Tinnitus Research Initiative (TRI Database with and without subjective TMJ complaints were compared with respect to demographic, tinnitus and audiological characteristics, questionnaires, and numeric ratings. Data were analysed according to a predefined statistical analysis plan. RESULTS: Tinnitus patients with TMJ complaints (22% of the whole group were significantly younger, had a lower age at tinnitus onset, and were more frequently female. They could modulate or mask their tinnitus more frequently by somatic maneuvers and by music or sound stimulation. Groups did not significantly differ for tinnitus duration, type of onset (gradual/abrupt, onset related events (whiplash etc., character (pulsatile or not, hyperacusis, hearing impairment, tinnitus distress, depression, quality of life and subjective ratings (loudness etc.. CONCLUSION: Replicating previous work in tinnitus patients with TMJ complaints, classical risk factors for tinnitus like older age and male gender are less relevant in tinnitus patients with TMJ complaints. By demonstrating group differences for modulation of tinnitus by movements and sounds our data further support the notion that tinnitus with TMJ complaints represents a subgroup of tinnitus with clinical

  18. 慢性耳鸣急性加重时的听阈改变及其对耳鸣预后的影响%Acute aggravation of chronic tinnitus: a study of the hearing characteristic and prognosis

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 王树芳; 黎志成; 岑锦添; 李源

    2009-01-01

    MRI were used at the same time for further diagnosis. For the chronic tinnitus, the patients accepted the intervention of tinnitus retraining therapy (TRT) both for the AACT group and the control group. As for the recent hearing loss appeared in the AACT group members, the patients were treated the cases as the sudden deafness, and then the heating characteristic of the AACT group was analyzed and the effect of the chronic tinnitus both for the AACT group and control group after the TRT for 3,6,9 and 12 months was evaluated. Results Three kinds of hearing changes appeared when chronic tinnitus acute aggravated. Based on the dated high frequencies hearing loss ranged 4-8 kHz, recent hearing loss appeared in 1-2 middle frequencies near the impaired high frequencies; Based on the dated single middle frequency hearing loss, another middle frequency hearing impaired near the dated hearing loss frequency, the sawtooth-like audiogram changed to groove-like audiogram; Hearing fluctuation in low frequency area, hearing threshold increased 10-30 dB in 125-1000 Hz but kept unchanged in the high frequency area. The recent local frequency hearing loss healed after the vasodilator and neurotrophic drugs therapy,but the dated hearing loss cann't rehabilitate. Along with the rehabilitation of recent local hearing loss, 25 of 32 cases chronic tinnitus victims get to habituation; this finding showed that the experience of tinnitus aggravation and relief accelerated the habituation. Until the 12 months after the TRT, the curative effect difference between AACT group and control group showed statistical significance. Conclusions When the chronic tinnitus acute aggravated,3 kinds of local area hearing impaired. Timely diagnosis and effective treatment had brought not only hearing rehabilitation but also promotion to habituation of chronic tinnitus.

  19. Plasticity in tinnitus patients : a role for the efferent auditory system?

    NARCIS (Netherlands)

    Geven, Leontien I.; Koeppl, Christine; de Kleine, Emile; van Dijk, Pim

    2014-01-01

    Hypothesis: The role of the corticofugal efferent auditory system in the origin or maintenance of tinnitus is currently mostly overlooked. Changes in the balance between excitation and inhibition after an auditory trauma are likely to play a role in the origin of tinnitus. The efferent auditory syst

  20. Psychoacoustic tinnitus loudness and tinnitus-related distress show different associations with oscillatory brain activity.

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    Tobias Balkenhol

    Full Text Available BACKGROUND: The phantom auditory perception of subjective tinnitus is associated with aberrant brain activity as evidenced by magneto- and electroencephalographic studies. We tested the hypotheses (1 that psychoacoustically measured tinnitus loudness is related to gamma oscillatory band power, and (2 that tinnitus loudness and tinnitus-related distress are related to distinct brain activity patterns as suggested by the distinction between loudness and distress experienced by tinnitus patients. Furthermore, we explored (3 how hearing impairment, minimum masking level, and (4 psychological comorbidities are related to spontaneous oscillatory brain activity in tinnitus patients. METHODS AND FINDINGS: Resting state oscillatory brain activity recorded electroencephalographically from 46 male tinnitus patients showed a positive correlation between gamma band oscillations and psychoacoustic tinnitus loudness determined with the reconstructed tinnitus sound, but not with the other psychoacoustic loudness measures that were used. Tinnitus-related distress did also correlate with delta band activity, but at electrode positions different from those associated with tinnitus loudness. Furthermore, highly distressed tinnitus patients exhibited a higher level of theta band activity. Moreover, mean hearing loss between 0.125 kHz and 16 kHz was associated with a decrease in gamma activity, whereas minimum masking levels correlated positively with delta band power. In contrast, psychological comorbidities did not express significant correlations with oscillatory brain activity. CONCLUSION: Different clinically relevant tinnitus characteristics show distinctive associations with spontaneous brain oscillatory power. Results support hypothesis (1, but exclusively for the tinnitus loudness derived from matching to the reconstructed tinnitus sound. This suggests to preferably use the reconstructed tinnitus spectrum to determine psychoacoustic tinnitus loudness

  1. Psychological characteristics of patients with Ménière's disease compared with patients with vertigo, tinnitus, or hearing loss.

    Science.gov (United States)

    Savastano, Marina; Marioni, Gino; Aita, Maria

    2007-03-01

    An association between Ménière 's disease and psychological distress is frequently reported. Patients who do not have Ménière's disease but who have similar symptoms also experience various kinds of psychological disturbances. We conducted a study to investigate the relationship between Ménière's disease and personality traits, illness behavior, depression, and anxiety. We compared these factors in 77 patients who had Ménière's disease and 133 controls who did not have the disease but had one of its symptoms--either vertigo, tinnitus, or hearing loss. The mental status of study participants was assessed with standard tests. Patients in both groups had higher than normal levels of anxiety and neuroticism. The only significant difference between the two groups was a higher rate of extroversion in the Ménière's disease group. Minor differences emerged when Ménière's patients with tinnitus or vertigo were compared with similar controls. Relationships between psychological observations and otologic symptomatology or an otologic diagnosis were not specific, which illustrates the need to consider the role of illness behavior and personality as targets for psychological support or therapy associated with ENT treatment.

  2. Analysis of the Clinical Features of Senile Tinnitus Patients%老年耳鸣患者的临床特征分析

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    王栋武

    2015-01-01

    ObjectiveTo analyze the clinical features in elderly patients with tinnitus. Methods The patients with tinnitus questionnaire and symptom self-assessment scale (SCL-90), the characteristics of patients with tinnitus and psychology health statistics and analysis.Results The patients with sudden onset and slow onset in patients with different grade of tinnitus loudness differences and somatization, depression, anxiety and so on seven factor score with the domestic norm differences were statistically significant, (P<0.05).Conclusion Patients with sudden onset of tinnitus loudness is given priority to with 2~4, more patients with slow onset of tinnitus degree, Tinnitus is less than tinnitus prone to depression, anxiety, hostility, terror, paranoia and other psychological problems.%目的:探析老年耳鸣患者的临床特征。方法向患者发放耳鸣调查表和症状自评量表(SCL-90),对患者耳鸣特征和心理学健康状况进行统计、分析。结果患者突然发病和缓慢发病在不同耳鸣响度分级的差异以及患者躯体化、抑郁、焦虑等七个因子的评分与国内常模的差异均具有统计学意义,P<0.05。结论突然发病患者耳鸣响度多以2~4级为主,耳鸣程度较缓慢发病患者重;耳鸣者较非耳鸣者易发抑郁、焦虑、敌对、恐怖、偏执等心理问题。

  3. 梅尼埃病患者耳鸣疗效分析%The Treatment Outcome of Tinnitus in Patients with Ménière's Disease

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    陈晓鸿; 吴子明; 张素珍; 刘兴健; 隆琰; 林春招; 黄秋平

    2012-01-01

    目的 分析梅尼埃病患者药物治疗前后耳鸣疗效与梅尼埃病分期、耳鸣病程分期、眩晕疗效及听力疗效等的相关性.方法 24例(29耳)梅尼埃病患者给予药物治疗膜迷路积水,并进行为期6个月的随访.29耳均行纯音测听,了解患者治疗前后6个月最差听力损失情况,以分析梅尼埃病临床分期、耳鸣病程分期、眩晕疗效、听力疗效与耳鸣疗效的关系.结果 入选的24例(共29耳)患者中,梅尼埃病早期10耳,中期19耳,晚期0耳.耳鸣分期:急性7耳,亚急性3耳,慢性19耳.耳鸣疗效:痊愈9耳,显效7耳,有效6耳,无效7耳.眩晕疗效:完全控制9耳,基本控制14耳,部分控制3耳,未控制0耳,加重3耳.听力疗效:显效3耳,有效4耳,无效14耳,恶化8耳.结论 通过药物可控制梅尼埃病眩晕发作,但该药物治疗耳鸣的疗效与梅尼埃病分期、耳鸣病程分期、眩晕疗效及听力疗效之间无相关性.%Objective To analyze the effects of medication on the tinnitus of patients with Ménière's disease and the correlation between treatment outcome and the stage of Ménière's disease, the duration of tinnitus and the treatment outcome of vertigo and hearing loss. Methods The medical treatment was performed in 24 patients (29 ears) with Ménière's disease and the follow-up duration was 6 months. The pure-tone audiometry was carried out in all patients to evaluate the worst level of hearing loss before the treatment and during the follow-up period respectively. Results Of the 29 ears with Ménière's disease, there were 10 ears at the early stage, 19 ears at the mid-stage and no ear at the late stage. There were 7 ears with acute tinnitus, 3 ears with subacute tinnitus and 19 ears with chronic tinnitus. As for the tinnitus treatment outcome, 9 ears were cured, 7 ears markedly effective, 6 ears effective and 7 ears ineffective. As for the treatment outcome of vertigo, 9 ears were completely controlled, 14 ears generally

  4. Análise da correlação entre a escala visual-análoga e o Tinnitus Handicap Inventory na avaliação de pacientes com zumbido Correlation analysis of the visual-analogue scale and the Tinnitus Handicap Inventory in tinnitus patients

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    Ricardo Rodrigues Figueiredo

    2009-02-01

    Full Text Available Um dos tópicos mais questionado nos estudos clínicos sobre zumbido é o método de mensuração do mesmo. As Escalas Visual-Análogas (EVAs e o Tinnitus Handicap Inventory (THI são freqüentemente utilizados para este fim. OBJETIVO: Verificar a correlação entre os escores da EVA e do THI em pacientes com zumbido neurossensorial através de um estudo prospectivo. MATERIAL E MÉTODO: 43 pacientes com zumbido neurossensorial quantificaram o zumbido pelos dois métodos, sendo os escores comparados através do Coeficiente de Relação de Spearman. RESULTADOS: Foi observada correlação entre os escores da EVA e do THI. CONCLUSÃO: Em pacientes com zumbido neurossensorial existe correlação entre os escores da EVA e do THI.One of the most challenging topics in tinnitus clinical studies is the measuring method used. Visual Analogue Scales (VAS and Tinnitus Handicap Inventory (THI are frequently used in tinnitus. AIM: To verify the relationship between VAS and THI scores in tinnitus patients in a prospective study. MATERIALS AND METHODS: 43 patients classified their tinnitus according to VAS and THI, and both scores were compared through the Spearman's correlation coefficient test. RESULTS: There was a correlation between the VAS and THI scores. CONCLUSION: There is correlation between VAS and THI scores in patients with sensorineural tinnitus.

  5. Tinnitus- and Task-Related Differences in Resting-State Networks.

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    Lanting, Cris; Woźniak, Aron; van Dijk, Pim; Langers, Dave R M

    2016-01-01

    We investigated tinnitus-related differences in functional networks in adults with tinnitus by means of a functional connectivity study. Previously it was found that various networks show differences in connectivity in patients with tinnitus compared to controls. How this relates to patients' ongoing tinnitus and whether the ecological sensory environment modulates connectivity remains unknown.Twenty healthy controls and twenty patients suffering from chronic tinnitus were enrolled in this study. Except for the presence of tinnitus in the patient group, all subjects were selected to have normal or near-normal hearing. fMRI data were obtained in two different functional states. In one set of runs, subjects freely viewed emotionally salient movie fragments ("fixed-state") while in the other they were not performing any task ("resting-state"). After data pre-processing, Principal Component Analysis was performed to obtain 25 components for all datasets. These were fed into an Independent Component Analysis (ICA), concatenating the data across both groups and both datasets, to obtain group-level networks of neural origin, each consisting of spatial maps with their respective time-courses. Subject-specific maps and their time-course were obtained by back-projection (Dual Regression). For each of the components a mixed-effects linear model was composed with factors group (tinnitus vs. controls), task (fixed-state vs. resting state) and their interaction. The neural components comprised the visual, sensorimotor, auditory, and limbic systems, the default mode, dorsal attention, executive-control, and frontoparietal networks, and the cerebellum. Most notably, the default mode network (DMN) was less extensive and shows significantly less connectivity in tinnitus patients than in controls. This group difference existed in both paradigms. At the same time, the DMN was stronger during resting-state than during fixed-state in the controls but not the patients. We attribute this

  6. The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus

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    Jinwei Hu

    2015-01-01

    Full Text Available Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression. Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their prevalence. Pure tone averages (PTA were used to assess hearing status. Results. Descriptive analyses revealed that 79.1% of the 91 tinnitus sufferers had a diagnosis of anxiety, 59.3% had depression, and 58.2% suffered from both anxiety/depression. Patients with anxiety had elevated total THI scores as compared to patients without anxiety (p<0.05. Patients with anxiety or depression had significantly increased Functional and Emotional THI scores, but not Catastrophic THI score. Significant positive correlations were illustrated between the degree of tinnitus and anxiety/depression (p<0.05. There were no differences in PTA among groups. Conclusions. A majority of patients with tinnitus exhibited anxiety and depression. These patients suffered more severe tinnitus than did patients without anxiety and depression. The data support the need for multidisciplinary intervention of veterans with tinnitus.

  7. [Questionnaire methods used in the psychosomatic evaluation of tinnitus].

    Science.gov (United States)

    Eğilmez, Oğuz Kadir; Kalcıoğlu, M Tayyar; Kökten, Numan

    2014-01-01

    Tinnitus is a common disorder in ear, nose and throat practice. Not only muscular, vascular, neuronal, odiologic and ear pathologies, also psychological parameters contribute to the formation of tinnitus. Scales which evaluate patients' perception of tinnitus and how they are affected from tinnitus psychosomatically have gained increasing importance. Questionnaire studies are very assisting in terms of showing the degree of anxiety and depression experienced by the patients, diagnosis of the disease, evaluation of treatment efficacy, and patient follow-up. In this study, we reviewed the visual analog scale which measures the level of subjective perception in tinnitus, tinnitus evaluation questionnaires, and questionnaires measuring the level of quality of life and depression.

  8. Transient reduction of tinnitus intensity is marked by concomitant reductions of delta band power

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    Weisz Nathan

    2008-01-01

    Full Text Available Abstract Background Tinnitus is an auditory phantom phenomenon characterized by the sensation of sounds without objectively identifiable sound sources. To date, its causes are not well understood. Previous research found altered patterns of spontaneous brain activity in chronic tinnitus sufferers compared to healthy controls, yet it is unknown whether these abnormal oscillatory patterns are causally related to the tinnitus sensation. Partial support for this notion comes from a neurofeedback approach developed by our group, in which significant reductions in tinnitus loudness could be achieved in patients who successfully normalized their patterns of spontaneous brain activity. The current work attempts to complement these studies by scrutinizing how modulations of tinnitus intensity alter ongoing oscillatory activity. Results In the present study the relation between tinnitus sensation and spontaneous brain activity was investigated using residual inhibition (RI to reduce tinnitus intensity and source-space projected magnetencephalographic (MEG data to index brain activity. RI is the sustained reduction (criteria: 50% for at least 30 s in tinnitus loudness after cessation of a tonal tinnitus masker. A pilot study (n = 38 identified 10 patients who showed RI. A significant reduction of power in the delta (1.3–4.0 Hz frequency band was observed in temporal regions during RI (p ≤ 0.001. Conclusion The current results suggest that changes of tinnitus intensity induced by RI are mediated by alterations in the pathological patterns of spontaneous brain activity, specifically a reduction of delta activity. Delta activity is a characteristic oscillatory activity generated by deafferented/deprived neuronal networks. This implies that RI effects might reflect the transient reestablishment of balance between excitatory and inhibitory neuronal assemblies, via reafferentation, that have been perturbed (in most tinnitus individuals by hearing damage. As

  9. Does tinnitus distress depend on age of onset?

    Directory of Open Access Journals (Sweden)

    Winfried Schlee

    Full Text Available OBJECTIVES: Tinnitus is the perception of a sound in the absence of any physical source of it. About 5-15% of the population report hearing such a tinnitus and about 1-2% suffer from their tinnitus leading to anxiety, sleep disorders or depression. It is currently not completely understood why some people feel distressed by their tinnitus, while others don't. Several studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. METHODS: Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. RESULTS: Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. CONCLUSION: We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation.

  10. 耳鸣掩蔽对耳鸣患者脑干听觉诱发电位波幅的影响%Effect of tinnitus masking on auditory brainstem response wave amplitude in patients with tinnitus

    Institute of Scientific and Technical Information of China (English)

    刘淑芳; 祝威; 闻雨婷

    2006-01-01

    背景:研究发现耳鸣患者常伴有脑干听觉诱发电位波幅大Ⅲ小Ⅴ波的变化,耳鸣掩蔽是耳鸣治疗中的一种方法,在耳鸣掩蔽的治疗过程中耳鸣患者脑干听觉诱发电位将会如何变化?目的:观察耳鸣患者的脑干听觉诱发电位变化特点,以及耳鸣掩蔽后脑干听觉诱发电位变化规律.设计:病例-对照及自身前后对照.单位:吉林大学第一医院耳鼻咽喉-头颈外科.对象:持续性耳鸣组:63例(68耳),为1999-03/2001-10吉林大学第一医院门诊收治;对照组:听力正常的青年人(20~23岁)10例(20耳).所有受试者自愿接受检测及治疗.方法:耳鸣患者首先进行脑干听觉诱发电位检查(采用额部乳突部引导方法记录),然后进行耳鸣检查及耳鸣掩蔽试验(掩蔽5 min),随后立刻做脑干听觉诱发电位检查,并与对照组进行对比观察.主要观察指标:①耳鸣患者脑干听觉诱发电位的特点.②耳鸣掩蔽后对脑干听觉诱发电位波幅的影响,分为后效抑制试验阳性和阴性2组进行分析.结果:83例全部进入结果分析.①听力正常青年人的脑干听觉诱发电位波幅为小Ⅲ波大Ⅴ波,而63例(68耳)中有22耳(312%)脑干听觉诱发电位为大Ⅲ波小Ⅴ波,其中17耳后效抑制试验阳性,5耳阴性.②后效抑制试验阳性17耳经耳鸣掩蔽治疗后10耳由大Ⅲ波小Ⅴ波转为小Ⅲ波大Ⅴ波,3耳Ⅲ波幅度减小;阴性5耳经耳鸣掩蔽治疗后有2耳转为小Ⅲ波大Ⅴ波,其余3耳无改变.结论:耳鸣掩蔽能使耳鸣患者异常的脑干听觉诱发电位波幅恢复至正常,此结果有望作为后效抑制阳性判定的客观指标.%BACKGROUND: Research shows that the auditory brainstem response (ABR) wave amplitude of tinnitus patients often act as big Ⅲ small Ⅴ.Tinnitus masking is a therapy of tinnitus, then how dose the ABR change in the process of tinnitus masking?OBJECTIVE: To observe the changing characteristics of ABR in patients

  11. Bojungikgitang and banhabaekchulchonmatang in adult patients with tinnitus, a randomized, double-blind, three-arm, placebo-controlled trial - study protocol

    Directory of Open Access Journals (Sweden)

    Yoon In-Hwan

    2010-03-01

    Full Text Available Abstract Background Tinnitus is the perception of hearing a sound for which there is no external acoustic source. It is often associated with sudden, temporary hearing loss and has a clear impact on a patient's quality of life. Despite numerous trials, there are no treatments that can be considered well established in terms of providing replicable long-term tinnitus reduction. Complementary and alternative medical approaches have been employed to relieve symptoms of tinnitus. Bojungikgitang and banhabaekchulchonmatang are among the most strongly preferred and widely used herbal medicines for tinnitus in Korea, as they cause very few serious adverse effects. We aim to establish basic clinical efficacy and safety data for bojungikgitang and banhabaekchulchonmatang, which are approved as herbal medications by the Korea Food and Drug Administration in adult patients with tinnitus. Methods/Design This study was a randomised, double-blind, placebo-controlled trial with three parallel arms (bojungikgitang, banhabaekchulchonmatang, and a placebo. Participants included in the study met the following criteria: typical conditions of intermittent or continuous tinnitus, for more than three months, with involuntary perceptions of the concept of a sound in the absence of an external source. Participants received bojungikgitang, banhabaekchulchonmatang, or a placebo-drug for eight weeks. The total duration of each arm was eleven weeks. Each participant was examined for signs and symptoms of tinnitus before and after taking medication. Post-treatment follow-up was performed two weeks after the final administration of medication. Discussion This trial provided evidence for the efficacy and safety of bojungikgitang and banhabaekchulchonmatang in adult patients with tinnitus. The primary outcome measure was the Tinnitus Handicap Inventory, an assessment used to identify difficulties that may be experienced due to tinnitus. The secondary measures were included an

  12. 重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣的短期疗效分析%The Short-term Effect Analysis of Repetitive Transcranial Magnetic Stimulation (rTMS) in Chronic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    杨海弟; 郑亿庆; 区永康; 黄夏茵

    2015-01-01

    Objective Evaluate the therapeutic effect of 1-Hz repetitive transcranial magnetic stimulation (rTMS) on tinnitus. Methods 46 chronic tinnitus patients were treated with repetitive transcranial magnetic stimulation for two weeks and the therapeutic effects were assessed afterward. Results rTMS treatment could improve tinnitus obviously. The overall effec⁃tive rate is 63.1%in subjective tinnitus, The effective rate is higher in decompensated tinnitus(THI≥40) than compensatory tinnitus (THI<40) (77%vs 45%;P<0.001), The THI score of tinnitus patients before and after treatment were r 51.8 ± 23.5 and 37 ± 18.8;espectively (t=5.94, p<0.001), VAS were 6.3 ± 2.4 and 4.9 ± 1.8;(t=5.27, p<0.01.) The difference of the changes of THI between decompensated tinnitus and compensated tinnitus group after rTMS treatment was 19.4 ± 8.5 (df=42, T=4.95, P<0.001). Conclusions rTMS could improve tinnitus, especially for decompensated tinnitus patients.%目的:采取1Hz低频重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣并评价其治疗效果。方法对慢性主观性耳鸣患者46例行1Hz低频rTMS连续治疗2周,治疗前后分别行耳鸣残疾量表评分(THI)评分及主观疗效评估。结果 rTMS对耳鸣治疗有明显效果,对主观耳鸣症状总体有效率为63.1%,其中失代偿性耳鸣(THI≥40)的有效率明显高于代偿性耳鸣(THI<40)(77%vs 45%;P<0.001),耳鸣患者治疗前后THI为(51.8±23.5 vs 37.0±18.8;t=5.94,p<0.001), VAS为(6.3±2.4 vs 4.9±1.8;t=5.27,p<0.01),治疗前后有统计学差异。失代偿组与代偿组耳鸣rTMS治疗后THI变化存在显著差异,两组差值为19.4±8.5(df=42,T=4.95,P<0.001)。结论 rTMS治疗耳鸣有效,可明显降低THI得分,改善耳鸣症状,特别在失代偿性耳鸣效果更明显。

  13. Efeito da timpanoplastia no zumbido de pacientes com hipoacusia condutiva: seguimento de seis meses The effect of timpanoplasty on tinnitus in patients with conductive hearing loss: a six month follow-up

    Directory of Open Access Journals (Sweden)

    Adriana da Silva Lima

    2007-06-01

    Full Text Available O timpanoplastia tem como objetivos erradicar a doença da orelha média e restaurar os mecanismos de condução sonora. Contudo, alguns pacientes apresentam incômodo com o zumbido e muitas vezes questionam o médico sobre os resultados da cirurgia em relação ao zumbido. OBJETIVO: Avaliar a evolução do zumbido em pacientes com hipoacusia condutiva após timpanoplastia. Forma de Estudo: Coorte prospectiva. CASUÍSTICA E MÉTODO: Foram avaliados 23 pacientes com queixa de zumbido e diagnóstico de otite média crônica simples com indicação cirúrgica. Os pacientes foram submetidos a um protocolo de investigação médica e audiológica do zumbido antes, 30 e 180 dias após a timpanoplastia. RESULTADOS: 82,6% dos pacientes apresentaram melhora ou abolição do zumbido. Melhora significante do incômodo do zumbido no pré-operatório (5,26 em relação ao pós-operatório (1,91 com 30 e 180 dias, assim como entre o incômodo da perda auditiva pré-operatória (6,56 e pós-operatória (3,65 e 2,91. A audiometria revelou melhora do limiar tonal em todas as freqüências, com exceção de 8KHz, havendo fechamento ou gap máximo de 10dB NA em 61% dos casos. Pega total do enxerto em 78% dos casos. CONCLUSÃO: Além da melhora da perda auditiva, a timpanoplastia também proporciona bons resultados sobre o controle do zumbido.Tympanoplasty is done to eradicate ear pathology and to restore the conductive hearing mechanism (eardrum and ossicles. Some patients, however, do not tolerate tinnitus and question physicians about the results of surgery when tinnitus persists. AIM: to evaluate the progression of tinnitus in patients with conductive hearing loss after tympanoplasty. STUDY DESIGN: a prospective cohort study. Material and Methods: 23 consecutive patients with tinnitus due to chronic otitis media underwent tympanoplasty. The patients underwent a medical and audiological protocol for tinnitus before and after tympanoplasty. RESULTS: 82.6% of

  14. Sensorineural Tinnitus: Its Pathology and Probable Therapies

    Directory of Open Access Journals (Sweden)

    Aage R. Møller

    2016-01-01

    Full Text Available Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain.

  15. Effects of Oxcarbazepine Versus Carbamazepine on Tinnitus: A Randomized Double-Blind Placebo-Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Ehsan Kazemnejad

    2012-07-01

    Full Text Available Background: It is still a challenge to find an effective treatment for tinnitus. The aim of this study was the evaluation of carbamazepine and oxcarbazepine effects on tinnitus.Methods: In a randomized double–blind clinical trial, 57 patients who were visited in a university hospital due to chronic non-pulsatile tinnitus, were randomized in three groups and treated with carbamazepine (300-600 mg/day, oxcarbazepine (450-900 mg/day and placebo for 12 weeks. Visual analogue scale (VAS and tinnitus severity index (TSI were measured in all subjects in the beginning and at the end of the 8th and 12th weeks of the trial. Data was analyzed by repeated measure analysis, paired and independent t-test.Results: Among 51 participants who completed the trial course (28 men, 23 women, carbamazepine, oxcarbazepine and placebo decreased tinnitus severity in 56.6%, 46.2% and 38.5% of patients according to VAS, and in 61.1%, 58.8% and 50% of patients according to TSI, respectively. The effects of carbamazepine and oxcarbazepine were better in the first 8 weeks of treatment. However, their effect on tinnitus did not show any statistical difference in comparison with placebo (P = 0.34, P = 0.28.Conclusion: Carbamazepine and oxcarbazepine are not more effective than placebo in decreasing tinnitus severity.

  16. Tinnitus severity, depression, and the big five personality traits.

    Science.gov (United States)

    Langguth, B; Kleinjung, T; Fischer, B; Hajak, G; Eichhammer, P; Sand, P G

    2007-01-01

    A growing number of self-report measures for the evaluation of tinnitus severity has become available to research and clinical practice. This has led to an increased awareness of depression and personality as predictors of tinnitus severity in addition to loudness and other psychoacoustic measures. However, the net impact of personality dimensions on tinnitus ratings has not been investigated when the effect of depressed mood is controlled. In the present study, we demonstrate the role of the big five personality traits, 'Neuroticism', 'Extraversion', 'Openness', 'Agreeableness', and 'Conscientiousness', in affecting scores on two standard instruments for grading tinnitus-related complaints, the tinnitus handicap inventory (THI), and the tinnitus questionnaire (TQ). When 72 individuals with chronic tinnitus were examined, 'Agreeableness' negatively correlated with THI scores (p=.003), whereas the anxiety trait 'Neuroticism' correlated both with depressive symptomatology (pdepression, low 'Agreeableness' was thus identified as a novel predictor of tinnitus severity on the THI.

  17. Surgical Treatment of Tinnitus.

    Science.gov (United States)

    Eisenman, David J; Teplitzky, Taylor B

    2016-05-01

    Surgery for tinnitus can be divided into procedures directed specifically at elimination of tinnitus versus those directed at an independent primary otopathology whose symptoms include tinnitus. For the latter, although there may be an independent primary goal for which the surgery is undertaken, tinnitus may be expected to improve secondarily. This article will address both tinnitus-specific and tinnitus non-specific procedures for objective and subjective causes.

  18. Preliminary results of transcutaneous vagus nerve stimulation for chronic subjective tinnitus:A controlled clinical study%经皮迷走神经刺激术治疗慢性耳鸣的初步研究

    Institute of Scientific and Technical Information of China (English)

    曾祥丽; 招柏明; 张姝琪; 黎志成; 岑锦添; 顾晶; 袁涛; 李水颜

    2016-01-01

    Objective To report the efficacy and safety of transcutaneous vagus nerve stimulation (T-VNS) for treat-ment of chronic subjective tinnitus. Methods Chronic subjective tinnitus patients whose THI score was≥38 points, and with a tinnitus history of ≥6 months, were randomly divided into a T-VNS and a control groups. For patients in the T-VNS group, in addition to routine treatments, T-VNS was added using a G6805-type I cupping therapy apparatus, while only routine treatment were provided to patients in the control group. Treatment efficacy was evaluated with the Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI) and Depression and Anxiety-Stress Scale-21 (DASS-21) administered before and after treatment. Results Tinnitus symptoms improved more in the T-VNS group than in the control group during the 10 days of T-VNS treatment (p<0.05), with significantly improved PSQI scores, al-though there was a mild rebound of the scores at 3 months follow-up. DASS-21 scores showed decreased anxiety in the T-VNS group during VNS therapy, but no change in the control group. THI scores showed no significant difference be-tween the T-VNS and control groups either during treatment or at 3 months follow-up, although within the T-VNS group, THI scores reduced after T-VNS therapy (with no statistically significant difference) and at 3 months follow-up (statistically significant). Conclusion T-VNS may improve anxiety and sleep quality in patients who suffer from chron-ic subjective tinnitus. The primary study showed that this therapy was safe, with only transient cough or ear tingling dur-ing treatment in a minority of patients, while partially improving tinnitus distress over the 10-days treatment. Stimula-tion parameters and treatment course remain to be further investigated.%目的:探讨经皮外耳道迷走神经刺激术对慢性主观性耳鸣的治疗效果、安全性及可行性。方法选取THI评分≥38分,病史6≥个月的慢性主观性耳

  19. Effect of low-level laser therapy in the treatment of cochlear tinnitus: a double-blind, placebo-controlled study.

    Science.gov (United States)

    Dehkordi, Mahboobeh Adami; Einolghozati, Sasan; Ghasemi, Seyyed Mohsen; Abolbashari, Samaneh; Meshkat, Mojtaba; Behzad, Hadi

    2015-01-01

    Many treatments for chronic tinnitus have been attempted, but the condition remains difficult to cure, especially in the case of cochlear tinnitus. We conducted a prospective, double-blind, placebo-controlled study to assess the effect of low-dose laser therapy on chronic cochlear tinnitus. Our study population was made up of 66 patients-33 who received active laser treatment (case group) and 33 who received inactive dummy treatment (control group). Patients in the laser group received 5 mV with a wavelength of 650 nm for 20 minutes a day, 5 days a week, for 4 weeks. The controls followed the same schedule, but they were "treated" with an inactive device. The degree of tinnitus was evaluated before and after treatment in each group in three ways: (1) the Tinnitus Severity Index (TSI), (2) a subjective 10-point self-assessment scale for tinnitus loudness, and (3) the Tinnitus Evaluation Test (TET). At study's end, we found no statistically significant differences between the case and control groups in the number of patients who experienced a reduction in TSI values (p = 0.589) or a reduction in subjective self-assessment scores (p = 0.475). Nor did we find any significant reductions in the loudness (p = 0.665) and frequency (p = 0.396) of tinnitus as determined by the TET. We conclude that 5-mV laser therapy with a wavelength of 650 nm is no better than placebo for improving hearing thresholds overall or for treating tinnitus with regard to age, sex, environmental noise level, and the duration of tinnitus.

  20. The effect of cochlear implantation on tinnitus in patients with bilateral hearing loss : A systematic review

    NARCIS (Netherlands)

    Ramakers, Geerte G J; van Zon, Alice; Stegeman, Inge; Grolman, Wilko

    2015-01-01

    OBJECTIVES: To present an overview of the effect of cochlear implantation on tinnitus in adults with bilateral sensorineural hearing loss. DATA SOURCES: PubMed, Cochrane Library, CINAHL, and Embase databases were searched for articles from database inception up to January 13, 2015. METHODS: A system

  1. Wavelet analysis demonstrates no abnormality in contralateral suppression of otoacoustic emissions in tinnitus patients

    NARCIS (Netherlands)

    Geven, Leontien I.; Wit, Hero P.; de Kleine, Emile; van Dijk, Pim

    2012-01-01

    The efferent auditory system is thought to play a role in the origin of tinnitus. Part of this system can be tested in humans with contralateral suppression of otoacoustic emissions. Stimulation of the medial olivocochlear efferent system is responsible for this reduction of otoacoustic emissions af

  2. Changes in tinnitus after cochlear implantation and its relation with psychological functioning.

    Science.gov (United States)

    Kloostra, Francka J J; Arnold, Rosemarie; Hofman, Rutger; Van Dijk, Pim

    2015-01-01

    This study retrospectively assessed the prevalence of tinnitus in cochlear implant patients and the changes after implantation in 212 patients implanted between 2000 and 2009. Patients were included at least 6 months after implantation and received 2 sets of questionnaires, one about the situation before implantation and one about the situation after implantation. Mostly standardized questionnaires assessed tinnitus handicap (Tinnitus Handicap Inventory, THI, and Tinnitus Handicap Questionnaire, THQ), tinnitus characteristics, hearing loss (Abbreviated Profile of Hearing Aid Benefit) and anxiety/depression (Hospital Anxiety and Depression Scale). Of the approached patients, 117 completed the full sets of questionnaires and 35 completed a short version. Preoperative tinnitus was reported by 51.3% of these patients, of which 55.6% reported a reduction or cessation of their tinnitus after implantation. However, 8.2% of the patients with tinnitus reported a postoperative deterioration of their tinnitus. In addition, among the patients without preoperative tinnitus, 19.6% reported the start of tinnitus after implantation. The self-reported change of tinnitus correlated with the pre- and postoperative scores on the THI and THQ. The THQ showed slightly more changes in scores after cochlear implantation compared to the THI. Overall hearing handicap and feelings of anxiety and depression decreased after implantation. In conclusion, tinnitus is reduced after cochlear implantation in an important part of the patients, but in a small part implantation has a negative effect on tinnitus. When tinnitus starts after implantation, the tinnitus handicap is mild.

  3. Survey Report of the DASS-21 in Tinnitus Patients%耳鸣患者负性情绪水平分析

    Institute of Scientific and Technical Information of China (English)

    黎志成; 古若雷; 戚敏; 曾祥丽

    2013-01-01

    [目的]探讨耳鸣患者负性情绪的临床表现.[方法]采用抑郁-焦虑-压力量表DASS-21简体中文版对117名以耳鸣为第一主诉的患者进行评估.数据运用SPSS19.0进行统计分析.[结果]绝大部分耳鸣患者并无严重的情绪问题.焦虑是耳鸣患者中最常见的负性情绪(占47%),抑郁最低(占18.8%).患耳量、病程、性别及年龄均对耳鸣的负性情绪体验有一定影响,表现为单侧患者高于双侧患者,亚急性期患者高于急性及慢性患者,女性患者高于男性患者,26岁以下年龄段及34岁以上年龄段患者高于26~34岁年龄段患者.[结论]DASS-21量表能同时反映耳鸣患者的抑郁及焦虑水平,有助于临床进行针对性干预.耳鸣患者的负性情绪体验受到耳鸣及非耳鸣因素的共同影响.%[Objective] To explore the clinical characteristics of negative emotion in tinnitus patients.[Method] A sample of 117 tinnitus patients was administrated with the DASS-21 and statistical analysis was performed with SPSS 19.0.[Result] No serious emotional problems in the most of tinnitus patients.Anxiety is the common negative emotion in tinnitus patients (47%),and depression is the least (18.8%).Negative emotion will be affected by the number,course of disease,gender,and age.[Conclusion] The DASS-21 is suitable for the use in reflect the level of depression and anxiety in tinnitus patients and facilitate the targeted clinical intervention.Tinnitus and non-tinnitus factors will affect the negative emotion in tinnitus patients together.

  4. Arteriovenøs fistel med objektiv tinnitus efter fødsel

    DEFF Research Database (Denmark)

    Fisker, Jacob; Katholm, Morten; Cortsen, Marie

    2011-01-01

    This case-report describes an otherwise healthy younger woman with post partum onset of objective pulsatile tinnitus. Neuroradiological examination revealed a dural fistula that was later closed using endovascular coiling technique, after which the patient's tinnitus disappeared. At 6-month follow......-up the patient was symptom-free. This case report emphasises the importance of examining for objective tinnitus in patients complaining of tinnitus, as the causes of objective pulsatile tinnitus can frequently be treated successfully....

  5. Comparison of the Clinical Characteristics of Tinnitus in Patients with Different Frequency%不同耳鸣频率患者的临床特征比较

    Institute of Scientific and Technical Information of China (English)

    王涂路; 李颖雯; 李松键

    2011-01-01

    Objective:To observe the clinical characteristics of patients with tinnitus in different frequency. Methods: A total of 70 patients with tinnitus were enrolled in this study. All the patients were received matching test. Tinnitus handicap inventory (THI) and visual-analogue scale (VAS) questionnaires were investigated. Results: There was no significant correlation between the side, pitch, tinnitus loudness and the hearing in tinnitus patients with different frequency;However, there was correlation between THI and VAS scores. Conclusions: Combined with the tinnitus matching test, it can be used in clinical evaluating of the tinnitus patients.%目的:探讨不同耳鸣频率患者的临床特征及其严重程度.方法:70例以主观性耳鸣为主诉的耳鸣患者,按其耳鸣频率的高低分为3组:高音调(4 000~8 000 Hz)组42例,中音调(1 000~3 000 Hz)组16例,低音调(125~750 Hz)组12例.所有入选患者均行纯音听阈测定、耳鸣匹配检查,同时由患者填写耳鸣残疾评估量表(tinnitus handicap inventory,THI)及视觉模拟量表(visual-analogue scale,VAS).结果:不同耳鸣频率患者的耳鸣部位、耳鸣音调、响度及听力状况构成比较无显著差异;不同耳鸣频率患者其THI评分及VAS评分关系密切.结论:不同耳鸣频率患者耳鸣匹配结果及其自我评分关系密切,临床上可以相互结合运用于临床耳鸣严重程度的评价.

  6. Anxiety and Depression in Tinnitus Patients: 5-Year Follow-Up Assessment after Completion of Habituation Therapy

    Directory of Open Access Journals (Sweden)

    Eva-Signe Falkenberg

    2012-01-01

    Full Text Available Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression. A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  7. Anxiety and depression in tinnitus patients: 5-year follow-up assessment after completion of habituation therapy.

    Science.gov (United States)

    Falkenberg, Eva-Signe; Wie, Ona Bø

    2012-01-01

    Treatment programs based on a neurophysiological model have shown a positive effect on anxiety and depression in tinnitus patients. The aim of this paper was to assess the long-term effect of tinnitus habituation therapy. Sixty-eight individuals were treated with a comprehensive therapy program. The degree of anxiety and depression was assessed before, after, and five years after intervention using the Hospital Anxiety and Depression Scale. The positive and significant changes achieved after habituation therapy (pre = 1.10, post = 0.92 for anxiety and pre = 0.77, post = 0.62 for depression) were maintained five years after treatment ended (0.87 for anxiety and 0.52 for depression). A regression analysis revealed that individual evaluation of the treatment lectures, self-reported health condition, individual experiences of hyperacusis, and hearing loss could explain 44.3% of the variation in anxiety and 30.5% of the variation in depression posttreatment. Five years after, individual evaluation of the treatment lectures and self-reported health condition explained 22.2% of the variation in anxiety. These factors and individual experiences of hyperacusis could further explain 34.9% of the variation in depression. The effect of a neurophysiologic-based management treatment was maintained five years after treatment ended, indicating that the patients continued the improvement process without becoming dependent on professionals.

  8. Evaluation of vardenafil for the treatment of subjective tinnitus: a controlled pilot study

    Science.gov (United States)

    Mazurek, Birgit; Haupt, Heidemarie; Szczepek, Agnieszka J; Sandmann, Jörg; Gross, Johann; Klapp, Burghard F; Kiesewetter, Holger; Kalus, Ulrich; Stöver, Timo; Caffier, Philipp P

    2009-01-01

    Background Vardenafil (Levitra®) represents a potent and highly selective phosphodiesterase type 5 (PDE5) inhibitor, which is established for treatment of various diseases. There are several unpublished reports from patients stating that vardenafil has a considerable therapeutic effect on their concomitant tinnitus. This pilot study was conducted to specifically assess the effect of vardenafil in patients with chronic tinnitus. Methods This trial was based on a prospective, randomized, double-blind, placebo-controlled, parallel group design. Fourty-two consecutive subjects with mon- or binaural chronic tinnitus received 10 mg vardenafil (N = 21) or matching placebo tablets (N = 21) administered orally twice a day over a period of 12 weeks. Clinical examination and data acquisition took place at each visit: at baseline, after 4 weeks, after 12 weeks (end of treatment with study medication), and at non-medicated follow-up after 16 weeks. Assessment of clinical effectiveness was based on a standardized tinnitus questionnaire (TQ), the Short Form 36 health survey (SF-36), audiometric measurements (mode, pitch and loudness of tinnitus; auditory thresholds) and biomarkers of oxidative stress in patients' blood (malondialdehyde, protein carbonyl, homocysteine and total antioxidative status). Therapeutic efficacy was evaluated by comparison of subjective and objective parameters with baseline data between both treatment groups (ANCOVA). Results Vardenafil had no superior efficacy over placebo in the treatment of chronic tinnitus during this study. The primary efficacy criterion 'TQ total score' failed to demonstrate significant improvement compared to placebo. Subjective reports of TQ subscales and general quality of life areas (SF-36), objective audiometric examinations as well as investigated biomarkers for oxidative stress did not reveal any significant treatment effects. The safety profile was favorable and consistent with that in other vardenafil studies. Conclusion

  9. Evaluation of vardenafil for the treatment of subjective tinnitus: a controlled pilot study

    Directory of Open Access Journals (Sweden)

    Stöver Timo

    2009-02-01

    Full Text Available Abstract Background Vardenafil (Levitra® represents a potent and highly selective phosphodiesterase type 5 (PDE5 inhibitor, which is established for treatment of various diseases. There are several unpublished reports from patients stating that vardenafil has a considerable therapeutic effect on their concomitant tinnitus. This pilot study was conducted to specifically assess the effect of vardenafil in patients with chronic tinnitus. Methods This trial was based on a prospective, randomized, double-blind, placebo-controlled, parallel group design. Fourty-two consecutive subjects with mon- or binaural chronic tinnitus received 10 mg vardenafil (N = 21 or matching placebo tablets (N = 21 administered orally twice a day over a period of 12 weeks. Clinical examination and data acquisition took place at each visit: at baseline, after 4 weeks, after 12 weeks (end of treatment with study medication, and at non-medicated follow-up after 16 weeks. Assessment of clinical effectiveness was based on a standardized tinnitus questionnaire (TQ, the Short Form 36 health survey (SF-36, audiometric measurements (mode, pitch and loudness of tinnitus; auditory thresholds and biomarkers of oxidative stress in patients' blood (malondialdehyde, protein carbonyl, homocysteine and total antioxidative status. Therapeutic efficacy was evaluated by comparison of subjective and objective parameters with baseline data between both treatment groups (ANCOVA. Results Vardenafil had no superior efficacy over placebo in the treatment of chronic tinnitus during this study. The primary efficacy criterion 'TQ total score' failed to demonstrate significant improvement compared to placebo. Subjective reports of TQ subscales and general quality of life areas (SF-36, objective audiometric examinations as well as investigated biomarkers for oxidative stress did not reveal any significant treatment effects. The safety profile was favorable and consistent with that in other vardenafil

  10. Tinnitus: Characterization of associated hearing loss and modalities of treatment

    Directory of Open Access Journals (Sweden)

    Natashya H Rent

    2013-01-01

    Full Text Available Purpose: To assess the characteristics of hearing loss with respect to tinnitus and to study the efficacy of various modalities of treatment of tinnitus. Design: Prospective study. Materials and Methods: Patients were assigned into three groups. All patients underwent a complete ENT examination, followed by pure tone audiometry, tinnitus matching, and tinnitus handicap inventory (THI score. Patients were treated with gingko biloba, gabapentin, or tinnitus-retraining therapy (TRT for a period of 6 weeks following which above investigations were repeated. Results: The study showed a positive correlation between tinnitus loudness matches and frequency of maximum hearing threshold (r = 0.687, P = 0.001 and a significant relation between tinnitus loudness matching and THI score (r = 0.383, P = 0.001. However, no correlations were observed between pitch match frequency and THI scores. Gingko biloba and TRT were found to be effective in the management of tinnitus (P < 0.01, but no improvement was observed with gabapentin therapy (P = 0.051. Conclusion: Tinnitus loudness matches near the threshold of frequency of maximum hearing loss, thus indicating that as threshold of hearing increases, the perception of tinnitus loudness increases. However, pitch match frequency does not affect severity of tinnitus. Gingko biloba and TRT are useful in the treatment of tinnitus.

  11. The effect of physical therapy treatment directed to the cervical spine or temporomandibular joint in patients with subjective tinnitus: A systematic review

    Directory of Open Access Journals (Sweden)

    Sarah Michiels

    2016-11-01

    Full Text Available Background: Tinnitus is a very common symptom that often causes distress and decreases the patient’s quality of life. Apart from the well-known causes, tinnitus can in some cases be elicited by dysfunctions of the cervical spine or the temporomandibular joint(TMJ. To date however, it is unclear whether alleviation of these dysfunctions, by physical therapy treatment, also decreases the tinnitus complaints. Such physical therapy could be an interesting treatment option for patients that are now often left without treatment.Objectives: The aim of this review was to investigate the current evidence regarding physical therapy treatment in patients with tinnitus.Data sources: The online databases Pubmed, Web of Science, Cochrane and Embase were searched up to March 2016. Two independent reviewers conducted the data extraction and methodological quality assessment.Study eligibility criteria: Only randomized controlled trials and quasi-experimental trials were included in the review. Studies had to be written in English, French, Dutch or German.Participants and interventions: The included studies investigated the effect of physical therapy treatment modalities on tinnitus severity in patients suffering from subjective tinnitus.Results: Six studies were included in this review, four investigating cervical spine treatment and two investigating TMJ treatment. These studies show positive effects of cervical spine treatment (manipulations, exercises, triggerpoint treatment on tinnitus severity. Additionally, decrease in tinnitus severity and intensity was demonstrated after TMJ treatment, following splints, occlusal adjustments as well as jaw exercises.Limitations: The risk of bias in the included studies was high, mainly due to lack of randomization, lack of blinding of subjects, therapists and/or investigators. Additionally, risk of bias is present due to incomplete presentation of the data and selective reporting. A major issue of the reviewed papers

  12. Brain areas controlling heart rate variability in tinnitus and tinnitus-related distress.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available BACKGROUND: Tinnitus is defined as an intrinsic sound perception that cannot be attributed to an external sound source. Distress in tinnitus patients is related to increased beta activity in the dorsal part of the anterior cingulate and the amount of distress correlates with network activity consisting of the amygdala-anterior cingulate cortex-insula-parahippocampus. Previous research also revealed that distress is associated to a higher sympathetic (OS tone in tinnitus patients and tinnitus suppression to increased parasympathetic (PS tone. METHODOLOGY: The aim of the present study is to investigate the relationship between tinnitus distress and the autonomic nervous system and find out which cortical areas are involved in the autonomic nervous system influences in tinnitus distress by the use of source localized resting state electroencephalogram (EEG recordings and electrocardiogram (ECG. Twenty-one tinnitus patients were included in this study. CONCLUSIONS: The results indicate that the dorsal and subgenual anterior cingulate, as well as the left and right insula are important in the central control of heart rate variability in tinnitus patients. Whereas the sympathovagal balance is controlled by the subgenual and pregenual anterior cingulate cortex, the right insula controls sympathetic activity and the left insula the parasympathetic activity. The perceived distress in tinnitus patients seems to be sympathetically mediated.

  13. 调整生活方式对难治性耳鸣及睡眠障碍的疗效%Treatment of patients with previously untreatable tinnitus and sleep disorders with lifestyle modifications

    Institute of Scientific and Technical Information of China (English)

    何荣萍; 郑芸; 刘蓬

    2016-01-01

    Objective:Investigate the effectiveness of treating previously untreatable chronic tinnitus and sleep disor-ders with lifestyle modifications.Methods:Medical records for patients with previously untreatable severe chronic tinnitus and sleep disorders lasting over 6 months were analyzed retrospectively.Only patients with complete medical records who were seen within the previous 7 months at the Tinnitus-Hearing Loss-Vertigo Clinic at West China Hospital of Sichuan Uni-versity were candidates for the study.Following termination of unsuccessful treatment,these patients were treated entirely with lifestyle modifications,which included appropriate diet and sleep,as well as psychological counseling to alleviate stress.Outcomes were assessed with the Sleep Quality Investigation Inventory (SQII),which characterizes important sleep patterns,and the Tinnitus Evaluation Questionnaire (TEQ),which characterizes tinnitus severity.Results:A total of 1 0 patients (5 males,5 females)22 to 71 years of age met the inclusion criteria.The duration of sleep disorders ranged from 7 months to 30 years,and the duration of tinnitus ranges from 7 months to 20 years.Following treatment with lifestyle modifications,all patients experienced reduction in both sleep disorders and tinnitus simultaneously within 4 to 48 days (1 7.8 days on average).Meaningful average improvement in 2 of the 4 important sleep indexes in SQII.Scores on the TEQ improved significantly by over 2.9 units (P <0.05).Conclusion:All 1 0 patients with previously untreatable chro-nic tinnitus and sleep disorders experienced satisfying and meaningful improvements in both tinnitus symptoms and sleep disorders.The amount of improvement was related to the degree of compliance with the recommended lifestyle modifica-tions.Future research with larger samples,long-term follow-up,and additional outcome measures is needed to further e-valuate the effectiveness of lifestyle modifications and to determine additional symptoms for which

  14. Sucesso no tratamento do zumbido com terapia em grupo Group therapy for patients with tinnitus at the University of Brasilia Medical School

    Directory of Open Access Journals (Sweden)

    Lisiane Holdefer

    2010-02-01

    Full Text Available Embora os tratamentos em grupos para o zumbido sejam uma área bem documentada na literatura internacional, até onde sabemos nunca foram realizados no Brasil. Este estudo apresenta uma experiência bem-sucedida de um tratamento em grupo para zumbido baseado na terapia de retreinamento do zumbido aliada com as técnicas cognitivo-comportamentais. O objetivo deste estudo é avaliar pacientes com zumbido antes e depois do tratamento em grupo estruturado baseado da terapia de retreinamento do zumbido e na terapia cognitivo comportamental. MATERIAL E MÉTODO: Estudo coorte prospectivo: 27 sujeitos aplicaram-se para a pesquisa. Responderam ao inventário do Handicap do Zumbido (THI e à escala da Ansiedade e Depressão Hospitalar (HAD,antes e depois do tratamento. Foram realizadas 6 sessões estruturadas segundo os princípios da terapia de retreinamento do zumbido associada com técnicas cognitivo-comportamentais. RESULTADOS: 27 pacientes iniciaram e 19 terminaram o tratamento (8 excluídos. 47,4% homens, média das idades 47.6. O resultado do THI antes e depois do tratamento foi respectivamente: funcionais, 29 e 14; emocional, 24 e 10; e catastrófico, 12 e 5; a escala HAD: ansiedade, 12 e 9 e depressão, 10 e 6. CONCLUSÃO: O tratamento descrito é efetivo na melhora do zumbido.Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. MATERIALS AND METHODS: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI and the Hospital Depression and Anxiety Scale (HAD

  15. The Role of Trace Elements in Tinnitus.

    Science.gov (United States)

    Yaşar, Mehmet; Şahin, Mehmet İlhan; Karakükçü, Çiğdem; Güneri, Erhan; Doğan, Murat; Sağıt, Mustafa

    2017-03-01

    In this study, we aimed to investigate the role of three trace elements, namely, zinc, copper, and lead, in tinnitus by analyzing the serum level of copper and lead and both the serum and tissue level of zinc. Eighty patients, who applied to outpatient otolaryngology clinic with the complaints of having tinnitus, and 28 healthy volunteers were included. High-frequency audiometry was performed, and participants who had hearing loss according to the pure tone average were excluded; tinnitus frequency and loudness were determined and tinnitus reaction questionnaire scores were obtained from the patients. Of all the participants, serum zinc, copper, and lead values were measured; moreover, zinc levels were examined in hair samples. The levels of trace elements were compared between tinnitus and control groups. The level of copper was found to be significantly lower in the tinnitus group (p = 0.02), but there was no significant difference between the groups in terms of the levels of zinc, neither in serum nor in hair, and lead in serum (p > 0.05). The lack of trace elements, especially that of "zinc," have been doubted for the etiopathogenesis of tinnitus in the literature; however, we only found copper levels to be low in patients having tinnitus.

  16. Evaluating the effect of the temporomandibular disorder treatment over tinnitus

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    Webster, Guilherme

    2011-07-01

    Full Text Available Introduction: The interaction between tinnitus and temporomandibular disorders is a very complex issue that has been long approached, because neither the etiologic factors nor the pathogenesis of such a two-way association has been clearly defined yet. Additionally, tinnitus is known to be more prevalent in temporomandibular dysfunction individuals in comparison with the general population, hence, suggesting the existence of this two-way association. Objective: Evaluate the effect of the temporomandibular disorder treatment when tinnitus is noticed. Methods: It is about a prospective cohort study, in which temporomandibular dysfunction (TMD individuals showing a tinnitus before and after the dental TMD treatment were studied. Patients' age, sex, and tinnitus features - place of symptom and time length were examined, and an audiometric evaluation was performed. Intensity of tinnitus was evaluated by a digital analogue scale before and after the TMD treatment. Results: We evaluated 15 TMD and tinnitus patients aged between 37.7±17.1, 86.7% of whom were female. In 60% of the cases, tinnitus was unilateral and the average time length was 24 months. In 5 (33.3% patients, a neurosensorial hearing loss was seen at audiometry. When comparing the visual analogue scale scores before and after the dental treatment, a significant decrease (p<0,001 in the intensity of tinnitus was evident. In 4 (26.6% patients, tinnitus disappeared. Conclusion: A significant decrease in the recognition of tinnitus by patients submitted to a temporomandibular dysfunction treatment was evident.

  17. A Survey of the Elderly and Young Elderly Tinnitus Patients with Tinnitus Handicap Inventory%老年及老年前期耳鸣患者耳鸣残疾度量化表问卷评估

    Institute of Scientific and Technical Information of China (English)

    赵素萍; 刘新颖; 赵阳; 冀飞; 周其友

    2011-01-01

    目的 研究老年前期及老年期患者的耳鸣对其情绪的影响,评估耳鸣残疾度,试图发现老年患者群中耳鸣的临床特征.方法 主诉耳鸣患者60例,其中男性37例,女性23例,平均年龄65.1±11.3岁.根据年龄将患者分为两组:老年组(60岁以上组)35例,男22例,女13例;老年前期组(49~59岁组)25例,男14例,女11例.使用问卷对患者进行病史调查和耳鸣残疾度量化评估.结果 在受调查患者中,78.3%(47/60)自觉有听力损失,2例使用助听器,8.3%(5/60)自诉有耳病史,38.3%(23/60)有噪声接触史,63.3%(38/60)伴发其他疾病,老年组伴发其他疾病的比例较高.60例患者中.耳鸣残疾1级38例,占63.3%,2级12例,占20%,3级5例,占8.3%,4级2例,占3.3%,5级3例,占5%.两组患者各自的分级构成无统计学差异(P=0.604).两组之间3类问题功能性(P=0.164)、情绪性(P=0.21 3)、灾难性(P=0.111)无统计学差异.结论 耳鸣所造成的主观影响在老年人群中很明显.对于老年及老年前期患者,加强针对耳鸣的心理和情绪性调节非常重要.%objective To study the influence of tinnitus on the emotions of the elderly and young elderly patients and to find out the clinical characteristics of tinnitus in elderly patients.Methods 60 patients with tinnitus were involved in the survey (37 males and 23 females). The mean age was 65.1 ± 11.3 years old. The patients were divided into two groups: the elderly group (older than 60 years old) including 35 patients (22 males and 13 females) and the young elderly group (49 to 59 years old) including 25 patients (14 males and 11 females). The medical histories of the patients were surveyed and the Tinnitus Handicap Inventory was used to measure the degree of tinnitus. Results Among the patients investigated, 78.3% of cases (47/60) complained of hearing loss and 2 cases worn hearing aids, 8.3%(5/60)reported ear disease history, 38.3% (23/60) reported a history of exposure to noise, and 63.3

  18. Priliminary investigation of psychologic factors in 76 tinnitus patients%76例耳鸣患者的心理因素初步分析

    Institute of Scientific and Technical Information of China (English)

    毛坤华; 江文; 冯永

    2011-01-01

    Objective: To study the psychological aspects of tinnitus patients , to analyze the distribution of psychologic obstacle in tinnitus patients, and then to provide information for diagnosing and treating tinnitus clini-cally. Method: All patients were detected their frequency and loundness of tinnitus. Then they were evaluated by symptom checklist 9CKSCL-90), life satisfaction scale, Pittsburgh sleep quality index(PSQI) and tinnitus handicap inventory(THI). All data were analyzed with statistical software SPSS11. 0. Result:①There was no straight line correlation beween frequency, loundness of tinnitus and the patient's scores from SCL-90,life satisfaction rating scale(LSR),life satisfaction index A(LSIA) ,LSIB,PSQ1,THI. ②To 76 tinnitus patients .some factors of SCL-90 were higher than internal nom. Compared with internal nom, tinitus patients' score of LSR, LSIA and LSIB were all lower than it. Many of tinnitus patients had sleep disorder, the ratio was higher than internal nom. ③Grouping these patients, based on the score of THI. To THI four grade group and THI five grade group, their satisfaction of lives were lower, some factors of SCL-90 were higher than internal nom. To THI five grade group, the ratio a-bout sleep disorder was higher than internal nom. Conclusion: There is no straight line correlation beween frequen-cy, loundness of tinnitus and the patient's scores from SCL-90,LSR,LSIA,LSIB.PSQI,THI. Grouping based on the score of THI, the groups of THI four grade and THI five grade are approved that they have psychologic obsta-cle obviously, they should be paid close attention.%目的:了解耳鸣患者的心理状态,并分析心理障碍在耳鸣患者中的分布,为临床上诊疗耳鸣提供参考.方法:所有患者均进行耳鸣的频率和响度测试,并使用90项症状清单(SCL-90)、生活满意度量表、匹兹堡睡眠质量指数量表(PSQI)、耳鸣残疾量化表(THI)对患者进行相关的评估.将所取得的数据采用SPSS11.0

  19. Tinnitus-Related Distress and the Personality Characteristic Resilience

    OpenAIRE

    Elisabeth Wallhäusser-Franke; Wolfgang Delb; Tobias Balkenhol; Wolfgang Hiller; Karl Hörmann

    2014-01-01

    It has been suggested that personality traits may be prognostic for the severity of suffering from tinnitus. Resilience as measured with the Wagnild and Young resilience scale represents a positive personality characteristic that promotes adaptation to adverse life conditions including chronic health conditions. Aim of the study was to explore the relation between resilience and tinnitus severity. In a cross-sectional study with a self-report questionnaire, information on tinnitus-related dis...

  20. Differences between a single session and repeated sessions of 1 Hz TMS by double-cone coil prefrontal stimulation for the improvement of tinnitus.

    Science.gov (United States)

    Vanneste, Sven; De Ridder, Dirk

    2013-03-01

    Tinnitus related distress is associated with increased activity in the anterior cingulate cortex (ACC). In a recent study, it was demonstrated that a single session of low frequency prefrontal TMS using a double-cone coil (DCC) modulating the ACC (AC/DC TMS, anterior cingulate cortex targeted modulation by Double-Cone coil) yields a transient improvement in subjects with chronic tinnitus. An increasing number of studies demonstrated that repeated sessions of low frequency TMS to the temporoparietal area can significantly improve tinnitus complaints. Our aim is to determine the extent to which repeated sessions of AC/DC TMS can modulate tinnitus in comparison to a single session. Seventy-three tinnitus patients received a single (N = 46) or repetitive (N = 27) session(s) of TMS using a DCC placed over the prefrontal cortex. Our results indicate that both single sessions as well as multiple sessions (i.e. 8 sessions) of AC/DC TMS suppress both tinnitus distress (respectively 7.60% vs. 26.19%) and tinnitus intensity (respectively 7.12% vs. 19.60%) transiently. It was further shown that multiple sessions of AC/DC TMS generate a higher suppression effect in comparison to a single session of AC/DC TMS and that more patients responded to repeated sessions of 1 Hz stimulation in comparison to a single session. Our findings give further support to the fact that non-auditory areas are involved in tinnitus intensity and tinnitus distress and that more patients respond to repeated sessions with a higher suppression effect in comparison to patients who received a single session, suggesting that the approach of daily TMS sessions is relevant.

  1. Zumbido em pacientes com audiometria normal: caracterização clínica e repercussões Tinnitus in normally hearing patients: clinical aspects and repercussions

    Directory of Open Access Journals (Sweden)

    Tanit Ganz Sanchez

    2005-08-01

    Full Text Available Pacientes com zumbido e audiometria normal constituem um grupo importante, pois seus achados não sofrem influência da perda auditiva. Apesar disso, este grupo é pouco estudado e não sabemos se suas características clínicas e repercussões são semelhantes às dos indivíduos com perda auditiva. OBJETIVOS: Comparar as características clínicas do zumbido e sua interferência nas atividades diárias em pacientes com e sem perda auditiva. FORMA DE ESTUDO: coorte histórica. MATERIAL E MÉTODO: Entre 744 pacientes atendidos no Grupo de Pesquisa em Zumbido do HCFMUSP, avaliou-se retrospectivamente com um corte transversal os 55 indivíduos com audiometria tonal normal. O grupo controle correspondeu a 198 pacientes com zumbido e perda auditiva atendidos sob o mesmo protocolo. Analisou-se os dados dos pacientes, as características clínicas do zumbido e sua repercussão na vida do paciente. RESULTADOS: A idade média no grupo de estudo (43,1 ± 13,4 anos foi significantemente menor do que a do grupo controle (49,9 ± 14,5 anos. Em ambos os grupos houve predomínio do sexo feminino e o zumbido foi predominantemente bilateral, único e constante, porém sem diferença entre os grupos. A interferência na concentração e no equilíbrio emocional foi significantemente menor no grupo de estudo (25,5% e 36,4% do que no controle (46% e 61,6%, porém sem diferença quanto à interferência no sono e na atividade social. CONCLUSÕES: O grupo de pacientes com zumbido e audição normal apresentou características clínicas semelhantes em relação ao grupo com perda auditiva. Entretanto, a faixa etária acometida e a interferência sobre a concentração e o equilíbrio emocional foram significantemente menores nestes.Patients with tinnitus and normal hearing constitute an important group, given that findings do not suffer influence of the hearing loss. However, this group is rarely studied, so we do not know whether its clinical characteristics and

  2. Tinnitus: probable association with the elderly's cervical alterations

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    Moreira, Michelle Damasceno

    2011-07-01

    Full Text Available Introduction: Tinnitus is a prevailing symptom that highly jeopardizes the elderly patient's quality of life. Neck pain and cervical column alterations are frequent in patients complaining about tinnitus. Objective: Evaluate the prevalence of both tinnitus and neck pain on an elderly group, and verify the likely association between tinnitus, neck pain and the constraint to make wide cervical movements. Methods: Retrospective transversal study, evaluating both the width of cervical movement by way of a goniometry and the tinnitus and neck pain by requesting a standard questionnaire to be filled out. Results: Sample was comprised of 147 individuals aged between 69.22, 61.90% of whom were female. Among these individuals, 42.85% showed a buzz complaint and 51% of these individuals claimed to have a neck pain. Neither was association found between tinnitus and neck pain nor it was between tinnitus and the width constraint of cervical movements. Conclusion: Despite not finding an association between tinnitus and neck pain or between tinnitus and the width constraint of cervical movements, there was a significant prevalence of tinnitus, neck pain and a reduction in the width of cervical movements on the elderly people. The results hereof, by finding this important prevalence of tinnitus in all the individuals of this study, will be the basis to integrate health professionals engaged in such alterations.

  3. 突发性聋伴耳鸣患者治疗前耳鸣性状分析%Analysis of Tinnitus Characteristics in the Idiopathic Sudden Sensorineural Hearing Loss Patients

    Institute of Scientific and Technical Information of China (English)

    张帅; 周莲; 冯宁宇; 郑虹

    2011-01-01

    Objective To evaluate the distribution and characteristics of tinnitus in idiopathic sudden sensorineural hearing loss(ISSHL) patients , the relationship with hearing loss, and to explore appropriate evaluating method of tinnitus to the ISSHL patients. Methods 56 patients(56 ears) were diagnosed as idiopathic sudden sensorineural hearing loss accompanied with tinnitus and the data were analyzed accordingly. Results ①The frequencies of tinnitus match focus in the hearing loss frequencies and tinnitus mostly matched was narrow band noise. The tinnitus loudness spread wildly. ②The tinnitus subjective distress scales have no obvious correlation with the tinnitus types,loudness of tinnitus, or hearing loss. The tinnitus type match has no obvious relationship with hearing loss. Conclusion Every patient has different tolerance capacity to tinnitus, tinnitus match combine with subjective scale evaluation are more appropriate method.%目的 分析突发性聋伴耳鸣患者的耳鸣性状及其与听力损失之间的关系,探讨耳鸣对患者影响的评估方法.方法 对56例(56耳)突发性聋伴耳鸣患者行听力检测和耳鸣主观分级(评估)及耳鸣匹配检查.结果 ①耳鸣匹配的频率集中于听力损失的频率范围,耳鸣匹配的类型主要为窄带噪声,匹配响度分布较为广泛;②耳鸣主观分级与匹配类型,响度、听力损失程度之间无明显关系;听力损失程度与耳鸣匹配类型无明显关系.结论 突发性聋伴耳鸣患者耳鸣主观分级具有个体差异,与耳鸣匹配共同评估更能反映出耳鸣对患者的影响.

  4. Role of acamprosate in sensorineural tinnitus

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    Dinesh Kumar Sharma

    2012-01-01

    Full Text Available Acamprosate with dual mechanism of action as glutamate antagonist and GABA agonist can be a potential target to decrease the severity of sensorineural tinnitus. Objective: (1To study the effectiveness of acamprosate in providing subjective relief and objective improvement in patients having tinnitus of sensorineural origin. (2 To evaluate the adverse events related to the use of acamprosate and also determine the change in quality of life (QOL parameters. Materials and Methods: The study was randomized double-blind, placebo controlled, crossover. Forty adult subjects (>18 years of age, of either sex with tinnitus of sensorineural origin, were administered either acamprosate 333 mg TDS or matched placebo for a period of six weeks followed by a washout period of one week. Drug therapy was switched for another six weeks in consonance with the crossover design. The effect of acamprosate and placebo on subjective relief and objective improvement was evaluated by using modified tinnitus severity, QOL scores and audiometry with tinnitus matching in frequency and loudness. Results: At the end of the study, the drug had shown a statistically significant improvement in reducing the tinnitus score in 92.5% of the patients and placebo with an improvement in 12.5% of the patients. The drug was well tolerated without any serious drug reactions. Conclusion: Acamprosate is an effective drug in treating the severity of sensorineural tinnitus without causing much of the side effects.

  5. 梅尼埃病的耳鸣特征与影响因素分析%Characteristics and contributing factors of tinnitus in patients with Meniere's disease

    Institute of Scientific and Technical Information of China (English)

    张祎; 李云; 刘博; 刘冬鑫; 贾若

    2016-01-01

    目的:分析与探讨梅尼埃病患者耳鸣的临床特征与影响因素。方法90例梅尼埃病患者,收集纯音听阈、耳鸣匹配结果,记录耳鸣侧别、时间、睡眠质量,使用耳鸣残障量表(Tinnitus Handicap Inventory,THI)进行评价。结果①患者平均年龄48.08±10.28岁,男女比例为1.09:1;耳鸣主调频率匹配为低频和言语频率耳鸣者65例(72.2%);响度匹配为响度<10dB SL者(51例,56.7%),≥10dBSL者(39例,43.3%),其中以5-9dB SL最多,为30例(33.3%);≥15dB SL者最少,为15例(16.7%);持续性耳鸣患者77例(85.6%);单侧耳鸣患者68例(75.6%);有睡眠障碍者28例(31.1%)。②耳鸣响度较大(F=3.203,P=0.027)、睡眠质量较差(t=2.813,P=0.006)和持续性耳鸣(t=3.018,P=0.003)的患者其THI评分高于耳鸣响度较小、睡眠质量较好和间断性耳鸣的患者。双侧耳鸣患者THI评分高于单侧耳鸣患者,但差异无统计学意义(t=1.892,P=0.062)。不同性别、听力损失水平和耳鸣频率的患者THI评分间无明显差异(P>0.05)。③耳鸣影响因素有序多分类Logistic回归分析:耳鸣严重程度与耳鸣响度[P=0.011,95%可信区间(confidence interval,CI)1.019~1.151,优势比(odds ratio,OR)=1.083]、睡眠质量(P=0.011,95%CI1.288~6.931,OR=2.986)和耳鸣持续时间(P=0.007,95%CI1.559~16.265,OR=5.033)有关。结论梅尼埃病患者的耳鸣常常为低频、持续性的。耳鸣的严重程度与耳鸣的响度、睡眠质量和耳鸣的持续有关。%Objective To report clinical characteristics and contributing factors of tinnitus in patients with Meniere's disease. Methods Detailed medical histories were collected in 90 patients with Meniere's disease. Routine physical examina-tion, pure tone test and pitch matching were recorded. The affected sides, tinnitus duration and quality of sleep were in-quired. All the patients

  6. Memory Networks in Tinnitus: A Functional Brain Image Study

    Science.gov (United States)

    Laureano, Maura Regina; Onishi, Ektor Tsuneo; Bressan, Rodrigo Affonseca; Castiglioni, Mario Luiz Vieira; Batista, Ilza Rosa; Reis, Marilia Alves; Garcia, Michele Vargas; de Andrade, Adriana Neves; de Almeida, Roberta Ribeiro; Garrido, Griselda J.; Jackowski, Andrea Parolin

    2014-01-01

    Tinnitus is characterized by the perception of sound in the absence of an external auditory stimulus. The network connectivity of auditory and non-auditory brain structures associated with emotion, memory and attention are functionally altered in debilitating tinnitus. Current studies suggest that tinnitus results from neuroplastic changes in the frontal and limbic temporal regions. The objective of this study was to use Single-Photon Emission Computed Tomography (SPECT) to evaluate changes in the cerebral blood flow in tinnitus patients with normal hearing compared with healthy controls. Methods: Twenty tinnitus patients with normal hearing and 17 healthy controls, matched for sex, age and years of education, were subjected to Single Photon Emission Computed Tomography using the radiotracer ethylenedicysteine diethyl ester, labeled with Technetium 99 m (99 mTc-ECD SPECT). The severity of tinnitus was assessed using the “Tinnitus Handicap Inventory” (THI). The images were processed and analyzed using “Statistical Parametric Mapping” (SPM8). Results: A significant increase in cerebral perfusion in the left parahippocampal gyrus (pFWE <0.05) was observed in patients with tinnitus compared with healthy controls. The average total THI score was 50.8+18.24, classified as moderate tinnitus. Conclusion: It was possible to identify significant changes in the limbic system of the brain perfusion in tinnitus patients with normal hearing, suggesting that central mechanisms, not specific to the auditory pathway, are involved in the pathophysiology of symptoms, even in the absence of clinically diagnosed peripheral changes. PMID:24516567

  7. Medio-lateral postural instability in subjects with tinnitus

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    Zoi eKapoula

    2011-05-01

    Full Text Available Background: Many patients show modulation of tinnitus by gaze, jaw or neck movements, reflecting abnormal sensorimotor integration and interaction between various inputs. Postural control is based on multi-sensory integration (visual, vestibular, somatosensory, and oculomotor and indeed there is now evidence that posture can also be influenced by sound. Perhaps tinnitus influences posture similarly to external sound. This study examines the quality of postural performance in quiet stance in patients with modulated tinnitus.Methods: Twenty-three patients with highly modulated tinnitus were selected in the ENT service. Twelve reported exclusively or predominately left tinnitus, eight right and three bilateral. Eighteen control subjects were also tested. Subjects were asked to fixate a target at 40cm for 51s; posturography was performed with the platform (Technoconcept, 40Hz for both the eyes open and eyes closed conditions.Results: For both conditions, tinnitus subjects showed abnormally high lateral body sway (SDx. This was corroborated by fast Fourrier Transformation (FFTx and wavelet analysis. For patients with left tinnitus only, medio-lateral sway increased significantly when looking away from the center. Conclusions: Similarly to external sound stimulation, tinnitus could influence lateral sway by activating attention shift, and perhaps vestibular responses. Poor integration of sensorimotor signals is another possibility. Such abnormalities would be accentuated in left tinnitus because of the importance of the right cerebral cortex in processing both auditory-tinnitus and attention.

  8. Memory networks in tinnitus: a functional brain image study.

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    Maura Regina Laureano

    Full Text Available Tinnitus is characterized by the perception of sound in the absence of an external auditory stimulus. The network connectivity of auditory and non-auditory brain structures associated with emotion, memory and attention are functionally altered in debilitating tinnitus. Current studies suggest that tinnitus results from neuroplastic changes in the frontal and limbic temporal regions. The objective of this study was to use Single-Photon Emission Computed Tomography (SPECT to evaluate changes in the cerebral blood flow in tinnitus patients with normal hearing compared with healthy controls.Twenty tinnitus patients with normal hearing and 17 healthy controls, matched for sex, age and years of education, were subjected to Single Photon Emission Computed Tomography using the radiotracer ethylenedicysteine diethyl ester, labeled with Technetium 99 m (99 mTc-ECD SPECT. The severity of tinnitus was assessed using the "Tinnitus Handicap Inventory" (THI. The images were processed and analyzed using "Statistical Parametric Mapping" (SPM8.A significant increase in cerebral perfusion in the left parahippocampal gyrus (pFWE <0.05 was observed in patients with tinnitus compared with healthy controls. The average total THI score was 50.8+18.24, classified as moderate tinnitus.It was possible to identify significant changes in the limbic system of the brain perfusion in tinnitus patients with normal hearing, suggesting that central mechanisms, not specific to the auditory pathway, are involved in the pathophysiology of symptoms, even in the absence of clinically diagnosed peripheral changes.

  9. Validity of the Italian adaptation of the Tinnitus Handicap Inventory; focus on quality of life and psychological distress in tinnitus-sufferers.

    Science.gov (United States)

    Monzani, D; Genovese, E; Marrara, A; Gherpelli, C; Pingani, L; Forghieri, M; Rigatelli, M; Guadagnin, T; Arslan, E

    2008-06-01

    The aim of this study was to determine the validity of the Italian translation of the Tinnitus Handicap Inventory (THI) by Newman et al. in order to make this self-report measure of perceived tinnitus handicap available both for clinical and research purposes in our country and to contribute to its cross-cultural validation as a self-report measure of perceived severity of tinnitus. The Italian translation of the Tinnitus Handicap Inventory (THI) was administered to 100 outpatients suffering from chronic tinnitus, aged between 20 and 82 years, who attended the audiological tertiary centres of the University Hospital of Modena and the Regional Hospital of Treviso. No segregation of cases was made on audiometric results; patients suffering from vertigo and neurological diseases were excluded. Pyschoacoustic characteristics of tinnitus (loudness and pitch) were determined and all patients also completed the MOS 36-Item Short Form Health Survey to assess self-perceived quality of life and the Hospital Anxiety and Depression Scale as a measure of self-perceived levels of anxiety and depression. The THI-I showed a robust internal consistency reliability (Cronbach's alpha = 0.91) that was only slightly lower than the original version (Tinnitus Handicap Inventory-US; Cronbach's alpha = 0.93) and its Danish (Cronbach's alpha = 0.93) and Portuguese (Cronbach's alpha = 0.94) translations. Also its two subscales (Functional and Emotional) showed a good internal consistency reliability (Cronbach's alpha = 0.85 and 0.86, respectively). On the other hand, the Catastrophic subscale showed an unacceptable internal consistency reliability as it is too short in length (5 items). A confirmatory factor analysis failed to demonstrate that the 3 subscales of the THI-I correspond to 3 different factors. Close correlations were found between the total score of the Italian translation of the Tinnitus Handicap Inventory and all the subscales of the MOS 36-Item Short Form Health Survey (SF-36

  10. Can the tinnitus spectrum identify tinnitus subgroups?

    NARCIS (Netherlands)

    Heijneman, Karin M.; de Kleine, Emile; Wiersinga-Post, Esther; van Dijk, Pim

    2013-01-01

    The tinnitus spectrum is a psycho-acoustic metric of tinnitus. Previous work found a tight relation between the spectrum and the tone audiogram. This suggests that the spectrum and the audiogram provide essentially the same information, and the added value of the spectrum is limited. In order to tes

  11. Tinnitus Neural Mechanisms and Structural Changes in the Brain: The Contribution of Neuroimaging Research

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    Simonetti, Patricia

    2015-03-01

    Full Text Available Introduction Tinnitus is an abnormal perception of sound in the absence of an external stimulus. Chronic tinnitus usually has a high impact in many aspects of patients' lives, such as emotional stress, sleep disturbance, concentration difficulties, and so on. These strong reactions are usually attributed to central nervous system involvement. Neuroimaging has revealed the implication of brain structures in the auditory system. Objective This systematic review points out neuroimaging studies that contribute to identifying the structures involved in the pathophysiological mechanism of generation and persistence of various forms of tinnitus. Data Synthesis Functional imaging research reveals that tinnitus perception is associated with the involvement of the nonauditory brain areas, including the front parietal area; the limbic system, which consists of the anterior cingulate cortex, anterior insula, and amygdala; and the hippocampal and parahippocampal area. Conclusion The neuroimaging research confirms the involvement of the mechanisms of memory and cognition in the persistence of perception, anxiety, distress, and suffering associated with tinnitus.

  12. An increase in alpha band frequency in resting state EEG after electrical stimulation of the ear in tinnitus patients - a pilot study

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    Marzena Mielczarek

    2016-10-01

    Full Text Available In our clinic invasive transtympanal promontory positive DC stimulations were first used, with a success rate of 42%. However, non-invasive hydrotransmissive negative DC stimulations are now favoured, with improvement being obtained in 37.8% directly after the treatment, and 51.3% in a follow up one month after treatment. The further improvement after one month may be due to neuroplastic changes at central level as a result of altered peripheral input. The aim of the study was to determine how a single electrical stimulation of the ear influences cortical activity, and whether changes observed in tinnitus after electrical stimulation are associated with any changes in cortical activity recorded in EEG.The study included 12 tinnitus patients(F–6, M-6 divided into two groups. Group I comprised six patients with unilateral tinnitus - unilateral, ipsilateral ES was performed. Group II comprised six patients with bilateral tinnitus - bilateral ES was performed.Electrical stimulation was performed using a custom-made apparatus.The active, silver probe – was immersed inside the external ear canal filled with saline. The passive electrode was placed on the forehead. The stimulating frequency was 250Hz, the intensity ranged from 0.14 to 1.08 mA. The voltage was kept constant at 3V. The duration of stimulation was four minutes. The EEG recording (Deymed QEST 32 was performed before and after electrical stimulation. We assessed the intensity of tinnitus on the visual analogue scale (1-10. Results.In both groups an improvement in VAS was observed– in group I - in five ears (83.3%, in group II - in seven ears (58.3%. In Group I,a significant increase in the upper and lower limits of the alpha frequency range was observed in the left central temporal and left frontal regions following electrical stimulation. These changes, however, were not correlated with improvement in tinnitus. No significant changes were observed in the beta and theta bands and in

  13. Different Teams, Same Conclusions? A Systematic Review of Existing Clinical Guidelines for the Assessment and Treatment of Tinnitus in Adults

    Science.gov (United States)

    Fuller, Thomas E.; Haider, Haula F.; Kikidis, Dimitris; Lapira, Alec; Mazurek, Birgit; Norena, Arnaud; Rabau, Sarah; Lardinois, Rachelle; Cederroth, Christopher R.; Edvall, Niklas K.; Brueggemann, Petra G.; Rosing, Susanne N.; Kapandais, Anestis; Lungaard, Dorte; Hoare, Derek J.; Cima, Rilana F. F

    2017-01-01

    Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year of publication were applied to guidelines. Results: Clinical guidelines from Denmark, Germany, Sweden, The Netherlands, and the United States were included in the review. There was a high level of consistency across the guidelines with regard to recommendations for audiometric assessment, physical examination, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across the included guidelines. Differences between the guidelines centered on the use of imaging in assessment procedures and sound therapy as a form of treatment for tinnitus distress respectively. Conclusion: Given the level of commonality across tinnitus guidelines from different countries the development of a European guideline for the assessment and treatment of subjective tinnitus in adults seems feasible. This guideline would have the potential to benefit the large number of clinicians in countries where clinical guidelines do not yet exist, and would support standardization of treatment for patients across Europe. PMID:28275357

  14. Eficácia da desativação dos pontos-gatilho miofasciais para o controle do zumbido Efficacy of myofascial trigger point deactivation for tinnitus control

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    Carina Bezerra Rocha

    2012-12-01

    Full Text Available Dor crônica nas imediações do ouvido pode influenciar o zumbido. OBJETIVO: Investigar a eficácia da desativação de pontos-gatilho miofasciais na melhora do zumbido. MÉTODO: Ensaio clínico randomizado com 71 pacientes com zumbido e síndrome dolorosa miofascial. O Grupo Experimental (n = 37 foi submetido a 10 sessões de desativação dos pontos-gatilho miofasciais e o Grupo Controle (n = 34, a 10 sessões de desativação placebo. RESULTADOS: O tratamento do Grupo Experimental foi eficaz para o controle do zumbido (p Chronic pain in areas surrounding the ear may influence tinnitus. OBJECTIVE: To investigate the efficacy of myofascial trigger point deactivation for the relief of tinnitus. METHOD: A double-blind randomized clinical trial enrolled 71 patients with tinnitus and myofascial pain syndrome. The experimental group (n = 37 underwent 10 sessions of myofascial trigger point deactivation and the control group (n = 34, 10 sessions with sham deactivation. RESULTS: Treatment of the experimental group was effective for tinnitus relief (p < 0.001. Pain and tinnitus relieves were associated (p = 0.013, so were the ear with worst tinnitus and the side of the body with more pain (p < 0.001. The presence of temporary tinnitus modulation (increase or decrease upon initial muscle palpation was frequent in both groups, but its temporary decrease was related to the persistent relief at the end of treatment (p = 0.002. CONCLUSION: Besides medical and audiological investigation, patients with tinnitus should also be checked for: 1 presence of myofascial pain surrounding the ear; 2 laterality between both symptoms; 3 initial decrease of tinnitus during muscle palpation. Treating this specific subgroup of tinnitus patients with myofascial trigger point release may provide better results than others described so far.

  15. 突发性耳聋患者耳鸣状况的危险因素研究%Risk factors of tinnitus in patients with sudden deafness

    Institute of Scientific and Technical Information of China (English)

    闫波

    2014-01-01

    目的:探讨突发性耳聋患者耳鸣状况的危险因素。方法收集2006年1月-2012年12月该院收治的507例突发性耳聋患者完整的病历资料,对其听力损失的程度、听力曲线的类型及治疗效果进行评定,对耳鸣响度进行分级。分析不同耳鸣程度的相关影响因素。结果507例突发性耳聋伴耳鸣患者的耳鸣程度以3级所占的比例最大,为32.94%(167/507);所占比例最低的为1级,为13.02%(66/507);2、4级分别各占27.02%(137/507)。不同耳鸣程度的患者在年龄、性别、耳侧、不同听力损害程度及不同听力曲线类型等方面的分布情况相比,均无统计学差异(P>0.05)。结论患者在年龄、性别、耳侧等方面的不同分布情况、不同听力损害程度及不同听力曲线类型等不同的突发性耳聋的听力学特征及治疗效果与耳鸣的严重程度并不存在相关性,并非造成突发性耳聋患者伴发不同严重程度耳鸣的独立的危险因素。%Objective To investigate risk factors of tinnitus in patients with sudden deafness.Methods Complete medical records of 507 cases of sudden deafness treated at The Hospital Affiliated to Panzhihua University from January 2006 to December 2012 were col-lected.Their degree of hearing loss,hearing curve type and treatment were evaluated for tinnitus loudness graded.Analysis of different degrees of tinnitus related factors was made.Results Of 507 cases of sudden deafness combined with tinnitus patients’tinnitus degree at level three accounted for the largest proportion (32.94%,167/507),that at level one accounted for the lowest proportion (13.02%, 66/507),and those at level two and four accounted for 27.02%,respectively,(137/507).There were no statistically significant differ-ences among patients with different degrees of tinnitus in age,gender,location of tinnitus,different degree of hearing loss,different types of hearing and other

  16. Tinnitus: A hospital-based retrospective study

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    Hanifa Akhtar Laskar

    2015-01-01

    Full Text Available Aims and Objectives: To find out age, sex, laterality distribution of patients with tinnitus, to investigate the type and characteristics of associated hearing loss and to find different etiology causing tinnitus. Materials and Methods: Retrospective hospital-based study. Data collected for 154 patients who attended tinnitus clinic of Department of ENT of our institute during the year 2013. Patients with incomplete data were excluded from the study. Results: Among 154 patients included for study, 73 were male and 81 were female. The highest percentage of patients were in the middle age group of 41-50 years (27.9% followed by 31-40 years (18.83% and 51-60 years (16.2% with decreasing number of patients in both younger and elderly age group. Conclusion: Tinnitus can affect any age group but its prevalence increases with age without any gender predilection. Left ear involvement is slightly more common among unilateral tinnitus. Sensorineural hearing loss is most common factor associated but in one-sixth of the cases no cause has been found for tinnitus.

  17. Measuring the moment-to-moment variability of tinnitus: the TrackYourTinnitus smart phone app

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    Winfried Schlee

    2016-12-01

    Full Text Available Tinnitus, the phantom perception of sound without a corresponding external sound, is a frequent disorder which causes significant morbidity. So far there is no treatment available that reliably reduces the tinnitus perception. The research is hampered by the large heterogeneity of tinnitus and the fact that the tinnitus perception fluctuates over time. It is therefore necessary to develop tools for measuring fluctuations of tinnitus perception over time and for analysing data on single subject basis. However, this type of longitudinal measurement is difficult to perform using the traditional research methods such as paper-and-pencil questionnaires or clinical interviews. Ecological Momentary Assessment (EMA represents a research concept that allows the assessment of subjective measurements under real-life conditions using portable electronic devices and thereby enables the researcher to collect longitudinal data under real-life conditions and high cost efficiency. Here we present a new method for recording the longitudinal development of tinnitus perception using a modern smartphone application available for iOS and Android devices with no costs for the users. The TrackYourTinnitus app is available and maintained since April 2014. A number of 857 volunteers with an average age of 44.1 years participated in the data collection between April 2014 and February 2016. The mean tinnitus distress at the initial measurement was rated on average 13.9 points on the Mini-Tinnitus Questionnaire (max. 24 points. Importantly, we could demonstrate that the regular use of the TrackYourTinnitus app has no significant negative influence on the perception of the tinnitus loudness nor on the tinnitus distress. The TrackYourTinnitus app can therefore be proposed as a safe instrument for the longitudinal assessment of tinnitus perception in the everyday life of the patient.

  18. Tinnitus: clinical experience of the psychosomatic connection

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    Salviati M

    2014-02-01

    Full Text Available Massimo Salviati,1 Francesco Saverio Bersani,1 Samira Terlizzi,1 Claudia Melcore,1 Roberta Panico,1 Graziella Francesca Romano,1 Guiseppe Valeriani,1 Francesco Macrì,1 Giancarlo Altissimi,2 Filippo Mazzei,2 Valeria Testugini,2 Luca Latini,1 Roberto Delle Chiaie,1 Massimo Biondi,1 Giancarlo Cianfrone21Department of Neurology and Psychiatry, Acute Psychiatric Ward (Servizio Psichiatrico di Diagnosi e Cura - SPDC, Sapienza University of Rome, Rome, Italy, 2Department of Sense Organs, Sapienza University of Rome, Rome, ItalyBackground: The connection between psychopathology and tinnitus is complex and not adequately studied. The aim of this study is to investigate the relationship between tinnitus and psychiatric comorbidities from different points of view: categorical, dimensional, temperamental, and perceived stress level.Methods: Two hundred and thirty-nine patients affected by tinnitus were recruited between January and October 2012. Patients underwent a preliminary battery of tests including the Tinnitus Handicap Inventory (THI, Symptom Check List (SCL90-R, Temperament and Character Inventory (TCI, and Stress-Related Vulnerability Scale (VRS, and eventually a full psychiatric evaluation. Results: One hundred and fourteen patients (48% of the total sample presented psychiatric comorbidity. Among these, a higher prevalence of depression, somatization, obsession, and anxiety was found. More than 41% of patients affected by decompensated tinnitus reported a family history of psychiatric disorders. Significant positive correlations between the psychopathological screening tools (SCL90-R and VRS and THI were found. Patients affected by comorbid psychiatric disorder showed specific temperamental and characterial predispositions.Conclusion: Psychiatric comorbidity in subjects affected by tinnitus is frequent. Stress can be considered as a factor leading to damage and dysfunction of the auditory apparatus. The vulnerability to neurotic disorders and

  19. Treatment options for subjective tinnitus: Self reports from a sample of general practitioners and ENT physicians within Europe and the USA

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    Hall Deborah A

    2011-11-01

    Full Text Available Abstract Background Tinnitus affects about 10-15% of the general population and risks for developing tinnitus are rising through increased exposure to leisure noise through listening to personal music players at high volume. The disorder has a considerable heterogeneity and so no single mechanism is likely to explain the presence of tinnitus in all those affected. As such there is no standardized management pathway nor singly effective treatment for the condition. Choice of clinical intervention is a multi-factorial decision based on many factors, including assessment of patient needs and the healthcare context. The present research surveyed clinicians working in six Westernized countries with the aims: a to establish the range of referral pathways, b to evaluate the typical treatment options for categories of subjective tinnitus defined as acute or chronic, and c to seek clinical opinion about levels of satisfaction with current standards of practice. Methods A structured online questionnaire was conducted with 712 physicians who reported seeing at least one tinnitus patients in the previous three months. They were 370 general practitioners (GPs and 365 ear-nose-throat specialists (ENTs from the US, Germany, UK, France, Italy and Spain. Results Our international comparison of health systems for tinnitus revealed that although the characteristics of tinnitus appeared broadly similar across countries, the patient's experience of clinical services differed widely. GPs and ENTs were always involved in referral and management to some degree, but multi-disciplinary teams engaged either neurology (Germany, Italy and Spain or audiology (UK and US professionals. For acute subjective tinnitus, pharmacological prescriptions were common, while audiological and psychological approaches were more typical for chronic subjective tinnitus; with several specific treatment options being highly country specific. All therapy options were associated with low levels

  20. 突发性聋伴耳鸣患者耳鸣特征%Characteristics of tinnitus in patients with idiopathic sudden sensorineural hearing loss

    Institute of Scientific and Technical Information of China (English)

    钟晓声; 杨海弟; 郑亿庆

    2015-01-01

    损失程度无相关性r=0.087,P=0.287>0.05。VAS得分与听力损失程度无相关性r=0.002,P=0.982>0.05。THI得分与耳鸣频率对数无相关性,相关系数r=-0.056,P=0.402>0.05。VAS 得分与耳鸣频率对数无相关性,相关系数 r=-0.003,P=0.970>0.05。THI得分与耳鸣响度无相关性,相关系数r=0.039,P=0.563>0.05。VAS得分与耳鸣响度无相关性,相关系数r=0.136,P=0.110>0.05。结论①突发性聋伴耳鸣患者中高频耳鸣最常见;②耳鸣频率与听力损失类型显著相关,低中频下降型以低频耳鸣多见,而中高频下降型及全聋型以高频耳鸣多见;③听力损失最大的频率与耳鸣的频率有较高的一致性;④突发性聋伴耳鸣患者急性期的耳鸣致残程度以3~4级为多;⑤THI及VAS得分与听力损失的程度、耳鸣的频率、耳鸣的响度均无相关性。%Objective To analyze the characteristics of tinnitus,correlation between tinnitus and hearing loss,effects of tinnitus,and mechanism of tinnitus in patients with sudden sensorineural hearing loss.Methods Clinical data of 23 1 tinnitus patients with idiopathic sudden sensorineural hearing loss were retrospectively reviewed.Results of Tinnitus Handicap Inventory (THI),visual analogue scale (VAS),pure tone audiometry,acoustic emission,tinnitus test and masking test were analyzed.Results ①Characteristics of hearing loss:Low-intermediate frequency hearing loss (rise type)was 8.7%,high-frequency hearing loss (fall type)was 26%,flat-type was 19%,total-deafness type was 34.2%,irregular type was 12.1%.②Frequency of tinnitus:Low-frequency (2 000 Hz)tinnitus was 52.8%,unmatched tinnitus was 2.6%.Of hearing loss with low-intermediate frequency,low,medium and high frequency tinnitus was 75%,15% and 10% respectively.Of hearing loss with medium-high frequency,low,medium and high frequency tinnitus was 13.3%, 26.7%and60.0%respectively

  1. TSG助听器用于耳鸣患者的临床结果%The Effect of TSG Hearing Aids on the Treatment of Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    刘海红; 张峰; 张华; 冯定香

    2011-01-01

    目的 评估TSG助听器(GN Resound Live 9 TS)改善患者耳鸣的效果,从而检验该技术用于治疗单纯性耳鸣和耳鸣伴有听力障碍患者的可行性和疗效.方法 采用耳鸣残疾评估量表(TinnitusHandicap Inventory,THI)作为评估素材,分别对9名受试者在TSG助听器配戴前后的耳鸣残疾程度进行评估.结果 ①全部受试者配戴GN Resound Live 9 TS助听器前后THI总分和各条目得分均有显著性差异(P<0.0001) ; ②GN Resound Live 9 TS助听器配戴前后受试者THI的功能性、情感性及严重性得分均得到显著性改善(P<0.0001).结论 GN Resound Live 9 TS助听器对单纯耳鸣受试者或耳鸣伴有轻中度感音神经性听力损失者均显示出明显的改善作用.%Objective To evaluate the effectiveness and feasibility of Tinnitus Sound Generator (TSG) hearing aid (GN Resound Live 9 TS) in the treatment of tinnitus. Methods The Tinnitus Handicap Inventory (THI) was used to assess the degree of tinnitus in 9 subjects before and after wearing TSG hearing aids. Results The THI scores after 8 weeks of trial were significantly lower than the baseline scores(P<0.0001). The significant improvements were found in the functional, emotional and catastrophic THI scores after wearing the TSG hearing aids(P<0.0001).Conclusion Based on the assessment results, the GN Resound Live 9 TS hearing aid is an effective instrument to treat tinnitus patients with mild-to-moderate sensorineural hearing losses or with normal hearing even after a short period of use.

  2. Stress-Related Functional Connectivity Changes Between Auditory Cortex and Cingulate in Tinnitus.

    Science.gov (United States)

    Vanneste, Sven; De Ridder, Dirk

    2015-08-01

    The question arises whether functional connectivity (FC) changes between the distress and tinnitus loudness network during resting state depends on the amount of distress tinnitus patients' experience. Fifty-five patients with constant chronic tinnitus were included in this study. Electroencephalography (EEG) recordings were performed and seed-based (at the auditory cortex) source localized FC (lagged phase synchronization) was computed for the different EEG frequency bands. Results initially demonstrate that the correlation between loudness and distress is nonlinear. Loudness correlates with beta3 and gamma band activity in the auditory cortices, and distress with alpha1 and beta3 changes in the subgenual, dorsal anterior, and posterior cingulate cortex. In comparison to nontinnitus controls, seed-based FC differed between the left auditory cortices for the alpha1 and beta3 bands in a network encompassing the posterior cingulate cortex extending into the parahippocampal area, the anterior cingulate, and insula. Furthermore, distress changes the FC between the auditory cortex, encoding loudness, and different parts of the cingulate, encoding distress: the subgenual anterior, the dorsal anterior, and the posterior cingulate. These changes are specific for the alpha1 and beta3 frequency bands. These results fit with a recently proposed model that states that tinnitus is generated by multiple dynamically active separable but overlapping networks, each characterizing a specific aspect of the unified tinnitus percept, but adds to this concept that the interaction between these networks is a complex interplay of correlations and anti-correlations between areas involved in distress and loudness depending on the distress state of the tinnitus patient.

  3. Betahistine in the treatment of tinnitus in patients with vestibular disorders Betaistina no tratamento do zumbido em pacientes com distúrbios vestibulares

    Directory of Open Access Journals (Sweden)

    Maurício Malavasi Ganança

    2011-08-01

    Full Text Available Betahistine is a medicine used to treat vestibular disorders that has also been used to treat tinnitus. AIM: To assess the effects of betahistine on tinnitus in patients with vestibular disorders. MATERIAL AND METHOD: Retrospective data were collected from patient records for individuals presenting with vestibular dysfunction and tinnitus. Patients included had received betahistine 48 mg/day and clinical outcomes were compared with a control group comprising individuals who were unable to receive betahistine due to gastritis, ulcers, pregnancy, asthma or hypersensitivity to the drug. Patients underwent control of any aggravating factors and also standard vestibular exercises as a basis for treatment. The intensity, frequency and duration of tinnitus were assessed on the first day of dosing and after 120 days of treatment. Clinical improvement was defined as a total or partial reduction of tinnitus after treatment. RESULTS: Clinical improvement was observed in 80/262 (30. 5% of patients treated with betahistine and 43/252 (17. 1% of control patients. Betahistine significantly (pA betaistina é um medicamento utilizado no tratamento de distúrbios da função vestibular, que também tem sido utilizado para tratar o zumbido. OBJETIVO: Avaliar o efeito da betaistina sobre o zumbido de pacientes com distúrbios vestibulares. MATERIAL E MÉTODO: Foram coletados dados retrospectivos de pacientes com vestibulopatia e zumbido. Os pacientes incluídos receberam 48 mg/dia de betaistina ao dia e os resultados clínicos foram comparados com os de um grupo controle, que incluiu indivíduos impossibilitados de receber betaistina devido à gastrite, úlceras, gravidez, asma ou hipersensibilidade ao medicamento. Os pacientes realizaram controle de fatores agravantes e exercícios de reabilitação vestibular, como tratamento de base para a vestibulopatia. A intensidade, frequência e duração do zumbido foram avaliadas no primeiro dia e após 120 dias de

  4. Disentangling Tinnitus Distress and Tinnitus Presence by Means of EEG Power Analysis

    Directory of Open Access Journals (Sweden)

    Martin Meyer

    2014-01-01

    Full Text Available The present study investigated 24 individuals suffering from chronic tinnitus (TI and 24 nonaffected controls (CO. We recorded resting-state EEG and collected psychometric data to obtain information about how chronic tinnitus experience affects the cognitive and emotional state of TI. The study was meant to disentangle TI with high distress from those who suffer less from persistent tinnitus based on both neurophysiological and behavioral data. A principal component analysis of psychometric data uncovers two distinct independent dimensions characterizing the individual tinnitus experience. These independent states are distress and presence, the latter is described as the perceived intensity of sound experience that increases with tinnitus duration devoid of any considerable emotional burden. Neuroplastic changes correlate with the two independent components. TI with high distress display increased EEG activity in the oscillatory range around 25 Hz (upper β-band that agglomerates over frontal recording sites. TI with high presence show enhanced EEG signal strength in the δ-, α-, and lower γ-bands (30–40 Hz over bilateral temporal and left perisylvian electrodes. Based on these differential patterns we suggest that the two dimensions, namely, distress and presence, should be considered as independent dimensions of chronic subjective tinnitus.

  5. Can Magnetic Coil Ease Tinnitus?

    Science.gov (United States)

    ... Research Updates Technology Horizons Can magnetic coil ease tinnitus? VA trial aims to find out February 3, ... pain. See, for example, this 2009 review study . Tinnitus and Veterans Tinnitus has been one of the ...

  6. 200例主观性耳鸣患者听力损失临床分析%Study of hearing loss in 200 patients with subjective tinnitus

    Institute of Scientific and Technical Information of China (English)

    唐建辉; 吉彬; 刘立中

    2011-01-01

    目的:对耳鸣患者的听力损失进行分析,为进一步探讨耳鸣的发病原因、检查方法提供临床依据.方法:对以主观性耳鸣为主诉的200例患者进行耳科专科检查、声导抗检测、常频纯音听阈测听和高频扩展听阈测听检查.结果:200例耳鸣患者中,单侧耳鸣123例(61.5%),双侧耳鸣77例(38.5%);46例(23.0%)听力正常.单侧耳鸣中,患侧与对侧听阈比较0.125~8 kHz差异有统计学意义(P0.05).常频听力正常组与听力异常组比较各频率阈值差异均具有统计学意义(均P 10 kHz), the difference between two groups was not statistically significant (P > 0.05). There was significant difference in hearing threshold between tinnitus patients with normal and abnormal hearing in normal frequency(P<0. 05) ,meantime the detection rate in abnormal hearing group was lower than the normal group. Conclusion:Tinnitus can occur in people with normal hearing. Early in tinnitus,further study need be undertaken on whether the audiometry extended high frequency can offer the early evidence of hearing loss for tin-nitus patients or not.

  7. Tinnitus- and Task-Related Differences in Resting-State Networks

    NARCIS (Netherlands)

    Lanting, Cris; Wozniak, Aron; van Dijk, Pim; Langers, Dave R. M.; VanDijk, P; Baskent, D; Gaudrain, E; DeKleine, E; Wagner, A; Lanting, C

    2016-01-01

    We investigated tinnitus-related differences in functional networks in adults with tinnitus by means of a functional connectivity study. Previously it was found that various networks show differences in connectivity in patients with tinnitus compared to controls. How this relates to patients' ongoin

  8. The Distressed (Type D) Personality Is Independently Associated With Tinnitus : A Case-Control Study

    NARCIS (Netherlands)

    Bartels, Hilke; Middel, Berrie; Pedersen, Susanne S.; Staal, Michiel J.; Albers, Frans W. J.

    2010-01-01

    Background: Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population. Objective: The authors sought to determine personality characteristics associated with tinnitus patients versus a control group of ear-nose-throat (ENT) patients without tinnitus. Method: Adu

  9. Tinnitus: an epidemiologic study in Iranian population.

    Directory of Open Access Journals (Sweden)

    Maryam Jalessi

    2013-12-01

    Full Text Available A wide range of population, 4% to 30%, suffers from tinnitus that is defined as perception of sound without apparent acoustic stimulus. We conducted the present study to determine the prevalence of tinnitus in Iranian population; Tehran province. This cross-sectional study was conducted from January 2009 to December 2009, recruiting 3207 individuals (age range, 7-98 who were residing in Tehran province, Iran. Participants were asked to fill two questionnaires; the validated Persian version of Tinnitus Questionnaire (TQ and another one that was specifically designed for this study. Prevalence of tinnitus and its association factors were evaluated. 3207 participants enrolled into our study comprising 1429 (44.7% male and 1765 (55.3% female with mean age of 55.01±17.85. Of total of 3207 participants, 146 (4.6% had tinnitus consisting of 80 male (54.8% and 66 (45.2% female participants. It showed a rising trend with increasing age that was especially significant after the sixth decade of life (P=0.001. The analysis showed mean TQ global score of 35.96±25.52 that was significantly different between male and female participants (P=0.051 and had no significant correlation with increasing age (Spearman's r=0.1, P=0.10. The tinnitus intensity was moderate to very severe in 95 (56.1% of the participants. Its severity level was not significantly different between men and women (P=0.09. Tinnitus intensity had no significant association with increasing age (Spearman's r=0.1, P=0.31. Patients with higher TQ global score had higher tinnitus intensities (P=0.001. The annoyance level was significantly different between men and women (P=0.04 and its impact on the participants daily routine functions were significantly higher in men (P=0.003. Given the results of the study, demonstrating that prevalence of tinnitus in Iranian population (Tehran province was lower than the other countries and had a direct correlation with increasing age only after the sixth

  10. Neuro-Music Therapy for Recent-Onset Tinnitus

    Directory of Open Access Journals (Sweden)

    Miriam Grapp

    2013-05-01

    Full Text Available The aim of this pilot study was the evaluation of the neuro-music therapy approach as a new treatment option for patients with recent-onset tinnitus whose tinnitus symptoms were enduring after initial pharmacological treatment. In all, 15 patients with recent-onset tinnitus took part in our manualized short-term music-therapeutic treatment. Tinnitus severity and individual tinnitus distress were assessed by the German version of the tinnitus questionnaire (TQ and the Attention and Performance Self-Assessment Scale (APSA at three different measurement times: baseline (T0, start of treatment (T1, and end of treatment (T2. Score changes in TQ and APSA from start to end of treatment indicated significant improvements in tinnitus-related distress. According to the Jacobson and Truax reliable change index (RC, 73.3% of the patients showed a reliable reduction in individual TQ-score. The neuro-music therapy for recent-onset tinnitus according to the “Heidelberg Model” introduced in this pilot study seems to provide an effective treatment option for patients with recent-onset tinnitus.

  11. Tinnitus and cell phones: the role of electromagnetic radiofrequency radiation

    OpenAIRE

    Seyed Mohammad Javad Mortazavi; Seyed Ali Reza Mortazavi

    2016-01-01

    ABSTRACT INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR). Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the availabl...

  12. Noise and Tinnitus

    Directory of Open Access Journals (Sweden)

    Mansoureh Adel Ghahraman

    1999-03-01

    Full Text Available Tinnitus from the Latin word tinnire meaning ringing is the perception of sound within the human ear in the absence of corresponding external sound. The most common cause is noise induced hearing loss. Tinnitus may be induced by an acoustic trauma or a permanent noise in the workplace. In case that Tinnitus is induced by acoustic trauma the site of lesion is commonly the base of the cochlea. Tinnitus in the senile population is mostly accompanying presbycusis. Although the incidence of permanent tinnitus following noise exposure is high, little is published about this issue. In the current article we are aimed at studying the prevalence of tinnitus in Minoo and other manufactures.

  13. Tinnitus and its radiological diagnosis and therpy

    Energy Technology Data Exchange (ETDEWEB)

    Nadjmi, M.; Hofmann, E.; Ratzka, M.; Schuknecht, B.

    1987-03-01

    Tinnitus is a familiar symptom in diseases of the central nervous system. Its aetiology being of a varied nature, the type of tinnitus is a pointer to the pathoanatomic findings that are responsible for the disease. The causes of tinnitus are often found in the borderline areas between various neighbouring disciplines, such as otology, neurology and neurosurgery, whereas the final identification of the real causes is mainly within the scope of radiological diagnosis, in which computed tomography and superselective angiography play an essential role. In addition to arteriovenous fistulas near the petrous bone and glomus tumours, which are well known, there are a few other aetiologies of pulse-synchronous tinnitus that are being discussed in this paper. In recent years there has been substantial therapeutical progress owing to the introduction of new techniques and the development of improved materials for embolisation in international neuroradiology. Their application is discussed in connection with various patient groups.

  14. The Results of Nurotron Cochlear Implant on Tinnitus Patients%诺尔康人工耳蜗植入对耳鸣的影响研究

    Institute of Scientific and Technical Information of China (English)

    王倩; 李佳楠; 焦青山; 孙丽; 李思阳; 刘日渊; 于丽玫; 杨仕明

    2015-01-01

    Objective To study the changes of tinnitus after Nurotron cochlear implantation and to evaluate the therapeutic evolution on tinnitus patients.Methods 26 Nurotron® Venus™ cochlear implant recipients received the Tinnitus Handicap Inventory investigation before and after wearing the cochlear implant device.Results 20 patients (76.9%) got the THI score decreased more than 20 points after the implantation. Three patients had tinnitus intensity unchanged and one patient felt worsen. Furthermore, one patient without tinnitus had it occurred post-operation. The average THI score of pre-operation was 56.5±20.6, and post-operation score was 20.2±20.9. Statistical analysis showed a significant difference of the THI total and subscale scores (P=0.000<0.05).Conclusion As an electrical stimulation treatment method, cochlear implant has the inhibitory effect on tinnitus. In order to avoid the bad risk, we need to do more in-depth research on it.%目的:研究诺尔康人工耳蜗对耳鸣的治疗效果。方法对26例语后聋患者植入诺尔康人工耳蜗前后进行耳鸣问卷评估,评估材料采用耳鸣残疾评估量表(Tinnitus Handicap Inventory,THI)。结果21例(80.8%)患者自觉耳鸣消失或减弱,其中20例(76.9%)患者耳鸣治疗有效,THI得分与植入人工耳蜗前相比下降≥20分;3例患者自觉耳鸣无改善;1例患者自述耳鸣加重;1例患者术前无耳鸣,术后出现中度耳鸣。26例患者人工耳蜗植入术前THI总分平均分56.5±20.6,术后THI总分平均分20.2±20.9。经过配对t检验分析,配戴人工耳蜗前后的总分及功能性、情感性、严重性3个维度的得分具有显著差异(P=0.000<0.05)。结论人工耳蜗植入对耳鸣有一定程度的改善作用,但仍存在一定风险。

  15. Medical management of tinnitus: role of the physician.

    Science.gov (United States)

    Shi, Yongbing; Robb, Michael J A; Michaelides, Elias M

    2014-01-01

    Tinnitus is a common auditory complaint that can be caused by many auditory as well as nonauditory systems diseases. Comorbidities including insomnia, anxiety, and depression are common in severe tinnitus. Other factors such as personality characteristics and socioeconomic difficulties can also contribute to tinnitus distress. Management of tinnitus therefore requires diagnosis and treatment expertise by physicians to adequately address existing etiologies and comorbidities, as well as relevant expertise by nonphysician specialists such as audiologists and psychologists. In assessing the efficacy of tinnitus treatments, nonspecific effects such as placebo effects must be taken into consideration. Management of complex tinnitus cases often requires a multidisciplinary team approach. Physicians and nonphysician specialists need to promptly refer patients to relevant specialist colleagues for adequate evaluation and treatment when such needs are present.

  16. 影响突发性聋患者耳鸣疗效的相关因素分析%Analysis of Related Factors on Tinnitus Curative Effect in Sudden Sensorineural Hearing Loss Patients

    Institute of Scientific and Technical Information of China (English)

    陈平; 周津徽

    2013-01-01

    Objective To provide the theoretic basis for clinical diagnosis, treatment and prognosis of sudden deafness patients, we investigated the related factors which might influence treatment effects on tinnitus of sudden deafness patients. Methods A prospective analysis was used to compare the relationship among the treatment effects of tinnitus for 70 patients with sudden deafness, such as genders, ears, ages, degrees of hearing lose, degrees of tinnitus and audiometric configurations. Results Tinnitus was detected in 87. 18% in 70 patients with sudden deaf ness, and the total effective rate of sudden deafness and tinnitus was 66. 22 % and 74. 32 %, respectively. The statis tical analysis has shown that the treatment effects of tinnitus were not related to genders, ears, ages, and degrees of tinnitus (P>0. 05). Comparing the tinnitus patients with various degrees of hearing lose and various audiometric curves, the total therapeutical rate was less in profound deafness and complete deafness patients with tinnitus(P< 0. 01). The total treatment effects of tinnitus in refractory sudden deafness patients was less than the patients who had recovery, remarkable therapeutic effects and therapeutic effects(P<0. 01). Conclusion The treatment effects on tinnitus in sudden deafness patients were more noticeable than that of sudden deafness. The treatment effects of tinnitus were not related to genders, ears, ages, and degrees of tinnitus. It was worse in the patients suffering pro found deafness, complete deafness and refractory sudden deafness.%目的 探讨影响突发性聋患者耳鸣疗效的相关因素,为突发性聋伴耳鸣患者的临床诊治及预后判断提供依据.方法 前瞻性分析比较117例突发性聋患者中符合入组条件的70例(74耳)突发性聋伴耳鸣患者的耳鸣疗效与性别、耳别、年龄、听力损失程度、听力曲线类型、耳鸣严重程度、听力损失疗效的关系.结果 本组117例突发性聋患者中102

  17. The Gap Detection Test : Can It Be Used to Diagnose Tinnitus?

    NARCIS (Netherlands)

    Boyen, Kris; Başkent, Deniz; van Dijk, Pim

    2015-01-01

    Objectives: Animals with induced tinnitus showed difficulties in detecting silent gaps in sounds, suggesting that the tinnitus percept may be filling the gap. The main purpose of this study was to evaluate the applicability of this approach to detect tinnitus in human patients. The authors first hyp

  18. Tinnitus: from cortex to cochlea

    NARCIS (Netherlands)

    Geven, Leontien

    2014-01-01

    Het medische woord voor oorsuizen is tinnitus. Tinnitus is het waarnemen van geluid, waar geen bron voor is. Het kan dus alleen worden waargenomen door de persoon zelf en niet door anderen. De meeste volwassenen hebben wel eens last gehad van tijdelijke tinnitus. Tinnitus kan echter ook blijvend zij

  19. 耳鸣观念的文艺复兴%Renaissance of Tinnitus management

    Institute of Scientific and Technical Information of China (English)

    赖仁淙; 马鑫

    2016-01-01

    耳鸣是最常见的耳科疾病,病因众多,机制不明,对耳鸣进行一定的分类是提高疗效的关键。本文对听觉系统,听觉系统外系统,心理情绪系统,管控系统在耳鸣中的发病机制做简要综述,并提出了实用的耳鸣临床分类:1.明显耳部疾病引起的耳鸣,主要和相当程度的听力损失相关;2.耳鸣的管控系统疾病,包括心理因素以及睡眠,女性激素水平、偏头痛、过敏、可能影响咽鼓管的鼻腔鼻窦病变、咽喉返流、呼吸睡眠暂停(OSAHS)等因素;3.混合性耳鸣为以上两种因素的混合;4.危险的耳鸣则要警惕可能的颅内病变以及精神疾病;5.原因不明的耳鸣。采用这个分类对耳鸣进行针对性的治疗,将大大提高耳鸣治疗的有效率。%Tinnitus is the most common otological disorder and remains a clinical enigma. Auditory system, non-audi-tory systems, emotional systems and other tinnitus modulating systems all play a certain role in tinnitus. This article is a re-view of its possible pathogenesis and proposes a simplified clinical algorithm for the management of tinnitus patients: 1. Disturbances of the hearing system–is there stable, significant or fluctuant hearing loss;2. Disturbances of tinnitus modu-lating systems, including the eustachian tube system and sleep systems and migraine,sleep changes related to stress, meno-pause in the female and obstructive sleep apnea (OSA) in the male, eustachian disorders possibly related to silent chronic rh-inosinusitis or laryngopharyngeal reflux;3. Mix of 1 and 2;4. Potentially dangerous tinnitus;5. Idiopathic subjective tinni-tus. Managing tinnitus patients following this clinical algorithm may result in improved outcomes.

  20. Tinnitus guidelines and treatment

    DEFF Research Database (Denmark)

    Larsen, Dalia Gustaityté; Ovesen, Therese

    2014-01-01

    In this study literature search was performed on tinnitus guidelines and treatment. Tinnitus can be described as the perception of sound in the absence of external acoustic stimulation, and validated questionnaires, oto-neurological examination, audiometry tests, MRI and angiography are necessary...

  1. Pitch and Loudness Tinnitus in Individuals with Presbycusis

    Directory of Open Access Journals (Sweden)

    Seimetz, Bruna Macangnin

    2016-02-01

    Full Text Available Introduction Tinnitus is a symptom that is often associated with presbycusis. Objective This study aims to analyze the existence of association among hearing thresholds, pitch, and loudness of tinnitus in individuals with presbycusis, considering the gender variable. Methods Cross-sectional, descriptive, and prospective study, whose sample consisted of individuals with tinnitus and diagnosis of presbycusis. For the evaluation, we performed anamnesis along with otoscopy, pure tone audiometry, and acuphenometry to analyze the psychoacoustic characteristics of tinnitus individuals. Results The sample consisted of 49 subjects, with a mean age of 69.57 ± 6.53 years, who presented unilateral and bilateral tinnitus, therefore, a sample of 80 ears. In analyzing the results, as for acuphenometry, the loudness of tinnitus was more present at 0dB and the pitch was 6HKz and 8HKz. Regarding the analysis of the association between the frequency of greater hearing threshold and tinnitus pitch, no statistical significance (p = 0.862 was found. As for the association between the intensity of greater hearing threshold and tinnitus loudness, no statistical significance (p = 0.115 was found. Conclusion There is no significant association between the hearing loss of patients with presbycusis and the pitch and loudness of tinnitus.

  2. [Physiopathological mechanisms in tinnitus generation and persistence].

    Science.gov (United States)

    Herraiz, C

    2005-10-01

    Progress in neuroscience research has given birth to new theories for tinnitus generation. From a point of view where cochlear dysfunctions would be considered as the origin and maintenance mechanisms, it has been introduced the important role of compensation systems from the central auditory pathways. They could act as the most relevant factor for chronic persistent tinnitus after a peripheral aggression. Unmasking of silent synapses or sprouting of new ones activate cortical reorganization for frecuencial areas nearby the non-stimulated ones through brain plasticity. Connections to associative cortex and limbic-amigdala area using the non-classical auditory system explain the presence of hyperacusis, anxiety or depression, factors that increase the severity of tinnitus. Implementation of these physiopathological theories reinforces the tinnitus neurophysiological model. The development of an aversive response through the survival reflex and the participation of negative emotional response are the responsible for signal persistence and vegetative reactions from the autonomous nervous system. Implications of this knowledge for tinnitus treatment involve the central auditory system approach through the combination of medical counselling for reduction of the aversive reaction and sound therapy to diminish its perception.

  3. Conversations with chronic schizophrenic patients.

    Science.gov (United States)

    Morgan, R

    1979-02-01

    An account is given of some of the topics discussed during a small informal weekly open group meeting of chronic schizophrenic patients, based on occasional notes compiled over eleven years. The main feature of the patients' condition as displayed was poverty--clinical, social, behavioural, material and financial--and certain features suggested an organic aetiology. Reasons are given for considering that the patients' condition was predominantly caused by schizophrenia rather than by institutionalism.

  4. Alterations in Event Related Potentials (ERP) associated with tinnitus distress and attention.

    Science.gov (United States)

    Delb, Wolfgang; Strauss, Daniel J; Low, Yin Fen; Seidler, Harald; Rheinschmitt, A; Wobrock, T; D'Amelio, Roberto

    2008-12-01

    Tinnitus related distress corresponds to different degrees of attention paid to the tinnitus. Shifting attention to a signal other than the tinnitus is therefore particularly difficult for patients with high tinnitus related distress. As attention effects on Event Related Potentials (ERP) have been shown this should be reflected in ERP measurements (N100, phase locking). In order to prove this hypothesis single sweep ERP recordings were obtained in 41 tinnitus patients as well as 10 control subjects during a period of time when attention was shifted to a tone (attended) and during a second phase (unattended) when they did not focus attention to the tone. Whereas tinnitus patients with low distress showed a significant reduction in both N100 amplitude and phase locking when comparing the attended and unattended measurement condition a group of patients with high tinnitus related distress did not show such ERP alterations. Using single sweep ERP measurements the results of our study show, that attention in high tinnitus related distress patients is captured by their tinnitus significantly more than in low distress patients. Furthermore our results provide the basis for future neurofeedback based tinnitus therapies aiming at maximizing the ability to shift attention away from the tinnitus.

  5. 300例大学生主观性耳鸣患者临床表现分析%Clinical study of 300 patients with subjective tinnitus from collegians

    Institute of Scientific and Technical Information of China (English)

    孙麦青; 叶放蕾; 丁虹

    2012-01-01

    Objective:To explore the clinical and psychoaeoustic characteristics of tinnitus patients from university students. Melhod:The study included 300 tinnitus patients. All patients were interviewed by the same investigator and using the same questionnaire. Data were collected and analyzed. Result: Hearing loss was seen in 54. 3% of the patients. There was no correlation between tinnitus severity and tinnitus loudness(PX). 05). There was a significant relationship between high-pitched tinnitus and high-frequency SNHL(P<0. 01). In 86.0% of these patients, tinnitus had produced an adverse effect on their psychology and daily life. Conclusion:There is a significant relationship between high-pitched tinnitus and high-frequency SNHL. Tinnitus has an impact on the life of patients from the university students.%目的:探讨大学生主观性耳鸣患者的临床表现及心理声学特点.方法:以问卷调查的方法,收集300例大学生主观性耳鸣患者的基本信息,并进行纯音测听及耳鸣匹配检查,分析耳鸣的基本特征及其与各相关因素之间的关系.结果:耳鸣伴听力下降163例(54.3%),耳鸣匹配频率与听力下降频率有密切关系(P<0.01),耳鸣响度与严重度无明显相关性(P>0.05).耳鸣对86.0%的患者的心理及学习生活产生较明显影响.结论:耳鸣与听力损失最大的音频近似;耳鸣响度与严重程度无相关性.耳鸣对患者心理及学习生活产生了较大的影响,在临床工作中应特别注重心理和社会因素对其的影响.

  6. 突发性聋患者耳鸣程度的相关因素分析%Related factor analysis of the degree of tinnitus in sudden sensorineural hearing loss patients

    Institute of Scientific and Technical Information of China (English)

    陈平; 周津徽

    2013-01-01

    Objective: To provide the theory basis for clinical diagnosis, treatment and prognosis of sudden deafness patients, we detected the relative factors of degree of tinnitus of the patients with sudden deafness. Method: Prospective analysis was used to compare degree of tinnitus with sex, ears, age, degree of hearing lose, hearing curve type and curative effect of tinnitus and sudden deafness. Result: Tinnitus was detected in 87. 2% in the 70 patients who with sudden deafness, and the most and least degree of tinnitus patients was the degree 3(32. 9%) and the degree 5 and 6(0). The total effective rate of sudden deafness and tinnitus was 66. 2% and 71. 3%, respectively. The statistical analysis shown the degree of tinnitus was not related to sex. ears, age, degree of hear-ing lose, auditory curve type and curative effect of tinnitus and sudden deafness (P>0. 05). Conclusion: There was a high rate of tinnitus occurrence in sudden deafness patients, and the moderate degree predominated. The curative effect of tinnitus was better than sudden deafness. There was no relationship between the degree of tinnitus and sex, ears, age, degree of hearing lose, auditory curve type and curative effect of tinnitus and sudden deafness.%目的:探讨影响突发性聋患者耳鸣程度的相关因素,为突发性聋患者耳鸣的临床诊治及预后判断提供依据.方法:前瞻性分析比较70例(74耳)突发性聋伴耳鸣患者的耳鸣程度与性别、耳侧、年龄、听力损失程度、听力曲线类型、耳鸣疗效、突发性聋疗效的关系.结果:突发性聋患者耳鸣的发生率为87.2%,其中耳鸣响度为3级者最多(32.9%),5、6级最少(0).突发性聋的总有效率为66.2%,耳鸣的总有效率为74.3%.耳鸣程度与性别、耳侧、年龄、听力损失程度、听力曲线类型、耳鸣疗效、突发性聋疗效的关系均差异无统计学意义(均P>0.05).结论:突发性聋患者的耳鸣发生率较高,耳鸣以中等程度为

  7. Tinnitus and insomnia: is hyperarousal the common denominator?

    Science.gov (United States)

    Wallhäusser-Franke, Elisabeth; Schredl, Michael; Delb, Wolfgang

    2013-02-01

    Tinnitus is an auditory sensation that is generated by aberrant activation within the auditory system. Sleep disturbances are a frequent problem in the tinnitus population. They are known to worsen the distress caused by the tinnitus which in turn worsens sleep quality. Beyond that, disturbed sleep is a risk factor for mental health problems and distressing tinnitus is often associated with enhanced depressivity, anxiety, and somatic symptom severity. Moreover there is evidence that therapies which alleviate tinnitus-related distress have a positive influence on sleep quality and help interrupt this vicious cycle. This suggests that distressing tinnitus and insomnia may both be promoted by similar physiological mechanisms. One candidate mechanism is hyperarousal caused by enhanced activation of the sympathetic nervous system. There is increasing evidence for hyperarousal in insomnia patients, and animal models of tinnitus and insomnia show conspicuous similarities in the activation pattern of limbic and autonomous brain regions. In this article we review the evidence for this hypothesis which may have implications for therapeutic intervention in tinnitus patients with comorbid insomnia.

  8. Clinical Validation of a New Tinnitus Assessment Technology

    Science.gov (United States)

    Hébert, Sylvie; Fournier, Philippe

    2017-01-01

    Current clinical assessment of tinnitus relies mainly on self-report. Psychoacoustic assessment of tinnitus pitch and loudness are recommended but methods yield variable results. Herein, we investigated the proposition that a previously validated fixed laboratory-based method (Touchscreen) and a newly developed clinically relevant portable prototype (Stand-alone) yield comparable results in the assessment of psychoacoustic tinnitus pitch and loudness. Participants with tinnitus [N = 15, 7 with normal hearing and 8 with hearing loss (HL)] and participants simulating tinnitus (simulators, N = 15) were instructed to rate the likeness of pure tones (250—16 kHz) to their tinnitus pitch and match their loudness using both methods presented in a counterbalanced order. Results indicate that simulators rated their “tinnitus” at lower frequencies and at louder levels (~10 dB) compared to tinnitus participants. Tinnitus subgroups (with vs. without HL) differed in their predominant tinnitus pitch (i.e., lower in the tinnitus with HL subgroups), but not in their loudness matching in decibel SL. Loudness at the predominant pitch was identified as a factor yielding significant sensitivity and specificity in discriminating between the two groups of participants. Importantly, despite differences in the devices’ physical presentations, likeness and loudness ratings were globally consistent between the two methods and, moreover, highly reproducible from one method to the other in both groups. All in all, both methods yielded robust tinnitus data in less than 12 min, with the Stand-alone having the advantage of not being dependent of learning effects, being user-friendly, and being adapted to the audiogram of each patient to further reduce testing time. PMID:28270792

  9. Tinnitus intensity dependent gamma oscillations of the contralateral auditory cortex.

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    Elsa van der Loo

    Full Text Available BACKGROUND: Non-pulsatile tinnitus is considered a subjective auditory phantom phenomenon present in 10 to 15% of the population. Tinnitus as a phantom phenomenon is related to hyperactivity and reorganization of the auditory cortex. Magnetoencephalography studies demonstrate a correlation between gamma band activity in the contralateral auditory cortex and the presence of tinnitus. The present study aims to investigate the relation between objective gamma-band activity in the contralateral auditory cortex and subjective tinnitus loudness scores. METHODS AND FINDINGS: In unilateral tinnitus patients (N = 15; 10 right, 5 left source analysis of resting state electroencephalographic gamma band oscillations shows a strong positive correlation with Visual Analogue Scale loudness scores in the contralateral auditory cortex (max r = 0.73, p<0.05. CONCLUSION: Auditory phantom percepts thus show similar sound level dependent activation of the contralateral auditory cortex as observed in normal audition. In view of recent consciousness models and tinnitus network models these results suggest tinnitus loudness is coded by gamma band activity in the contralateral auditory cortex but might not, by itself, be responsible for tinnitus perception.

  10. Efeito da acupuntura sobre as emissões otoacústicas de pacientes com zumbido Impact of acupuncture on otoacoustic emissions in patients with tinnitus

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    Renata Frasson de Azevedo

    2007-10-01

    Full Text Available O tratamento do zumbido continua a ser um desafio da atualidade. Na medicina tradicional chinesa, a acupuntura é recomendada para o alívio do zumbido, apesar de faltarem provas cientificas nesta área. OBJETIVO: Verificar o efeito da acupuntura sobre a função coclear de indivíduos com zumbido através do uso das emissões otoacústicas. CASUÍSTICA E MÉTODO: Foi realizado um estudo clínico-prospectivo, no qual foram avaliados 38 pacientes do ambulatório de zumbido. Os pacientes foram avaliados por meio de emissões otoacústicas transitórias e pela medida da supressão das emissões otoacústicas transitórias. Essa avaliação foi realizada antes e após a aplicação de acupuntura em um ponto na região têmporo-parietal, correspondente à área cócleo-vestibular (no grupo intervenção 1 n=19 e em um ponto 3cm acima dessa região (para o grupo intervenção 2 n=19. RESULTADOS: Os resultados mostraram uma diferença estatisticamente significante na amplitude das emissões otoacústicas antes e após a aplicação da acupuntura para o grupo intervenção 1. Não foram observadas diferenças para o grupo intervenção 2. CONCLUSÃO: Os resultados sugerem que houve um efeito da acupuntura sobre as emissões otoacústicas dos pacientes com zumbido.The treatment of tinnitus is still a challenge. Acupuncture is recommended for the relief of tinnitus in traditional Chinese Medicine, although scientific evidence is lacking. AIM: The aim of this study was to assess the effect of acupuncture on the cochlear function in patients with tinnitus by analyzing otoacoustic emissions. METHODS: Thirty eight patients with tinnitus were included in the prospective clinical study. Measures of transitory otoacoustic emissions and suppression of otoacoustic emissions were obtained from all subjects before and after acupuncture. Patients were assigned to one of two groups: intervention group 1 (n=19, in which needle acupuncture was applied at the

  11. 浅谈伴有心理因素耳鸣患者的中西医治疗方法%1Shallowly discussed with the Chinese and western medicine treatment of tinnitus patients psychological factors

    Institute of Scientific and Technical Information of China (English)

    涂小红; 黄玉婷; 何跃; 冉晓燕; 彭顺林

    2013-01-01

    According to the survey ,the onset of tinnitus and the outcome is closely related to psychological factors ,and tinnitus also brings to the patients with anxiety ,depression ,irritability ,etc all kinds of psychological problems .Therefore ,the future of tinnitus treatment should be considered to help patients alleviate negative emotions ,eliminate anxiety ,depression and other psychological factors ,help them to lead normal lives .This article mainly discusses in recent years ,accompanied by psychological problems of the traditional Chinese and western medicine treatment of tinnitus patients .%据调查显示,耳鸣的发病及病情转归与心理因素密切相关,同时耳鸣也给患者带来焦虑、抑郁、烦躁等各种心理问题。故未来耳鸣的治疗应考虑帮助患者缓解负面情绪,消除焦虑、抑郁等心理因素,帮助其重新过上正常的生活。本文主要探讨近年来伴有心理问题的耳鸣患者的中西医治疗方法。

  12. Tinnitus and its current treatment--Still an enigma in medicine.

    Science.gov (United States)

    Swain, Santosh Kumar; Nayak, Saumyadarshan; Ravan, Jayprakash Russel; Sahu, Mahesh Chandra

    2016-03-01

    Tinnitus is a phantom auditory perception that occurs in humans. Tinnitus, which is a distressing problem affecting many people around the world, is commonly referred to as ringing in the ears. No effective drug therapy is available for this elusive disease, although much research work into mechanism and possible treatment is underway. As yet, there are no Food and Drug Administration approved drugs available and the quest for a new treatment option for tinnitus focus on important challenges in tinnitus management. A number of options have been used to treat patients with tinnitus, but outcomes have been limited. A new, curative modality will provide a turning point in the management of tinnitus. The purpose of this review article is to discuss the pathophysiology, global burden, current treatment, and prevention of tinnitus, with future prospective studies in new drug therapy for this elusive condition.

  13. Differential pathologies resulting from sound exposure: Tinnitus vs hearing loss

    Science.gov (United States)

    Longenecker, Ryan James

    The first step in identifying the mechanism(s) responsible for tinnitus development would be to discover a neural correlate that is differentially expressed in tinnitus-positive compared to tinnitus negative animals. Previous research has identified several neural correlates of tinnitus in animals that have tested positive for tinnitus. However it is unknown whether all or some of these correlates are linked to tinnitus or if they are a byproduct of hearing loss, a common outcome of tinnitus induction. Abnormally high spontaneous activity has frequently been linked to tinnitus. However, while some studies demonstrate that hyperactivity positively correlates with behavioral evidence of tinnitus, others show that when all animals develop hyperactivity to sound exposure, not all exposed animals show evidence of tinnitus. My working hypothesis is that certain aspects of hyperactivity are linked to tinnitus while other aspects are linked to hearing loss. The first specific aim utilized the gap induced prepulse inhibition of the acoustic startle reflex (GIPAS) to monitor the development of tinnitus in CBA/CaJ mice during one year following sound exposure. Immediately after sound exposure, GIPAS testing revealed widespread gap detection deficits across all frequencies, which was likely due to temporary threshold shifts. However, three months after sound exposure these deficits were limited to a narrow frequency band and were consistently detected up to one year after exposure. This suggests the development of chronic tinnitus is a long lasting and highly dynamic process. The second specific aim assessed hearing loss in sound exposed mice using several techniques. Acoustic brainstem responses recorded initially after sound exposure reveal large magnitude deficits in all exposed mice. However, at the three month period, thresholds return to control levels in all mice suggesting that ABRs are not a reliable tool for assessing permanent hearing loss. Input/output functions of

  14. Analysis of psychoacoustic characteristics and audiology tests of tinnitus patients with sensorineural hearing loss%伴感音神经性聋耳鸣的心理声学和听力学特征

    Institute of Scientific and Technical Information of China (English)

    陈秋坚; 郑亿庆; 邱泽恒; 骆辉珍

    2012-01-01

    Objective:Tried to find the relationship between tinnitus and each testing method, provided information for objective diagnosis and treatment for tinnitus patients with sensorineural hearing loss. Method: The characteristics of audiology tests, including pure tone audiometric, acoustic immittance, middle ear muscle reflexes, matching test, distortion products otoacoustic emission(DPOAE) were compared in 79 ears of 69 tinnitus patients with sensorineural hearing loss. Result:The RI positive rate was higher in Convergence curve in tinnitus patients of sensorineural hearing loss, with the rate being 51. 3%. The detection rates of DPOAE were 15. 2% in patients of sensorineural hearing loss tinnitus groups, which were significant lower than those in control group. Conclusion : Psychoacoustic techniques can produce a useful amount of clinical data regarding tinnitus in different aspects, these data can help clinicians design needed based managements. DPOAE test is helpful for the diagnosis of lesions in some tinnitus patients.%目的:研究伴感音神经性聋耳鸣的心理声学特征测试及听力学的特征.方法:选取感音神经性聋耳鸣患者61例(79耳)作为实验组,选取25例(50耳)听力正常且无耳鸣的志愿者作对照组,分别检测2组对象的纯音测听、声导抗测试、耳鸣检测、畸变产物耳声发射(DPOAE),并进行统计学分析.结果:实验组平均后效抑制阳性率为51.3%,其中耳鸣掩蔽曲线为汇聚型者掩蔽效果较好;实验组与对照组DPOAE的通过率差异有统计学意义,实验组(15.2%)低于对照组(96.0%);在500~8000Hz各个频率点实验组DPOAE幅值低于对照组有统计学意义.结论:耳鸣心理声学测试能够更全面了解耳鸣详细的心理声学特征资料,对耳鸣康复指导提供更加详尽量化指标依据,DPOAE测试可以辅助对耳鸣患者耳蜗病变的诊断.

  15. 综合干预对耳鸣患者心理状态及疗效的影响%Influence of Comprehensive Intervention on Psychological State and Efficacy of Tinnitus Patients

    Institute of Scientific and Technical Information of China (English)

    鲍爱春; 龚齐; 王井红; 支纪治

    2012-01-01

    [Objective] To explore the influence of comprehensive intervention therapy on the psychological state and therapeutic efficacy of tinnitus patients in order to provide the evidence for clinical application. [Methods] Totally 78 tinnitus patients in clinic service were randomly divided into control group and comprehensive intervention group. Control group received conventional drug therapy. Based on conventional drug therapy, comprehensive intervention group was given regular acclimatization therapy guidance for tinnitus combined with cognitive therapy. Symptom checklist-90(SCL-90) scale and tinnitus handicap inventory were used for the comparison between before and 6 months after the treatment. [Results] Compared with control group, the difference in SCL-90 score of comprehensive intervention group between before and after treatment was more obvious( P 0. 05). There were significant differences in the scores of somatization, compulsive, depression, anxiety and mental disease between two groups after treatment( P 0.05),两组治疗后在躯体化、强迫性、抑郁、焦虑、精神病性因子分上相比均有显著差异(P<0.05).两组患者疗效均有改善,而干预组改善更为明显(P<0.05).[结论]综合干预治疗可改善耳鸣患者心理状态,提高疗效.

  16. An electromyography guided botulinum toxin injection is effective treatment for objective tinnitus as an office procedure: A case report

    Directory of Open Access Journals (Sweden)

    Emel Çadallı Tatar

    2016-11-01

    Full Text Available Patients with palatal myoclonus may suffer from pulsatile tinnitus stemming from involuntary contractions of tensor veli palatini and levator veli palatini muscles. Botulinum toxin (BTX injection to these muscles is effective in resolving pulsatile tinnitus symptom. We present a case of pulsatile tinnitus who was effectively treated with BTX injection under an electromyography guidance as an office procedure.

  17. Objective tinnitus from palatal myoclonus. Use of botulinum toxin: a case report.

    Science.gov (United States)

    Conill Tobías, Noemi; de Paula Vernetta, Carlos; García Callejo, Francisco Javier; Marco Algarra, Jaime

    2012-01-01

    Objective tinnitus can have many different etiologies, palatal myoclonus being one of the less frequent. This type of tinnitus is generated by involuntary rhythmic contraction of the soft palate, which generates an audible click for the patient and for the explorer. Botulinum toxin achieves temporary muscle paralysis through presynaptic inhibition of the acetylcholine level at the neuromuscular union. We present a patient with long-term objective tinnitus, along with this patient's response to botulinum toxin injection.

  18. Can temporal repetitive transcranial magnetic stimulation be enhanced by targeting affective components of tinnitus with frontal rTMS? a randomized controlled pilot trial

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    Peter Michael Kreuzer

    2011-11-01

    Full Text Available Objectives: Low-frequency repetitive transcranial magnetic stimulation (rTMS of the temporal cortex has been investigated as a new treatment tool for chronic tinnitus during the last years and has shown moderate efficacy. However, there is growing evidence that tinnitus is not a pathology of a specific brain region, but rather the result of network dysfunction involving both auditory and non-auditory brain regions. In functional imaging studies the right dorsolateral prefrontal cortex has been identified as an important hub in tinnitus related networks and has been shown to particularly reflect the affective components of tinnitus. Based on these findings we aimed to investigate whether the effects of left low frequency rTMS can be enhanced by antecedent right prefrontal low-frequency rTMS. Study Design: Fifty-six patients were randomized to receive either low-frequency left temporal rTMS or a combination of low-frequency right prefrontal followed by low-frequency left temporal rTMS. The change of the tinnitus questionnaire (TQ score was the primary outcome, secondary outcome parameters included the Tinnitus Handicap Inventory, numeric rating scales and the Beck Depression Inventory. The study is registered in clinicaltrials.gov (NCT01261949.Results: Directly after therapy there was a significant improvement of the TQ-score in both groups. Comparison of both groups revealed a trend towards more pronounced effects for the combined group (effect size: Cohen’s d=0.176, but this effect did not reach significance. A persistent trend towards better efficacy was also observed in all other outcome criteria. Conclusion: Additional stimulation of the right prefrontal cortex seems to be a promising strategy for enhancing TMS effects over the temporal cortex. These results further support the involvement of the right DLPFC in the pathophysiology of tinnitus. The small effect size might be due to the study design comparing the protocol to an active control

  19. [Multi-sensory interaction in tinnitus: visual evoked potentials and somatosensory stimulation].

    Science.gov (United States)

    Herráiz, C; Hernández-Calvín, F J; Plaza, G; Toledano, A; De los Santos, G

    2003-05-01

    Anomalous cross-modal interactions along the audiovestibular, visual and soma-tosensorial pathways could be the responsible for aberrant signals, clinically expressed as phantom perceptions. This results in tinnitus that can be modified by gaze movements or somatosensorial stimulation through skin, orofacial (jaw) and cervical movements. This phenomenon has also been described in some patients with acute unilateral deafferentation of the auditory peripheral system as a result of surgery to remove a tumour in the posterior fossal. Neuroimaging preliminary studies (PET, f-MRI) describe multisensorial interactions and cortical reorganisation processes in chronic tinnitus. Treatment approaches are still unknown although counselling regarding the benignity of the process and the high percentage of habituation to the symptom is the most effective framework. We present our experience in four cases.

  20. The Prevalence of Fabry Disease in Patients with Chronic Kidney Disease in Turkey: The TURKFAB Study

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    Kultigin Turkmen

    2016-12-01

    Full Text Available Background/Aims: Fabry disease is a treatable cause of chronic kidney disease (CKD characterized by a genetic deficiency of α-galactosidase A. European Renal Best Practice (ERBP recommends screening for Fabry disease in CKD patients. However, this is based on expert opinion and there are no reports of the prevalence of Fabry disease in stage 1-5 CKD. Hence, we investigated the prevalence of Fabry disease in CKD patients not receiving renal replacement therapy. Methods: This prospective study assessed α-galactosidase activity in dried blood spots in 313 stage 1-5 CKD patients, 167 males, between ages of 18-70 years whose etiology of CKD was unknown and were not receiving renal replacement therapy. The diagnosis was confirmed by GLA gene mutation analysis. Results: Three (all males of 313 CKD patients (0.95% were diagnosed of Fabry disease, for a prevalence in males of 1.80%. Family screening identified 8 aditional Fabry patients with CKD. Of a total of 11 Fabry patients, 7 were male and started enzyme replacement therapy and 4 were female. The most frequent manifestations in male patients were fatigue (100%, tinnitus, vertigo, acroparesthesia, hypohidrosis, cornea verticillata and angiokeratoma (all 85%, heat intolerance (71%, and abdominal pain (57%. The most frequent manifestations in female patients were fatigue and cornea verticillata (50%, and tinnitus, vertigo and angiokeratoma (25%. Three patients had severe episodic abdominal pain attacks and proteinuria, and were misdiagnosed as familial Mediterranean fever. Conclusions: The prevalence of Fabry disease in selected CKD patients is in the range found among renal replacement therapy patients, but the disease is diagnosed at an earlier, treatable stage. These data support the ERBP recommendation to screen for Fabry disease in patients with CKD of unknown origin.

  1. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Soleimani, Robabeh; Jalali, Mir Mohammad; Hasandokht, Tolou

    2016-07-01

    In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn.

  2. Análise da correlação entre limiares auditivos, questionários validados e medidas psicoacústicas em pacientes com zumbido Correlation analysis of hearing thresholds, validated questionnaires and psychoacoustic measurements in tinnitus patients

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    Ricardo Rodrigues Figueiredo

    2010-08-01

    Full Text Available Uma das principais dificuldades nos estudos clínicos sobre zumbido reside na falta de consenso sobre os métodos de mensuração. OBJETIVO: Avaliar a correlação entre os limiares audiométricos, pitch matching (PM, minimum masking level (MML, Tinnitus Handicap Inventory (THI e o Inventário de Depressão de Beck (BDI em pacientes com zumbido. MODELO DE ESTUDO: Prospectivo, coorte transversal. MATERIAL E MÉTODO: 48 pacientes com zumbido como queixa principal foram submetidos aos testes audiométricos e questionários acima descritos. Os dados foram comparados estatisticamente para as correlações entre os métodos. RESULTADOS: Não houve correlação estatisticamente significativa entre o THI e MML, tanto em pacientes com BDI acima e abaixo de 14 pontos, bem como entre a frequência de pior limiar auditivo e o Pitch matching e entre a frequência de "cut-off" e o PM nos pacientes com curvas descendentes em rampa. CONCLUSÕES: Não existe correlação estatisticamente significativa entre as medidas psicoacústicas do zumbido, os limiares audiométricos e os questionários de avaliação. O zumbido é um sintoma muito complexo e avaliações isoladas pelos métodos acima não são satisfatórias.One of the most criticized points in tinnitus clinical studies arise from the lack of consensus about measurement methods. AIM: To evaluate the correlation between audiometric thresholds, pitch matching (PM, minimum masking level (MML, Tinnitus Handicap Inventory (THI and the Beck Depression Inventory (BDI in tinnitus patients. STUDY DESIGN: Prospective, cross-sectional. MATERIALS AND METHODS: Subjects were submitted to tonal audiometry, PM and MML for tinnitus. They also filled out the THI and BDI. Data was statistically compared for correlation purposes between audiometric thresholds, psycho-acoustic measures and questionnaires. RESULTS: There was no statistically significant correlation between THI and MML, both in patients with BDI scores under and

  3. Methodological aspects of clinical trials in tinnitus: A proposal for an international standard

    Science.gov (United States)

    Landgrebe, Michael; Azevedo, Andréia; Baguley, David; Bauer, Carol; Cacace, Anthony; Coelho, Claudia; Dornhoffer, John; Figueiredo, Ricardo; Flor, Herta; Hajak, Goeran; van de Heyning, Paul; Hiller, Wolfgang; Khedr, Eman; Kleinjung, Tobias; Koller, Michael; Lainez, Jose Miguel; Londero, Alain; Martin, William H.; Mennemeier, Mark; Piccirillo, Jay; De Ridder, Dirk; Rupprecht, Rainer; Searchfield, Grant; Vanneste, Sven; Zeman, Florian; Langguth, Berthold

    2013-01-01

    Chronic tinnitus is a common condition with a high burden of disease. While many different treatments are used in clinical practice, the evidence for the efficacy of these treatments is low and the variance of treatment response between individuals is high. This is most likely due to the great heterogeneity of tinnitus with respect to clinical features as well as underlying pathophysiological mechanisms. There is a clear need to find effective treatment options in tinnitus, however, clinical trials differ substantially with respect to methodological quality and design. Consequently, the conclusions that can be derived from these studies are limited and jeopardize comparison between studies. Here, we discuss our view of the most important aspects of trial design in clinical studies in tinnitus and make suggestions for an international methodological standard in tinnitus trials. We hope that the proposed methodological standard will stimulate scientific discussion and will help to improve the quality of trials in tinnitus. PMID:22789414

  4. Transcranial Magnetic Stimulation for the treatment of tinnitus: Effects on cortical excitability

    Directory of Open Access Journals (Sweden)

    Hajak Göran

    2007-07-01

    Full Text Available Abstract Background Low frequency repetitive transcranial magnetic stimulation (rTMS has been proposed as an innovative treatment for chronic tinnitus. The aim of the present study was to elucidate the underlying mechanism and to evaluate the relationship between clinical outcome and changes in cortical excitability. We investigated ten patients with chronic tinnitus who participated in a sham-controlled crossover treatment trial. Magnetic-resonance-imaging and positron-emission-tomography guided 1 Hz rTMS were performed over the auditory cortex on 5 consecutive days. Active and sham treatments were separated by one week. Parameters of cortical excitability (motor thresholds, intracortical inhibition, intracortical facilitation, cortical silent period were measured serially before and after rTMS treatment by using single- and paired-pulse transcranial magnetic stimulation. Clinical improvement was assessed with a standardized tinnitus-questionnaire. Results We noted a significant interaction between treatment response and changes in motor cortex excitability during active rTMS. Specifically, clinical improvement was associated with an increase in intracortical inhibition, intracortical facilitation and a prolongation of the cortical silent period. These results indicate that intraindividual changes in cortical excitability may serve as a correlate of response to rTMS treatment. Conclusion The observed alterations of cortical excitability suggest that low frequency rTMS may evoke long-term-depression like effects resulting in an improvement of subcortical inhibitory function.

  5. Permanent Sensorineural Deafness in a Patient with Chronic Myelogenous Leukemia Secondary to Intracranial Hemorrhage

    Directory of Open Access Journals (Sweden)

    Sakshi Kapur

    2013-01-01

    Full Text Available A 52-year-old male presented with tinnitus and fullness in left ear for one day. Workup revealed a white blood cell count of 685×103/μL with marked increase in granulocyte series and myeloid precursors on peripheral smear. The initial impression was chronic myelogenous leukemia with hyperleukocytosis, and patient was started on hydration, hydroxyurea, and allopurinol. Patient tolerated bone marrow biopsy well but continued to bleed excessively from the biopsy site. Results confirmed Philadelphia chromosome positive chronic myelogenous leukemia (chronic phase. On day three of hospitalization, patient developed sudden slurred speech along with shaking movements involving extremities. Magnetic resonance imaging revealed multiple hemorrhages throughout the brain. Hydroxyurea was continued until insurance coverage for nilotinib was getting approved. On day nine of hospitalization, patient developed sudden bilateral sensorineural deafness. Repeat magnetic resonance imaging revealed multiple new hemorrhages throughout the brain. Computer tomography of the temporal bones showed inflammatory changes in right and left mastoid cells. Nilotinib was started on day eleven of hospitalization. Patient’s white blood cell count continued to decrease, but there was no improvement in hearing. Four months later, patient was treated with bilateral transmastoid cochlear implants. This case highlights permanent deafness as a hemorrhagic complication secondary to chronic myelogenous leukemia.

  6. The Tinnitus Research Initiative (TRI database: A new approach for delineation of tinnitus subtypes and generation of predictors for treatment outcome

    Directory of Open Access Journals (Sweden)

    Staudinger Susanne

    2010-08-01

    Full Text Available Abstract Tinnitus, the phantom perception of sound, is a frequent disorder that causes significant morbidity and treatment is elusive. A large variety of different treatment options have been proposed and from most of them some patients benefit. However, a particular treatment that helps one patient may fail for others. This suggests that there are different forms of tinnitus which differ in their pathophysiology and their response to specific treatments. Therefore, it is a major challenge for tinnitus treatment to identify the most promising therapy for a specific patient. However, most published clinical treatment studies have enrolled only relatively small patient samples, making it difficult to identify predictors of treatment response for specific approaches. Furthermore, inter-study comparability is limited because of varying methods of tinnitus assessment and different outcome parameters. Performing clinical trials according to standardized methodology and pooling the data in a database should facilitate both clinical subtypisation of different forms of tinnitus, and identification of promising treatments for different types of tinnitus. This would be an important step towards the goal of individualized treatment of tinnitus. For these reasons, an international database of tinnitus patients, who undergo specific treatments, and are assessed during the course of this treatment with standardized instruments (e.g., psychoacoustic measures, questionnaires has been established. The primary objectives of this database are (1 collecting a standardized set of data on patient characteristics, treatments, and outcomes from tinnitus patients consulting specialized tinnitus clinics all over the world (at present 13 centers in 8 countries, (2 delineating different subtypes of tinnitus based on data that has been systematically collected and (3 identifying predictors for individual treatment response based on the clinical profile. Starting in 2008, the

  7. Deafferentation-based pathophysiological differences in phantom sound: Tinnitus with and without hearing loss.

    Science.gov (United States)

    Vanneste, Sven; De Ridder, Dirk

    2016-04-01

    Tinnitus has been considered an auditory phantom percept. Recently a theoretical multiphase compensation mechanism at a cortical level has been hypothesized linking auditory deafferentation to tinnitus. This Bayesian brain model predicts that two very different kinds of tinnitus should exist, depending on the amount of hearing loss: an auditory cortex related form of tinnitus not associated with hearing loss, and a (para)hippocampal form associated with hearing loss, in which the auditory cortex might be of little relevance. In order to verify this model, resting state source analyzed EEG recordings were made in 129 tinnitus patients, and correlated to the mean hearing loss, the range of the hearing loss and the hearing loss at the tinnitus frequency. Results demonstrate that tinnitus can be linked to 2 very different mechanisms. In patients with little or no hearing loss, the tinnitus seems to be more related to auditory cortex activity, but not to (para)hippocampal memory related activity, whereas in tinnitus patients with more severe hearing loss, tinnitus seems to be related to (para)hippocampal mechanisms. Furthermore hearing loss seems to drive the communication between the auditory cortex and the parahippocampus, as measured by functional and effective connectivity.

  8. Chronic constipation in hemiplegic patients

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To assess the prevalence of bowel dysfunction in hemiplegic patients, and its relationship with the site of neurological lesion, physical immobilization and pharmacotherapy.METHODS: Ninety consecutive hemiplegic patients and 81 consecutive orthopedic patients were investigated during physical motor rehabilitation in the same period, in the same center and on the same diet. All subjects were interviewed ≥ 3 mo after injury using a questionnaire inquiring about bowel habits before injury and at the time of the interview. Patients' mobility was evaluated by the Adapted Patient Evaluation Conference System. Drugs considered for the analysis were nitrates, angiogenic converting enzyme (ACE) inhibitors,calcium antagonists, anticoagulants, antithrombotics,antidepressants, anti-epileptics.RESULTS: Mobility scores were similar in the two groups. De novo constipation (OR = 5.36) was a frequent outcome of the neurological accident.Hemiplegics showed an increased risk of straining at stool (OR: 4.33), reduced call to evacuate (OR: 4.13),sensation of incomplete evacuation (OR: 3.69), use of laxatives (OR: 3.75). Logistic regression model showed that constipation was significantly and independently associated with hemiplegia. A positive association was found between constipation and use of nitrates and antithrombotics in both groups. Constipation was not related to the site of brain injury.CONCLUSION: Chronic constipation is a possible outcome of cerebrovascular accidents occurring in 30% of neurologically stabilized hemiplegic patients.Its onset after a cerebrovascular accident appears to be independent from the injured brain hemisphere,and unrelated to physical inactivity. Pharmacological treatment with nitrates and antithrombotics may represent an independent risk factor for developing chronic constipation.

  9. Genetics of Tinnitus : An Emerging Area for Molecular Diagnosis and Drug Development

    NARCIS (Netherlands)

    Lopez-Escamez, Jose A; Bibas, Thanos; Cima, Rilana F F; Van de Heyning, Paul; Knipper, Marlies; Mazurek, Birgit; Szczepek, Agnieszka J; Cederroth, Christopher R

    2016-01-01

    Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorde

  10. 伴乙肝的耳鸣患者心理声学特征初探%A Preliminary Study of the Psychoacoustic Characteristics of Tinnitus Patients with Hepatitis B Virus

    Institute of Scientific and Technical Information of China (English)

    张帆; 鲍诗平; 刘勇刚; 刘志成

    2014-01-01

    目的:初步探讨伴乙肝的耳鸣患者的心理声学特征,为此类人群制订更为个性化的耳鸣治疗方案提供临床依据。方法使用听尼特TM1000A耳鸣综合诊断治疗仪对35例伴乙肝的耳鸣患者进行纯音测听和耳鸣心理声学测试,对结果进行统计分析。结果35例患者中,听力正常组12例,听力损失组23例;耳鸣音调匹配失败5耳;耳鸣音调匹配类型以纯音为主(占68.6%);耳鸣频率以高频居多(占70.0%);耳鸣响度不大,以10 dB SL以内为主(占80.0%);耳鸣佛德曼曲线在听力正常组与听力损失组均以汇聚型最多;残余抑制试验阳性率听力损失组(占70.0%)高于听力正常组(占50.0%)。结论伴乙肝的耳鸣患者,听力损失人数居多;汇聚型佛德曼曲线且伴听力下降的患者残余抑制试验阳性率最高,耳鸣更易被掩蔽。%Objective To explore the psychoacoustic characteristics of tinnitus patients with hepatitis B virus and to provide clinical evidences for the development of individualized tinnitus therapy. Methods Thirty-five tinnitus patients with hepatitis B virus received the pure-tone audiometry and tinnitus psychoacoustic assessment using a patented digital system, 1000A TinniTestTM. Results The 35 patients were divided into normal-hearing group(12 patients) and hearing-impaired group(23 patients). 5 patients failed in the tinnitus pitch-matching test. The pitch-matching type was mainly pure tone(68.6%). Tinnitus was present mostly in the high-frequency range(70.0%). The tinnitus loudness was usually lower than 10 dB SL(80.0%). The convergent Feldmann curve was mostly seen in both normal-hearing group and in hearing-impaired group. The positive rate of residual inhibition test for hearing-impaired group(70.0%)was higher than that for normal-hearing group(50.0%). Conclusion A large proportion of tinnitus patients with hepatitis B virus suffer from hearing loss. The positive rate of

  11. Polish translation and validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index

    Directory of Open Access Journals (Sweden)

    Małgorzata Wrzosek

    2016-11-01

    Full Text Available The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to the translation into Polish and the validation of two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI and the Tinnitus Functional Index (TFI. Design: The original English version of questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl and a Polish TFI (TFI-Pl. Participants from three laryngological centers in Poland answered anonymously the THI-Pl (N=98 and the TFI-Pl (N=108 in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale (CES-D as a measure of self-perceived level of depression, and the Satisfaction With Life Scale (SWLS to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales (VAS were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's alpha=0.93. The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic and emotional subscales. Convergent and discriminant validity were confirmed. The TFI-Pl showed high internal consistency (Cronbach's alpha=0.96 with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validity were also confirmed for the TFI-Pl. Conclusions: We translated and validated the Polish versions of the THI and the TFI

  12. Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index

    Science.gov (United States)

    Wrzosek, Małgorzata; Szymiec, Eugeniusz; Klemens, Wiesława; Kotyło, Piotr; Schlee, Winfried; Modrzyńska, Małgorzata; Lang-Małecka, Agnieszka; Preis, Anna; Bulla, Jan

    2016-01-01

    Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach’s α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach’s α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them

  13. Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index.

    Science.gov (United States)

    Wrzosek, Małgorzata; Szymiec, Eugeniusz; Klemens, Wiesława; Kotyło, Piotr; Schlee, Winfried; Modrzyńska, Małgorzata; Lang-Małecka, Agnieszka; Preis, Anna; Bulla, Jan

    2016-01-01

    Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI). Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity. Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach's α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach's α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl. Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them suitable

  14. The study of cochlear outer hair cells function in normally hearing patients with tinnitus%听力正常的耳鸣患者的耳蜗外毛细胞功能研究

    Institute of Scientific and Technical Information of China (English)

    刁明芳; 孙建军; 田芳洁; 贾仲红; 刘阳; 陈东兰

    2012-01-01

    目的 用畸变产物耳声发射(distortion product evoked oto-acoustic emissions,DPOAE)检测听力正常耳鸣患者的耳蜗外毛细胞(outer hair cell,OHC)功能.方法 选取门诊50例听力正常(250~8000Hz)伴有耳鸣的患者,对照组选取年龄性别匹配的听力正常无耳鸣的志愿者.比较两组受试者的DPOAE幅值.结果 与对照组相比,耳鸣组DPOAE幅值降低,在高频(4~8kHz)的幅值差异有显著性(P<0.05).结论 DPOAE幅值下降与听力正常患者的耳鸣产生有关,耳蜗OHC功能受损可能是耳鸣的来源.%Objective To compare cochlear outer hair cells functionin normally hearing patients with and without tinnitus based on distortion product otoacoustic emission(DPOAE). Methods Fifty tinnitus patients with normal hearing in the frequency range between 250 to 8000 Hz were selected as a study group. The control group consisted of 50 otologically normal subjects who have normal hearing threshold levels without tinnitus and were selected to match the study group by age and gender. DPOAE-grams of tinnitus group were compared with theose of control group. Results Tinnitus ears exhibited relatively decrease amplitudes of DPOAE when compared with the group of healthy ears .Statistically significant (P< 0.05) decrease mean values of DPOAE amplitudes were observed at a frequency of 4-8kHz. Conclusions There is an association between tinnitus and reduced distortion product otoacoustic emission amplitudes. The reduced cochlear outer hair cells function may be the source of tinnitus.

  15. Evaluation of Sound Therapy Tinnitus Treatments with Concurrent Counseling in Active Duty Military Personnel

    Science.gov (United States)

    2014-07-04

    according to the Tinnitus Retraining Therapy (TRT) Patient Counseling Guide (Henry, Trune, Robb and Jastreboff, 2007). All participants used Bang...Mori, N. 2010. Tinnitus retraining therapy using portable music players. Auris Nasus Larynx, 38(6), 692-696. 13   Goddard, J.C., Berliner...J. A., and Jastreboff, P. J. 2007. Tinnitus retraining therapy : Patient Counseling Guide. San Diego, CA: Plural Publishing, Inc. Hill, M. M

  16. The Characteristics of Tinnitus Psychoacoustic in 159 Patient%耳鸣患者耳鸣的心理声学特征分析

    Institute of Scientific and Technical Information of China (English)

    叶放蕾; 王乐; 陈蓓; 高佩

    2012-01-01

    Objective To observe and analyze the psychoacoustic characteristics of tinnitus patients in order to assess tinnitus psychoacoustics for effective treatment. Methods Detailed history information was obtained from the tinnitus patients complaining of tinnitus. The characteristics of psychoacoustics were evaluated using the TTS- 1000A and the results were statistically analyzed. Results There was no significant age difference between men and women (l = l. 13, P>0. 05). There were significant deviations in the residual inhibition and therapeutic efficacy ac cording to the hearing and the residual inhibition results(x2 = 4. 440,P<0. 05). There were significant deviations in the residual inhibition according to the Feldmann masking curves and the hearing thresholds. Conclusion Patients exhibiting convergence type and hearing loss had the most noticeable residual inhibition.%目的 分析耳鸣患者耳鸣的心理声学特征,为开展耳鸣心理声学治疗提供依据.方法 对159例以耳鸣为第一主诉的患者用耳鸣综合诊断治疗仪TTS-1000A进行耳鸣心理声学测试,对相关结果进行分析.结果 159例患者的耳鸣主调大多为纯音(103例,64.78%),且主调频率以8 000 Hz最多(58例,36.48%);耳鸣响度分布<5 dB SL者最多(80例,50.31%);耳鸣最小掩蔽级测试佛德曼曲线中以汇聚型最多( 63例,39.62%);残余抑制时间1~60秒者最多(75例47.17%),90例(56.60%)残余抑制试验部分阳性;117例(73.58%)伴听力下降,听力下降组患者的抑制试验阳性和部分阳性病例所占比例显著高于听力正常组(P<0.05).在掩蔽曲线为汇聚型的听力下降组中,残余抑制试验阳性和部分阳性者(73.33%)明显高于其它组(P<0.05).结论 耳鸣患者中,耳鸣掩蔽曲线为汇聚型且伴听力下降的患者,其耳鸣更易被掩蔽.

  17. Tinnitus and cell phones: the role of electromagnetic radiofrequency radiation

    Directory of Open Access Journals (Sweden)

    Luisa Nascimento Medeiros

    2016-02-01

    Full Text Available ABSTRACT INTRODUCTION: Tinnitus is a multifactorial condition and its prevalence has increased on the past decades. The worldwide progressive increase of the use of cell phones has exposed the peripheral auditory pathways to a higher dose of electromagnetic radiofrequency radiation (EMRFR. Some tinnitus patients report that the abusive use of mobiles, especially when repeated in the same ear, might worsen ipsilateral tinnitus. OBJECTIVE: The aim of this study was to evaluate the available evidence about the possible causal association between tinnitus and exposure to electromagnetic waves. METHODS: A literature review was performed searching for the following keywords: tinnitus, electromagnetic field, mobile phones, radio frequency, and electromagnetic hypersensitivity. We selected 165 articles that were considered clinically relevant in at least one of the subjects. RESULTS: EMRFR can penetrate exposed tissues and safety exposure levels have been established. These waves provoke proved thermogenic effects and potential biological and genotoxic effects. Some individuals are more sensitive to electromagnetic exposure (electrosensitivity, and thus, present earlier symptoms. There may be a common pathophysiology between this electrosensitivity and tinnitus. CONCLUSION: There are already reasonable evidences to suggest caution for using mobile phones to prevent auditory damage and the onset or worsening of tinnitus.

  18. 听力正常耳鸣患者的听力学检测分析%Analysis of audiology tests on tinnitus patients with normal hearing

    Institute of Scientific and Technical Information of China (English)

    王培; 邱泽恒; 杨湘宁; 梁象逢

    2011-01-01

    Objective To find the relationship between tinnitus and each testing method,and provide information for its diagnosis and treatment.Methods Compared the characteristics of audiology tests,including pure tone audiometric,acoustic immittance,middle ear muscle reflexes,matching test,distortion products otoacoustic emission (DPOAE),and auditory brainstem response(ABR).Results The detection rates of DPOAE were 67.3% in patients of normal hearing tinnitus groups,which were significant lower than those in control group.Comparing with the control group,the normal hearing tinnitus group performed PL of wave Ⅰ,Ⅲ,Ⅴ and IPL of Ⅲ-Ⅴ prolonged.Conclusion DPOAE can reflect cochlear hair cells' lesion in early stage; DPOAE and ABR test are helpful for diagnosis of lesions in some tinnitus patients.%目的 探讨耳鸣与各种听力学检查的关系,探索耳鸣的客观诊断方法.方法 选取听力正常耳鸣患者38例56耳作为实验组,选取无年龄及性别差异的25例50耳听力正常且无耳鸣的志愿者作对照组,分别检测两组对象的纯音测听、声导抗测试、耳鸣检查、畸变产物耳声发射(DPOAE)、听性脑干反应(ABR),并进行统计学分析.结果 听力正常耳鸣组与对照组DPOAE的通过率有统计学意义,耳鸣组(67.3%)低于对照组(96.0%);在700 Hz、1 KHz、4 KHz、6 KHz及8 KHz耳鸣组DPOAE幅值低于对照组(P<0.05);耳鸣组ABR Ⅰ、Ⅲ、Ⅴ波潜伏期及Ⅲ-Ⅴ波间期与对照组相比有所延长,差异有显著性(P<0.05);耳鸣组平均后效抑制阳性率为64.3%,其中耳鸣掩蔽曲线为汇聚型者掩蔽效果较好.结论 DPOAE可以先于纯音测听发现耳蜗功能的早期改变,对耳鸣患者行DPOAE和ABR测试可以帮助对部分耳鸣进行病变部位的诊断.

  19. 心理护理干预对耳鸣患者生活质量的影响分析%The Impact Analysis Of Psychological Nursing Intervention on Quality of Life in Patients with Tinnitus

    Institute of Scientific and Technical Information of China (English)

    魏杰英; 杨崇英; 普自红

    2014-01-01

    目的:探讨心理护理对耳鸣患者生活质量的影响。方法对132例耳鸣患者资料进行分析,并给予患者相应的心理护理手段干预。结果患者实施心理护理干预后较之前在人际关系、患者躯体化、焦虑、抑郁情绪方面均得到改善(P<0.05);生活质量提高。结论对耳鸣患者实施针对性的心理护理干预可有效改善生存质量,降低不良情绪发生率。%Objective To investigate the psychological care of patients with tinnitus impact on quality of life.Methods 132 cases of tinnitus patients were analyzed, and give patients the appropriate psychological care means to intervene.Results After the implementation of psychological nursing intervention in patients compared to the previous relationship, the patient somatization, anxiety and depression areas were improved (P<0.05); Improved quality of life.Conclusion The implementation of tinnitus patients targeted psychological care intervention can effectively improve the quality of life and reduce the incidence of negative emotions.

  20. Is the effect of tinnitus on auditory steady-state response amplitude mediated by attention?

    Directory of Open Access Journals (Sweden)

    Eugen eDiesch

    2012-05-01

    Full Text Available Objectives: The amplitude of the auditory steady-state response (ASSR is enhanced in tinnitus. As ASSR ampli¬tude is also enhanced by attention, the effect of tinnitus on ASSR amplitude could be interpreted as an effect of attention mediated by tinnitus. As attention effects on the N1 are signi¬fi¬cantly larger than those on the ASSR, if the effect of tinnitus on ASSR amplitude were due to attention, there should be similar amplitude enhancement effects in tinnitus for the N1 component of the auditory evoked response. Methods: MEG recordings of auditory evoked responses which were previously examined for the ASSR (Diesch et al. 2010 were analysed with respect to the N1m component. Like the ASSR previously, the N1m was analysed in the source domain (source space projection. Stimuli were amplitude-modulated tones with one of three carrier fre¬quen¬cies matching the tinnitus frequency or a surrogate frequency 1½ octaves above the audio¬metric edge frequency in con¬trols, the audiometric edge frequency, and a frequency below the audio¬metric edgeResults: In the earlier ASSR study (Diesch et al., 2010, the ASSR amplitude in tinnitus patients, but not in controls, was significantly larger in the (surrogate tinnitus condition than in the edge condition. In the present study, both tinnitus patients and healthy controls show an N1m-amplitude profile identical to the one of ASSR amplitudes in healthy controls. N1m amplitudes elicited by tonal frequencies located at the audiometric edge and at the (surrogate tinnitus frequency are smaller than N1m amplitudes elicited by sub-edge tones and do not differ among each other.Conclusions: There is no N1-amplitude enhancement effect in tinnitus. The enhancement effect of tinnitus on ASSR amplitude cannot be accounted for in terms of attention induced by tinnitus.

  1. Chronic diseases among older cancer patients.

    NARCIS (Netherlands)

    Deckx, L.D.; Akker, M.A. van der; Metsemakers, J.M.; Knottnerus, A.K.; Schellevis, F.G.; Buntinx, F.B.

    2011-01-01

    Introduction: With the growing number of older cancer patients, the burden of chronic diseases among older cancer patients will become increasingly important. Chronic diseases often interfere with treatment decisions and prognosis for cancer patients. However, little is known about the occurrence of

  2. HBV Vaccination in Chronic Renal Failure Patients

    OpenAIRE

    Mir-davood Omrani; Mohammad Hassan Khadem Ansari

    2006-01-01

    HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unre...

  3. Clinical Neurology of Tinnitus Patients with 110 Cases%110例耳鸣患者的神经内科临床治疗

    Institute of Scientific and Technical Information of China (English)

    石昌成

    2015-01-01

    目的:对该院110例耳鸣患者的神经内科临床治疗进行探究,对其治疗效果和治疗方法进行总结。方法随机选择2012年4月-2013年5月该院110例耳鸣患者作为研究对象,随机将其分成实验组和对照组,实验组50例,对照组60例。对照组患者给予常规的西比灵药物治疗,实验组患者在对照组患者治疗的基础上加用敏使朗药物,之后对两组患者的治疗效果和全血粘度性指标进行比较分析。结果实验组患者的治疗总有效率为94.00%,对照组患者的治疗总有效率是45.00%;实验组患者的血浆黏度、全血黏度低切值分别为(12.29±2.57)、(1.35±0.26);对照组患者的血浆黏度、全血黏度低切值分别为(14.93±3.54)、(1.61±0.45)。实验组患者的治疗总有效率、血浆黏度、全血黏度低切均优于对照组患者,差异有统计学意义(P<0.05)。结论西比灵联合敏使朗治疗耳鸣疾病具有积极的临床应用效果,值得实践和推广。%Objective To study for 110 cases of hospital patients with tinnitus neural Department of internal medicine clinical treatment, to explore the effect of treatment and the treatment method. Methods Selected from April 2012 to May 2013 in our hos-pital 110 cases of tinnitus patients as the research object, according to a randomized method, divided into experimental group and control group, 60 cases in the experimental group, the control group for 50 cases. Patients in control group were treated with flu-narizine routine drug treatment, patients in the experimental group with betahistine treatment in the control group patients based on the index, after the treatment effect and blood viscosity of two groups of patients were compared and analyzed. Results The treat-ment of the patients in the experimental group the total efficiency is 94%, the total effective rate of the control group is 45%; the patients in the experimental group the plasma viscosity, whole

  4. 新疆维吾尔族耳鸣掩蔽曲线与掩蔽治疗效果的观察%Observation of Tinnitus Masking Curves and Effect of Masking Treatment in Uygur' s Patients

    Institute of Scientific and Technical Information of China (English)

    张伦; 丁伟; 余勐

    2011-01-01

    目的 观察维吾尔族耳鸣患者听力图及掩蔽曲线,探讨治疗效果及其相关性.方法 对105例(118耳)耳鸣为主诉的维吾尔族患者进行纯音测试,根据听力图分为正常听力(32耳)、轻度听力损失(24耳)、中度听力损失( 39耳)、重度听力损失(17耳)、极重度听力损失(6耳)5组.纳入对象均为维吾尔族耳鸣患者.按照弗德曼掩蔽曲线不同分别进行耳鸣测试及掩蔽治疗.结果105例(118耳)患者中,正常听力、轻度、中度听力损失组中耳鸣掩蔽曲线以重叠型为主;重度听力损失中耳鸣掩蔽曲线以间距为主.在所有病例中以重叠型和汇聚型居多.残余抑制试验在轻、中度听力损失组中均以重叠型阳性率高,与其他类型比较差异有统计学意义(P<0.05).结论 在耳鸣患者中存在心理焦虑的较多.因此心理暗示治疗和习服治疗尤为关键.耳鸣曲线的掩蔽不同所得到的后效抑制结果和耳鸣掩蔽治疗结果也不同.%Objective To analyze the audiogram and masking audiogram curve Uygur' s patients with tinnitus, and to evaluate the effect of masking treatment. Methods The pure tone test were performed in 105 Uygur patients(118 ears) with tinnitus. Based on the audiogram,all patients were divided into five groups:normal hearing(32 ears) ,mild hearing loss(24 ears) .moderate hearing loss(39 ears) .severe hearing Ioss( 17 ears) and extreme hearing loss(6 ears). The tinnitus test or masking treatment was chose according to Feldmann masking curves. Results In normal hearing,mild,moderate hearing loss group,overlapping tinnitus masking curve was the major part. In severe hearing loss group,the spacing tinnitus masking curve was the major part. In all cases, the overlapping and convergent was the major part. By taking residual inhibition test, the positive rate of overlapping tinnitus masking curve in mild and moderate hearing loss group was high,and the difference was

  5. Theoretical Tinnitus framework: A Neurofunctional Model

    Directory of Open Access Journals (Sweden)

    Iman Ghodratitoostani

    2016-08-01

    Full Text Available Subjective tinnitus is the conscious (attended awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional tinnitus model to indicate that the conscious perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional tinnitus model includes the peripheral auditory system, the thalamus, the limbic system, brain stem, basal ganglia, striatum and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the sourceless sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general

  6. Theoretical Tinnitus Framework: A Neurofunctional Model.

    Science.gov (United States)

    Ghodratitoostani, Iman; Zana, Yossi; Delbem, Alexandre C B; Sani, Siamak S; Ekhtiari, Hamed; Sanchez, Tanit G

    2016-01-01

    Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the "sourceless" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be

  7. Hypacusis and Tinnitus Associated to Otosyphilis

    Directory of Open Access Journals (Sweden)

    Oliveira, Neide Fátima Cordeiro Diniz

    2009-12-01

    Full Text Available Introduction: Both congenital and acquired syphilis may cause cochleovestibular dysfunction. In the literature, the neurosensorial hearing loss, tinnitus and unbalance have been described in the secondary and tertiary syphilis. Objective: The objective of this work was to emphasize the need for etiologic identification for treatment and control of individuals with cochleovestibular symptoms. Case Report: We described the case of a patient, aged 64 years, black, with complaints of slow and progressive diminishing of auditory accuracy since about 12 years ago, associated with tinnitus and occasional unbalances. In the laboratorial and audiometric evaluation, after exclusion of other related causes, we came to the additional diagnosis of otosyphilis. Final Comments: Syphilis must always be taken into account in patients with cochleovestibular complications, irrespectively of the age range, whether or not belonging to risk groups, and the number of partners of each patient. The etiological diagnosis is very important for the control and treatment of such patients.

  8. 特发性耳鸣心理声学及临床特征的多因素分析%Multivariate Analysis of Psychoacoustic and Clinical Characteristics in Patients with Idiopathic Tinnitus

    Institute of Scientific and Technical Information of China (English)

    李昕琚; 梁勇; 赵靖; 刘友利; 李衍菲; 虞幼军; 赵远新

    2013-01-01

    Objective To study the psychoacoustic and clinical characteristics of idiopathic tinnitus and their correla-tions in order to improve clinic therapy for tinnitus. Method Systematic otorhinolaryngologic examination, audiometric test-ing, tinnitus evaluation were performed on 128 patients (159 ears) with idiopathic tinnitus. Tinnitus evaluation included tin-nitus pitch and loudness assessments and the Tinnitus Handicap Inventory (THI). Variables including gender, age, side of tinnitus, tinnitus duration and persistency, hearing loss, audiometric configuration, tinnitus pitch, loudness, Feldmann mask-ing curves, residual inhibition and THI score were quantified and their correlations analyzed by logistic regression models. Result Of the 159 ears, tinnitus was of high pitch in 102 ears (64.15%) and of mid or low pitch in 57 ears (35.85%), and its loudness was high in 53 ears (33.33%), moderate in 67 ears (42.14%) and soft in 39 ears (24.53%). Feldmann masking curves were dominated by convergent (32 ears, 20.13%), congruent (46 ears, 28.93%) and separate (62 ears, 38.99%) types. Residual inhibition was positive in 47 ears (33.57%), partially positive in 59 ears (42.14%) and negative in 34 ears (24.29%). THI scores indicated slight (67 ears, 42.14%) or mild (56 ears, 35.22%) tinnitus severity in most patients. Logis-tic regression showed correlation between tinnitus pitch and gender (χ2=12.588, P<0.001) and tinnitus persistency (χ2=3.866, P=0.049). Tinnitus loudness was correlated to hearing loss (χ2=50.006, P<0.001), audiometric configuration (χ2=63.187, P<0.001) and tinnitus pitch (χ2=14.757,P=0.001). Feldmann masking curve was chiefly influenced by audiomet-ric configuration (χ2=21.798, P=0.001). Theχ2 test showed that residual inhibition was correlated to THI scores (χ2=16.284, P=0.012), but not to the rest 10 items. Conclusion Certain psychoacoustic and clinical characteristics in idiopathic tinnitus appear to be correlated to each other. This information

  9. Psychoacoustic characteristics of tinnitus in individuals with auditory neuropathy spectrum disorder

    Directory of Open Access Journals (Sweden)

    P. Prashanth Prabhu

    2014-03-01

    Full Text Available The study aimed at understanding the psychoacoustic characteristics of tinnitus in individuals with auditory neuropathy spectrum disorder (ANSD. It attempts to assess the pitch and intensity of loudness of tinnitus matched by individuals with ANSD. Fifty individuals who were diagnosed as having auditory neuropathy spectrum disorder were included in the study. Tinnitus evaluation was carried out where the individuals matched the frequency and intensity of loudness of the tinnitus. The results of the study shows that pitch matched by majority of patients with ANSD is predominantly low pitched (<1000 Hz. The frequency of tinnitus matched by the patients with ANSD also correlated with the degree of maximal hearing loss. The intensity of loudness of the tinnitus was around 10-15 dB higher than their threshold in majority of the patients considered in the study. There was a weak negative correlation for the matched frequency and intensity of loudness. The results of the study suggest that majority of individuals with low frequency hearing loss had low pitched tinnitus. Thus, there could be discordant damage between outer and inner hair cells, abnormal firing of auditory nerve in individuals with ANSD which can lead to tinnitus. Thus, it can help to understand the physiology of tinnitus in individuals with ANSD.

  10. ANIMAL BEHAVIORAL MODELS OF TINNITUS

    Institute of Scientific and Technical Information of China (English)

    ZHANG Chao; WANG Qiuju; SUN Wei

    2014-01-01

    The pathophysiology of tinnitus is poorly understood and treatments are often unsuccessful. A number of animal models have been developed in order to gain a better understanding of tinnitus. A great deal has been learned from these models re-garding the electrophysiological and neuroanatomical correlates of tinnitus following exposure to noise or ototoxic drugs. Re-liable behavioral data is important for determining whether such electrophysiological or neuroanatomical changes are indeed related to tinnitus. Of the many documented tinnitus animal behavioral paradigms, the acoustic startle reflex had been pro-posed as a simple method to identify the presence or absence of tinnitus. Several behavioral models based on conditioned re-sponse suppression paradigms have also been developed. In addition to determining the presence or absence of tinnitus, some of the behavioral paradigms have provided signs of the onset, frequency, and intensity of tinnitus in animals. Although none of these behavioral models have been proved to be a perfect model, these studies provide useful information on understanding the neural mechanisms underlying tinnitus.

  11. Arterial Abnormalities Leading to Tinnitus.

    Science.gov (United States)

    Miller, Timothy R; Serulle, Yafell; Gandhi, Dheeraj

    2016-05-01

    Tinnitus is a common symptom that usually originates in the middle ear. Vascular causes of pulsatile tinnitus are categorized by the location of the source of the noise within the cerebral-cervical vasculature: arterial, arteriovenous, and venous. Arterial stenosis secondary to atherosclerotic disease or dissection, arterial anatomic variants at the skull base, and vascular skull base tumors are some of the more common causes of arterial and arteriovenous pulsatile tinnitus. Noninvasive imaging is indicated to evaluate for possible causes of pulsatile tinnitus, and should be followed by catheter angiography if there is a strong clinical suspicion for a dural arteriovenous fistula.

  12. Tinnitus referral pathways within the National Health Service in England: a survey of their perceived effectiveness among audiology staff

    Directory of Open Access Journals (Sweden)

    Collins Luke

    2011-07-01

    Full Text Available Abstract Background In the UK, audiology services deliver the majority of tinnitus patient care, but not all patients experience the same level of service. In 2009, the Department of Health released a Good Practice Guide to inform commissioners about key aspects of a quality tinnitus service in order to promote equity of tinnitus patient care in UK primary care, audiology, and in specialist multi-disciplinary centres. The purpose of the present research was to evaluate utilisation and opinions on pathways for the referral of tinnitus patients to and from English Audiology Departments. Methods We surveyed all audiology staff engaged in providing tinnitus services across England. A 36-item questionnaire was mailed to 351 clinicians in all 163 National Health Service (NHS Trusts identified as having a tinnitus service. 138 clinicians responded. The results presented here describe experiences and opinions of the current patient pathways to and from the audiology tinnitus service. Results The most common referral pathway was from general practice to a hospital-based Ear, Nose & Throat department and from there to a hospital-based audiology department (64%. Respondents considered the NHS tinnitus referral process to be generally effective (67%, but expressed needs for improving GP referral and patients' access to services. 'Open access' to the audiology clinic was rarely an option for patients (9%, nor was the opportunity to access specialist counselling provided by clinical psychology (35%. To decrease the number of inappropriate referrals, 40% of respondents called for greater awareness by referrers about the audiology tinnitus service. Conclusions Respondents in the present survey were generally satisfied with the tinnitus referral system. However, they highlighted some potential targets for service improvement including 1] faster and more appropriate referral from GPs, to be achieved through education on tinnitus referral criteria, 2] improved

  13. Increased intensity discrimination thresholds in tinnitus subjects with a normal audiogram

    DEFF Research Database (Denmark)

    Epp, Bastian; Hots, J.; Verhey, J. L.

    2012-01-01

    Recent auditory brain stem response measurements in tinnitus subjects with normal audiograms indicate the presence of hidden hearing loss that manifests as reduced neural output from the cochlea at high sound intensities, and results from mice suggest a link to deafferentation of auditory nerve...... fibers. As deafferentation would lead to deficits in hearing performance, the present study investigates whether tinnitus patients with normal hearing thresholds show impairment in intensity discrimination compared to an audiometrically matched control group. Intensity discrimination thresholds were...... significantly increased in the tinnitus frequency range, consistent with the hypothesis that auditory nerve fiber deafferentation is associated with tinnitus....

  14. Endovascular Interventions for Idiopathic Intracranial Hypertension and Venous Tinnitus: New Horizons.

    Science.gov (United States)

    Hui, Ferdinand K; Abruzzo, Todd; Ansari, Sameer A

    2016-05-01

    Pulsatile tinnitus from intracranial venous abnormalities is an uncommon cause of pulse synchronous tinnitus. Endovascular therapies may have applications in many of these disease conditions. They have the advantage of being minimally invasive and may selectively eliminate the site of turbulence. Venous stenting has been used successfully to treat venous stenoses with low complication rates and high success rates in patients with idiopathic intracranial hypertension though randomized controlled data are lacking. Careful exclusion of other causes of tinnitus should be performed before consideration for surgical or endovascular treatment of presumed causative lesions of venous tinnitus.

  15. Application of distort product otoacoustic emission(DPOAE)in the tinnitus patients with normal hearing capability%畸变产物耳声发射在听力正常的耳鸣患者中的应用

    Institute of Scientific and Technical Information of China (English)

    邵渊; 安燕; 张少强

    2013-01-01

    Objective To explore the clinical characteristics of the distort product otoacoustic emission( DPOAE )in the tinnitus patients with normal hearing capability and its applied value. Methods DPOAE test was held in 160 tinnitus patients with the normal hearing capability and 120 healthy controls with the normal hearing capability and no tinnitus symptoms. The results were compared between two groups. The tinnitus patients were given nerve-nourishing medicine and vasodilator medicine for consecutive 3 weeks and then DPOAE test was performed again. The results before and after treatment were compared. Results In tinnitus group, the incidence of DPOAE in each frequency was significantly lower than that in healthy controls( P <0. 05 ). After the treatment, the DPOAE reacting amplitudes in high frequency were obviously improved in the tinnitus patients( P < 0. 05 ). Conclusion The occurrence of the tinnitus may be relevant to the cochlear outer hair cell early injury-induced high frequency hearing loss, and DPOAE test can reflect the early stage cochlear injury and act as an objective method for detecting the tinnitus.%目的 探讨听力正常的耳鸣患者畸变产物耳声发射(DPOAE)的临床特点,了解畸变产物耳声发射在耳鸣患者中的应用价值.方法 对160例听力正常伴耳鸣的患者设定为耳鸣组,进行DPOAE测试,同时对120例听力正常且无耳鸣健康者设定为对照组,进行DPOAE测试,对比两组检测结果.对耳鸣患者给予营养神经药物和改善内耳血液循环药物联合治疗3周后再次进行DPOAE测试,对比治疗前后结果.结果 耳鸣组中,DPOAE测试在各频率点的检出率均显著低于健康对照组(P<0.05).耳鸣组经过治疗后,耳声发射在高频段的反应幅值明显提高,与治疗前相比,差异具有统计学意义(P<0.05).结论 耳鸣的产生可能与耳蜗外毛细胞早期损伤导致的高频听力损失相关,DPOAE的检测可反映早期耳蜗病变并可作为耳

  16. Mental health and quality of life in patients with chronic otitis media.

    Science.gov (United States)

    Bakir, Salih; Kinis, Vefa; Bez, Yasin; Gun, Ramazan; Yorgancilar, Ediz; Ozbay, Musa; Aguloglu, Bülent; Meric, Faruk

    2013-02-01

    The present study focused on the comparison of mental health and quality of life (QoL) between chronic otitis media (COM) patients and the hearing population. The patients with chronic otitis media and healthy control group were enrolled in the study. The duration and severity of the auditory impairment were recorded. In addition to hearing loss (HL), the findings of each patient's other ear disorders (ear discharge and tinnitus) were also recorded. In both the groups, psychological symptom profile and health-related QoL were evaluated and compared using a sociodemographic questionnaire, the Symptom Check List 90-Revised Form (SCL-90-R), and the Short Form-36 (SF-36). According to SCL-90-R, somatization (p health perception (p social functioning (p mental health (p < 0.017) than those of control subjects. Our results indicated that COM patients with mild or moderate HL have poorer life quality and higher psychological problems. Psychological well being should be also considered in assessment of COM patients in addition to the clinical evaluation and audiological tests.

  17. Association of tinnitus and electromagnetic hypersensitivity: hints for a shared pathophysiology?

    Directory of Open Access Journals (Sweden)

    Michael Landgrebe

    Full Text Available BACKGROUND: Tinnitus is a frequent condition with high morbidity and impairment in quality of life. The pathophysiology is still incompletely understood. Electromagnetic fields are discussed to be involved in the multi-factorial pathogenesis of tinnitus, but data proofing this relationship are very limited. Potential health hazards of electromagnetic fields (EMF have been under discussion for long. Especially, individuals claiming themselves to be electromagnetic hypersensitive suffer from a variety of unspecific symptoms, which they attribute to EMF-exposure. The aim of the study was to elucidate the relationship between EMF-exposure, electromagnetic hypersensitivity and tinnitus using a case-control design. METHODOLOGY: Tinnitus occurrence and tinnitus severity were assessed by questionnaires in 89 electromagnetic hypersensitive patients and 107 controls matched for age-, gender, living surroundings and workplace. Using a logistic regression approach, potential risk factors for the development of tinnitus were evaluated. FINDINGS: Tinnitus was significantly more frequent in the electromagnetic hypersensitive group (50.72% vs. 17.5% whereas tinnitus duration and severity did not differ between groups. Electromagnetic hypersensitivity and tinnitus were independent risk factors for sleep disturbances. However, measures of individual EMF-exposure like e.g. cell phone use did not show any association with tinnitus. CONCLUSIONS: Our data indicate that tinnitus is associated with subjective electromagnetic hypersensitivity. An individual vulnerability probably due to an over activated cortical distress network seems to be responsible for, both, electromagnetic hypersensitivity and tinnitus. Hence, therapeutic efforts should focus on treatment strategies (e.g. cognitive behavioral therapy aiming at normalizing this dysfunctional distress network.

  18. The effect of tinnitus volume on the ascending speed of auditory threshold%从耳鸣响度看听阈提高的速度

    Institute of Scientific and Technical Information of China (English)

    高福秀; 王斌全; 王建明

    2001-01-01

    Objective To study the reaction between tinnitus volume and the ascending speed of auditory threshold in chronic nervous tinnitus patients.Methods The tinnitus volmue and auditory threshold in 50 nervous tinnitus patients (76 ears) with raising auditory threshold were detected by pure tone audiometer.Results There was a significant difference between the 24 ears with tinnitus volume ≤10 dB HL and the 52 ears with tinnitus volume >10 dB HL (P<0.01),especially in above 3 kHz frequency field.Conclusion There are relations between tinnitus volume and the ascending speed of auditory threshold,clinical doctors should slow down the ascending speed of auditory threshold by treating tinnitus.%目的了解神经性渐进性耳鸣、耳聋患者的耳鸣响度与听阈提高速度的关系。方法对50例(76耳)神经性耳鸣并伴听阈提高的患者作纯音听阈及耳鸣响度的测试,并根据病程时间计算听阈提高速度。对25耳耳鸣响度在≤10 dB听力级(HL)的患者与52耳耳鸣响度在>10 dB HL的患者之提高速度进行比较,并进行统计学分析。结果耳鸣响度≤10 dB的24耳与>10 dB的52耳听阈之提高速度在3 kHz以上高频区差异有显著性(P<0.01)。结论耳鸣响度大小与听阈提高速度有关联。听阈的提高速度随着耳鸣响度的加大而增快。

  19. Self-Administered Domiciliary tDCS Treatment for Tinnitus: A Double-Blind Sham-Controlled Study.

    Directory of Open Access Journals (Sweden)

    Petteri Hyvärinen

    Full Text Available Transcranial direct current stimulation (tDCS has shown potential for providing tinnitus relief, although positive effects have usually been observed only during a short time period after treatment. In recent studies the focus has turned from one-session experiments towards multi-session treatment studies investigating long-term outcomes with double-blinded and sham-controlled study designs. Traditionally, tDCS has been administered in a clinical setting by a healthcare professional but in studies involving multiple treatment sessions, often a trade-off has to be made between sample size and the amount of labor needed to run the trial. Also, as the number of required visits to the clinic increases, the dropout rate is likely to rise proportionally.The aim of the current study was to find out if tDCS treatment for tinnitus could be patient-administered in a domiciliary setting and whether the results would be comparable to those from in-hospital treatment studies. Forty-three patients with chronic (> 6 months tinnitus were involved in the study, and data on 35 out of these patients were included in final analysis. Patients received 20 minutes of left temporal area anodal (LTA or bifrontal tDCS stimulation (2 mA or sham stimulation (0.3 mA for ten consecutive days. An overall reduction in the main outcome measure, Tinnitus Handicap Inventory (THI, was found (mean change -5.0 points, p < 0.05, but there was no significant difference between active and sham treatment outcomes. Patients found the tDCS treatment easy to administer and they all tolerated it well. In conclusion, self-administered domiciliary tDCS treatment for tinnitus was found safe and feasible and gave outcome results similar to recent randomized controlled long-term treatment trials. The results suggest better overall treatment response-as measured by THI-with domiciliary treatment than with in-hospital treatment, but this advantage is not related to the tDCS variant. The study

  20. Lower Gastrointestinal Bleeding in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Fahad Saeed

    2011-01-01

    Full Text Available Gastrointestinal (GI bleeding is more common in patients with chronic kidney disease and is associated with higher mortality than in the general population. Blood losses in this patient population can be quite severe at times and it is important to differentiate anemia of chronic diseases from anemia due to GI bleeding. We review the literature on common causes of lower gastrointestinal bleeding (LGI in chronic kidney disease (CKD and end-stage renal disease (ESRD patients. We suggest an approach to diagnosis and management of this problem.

  1. [Some aspects of pharmacotherapy of tinnitus. Compound therapy with Xylocaine and directive counseling--long-term results].

    Science.gov (United States)

    Rogowski, Marek; Sieśkiewicz, Andrzej; Rózańska-Kudelska, Małgorzata; Walenczak, Izabela

    2004-01-01

    29 out of 49 patients, who were treated in 1996-1998 with Xylocaine and directive counselling for their tinitus, were reevaluated. Non of the patients used any other pharmacological treatment of the tinnitus or underwent full tinnitus retraining therapy (TRT) since 10-days treatment with Xylocaine had been completed. Initially 65.3% of patients declared improvement in their tinnitus. After over 5 years of observation success rate decreased to only 41.3%. Since the positive effect of 10-days treatment with Xylocaine and directive counselling was not stable we concluded that tinnitus patients should receive full TRT.

  2. Which tinnitus-related characteristics affect current health-related quality of life and depression? A cross-sectional cohort study.

    Science.gov (United States)

    Weidt, Steffi; Delsignore, Aba; Meyer, Martin; Rufer, Michael; Peter, Nicole; Drabe, Natalie; Kleinjung, Tobias

    2016-03-30

    Tinnitus is sometimes associated with lower health-related quality of life (HRQoL) and depressive symptoms. However, only limited evidence exists identifying which tinnitus characteristics are responsible for these associations. The aim of this cross-sectional study was to assess associations between tinnitus, HRQoL, depressive symptoms, subjective tinnitus loudness and audiometrically assessed tinnitus characteristics (e.g., hearing threshold). Two hundred and eight outpatients reporting tinnitus completed questionnaires on tinnitus (Tinnitus Handicap Inventory, THI), HRQoL (World-Health-Organisation Quality of Life Short Form Survey, WHOQOL-BREF), and depressive symptoms (Beck Depression Inventory, BDI), and underwent audiometry. Patients with higher THI scores exhibited significantly lower HRQoL, and higher depression scores. THI total-score, THI subscales, and subjective tinnitus loudness explained significant variance of WHOQOL-BREF and BDI. Audiometrically measured features were not associated with WHOQOL-BREF or BDI. Overall, we confirmed findings that different features of tinnitus are associated with HRQoL and depressive symptoms but not with audiometrically assessed tinnitus characteristics. Consequently, physicians should evaluate THI total score, its sub-scores, and subjective tinnitus loudness to reliably and quickly identify patients who potentially suffer from depressive symptoms or significantly lower HRQoL. Supporting these patients early might help to prevent the development of reactive depressive symptoms and impairment of HRQoL.

  3. Tinnitus pitch and acoustic trauma

    Energy Technology Data Exchange (ETDEWEB)

    Cahani, M.; Paul, G.; Shahar, A.

    1983-01-01

    Fifty-six subjects complaining of tinnitus underwent an audiometric test and a test for identifying the analogous pitch of their tinnitus. All of the subjects reported that they had been exposed to noise in the past. The subjects were divided into two groups on the basis of their audiometric test results. Group P was composed of subjects who showed a sensorineural hearing loss typical of acoustic trauma. Group N was composed of subjects whose hearing was within normal limits. The pitch of the tinnitus in group P was concentrated in the high-frequency range, whereas in group N tinnitus pitch values were distributed over the low and mid-audiometric frequency spectrum. It was deduced that different processes are involved in the generation of tinnitus in the two groups.

  4. 慢性肾脏病患者耳鸣耳聋患病率及临床特点调查%The Research of Morbidity of Tinnitus and Deafness of CKD Patient and Clinical Characteristics

    Institute of Scientific and Technical Information of China (English)

    梁莹; 屈欢欢; 全春梅; 杨丛旭; 余仁欢

    2012-01-01

    Objective: Probe into the morbidity of tinnitus and deafness of CKD patient and clinical characteristics. Methods :Cross - sectional survey research methods is used, collecting CKD patientS information anf the properties and degree of tinnitus and deafness, to analyze the morbidity of tinnitus and deafness of CKD patient and clinical characteristics. ResultS:( 1 )CKD patients, tinnitus morbidity is 51. 6% , deafness prevalence is 44. 8% . Tinnitus frequency is mainly high - frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number. ( 2 Jdeafness for increases with age, the prevalence of deafness is significantly rising trend. ( 3 Jsecondary kidney patients morbidity of deafness is higher than primary glomerular disease patients. (4 )ln the different clinical diagnosis, diabetic nephropathy and hypertensive renal disease are the main influence factors in the deafness morbidity of CKD patients.( 5 Jlncreasing with CKD stage, the morbidity of CKD patients with deafness is significantly rising trend. That improves the morbidity of CKD patients with deafness is closely related to the renal function state and glomerular filtration rate. Conclusion:( 1 )CKD patients, Tinnitus frequency is mainly high -frequency, and deafness with mild hearing damage sensorineural neuropathic deafness accounts for a large number. ( 2 Jlncreasing with the age or decreasing with the renal function state and glomerular filtration rate, the morbidity of CKD patients with deafness is significantly rising trend. ( 3 Jsecondary kidney disease patients morbidity of deafness is higher than primary glomerular disease patients. In Secondary kidney diseases, diabetic nephropathy and hypertensive renal disease are the main influence factors.%目的:探讨慢性肾脏病(CKD)患者耳鸣耳聋的患病率及其相关临床特点.方法:采用横断面的调查方法,收集CKD患者相关信息和耳鸣耳聋的性质及程度,对肾脏病患者耳

  5. Muscle strength in patients with chronic pain

    NARCIS (Netherlands)

    van Wilgen, C.P.; Akkerman, L.; Wieringa, J.; Dijkstra, P.U.

    2003-01-01

    Objective: To analyse the influence of chronic pain on muscle strength. Design: Muscle strength of patients with unilateral nonspecific chronic pain, in an upper or lower limb, were measured according to a standardized protocol using a hand-held dynamometer. Before and after muscle strength measurem

  6. Urea synthesis in patients with chronic pancreatitis

    DEFF Research Database (Denmark)

    Hamberg, Ole; Sonne, J; Larsen, S

    2001-01-01

    Up-regulation of urea synthesis by amino acids and dietary protein intake may be impaired in patients with chronic pancreatitis (CP) due to the reduced glucagon secretion. Conversely, urea synthesis may be increased as a result of the chronic inflammation. The aims of the study were to determine...

  7. Salicylate induced tinnitus: behavioral measures and neural activity in auditory cortex of awake rats.

    Science.gov (United States)

    Yang, Guang; Lobarinas, Edward; Zhang, Liyan; Turner, Jeremy; Stolzberg, Daniel; Salvi, Richard; Sun, Wei

    2007-04-01

    Neurophysiological studies of salicylate-induced tinnitus have generally been carried out under anesthesia, a condition that abolishes the perception of tinnitus and depresses neural activity. To overcome these limitations, measurement of salicylate induced tinnitus were obtained from rats using schedule induced polydipsia avoidance conditioning (SIPAC) and gap pre-pulse inhibition of acoustic startle (GPIAS). Both behavioral measures indicated that tinnitus was present after treatment with 150 and 250 mg/kg of salicylate; measurements with GPIAS indicated that the pitch of the tinnitus was near 16 kHz. Chronically implanted microwire electrode arrays were used to monitor the local field potentials and spontaneous discharge rate from multiunit clusters in the auditory cortex of awake rats before and after treatment with 150 mg/kg of salicylate. The amplitude of the local field potential elicited with 60 dB SPL tone bursts increased significantly 2h after salicylate treatment particularly at 16-20 kHz; frequencies associated with the tinnitus pitch. Field potential amplitudes had largely recovered 1-2 days post-salicylate when behavioral results showed that tinnitus was absent. The mean spontaneous spike recorded from the same multiunit cluster pre- and post-salicylate decreased from 22 spikes/s before treatment to 14 spikes/s 2h post-salicylate and recovered 1 day post-treatment. These preliminary physiology data suggest that salicylate induced tinnitus is associated with sound evoked hyperactivity in auditory cortex and spontaneous hypoactivity.

  8. Troublesome Tinnitus in Children: Epidemiology, Audiological Profile, and Preliminary Results of Treatment

    Directory of Open Access Journals (Sweden)

    G. Bartnik

    2012-01-01

    Results. The study showed that 41.3% of the children suffered from bothersome tinnitus. In this group 44.1% of the patients demonstrated normal hearing. The success of the therapy after 6 months was estimated on 81.4% of significant improvement. Conclusions. It is recommended that a questionnaire include an inquiry about the presence of tinnitus during hearing screening tests.

  9. Neurostimulation as a new treatment for severe tinnitus : A pilot study

    NARCIS (Netherlands)

    Holm, AF; Staal, TJ; Mooij, TJA; Albers, FWJ

    2005-01-01

    Background: Tinnitus is an uncomfortable symptom for the patient and an embarrassing one for the consulted physician. So far, there is no treatment that can be considered well established in terms of providing long-term reduction of tinnitus in excess of placebo effects. There is considerable eviden

  10. The Correlation of the Tinnitus Handicap Inventory with Depression and Anxiety in Veterans with Tinnitus

    OpenAIRE

    Jinwei Hu; Jane Xu; Matthew Streelman; Helen Xu; O’neil Guthrie

    2015-01-01

    Objective. The mechanisms of tinnitus are known to alter neuronal circuits in the brainstem and cortex, which are common to several comorbid conditions. This study examines the relationship between tinnitus and anxiety/depression. Subjects and Methods. Ninety-one male veterans with subjective tinnitus were enrolled in a Veterans Affairs Tinnitus Clinic. The Tinnitus Handicap Inventory (THI) was used to assess tinnitus severity. ICD-9 codes for anxiety/depression were used to determine their p...

  11. Disentangling depression and distress networks in the tinnitus brain.

    Directory of Open Access Journals (Sweden)

    Kathleen Joos

    Full Text Available Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6-25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways.

  12. Disentangling depression and distress networks in the tinnitus brain.

    Science.gov (United States)

    Joos, Kathleen; Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6-25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways.

  13. Enhancing inhibition-induced plasticity in tinnitus--spectral energy contrasts in tailor-made notched music matter.

    Science.gov (United States)

    Stein, Alwina; Engell, Alva; Lau, Pia; Wunderlich, Robert; Junghoefer, Markus; Wollbrink, Andreas; Bruchmann, Maximilian; Rudack, Claudia; Pantev, Christo

    2015-01-01

    Chronic tinnitus seems to be caused by reduced inhibition among frequency selective neurons in the auditory cortex. One possibility to reduce tinnitus perception is to induce inhibition onto over-activated neurons representing the tinnitus frequency via tailor-made notched music (TMNM). Since lateral inhibition is modifiable by spectral energy contrasts, the question arises if the effects of inhibition-induced plasticity can be enhanced by introducing increased spectral energy contrasts (ISEC) in TMNM. Eighteen participants suffering from chronic tonal tinnitus, pseudo randomly assigned to either a classical TMNM or an ISEC-TMNM group, listened to notched music for three hours on three consecutive days. The music was filtered for both groups by introducing a notch filter centered at the individual tinnitus frequency. For the ISEC-TMNM group a frequency bandwidth of 3/8 octaves on each side of the notch was amplified, additionally, by about 20 dB. Before and after each music exposure, participants rated their subjectively perceived tinnitus loudness on a visual analog scale. During the magnetoencephalographic recordings, participants were stimulated with either a reference tone of 500 Hz or a test tone with a carrier frequency representing the individual tinnitus pitch. Perceived tinnitus loudness was significantly reduced after TMNM exposure, though TMNM type did not influence the loudness ratings. Tinnitus related neural activity in the N1m time window and in the so called tinnitus network comprising temporal, parietal and frontal regions was reduced after TMNM exposure. The ISEC-TMNM group revealed even enhanced inhibition-induced plasticity in a temporal and a frontal cortical area. Overall, inhibition of tinnitus related neural activity could be strengthened in people affected with tinnitus by increasing spectral energy contrast in TMNM, confirming the concepts of inhibition-induced plasticity via TMNM and spectral energy contrasts.

  14. Objective Tinnitus and the Tensor Tympani Muscle.

    Science.gov (United States)

    Rock

    1995-01-01

    Objective tinnitus (OT) may be caused by contraction of the tensor tympani muscle (TTM). The more forcefully the TTM contracts, the greater the intensity of the OT heard. Forceful closure of both eyelids can reflexively cause OT by contracting the TTM. The Forceful Eyelid Closure Syndrome (FECS) was reported at the Proceedings of the Second International Tinnitus Seminar in 1983.(1) FECS consists of several factors: (1) Objective tinnitus (2) An associated waning of hearing primarily of the lower frequencies, as much as 45 dB at 125 Hz, 30 to 40 dB at 250 Hz ascending to the patient's norm at 2000 Hz and approximately a 5 to 10 dB at 4000 Hz and 5 to 20 dB at 8000 Hz (3) Retraction of the manubrium and posterior mid-third of the tympanic membrane (TM) at the malleus-umbo area as seen under the otomicroscope (OM) in 25% (108) of 432 ears examined (4) These same ears were 75% (324) positive for increased impedance at maximum compliance with FEC. Of the patients studied, 25% had no response under the otomicroscope or by impedance audiometry.

  15. Assessment of patients with chronic pain.

    Science.gov (United States)

    Dansie, E J; Turk, D C

    2013-07-01

    Chronic pain is a public health concern affecting 20-30% of the population of Western countries. Although there have been many scientific advances in the understanding of the neurophysiology of pain, precisely assessing and diagnosing a patient's chronic pain problem is not straightforward or well-defined. How chronic pain is conceptualized influences how pain is evaluated and the factors considered when making a chronic pain diagnosis. There is no one-to-one relationship between the amount or type of organic pathology and pain intensity, but instead, the chronic pain experience is shaped by a myriad of biomedical, psychosocial (e.g. patients' beliefs, expectations, and mood), and behavioural factors (e.g. context, responses by significant others). Assessing each of these three domains through a comprehensive evaluation of the person with chronic pain is essential for treatment decisions and to facilitate optimal outcomes. This evaluation should include a thorough patient history and medical evaluation and a brief screening interview where the patient's behaviour can be observed. Further assessment to address questions identified during the initial evaluation will guide decisions as to what additional assessments, if any, may be appropriate. Standardized self-reported instruments to evaluate the patient's pain intensity, functional abilities, beliefs and expectations, and emotional distress are available, and can be administered by the physician, or a referral for in depth evaluation can be made to assist in treatment planning.

  16. Thrombophilia in patients with chronic immune thrombocytopenia.

    Science.gov (United States)

    Wong, Raymond S M; Bakshi, Kalpana; Brainsky, Andres

    2015-01-01

    An increased risk of thromboembolic events among patients with chronic immune thrombocytopenia has been reported but is still not fully understood. A thrombophilia panel (factors suspected/known to denote a thrombophilic state or indicate activation of the clotting cascade) was measured in previously treated patients with chronic immune thrombocytopenia enrolled in an eltrombopag trial to assess potential thrombophilia risk markers. Of 167 patients, 136 (81%) had abnormal levels of at least 1 known or suspected thrombosis risk marker or coagulation cascade activation marker. Six patients reported thromboembolic events, and all of these patients had at least two abnormal analytes in the thrombophilia panel. The presence of multiple baseline thrombophilia risk markers support the theory that chronic immune thrombocytopenia is a pro-thrombotic disease.

  17. An Adaptation Level Theory of tinnitus audibility

    Directory of Open Access Journals (Sweden)

    Grant eSearchfield

    2012-06-01

    Full Text Available Models of tinnitus suggest roles for auditory, attention and emotional networks in tinnitus perception. A model of tinnitus audibility based on Helson’s (1964 Adaptation Level Theory (ALT is hypothesized to explain the relationship between tinnitus audibility, personality, memory and attention. This theory attempts to describe how tinnitus audibility or detectability might change with experience and context. The basis of ALT and potential role of Auditory Scene Analysis in tinnitus perception are discussed. The proposed psychoacoustic model lends itself to incorporation into existing neurophysiological models of tinnitus perception. It is hoped that the ALT hypothesis will allow for greater empirical investigation of factors influencing tinnitus perception, such as attention and tinnitus sound therapies.

  18. Electroacupuncture for Tinnitus: A Systematic Review.

    Directory of Open Access Journals (Sweden)

    Miao He

    Full Text Available Treatment effects of electroacupuncture for patients with subjective tinnitus has yet to be clarified.To assess the effect of electroacupuncutre for alleviating the symptoms of subjective tinnitus.Extensive literature searches were carried out in three English and four Chinese databases (PubMed, EMBASE, Cochrane Library, CNKI, Wanfang Chinese Digital Periodical and Conference Database, VIP, and ChiCTR.The date of the most recent search was 1 June 2014. Randomized controlled trials (RCTs or quasi-RCTs were included. The titles, abstracts, and keywords of all records were reviewed by two authors independently. The data were collected and extracted by three authors. The risk of bias in the trials was assessed in accordance with the Cochrane Handbook, version 5.1.0. (http://www.handbook.cochrane.org. Eighty-nine studies were retrieved. After discarding 84 articles, five studies with 322 participants were identified. Assessment of the methodological quality of the studies identified weaknesses in all five studies. All studies were judged as having a high risk of selection and performance bias. The attrition bias was high in four studies. Incompleteness bias was low in all studies. Reporting bias was unclear in all studies. Because of the limited number of trials included and the various types of interventions and outcomes, we were unable to conduct pooled analyses.Due to the poor methodological quality of the primary studies and the small sample sizes, no convincing evidence that electroacupuncture is beneficial for treating tinnitus could be found. There is an urgent need for more high-quality trials with large sample sizes for the investigation of electroacupuncture treatment for tinnitus.

  19. Does Attempt at Hearing Preservation Microsurgery of Vestibular Schwannoma Affect Postoperative Tinnitus?

    Directory of Open Access Journals (Sweden)

    Martin Chovanec

    2015-01-01

    Full Text Available Background. The aim of this study was to analyze the effect of vestibular schwannoma microsurgery via the retrosigmoid-transmeatal approach with special reference to the postoperative tinnitus outcome. Material and Methods. A prospective study was performed in 89 consecutive patients with unilateral vestibular schwannoma indicated for microsurgery. Patient and tumor related parameters, pre- and postoperative hearing level, intraoperative findings, and hearing and tinnitus handicap inventory scores were analyzed. Results. Cochlear nerve integrity was achieved in 44% corresponding to preservation of preoperatively serviceable hearing in 47% and useful hearing in 21%. Main prognostic factors of hearing preservation were grade/size of tumor, preoperative hearing level, intraoperative neuromonitoring, tumor consistency, and adhesion to neurovascular structures. Microsurgery led to elimination of tinnitus in 66% but also new-onset of the symptom in 14% of cases. Preservation of useful hearing and neurectomy of the eighth cranial nerve were main prognostic factors of tinnitus elimination. Preservation of cochlear nerve but loss of preoperative hearing emerged as the main factor for tinnitus persistence and new onset tinnitus. Decrease of THI scores was observed postoperatively. Conclusions. Our results underscore the importance of proper pre- and intraoperative decision making about attempt at hearing preservation versus potential for tinnitus elimination/risk of new onset of tinnitus.

  20. A clinic nursing research on the effect of sound information therapy in treating patients of tinnitus associated with sensorinueral hearing loss%声信息治疗神经性耳鸣患者的护理

    Institute of Scientific and Technical Information of China (English)

    王晓利; 武彦; 章红

    2010-01-01

    Objective To explore the effect of sound information therapy in treating patients of tinnitus associated with sensorinueral hearing loss, and to conclude nursing key points. Methods 65 patients of tinnitus associated with sensorinueral hearing loss were randomly divided into 2 groups. 35 patients in the experimental group received sound information therapy and routine medical therapy. The other 30 patients in the control group received only routine medical therapy. Both of the therapeutic periods were 10 days. Recorded and compared the degrees of tinnitus before and after the respond therapies between two groups. Results There was significant difference between the therapeutic effects of the two groups ( P < 0. 05 ). Conclusions The effect of sound information therapy is positive in treating patients of tinnitus associated with sensorinueral hearing loss. The key nursing points include that to master the correct operating methods of the sound information therapy apparatus and to enhance the patients' health education in sound information therapy.%目的 观察声信息治疗神经性耳鸣患者的临床应用效果,总结其护理要点.方法 选择65例神经性耳鸣患者,随机分为2组,实验组35例,42耳,在常规改善微循环、营养耳神经等处理的基础上采用声信息治疗,其中4名患者因不能坚持治疗而剔除;对照组30例,41耳,采用常规改善微循环、营养耳神经等处理.治疗时间均为10 d.记录比较两组患者治疗前、后的耳鸣程度及疗效.结果实验组对神经性耳鸣的疗效与对照组相比较差异有统计学意义(P<0.05).结论 利用声信息治疗神经性耳鸣患者疗效值得肯定;声信息治疗的护理要点为:熟练掌握S9818声信息治疗仪的操作方法 和注意事项,加强对患者的健康教育,提高其遵医行为.

  1. Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact.

    Science.gov (United States)

    Westin, Vendela; Hayes, Steven C; Andersson, Gerhard

    2008-12-01

    Tinnitus is an experience of sound in the absence of an appropriate external source. A symptom that can accompany most central or peripheral dysfunctions of the auditory system, tinnitus can lead to significant distress, depression, anxiety, and decreases in life quality. This paper investigated the construct of psychological acceptance in a population of tinnitus patients. First, a cross-sectional study (N=77) was conducted in which a tinnitus specific acceptance questionnaire was developed. Results showed that a Tinnitus Acceptance Questionnaire (TAQ) generated good internal consistency. A factor solution was derived with two factors: activity engagement and tinnitus supression. Second, a longitudinal study (N=47) investigated the mediating role of acceptance on the relationship between tinnitus distress at baseline and tinnitus distress, anxiety, life quality, and depression at a 7-month follow-up. The results showed full mediation of activity engagement for depression and life quality at follow-up, partial mediation for tinnitus distress, and no mediation for anxiety. The role of acceptance in the negative impact of tinnitus distress merits further investigation.

  2. Analysis of Clinical Features and Tinnitus Characteristics in 225 Patients with Auditory Neuropathy%225例听神经病患者的耳鸣发生特点及临床特征分析

    Institute of Scientific and Technical Information of China (English)

    齐悦; 王秋菊; 兰兰; 史伟; 张秋静; 纵亮; 张娇; 李娜; 王大勇; 李倩

    2013-01-01

      目的调查听神经病患者的耳鸣发生情况,并分析伴发耳鸣的听神经病患者的临床特征及听力学特点.方法对225例听神经病患者(均可准确陈述病史)进行病史采集及纯音测听、声导抗、听性脑干反应、DPOAE、言语识别率、耳蜗电图等听力学检测,并对结果总结分析.结果①225例听神经病患者就诊年龄3~45岁,男女比例1:1.23,发生耳鸣的患者126例,比例达56%,青少年期及青年期发病的患者耳鸣发生率最高,分别为63.03%(75/119)和66.67%(32/48);②男性和女性患者耳鸣发生率分别为52.48%和58.87%,差异无统计学意义;③耳鸣发生率随病程增长而增高,病程10年以上的听神经病患者耳鸣发生率高达82.14%(23/28);④综合征型听神经病患者耳鸣发生率明显高于非综合征性听神经病患者(84.00%>42.00%);⑤轻中度听力损失的听神经病患者耳鸣发生率明显高于其他听力损失类型.结论本组听神经病患者耳鸣发生与听神经病发病年龄、病程、听力损失程度及类型有一定相关性.听神经病患者耳鸣发生的临床特征分析对进一步探讨听神经病患者耳鸣发生机理提供临床资料.%Objective To investigate the occurrence of tinnitus in patients with auditory neuropathy and analyze their clinical and audiological characteristics. Methods Clinical history, physical examination and audiological examination data (including pure tone audiometry, acoustic impedance, ABRs, DPOAEs, speech perception and ECochG) were reviewed and analyzed in 225 patients with auditory neuropathy (age 3 to 45 years, male to female ratio=1:1.23 ). Results 1) Tinnitus was reported by 126 of the 225 AN patients (56%), more in adolescent patients. 2) Incidence of tinnitus in male and female patients was 52.48% and 58.87%, respectively, without significant difference (P>0.05). 3) The incidence of tinnitus in⁃creased as the duration of AN,increased and was as high

  3. The Application of Biofeedback in Subjective Tinnitus Patients%全参数生物反馈指标在主观性耳鸣患者中的应用

    Institute of Scientific and Technical Information of China (English)

    黄夏茵; 杨海弟; 熊浩; 郑亿庆

    2014-01-01

    目的:研究全参数生物反馈在治疗主观性耳鸣患者中的效果。方法对20例主观性耳鸣患者行全参数生物反馈治疗10次,观察治疗前后耳鸣残疾评估量表(Tinnitus Handicap Inventory,THI)得分及全参数生物反馈指标的变化。结果耳鸣患者治疗前后THI总分分别为44.9±22.3和28.0±14.8,差异达到极显著性水平(P<0.01);治疗前后生物反馈指标肌电分别为6.7±1.6和5.1±1.2,差异达到显著性水平(P<0.05)、治疗前后α波分别为13.3±6.4和16.4±6.2,差异极显著(P<0.01)、治疗前后SMR波分别为5.4±1.6和6.2±2.2,差异显著(P<0.05)。结论主观性耳鸣患者进行生物反馈治疗有效,可明显降低THI总分,改善耳鸣症状,随着耳鸣患者症状减轻,其对应生物反馈指标也发生相应改变。%Objective To study the effectiveness of whole parameter biofeedback in the treatment of patients with subjective tinnitus.Methods 20 patients with subjective tinnitus patients were treated with biofeedback therapy 10 times. The THI scores and biofeedback indexes were observed and compared before and after the treatment.Results The total THI scores of the tinnitus patients were 44.9 ± 22.3 and 28.0 ± 14.8 before and after the treatment, showing a significant difference. There were significant differences in electromyography (EMG) (6.7 ± 1.6 vs 5.1 ± 1.2;P<0.05),αwave (13.3 ± 6.4 vs 16.4 ± 6.2;P<0.01) and SMR wave (5.4 ± 1.6 vs 6.2 ± 2.2;P<0.05) before and after the treatment.Conclusion Biofeedback therapy can significantly reduce the THI scores, improve the symptoms of tinnitus patients, reduce the EMG and increase theα wave and SMR wave, so it is effective in treating patients with subjective tinnitus.

  4. The Effects of Acute Stress-Induced Sleep Disturbance on Acoustic Trauma-Induced Tinnitus in Rats

    Directory of Open Access Journals (Sweden)

    Yiwen Zheng

    2014-01-01

    Full Text Available Chronic tinnitus is a debilitating condition and often accompanied by anxiety, depression, and sleep disturbance. It has been suggested that sleep disturbance, such as insomnia, may be a risk factor/predictor for tinnitus-related distress and the two conditions may share common neurobiological mechanisms. This study investigated whether acute stress-induced sleep disturbance could increase the susceptibility to acoustic trauma-induced tinnitus in rats. The animals were exposed to unilateral acoustic trauma 24 h before sleep disturbance being induced using the cage exchange method. Tinnitus perception was assessed behaviourally using a conditioned lick suppression paradigm 3 weeks after the acoustic trauma. Changes in the orexin system in the hypothalamus, which plays an important role in maintaining long-lasting arousal, were also examined using immunohistochemistry. Cage exchange resulted in a significant reduction in the number of sleep episodes and acoustic trauma-induced tinnitus with acoustic features similar to a 32 kHz tone at 100 dB. However, sleep disturbance did not exacerbate the perception of tinnitus in rats. Neither tinnitus alone nor tinnitus plus sleep disturbance altered the number of orexin-expressing neurons. The results suggest that acute sleep disturbance does not cause long-term changes in the number of orexin neurons and does not change the perception of tinnitus induced by acoustic trauma in rats.

  5. 心理干预对突发性耳聋伴耳鸣患者的影响%Influence of psychological Intervention on patients suffered from sudden hearing loss with tinnitus

    Institute of Scientific and Technical Information of China (English)

    谢文涛; 梁立雪; 刘秀容

    2013-01-01

    Objective:To study the influence of psychological intervention on the patients suffered from sudden hearing loss with tinnitus.Methods:Chose 108 patients suffered from sudden hearing loss with tinnitus from May 2008 to April 2012.They were divided into psychological intervention group of 61 cases and control group of 47 cases.All cases were given medicine to improve inner ear circulation and nerve nutrition,but the psychological intervention was added to intervention group.The curative effect of sudden deafness and tinnitus patients were compared between the two groups.Results:The patients in the intervention group,therapeutic effects of depression and anxiety symptoms than the control group (P <0.05).Conclusion:The psychological intervention can effectively alleviate the situation of psychological barriers of sudden deafness and tinnitus patients,play a active and effective role in the treatment.%目的:观察心理干预对突发性耳聋患者耳鸣疗效的影响.方法:将2008年5月~2012年4月伴不同程度心理障碍的108例突发性耳聋伴耳鸣患者随机分为对照组47例和干预组61例,两组患者均给予改善内耳循环及营养神经治疗,对照组采用常规护理,干预组同时施加心理疏导干预治疗.比较两组突发性耳聋伴耳鸣患者的疗效.结果:干预组患者耳鸣疗效、抑郁与焦虑症状改善情况优于对照组(P<0.05).结论:心理干预可有效缓解突发性耳聋伴耳鸣患者的心理障碍状况,起到积极有效的治疗作用.

  6. Dyspepsia in chronic psychiatric patients

    NARCIS (Netherlands)

    Mookhoek, E.J.; Meijs, V.M.M.; Loonen, A.J.M.; Leufkens, H.G.M.

    2005-01-01

    Introduction: We report on dyspeptic complaints among patients hospitalized in the long-stay ward of a general psychiatric hospital. Methods: A representative sample of the patients was interviewed using a structured questionnaire. Results: Eighty percent of the patients reported one or more symptom

  7. Cochlear implants as a treatment option for unilateral hearing loss, severe tinnitus and hyperacusis.

    Science.gov (United States)

    Ramos Macías, Angel; Falcón González, Juan Carlos; Manrique, Manuel; Morera, Constantino; García-Ibáñez, Luis; Cenjor, Carlos; Coudert-Koall, Chrystellel; Killian, Matthijs

    2015-01-01

    Tinnitus is an incapacitating condition commonly affecting cochlear implant (CI) candidates. The aim of this clinical study is to assess the long-term effects of CI treatment in patients with severe-to-profound, sensorineural, unilateral hearing loss (UHL) and incapacitating tinnitus. We performed a prospective Cochlear™ company-sponsored multicentre study in five Spanish centres. Sixteen patients with UHL and incapacitating tinnitus, which was indicated by a Tinnitus Handicap Inventory (THI) score >58%, received a Nucleus® CI in their deaf ear. The study design includes repeated within-subject measures on hearing, tinnitus, hyperacusis and quality of life up to 12 months after initial CI fitting. In addition to hearing loss and tinnitus, all patients suffered from hyperacusis. Most patients had a sudden hearing loss and received a CI within 2 years after their hearing loss. Preliminary 6-month, post-CI activation data of 13 subjects showed that the majority of patients perceived a subjective benefit from CI treatment, which was assessed using the THI, a Visual Analogue Scale of tinnitus loudness/annoyance and the Speech, Spatial and Qualities of Hearing Scale. Preliminary 12-month data of 7 subjects showed that most patients also perceived a degree of relief from their hyperacusis. One patient showed no improvements in any of the applied scales, which could be explained by partial insertion of the electrode due to obstruction of the cochlea by otosclerosis. In conclusion, CI can successfully be used in the treatment of UHL patients with accompanying severe tinnitus and hyperacusis. Implantation resulted in hearing benefits and a durable relief from tinnitus and hyperacusis in the majority of patients. These findings support the hypothesis that pathophysiological mechanisms after peripheral sensorineural hearing loss are at least partly reversible when hearing is restored with a CI.

  8. Can Magnetic Coil Ease Tinnitus?

    Science.gov (United States)

    ... its use in a variety of other conditions. German researchers first used it with tinnitus about 10 ... optimistic because of everything he has now been learning from the audiologists at the Portland VA. "My ...

  9. MALONDIALDEHYDE LEVELS IN PATIENTS WITH CHRONIC PERIODONTITIS

    Directory of Open Access Journals (Sweden)

    Madhur

    2013-06-01

    Full Text Available ABSTRACT: Periodontitis is a chronic condition leading to the destruction of the periodontium. A case control study was carried out in 30 subjects with chronic periodontitis aged 30 - 65 ye ars (group II and age matched with 30 control subjects (group I. Salivary and serum malondialdehyde, which is a marker of lipid peroxidation, was estimated in the cases and controls. Salivary MDA was elevated (p<0.001 in patients with chronic periodonti tis there was no change in serum MDA levels when compared with normal controls. Increased levels in MDA may be closely associated with periodontal disease and salivary estimation may provide advantage in pathogenesis of the periodontal disease. .

  10. Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo : a systematic review and meta-analysis of individual patient data

    NARCIS (Netherlands)

    van den Berge, Minke J C; van Dijk, J. Marc C.; Posthumus, Iris A; Smidt, Nynke; van Dijk, Pim; Free, Rolien H

    2016-01-01

    OBJECTIVE Microvascular decompression (MVD) is regarded as a valid treatment modality in neurovascular conflicts (NVCs) causing, for example, trigeminal neuralgia and hemifacial spasms. An NVC of the cochleovestibular nerve might cause tinnitus and/or vertigo; however, general acceptance of MVD for

  11. Hearing loss and tinnitus in rock musicians: A Norwegian survey

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    Carl Christian Lein Størmer

    2015-01-01

    Full Text Available Our focus in this study was to assess hearing thresholds and the prevalence and characteristics of tinnitus in a large group of rock musicians based in Norway. A further objective was to assess related factors such as exposure, instrument category, and the preventive effect of hearing protection. The study was a cross-sectional survey of rock musicians selected at random from a defined cohort of musicians. A random control group was included for comparison. We recruited 111 active musicians from the Oslo region, and a control group of 40 nonmusicians from the student population at the University of TromsØ. The subjects were investigated using clinical examination, pure tone audiometry, tympanometry, and a questionnaire. We observed a hearing loss in 37.8% of the rock musicians. Significantly poorer hearing thresholds were seen at most pure-tone frequencies in musicians than controls, with the most pronounced threshold shift at 6 kHz. The use of hearing protection, in particular custom-fitted earplugs, has a preventive effect but a minority of rock musicians apply them consistently. The degree of musical performance exposure was inversely related to the degree of hearing loss in our sample. Bass and guitar players had higher hearing thresholds than vocalists. We observed a 20% prevalence of chronic tinnitus but none of the affected musicians had severe tinnitus symptomatology. There was no statistical association between permanent tinnitus and hearing loss in our sample. We observed an increased prevalence of hearing loss and tinnitus in our sample of Norwegian rock musicians but the causal relationship between musical exposure and hearing loss or tinnitus is ambiguous. We recommend the use of hearing protection in rock musicians.

  12. Hearing loss and tinnitus in rock musicians: A Norwegian survey.

    Science.gov (United States)

    Størmer, Carl Christian Lein; Laukli, Einar; Høydal, Erik Harry; Stenklev, Niels Christian

    2015-01-01

    Our focus in this study was to assess hearing thresholds and the prevalence and characteristics of tinnitus in a large group of rock musicians based in Norway. A further objective was to assess related factors such as exposure, instrument category, and the preventive effect of hearing protection. The study was a cross-sectional survey of rock musicians selected at random from a defined cohort of musicians. A random control group was included for comparison. We recruited 111 active musicians from the Oslo region, and a control group of 40 nonmusicians from the student population at the University of TromsØ. The subjects were investigated using clinical examination, pure tone audiometry, tympanometry, and a questionnaire. We observed a hearing loss in 37.8% of the rock musicians. Significantly poorer hearing thresholds were seen at most pure-tone frequencies in musicians than controls, with the most pronounced threshold shift at 6 kHz. The use of hearing protection, in particular custom-fitted earplugs, has a preventive effect but a minority of rock musicians apply them consistently. The degree of musical performance exposure was inversely related to the degree of hearing loss in our sample. Bass and guitar players had higher hearing thresholds than vocalists. We observed a 20% prevalence of chronic tinnitus but none of the affected musicians had severe tinnitus symptomatology. There was no statistical association between permanent tinnitus and hearing loss in our sample. We observed an increased prevalence of hearing loss and tinnitus in our sample of Norwegian rock musicians but the causal relationship between musical exposure and hearing loss or tinnitus is ambiguous. We recommend the use of hearing protection in rock musicians.

  13. Attitudes toward patient expertise in chronic illness.

    Science.gov (United States)

    Thorne, S E; Ternulf Nyhlin, K; Paterson, B L

    2000-08-01

    Although it has become an accepted standard to acknowledge the patient as a full partner in health care decisions, replacing traditional authoritative relationships with those based on an emancipatory model, the experiences of persons living with chronic illness confirm that this paradigm shift is not yet apparent in many health care relationships. In this paper, the authors present a qualitative secondary analysis of combined data sets from their research into chronic illness experience with two quite different chronic diseases - Type I Diabetes (a socially legitimized chronic disease) and Environmental Sensitivities (a disease which is currently treated with considerable scepticism). Comparing the experiences of individuals with diseases that are quite differently socially constructed, it becomes possible to detect common underlying health professional values and attitudes that powerfully influence the experience of living with and negotiating health care for a chronic illness. In the discussion of findings from this study, the authors examine the implications of the spiral of behaviors that fuels mutual alienation in chronic illness care relationships if professionals are unable to value patient expertise.

  14. The 'Love Hormone' May Quiet Tinnitus

    Science.gov (United States)

    ... medlineplus.gov/news/fullstory_161110.html The 'Love Hormone' May Quiet Tinnitus Small, preliminary study suggests oxytocin ... tinnitus -- may find some relief by spraying the hormone oxytocin in their nose, a small initial study ...

  15. Clinical value of distortion product otoacoustic emission in tinnitus patients with normal hearing%畸变产物耳声发射测试在听力正常的耳鸣者中的应用价值

    Institute of Scientific and Technical Information of China (English)

    朱小平; 张香玉

    2011-01-01

    Objective To investigate the clinical value of distortion product otoacoustic emission (DPOAE) application in normal hearing patients with tinnitus. Methods A total of 82 healthy volunteers (164 ears) without tinnitus or hearing loss were enrolled as control group and tested with DPOAE. Meanwhile, 84 normal hearing patients (109 ears) with tinnitus were tested with DPOAE before and after 20-days treatment including circulation improvement and supplemental nutrition for inner ear. Results At the frequency of 0.5, 0.75, 1.00, 1.50, 2.00, 3.00, 4.00, 6.00 and 8.00 kHz, the detection rate of DPOAE in tinnitus group was significantly lower than that in control group (all P0.05); the wave height in every frequency was increased after treatment, especially in high frequency (3.00. 4.00, 6.00 and 8.00 kHz, all P< 0.05). Conclusion Tinnitus with normal hearing is likely to be related to hearing loss of super high frequency caused by early impairment of outer hair cells in cochlea. DPOAE examination can be used as an objective assessment for early change of cochlea and periphery tinnitus.%目的 探讨畸变产物耳声发射( DPOAE)测试在听力正常的耳鸣患者中的临床应用价值.方法 对82名(164耳)听力正常且无耳鸣的健康者(对照组)进行DPOAE测试.同时对84例(109耳)听力正常的耳鸣患者(耳鸣组)进行DPOAE测试,并给予改善内耳循环、补充营养等治疗20 d后再次进行DPOAE测试.结果 耳鸣组中,DPOAE测试在0.50、0.75、1.00、1.50、2.00、3.00、4.00、6.00、8.00 kHz各频率点的检出率均显著低于对照组(P值均<0.05).耳鸣组治疗后DPOAE的检出率为43.1%,与治疗前(56.9%)的差异无统计学意义(P>0.05),治疗后在各频率点的DPOAE反应幅值呈提高趋势,尤其在高频(3.00、4.00、6.00、8.00 kHz)的差异有统计学意义(P值均<0.05).结论 听力正常的耳鸣发生可能与耳蜗外毛细胞的早期损伤导致的超高频听力损失有关,DPOAE检测可以

  16. Psychoacoustic assessment to improve tinnitus diagnosis.

    Directory of Open Access Journals (Sweden)

    Charles-Édouard Basile

    Full Text Available The diagnosis of tinnitus relies on self-report. Psychoacoustic measurements of tinnitus pitch and loudness are essential for assessing claims and discriminating true from false ones. For this reason, the quantification of tinnitus remains a challenging research goal. We aimed to: (1 assess the precision of a new tinnitus likeness rating procedure with a continuous-pitch presentation method, controlling for music training, and (2 test whether tinnitus psychoacoustic measurements have the sensitivity and specificity required to detect people faking tinnitus. Musicians and non-musicians with tinnitus, as well as simulated malingerers without tinnitus, were tested. Most were retested several weeks later. Tinnitus pitch matching was first assessed using the likeness rating method: pure tones from 0.25 to 16 kHz were presented randomly to participants, who had to rate the likeness of each tone to their tinnitus, and to adjust its level from 0 to 100 dB SPL. Tinnitus pitch matching was then assessed with a continuous-pitch method: participants had to match the pitch of their tinnitus to an external tone by moving their finger across a touch-sensitive strip, which generated a continuous pure tone from 0.5 to 20 kHz in 1-Hz steps. The predominant tinnitus pitch was consistent across both methods for both musicians and non-musicians, although musicians displayed better external tone pitch matching abilities. Simulated malingerers rated loudness much higher than did the other groups with a high degree of specificity (94.4% and were unreliable in loudness (not pitch matching from one session to the other. Retest data showed similar pitch matching responses for both methods for all participants. In conclusion, tinnitus pitch and loudness reliably correspond to the tinnitus percept, and psychoacoustic loudness matches are sensitive and specific to the presence of tinnitus.

  17. Condition of hearing sense and tinnitus before and after the treatment of otosclerosis

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    Terzić Negra

    2010-01-01

    Full Text Available Introduction. Otosclerosis is an osteodystrophy disease of the bony labyrinth of the ear which leads to stapes fixation and to bradyecoia of a conductive type. The microsurgical treatment by the use of a stapes prosthesis provides hearing improvement and a reduction or disappearing of tinnitus. The aim of our study was to determine the hearing condition and tinnitus before and after the treatment of otosclerosis. Material and methods. A hundred patients with otosclerosis, aged 20 to 70, were surgically treated at the Otorhinolaryngology Clinic and the Functional Diagnostics, Military Medical Academy, Belgrade. After the treatment, the audiometric examinations were performed in order to assess the hearing condition and tinnitus was assessed by a questionnaire. The subjective assessment of tinnitus was ranged as present, reduced or absent. Results. Before the treatment, hearing impairment was present in all the patients, while tinnitus was found in 91% of them. One year following the surgical treatment hearing improvement was found in 96% of the patients, and tinnitus cessation in 89% of them. Conclusion. The surgical treatment can result in hearing improvement and cessation or reduction of tinnitus.

  18. 21 CFR 874.3400 - Tinnitus masker.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Tinnitus masker. 874.3400 Section 874.3400 Food... DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3400 Tinnitus masker. (a) Identification. A tinnitus masker is an electronic device intended to generate noise of sufficient intensity and bandwidth...

  19. Brain regions responsible for tinnitus distress and loudness: a resting-state FMRI study.

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    Takashi Ueyama

    Full Text Available Subjective tinnitus is characterized by the perception of phantom sound without an external auditory stimulus. We hypothesized that abnormal functionally connected regions in the central nervous system might underlie the pathophysiology of chronic subjective tinnitus. Statistical significance of functional connectivity (FC strength is affected by the regional autocorrelation coefficient (AC. In this study, we used resting-state functional MRI (fMRI and measured regional mean FC strength (mean cross-correlation coefficient between a region and all other regions without taking into account the effect of AC (rGC and with taking into account the effect of AC (rGCa to elucidate brain regions related to tinnitus symptoms such as distress, depression and loudness. Consistent with previous studies, tinnitus loudness was not related to tinnitus-related distress and depressive state. Although both rGC and rGCa revealed similar brain regions where the values showed a statistically significant relationship with tinnitus-related symptoms, the regions for rGCa were more localized and more clearly delineated the regions related specifically to each symptom. The rGCa values in the bilateral rectus gyri were positively correlated and those in the bilateral anterior and middle cingulate gyri were negatively correlated with distress and depressive state. The rGCa values in the bilateral thalamus, the bilateral hippocampus, and the left caudate were positively correlated and those in the left medial superior frontal gyrus and the left posterior cingulate gyrus were negatively correlated with tinnitus loudness. These results suggest that distinct brain regions are responsible for tinnitus symptoms. The regions for distress and depressive state are known to be related to depression, while the regions for tinnitus loudness are known to be related to the default mode network and integration of multi-sensory information.

  20. An evaluation of the content and quality of tinnitus information on websites preferred by General Practitioners

    Directory of Open Access Journals (Sweden)

    Fackrell Kathryn

    2012-07-01

    Full Text Available Abstract Background Tinnitus is a prevalent and complex medical complaint often co-morbid with stress, anxiety, insomnia, depression, and cognitive or communication difficulties. Its chronicity places a major burden on primary and secondary healthcare services. In our recent national survey of General Practitioners (GPs from across England, many reported that their awareness of tinnitus was limited and as a result were dissatisfied with the service they currently provide. GPs identified 10 online sources of information they currently use in clinical practice, but welcomed further concise and accurate information on tinnitus assessment and management. The purpose of this study was to assess the content, reliability, and quality of the information related to primary care tinnitus assessment and management on these 10 websites. Methods Tinnitus related content on each website was assessed using a summative content analysis approach. Reliability and quality of the information was assessed using the DISCERN questionnaire. Results Quality of information was rated using the validated DISCERN questionnaire. Significant inter-rater reliability was confirmed by Kendall’s coefficient of concordance (Wt which ranged from 0.48 to 0.92 across websites. The website Map of Medicine achieved the highest overall DISCERN score. However, for information on treatment choice, the British Tinnitus Association was rated best. Content analysis revealed that all websites lacked a number of details relating to either tinnitus assessment or management options. Conclusions No single website provides comprehensive information for GPs on tinnitus assessment and management and so GPs may need to refer to more than one if they want to maximise their coverage of the topic. From those preferred by GPs we recommend several specific websites as the current ‘best’ sources. Our findings should guide healthcare website providers to improve the quality and inclusiveness of the

  1. Brain regions responsible for tinnitus distress and loudness: a resting-state FMRI study.

    Science.gov (United States)

    Ueyama, Takashi; Donishi, Tomohiro; Ukai, Satoshi; Ikeda, Yorihiko; Hotomi, Muneki; Yamanaka, Noboru; Shinosaki, Kazuhiro; Terada, Masaki; Kaneoke, Yoshiki

    2013-01-01

    Subjective tinnitus is characterized by the perception of phantom sound without an external auditory stimulus. We hypothesized that abnormal functionally connected regions in the central nervous system might underlie the pathophysiology of chronic subjective tinnitus. Statistical significance of functional connectivity (FC) strength is affected by the regional autocorrelation coefficient (AC). In this study, we used resting-state functional MRI (fMRI) and measured regional mean FC strength (mean cross-correlation coefficient between a region and all other regions without taking into account the effect of AC (rGC) and with taking into account the effect of AC (rGCa) to elucidate brain regions related to tinnitus symptoms such as distress, depression and loudness. Consistent with previous studies, tinnitus loudness was not related to tinnitus-related distress and depressive state. Although both rGC and rGCa revealed similar brain regions where the values showed a statistically significant relationship with tinnitus-related symptoms, the regions for rGCa were more localized and more clearly delineated the regions related specifically to each symptom. The rGCa values in the bilateral rectus gyri were positively correlated and those in the bilateral anterior and middle cingulate gyri were negatively correlated with distress and depressive state. The rGCa values in the bilateral thalamus, the bilateral hippocampus, and the left caudate were positively correlated and those in the left medial superior frontal gyrus and the left posterior cingulate gyrus were negatively correlated with tinnitus loudness. These results suggest that distinct brain regions are responsible for tinnitus symptoms. The regions for distress and depressive state are known to be related to depression, while the regions for tinnitus loudness are known to be related to the default mode network and integration of multi-sensory information.

  2. Acoustic trauma-induced auditory cortex enhancement and tinnitus

    Institute of Scientific and Technical Information of China (English)

    Erin Laundrie; Wei Sun

    2014-01-01

    There is growing evidence suggests that noise-induced cochlear damage may lead to hyperexcitability in the central auditory system (CAS) which may give rise to tinnitus. However, the correlation between the onset of the neurophysiological changes in the CAS and the onset of tinnitus has not been well studied. To investigate this relationship, chronic electrodes were implanted into the auditory cortex (AC) and sound evoked activities were measured from awake rats before and after noise exposure. The auditory brainstem response (ABR) was used to assess the degree of noise-induced hearing loss. Tinnitus was evaluated by measuring gap-induced prepulse inhibition (gap-PPI). Rats were exposed monaurally to a high-intensity narrowband noise centered at 12 kHz at a level of 120 dB SPL for 1 h. After the noise exposure, all the rats developed either permanent (>2 weeks) or temporary (<3 days) hearing loss in the exposed ear(s). The AC amplitudes increased significantly 4 h after the noise exposure. Most of the exposed rats also showed decreased gap-PPI. The post-exposure AC enhancement showed a positive correlation with the amount of hearing loss. The onset of tinnitus-like behavior was happened after the onset of AC enhancement.

  3. Discrimination task reveals differences in neural bases of tinnitus and hearing impairment.

    Directory of Open Access Journals (Sweden)

    Fatima T Husain

    Full Text Available We investigated auditory perception and cognitive processing in individuals with chronic tinnitus or hearing loss using functional magnetic resonance imaging (fMRI. Our participants belonged to one of three groups: bilateral hearing loss and tinnitus (TIN, bilateral hearing loss without tinnitus (HL, and normal hearing without tinnitus (NH. We employed pure tones and frequency-modulated sweeps as stimuli in two tasks: passive listening and active discrimination. All subjects had normal hearing through 2 kHz and all stimuli were low-pass filtered at 2 kHz so that all participants could hear them equally well. Performance was similar among all three groups for the discrimination task. In all participants, a distributed set of brain regions including the primary and non-primary auditory cortices showed greater response for both tasks compared to rest. Comparing the groups directly, we found decreased activation in the parietal and frontal lobes in the participants with tinnitus compared to the HL group and decreased response in the frontal lobes relative to the NH group. Additionally, the HL subjects exhibited increased response in the anterior cingulate relative to the NH group. Our results suggest that a differential engagement of a putative auditory attention and short-term memory network, comprising regions in the frontal, parietal and temporal cortices and the anterior cingulate, may represent a key difference in the neural bases of chronic tinnitus accompanied by hearing loss relative to hearing loss alone.

  4. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus : A randomized controlled trial

    NARCIS (Netherlands)

    van Zon, Alice; Smulders, Yvette E; Ramakers, Geerte G J; Stegeman, Inge; Smit, Adriana L; Van Zanten, Gijsbert A; Stokroos, Robert J; Hendrice, Nadia; Free, Rolien H; Maat, Bert; Frijns, Johan H M; Mylanus, Emmanuel A M; Huinck, Wendy J; Topsakal, Vedat; Tange, Rinze A; Grolman, Wilko

    2015-01-01

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. STUDY DESIGN: Prospective study. MET

  5. Effect of unilateral and simultaneous bilateral cochlear implantation on tinnitus: A Prospective Study

    NARCIS (Netherlands)

    Zon, A. van; Smulders, Y.E.; Ramakers, G.G.; Stegeman, I.; Smit, A.L.; Zanten, G.A.; Stokroos, R.J.; Hendrice, N.; Free, R.H.; Maat, B.; Frijns, J.H.; Mylanus, E.A.M.; Huinck, W.J.; Topsakal, V.; Tange, R.A.; Grolman, W.

    2016-01-01

    OBJECTIVES/HYPOTHESIS: To determine the effect of cochlear implantation on tinnitus perception in patients with severe bilateral postlingual sensorineural hearing loss and to demonstrate possible differences between unilateral and bilateral cochlear implantation. STUDY DESIGN: Prospective study. MET

  6. Acupuncture for patients with chronic neck pain.

    Science.gov (United States)

    Witt, Claudia M; Jena, Susanne; Brinkhaus, Benno; Liecker, Bodo; Wegscheider, Karl; Willich, Stefan N

    2006-11-01

    Acupuncture is widely used by patients with neck pain, but there is a lack of information about its effectiveness in routine medical care. The aim was to investigate the effectiveness of acupuncture in addition to routine care in patients with chronic neck pain compared to treatment with routine care alone. We performed a randomized controlled multicentre trial plus non-randomized cohort in general practices in Germany. 14,161 patients with chronic neck pain (duration >6 months). Patients were randomly allocated to an acupuncture group or a control group receiving no acupuncture. Patients in the acupuncture group received up to 15 acupuncture sessions over three months. Patients who did not consent to randomization received acupuncture treatment. All subjects were allowed to receive usual medical care in addition to study treatment. Neck pain and disability (NPAD Scale by Wheeler) after three months. Of 14,161 patients (mean age 50.9+/-13.1 years, 68% female) 1880 were randomized to acupuncture and 1886 to control, and 10,395 included into the non-randomized acupuncture group. At three months, neck pain and disability improved by 16.2 (SE: 0.4) to 38.3 (SE: 0.4); and by 3.9 (SE: 0.4) to 50.5 (SE: 0.4), difference 12.3 (pacupuncture and control group, respectively. Treatment success was essentially maintained through six months. Non-randomized patients had more severe symptoms at baseline and showed higher neck pain and disability improvement compared to randomized patients. Treatment with acupuncture added to routine care in patients with chronic neck pain was associated with improvements in neck pain and disability compared to treatment with routine care alone.

  7. Chronic tophaceous gout in patients with psoriasis.

    Science.gov (United States)

    Lobato, Laís Cruz; Coutinho, Jéssica Castiel; Frota, Maria Zeli Moreira; Schettini, Antonio Pedro Mendes; Santos, Mônica

    2017-01-01

    Psoriasis is a chronic inflammatory disease of multifactorial etiology influenced by genetic, immunological, and environmental factors. We report the case of a patient with psoriasis for more than 25 years who developed hyperuricemia and chronic tophaceous gout with unusual appearance. In psoriasis, hyperuricemia may occur by increased epidermal cell turnover, which accelerates purine metabolism and has uric acid as the product of its catabolism. The association of psoriasis with hyperuricemia can trigger the onset of gouty arthritis, and pose a greater risk of developing other inflammatory comorbidities. Therefore, it is important to periodically investigate uric acid levels in order to treat changes triggered by hyperuricemia.

  8. Chronic tophaceous gout in patients with psoriasis*

    Science.gov (United States)

    Lobato, Laís Cruz; Coutinho, Jéssica Castiel; Frota, Maria Zeli Moreira; Schettini, Antonio Pedro Mendes; Santos, Mônica

    2017-01-01

    Psoriasis is a chronic inflammatory disease of multifactorial etiology influenced by genetic, immunological, and environmental factors. We report the case of a patient with psoriasis for more than 25 years who developed hyperuricemia and chronic tophaceous gout with unusual appearance. In psoriasis, hyperuricemia may occur by increased epidermal cell turnover, which accelerates purine metabolism and has uric acid as the product of its catabolism. The association of psoriasis with hyperuricemia can trigger the onset of gouty arthritis, and pose a greater risk of developing other inflammatory comorbidities. Therefore, it is important to periodically investigate uric acid levels in order to treat changes triggered by hyperuricemia. PMID:28225966

  9. The evaluation of ozone and betahistine in the treatment of tinnitus.

    Science.gov (United States)

    Sönmez, Onur; Külahlı, Ismail; Vural, Alperen; Sahin, Mehmet Ilhan; Aydın, Mesut

    2013-07-01

    The aim of the study is to evaluate the effectiveness of ozone and betahistine treatments in the treatment of tinnitus. Sixty-eight patients were enrolled in this randomized, prospective controlled study. The ozone group consisted of 27, betahistine group consisted of 26 and control group consisted of 15 patients. The patients in ozone group received 10 sessions of ozone treatment via major autohemotherapy. Betahistine group received 48 mg/day betahistine tablets per oral for 3 months duration. The control group was followed up without any treatment given. The evaluation of tinnitus was made by tinnitus loudness and tinnitus handicap inventory (THI). The changes in findings from baseline to 3rd and 6th months were assessed, and the group results were compared. Comparison of the initial mean tinnitus loudness and 3 and 6 months after treatment in each of the three groups did not reveal a significant difference. The comparison between the groups in terms of the improvement of tinnitus loudness was not significant (p = 0.821). Comparison of the initial mean THI and 3 and 6 months after treatment revealed a significant difference in ozone and betahistine groups but not in the control group. When the delta (Δ) THI (the change of mean THI between the initial and 6th month) was compared between the groups, there was no significant difference. This randomized controlled study investigating the effects of ozone in tinnitus tries to shed light to a new method of treatment in tinnitus. The findings of the study does not provide enough evidence to support ozone and betahistine as a treatment for tinnitus and further research on the subject is necessary.

  10. Psychosocial interventions for patients with chronic disease

    Directory of Open Access Journals (Sweden)

    Deter Hans-Christian

    2012-01-01

    Full Text Available Abstract Treatment of patients with chronic diseases will be one of the main challenges of medicine in the future. This paper presents an overview of different origins, mechanism, and symptoms necessary for understanding new and different interventions that include a psychosomatic view. In a psychosomatic therapeutic intervention there are very different targets, such as psychological symptoms, personality traits, attitudes toward disease and life, risk behaviour, and social isolation and as biological targets the change of autonomic imbalance and of the effects of the psycho-endocrinological or psycho-immunological stress responses. And there are also different psychosomatic measures that influence the individual biological, psychological and sociological targets. There is a need to give different answer to different questions in the field of psychosomatic and behavioral medicine. Comparative effectiveness research is an important strategy for solving some methodological issues. What is the target of treatment for different diseases: Symptom reduction, healing, or limiting progression to the worst case - the death of patients. We know that, the patient-physician relationship is important for every medical/therapeutic action for patients with chronic diseases. This volume of BioPsychoSocial Medicine will present four different psychosomatic treatment studies from the clinical field in the sense of phase 2 studies: Reports of patients with obesity, anorexia nervosa, chronic somatoform pain and coronary artery disease were presented

  11. 自觉听力正常耳鸣患者纯音听力及畸变产物耳声发射临床分析%Audiometry and distortion product otoacoustic emissions in tinnitus patients without hearing complaints

    Institute of Scientific and Technical Information of China (English)

    王晓晖; 肖玉丽

    2011-01-01

    Objective To study pure tone audiometry and distortion product otoacoustic emissions (DPOAE) features in tinnitus patients who do not perceive hearing loss. Methods Pure tone threshold, hearing loss, SNR of DPOAE were performed in 114 (190 ears) adults with tinnitus cases with never perceived hearing loss, investigate the relationship between every risk factor and tinnitus. Results Audiometry showed high frequency hearing loss in 46.31% (88/ 190), low frequency hearing loss in 14.73% (28/190), normal hearing in 23.15% (44/190), and other types of audio-grams in 15.78%(30/190) of the patients. Risk factors included noise exposure, fatigue, stress, and pre-existing diseases. There was a negative correlation between DPOAE amplitude and pure tone threshold. DPOAE response frequencies were closely related to frequency distribution of pure tone thresholds. Conclusion A significant number of patients with tinnitus but no hearing complaints may still have abnormal hearing, especially in the high frequency range. A negative correlation exists between DPOAE amplitude and pure tone threshold. DPOAEs may serve as an objective indicator of the level of hearing loss in tinnitus patients with no hearing complaints, which may be of value in the clinic.%目的 分析自觉听力正常耳鸣患者的纯音听力特征,并探讨自觉听力正常耳鸣患者畸变产物耳声发射(distortion product otoacoustic emission,DPOAE)测定值与纯音听阈值之间的相关性及其意义.方法 2010-2011年在我科就诊的以耳鸣为第一主诉但无明显自觉听力障碍患者114例(190耳),对所有入组患者进行纯音测听及DPOAE检测.分析DPOAE测定值与纯音听阈值之间的相关性,并结合其发病的可能危险因素进行相关分析.结果 自觉听力正常的耳鸣患者中,听力异常可达76.84% (146/190).纯音测听表现为:高频下降型46.31% (88/190);低频下降型14.73% (28/190);正常23.15% (44/190);其它类型15.78% (30/190).

  12. The Additive Effect of Co-Occurring Anxiety and Depression on Health Status, Quality of Life and Coping Strategies in Help-Seeking Tinnitus Sufferers

    NARCIS (Netherlands)

    Bartels, H.; Middel, B. L.; van der Laan, B. F. A. M.; Staal, M. J.; Albers, F. W. J.

    2008-01-01

    Objective: Evaluating the effect of anxiety and depression on clinical measures of general health, tinnitus-specific quality of life, and coping abilities. Design: Two hundred sixty-five chronic, subjective tinnitus sufferers were divided into four psychological symptom groups according to cut-off s

  13. Acinarcellcarcinomaofthepancreasina young patient with chronic pancreatitis

    Institute of Scientific and Technical Information of China (English)

    Fatima-Zahra Kebir; Ahlem Lahmar; Nafaa Arfa; Saber Manai; Mohamed Ali El Ouaer; Saadia Bouraoui; Carole Gouttalier; Sabah Mezabi-Regaya

    2010-01-01

    BACKGROUND: Acinar cell carcinoma (ACC) is a rare malignancy of the pancreas arising from acinar cells. Unlike ductal adenocarcinoma, this tumor rarely presents with pancreatitis. METHODS: We present a case of ACC associated with chronic calcifying pancreatitis, and a review of the literature focusing on diagnosis and management. RESULTS: A 43-year-old man was proposed for Wirsungo-jejunal derivation for chronic pancreatitis. Histopathological examination of the tissue extracted revealed an ACC. Duodenopancreatectomy was performed. Six months post-operatively, the patient developed hepatic metastasis and was treated with gemcitabine as palliative chemotherapy. CONCLUSIONS: The clinical presentation of ACC of the pancreas is not speciifc and the tumor can be under-diagnosed when associated with chronic pancreatitis. Data regarding course, treatment, and prognosis of this tumor are generally lacking.

  14. Salicylate toxicity model of tinnitus

    Directory of Open Access Journals (Sweden)

    Daniel eStolzberg

    2012-04-01

    Full Text Available Salicylate, the active component of the common drug aspirin, has mild analgesic, antipyretic, and anti-inflammatory effects at moderate doses. At higher doses, however, salicylate temporarily induces moderate hearing loss and the perception of a high-pitch ringing in humans and animals. This phantom perception of sound known as tinnitus is qualitatively similar to the persistent subjective tinnitus induced by high-level noise exposure, ototoxic drugs or aging which affects ~14% of the general population. For over a quarter century, auditory scientists have used the salicylate toxicity model to investigate candidate biochemical and neurophysiological mechanisms underlying phantom sound perception. In this review, we summarize some of the intriguing biochemical and physiological effects associated with salicylate-induced tinnitus, some of which occur in the periphery and others in the central nervous system. The relevance and general utility of the salicylate toxicity model in understanding phantom sound perception in general are discussed.

  15. Cannabinoids, cannabinoid receptors and tinnitus.

    Science.gov (United States)

    Smith, Paul F; Zheng, Yiwen

    2016-02-01

    One hypothesis suggests that tinnitus is a form of sensory epilepsy, arising partly from neuronal hyperactivity in auditory regions of the brain such as the cochlear nucleus and inferior colliculus. Although there is currently no effective drug treatment for tinnitus, anti-epileptic drugs are used in some cases as a potential treatment option. There is increasing evidence to suggest that cannabinoid drugs, i.e. cannabinoid receptor agonists, can also have anti-epileptic effects, at least in some cases and in some parts of the brain. It has been reported that cannabinoid CB1 receptors and the endogenous cannabinoid, 2-arachidonylglycerol (2-AG), are expressed in the cochlear nucleus and that they are involved in the regulation of plasticity. This review explores the question of whether cannabinoid receptor agonists are likely to be pro- or anti-epileptic in the cochlear nucleus and therefore whether cannabinoids and Cannabis itself are likely to make tinnitus better or worse.

  16. Effect of Cognitive Nursing Intervention on Anxiety and Depression of Patients with Tinnitus%认知护理干预对改善耳鸣患者焦虑、抑郁情绪的效果

    Institute of Scientific and Technical Information of China (English)

    梁倩清; 莫志芳; 李秋红

    2015-01-01

    目的 探讨认知护理干预对改善耳鸣患者焦虑、 抑郁情绪的效果. 方法 选取我院收治的耳鸣患者120例作为研究对象, 并随机分为对照组和观察组各60例, 对照组行常规护理, 观察组在对照组基础上行认知护理干预, 护理前后行抑郁自评量表 (SDS)、 焦虑自评量表 (SAS) 评分, 并评估护理后对耳鸣的适应程度. 结果 观察组治疗后SDS评分和SAS评分分别为(35.26士4.29) 分、 (41.36士3.58) 分, 均显著低于对照组 (均P<0.05); 观察组护理后耳鸣适应率为31.67%, 显著高于对照组15.00%, 差异具有统计学意义 (P<0.05). 结论 认知护理干预可提高耳鸣患者对疾病相关知识的认知度, 缓解负面情绪.%Objective To explore the effect of cognitive nursing intervention on anxiety and depression of patients with tinnitus. Methods 120 patients with tinnitus admitted to our hospital were selected as research objects, and randomly divided into two groups, with 60 cases in each group. The control group was given routine care, while the observation group received cognitive nursing intervention on the basis of routine care. Before and after care, the self-rating depression scale (SDS) and self-rating anxiety scale (SAS) were used for evaluation, and the adaptive degree to tinnitus was evaluated. Results After care, the SDS and SAS scores of the observation group were (35.26 ± 4.29) points and (41.36 ± 3.58) points respectively, significantly lower than those of the control group (P<0.05). The adaptation rate to tinnitus after care of the observation group was 31.67%, significantly higher than 15.00%of the control group (P<0.05). Conclusions Cognitive nursing intervention can improve the awareness of the disease-related knowledge in patients with tinnitus, and alleviate the negative emotions.

  17. A case report of pulsatile tinnitus as a symptom of brain arteriovenous malformation

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    M. Sayadnasiri

    2015-12-01

    Full Text Available Pulsatile tinnitus is the result of blood flow related sounds transmitted to the inner ear and coincides with heartbeat. Although pulsatile tinnitus is a rare entity, this symptom is most often indicative of a serious underlying disease in central nervous system. Unfortunately, this symptom is often not properly assessed by clinician that leads to delayed diagnosis of underlying brain pathology. In this report, a patient is presented with chief complaint of tinnitus that had many medical visits for 2 years. Finally, a cerebral vascular malformation was diagnosed with regards to physical examination and neuroimaging findings.

  18. Frequency of anemia in chronic psychiatry patients

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    Korkmaz S

    2015-10-01

    Full Text Available Sevda Korkmaz,1 Sevler Yildiz,1 Tuba Korucu,1 Burcu Gundogan,1 Zehra Emine Sunbul,1 Hasan Korkmaz,2 Murad Atmaca1 1Department of Psychiatry, 2Department of Cardiology, Faculty of Medicine, Firat University, Elazig, Turkey Purpose: Anemia could cause psychiatric symptoms such as cognitive function disorders and depression or could deteriorate an existing psychiatric condition when it is untreated. The objective of this study is to scrutinize the frequency of anemia in chronic psychiatric patients and the clinical and sociodemographic factors that could affect this frequency.Methods: All inpatients in our clinic who satisfied the study criteria and received treatment between April 2014 and April 2015 were included in this cross-sectional study. Sociodemographic data for 378 patients included in the study and hemoglobin (Hb and hematocrit values observed during their admission to the hospital were recorded in the forms. Male patients with an Hb level of <13 g/dL and nonpregnant female patients with an Hb level of <12 g/dL were considered as anemic.Findings: Axis 1 diagnoses demonstrated that 172 patients had depressive disorder, 51 patients had bipolar disorder, 54 patients had psychotic disorder, 33 patients had conversion disorder, 19 patients had obsessive-compulsive disorder, 25 patients had generalized anxiety disorder, and 24 patients had other psychiatric conditions. It was also determined that 25.4% of the patients suffered from anemia. Thirty-five percent of females and 10% of males were considered as anemic. The frequency of anemia was the highest among psychotic disorder patients (35%, followed by generalized anxiety disorder patients (32%, and obsessive-compulsive disorder patients (26%. Anemia was diagnosed in 22% of depressive disorder patients, 25% of bipolar disorder patients, and 24% of conversion disorder patients.Results: The prevalence of anemia among chronic psychiatry patients is more frequent than the general population

  19. Uremic pleuritis in chronic hemodialysis patients.

    Science.gov (United States)

    Rashid-Farokhi, Farin; Pourdowlat, Guitti; Nikoonia, Mohammad-Reza; Behzadnia, Neda; Kahkouee, Shahram; Nassiri, Amir-Ahmad; Masjedi, Mohammad-Reza

    2013-01-01

    Chronic hemodialysis (HD) patients are predisposed to several complications associated with pleural effusion. In addition, uremia can directly cause pleuritis. However, there are inadequate data about pathogenesis and natural course of uremic pleuritis. In this study, 76 chronic HD patients with pleural effusion admitted to the Respiratory Center of Masih Daneshvari Hospital, in Tehran, Iran between June 2005 and May 2011 were evaluated to figure out the etiology of their pleural disease. Among these patients, patients with uremic pleuritis were identified and studied. The rate of uremic pleuritis was 23.7%. Other frequent etiologies of pleural effusion were parapneumonic effusion (23.7%), cardiac failure (19.7%), tuberculosis (6.6%), volume overload, malignancy, and unknown. In patients with uremic pleuritis, dyspnea was the most common symptom, followed by cough, weight loss, anorexia, chest pain, and fever. Compared to patients with parapneumonic effusion, patients with uremic effusion had a significantly higher rate of dyspnea and lower rate of cough and fever. Pleural fluid analysis showed that these patients had a significantly lower pleural to serum lactic dehydrogenase ratio, total pleural leukocytes, and polymorphonuclear count compared to patients with parapneumonic effusion. Improvement was achieved in 94.1% of patients with uremic pleuritis by continuation of HD, chest tube insertion or pleural decortication; an outcome better than the previous reports. Despite the association with an exudative effusion, inflammatory pleural reactions in patients with uremic pleuritis may not be as severe as infection-induced effusions. Owing to the advancement in HD technology and other interventions, outcome of uremic pleuritis may be improved.

  20. The Epworth Sleepiness Scale in the Assessment of Sleep Disturbance in Veterans with Tinnitus

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    Yuan F. Liu

    2015-01-01

    Full Text Available Purpose. Tinnitus and sleep disturbance are prevalent in veterans, and a better understanding of their relationship can help with tinnitus treatment. Materials and Methods. Retrospective chart review of 94 veterans seen in audiology clinic between 2010 and 2013 is presented. Results. The mean age was 62 years, and 93 of 94 veterans were males. The majority (96% had hearing loss. The positive predictive value of the ESS for sleep disorder was 97% and the negative predictive value was 100%. Veterans with a Tinnitus Handicap Inventory (THI score ≥38 had significantly higher Epworth Sleepiness Scale (ESS scores compared to those with THI score <38 (P=0.006. The former had a significantly higher incidence of PTSD, anxiety, and sleep disorder. A subgroup of patients had normal sleep despite rising THI scores. Bilateral tinnitus, vertigo, and anxiety were found to be predictors of sleep disturbance. Conclusions. The ESS can be used as a tool in the initial assessment of sleep disorders in veterans with tinnitus. Higher tinnitus handicap severity is significantly associated with greater sleep disturbance. Optimal management of tinnitus may require concomitant treatment of sleep disorder, PTSD, anxiety, and depression.

  1. Theta, alpha and beta burst transcranial magnetic stimulation: brain modulation in tinnitus

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    Dirk De Ridder, Elsa van der Loo, Karolien Van der Kelen, Tomas Menovsky, Paul van de Heyning, Aage Moller

    2007-01-01

    Full Text Available Introduction: Some forms of tinnitus are considered to be auditory phantom phenomena related to reorganization and hyperactivity of the auditory central nervous system. Repetitive transcranial magnetic stimulation (rTMS is a non-invasive tool capable of modulating human brain activity, using single pulse or burst stimuli. Burst rTMS has only been performed in the theta range, and has not been used clinically. The authors analyze whether burst TMS at theta (5 Hz, alpha (10 Hz and beta (20 Hz frequencies can temporarily suppress narrow band noise/white noise tinnitus, which has been demonstrated to be intractable to tonic stimulation. Methods: rTMS is performed both in tonic and burst mode in 46 patients contralateral to the tinnitus side, at 5, 10 and 20 Hz. Fourteen placebo negative rTMS responders are further analyzed. Results: In 5 patients, maximal tinnitus suppression is obtained with theta, in 2 with alpha and in 7 with beta burst stimulation. Burst rTMS suppresses narrow band/white tinnitus much better than tonic rTMS t(13=6.4, p<.000. Women experience greater suppression of their tinnitus with burst stimulation than men, t(12=2.9, p<.05. Furthermore left sided tinnitus is perceived as more distressing on the TQ than right sided tinnitus, t(12=3.2, p<.01. The lower the tinnitus pitch the more effectively rTMS suppresses tinnitus(r=-0.65, p<0.05. Discussion: Burst rTMS can be used clinically, not only theta burst, but also alpha and beta burst. Burst rTMS is capable of suppressing narrow band/white noise tinnitus very much better than tonic rTMS. This could be due the simple fact that burst neuromodulation is more powerful than tonic neuromodulation or to a differential effect of burst and tonic stimulation on the lemniscal and extralemniscal auditory system. In some patients only alpha or beta burst rTMS is capable of suppressing tinnitus, and theta burst not. Therefore in future rTMS studies it could be worthwhile not to limit burst

  2. Ghrelin levels in chronic periodontitis patients.

    Science.gov (United States)

    Yılmaz, Gülin; Kırzıoğlu, Fatma Yeşim; Doğuç, Duygu Kumbul; Koçak, Havva; Orhan, Hikmet

    2014-01-01

    Ghrelin is a peptide hormone that has modulatory effects on the immune system. This study was designed to evaluate plasma ghrelin levels in patients with chronic periodontitis and to investigate if a relationship exists between ghrelin and periodontal parameters, serum cytokines, and bone turnover markers. Thirty-five chronic periodontitis patients (CP) and periodontal healthy individuals (C) were included in this study. Periodontal parameters were recorded. Blood samples were obtained to determine the levels of total and acylated ghrelin, interleukin-1 beta (IL-1β), tumor necrosis factor-alpha (TNF-α), the soluble receptor activator nuclear factor kappaB ligand (sRANKL), alkaline phosphatase (ALP), and osteocalcin (OSC). Plasma levels of total and acylated ghrelin were significantly elevated in the CP group compared with the C group (p periodontal parameters. Our results indicate an increase of total and acylated ghrelin levels in patients with chronic periodontitis. Further, studies in larger populations (which could include ghrelin levels in gingival tissue, gingival crevicular fluid, and saliva) are needed in order to confirm the role of ghrelin in periodontal disease.

  3. HBV Vaccination in Chronic Renal Failure Patients

    Directory of Open Access Journals (Sweden)

    Mir-davood Omrani

    2006-12-01

    Full Text Available HBV infection in chronic renal failure (CRF becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients. Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α| and interleukin (IL 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction. Moreover, human leukocyte antigen (HLA genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response. Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID administered second-generation S antigen vaccines. Both intramuscular (IM and intradermal (ID vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.

  4. Exercise for older patients with chronic disease.

    Science.gov (United States)

    Petrella, R J

    1999-10-01

    Coronary artery disease, hypertension, congestive heart failure, type 2 diabetes mellitus, osteoarthritis, osteoporosis, and cognitive disorders become more prevalent as people age. Besides delaying the onset of many of these conditions, regular exercise may improve function and delay disability and morbidity in those who have them. Further, exercise may work synergistically with medication to combat the effects of some chronic diseases. Special adaptations for older patients include lower-intensity exercise (eg, fewer repetitions), low-impact exercise (cycling, exercise while sitting), and modified equipment (smaller weights, special shoes, loose clothing). Unresolved issues include development of optimal strategies for motivating older patients to begin and maintain exercise programs.

  5. Does the location of a vascular loop in the cerebellopontine angle explain pulsatile and non-pulsatile tinnitus?

    Energy Technology Data Exchange (ETDEWEB)

    Nowe, V.; Wang, X.L.; Gielen, J.; Goethem, J.Van; Oezsarlak, Oe.; De Schepper, A.M.; Parizel, P.M. [University of Antwerp, Department of Radiology, Edegem (Belgium); Ridder, D. De [University of Antwerp, Department of Neurosurgery, Edegem (Belgium); Heyning, P.H.Van de [University of Antwerp, Department of Otorhinolaryngology, Edegem (Belgium)

    2004-12-01

    The purpose was to investigate patients with unexplained pulsatile and non-pulsatile tinnitus by means of MR imaging of the cerebellopontine angle (CPA) and to correlate the clinical subtype of tinnitus with the location of a blood vessel (in the internal auditory canal or at the cisternal part of the VIIIth cranial nerve). Clinical presentation of tinnitus and perceptive hearing loss were correlated. In 47 patients with unexplained tinnitus, an MR examination of the CPA was performed. Virtual endoscopy reconstructions were obtained using a 3D axial thin-section high-resolution heavily T2-weighted gradient echo constructive interference in steady state (CISS) data-set. High-resolution T2-weighted CISS images showed a significantly higher number of vascular loops in the internal auditory canal in patients with arterial pulsatile tinnitus compared to patients with non-pulsatile tinnitus (P<0.00001). Virtual endoscopy images were used to investigate vascular contacts at the cisternal part of the VIIIth cranial nerve in patients with low pitch and high pitch non-pulsatile tinnitus. A significantly different distribution of the vascular contacts (P=0.0320) was found. Furthermore, a correlation between the clinical presentation of non-pulsatile tinnitus (high pitch and low pitch) and the perceptive hearing loss was found (P=0.0235). High-resolution heavily T2-weighted CISS images and virtual endoscopy of the CPA can be used to evaluate whether a vascular contact is present in the internal auditory canal or at the cisternal part of the VIIIth cranial nerve and whether the location of the vascular contact correlates with the clinical subtype of tinnitus. Our findings suggest that there is a tonotopical structure of the cisternal part of the VIIIth cranial nerve. A correlation between the clinical presentation of tinnitus and hearing loss was found. (orig.)

  6. Perioperative management of the chronically anticoagulated patient.

    Science.gov (United States)

    Heit, J A

    2001-09-01

    Common indications for chronic anticoagulation include mechanical prosthetic heart valve, non-rheumatic atrial fibrillation, and venous thromboembolism. Perioperative management of the chronically anticoagulated patient is a complex medical problem, and includes the following issues: urgency of surgery, risk of thromboembolism in the absence of anticoagulation, bleeding risk, consequences of bleeding, ability to control bleeding physically, and duration of bleeding risk after the procedure. Most patients can be managed safely by stopping oral anticoagulants 4-5 days before surgery and restarting anticoagulation after the procedure at the patient's usual daily dose. In general, dental procedures and cataract extraction can be performed without interrupting anticoagulation. Most other procedures can be safely performed with an INR patients with double-wing prosthetic valves (e.g., St. Jude, Carbomedics) in the aortic position, uncomplicated atrial fibrillation, or a remote (>3 months) history of venous thromboembolism, oral anticoagulants can be stopped 4-5 days before surgery and restarted at the usual daily dose immediately after surgery. For other patients at higher risk of thrombosis, "bridging therapy" with outpatient low molecular weight heparin is safe and effective. For urgent procedures, a small dose of oral vitamin K usually will reduce the INR within 24-36 hours to a level sufficient for surgery and avoids exposure to transfused blood products.

  7. Is It Necessary to Do Temporal Bone Computed Tomography of the Internal Auditory Canal in Tinnitus with Normal Hearing?

    Directory of Open Access Journals (Sweden)

    Tolgar Lutfi Kumral

    2013-01-01

    Full Text Available Objective. To investigate the compression of the vestibulocochlear nerve in the etiology of the tinnitus in the normal hearing ears with temporal bone computed tomography scans. Methods. A prospective nonrandomized study of 30 bilateral tinnitus and 30 normal hearing patients enrolled in this study. Results. A total of 60 patients (ages ranged from 16 to 87 were included. The tinnitus group comprised 11 males and 19 females (mean age 49,50 ± 12,008 and the control group comprised 6 males and 24 females (mean age 39,47 ± 12,544. Regarding the right and left internal acoustic canals measurements (inlet, midcanal, and outlet canal lengths, there were no significant differences between the measurements of the control and tinnitus groups (P>0.005. There was no narrowness in the internal acoustic canal of the tinnitus group compared with the control group. High-frequency audiometric measurements of the right and left ears tinnitus group at 8000, 9000, 10000, 11200, 12500, 14000, 16000, and 18000 Hz frequencies were significantly lower than the control group thresholds (P<0.05. There was high-frequency hearing loss in the tinnitus group. Conclusion. There were no anatomical differences in the etiology of tinnitus rather than physiological degeneration in the nerves.

  8. [Bile composition in patients with chronic pancreatitis].

    Science.gov (United States)

    Dronov, O I; Koval's'ka, I O; Shvets', Iu P; Vesel's'kyĭ, S P

    2013-05-01

    There was investigated a hepatic bile in 50 persons, aged 35-58 years old, including 20--practically healthy persons (I group), 20 patients, suffering chronic fibrose-degenerative pancreatitis (CHFDP) without jaundice syndrome (II group) and 10 patients, suffering CHFDP with jaundice syndrome (III group). There were determined the contents of the bile acids, the lipids and electrolytic contents of bile. A trustworthy difference in the bile contents was registered in patients, suffering CHFDP with the jaundice syndrome and without it, comparing with such in healthy persons. This have had permitted to add the complex of medicinal preoperative preparation of these patients substantially, and to apply the electrolytes content of a bile to apply as an additional diagnostic marker.

  9. The Comparison of the Average Thresholds of Auditory Steady-State Response in Adult Subjective Idiopathic Tinnitus and Normal Subjects

    Directory of Open Access Journals (Sweden)

    Zahra Ghasem Ahmad

    2009-12-01

    Full Text Available Background and Aim: Tinnitus is a common symptom among lots of people but little is known about its origins. This study was aimed at comparing the Auditory Steady-State Response (ASSR thresholds in normal cases and patients with subjective idiopathic tinnitus (SIT in order to diagnose its real origins.Materials and Methods: This case-control study was conducted on 19 patients with tinnitus and 24 normal cases aged 18-40 yr.The patients underwent broad medical tests to roll out any background reason for their tinnitus. ASSR thresholds were estimated in both groups at 20 and 40 amplitude modulation. The patients were selected from tinnitus patients in Research Center in Hazrat Rasoul Hospital, Tehran, Iran.Results: The mean ASSR thresholds at 40HZ modulation were worse in tinnitus patients compared to normal ones (p<0.05 but no significant statistical differences was detected at 20HZ. These results were found in both situations in which we averaged both ears thresholds and when we estimated the thresholds of the ears separately.Conclusion: It seems that the origin of the responses of the modulation of 40Hz, primary auditory cortex, midbrain regions and subcortical areas, in these patients is involved or the origin of their tinnitus is related to some kind of problems in these areas, although more investigation is needed about 20Hz.

  10. Alterations in peripheral and central components of the auditory brainstem response: a neural assay of tinnitus.

    Directory of Open Access Journals (Sweden)

    Andrea S Lowe

    Full Text Available Chronic tinnitus, or "ringing of the ears", affects upwards of 15% of the adult population. Identifying a cost-effective and objective measure of tinnitus is needed due to legal concerns and disability issues, as well as for facilitating the effort to assess neural biomarkers. We developed a modified gap-in-noise (GIN paradigm to assess tinnitus in mice using the auditory brainstem response (ABR. We then compared the commonly used acoustic startle reflex gap-prepulse inhibition (gap-PPI and the ABR GIN paradigm in young adult CBA/CaJ mice before and after administrating sodium salicylate (SS, which is known to reliably induce a 16 kHz tinnitus percept in rodents. Post-SS, gap-PPI was significantly reduced at 12 and 16 kHz, consistent with previous studies demonstrating a tinnitus-induced gap-PPI reduction in this frequency range. ABR audiograms indicated thresholds were significantly elevated post-SS, also consistent with previous studies. There was a significant increase in the peak 2 (P2 to peak 1 (P1 and peak 4 (P4 to P1 amplitude ratios in the mid-frequency range, along with decreased latency of P4 at higher intensities. For the ABR GIN, peak amplitudes of the response to the second noise burst were calculated as a percentage of the first noise burst response amplitudes to quantify neural gap processing. A significant decrease in this ratio (i.e. recovery was seen only at 16 kHz for P1, indicating the presence of tinnitus near this frequency. Thus, this study demonstrates that GIN ABRs can be used as an efficient, non-invasive, and objective method of identifying the approximate pitch and presence of tinnitus in a mouse model. This technique has the potential for application in human subjects and also indicates significant, albeit different, deficits in temporal processing in peripheral and brainstem circuits following drug induced tinnitus.

  11. EEG oscillatory power dissociates between distress- and depression-related psychopathology in subjective tinnitus.

    Science.gov (United States)

    Meyer, Martin; Neff, Patrick; Grest, Angelina; Hemsley, Colette; Weidt, Steffi; Kleinjung, Tobias

    2017-03-14

    Recent research has used source estimation approaches to identify spatially distinct neural configurations in individuals with chronic, subjective tinnitus (TI). The results of these studies are often heterogeneous, a fact which may be partly explained by an inherent heterogeneity of/in the TI population and partly by the applied EEG data analysis procedure and EEG hardware. Hence this study was performed to re-enact a formerly published study (Joos et al., 2012) to better understand the reason for differences and overlap between studies from different labs. We re-investigated the relationship between neural oscillations and behavioral measurements of affective states in TI, namely depression and tinnitus-related distress by recruiting 45 TI who underwent resting-state EEG. Comprehensive psychopathological (depression and tinnitus-related distress scores) and psychometric data (including other tinnitus characteristics) were gathered. A principal component analysis (PCA) was performed to unveil independent factors that predict distinct aspects of tinnitus-related pathology. Furthermore, we correlated EEG power changes in the standard frequency bands with the behavioral scores for both the whole-brain level and, as a post hoc approach, for selected regions of interest (ROI) based on sLORETA. Behavioral data revealed significant relationships between measurements of depression and tinnitus-related distress. Notably, no significant results were observed for the depressive scores and modulations of the EEG signal. However, akin to the former study we evidenced a significant relationship between a power increase in the beta1-bands and tinnitus-related distress. In conclusion, it has emerged that depression and tinnitus-related distress, even though they are assumed not to be completely independent, manifest in distinct neural configurations.

  12. Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness - A Prospective Clinical Trial: Follow-Up.

    Directory of Open Access Journals (Sweden)

    Remo A G J Arts

    Full Text Available Earlier studies show that a Cochlear Implant (CI, capable of providing intracochlear electrical stimulation independent of environmental sounds, appears to suppress tinnitus at least for minutes. The current main objective is to compare the long-term suppressive effects of looped (i.e. repeated electrical stimulation (without environmental sound perception with the standard stimulation pattern of a CI (with environmental sound perception. This could open new possibilities for the development of a "Tinnitus Implant" (TI, an intracochlear pulse generator for the suppression of tinnitus.Ten patients with single sided deafness suffering from unilateral tinnitus in the deaf ear are fitted with a CI (MED-EL Corporation, Innsbruck, Austria. Stimulation patterns are optimized for each individual patient, after which they are compared using a randomized crossover design, with a follow-up of six months, followed by a 3 month period using the modality of patient's choice.Results show that tinnitus can be suppressed with intracochlear electrical stimulation independent of environmental sounds, even long term. No significant difference in tinnitus suppression was found between the standard clinical CI and the TI.It can be concluded that coding of environmental sounds is no requirement for tinnitus suppression with intracochlear electrical stimulation. It is therefore plausible that tinnitus suppression by CI is not solely caused by an attention shift from the tinnitus to environmental sounds. Both the standard clinical CI and the experimental TI are potential treatment options for tinnitus. These findings offer perspectives for a successful clinical application of the TI, possibly even in patients with significant residual hearing.TrialRegister.nl NTR3374.

  13. [Clinical integration in the chronic patient].

    Science.gov (United States)

    Carretero-Alcántara, Luis; Comes-Górriz, Natividad; Borrás-López, Agustina; Rodríguez-Balo, Alberto; Seara-Aguilar, Germán

    2014-01-01

    Castilla-La Mancha Health Service is developing the integration of care levels due to the challenge of an aging population in the region. Aging is associated with chronic diseases and an increasing number of concomitant diseases. This poses a major care challenge care, with more fragile patients and new needs. This also requires a sustainable approach: the concurrence of several chronic diseases affects the cost of care, which is especially acute in times of severe economic crisis. One of the pillars of the strategy for dealing with chronic diseases in our region is care integration, in an effort to adapt the organization to the new needs. The Balanced Scorecard or Integrated Scorecard of the integration process was introduced as it has been designed. The integration of primary and hospital care at an organizational level has already been completed, and the development of integrated care processes has also been performed in order to achieve real integration at care level. To help finance this, a prospective capitation system is gradually being implemented, achieving a convergence of per capita costs in the different health areas integrated. Nurses has a key role in this process, their skills as educators and trainers in self-care, in the role of case managers of patients with particularly complex conditions, and the role of professional liaison to improve the transition between care areas and units.

  14. Characteristics and Spontaneous Recovery of Tinnitus Related to Idiopathic Sudden Sensorineural Hearing Loss

    OpenAIRE

    Mühlmeier, Guido; Baguley, David; Cox, Tony; Suckfüll, Markus; De Meyer, Thomas

    2016-01-01

    Objective: To evaluate the characteristics and spontaneous recovery of tinnitus related to idiopathic sudden sensorineural hearing loss (ISSNHL). Study Design: Retrospective analysis from two randomized placebo-controlled clinical trials for treatment of ISSNHL within 48 hours from onset (Study A), or of tinnitus related to ISSNHL within 3 months from onset (Study B). Setting: Forty-eight European sites (academic tertiary referral centers, private ENT practices). Patients: One hundred thirtee...

  15. Hearing aids and tinnitus--an experimental group study.

    Science.gov (United States)

    Melin, L; Scott, B; Lindberg, P; Lyttkens, L

    1987-05-01

    From a waiting list consisting of hearing-impaired patients waiting for hearing aids to be fitted, 39 subjects who at interview also stated that they had tinnitus took part in an experimental group study with the aim of investigating the effect of a hearing aid on tinnitus. No subject had any previous experience of hearing aids. The subjects were randomly allocated to a treatment and a waiting list control group. After an initial interview, the routine programme for the fitting of hearing aids started in the treatment group, while the waiting list control group had to wait for 6 weeks before starting the same hearing aid rehabilitation programme. The hearing aids were fitted exclusively for hearing purposes. As expected, the hearing aids improved the hearing capacity, but they did not reduce tinnitus as recorded on a visual analogue scale. According to information obtained at the final interview, there were significant differences in tinnitus between subjects who used their aid for more than 2 hours daily and those who used it for less than 2 hours. However, the results of scaling (pre- and post-fitting) did not support this finding. The discrepancy between the scaling and interview data is probably due to demand characteristics.

  16. 分析护理干预对老年性聋伴耳鸣患者心理状态及疗效的影响%To Analyze the Effect of Nursing Intervention on Mental State and Curative Effect of Elderly Patients With Hearing Loss and Tinnitus

    Institute of Scientific and Technical Information of China (English)

    梁亚琴

    2016-01-01

    Objective To analyze the effect of nursing intervention on mental state and curative effect of elderly patients with deafness and tinnitus. Methods 120 cases of elderly patients with deafness were randomly divided into observation group and control group. The observation group of 60 cases, including 51 cases of tinnitus, 60 cases of the control group, including 46 cases of tinnitus. The two groups received the same treatment, the observation group on the basis of drug treatment, the implementation of nursing intervention therapy. Results Compared with the control group, there were signiifcant differences in anxiety and depression state and tinnitus symptoms (P<0.05). Conclusion Nursing intervention has a good effect on the psychological state and treatment of elderly patients with tinnitus.%目的分析护理干预对老年性聋伴耳鸣患者心理状态及疗效的影响。方法选择老年性聋患者120例,随即分为观察组和对照组。其中观察组60例患者,其中耳鸣51例;对照组60例患者,其中耳鸣46例。两组均接受相同的治疗;观察组在药物治疗基础上实施护理干预疗法。结果治疗组与对照组焦虑抑郁状态差异均有统计学意义(P<0.05)。结论护理干预对老年性聋伴耳鸣患者心理状态及治疗有较好辅助作用。

  17. [Hyperinsulinemia in vertigo, tinnitus and hearing loss].

    Science.gov (United States)

    Doroszewska, Grazyna; Kaźmierczak, Henryk

    2002-01-01

    48 patients (25 woman, mean age 42 +/- 9.9 years and 23 men, mean age 46.6 +/- 8.3 years) suffering from vertigo, tinnitus and hearing loss of unknown origin were included into this study. The occurrence and coexistence of symptoms was measured. Insulin levels were measured fasting and at the second hour of OGTT. Results were compared with the control group of 31 healthy persons (16 women, mean age 41.3 +/- 5.6 years and 15 men, mean age 47.6 +/- 9.4 years). The character of vertigo, localization of hearing loss and electronystagmographic findings showed the pathology of the inner ear. The occurrence of hyperinsulinemia was significantly more common in the patients group--43.8%, comparing to the control group--22.6%. Also the insulin levels in the second hour of OGTT, were statistically significantly higher in patients that in the control group.

  18. Investigating the association between tinnitus severity and symptoms of depression and anxiety, while controlling for neuroticism, in a large middle-aged UK population

    OpenAIRE

    McCormack, Abby; Edmondson-Jones, Mark; Fortnum, Heather; Dawes, Piers D; Middleton, Hugh; Kevin J. Munro; Moore, David R.

    2015-01-01

    Abstract Objective: Clinical studies indicate increased risk for depression and anxiety among tinnitus patients. However population data are scarce, and no studies have controlled for neuroticism. We examined associations between tinnitus and symptoms of depression and anxiety in a large UK population, controlling for neuroticism, to explore whether neuroticism, as previously reported, fully explains the association between symptoms of depression and anxiety, and tinnitus. Design: We used the...

  19. Risk of chronic anxiety in implantable defibrillator patients

    DEFF Research Database (Denmark)

    Pedersen, Susanne S.; den Broek, Krista C van; Theuns, Dominic A M J

    2011-01-01

    Little is known about the prevalence of chronic anxiety in patients with an implantable cardioverter defibrillator (ICD). In a multi-center, prospective study, we examined 1) the prevalence of chronic anxiety (i.e., patients anxious at implantation and 12 months), and 2) predictors of chronic...... anxiety....

  20. Neurodegenerative Properties of Chronic Pain: Cognitive Decline in Patients with Chronic Pancreatitis

    NARCIS (Netherlands)

    Jongsma, M.L.A.; Postma, S.A.E.; Souren, P.M.; Arns, M.W.; Gordon, E.; Vissers, K.C.P.; Wilder-Smith, O.H.G.; Rijn, C.M. van; Goor, H. van

    2011-01-01

    Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance),

  1. [Telemedicine for patients with chronic intestinal failure].

    Science.gov (United States)

    Nauta, Sjoukje; Feibig, Doreen; Wanten, Geert

    2014-01-01

    Telemedicine is a valuable extension of the ways in which patients with chronic diseases can be contacted. Patients can easily contact their caregivers within the safe environment of the digital waiting room. Telemedicine especially offers an advantage for those forms of care where the visual aspect is important. Care should be taken with respect to its implementation into the disease management process with careful synchronisation between all involved parties, e.g. patient, caregiver, and organisation. The effectiveness of telemedicine and the savings that can be achieved should be properly established in order to justify the funding of a telemedicine project. Rather than focusing on the possible drawbacks of telemedicine, e.g. safety concerns and the user-friendliness of the system, we should highlight the possibilities that information technology offers.

  2. Hemorheological Alteration in Patients Clinically Diagnosed with Chronic Liver Diseases.

    Science.gov (United States)

    Jang, Bohyun; Han, Ji Won; Sung, Pil Soo; Jang, Jeong Won; Bae, Si Hyun; Choi, Jong Young; Cho, Young I; Yoon, Seung Kew

    2016-12-01

    Since liver function is changed by chronic liver diseases, chronic liver disease can lead to different hemorheological alterations during the course of the progression. This study aims to compare alterations in whole blood viscosity in patients with chronic liver disease, focusing on the gender effect. Chronic liver diseases were classified into three categories by patient's history, serologic markers, and radiologic findings: nonalcoholic fatty liver disease (NAFLD) (n = 63), chronic viral hepatitis B and C (n = 50), and liver cirrhosis (LC) (n = 35). Whole blood viscosity was measured by automated scanning capillary tube viscometer, while liver stiffness was measured by transient elastography using FibroScan®. Both systolic and diastolic whole blood viscosities were significantly lower in patients with LC than NAFLD and chronic viral hepatitis (P chronic viral hepatitis. Our data suggest that whole blood viscosity test can become a useful tool for classifying chronic liver disease and determining the prognosis for different types of chronic liver diseases.

  3. 77 FR 59929 - Guidance for Industry on Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With...

    Science.gov (United States)

    2012-10-01

    ... treatment of acute bacterial exacerbations of chronic bronchitis in patients with chronic obstructive... Bacterial Exacerbations of Chronic Bronchitis-- Developing Antimicrobial Drugs for Treatment'' published in... Chronic Bronchitis in Patients With Chronic Obstructive Pulmonary Disease: Developing Antimicrobial...

  4. Endovascular treatment of jugular bulb diverticula causing debilitating pulsatile tinnitus.

    Science.gov (United States)

    Mortimer, Alex M; Harrington, Tim; Steinfort, Brendan; Faulder, Ken

    2016-03-01

    We describe the case of a patient who presented with debilitating pulsatile tinnitus in association with two jugular bulb diverticula. The diverticula were treated with stenting of the jugular bulb and coil embolization of the diverticula over two procedures. This resulted in successful resolution of symptoms and at 10 months follow-up the patient is asymptomatic. The technique is discussed with regard to similar published cases and surrogate measures of safety taken from the literature pertaining to idiopathic intracranial hypertension.

  5. A fatal encephalopathy in chronic haemodialysis patients.

    Science.gov (United States)

    Burks, J S; Alfrey, A C; Huddlestone, J; Norenberg, M D; Lewin, E

    1976-04-10

    A distinct neurological syndrome in twelve chronic haemodialysis patients is described. This syndrome is currently the leading cause of death in one Denver dialysis unit. The hallmarks of this syndrome are progressive speech difficulties, mental changes, and a markedly abnormal electroencephalogram which may be present months before the clinical signs appear. Additional clinical features including seizures, myoclonus, asterixis, apraxia, focal neurological signs, and psychiatric symptoms may also be observed. Neuropathological changes are slight and non-specific. The aetiology of this syndrome is unknown but the clinical and pathological features suggest a toxic/metabolic disorder. To date, this disorder has been refractory to several therapeutic measures.

  6. Sympathetic hyperactivity in patients with chronic kidney disease

    NARCIS (Netherlands)

    Neumann, N.

    2007-01-01

    Sympathetic hyperactivity in patients with chronic kidney disease Chronic kidney disease (CKD) is often characterized by the presence of sympathetic hyperactivity. This contributes to the pathogenesis of renal hypertension. It is also associated with cardiovascular (CV) morbidity and mortality indep

  7. Telehomecare for patients with multiple chronic illnesses

    Science.gov (United States)

    Liddy, Clare; Dusseault, Joanne J.; Dahrouge, Simone; Hogg, William; Lemelin, Jacques; Humber, Jennie

    2008-01-01

    OBJECTIVE To examine the feasibility and efficacy of integrating home health monitoring into a primary care setting. DESIGN A mixed method was used for this pilot study. It included in-depth interviews, focus groups, and surveys. SETTING A semirural family health network in eastern Ontario comprising 8 physicians and 5 nurses caring for approximately 10 000 patients. PARTICIPANTS Purposeful sample of 22 patients chosen from the experimental group of 120 patients 50 years old or older in a larger randomized controlled trial (N = 240). These patients had chronic illnesses and were identified as being at risk based on objective criteria and physician assessment. INTERVENTIONS Between November 2004 and March 2006, 3 nurse practitioners and a pharmacist installed telehomecare units with 1 or more peripheral devices (eg, blood-pressure monitor, weight scale, glucometer) in patients’ homes. The nurse practitioners incorporated individualized instructions for using the unit into each patient’s care plan. Patients used the units every morning for collecting data, entering values into the system either manually or directly through supplied peripherals. The information was transferred to a secure server and was then uploaded to a secure Web-based application that allowed care providers to access and review it from any location with Internet access. The devices were monitored in the office on weekdays by the nurse practitioners. MAIN OUTCOME MEASURES Acceptance and use of the units, patients’ and care providers’ satisfaction with the system, and patients’ demographic and health characteristics. RESULTS All 22 patients, 12 men and 10 women with an average age of 73 years (range 60 to 88 years), agreed to participate. Most were retired, and a few were receiving community services. Common diagnoses included hypertension, diabetes, cardiovascular disease, and chronic obstructive pulmonary disease. All patients had blood pressure monitors installed, 11 had wired weight

  8. High-quality chronic care delivery improves experiences of chronically ill patients receiving care

    NARCIS (Netherlands)

    J.M. Cramm (Jane); A.P. Nieboer (Anna)

    2013-01-01

    markdownabstract__Abstract__ Objective. Investigate whether high-quality chronic care delivery improved the experiences of patients. Design. This study had a longitudinal design. Setting and Participants. We surveyed professionals and patients in 17 disease management programs targeting patients wi

  9. Ginkgo biloba extract in the treatment of tinnitus: a systematic review

    Directory of Open Access Journals (Sweden)

    von Boetticher A

    2011-07-01

    Full Text Available Alexander von BoetticherEar, Nose and Throat Surgery, Lueneburg, GermanyAbstract: Tinnitus is a symptom frequently encountered by ear, nose, and throat practitioners. A causal treatment is rarely possible, and drug and nondrug treatment options are limited. One of the frequently prescribed treatments is Ginkgo biloba extract. Therefore, randomized, placebo-controlled clinical trials of Ginkgo biloba extract preparations were searched for and reviewed systematically. There is evidence of efficacy for the standardized extract, EGb 761® (Dr Willmar Schwabe GmbH & Co KG Pharmaceuticals, Karlsruhe, Germany, in the treatment of tinnitus from three trials in patients in whom tinnitus was the primary complaint. Supportive evidence comes from a further five trials in patients with age-associated cognitive impairment or dementia in whom tinnitus was present as a concomitant symptom. As yet, the efficacy of other ginkgo preparations has not been proven, which does not necessarily indicate ineffectiveness, but may be due to flawed clinical trials. In conclusion, EGb 761®, a standardized Ginkgo biloba extract, is an evidence-based treatment option in tinnitus.Keywords: tinnitus, Ginkgo biloba, EGb 761®, systematic review

  10. The Effectiveness of Hypnotherapy in Treating Depression, Anxiety and Sleep Disturbance Caused by Subjective Tinnitus

    Directory of Open Access Journals (Sweden)

    Seyed Mahmoud Mirzamani

    2012-09-01

    Full Text Available Background: Patients with tinnitus encounter many problems, including depression, anxiety, insomnia, increased sensitivity to sound, and negativity. The aim of this study was to evaluate the efficacy of hypnotherapy on the depression, anxiety, and insomnia caused by tinnitus. Materials and Methods: This study was a pilot research with a pretest-posttest and control design. The statistical population included individuals who suffered from tinnitus and its associated symptoms. Twenty patients with tinnitus were selected through available sampling. The subjects were divided randomly into two experimental and control groups. Both groups completed the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and the Pittsburgh Sleep Quality Index in both pretest and post-test phases. Only the experimental group received 10 sessions of hypnotherapy. In this study, independent and dependent t-tests were used to obtain the data.Results: The two groups were similar in terms of tinnitus severity and age range. The results of independent and dependent t-tests at p=0.05 level in all three variables of depression, anxiety, and insomnia showed a significant difference between the scores of pretest and post-test as well as the post-test scores of control and experimental groups.Conclusion: The results indicated the effectiveness and usefulness of hypnotherapy in the reduction and treatment of the depression, anxiety, and insomnia caused by tinnitus in the experimental group.

  11. Acupuncture for the treatment of tinnitus: a systematic review of randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Kim Jong-In

    2012-07-01

    Full Text Available Abstract Background Complementary and alternative medicine (CAM has frequently been used to treat tinnitus, and acupuncture is a particularly popular option. The objective of this review was to assess the evidence concerning the effectiveness of acupuncture as a treatment for tinnitus. Methods Fourteen databases were searched from the dates of their creation to July 4th, 2012. Randomized clinical trials (RCTs were included if acupuncture was used as the sole treatment. The Cochrane risk of bias tool was used to assess the risk of bias. Results A total of 9 RCTs met all the inclusion criteria. Their methodological quality was mostly poor. Five RCTs compared the effectiveness of acupuncture or electroacupuncture with sham acupuncture for treating tinnitus. The results failed to show statistically significant improvements. Two RCTs compared a short one-time scalp acupuncture treatment with the use of penetrating sham acupuncture at non-acupoints in achieving subjective symptom relief on a visual analog scale; these RCTs demonstrated significant positive effects with scalp acupuncture. Two RCTs compared acupuncture with conventional drug treatments. One of these RCTs demonstrated that acupuncture had statistically significant effects on the response rate in patients with nervous tinnitus, but the other RCT did not demonstrate significant effects in patients with senile tinnitus. Conclusions The number, size and quality of the RCTs on the effectiveness of acupuncture for the treatment of tinnitus are not sufficient for drawing definitive conclusions. Further rigorous RCTs that overcome the many limitations of the current evidence are warranted.

  12. Complement defects in patients with chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Gaunsbaek, Maria Quisgaard; Lange, Bibi; Kjeldsen, Anette D;

    2012-01-01

    The complement system is an important part of our immune system, and complement defects lead generally to increased susceptibility to infections and autoimmune diseases. We have studied the role of complement activity in relation with chronic rhinosinusitis (CRS), and more specifically studied...... whether complement defects collectively predispose individuals for CRS or affect CRS severity. The participants comprised 87 CRS patients randomly selected from the general population, and a control group of 150 healthy blood donors. The CRS patients were diagnosed according to the European Position Paper...... on Rhinosinusitis and nasal Polyps criteria, and severity was evaluated by the Sino-nasal Outcome Test-22. Serum samples were analysed by ELISA for activity of the respective pathways of complement, and subsequently for serum levels of relevant components. We found that the frequency of complement defects...

  13. The Effectiveness of Hearing Aids in the Treatment for Tinnitus Patients with Sensorineural Hearing Loss%配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的临床初探

    Institute of Scientific and Technical Information of China (English)

    徐万红; 向阳红; 邓安春; 刘庆顺

    2013-01-01

      目的探讨配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的临床疗效.方法根据入组时的听力图类型将56名伴有感音神经性听力减退的耳鸣患者分为平坦型、上升型、下降型和切迹型4组,采用耳鸣残疾评估量表评估其配戴助听器前后耳鸣的变化程度,了解配戴助听器治疗伴有感音神经性听力减退的耳鸣患者的疗效.结果配戴助听器半年后,耳鸣情况得到改善,无论从THI总体得分,还是分别从功能性、情感性、严重性三个方面的评分来看,配戴助听器后均有明显改善(P0.05).结论配戴助听器对部分伴有感音神经性听力减退的耳鸣患者有效.%Objective To study the efficacy of the application of hearing aids to the treatment of tinnitus patients with sensorineural hearing loss. Methods The tinnitus patients were divided into 4 groups according to the audiometric curve types: flat, ascending, descending and notched. The Tinnitus Handicap Inventory (THI) was used to assess the tinnitus degrees of the patients. Results Half a year after wearing hearing aids, the tinnitus of the patients was significantly reduced according to the total THI scores or functional, emotional and catastrophic scores(P0.05). Conclusion Appropriate hearing aids are effective in the treatment for some tinnitus patients with sensorineural hearing loss.

  14. Invasive Aspergillus infections in hospitalized patients with chronic lung disease

    Directory of Open Access Journals (Sweden)

    Wessolossky M

    2013-05-01

    Full Text Available Mireya Wessolossky,1 Verna L Welch,2 Ajanta Sen,1 Tara M Babu,1 David R Luke21Division of Infectious Diseases, University of Massachusetts Medical School, Worcester, MA, USA; 2Medical Affairs, Pfizer Inc, Collegeville, PA, USABackground: Although invasive pulmonary aspergillosis (IPA is more prevalent in immunocompromised patients, critical care clinicians need to be aware of the occurrence of IPA in the nontraditional host, such as a patient with chronic lung disease. The purpose of this study was to describe the IPA patient with chronic lung disease and compare the data with that of immunocompromised patients.Methods: The records of 351 patients with Aspergillus were evaluated in this single-center, retrospective study for evidence and outcomes of IPA. The outcomes of 57 patients with chronic lung disease and 56 immunocompromised patients were compared. Patients with chronic lung disease were defined by one of the following descriptive terms: emphysema, asthma, idiopathic lung disease, bronchitis, bronchiectasis, sarcoid, or pulmonary leukostasis.Results: Baseline demographics were similar between the two groups. Patients with chronic lung disease were primarily defined by emphysema (61% and asthma (18%, and immunocompromised patients primarily had malignancies (27% and bone marrow transplants (14%. A higher proportion of patients with chronic lung disease had a diagnosis of IPA by bronchoalveolar lavage versus the immunocompromised group (P < 0.03. The major risk factors for IPA were found to be steroid use in the chronic lung disease group and neutropenia and prior surgical procedures in the immunocompromised group. Overall, 53% and 69% of chronic lung disease and immunocompromised patients were cured (P = 0.14; 55% of chronic lung patients and 47% of immunocompromised patients survived one month (P = 0.75.Conclusion: Nontraditional patients with IPA, such as those with chronic lung disease, have outcomes and mortality similar to that in the

  15. Substance P and Chronic Pain in Patients with Chronic Inflammation of Connective Tissue.

    Directory of Open Access Journals (Sweden)

    Barbara Lisowska

    Full Text Available Evidence suggests that substance P (SP is involved in chronic joint inflammation, such as the pathogenesis of rheumatoid arthritis and osteoarthritis. The goal of the research was to evaluate the correlation between chronic pain and changes in the SP level in patients with chronic inflammation of the connective tissue.Patients with osteoarthritis and rheumatoid arthritis were enrolled in this study. The relationship between chronic pain intensity and the serum SP concentration was evaluated in these groups of patients with osteoarthritis and rheumatoid arthritis.The results showed a positive correlation between the serum SP concentrations and chronic pain intensity.1. The SP serum concentration was significantly different between the groups of patients with OA and RA. 2. There was a positive correlation between the serum SP concentration and chronic pain intensity in OA and RA patients.

  16. Complement defects in patients with chronic rhinosinusitis.

    Directory of Open Access Journals (Sweden)

    Maria Q Gaunsbaek

    Full Text Available The complement system is an important part of our immune system, and complement defects lead generally to increased susceptibility to infections and autoimmune diseases. We have studied the role of complement activity in relation with chronic rhinosinusitis (CRS, and more specifically studied whether complement defects collectively predispose individuals for CRS or affect CRS severity. The participants comprised 87 CRS patients randomly selected from the general population, and a control group of 150 healthy blood donors. The CRS patients were diagnosed according to the European Position Paper on Rhinosinusitis and nasal Polyps criteria, and severity was evaluated by the Sino-nasal Outcome Test-22. Serum samples were analysed by ELISA for activity of the respective pathways of complement, and subsequently for serum levels of relevant components. We found that the frequency of complement defects was significantly higher among CRS patients than among healthy control subjects. A majority of Mannan-binding lectin deficient CRS patients was observed. The presence of complement defects had no influence on the severity of subjective symptoms. Our studies show that defects in the complement system collectively may play an immunological role related to the development of CRS. However, an association between severity of symptoms and presence of complement defects could not be demonstrated.

  17. Psychometric properties of the Persian version of the Tinnitus Handicap Inventory (THI-P

    Directory of Open Access Journals (Sweden)

    Mir Mohammad Jalali

    2015-03-01

    Full Text Available Introduction: Tinnitus can have a significant effect on an individual’s quality of life, and is very difficult quantify. One of the most popular questionnaires used in this area is the Tinnitus Handicap Inventory (THI. The aim of this study was to determine the reliability and validity of a Persian translation of the Tinnitus Handicap Inventory (THI-P.   Materials and Methods: This prospective clinical study was performed in the Otolaryngology Department of Guilan University of Medical Sciences, Iran. A total of 102 patients aged 23–80 years with tinnitus completed the (THI-P. The patients were instructed to complete the Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI. Audiometry was performed. Eight-five patients were asked to complete the THI-P for a second time 7–10 days after the initial interview. We assessed test–retest reliability and internal reliability of the THI-P. Validity was assessed by analyzing the THI-P of patients according to their age, tinnitus duration and psychological distress (BDI and STAI. A factor analysis was computed to verify if three subscales (functional, emotional, and catastrophic represented three distinct variables.   Results: Test–retest correlation coefficient scores were highly significant. The THI-P and its subscales showed good internal consistency reliability (α = 0.80 to 0.96. High-to-moderate correlations were observed between THI-P and psychological distress and tinnitus symptom ratings. A confirmatory factor analysis failed to validate the three subscales of THI, and high inter-correlations found between the subscales question whether they represent three distinct factors. Conclusion:  The results suggest that the THI-P is a reliable and valid tool which can be used in a clinical setting to quantify the impact of tinnitus on the quality of life of Iranian patients.

  18. Association of tinnitus and hearing loss in otological disorders: a decade-long epidemiological study in a South Indian population

    Directory of Open Access Journals (Sweden)

    Santoshi Kumari Manche

    Full Text Available Abstract Introduction: Tinnitus is a common disorder that occurs frequently across all strata of population and has an important health concern. Tinnitus is often associated with different forms of hearing loss of varying severity. Objective: The present study aimed to identify the association of tinnitus with hearing loss in various otological disorders of a South Indian population. Methods: A total of 3255 subjects referred to the MAA ENT Hospital, Hyderabad, from 2004 to 2014, affected with various otological diseases have been included in the present cross-sectional study. Diagnosis of the diseases was confirmed by an ear, nose, and throat (ENT specialist using detailed medical and clinical examination. Statistical analysis was performed using the χ 2 test and binary logistic regression. Results: Tinnitus was observed in 29.3% (956 of the total study subjects that showed an increased prevalence in greater than 40 years of age. There was a significant increase in risk of tinnitus with middle (OR = 1.79, 95% CI = 1.02-3.16 and inner (OR = 3.00, 95% CI = 1.65-5.45 inner ear diseases. It was noted that 96.9% (n = 927 of the tinnitus subjects was associated with hearing loss. Otitis media (60.9%, presbycusis (16.6% and otosclerosis (14.3% are the very common otological disorders leading to tinnitus. Tinnitus was significantly associated with higher degree of hearing loss in chronic suppurative otitis media (CSOM subjects. Conclusion: The present study could identify the most prevalent otological risk factors leading to development of tinnitus with hearing loss in a South Indian population.

  19. Chronic aseptic meningitis in a patient with systemic lupus erythematosus.

    Science.gov (United States)

    Lancman, M E; Mesropian, H; Granillo, R J

    1989-08-01

    Chronic aseptic meningitis is a rare manifestation of systemic lupus erythematosus. It may occur early in the course of the disease and sometimes may be the initial symptom. We report a patient with chronic aseptic meningitis associated with systemic lupus erythematosus. Magnetic resonance imaging showed several ischemic lesions and an appearance which was compatible with chronic inflammation of the ependyma of the lateral ventricles.

  20. Association between otalgia, tinnitus, vertigo and hypoacusia, with temporomandibular disorders

    OpenAIRE

    Francisco Guedes Pereira de Alencar Junior; Sabrina Pavan; Karin Hermana Neppelenbroek; Vanessa Migliorini Urban; Janaina Habib Jorge; Hércules Jorge Almilhati

    2009-01-01

    Because nonespecific symptoms and signs are associated with others well-established in the temporomandibular disorders, it is difficult for the clinician to decide what symptoms and signs should be considered during the diagnosis and the treatment plan. Therefore, the aim of this literature review was to evaluate the prevalence of aural symptoms (otalgias, tinnitus, dizziness and deafness) in patients with orofacial pain. Although several hypotheses have been proposed to explain the associati...

  1. Assessment of distress associated with tinnitus.

    NARCIS (Netherlands)

    Veen, E.D. van; Jacobs, J.B.; Bensing, J.M.

    1998-01-01

    This paper focuses upon the quality of the Dutch translation of the STSS (Subjective Tinnitus Severity Scale), a scale which assesses the severity of tinnitus and the related distress. Research has been done on the psychometric qualities of this scale, its relationship with loudness-matching procedu

  2. [Cerebral arachnoiditis in patients with chronic rhinosinusitis].

    Science.gov (United States)

    Gushchin, A N

    1994-01-01

    The examination and treatment of 66 patients with rhinosinusogenic cerebral arachnoiditis (RCA) were performed using otorhinolaryngological and neurological tests with special emphasis on pneumoencephalography to provide objective assessment of the brain layers and ventricles. It is shown that RCA occurs most frequently in subjects suffering from chronic purulent axillary sinusitis or recurrent polysinusitis. RCA manifestations depend on the duration of rhinosinusitis and its recurrence rate. RCA onset is usually not acute and takes place at the time of rhinosinusitis exacerbation. There are also mild frontal headaches, pathological changes in the coats of the anterior cranial fossa. The above abnormalities were most pronounced at the side of rhinosinusitis or most affected sinus. The treatment should be first of all oriented on elimination of maxillary infection in line with pathogenetic treatment of RCA. An individual approach to treatment policy is advocated.

  3. The role of “on demand” therapist guidance vs. no support in the treatment of tinnitus via the internet: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Julia Rheker

    2015-05-01

    Conclusions: The iCBT self-help program is a good treatment option for tinnitus sufferers whether or not support-on-demand is provided. Furthermore, our results show the importance of outcome expectations to the efficacy of iCBT in tinnitus patients. Future research should focus on discovering further predictors of treatment outcome.

  4. Effect of social support intervention on the anxiety and depression status of patients with tinnitus%社会支持干预对耳鸣患者焦虑及抑郁状况的影响

    Institute of Scientific and Technical Information of China (English)

    金伟; 侯军华; 程雪; 郭莹

    2009-01-01

    Objective To study the effect of social support intervention on anxiety and depression of patients with tinnitus, in order to provide a theoretical basis for the clinical nursing for the patients. Methods A questionnaire was performed using serf-rating anxiety scale (SAS), self-rating depression scale (SDS) and social support rating scale (SSRS) in 60 tinnitus cases. These cases were randomly divided into a control group and an intervention group. The effective intervention of social support was given to the intervention group. The influence of social support on the anxiety and depression status was compared. Results For patients with tinnitus, the score of depression was negatively correlated with the score of total social support and the availabihty of social support (P<0.05). Compared with the control group, the scores of anxiety and depression were reduced after an effective social support intervention was given to the intervention group (P<0. 05). Conclusions The social support of the tinnitas patients obtained from the society is closely related to the depression state. And the effective social support has a positive effect in reducing the negative emotions of anxiety and depression.%目的 探讨社会支持干预对耳鸣患者焦虑及抑郁状况的影响,为护理耳鸣患者提供理论依据.方法 对60例耳鸣住院患者采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、社会支持评定量表(SSRS)进行问卷调查,并随机分为对照组和干预组各30例,对干预组患者的焦虑、抑郁状况进行有效的社会支持,比较社会支持对患者焦虑、抑郁状况的影响.结果 耳鸣患者抑郁得分与社会支持总分、社会支持利用度呈负相关(P<0.05);干预组给予有效的社会支持后焦虑、抑郁得分降低,与对照组比较差异有统计学意义(P<0.05).结论 耳鸣患者获得社会支持与抑郁状况关系密切,有效的社会支持对减少焦虑、抑郁负面情绪有积极的作用.

  5. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E;

    2012-01-01

    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...... with opioids....

  6. Burnout in Patients with Chronic Whiplash-Associated Disorders

    Science.gov (United States)

    Clementz, Gunilla; Borsbo, Bjorn; Norrbrink, Cecilia

    2012-01-01

    This study sought to assess burnout and its relation to pain, disability, mood and health-related quality of life in a group of patients with chronic whiplash-associated disorders (WAD). Forty-five patients with chronic WAD ([greater than or equal to] 3 months) referred to a multidisciplinary rehabilitation centre were included. A questionnaire…

  7. Patients with chronic pancreatitis are at increased risk for osteoporosis.

    LENUS (Irish Health Repository)

    Duggan, SN

    2012-10-01

    Patients with chronic pancreatitis may be at an increased risk of low bone density because of malabsorption of vitamin D and calcium, poor diet, pain, alcoholism, and smoking. We investigated the rates of osteoporosis in patients with chronic pancreatitis compared to matched controls.

  8. Electrophysiology quantitative electroencephalography/low resolution brain electromagnetic tomography functional brain imaging (QEEG LORETA): Case report: Subjective idiopathic tinnitus - predominantly central type severe disabling tinnitus.

    Science.gov (United States)

    Shulman, Abraham; Goldstein, Barbara

    2014-01-01

    The clinical significance of QEEG LORETA data analysis performed sequentially within 6 months is presented in a case report of a predominantly central type severe disabling subjective idiopathic tinnitus (SIT) before and following treatment. The QEEG LORETA data is reported as Z-scores of z = ± 2.54, p Loreta source localization non auditory ROI Images at the maximal abnormality in the very narrow band frequency spectra (24.21 Hz), showed the mathematically most probable underlying sources of the scalp recorded data to be greatest in the mid-cingulate, bilateral precuneus, cingulate and the bilateral caudate nucleus. Clinical correlation of the data with the history and course of the SIT is considered an objective demonstration of the affect, behavioral, and emotional component of the SIT. The correlation of the caudate activity, SIT as the traumatic event with the clinical course of PTSD, and the clinical diagnosis of PTSD is discussed. The clinical translation for patient care is highlighted in a SIT patient with multiple comorbidities by translation of QEEG/LORETA electrophysiologic data, as an adjunct to: provide an objectivity of patterns of brain wave activity in multiple regions of interest (ROIs) reflecting multiple brain functions, in response to and in the presence of the tinnitus signal, recorded from the scalp and analyzed with the metrics of absolute power, relative power, asymmetry, and coherence, for the subjective tinnitus complaint (SIT); 2) provide an increase in the accuracy of the tinnitus diagnosis; 3) assess/monitor treatment efficacy; 4) provide a rationale for selection of a combined tinnitus targeted therapy of behavioral, pharmacologic, sound therapy modalities of treatment attempting tinnitus relief; 5) provide insight into the medical significance of the SIT; 6) attempt discriminant function analysis for identification of a particular diagnostic clinical category of CNS neuropsychiatric disease; and 7) attempt to translate what is known

  9. Effect of cognitive nursing intervention in improving anxiety and depression in patients with tinnitus%认知护理干预对耳鸣患者焦虑抑郁情绪的影响

    Institute of Scientific and Technical Information of China (English)

    张中华; 刘庭惠; 邓莹莹; 张松志

    2013-01-01

    Objective To discuss the effect of cognitive nursing intervention in improving anxiety and depression in patients with tinnitus.Methods A total of 100 patients with tinnitus in the Department of Otolaryngology,Shenzhen Yantian People's Hospital from October 2008 to October 2010 were randomly divided into the observation group (50 cases) and the control group (50 cases).Both groups received conventional treatment and nursing,and the observation group had cognitive nursing intervention in addition.The score of SAS and SDS were used to evaluate their degree of anxiety and depression before and 4 weeks after treatment.Results Before treatment,SAS was (51.14 ±0.97) and SDS was (53.60 ± 1.05) in the observation group,SAS was (51.04 ± 0.90) and SDS was (53.00 ± 1.54) in the control group,and the differences were not statistically significant (t =0.534,2.278,respectively; P > 0.05).After intervention,score of SAS was (43.86 ± 1.51) and SDS was (46.10 ± 1.87) in the observation group,SAS was (49.54 ± 1.11) and SDS was (50.74 ± 1.12) in the control group,and the differences were statistically significant (t =-21.41,-15.08,respectively; P < 0.01).Conclusions Cognitive nursing intervention can effectively release the anxiety and depression in patients with tinnitus,thus worthy of clinical application.%目的 探讨认知护理干预对改善耳鸣患者焦虑、抑郁情绪的效果.方法 2008年10月至2010年10月将深圳市盐田区人民医院耳鼻喉科100例耳鸣患者随机分为观察组和对照组,两组各50例.两组患者均采用常规治疗及护理措施,观察组患者有针对性地进行认知护理干预.分别对两组患者在治疗前和治疗4周后采用Zung焦虑自评量表(SAS)及抑郁自评量表(SDS)对患者的焦虑、抑郁程度进行评定.结果 治疗前观察组患者SAS及SDS评分分别为(51.14±0.97),(53.60±1.05)分,对照组分别为(51.04±0.90),(53.00±1.54)分,两组比较,差异无统计学意义(t值分别为0

  10. 舒适护理对耳鸣耳聋患者睡眠质量的影响%Effect of comfort care on the sleep quality of patients with tinnitus and deafness

    Institute of Scientific and Technical Information of China (English)

    梁思杏; 侯晓慧; 魏丽芳

    2013-01-01

    Objective To explore the effect of comfort nursing care on the sleep quality of patients with tinnitus and deafness.Methods From 2011 May to 2012 May,104 patients with tinnitus and deafness who hospitalized in our hospital were selected and surveyed with the sleep quality by the symptom checklist (SCL-90) law and Assens Insomnia Scale (AIS),and divided into control group and experimental group with 52 cases in each.The control group only received basic drug therapy,experimental group received normal treatment and comfort nursing treatment.Results The relationship between symptom checklist (SCL-90) scores,other factors and insomnia status was positively.There were obvious difference with the sleep quality,somatization,anxiety,depression between two groups.Conclusions Comfort nursing therapy can improve the quality of sleep on patients with tinnitus and deafness%目的 分析舒适性护理对耳鸣耳聋患者睡眠质量的影响.方法 根据本院2011年5月至2012年5月收治的耳呜耳聋患者,共筛选出104名患者.采用症状自评量表(SCL-90)的法和阿森斯失眠量表(AIS)[1],将耳鸣耳聋患者的睡眠质量进行评定,然后将两组患者分别随机分成试验组和对照组,各52例.其中试验组在接受正常的药物治疗的同时接受舒适的护理治疗方法,而对照组只接受基础的药物治疗.结果 耳鸣耳聋患者的症状自评量表(SCL-90)的总分以及其他各因子与失眠状况呈正相关(r=0.81,0.72,0.52,0.69,0.72,0.73,0.51,0.64,0.59;P <0.001);对试验组的患者进行相关的舒适护理后,两组患者的睡眠质量、躯体化、焦虑不安、抑郁等方面都出现了明显的差异性,试验组的患者睡眠质量明显得到提高.结论 舒适性护理疗法对提高耳鸣耳聋患者的睡眠质量有很好的疗效[2].

  11. Changes in Tinnitus after Cochlear Implantation and Its Relation with Psychological Functioning

    NARCIS (Netherlands)

    Kloostra, Francka J. J.; Arnold, Rosemarie; Hofman, Rutger; Van Dijk, Pim

    2015-01-01

    This study retrospectively assessed the prevalence of tinnitus in cochlear implant patients and the changes after implantation in 212 patients implanted between 2000 and 2009. Patients were included at least 6 months after implantation and received 2 sets of questionnaires, one about the situation b

  12. Review article: hepatitis vaccination in patients with chronic liver disease.

    Science.gov (United States)

    Reiss, G; Keeffe, E B

    2004-04-01

    Evidence regarding the outcomes of viral super-infection in patients with chronic liver disease and practical strategies for hepatitis A and B vaccination of these individuals are reviewed. Patients with acute hepatitis A and chronic hepatitis B have a more severe clinical course and a higher death rate compared with otherwise healthy individuals with hepatitis A, and these differences are most pronounced in older patients and those with histological evidence of chronic hepatitis or cirrhosis, rather than in asymptomatic hepatitis B carriers. Patients with acute hepatitis A super-infection and chronic hepatitis C have an increased risk of fulminant hepatitis and death. In addition, patients with other chronic liver diseases also appear to be at increased risk for more severe disease with superimposed hepatitis A. Patients with chronic hepatitis B and hepatitis C virus co-infection have more severe laboratory abnormalities, more severe histological disease, a greater frequency of cirrhosis and complications of cirrhosis, and a higher incidence of hepatocellular carcinoma. Vaccines for both hepatitis A and B are safe and effective if used early in the course of chronic liver disease. Hepatitis A and B vaccination should be part of the routine management of patients with chronic liver disease, preferably as early as possible in the natural course of their disease.

  13. Tinnitus: Network pathophysiology-network pharmacology

    Directory of Open Access Journals (Sweden)

    Ana Belen eElgoyhen

    2012-01-01

    Full Text Available Tinnitus, the phantom perception of sound, is a prevalent disorder. One in 10 adults has clinically significant subjective tinnitus, and for 1 in 100, tinnitus severely affects their quality of life. Despite the significant unmet clinical need for a safe and effective drug targeting tinnitus relief, there is currently not a single FDA-approved drug on the market. The search for drugs that target tinnitus is hampered by the lack of a deep knowledge of the underlying neural substrates of this pathology. Recent studies are increasingly demonstrating that, as described for other central nervous system disorders, tinnitus is a pathology of brain networks. The application of graph theoretical analysis to brain networks has recently provided new information concerning their topology, their robustness and their vulnerability to attacks. Moreover, the philosophy behind drug design and pharmacotherapy in central nervous system pathologies is changing from that of magic bullets that target individual chemoreceptors or disease-causing genes into that of magic shotguns, promiscuous or dirty drugs that target disease-causing networks, also known as network pharmacology. In the present work we provide some insight into how this knowledge could be applied to tinnitus pathophysiology and pharmacotherapy.

  14. Unusual presentation of tuberculosis in chronic hemodialysis patients.

    Science.gov (United States)

    Amedia, C; Oettinger, C W

    1977-08-01

    Four patients developed miliary tuberculosis while undergoing chronic hemodialysis. Two patients had diabetes mellitus. Three of the four patients were hemodialyzed 18--24 months prior to the onset of symptoms. Signs and symptoms included prolonged fever, pleural effusion, pericarditis with pericardial effusion, abdominal pain, weight loss, and ascites. All patients were PPD negative and without historical or radiographic evidence of latent tuberculosis. Disseminated tuberculosis was proven at autopsy in three patients. M. tuberculosis was eventually recovered from pleural fluid and urine in the fourth patient. The immune deficiencies of chronic renal failure and diabetes mellitus are suspected predisposing factors to the development of miliary tuberculosis in these patients.

  15. [The physician-patient relationship in chronic disease management].

    Science.gov (United States)

    Ginies, P

    2008-07-01

    The relationship between patients and clinicians is a key element in the management of chronic diseases. With the objective of a more efficient communication, the clinician should know his own personality but also the patient personality. The organisation of the consultation, of the waiting room and of the secretary has to facilitate this relationship. The amelioration of this relationship is usefulness only for the clinician in particularly complicated cases but also for the patients suffering from chronic diseases.

  16. Osteoporosis in chronic obstructive pulmonary disease patients

    DEFF Research Database (Denmark)

    Jørgensen, Niklas Rye; Schwarz, Peter

    2008-01-01

    The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence.......The purpose of this review is to examine the state of knowledge and clinical practice in the association of chronic obstructive pulmonary disease to osteoporosis and fracture incidence....

  17. Treatment of chronic periodontitis decreases serum prohepcidin levels in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Eduardo Machado Vilela

    2011-01-01

    Full Text Available OBJECTIVE: To determine the impact of periodontal treatment on serum levels of prohepcidin (the prohormone of hepcidin and systemic inflammation markers, as well as correlations among these markers, in patients with chronic periodontitis and chronic kidney disease who were not undergoing dialysis. METHODS: We included 56 chronic periodontitis patients, 36 with chronic kidney disease and 20 without systemic diseases and with normal renal function (control group. Chronic kidney disease was defined as suggested by the clinical practice guidelines in the National Kidney Foundation. Chronic periodontitis was defined through clinical attachment level and by probing pocket depth, according to the American Association of Periodontology. The inflammatory markers ultrasensitive C-reactive protein, interleukin-6, and prohepcidin were evaluated before and 3 months after periodontal treatment. RESULTS: The efficacy of periodontal treatment was confirmed by the improvement in clinical parameters of chronic periodontitis in the control and chronic kidney disease groups. Periodontal treatment resulted in significant reductions in ultrasensitive C-reactive protein, interleukin-6 and serum prohepcidin levels in both groups. Moreover, in multivariate linear regression, the reduction in prohepcidin after periodontal treatment was significantly and independently associated with interleukin-6 levels in the control group. CONCLUSIONS: By inducing a decline in the systemic inflammatory response and a decrease in serum prohepcidin, successful periodontal treatment may represent an important means of ameliorating the inflammatory burden seen in patients with chronic kidney disease.

  18. [A new method for treating patients with chronic prostatitis].

    Science.gov (United States)

    Boĭko, M I

    1995-01-01

    A new preparation is reported for treatment of chronic inflammation of the prostate, which substantially lowers rates of patients' complaints and depresses the secretion leucocyte reaction. Prostatilen was shown to be capable of normalization of immunity status of the chronic prostatitis patients thus lowering the microbial index of the cultured prostate secretion microorganisms. The following new nonantibacterial strategy of treatment of chronic prostatitis patients is proposed: prostatilen given as a single agent or in combination with immunomodulators and physiotherapeutic methods. Antibacterial therapy is to be instituted on a short-term basis only during the period of exacerbation of the inflammatory process.

  19. Assessing and Managing Sleep Disturbance in Patients with Chronic Pain.

    Science.gov (United States)

    Cheatle, Martin D; Foster, Simmie; Pinkett, Aaron; Lesneski, Matthew; Qu, David; Dhingra, Lara

    2016-06-01

    Chronic pain is associated with symptoms that may impair a patient's quality of life, including emotional distress, fatigue, and sleep disturbance. There is a high prevalence of concomitant pain and sleep disturbance. Studies support the hypothesis that sleep and pain have a bidirectional and reciprocal relationship. Clinicians who manage patients with chronic pain often focus on interventions that relieve pain, and assessing and treating sleep disturbance are secondary or not addressed. This article reviews the literature on pain and co-occurring sleep disturbance, describes the assessment of sleep disturbance, and outlines nonpharmacologic and pharmacologic treatment strategies to improve sleep in patients with chronic pain.

  20. Periodontal treatment reduces chronic systemic inflammation in peritoneal dialysis patients.

    Science.gov (United States)

    Siribamrungwong, Monchai; Yothasamutr, Kasemsuk; Puangpanngam, Kutchaporn

    2014-06-01

    Chronic systemic inflammation, a non traditional risk factor of cardiovascular diseases, is associated with increasing mortality in chronic kidney disease, especially peritoneal dialysis patients. Periodontitis is a potential treatable source of systemic inflammation in peritoneal dialysis patients. Clinical periodontal status was evaluated in 32 stable chronic peritoneal dialysis patients by plaque index and periodontal disease index. Hematologic, blood chemical, nutritional, and dialysis-related data as well as highly sensitive C-reactive protein were analyzed before and after periodontal treatment. At baseline, high sensitive C-reactive protein positively correlated with the clinical periodontal status (plaque index; r = 0.57, P chronic systemic inflammation in peritoneal dialysis patients. Treatment of periodontal diseases can improve systemic inflammation, nutritional status and erythropoietin responsiveness in peritoneal dialysis patients.

  1. Mitochondrial DNA deletions in patients with chronic suppurative otitis media.

    Science.gov (United States)

    Tatar, Arzu; Tasdemir, Sener; Sahin, Ibrahim; Bozoglu, Ceyda; Erdem, Haktan Bagis; Yoruk, Ozgur; Tatar, Abdulgani

    2016-09-01

    The aim of this study was to investigate the 4977 and 7400 bp deletions of mitochondrial DNA in patients with chronic suppurative otitis media and to indicate the possible association of mitochondrial DNA deletions with chronic suppurative otitis media. Thirty-six patients with chronic suppurative otitis media were randomly selected to assess the mitochondrial DNA deletions. Tympanomastoidectomy was applied for the treatment of chronic suppurative otitis media, and the curettage materials including middle ear tissues were collected. The 4977 and 7400 bp deletion regions and two control regions of mitochondrial DNA were assessed by using the four pair primers. DNA was extracted from middle ear tissues and peripheral blood samples of the patients, and then polymerase chain reactions (PCRs) were performed. PCR products were separated in 2 % agarose gel. Seventeen of 36 patients had the heterozygote 4977 bp deletion in the middle ear tissue but not in peripheral blood. There wasn't any patient who had the 7400 bp deletion in mtDNA of their middle ear tissue or peripheral blood tissue. The patients with the 4977 bp deletion had a longer duration of chronic suppurative otitis media and a higher level of hearing loss than the others (p media and the reactive oxygen species can cause the mitochondrial DNA deletions and this may be a predisposing factor to sensorineural hearing loss in chronic suppurative otitis media. An antioxidant drug as a scavenger agent may be used in long-term chronic suppurative otitis media.

  2. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients

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