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Sample records for chronic tinnitus patients

  1. Catastrophizing and fear of tinnitus predict quality of life in patients with chronic tinnitus

    OpenAIRE

    Cima, Rilana FF; Crombez, Geert; Vlaeyen, Johan WS

    2011-01-01

    Objectives: It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was ...

  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; Gerhard Rumpold; Annette Schmidt; Zorowka, Patrick G.; Bliem, Harald R.; Roland Moschen

    2015-01-01

    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 acce...

  3. 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.

  4. Disrupted Brain Functional Network Architecture in Chronic Tinnitus Patients

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    Chen, Yu-Chen; Feng, Yuan; Xu, Jin-Jing; Mao, Cun-Nan; Xia, Wenqing; Ren, Jun; Yin, Xindao

    2016-01-01

    Purpose: Resting-state functional magnetic resonance imaging (fMRI) studies have demonstrated the disruptions of multiple brain networks in tinnitus patients. Nonetheless, several studies found no differences in network processing between tinnitus patients and healthy controls (HCs). Its neural bases are poorly understood. To identify aberrant brain network architecture involved in chronic tinnitus, we compared the resting-state fMRI (rs-fMRI) patterns of tinnitus patients and HCs. Materials and Methods: Chronic tinnitus patients (n = 24) with normal hearing thresholds and age-, sex-, education- and hearing threshold-matched HCs (n = 22) participated in the current study and underwent the rs-fMRI scanning. We used degree centrality (DC) to investigate functional connectivity (FC) strength of the whole-brain network and Granger causality to analyze effective connectivity in order to explore directional aspects involved in tinnitus. Results: Compared to HCs, we found significantly increased network centrality in bilateral superior frontal gyrus (SFG). Unidirectionally, the left SFG revealed increased effective connectivity to the left middle orbitofrontal cortex (OFC), left posterior lobe of cerebellum (PLC), left postcentral gyrus, and right middle occipital gyrus (MOG) while the right SFG exhibited enhanced effective connectivity to the right supplementary motor area (SMA). In addition, the effective connectivity from the bilateral SFG to the OFC and SMA showed positive correlations with tinnitus distress. Conclusions: Rs-fMRI provides a new and novel method for identifying aberrant brain network architecture. Chronic tinnitus patients have disrupted FC strength and causal connectivity mostly in non-auditory regions, especially the prefrontal cortex (PFC). The current findings will provide a new perspective for understanding the neuropathophysiological mechanisms in chronic tinnitus. PMID:27458377

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

    Directory of Open Access Journals (Sweden)

    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.

  6. 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.

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

    International Nuclear Information System (INIS)

    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

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

    Energy Technology Data Exchange (ETDEWEB)

    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. 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.

  10. Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study

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    Charu Singh

    2016-01-01

    Full Text Available True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg weekly for a period of 6 weeks and Group B (20 patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus.

  11. Therapeutic role of Vitamin B12 in patients of chronic tinnitus: A pilot study.

    Science.gov (United States)

    Singh, Charu; Kawatra, Rahul; Gupta, Jaya; Awasthi, Vishnu; Dungana, Homnath

    2016-01-01

    True tinnitus is a phantom auditory perception arising from a source or trigger in the cochlea, brainstem, or at higher centers and has no detectable acoustic generator. The most accepted is the famous neurophysiologic model of Jastreboff, which stresses that tinnitus, is a subcortical perception and results from the processing of weak neural activity in the periphery. The aim of this study is to determine the role of Vitamin B12 in treatment of chronic tinnitus. In this randomized, double-blind pilot study, total 40 patients were enrolled, of which 20 in Group A (cases) received intramuscular therapy of 1 ml Vitamin B12 (2500 mcg) weekly for a period of 6 weeks and Group B (20) patients received placebo isotonic saline 01 ml intramuscular. The patients were subjected to Vitamin B12 assay and audiometry pre- and post-therapy. Of the total patients of tinnitus, 17 were Vitamin B12 deficient that is 42.5% showed deficiency when the normal levels were considered to be 250 pg/ml. A paired t-test showed that in Group A, patients with Vitamin B12 deficiency showed significant improvement in mean tinnitus severity index score and visual analog scale (VAS) after Vitamin B12 therapy. This pilot study highlights the significant prevalence of Vitamin B12 deficiency in North Indian population and improvement in tinnitus severity scores and VAS in cobalamin-deficient patients receiving intramuscular Vitamin B12 weekly for 6 weeks further provides a link between cobalamin deficiency and tinnitus thereby suggestive of a therapeutic role of B12 in cobalamin-deficient patients of tinnitus. PMID:26960786

  12. Multimodal therapy for chronic tinnitus.

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    Hahn, Ales; Radkova, Lenka; Achiemere, Gabriela; Klement, Vladislav; Alpini, Dario; Strouhal, Jaroslav

    2008-01-01

    From 2001 to 2006, we performed a retrospective study of patients suffering from chronic unilateral or bilateral tinnitus that was previously ineffectively treated by oral drugs [betahistine (Betaserc), extract of Ginkgo biloba (EGb 761), tanakan (Tebokan), and cinnarizine-dimenhydrinate (Arlevert), singly or in combination]. We divided 150 tinnitus patients (80 men, 70 women) into seven treatment groups. Treatments consisted of application of intravenous pentoxifylline, lidocaine, or vinpocetine (Cavinton) and combination of these agents with physiotherapy and soft laser. Mean duration (+/- standard deviation) of tinnitus in these patients was 7.4 +/- 6.0 years; their mean age was 55.6 +/- 12.5 years. The aim of our study was to compare treatment modalities and define their effectiveness for tinnitus relief. The most effective treatment was defined as a combination of Cavinton and physiotherapy. We evaluated pure lidocaine infusion therapy as ineffective. None of the treatment modalities had an objective correlate of improvement, though improvement was reported by a visual analog scale. PMID:18616089

  13. 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.

  14. Sleep Quality of Patients with Tinnitus

    OpenAIRE

    Özler, Gül Soylu; Arlı, Cengiz; Çevik, Cengiz; Ercan AKBAY; Yengil, Erhan

    2014-01-01

    Objective: The aim of this study is to assess the sleep quality of tinnitus sufferers and to confirm the relationship between age, gender, tinnitus duration and tinnitus severity and sleep disturbances.Materials and methods: Sixty tinnitus patients and 60 control subjects without tinnitus were included in this study. Age, gender, duration of tinnitus were listed on a chart. Tinnitus severity was measured by Tinnitus Handicap Inventory (THI) (for tinnitus group). Pittsburgh Sleep Quality Index...

  15. Tinnitus

    OpenAIRE

    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.

  16. Tinnitus

    OpenAIRE

    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. 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.

  18. 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

  19. Medium-Level Laser in Chronic Tinnitus Treatment

    OpenAIRE

    K. Dejakum; Piegger, J.; C. Plewka; A. Gunkel; Thumfart, W.; S. Kudaibergenova; Goebel, G.; Kral, F.; Freysinger, W

    2013-01-01

    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 sc...

  20. Chronic Cervicogenic Tinnitus Rapidly Resolved by Intermittent Use of Cervical Collar

    OpenAIRE

    Bechter, Karl; Wieland, Martin; Hamann, Gerhard F

    2016-01-01

    Introduction Cervicogenic tinnitus is not a 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 (CPS) and successful add-on treatment with cervical collar (CC), the idea was pursued in several individual treatments in patients. Patients and methods Reporting one particular case with chronic tinnitus, considered untreatable, t...

  1. Slow Cortical Potential Neurofeedback in Chronic Tinnitus Therapy: A Case Report.

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    Milner, Rafał; Lewandowska, Monika; Ganc, Małgorzata; Cieśla, Katarzyna; Niedziałek, Iwona; Skarżyński, Henryk

    2016-06-01

    This study is the first to demonstrate outcomes of slow cortical potential (SCP) Neurofeedback training in chronic tinnitus. A 50-year old male patient with tinnitus participated in three SCP training blocks, separated with 1-month breaks. After the training the patient reported decreased tinnitus loudness and pitch, as well as improved quality of daily life. A quantitative electroencephalography analysis revealed close to normal changes of resting state bioelectrical activity in cortical areas considered to be involved in tinnitus generation. The present case study indicates that SCP Neurofeedback training can be considered a promising method for tinnitus treatment. PMID:26459345

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

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    Schecklmann, Martin; Landgrebe, Michael; Kleinjung, Tobias; Frank, Elmar; Rupprecht, Rainer; Sand, Philipp G.; Eichhammer, Peter; Hajak, Göran; Langguth, Berthold

    2014-01-01

    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...

  3. Feasibility and Safety of Transcutaneous Vagus Nerve Stimulation Paired with Notched Music Therapy for the Treatment of Chronic Tinnitus

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    Shim, Hyun Joon; Kwak, Min Young; An, Yong-Hwi; Kim, Dong Hyun; Kim, Yun Jin; Kim, Hyo Jung

    2015-01-01

    Background and Objectives A recent study demonstrated that tinnitus could be eliminated by vagus nerve stimulation (VNS) paired with notched sounds in a rat tinnitus model. The aims of this clinical study were to investigate the effects and safety of transcutaneous VNS (tVNS) by patch-type electrode paired with notched music for treating chronic tinnitus. Subjects and Methods Thirty patients with refractory chronic tinnitus for >12 months were included in this study. A patch-type electrode wa...

  4. Tinnitus

    NARCIS (Netherlands)

    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

  5. Predictors for rTMS response in chronic tinnitus

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    Astrid Lehner

    2012-02-01

    Full Text Available Background: Repetitive transcranial magnetic stimulation (rTMS has been studied as a treatment option for chronic tinnitus for almost ten years now. Although most of these studies have demonstrated beneficial effects, treatment results show high interindividual variability and yet, little is known about predictors for treatment response. Methods: Data from 538 patients with chronic tinnitus were analysed. Patients received either low-frequency rTMS over the left temporal cortex (n= 345, 1 Hz, 110% motor threshold, 2000 stimuli/day or combined temporal and frontal stimulation (n = 193, 110% motor threshold, 2000 stimuli at 20 Hz, left dorsolateral prefrontal cortex plus 2000 stimuli at 1 Hz, temporal cortex. Numerous demographic, clinical and audiological variables as well as different tinnitus characteristics were analysed as potential predictors for treatment outcome, which was defined as change in the tinnitus questionnaire (TQ score. Results: Both stimulation protocols resulted in a significant improvement in TQ scores. In the group receiving combined treatment, patients with comorbid temporomandibular complaints benefited more from rTMS than patients without those complaints. In addition, for both stimulation protocols the TQ score at baseline as well as the change in TQ score from screening to baseline correlated significantly with treatment response. Patients with higher TQ scores at baseline had more pronounced TQ reductions than patients with low TQ baseline scores. Also, patients who had already improved from screening to baseline benefited less than patients without initial improvement. Conclusions: The results from this large sample confirm the effectiveness of rTMS for the treatment of chronic tinnitus. Nonetheless, the high interindividual variability in treatment response can only be partly explained by the investigated clinical variables.

  6. 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.

  7. Neuromagnetic indicators of tinnitus and tinnitus masking in patients with and without hearing loss

    OpenAIRE

    Adjamian, Peyman; Sereda, Magdalena; Zobay, Oliver; Hall, Deborah A; Palmer, Alan R

    2012-01-01

    Tinnitus is an auditory phenomenon characterised by the perception of a sound in the absence of an external auditory stimulus. Chronic subjective tinnitus is almost certainly maintained via central mechanisms, and this is consistent with observed measures of altered spontaneous brain activity. A number of putative central auditory mechanisms for tinnitus have been proposed. The influential thalamocortical dysrhythmia model suggests that tinnitus can be attributed to the disruption of coherent...

  8. 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.

  9. From Signal Space to Source Space : does Source Space Projection Improve the Neurofeedback Therapy in Chronic Tinnitus Patients?

    OpenAIRE

    Lorenz, Isabel

    2007-01-01

    Tinnitus, the subjective perception of a sound in the absence of any external stimulus, is an auditory phantom phenomenon, which affects millions of people worldwide. The neurophysiological mechanisms of tinnitus are still poorly understood. Although multiple treatments have been developed, to date there is no validated cure of tinnitus.Based on findings of abnormal oscillatory cortical activity regarding a reduction of temporal alpha power (8 - 12 Hz) and an enhancement of temporal delta pow...

  10. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  12. 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, ...

  13. Correlation between Hearing Threshold Tinnitus Pitch and Loundness with Quality Of Life of Tinnitus Patients in Makassar

    OpenAIRE

    Savitri, Eka

    2014-01-01

    Introduction: Tinnitus is an unwanted auditory perception, with many causes, subjectively and affects the quality of life. It is important to evaluating the quality of life of tinnitus patients and related factors in treatment of tinnitus. The measurements of tinnitus psychoacoustic include pitch, loudness, minimum masking levels and residual inhibition. Aim: To analyze the correlation between hearing threshold, tinnitus pitch and loudness with quality of life of tinnitus patients in Makassar...

  14. 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

  15. Evaluation of Distortion and Transient Evoked Otoacoustic Emission in Tinnitus Patients with Normal Hearing

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    Helnaz Mokrian

    2014-01-01

    Full Text Available Introduction: Tinnitus is a perception of sound without external source. The exact etiology of tinnitus is not fully understood, although some researchers believe that the condition usually starts in the cochlea. The aim of this study was to determine the potential contribution of outer hair cell dysfunction to chronic tinnitus, by application of Distortion-Product Evoked Otoacoustic Emission (DPOAE and Transient Evoked Otoacoustic Emission (TEOAE and also to determine the relationship between tinnitus loudness and the amplitude of these two potentials.   Materials and Methods: This study was conducted on 20 tinnitus patients aged 20–45 years and 20 age- and gender-matched control subjects. DPOAE and TEOAE were performed on each subject.   Results: The difference in the amplitudes of TEOAE between the two groups was not significantly different (P=0.08, but the amplitude of DPOAE in patients with tinnitus was significantly lower than the corresponding value in the control subjects (P=0.01. There was no correlation between tinnitus loudness and the amplitudes of neither DPOAE nor TEOAE.   Conclusion:  Abnormal findings in the DPOAE of tinnitus sufferers suggest some form of cochlear dysfunction in these patients. As there was no correlation between the amplitude of the recorded potentials and tinnitus loudness, factors other than cochlear dysfunction may also influence the loudness of tinnitus.

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

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    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.

  17. 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

  18. 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

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

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    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.

  20. Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus

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    Martin eSchecklmann

    2015-10-01

    Full Text Available Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About ten years ago, repetitive transcranial magnetic stimulation (rTMS of auditory and prefrontal cortex was introduced as potential treatment for tinnitus. The resulting changes in tinnitus loudness are interpreted in the context of rTMS induced activity changes (neuroplasticity. Here, we investigate the effect of single rTMS sessions on oscillatory power to probe the capacity of rTMS to interfere with tinnitus-specific cortical plasticity. We measured 20 patients with bilateral chronic tinnitus and 20 healthy controls comparable for age, sex, handedness, and hearing level with a 63-channel EEG system. Educational level, intelligence, depressivity and hyperacusis were controlled for by analysis of covariance. Different rTMS protocols were tested: Left and right temporal and left and right prefrontal cortices were each stimulated with 200 pulses at 1Hz and with an intensity of 60% stimulator output. Stimulation of central parietal cortex with 6-fold reduced intensity (inverted passive-cooled coil served as sham condition. Before and after each rTMS protocol five minutes of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with one week interval in between.Analyses on electrode level showed that people with and without tinnitus differed in their response to left temporal and right frontal stimulation. In tinnitus patients left temporal rTMS decreased frontal theta and delta and increased beta2 power, whereas right frontal rTMS decreased right temporal beta3 and gamma power. No changes or increases were observed in the control group. Only non-systematic changes in tinnitus loudness were induced by single sessions of rTMS.This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency. The observed effects can be interpreted

  1. Triple-site rTMS for the treatment of chronic tinnitus: a randomized controlled trial.

    Science.gov (United States)

    Lehner, Astrid; Schecklmann, Martin; Greenlee, Mark W; Rupprecht, Rainer; Langguth, Berthold

    2016-01-01

    Recent research indicates that tinnitus is related to alterations of neural networks including temporal, parietal, and prefrontal brain regions. The current study examines a rTMS protocol which targets three central nodes of these networks in a two-arm randomized parallel group trial. Overall, 49 patients with chronic tinnitus were randomized to receive either triple-site stimulation (left dorsolateral prefrontal stimulation, 1000 pulses, 20 Hz plus left and right temporoparietal stimulation, 1000 pulses each, 1 Hz) or single-site stimulation (left temporoparietal stimulation, 3000 pulses, 1 Hz). Both groups were treated in ten sessions. Tinnitus severity as measured by the tinnitus questionnaire was assessed before rTMS (day1), after rTMS (day12) and at two follow-up visits (day 90 and day 180). The triple-site protocol was well tolerated. There was a significant reduction in tinnitus severity for both treatment groups. The triple-site group tended to show a more pronounced treatment effect at day 90. However, the measurement time point x group interaction effect was not significant. The current results confirm former studies that indicated a significant reduction of tinnitus severity after rTMS treatment. No significant superiority of the multisite protocol was observed. Future approaches for the enhancement of treatment effects are discussed. PMID:26927363

  2. Influence of tinnitus on pain severity and quality of life in patients with temporomandibular disorders

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    Patrícia dos Santos Calderon

    2012-04-01

    Full Text Available OBJECTIVE:The aim of this cross-sectional study was to evaluate the relationship among pain intensity and duration, presence of tinnitus and quality of life in patients with chronic temporomandibular disorders (TMD. MATERIAL AND METHODS: Fifty-nine female patients presenting with chronic TMD were selected from those seeking for treatment at the Bauru School of Dentistry Orofacial Pain Center. Patients were submitted to the Research Diagnostic Criteria anamnesis and physical examination. Visual analog scale was used to evaluate the pain intensity while pain duration was assessed by interview. Oral Health Impact Profile inventory modified for patients with orofacial pain was used to evaluate the patients' quality of life. The presence of tinnitus was assessed by self report. The patients were divided into: with or without self report of tinnitus. The data were analyzed statistically using the Student's t-test and Pearson's Chi-square test, with a level of significance of 5%. RESULTS: The mean age for the sample was 35.25 years, without statistically significant difference between groups. Thirty-two patients (54.24% reported the presence of tinnitus. The mean pain intensity by visual analog scale was 77.10 and 73.74 for the groups with and without tinnitus, respectively. The mean pain duration was 76.12 months and 65.11 months for the groups with and without tinnitus, respectively. The mean OHIP score was 11.72 and 11.74 for the groups with and without tinnitus, respectively. There was no statistically significant difference between groups for pain intensity, pain duration and OHIP scoreS (p>0.05. CONCLUSION: Chronic TMD pain seems to play a more significant role in patient 's quality of life than the presence of tinnitus.

  3. Tinnitus

    Science.gov (United States)

    ... and causes, some people develop tinnitus for no obvious reason. Most of the time, tinnitus isn’t a sign of a serious health problem, although if it’s loud or doesn’t go away, it can cause fatigue, depression, anxiety, and problems with memory and concentration. For ...

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

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    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.

  5. Paraoxonase Activity and Oxidative Status in Patients with Tinnitus

    Science.gov (United States)

    Akyüz, Servet; Somuk, Battal Tahsin; Soyalic, Harun; Yılmaz, Beyhan; Taskin, Abdullah; Bilinc, Hasan; Aksoy, Nurten

    2016-01-01

    Background and Objectives The aim of this study was to investigate serum paraoxanase-1 (PON) activity, total oxidant status (TOS), total antioxidant status (TAS), and the oxidative stress index (OSI) in tinnitus; and to compare the results with data from healthy subjects. Subjects and Methods A total of 114 subjects-54 patients with tinnitus and 60 healthy controls were enrolled in this study. Serum PON activity, TOS, TAS, and OSI levels were measured. Results In the tinnitus group, TAS, and PON were significantly lower than in the control group (p<0.001). However, the TOS, and OSI levels were significantly higher in the tinnitus group than in the control group (p<0.001). Conclusions According to the data obtained from the present study, patients with tinnitus were exposed to potent oxidative stress. Oxidative stress may be the key contributing factor to the pathogenesis of tinnitus. PMID:27144229

  6. 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.

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

    OpenAIRE

    Pia Lau; Miriam Miesen; Robert Wunderlich; Alwina Stein; Alva Engell; Andreas Wollbrink; Gerlach, Alexander L.; Markus Junghöfer; Thomas Ehring; Christo Pantev

    2015-01-01

    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 interocep...

  8. Tinnitus

    Science.gov (United States)

    ... case. There is no need for radiologic testing (X-rays, CT scans or MRI scans) unless your tinnitus ... MP3 devices and nearly all hand-held electronic games are equipped with ear buds. It is difficult ...

  9. 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.

  10. Cortico-limbic morphology separates tinnitus from tinnitus distress

    OpenAIRE

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

    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 ...

  11. 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. PMID:23104014

  12. 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.

  13. 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.

  14. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  16. 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)....

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Tinnitus: distinguishing between subjectively perceived loudness and tinnitus-related distress.

    Directory of Open Access Journals (Sweden)

    Elisabeth Wallhäusser-Franke

    Full Text Available OBJECTIVES: Overall success of current tinnitus therapies is low, which may be due to the heterogeneity of tinnitus patients. Therefore, subclassification of tinnitus patients is expected to improve therapeutic allocation, which, in turn, is hoped to improve therapeutic success for the individual patient. The present study aims to define factors that differentially influence subjectively perceived tinnitus loudness and tinnitus-related distress. METHODS: In a questionnaire-based cross-sectional survey, the data of 4705 individuals with tinnitus were analyzed. The self-report questionnaire contained items about subjective tinnitus loudness, type of onset, awareness and localization of the tinnitus, hearing impairment, chronic comorbidities, sleep quality, and psychometrically validated questionnaires addressing tinnitus-related distress, depressivity, anxiety, and somatic symptom severity. In a binary step-wise logistic regression model, we tested the predictive power of these variables on subjective tinnitus loudness and tinnitus-related distress. RESULTS: The present data contribute to the distinction between subjective tinnitus loudness and tinnitus-related distress. Whereas subjective loudness was associated with permanent awareness and binaural localization of the tinnitus, tinnitus-related distress was associated with depressivity, anxiety, and somatic symptom severity. CONCLUSIONS: Subjective tinnitus loudness and the potential presence of severe depressivity, anxiety, and somatic symptom severity should be assessed separately from tinnitus-related distress. If loud tinnitus is the major complaint together with mild or moderate tinnitus-related distress, therapies should focus on auditory perception. If levels of depressivity, anxiety or somatic symptom severity are severe, therapies and further diagnosis should focus on these symptoms at first.

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

    OpenAIRE

    Francesco Martines; Daniela Bentivegna; Fabiola Di Piazza; Enrico Martines; Vincenzo Sciacca; Gioacchino Martinciglio

    2010-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    OpenAIRE

    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: Adult chronic tinnitus sufferers (N = 265) and ENT patients without tinnitus (N = 265) participated in a cross-sectional study. The authors evaluated personality characteristics with tests for distres...

  3. Cognitive Mechanisms in Chronic Tinnitus: Psychological Markers of a Failure to Switch Attention

    Science.gov (United States)

    Trevis, Krysta J.; McLachlan, Neil M.; Wilson, Sarah J.

    2016-01-01

    The cognitive mechanisms underpinning chronic tinnitus (CT; 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 CT. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional well-being, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional well-being 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 CT. 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.

  4. 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. PMID:27180191

  5. Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity

    OpenAIRE

    Okamoto, Hidehiko; Stracke, Henning; Stoll, Wolfgang; Pantev, Christo

    2009-01-01

    Maladaptive auditory cortex reorganization may contribute to the generation and maintenance of tinnitus. Because cortical organization can be modified by behavioral training, we attempted to reduce tinnitus loudness by exposing chronic tinnitus patients to self-chosen, enjoyable music, which was modified (“notched”) to contain no energy in the frequency range surrounding the individual tinnitus frequency. After 12 months of regular listening, the target patient group (n = 8) showed significan...

  6. Tinnitus and psychological comorbidities

    OpenAIRE

    Zirke, Nina

    2014-01-01

    To explain pathogenetic reasons for tinnitus cochlear, acustic or neurophysiological reasons are discussed. Regardless of the origin of tinnitus, psychological factors are attributed to the chronification of tinnitus. Psychological comorbidities seem to decrease the opportunity of tinnitus habituation. Studies have demonstrated that patients with high tinnitus related distress are frequently accompanied by psychological comorbidities. We examined the prevalence of psychological disorders ...

  7. 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

  8. Resequencing of the auxiliary GABAB receptor subunit gene KCTD12 in chronic tinnitus

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    Philipp G Sand

    2012-05-01

    Full Text Available Tinnitus is a common and often incapacitating hearing disorder marked by the perception of phantom sounds. Susceptibility factors remain largely unknown but GABAB receptor signalling has long been implicated in the response to treatment and, putatively, in the etiology of the disorder. We hypothesized that variation in KCTD12, the gene encoding an auxiliary subunit of GABAB receptors, could help to predict the risk of developing tinnitus. 95 Caucasian outpatients with a diagnosis of chronic tinnitus were systematically screened for mutations in the KCTD12 open reading frame and the adjacent 3' untranslated region by Sanger sequencing. Allele frequencies were determined for 14 known variants of which three (rs73237446, rs34544607 and rs41287030 were polymorphic. When allele frequencies were compared to data from a large reference population of European ancestry, rs34544607 was associated with tinnitus (p=.04. However, KCTD12 genotype did not predict tinnitus severity (p=.52 and the association with rs34544607 was weakened after screening 50 additional cases (p=.07. Pending replication in a larger cohort, KCTD12 may act as a risk modifier in chronic tinnitus. Issues that are yet to be addressed include the effects of neighbouring variants, e.g. in the KCTD12 gene regulatory region, plus interactions with variants of GABAB1 and GABAB2.

  9. 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.

  10. 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.

  11. Tinnitus and Headache

    OpenAIRE

    Berthold Langguth; Verena Hund; Volker Busch; Jürgens, Tim P; Jose-Miguel Lainez; Michael Landgrebe; Martin Schecklmann

    2015-01-01

    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 a...

  12. Retraining therapy for chronic tinnitus. A critical analysis of its status.

    Science.gov (United States)

    Kroener-Herwig, B; Biesinger, E; Gerhards, F; Goebel, G; Verena Greimel, K; Hiller, W

    2000-01-01

    Tinnitus retraining therapy (TRT), as conceived of mainly by PJ Jastreboff, has recently received increasing attention in the media, as well as in seminars and congresses on treatment methods for chronic tinnitus. It is often claimed, though not explicitly in scientific publications, that TRT is currently the most efficacious therapy for tinnitus, obtaining improvement rates exceeding 80%. This assertion is highly significant in light of the most likely increasing prevalence of chronic tinnitus and ensuing urgent demand for effective therapies. Before examining the evidence regarding the effectiveness of TRT, Jastreboff's theoretical idea of tinnitus as a neurophysiological disorder is examined and evaluated. This idea is plausible and is supported by some evidence. The interaction between neuroacoustic and emotional processes emphasized by Jastreboff is, however, neither new nor sufficiently elaborated with respect to the underlying psychological factors. The TRT intervention technique and its main components 'directive counselling' and use of 'noise generators' are found to be theoretically well grounded. The lack of detailed information concerning TRT implementation and the potential consequence that differing interventions may be labelled TRT are criticized. Jastreboff's obvious opposition to psychologists' participation in TRT, despite the increase in efficacy they could affect through utilization of cognitive restructuring techniques and behaviour modification interventions, is also criticized. Finally, studies regarding the efficacy of TRT are reviewed and severe methodological shortcomings (e.g. lack of controlled randomized group studies) in TRT research are noted. Taking the current state of evidence into account, we conclude that there is no convincing empirical support for the assumption that TRT is superior to other treatments, since no comparative studies have been conducted. It is contended that there is more substantial empirical support for the

  13. Plasma brain-derived neurotrophic factor levels are increased in patients with tinnitus and correlated with therapeutic effects.

    Science.gov (United States)

    Xiong, Hao; Yang, Haidi; Liang, Maojin; Ou, Yongkang; Huang, Xiayin; Cai, Yuexin; Lai, Lan; Pang, Jiaqi; Zheng, Yiqing

    2016-05-27

    Tinnitus is the perception of sound without an external source and is known to be associated with altered neuronal excitability in the auditory system. Tinnitus severity can be assessed by various psychometric instruments and there is no objective measures developed to evaluate tinnitus severity and therapeutic effects so far. Brain-derived nerve growth factor (BDNF) is believed in playing a key role in regulating neuronal excitability in the brain. To determine whether BDNF correlates with tinnitus induction and severity, we described plasma BDNF levels in patients with tinnitus and healthy controls and evaluated the correlation between plasma BDNF levels and tinnitus severity measured by Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS). Moreover, alteration of plasma BDNF levels before and after tinnitus retraining therapy (TRT) in patients with severe tinnitus was also analyzed. We found plasma BDNF levels were elevated in patients with tinnitus compared with healthy controls. In addition, plasma BDNF levels in patients with severe tinnitus were decreased significantly after effective TRT. However, plasma BDNF levels were not correlated with tinnitus loudness and tinnitus severity measured by THI and VAS. These findings support plasma BDNF as a marker for activity changes in the auditory system and could possibly evaluate therapeutic effects in patients with tinnitus. PMID:27095590

  14. 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.

  15. Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo

    Directory of Open Access Journals (Sweden)

    Li Zhang

    2012-01-01

    Full Text Available Aim: The aim of this study was to investigate the patient selection, indications for operation, surgical methods and effects of microvascular decompression (MVD for treatment of intractable and incapacitating tinnitus and vertigo. Materials and Methods: A total of 35 patients were recruited from January 2009 to June 2010 for the MVD surgery. Results: Arterial compression of cochleovestibular nerve was found in all the 35 patients. The immediate effect of MVD was observed in 22 patients with tinnitus and 10 patients with vertigo. The follow-up data for the effect of MVD showed complete resolution of tinnitus in 14 patients and vertigo in 6 patients. Conclusions: Vascular compression of cochleovestibular nerve in cerebellopontine angle may be one of the causes of intractable and incapacitating tinnitus and/or vertigo. MVD may be a safe and effective surgical procedure for treatment of severe tinnitus and/or vertigo in patients.

  16. Untersuchung von Angststörung und Stressempfinden bei chronischem Tinnitus

    OpenAIRE

    Hubatsch, Linda

    2013-01-01

    Background: Due to its multidimensionality tinnitus is a complex disease. To improve existing treatment protocols and develop more efficient alternatives it is necessary to have an exact knowledge of aetiology and mechanisms of chronicity. Methods: We studied 250 patients with chronic tinnitus and analysed their information from admission to outpatient treatment retrospectively. As a measurement tool for tinnitus distress the Tinnitus Questionnaire of Goebel and Hiller were used, as well as t...

  17. 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.

  18. Objective pulsatile tinnitus

    OpenAIRE

    Yacovino, Dario A.; Casas, Pablo

    2015-01-01

    Key Clinical Message Tinnitus is the usually unwanted perception of sound, in most cases there is no genuine physical source of sound. Less than 10% of tinnitus patients suffer from pulsatile tinnitus. Objective Pulsatile tinnitus can also be the first indication of dural arteriovenous fistula, so examination for such vascular origin must be performed.

  19. Auditory Resting-State Network Connectivity in Tinnitus: a Functionnal MRI Study.

    OpenAIRE

    Maudoux, Audrey; Lefebvre, Philippe; Cabay, Jean-Evrard; Vanhaudenhuyse, Audrey; Demertzi, Athina; Laureys, Steven; Soddu, Andrea

    2012-01-01

    The underlying functional neuroanatomy of tinnitus remains poorly understood. Few studies have focused on functional cerebral connectivity changes in tinnitus patients. The aim of this study was to test if functional MRI ‘‘resting-state’’ connectivity patterns in auditory network differ between tinnitus patients and normal controls. Thirteen chronic tinnitus subjects and fifteen age-matched healthy controls were studied on a 3 tesla MRI. Connectivity was investigated using independent compone...

  20. 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

  1. Intra-individual variability in tinnitus patients : current thoughts and perspectives.

    Science.gov (United States)

    Dauman, N; Erlandsson, S; Lundlin, L; Dauman, R

    2015-04-01

    Most tinnitus studies have attempted to compare groups of individuals, thus revealing inter-individuals differences, i.e., variations between compared subjects. For methodological reasons, inter-individual studies cannot take into account the variability of tinnitus experience, which has been known for decades to be relevant in daily practice with tinnitus patients. The concept of intra-individual variability has been promoted in the research literature, in order to shed light on this aspect of individual perception. In previous studies, unrelated to hearing, the concept of intra-individual variability implied inclusion of the environment (i.e., physical and social interactions) as a factor of individual performance. In tinnitus research, we believe that the concept of variability (within a person) could find a place beside the concept of variation (between groups of subjects). In this paper, four perspectives of tinnitus experiences from the clinical and research fields are described: (1) ENT consultation; (2) short-term group psychotherapy; (3) psychodynamic psychotherapy; and (4) clinical psychological research. Intra-individual variability stresses the importance of defining tinnitus in a dynamic way, contrary to the current definition of tinnitus as the perception of sound(s). In clinical practice, it is useful to embrace the perspective of the perceiver of tinnitus, and to include social and cultural circumstances as well as audiological/physical changes. PMID:25862625

  2. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. Assessment evaluation of transient evoked otoacoustic emission by contralateral suppression in tinnitus patient with normal hearing

    Directory of Open Access Journals (Sweden)

    Helnaz Mokrian

    2014-01-01

    Conclusion: The suppression of the transient evoked otoacoustic emission by contralateral white noise did not reach statistically significant levels in tinnitus patients while the amplitude in control group reduced significantly.

  6. 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...

  7. 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.

  8. The comparison of audiological tests and VAS scores after use of trimetazidine hydrocloride in patients with tinnitus

    Directory of Open Access Journals (Sweden)

    Ali Kılıç

    2012-03-01

    Full Text Available Objectives: Although the pathophysiology of tinnitus hasnot been understood well it is thought to be as a result ofanatomical and/or functional change in hearing system.The aim of this study was to compare audiological testresults and visual analog scala (VAS scores after use oftrimetazidine hydrocloride in patients with tinnitus.Materials and methods: Forty patients (12 female, 28male who were admitted to our clinic with tinnitus complaintwere included in this study. Demographical andmedical records and tinnitus assessment data of thecases were recorded who received regular trimetazidinehydrochloride treatment for 3 months. Both pre- and posttreatmentvalues of pure audiograms, frequency and intensityof tinnitus, minimal masking, residual inhibition,and the values in VAS questionnaire form were also evaluatedfrom patient files.Results: According to the statistical analysis, tinnitus intensity,frequency of tinnitus, discomfort value due to tinnitusand the concentration loss due to tinnitus values inVAS test were found to be decreased after medication(p=0.001. Among the audiological findings of patients,tinnitus frequency (p=0.250, tinnitus intensity (p=0.057,minimal masking level (p= 0.213, and residual inhibitionvalues were found to have no statistically significantchanges.Conclusions: It was found that three-months treatmentof trimetazidine treatment caused reduction in tinnituscomplaints of patients and did not cause any significantchange in audiological test results. J Clin Exp Invest2012; 3(1: 81-86

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

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    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.

  10. Animal models of tinnitus.

    Science.gov (United States)

    Brozoski, Thomas J; Bauer, Carol A

    2016-08-01

    Presented is a thematic review of animal tinnitus models from a functional perspective. Chronic tinnitus is a persistent subjective sound sensation, emergent typically after hearing loss. Although the sensation is experientially simple, it appears to have central a nervous system substrate of unexpected complexity that includes areas outside of those classically defined as auditory. Over the past 27 years animal models have significantly contributed to understanding tinnitus' complex neurophysiology. In that time, a diversity of models have been developed, each with its own strengths and limitations. None has clearly become a standard. Animal models trace their origin to the 1988 experiments of Jastreboff and colleagues. All subsequent models derive some of their features from those experiments. Common features include behavior-dependent psychophysical determination, acoustic conditions that contrast objective sound and silence, and inclusion of at least one normal-hearing control group. In the present review, animal models have been categorized as either interrogative or reflexive. Interrogative models use emitted behavior under voluntary control to indicate hearing. An example would be pressing a lever to obtain food in the presence of a particular sound. In this type of model animals are interrogated about their auditory sensations, analogous to asking a patient, "What do you hear?" These models require at least some training and motivation management, and reflect the perception of tinnitus. Reflexive models, in contrast, employ acoustic modulation of an auditory reflex, such as the acoustic startle response. An unexpected loud sound will elicit a reflexive motor response from many species, including humans. Although involuntary, acoustic startle can be modified by a lower-level preceding event, including a silent sound gap. Sound-gap modulation of acoustic startle appears to discriminate tinnitus in animals as well as humans, and requires no training or

  11. 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.

  12. Attentional Bias in Patients with Decompensated Tinnitus: Prima Facie Evidence from Event-Related Potentials.

    Science.gov (United States)

    Li, Zhicheng; Gu, Ruolei; Zeng, Xiangli; Zhong, Weifang; Qi, Min; Cen, Jintian

    2016-01-01

    Tinnitus refers to the auditory perception of sound in the absence of external sound or electric stimuli. The influence of tinnitus on cognitive processing is at the cutting edge of ongoing tinnitus research. In this study, we adopted an objective indicator of attentional processing, i.e. the mismatch negativity (MMN), to assess the attentional bias in patients with decompensated tinnitus. Three kinds of pure tones, D1 (8,000 Hz), S (8,500 Hz) and D2 (9,000 Hz), were used to induce event-related potentials (ERPs) in the normal ear. Employing the oddball paradigm, the task was divided into two blocks in which D1 and D2 were set as deviation stimuli, respectively. Only D2 induced a significant MMN in the tinnitus group, while neither D1 nor D2 was able to induce MMN in the control group. In addition, the ERPs in the left hemisphere, which were recorded within the time window of 90-150 ms (ERP90-150 ms), were significantly higher than those in the right hemisphere in the tinnitus group, while no significant difference was observed in the control group. Lastly, the amplitude of ERP90-150 ms in the tinnitus group was significantly higher than that in the control group. These findings suggest that patients with decompensated tinnitus showed automatic processing of acoustic stimuli, thereby indicating that these patients allocated more cognitive resources to acoustic stimulus processing. We suggest that the difficulty in disengaging or facilitated attention of patients might underlie this phenomenon. The limitations of the current study are discussed. PMID:26800229

  13. 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

  14. Impact of Multiple Factors on the Degree of Tinnitus Distress

    Science.gov (United States)

    Brüggemann, Petra; Szczepek, Agnieszka J.; Rose, Matthias; McKenna, Laurence; Olze, Heidi; Mazurek, Birgit

    2016-01-01

    Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress. PMID:27445776

  15. 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.

  16. Functional Near-Infrared Spectroscopy to Probe State- and Trait-Like Conditions in Chronic Tinnitus: A Proof-of-Principle Study

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    Martin Schecklmann

    2014-01-01

    Full Text Available Objective. Several neuroscience tools showed the involvement of auditory cortex in chronic tinnitus. In this proof-of-principle study we probed the capability of functional near-infrared spectroscopy (fNIRS for the measurement of brain oxygenation in auditory cortex in dependence from chronic tinnitus and from intervention with transcranial magnetic stimulation. Methods. Twenty-three patients received continuous theta burst stimulation over the left primary auditory cortex in a randomized sham-controlled neuronavigated trial (verum = 12; placebo = 11. Before and after treatment, sound-evoked brain oxygenation in temporal areas was measured with fNIRS. Brain oxygenation was measured once in healthy controls (n=12. Results. Sound-evoked activity in right temporal areas was increased in the patients in contrast to healthy controls. Left-sided temporal activity under the stimulated area changed over the course of the trial; high baseline oxygenation was reduced and vice versa. Conclusions. By demonstrating that rTMS interacts with auditory evoked brain activity, our results confirm earlier electrophysiological findings and indicate the sensitivity of fNIRS for detecting rTMS induced changes in brain activity. Moreover, our findings of trait- and state-related oxygenation changes indicate the potential of fNIRS for the investigation of tinnitus pathophysiology and treatment response.

  17. 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.

  18. Short and Intense Tailor-Made Notched Music Training against Tinnitus: The Tinnitus Frequency Matters

    OpenAIRE

    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) persis...

  19. 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.)

  20. Acceptance of Tinnitus : Validation of the Tinnitus Acceptance Questionnaire

    OpenAIRE

    Weise, Cornelia; Kleinstäuber, Maria; Hesser, Hugo; Westin, Vendela; 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 acce...

  1. 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.

  2. 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.

  3. 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…

  4. 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.

  5. 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.

  6. 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.

  7. 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.)

  8. Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo

    OpenAIRE

    Li Zhang; Yanbing Yu; Yue Yuan; Jun Xu; Xialo Xu; Jianguo Zhang

    2012-01-01

    Aim: The aim of this study was to investigate the patient selection, indications for operation, surgical methods and effects of microvascular decompression (MVD) for treatment of intractable and incapacitating tinnitus and vertigo. Materials and Methods: A total of 35 patients were recruited from January 2009 to June 2010 for the MVD surgery. Results: Arterial compression of cochleovestibular nerve was found in all the 35 patients. The immediate effect of MVD was observed in 22 patients with ...

  9. When Your Child Has Tinnitus

    Science.gov (United States)

    ... an ENT Doctor Near You When Your Child Has Tinnitus When Your Child Has Tinnitus Patient Health Information News media interested in ... be continuous or sporadic. This often debilitating condition has been linked to ear injuries, circulatory system problems, ...

  10. 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

  11. Multisensory attention training for treatment of tinnitus

    OpenAIRE

    Spiegel D. P.; Linford T.; Thompson B; Petoe M. A.; Kobayashi K; Stinear C. M.; Searchfield G. D.

    2015-01-01

    Tinnitus is the conscious perception of sound with no physical sound source. Some models of tinnitus pathophysiology suggest that networks associated with attention, memory, distress and multisensory experience are involved in tinnitus perception. The aim of this study was to evaluate whether a multisensory attention training paradigm which used audio, visual, and somatosensory stimulation would reduce tinnitus. Eighteen participants with predominantly unilateral chronic tinnitus were randomi...

  12. Temporary Suppression of Tinnitus by Modulated Sounds

    OpenAIRE

    Reavis, Kelly M.; Rothholtz, Vanessa S.; Tang, Qing; Carroll, Jeff A.; Djalilian, Hamid; Zeng, Fan-Gang

    2012-01-01

    Despite high prevalence of tinnitus and its impact on quality life, there is no cure for tinnitus at present. Here, we report an effective means to temporarily suppress tinnitus by amplitude- and frequency-modulated tones. We systematically explored the interaction between subjective tinnitus and 17 external sounds in 20 chronic tinnitus sufferers. The external sounds included traditionally used unmodulated stimuli such as pure tones and white noise and dynamically modulated stimuli known to ...

  13. Structural brain changes following left temporal low-frequency rTMS in patients with subjective tinnitus

    OpenAIRE

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

    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 ...

  14. The radiologic evaluation of tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  15. Prefrontal Cortex Based Sex Differences in Tinnitus Perception: Same Tinnitus Intensity, Same Tinnitus Distress, Different Mood

    OpenAIRE

    Sven Vanneste; Kathleen Joos; Dirk De Ridder

    2012-01-01

    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 regula...

  16. Auditory resting-state network connectivity in tinnitus: a functional MRI study.

    Directory of Open Access Journals (Sweden)

    Audrey Maudoux

    Full Text Available The underlying functional neuroanatomy of tinnitus remains poorly understood. Few studies have focused on functional cerebral connectivity changes in tinnitus patients. The aim of this study was to test if functional MRI "resting-state" connectivity patterns in auditory network differ between tinnitus patients and normal controls. Thirteen chronic tinnitus subjects and fifteen age-matched healthy controls were studied on a 3 tesla MRI. Connectivity was investigated using independent component analysis and an automated component selection approach taking into account the spatial and temporal properties of each component. Connectivity in extra-auditory regions such as brainstem, basal ganglia/NAc, cerebellum, parahippocampal, right prefrontal, parietal, and sensorimotor areas was found to be increased in tinnitus subjects. The right primary auditory cortex, left prefrontal, left fusiform gyrus, and bilateral occipital regions showed a decreased connectivity in tinnitus. These results show that there is a modification of cortical and subcortical functional connectivity in tinnitus encompassing attentional, mnemonic, and emotional networks. Our data corroborate the hypothesized implication of non-auditory regions in tinnitus physiopathology and suggest that various regions of the brain seem involved in the persistent awareness of the phenomenon as well as in the development of the associated distress leading to disabling chronic tinnitus.

  17. Auditory Resting-State Network Connectivity in Tinnitus: A Functional MRI Study

    Science.gov (United States)

    Maudoux, Audrey; Lefebvre, Philippe; Cabay, Jean-Evrard; Demertzi, Athena; Vanhaudenhuyse, Audrey; Laureys, Steven; Soddu, Andrea

    2012-01-01

    The underlying functional neuroanatomy of tinnitus remains poorly understood. Few studies have focused on functional cerebral connectivity changes in tinnitus patients. The aim of this study was to test if functional MRI “resting-state” connectivity patterns in auditory network differ between tinnitus patients and normal controls. Thirteen chronic tinnitus subjects and fifteen age-matched healthy controls were studied on a 3 tesla MRI. Connectivity was investigated using independent component analysis and an automated component selection approach taking into account the spatial and temporal properties of each component. Connectivity in extra-auditory regions such as brainstem, basal ganglia/NAc, cerebellum, parahippocampal, right prefrontal, parietal, and sensorimotor areas was found to be increased in tinnitus subjects. The right primary auditory cortex, left prefrontal, left fusiform gyrus, and bilateral occipital regions showed a decreased connectivity in tinnitus. These results show that there is a modification of cortical and subcortical functional connectivity in tinnitus encompassing attentional, mnemonic, and emotional networks. Our data corroborate the hypothesized implication of non-auditory regions in tinnitus physiopathology and suggest that various regions of the brain seem involved in the persistent awareness of the phenomenon as well as in the development of the associated distress leading to disabling chronic tinnitus. PMID:22574141

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

    OpenAIRE

    Carla Carnovale; Paolo Pellegrino; Silvia Beretta; Gian Vincenzo Zuccotti; Valentina Perrone; Stefania Antoniazzi; Marco Pozzi; Emilio Clementi; Sonia Radice

    2014-01-01

    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 n...

  19. Phenotypic Characteristics of Hyperacusis in Tinnitus

    OpenAIRE

    Martin Schecklmann; Michael Landgrebe; Berthold Langguth

    2014-01-01

    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 R...

  20. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  2. The cerebellum as a novel tinnitus generator.

    Science.gov (United States)

    Bauer, Carol A; Kurt, Wisner; Sybert, Lauren T; Brozoski, Thomas J

    2013-01-01

    The role of the cerebellum in auditory processing is largely unknown. Recently it was shown that rats with psychophysical evidence of tinnitus had significantly elevated neural activity in the paraflocculus of the cerebellum (PFL), as indicated by functional imaging. It was further shown that PFL activity was not elevated in normal rats listening to a tinnitus-like sound. This suggests that plastic changes in the PFL may underpin chronic tinnitus, i.e., it may serve as a tinnitus generator. Using a rat model of acoustic trauma-induced tinnitus, the role of the cerebellum was further examined in a series of experiments:The PFL was surgically ablated in animals with established tinnitus; the PFL was surgically ablated in animals before induction of tinnitus; the PFL was reversibly inactivated by chronic lidocaine infusion into the subarcuate fossa of animals with established tinnitus. It was found that PFL ablation eliminated established tinnitus without altering auditory discrimination. Similar to the ablation results, PFL inactivation with lidocaine reversibly eliminated existing tinnitus. In contrast however, PFL ablation before tinnitus induction attenuated, but did not completely eliminate, tinnitus. In a rat model of noise-induced chronic tinnitus, the cerebellar PFL may serve as a sufficient but non-obligatory generator of tinnitus. PMID:23418634

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

    Directory of Open Access Journals (Sweden)

    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

  4. 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.

  5. Tinnitus: Distinguishing between Subjectively Perceived Loudness and Tinnitus-Related Distress

    OpenAIRE

    Elisabeth Wallhäusser-Franke; Joachim Brade; Tobias Balkenhol; Roberto D'Amelio; Andrea Seegmüller; Wolfgang Delb

    2012-01-01

    OBJECTIVES: Overall success of current tinnitus therapies is low, which may be due to the heterogeneity of tinnitus patients. Therefore, subclassification of tinnitus patients is expected to improve therapeutic allocation, which, in turn, is hoped to improve therapeutic success for the individual patient. The present study aims to define factors that differentially influence subjectively perceived tinnitus loudness and tinnitus-related distress. METHODS: In a questionnaire-based cross-section...

  6. Tinnitus in elderly patients and prognosis of mild-to-moderate congestive heart failure: a cross-sectional study with a long-term extension of the clinical follow-up

    Directory of Open Access Journals (Sweden)

    Cicero Arrigo FG

    2011-06-01

    Full Text Available Abstract Background The complex mechanism responsible for tinnitus, a symptom highly prevalent in elderly patients, could involve an impaired control of the microcirculation of the inner ear, particularly in patients with poor blood pressure control and impaired left ventricular (LV function. Methods In order to define the relationship between the presence of tinnitus and the severity and clinical prognosis of mild-to-moderate chronic heart failure (CHF in a large population of elderly patients (N = 958, a cross-sectional study was conducted with a long-term extension of the clinical follow-up. Blood pressure, echocardiographic parameters, brain natriuretic peptide (BNP, hospitalization, and mortality for CHF were measured. Multivariate logistic regression analysis was used to assess the association between the presence of tinnitus and some of the prognostic determinants of heart failure. Results The presence of tinnitus was ascertained in 233 patients (24.3%; mean age 74.9 ± 6 years and was associated with reduced systolic and diastolic blood pressure (123.1 ± 16/67.8 ± 9 vs 125.9 ± 15/69.7 ± 9; P = .027/P = .006, reduced LV ejection fraction (LVEF%; 43.6 ± 15 vs 47.9 ± 14%, P = .001, and increased BNP plasma levels (413.1 ± 480 vs 286.2 ± 357, P = .013 in comparison to patients without symptoms. The distribution of CHF functional class was shifted toward a greater severity of the disease in patients with tinnitus. Combined one-year mortality and hospitalization for CHF (events/year was 1.43 ± 0.2 in patients with tinnitus and 0.83 ± 0.1 in patients without tinnitus, with an adjusted hazard ratio (HR of 0.61 (95% confidence interval (CI: 0.37 to 0.93, P Conclusions Our preliminary data indirectly support the hypothesis that tinnitus is associated with a worse CHF control in elderly patients and can have some important clinical implications for the early identification of patients who deserve a more aggressive management of CHF.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. [Somatosensoric tinnitus].

    Science.gov (United States)

    Biesinger, E; Groth, A; Höing, R; Hölzl, M

    2015-04-01

    Tinnitus can be caused or triggered by functional disorders of the cervical spine, temporomandibular joint or any other musculoskeletal structure of the neck or head. This special form of tinnitus is called somatosensory tinnitus and represents a discrete subgroup among the different kinds of tinnitus. Distinctive for this kind of tinnitus are alterations in volume and frequency during movement or the stimulation of certain muscles and joints. This can be evaluated using a structured testing method. To be able to easily perceive tinnitus modulations, the test must be performed in total silence. Effective treatment modules are physiotherapy, osteopathy, neural therapy, and Qigong for self-help. PMID:25862620

  9. Structural brain changes following left temporal low-frequency rTMS in patients with subjective tinnitus.

    Science.gov (United States)

    Lehner, Astrid; 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

  10. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    OpenAIRE

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting; Gong, Shusheng; Wang, Zhenchang

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subc...

  11. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    Directory of Open Access Journals (Sweden)

    Han Lv

    2016-01-01

    Full Text Available Previous resting-state functional magnetic resonance imaging (rs-fMRI studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp. were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule, left IFG (inferior frontal gyrus, and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future.

  12. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus.

    Science.gov (United States)

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting; Gong, Shusheng; Wang, Zhenchang

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027-0.073 Hz, and slow-5, 0.010-0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp.) were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule), left IFG (inferior frontal gyrus), and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future. PMID:27413554

  13. Frequency-Dependent Neural Activity in Patients with Unilateral Vascular Pulsatile Tinnitus

    Science.gov (United States)

    Lv, Han; Zhao, Pengfei; Liu, Zhaohui; Wang, Guopeng; Zeng, Rong; Yan, Fei; Dong, Cheng; Zhang, Ling; Li, Rui; Wang, Peng; Li, Ting

    2016-01-01

    Previous resting-state functional magnetic resonance imaging (rs-fMRI) studies have shown that neurological changes are important findings in vascular pulsatile tinnitus (PT) patients. Here, we utilized rs-fMRI to measure the amplitude of low-frequency fluctuations (ALFF) in forty patients with unilateral PT and forty age-, gender-, and education-matched normal control subjects. Two different frequency bands (slow-4, 0.027–0.073 Hz, and slow-5, 0.010–0.027 Hz, which are more sensitive to subcortical and cortical neurological signal changes, resp.) were analyzed to examine the intrinsic brain activity in detail. Compared to controls, PT patients had increased ALFF values mainly in the PCu, bilateral IPL (inferior parietal lobule), left IFG (inferior frontal gyrus), and right IFG/anterior insula and decreased ALFF values in the multiple occipital areas including bilateral middle-inferior occipital lobe. For the differences of the two frequency bands, widespread ALFF differences were observed. The ALFF abnormalities in aMPFC/ACC, PCu, right IPL, and some regions of occipital and parietal cortices were greater in the slow-5 band compared to the slow-4 band. Additionally, the THI score of PT patients was positively correlated with changes in slow-5 and slow-4 band in PCu. Pulsatile tinnitus is a disease affecting the neurological activities of multiple brain regions. Slow-5 band is more sensitive in detecting the alternations. Our results also indicated the importance of pathophysiological investigations in patients with pulsatile tinnitus in the future. PMID:27413554

  14. 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

  15. High frequency localised "hot spots" in temporal lobes of patients with intractable tinnitus: a quantitative electroencephalographic (QEEG) study.

    Science.gov (United States)

    Ashton, Heather; Reid, Keith; Marsh, Richard; Johnson, Ian; Alter, Kai; Griffiths, Tim

    2007-10-01

    Tinnitus, the perception of noise in the absence of an external auditory stimulus, is common, frequently distressing and often intractable. It is associated with a number of conditions including deafness but may arise spontaneously. Brain imaging studies indicate increased neuronal excitability and decreased density of benzodiazepine receptors in temporal (auditory) cortex but the source and mechanism of such changes are unknown. Various electroencephalographic (EEG) abnormalities involving temporal lobe and other brain areas have been described but recordings have been limited to standard EEG wave bands up to frequencies of 22Hz. This clinical study of otherwise healthy patients with intractable unilateral tinnitus, using quantitative EEG power spectral mapping (QEEG), identified discrete localised unilateral foci of high frequency activity in the gamma range (>40-80Hz) over the auditory cortex in eight patients experiencing tinnitus during recording. These high frequency "hot spots" were not present in 25 subjects without tinnitus. The results suggest that further EEG investigations should include recordings in the gamma frequency range since such high frequency oscillations are believed to be necessary for perception. Identification of "hot spots" in tinnitus patients would provide a means for monitoring the effects of new treatments. These findings may also provide a model for exploration of more complex phenomena such as verbal and musical hallucinations. PMID:17888572

  16. Customized notched music training reduces tinnitus loudness

    OpenAIRE

    Stracke, Henning; Okamoto, Hidehiko; Pantev, Christo

    2010-01-01

    Chronic tinnitus is a symptom with high prevalence. There is evidence that the tinnitus perception is related to unfavorable cortical plastic changes. In our recent study we have developed and evaluated a customized music training strategy that appears capable of both reducing cortical tinnitus related neuronal activity and alleviating subjective tinnitus perception. We hypothesize that the regular and enjoyable music training reverses unprofitable cortical reorganization to a certain degree ...

  17. The Cerebellum as a Novel Tinnitus Generator

    OpenAIRE

    Bauer, Carol A.; Wisner, Kurt; Sybert, Lauren T.; Brozoski, Thomas J.

    2013-01-01

    The role of the cerebellum in auditory processing is largely unknown. Recently it was shown that rats with psychophysical evidence of tinnitus had significantly elevated neural activity in the paraflocculus of the cerebellum (PFL), as indicated by functional imaging. It was further shown that PFL activity was not elevated in normal rats listening to a tinnitus-like sound. This suggests that plastic changes in the PFL may underpin chronic tinnitus, i.e., it may serve as a tinnitus generator. U...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Carnovale, Carla; Pellegrino, Paolo; Beretta, Silvia; Zuccotti, Gian Vincenzo; Perrone, Valentina; Antoniazzi, Stefania; Pozzi, Marco; Clementi, Emilio; Radice, Sonia

    2014-01-01

    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. PMID:24799822

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

    Directory of Open Access Journals (Sweden)

    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.

  1. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  3. Changes of oscillatory activity in pitch processing network and related tinnitus relief induced by acoustic CR neuromodulation

    Directory of Open Access Journals (Sweden)

    Ilya Adamchic

    2012-04-01

    Full Text Available Chronic subjective tinnitus is characterized by abnormal neuronal synchronization in the central auditory system. As shown in a controlled clinical trial, acoustic coordinated reset (CR neuromodulation causes a significant relief of tinnitus symptoms along with a significant decrease of pathological oscillatory activity in a network comprising auditory and non-auditory brain areas, which is often accompanied with a significant tinnitus pitch change. Here, we studied if the tinnitus pitch change correlates with a reduction of tinnitus loudness and/or annoyance as assessed by visual analogue scale (VAS scores. Furthermore, we studied if the changes of the pattern of brain synchrony in tinnitus patients induced by 12 weeks of CR-therapy depend on whether or not the patients undergo a pronounced tinnitus pitch change. For this, we applied standardized low-resolution brain electromagnetic tomography (sLORETA to EEG recordings from two groups of patients with a sustained CR-induced relief of tinnitus symptoms with and without tinnitus pitch change. We found that absolute changes of VAS loudness and VAS annoyance scores significantly correlate with the modulus of the tinnitus pitch change. Moreover, as opposed to patients with weak or no pitch change we found a significantly stronger decrease in gamma power in patients with pronounced tinnitus pitch change in right parietal cortex (BA 1, 40, right frontal cortex (BA 8, 9, 46, and left frontal cortex (BA 4, 6, combined with a significantly stronger increase of alpha (10-12 Hz activity in the right anterior cingulate cortex (BA 32, 24. In addition, we revealed a significantly lower functional connectivity in the gamma band between the right dorsolateral prefrontal cortex (BA 9 and the right anterior cingulate cortex (BA 32 after 12 weeks of CR-therapy in patients with pronounced pitch change. Our results indicate a substantial, CR-induced reduction of tinnitus-related auditory binding in a pitch

  4. Therapy of unspecific tinnitus without organic cause

    Directory of Open Access Journals (Sweden)

    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

  5. Imaging in pulsatile tinnitus

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Transdermal electrical stimulation in sensorineural tinnitus

    OpenAIRE

    S Maini; Deoganonkar, S. C.

    1999-01-01

    In 73 patients, comprising of 84 ears, with persistent decompensated tinnitus and sensorineu-ral deafness, tinnitus suppression was attempted with low frequency, low ampere transdermal electrical stimula-tion (TDES). The causes of tinnitus were presbyacusis, unknown aetiology, noise exposure, otosclerosis, ototoxic drugs, endolymphatic hydrops, labyrinthitis and post head injury. Reduction of tinnitus was achieved in 38 of 84 ears. Results i.e. improvement were achieved in patients in the fol...

  7. Long-term reductions in tinnitus severity

    OpenAIRE

    Folmer Robert L

    2002-01-01

    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 Or...

  8. Long-term reductions in tinnitus severity

    OpenAIRE

    Folmer, Robert L.

    2002-01-01

    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 Heal...

  9. Studying the Difference in the Effect of Noise and Pure Tone on the Residual Inhibition in Patients Suffering Tinnitus

    OpenAIRE

    Majid Norouzi; Abdollah Mousavi; Masoumeh Rouzbehani

    1998-01-01

    Objectives: we were aimed at studying the difference in the effect of noise and pure tone on the residual inhibition in patients suffering tinnitus. "nMethod: patients were selected among whom referred to audiology clinic in Ran faculty of rehabilitation sciences and aged between 20-70 years old. Our method in studying patients was experimental- masking with pure tone was performed in patients who had experienced partial residual inhibition with noise. Results; the differences between the mas...

  10. Long-term reductions in tinnitus severity

    Directory of Open Access Journals (Sweden)

    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.

  11. Autonomic Conditions in Tinnitus and Implications for Korean Medicine

    OpenAIRE

    Eun Ji Choi; Younghee Yun; Seungyeon Yoo; Kyu Seok Kim; Jeong-Su Park; Inhwa Choi

    2013-01-01

    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 retrospe...

  12. 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.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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。

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

    Institute of Scientific and Technical Information of China (English)

    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

  16. 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

    Directory of Open Access Journals (Sweden)

    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.

  17. Cognitive Behavioral Therapy for Tinnitus: Evidence and Efficacy

    OpenAIRE

    Jun, Hyung Jin; Park, Moo Kyun

    2013-01-01

    Tinnitus is defined as auditory perception without external sound. There is currently no cure for tinnitus. Cognitive behavioral therapy (CBT) is a tinnitus treatment that addresses the affected individual's reaction to tinnitus. It aims not to eliminate auditory perception as sound but to reduce or correct one's negative response to tinnitus. CBT identifies negative automatic thought and then evaluates its validity with the patient. It also aims to change negative automatic thought to more p...

  18. Titus's tinnitus.

    OpenAIRE

    Dan, Bernard

    2005-01-01

    Historical approaches to tinnitus have depended highly on cultural factors. While ancient Oriental mysticism regarded it as sensitivity to the divine, Roman medicine associated it with depressive and seizure disorders on the basis of presumed common pathophysiology shared by the three conditions. In the Babylonian Talmud, tinnitus appears as Titus's curse: a gnat buzzing in the brain, responding to sound therapy, and then habituating. Various sources show varied emphases with common attention...

  19. Prevalence and characteristics of tinnitus after leisure noise exposure in young adults

    OpenAIRE

    Sofie Degeest; Paul Corthals; Bart Vinck; Hannah Keppler

    2014-01-01

    The main goal of this study was to assess the prevalence and characteristics of tinnitus among students after exposure to leisure noise. In addition, the effects of tinnitus on otoacoustic emissions (OAEs) in participants suffering from chronic tinnitus were evaluated. The study consisted of two parts. First, a questionnaire regarding leisure noise exposure and tinnitus was completed. Second, the hearing status of the subjects suffering from chronic tinnitus was evaluated and compared with a ...

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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

  2. Can Magnetic Coil Ease Tinnitus?

    Science.gov (United States)

    ... often recommend are cognitive behavior therapy, mindfulness, self-hypnosis, and relaxation therapy. These approaches can help patients ... a certain percentage do experience discomfort or even pain. See, for example, this 2009 review study . Tinnitus ...

  3. 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。

  4. 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.

  5. Sensorineural Tinnitus: Its Pathology and Probable Therapies.

    Science.gov (United States)

    Møller, Aage R

    2016-01-01

    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. PMID:26977153

  6. Physical therapy treatment in patients suffering from cervicogenic somatic tinnitus: study protocol for a randomized controlled trial

    OpenAIRE

    Michiels, Sarah; De Hertogh, Willem; Truijen, Steven; van de Heyning, Paul

    2014-01-01

    Background Tinnitus occurs in a large part of the general population with prevalences ranging from 10% to 15% in an adult population. One subtype is cervicogenic somatic tinnitus, arising from cervical spine dysfunctions, justifying cervical spine assessment and treatment. This study aims to investigate the effect of a standardized physical therapy treatment, directed to the cervical spine, on tinnitus. Additionally, a second aim is to identify a subgroup within the tinnitus population that b...

  7. Investigation of Electrophysiological Patterns and Multiple Treatments in Tinnitus

    OpenAIRE

    Cartocci, Giulia

    2014-01-01

    Tinnitus is the most common auditory desorder, it is defined as a sound sensation in the absence of any external sound source. Sleep disturbances and depression are symptoms very often present in tinnitus patients. Starting from this observation, in the present thesis two electrophysiological approaches to tinnitus study are described: the former concerns sleep architecture pattern investigation in tinnitus patients, and the second concerns an index of serotonin activity in the auditory corte...

  8. Intrinsic network activity in tinnitus investigated using functional MRI.

    Science.gov (United States)

    Leaver, Amber M; Turesky, Ted K; Seydell-Greenwald, Anna; Morgan, Susan; Kim, Hung J; Rauschecker, Josef P

    2016-08-01

    Tinnitus is an increasingly common disorder in which patients experience phantom auditory sensations, usually ringing or buzzing in the ear. Tinnitus pathophysiology has been repeatedly shown to involve both auditory and non-auditory brain structures, making network-level studies of tinnitus critical. In this magnetic resonance imaging (MRI) study, two resting-state functional connectivity (RSFC) approaches were used to better understand functional network disturbances in tinnitus. First, we demonstrated tinnitus-related reductions in RSFC between specific brain regions and resting-state networks (RSNs), defined by independent components analysis (ICA) and chosen for their overlap with structures known to be affected in tinnitus. Then, we restricted ICA to data from tinnitus patients, and identified one RSN not apparent in control data. This tinnitus RSN included auditory-sensory regions like inferior colliculus and medial Heschl's gyrus, as well as classically non-auditory regions like the mediodorsal nucleus of the thalamus, striatum, lateral prefrontal, and orbitofrontal cortex. Notably, patients' reported tinnitus loudness was positively correlated with RSFC between the mediodorsal nucleus and the tinnitus RSN, indicating that this network may underlie the auditory-sensory experience of tinnitus. These data support the idea that tinnitus involves network dysfunction, and further stress the importance of communication between auditory-sensory and fronto-striatal circuits in tinnitus pathophysiology. Hum Brain Mapp 37:2717-2735, 2016. © 2016 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc. PMID:27091485

  9. Assessment of distress associated with tinnitus.

    OpenAIRE

    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 procedures and several psychological variables. Data presented on 104 tinnitus patients demonstrated the reliability of the STSS with a coefficient alpha of 0.71. Factor analysis revealed four factors: em...

  10. 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

  11. 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

  12. Tinnitus activities treatment.

    Science.gov (United States)

    Tyler, Richard S; Gogel, Stephanie A; Gehringer, Anne K

    2007-01-01

    Tinnitus Activities Treatment includes counseling of the whole person, and considers individual differences and needs. We consider four areas: thoughts and emotions, hearing and communication, sleep, and concentration. We typically use Partial Masking Sound Therapy, with a noise or music set to the lowest level that provides relief. A picture-based approach facilitates engagement of the patient, and provides thorough and structured counseling. We engage the patient by including homework and activities to demonstrate understanding and facilitate progress. PMID:17956807

  13. 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.

  14. 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....

  15. 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

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

    OpenAIRE

    Krick, Christoph M.; Grapp, Miriam; Daneshvar-Talebi, Jonas; Reith, Wolfgang; Plinkert, Peter K; Bolay, Hans Volker

    2015-01-01

    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-min sessions of individualized therapy implemented over 1 week. Clinical improvement and long-term eff...

  17. 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.

  18. The Enigma of the Tinnitus-Free Dream State in a Bayesian World

    OpenAIRE

    2014-01-01

    There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of these 74 claim not to perceive tinnitus during their dreams (97%). This can be most easily explained b...

  19. 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

  20. 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

  1. 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

  2. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  4. 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.

  5. A randomized, double-blind, placebo-controlled clinical trial to evaluate the efficacy and safety of neramexane in patients with moderate to severe subjective tinnitus

    Directory of Open Access Journals (Sweden)

    Jastreboff Pawel J

    2011-01-01

    Full Text Available Abstract Background Neramexane is a new substance that exhibits antagonistic properties at α9α10 cholinergic nicotinic receptors and N-methyl-D-aspartate receptors, suggesting potential efficacy in the treatment of tinnitus. Methods A total of 431 outpatients with moderate to severe subjective tinnitus (onset 3-18 months before screening were assigned randomly to receive either placebo or neramexane mesylate (25 mg/day, 50 mg/day and 75 mg/day for 16 weeks, with assessment at 4-week intervals. The primary (intention-to-treat efficacy analysis was based on the change from baseline in Week 16 in the total score of the adapted German short version of the validated Tinnitus Handicap Inventory questionnaire (THI-12. Results Compared with placebo, the largest improvement was achieved in the 50 mg/d neramexane group, followed by the 75 mg/d neramexane group. This treatment difference did not reach statistical significance at the pre-defined endpoint in Week 16 (p = 0.098 for 50 mg/d; p = 0.289 for 75 mg/d neramexane, but consistent numerical superiority of both neramexane groups compared with placebo was observed. Four weeks after the end of treatment, THI-12 scores in the 50 mg/d group were significantly better than those of the controls. Secondary efficacy variables supported this trend, with p values of Conclusions This study demonstrated the safety and tolerability of neramexane treatment in patients with moderate to severe tinnitus. The primary efficacy variable showed a trend towards improvement of tinnitus suffering in the medium- and high-dose neramexane groups. This finding is in line with consistent beneficial effects observed in secondary assessment variables. These results allow appropriate dose selection for further studies. Trial Registration ClinicalTrials.gov NCT00405886

  6. American Tinnitus Association

    Science.gov (United States)

    American Tinnitus Association Donate Become A Member Member Login Find A Provider Search form Search Menu Close Understanding The Facts Managing Your Tinnitus Research Toward A Cure About Us Initiatives News & ...

  7. Role of acamprosate in sensorineural tinnitus

    Directory of Open Access Journals (Sweden)

    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.

  8. 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...... as diagnostic tools. Antidepressants, melatonin and cognitive behavioural therapy have no effect on tinnitus, whereas sound generators, hearing aids and tinnitus retraining therapy show some but limited improvement. National recommendations are required to ensure a homogenous and optimum offer for...

  9. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

  12. Central crosstalk for somatic tinnitus: abnormal vergence eye movements.

    Directory of Open Access Journals (Sweden)

    Qing Yang

    Full Text Available BACKGROUND: Frequent oulomotricity problems with orthoptic testing were reported in patients with tinnitus. This study examines with objective recordings vergence eye movements in patients with somatic tinnitus patients with ability to modify their subjective tinnitus percept by various movements, such as jaw, neck, eye movements or skin pressure. METHODS: Vergence eye movements were recorded with the Eyelink II video system in 15 (23-63 years control adults and 19 (36-62 years subjects with somatic tinnitus. FINDINGS: 1 Accuracy of divergence but not of convergence was lower in subjects with somatic tinnitus than in control subjects. 2 Vergence duration was longer and peak velocity was lower in subjects with somatic tinnitus than in control subjects. 3 The number of embedded saccades and the amplitude of saccades coinciding with the peak velocity of vergence were higher for tinnitus subjects. Yet, saccades did not increase peak velocity of vergence for tinnitus subjects, but they did so for controls. 4 In contrast, there was no significant difference of vergence latency between these two groups. INTERPRETATION: The results suggest dysfunction of vergence areas involving cortical-brainstem-cerebellar circuits. We hypothesize that central auditory dysfunction related to tinnitus percept could trigger mild cerebellar-brainstem dysfunction or that tinnitus and vergence dysfunction could both be manifestations of mild cortical-brainstem-cerebellar syndrome reflecting abnormal cross-modality interactions between vergence eye movements and auditory signals.

  13. 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

  14. Supressão contralateral das emissões otoacústicas nos indivíduos com zumbido Contralateral suppression of otoacoustic emission in patients with tinnitus

    Directory of Open Access Journals (Sweden)

    Mariana Lopes Fávero

    2006-04-01

    Full Text Available INTRODUÇÃO: A função do trato olivococlear medial é estudada pela supressão das emissões otoacústicas com o uso de uma estimulação contralateral e sofre influência da lateralidade do sistema nervoso central, não apresentando respostas iguais entre as orelhas. Uma disfunção neste trato pode implicar na geração do zumbido, porém isto ainda não foi confirmado. OBJETIVO: Estudar a supressão das emissões otoacústicas por produto de distorção em indivíduos com zumbido. MATERIAL E MÉTODO: Estudo caso-controle com 44 pessoas com zumbido, matriculadas no Ambulatório de Zumbido da Divisão de Clínica Otorrinolaringológica do Hospital das Clínicas da Universidade de São Paulo e 44 voluntários submetidos à emissão otoacústica por produto de distorção com e sem estimulação contralateral. Comparou-se os resultados das orelhas direita dos dois grupos. RESULTADOS: Houve associação entre zumbido e ausência de supressão em todas as freqüências estudadas (OR>2,1. CONCLUSÕES: Houve uma correlação entre menor efetividade do trato olivococlear medial e a presença de zumbido.INTRODUCTION: The medial olivocochlear bundle effect is studied through the suppression of otoacoustic emissions and seems to be influenced by the laterality of the central nervous system, presenting no symmetry between right and left ear. A dysfunction of this bundle may be involved in the generation of tinnitus, although this fact was not confirmed. OBJECTIVES: Study the suppression of distortion product otoacoustic emissions in tinnitus patients. MATERIAL AND METHOD: A case-controlled study involving 44 tinnitus patients from the Tinnitus Group of the ENT Department of the University of São Paulo Medical School and 44 controls who underwent distortion product otoacoustic emissions testing with and without contralateral noise. Only the results from the right ears from both groups were compared. RESULTS: There was a relationship between the

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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

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

    OpenAIRE

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

    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...

  18. The Distressed Brain: A Group Blind Source Separation Analysis on Tinnitus

    OpenAIRE

    De Ridder, Dirk; Vanneste, Sven; Congedo, Marco

    2011-01-01

    Background: Tinnitus, the perception of a sound without an external sound source, can lead to variable amounts of distress. Methodology: In a group of tinnitus patients with variable amounts of tinnitus related distress, as measured by the Tinnitus Questionnaire (TQ), an electroencephalography (EEG) is performed, evaluating the patients' resting state electrical brain activity. This resting state electrical activity is compared with a control group and between patients with low (N = 30) and h...

  19. 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

  20. Tinnitus: clinical experience of the psychosomatic connection

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

    Directory of Open Access Journals (Sweden)

    Ananya Panda

    2013-01-01

    Full Text Available Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications.

  3. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus

    Science.gov (United States)

    Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  4. Persistent primitive trigeminal artery: an unusual cause of vascular tinnitus.

    Science.gov (United States)

    Panda, Ananya; Arora, Arundeep; Jana, Manisha

    2013-01-01

    Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. PMID:24459596

  5. 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

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

    OpenAIRE

    Luisa Nascimento Medeiros; Tanit Ganz Sanchez

    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...

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

    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

    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。%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.

  8. 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.

  9. Cortical Reorganisation during a 30-Week Tinnitus Treatment Program.

    Directory of Open Access Journals (Sweden)

    Catherine M McMahon

    Full Text Available Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants' 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual's objective (source strength and anterior-posterior source location and subjective measures (using tinnitus reaction questionnaire, TRQ. The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by

  10. Cortical Reorganisation during a 30-Week Tinnitus Treatment Program.

    Science.gov (United States)

    McMahon, Catherine M; Ibrahim, Ronny K; Mathur, Ankit

    2016-01-01

    Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i) compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii) investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG) recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants) showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants' 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual's objective (source strength and anterior-posterior source location) and subjective measures (using tinnitus reaction questionnaire, TRQ). The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by the tinnitus

  11. Cortical Reorganisation during a 30-Week Tinnitus Treatment Program

    Science.gov (United States)

    McMahon, Catherine M.; Ibrahim, Ronny K.; Mathur, Ankit

    2016-01-01

    Subjective tinnitus is characterised by the conscious perception of a phantom sound. Previous studies have shown that individuals with chronic tinnitus have disrupted sound-evoked cortical tonotopic maps, time-shifted evoked auditory responses, and altered oscillatory cortical activity. The main objectives of this study were to: (i) compare sound-evoked brain responses and cortical tonotopic maps in individuals with bilateral tinnitus and those without tinnitus; and (ii) investigate whether changes in these sound-evoked responses occur with amelioration of the tinnitus percept during a 30-week tinnitus treatment program. Magnetoencephalography (MEG) recordings of 12 bilateral tinnitus participants and 10 control normal-hearing subjects reporting no tinnitus were recorded at baseline, using 500 Hz, 1000 Hz, 2000 Hz, and 4000 Hz tones presented monaurally at 70 dBSPL through insert tube phones. For the tinnitus participants, MEG recordings were obtained at 5-, 10-, 20- and 30- week time points during tinnitus treatment. Results for the 500 Hz and 1000 Hz sources (where hearing thresholds were within normal limits for all participants) showed that the tinnitus participants had a significantly larger and more anteriorly located source strengths when compared to the non-tinnitus participants. During the 30-week tinnitus treatment, the participants’ 500 Hz and 1000 Hz source strengths remained higher than the non-tinnitus participants; however, the source locations shifted towards the direction recorded from the non-tinnitus control group. Further, in the left hemisphere, there was a time-shifted association between the trajectory of change of the individual’s objective (source strength and anterior-posterior source location) and subjective measures (using tinnitus reaction questionnaire, TRQ). The differences in source strength between the two groups suggest that individuals with tinnitus have enhanced central gain which is not significantly influenced by the

  12. 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

  13. Atorvastatin in the management of tinnitus with hyperlipidemias

    International Nuclear Information System (INIS)

    To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Methodology: Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Results: Serum cholesterol came to within normal limits in 51 (52%) patients (responsive group), while it remained high in 47 (48%) patients (unresponsive group). Improvement in tinnitus score in the responsive group was seen in 36 (70.5%) patients and in 2 (4.2%) patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group (p < 0.001). Conclusion: Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin. (author)

  14. Development of a progressive audiologic tinnitus management program for Veterans with tinnitus

    Directory of Open Access Journals (Sweden)

    Paula J. Myers, PhD

    2014-07-01

    Full Text Available Tinnitus is the most prevalent service-connected disability awarded to Veterans. However, clinical protocols for management of tinnitus have been inconsistent across Department of Veterans Affairs (VA medical centers. A study was funded to develop and pilot test a protocol to provide tinnitus services consistently across VA audiology clinics. Drawing on a series of prior VA and external research projects, a clinical model was formulated, supporting materials in multimedia were developed, and a pilot study was conducted. Five hierarchical levels of care were defined and labeled the Progressive Audiologic Tinnitus Management (PATM model. The model facilitates access to medical services for tinnitus and includes detailed protocols for evaluation, education, and counseling of patients. Patients at each level of care have the option to "progress" to the next level of PATM if further services are required. Clinical procedures were defined for each level and materials were produced for audiologists and patients. The PATM model was then piloted with clinical patients at the James A. Haley Veterans’ Hospital (JAHVH in Tampa, Florida. Throughout the pilot study, feedback from patients and clinicians was carefully noted. Training materials for audiologists, incorporation of the protocol into clinic activities, and patient outcomes were evaluated. The model was implemented within the JAHVH Audiology Clinic and to assist Veterans with tinnitus management. The most notable finding was how little tinnitus-specific intervention was required for the majority of patients. This finding supports a clinical model that offers stepped-care ("progressive" levels of care until tinnitus management is achieved by the patient.

  15. Tinnitus: a large VBM-EEG correlational study.

    Science.gov (United States)

    Vanneste, Sven; Van De Heyning, Paul; De Ridder, Dirk

    2015-01-01

    A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography) was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum) that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus. PMID:25781934

  16. Tinnitus: a large VBM-EEG correlational study.

    Directory of Open Access Journals (Sweden)

    Sven Vanneste

    Full Text Available A surprising fact in voxel-based morphometry (VBM studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to pathologies like Alzheimer's disease where it is known the pathology is related to cell loss. In a large sample of 154 tinnitus patients VBM and QEEG (Quantitative Electroencephalography was performed and evaluated by a regression analysis. Correlation analyses are performed between VBM and QEEG data. Uncorrected data demonstrated structural differences in grey matter in hippocampal and cerebellar areas related to tinnitus related distress and tinnitus duration. After control for multiple comparisons, only cerebellar VBM changes remain significantly altered. Electrophysiological differences are related to distress, tinnitus intensity, and tinnitus duration in the subgenual anterior cingulate cortex, dorsal anterior cingulate cortex, hippocampus, and parahippocampus, which confirms previous results. The absence of QEEG-VBM correlations suggest functional changes are not reflected by co-occurring structural changes in tinnitus, and the absence of VBM changes (except for the cerebellum that survive correct statistical analysis in a large study population suggests that VBM might not be very sensitive for studying tinnitus.

  17. Fibromyalgia syndrome in chronic urticaria patients

    OpenAIRE

    Aylin Gözübüyükoğulları; Duru Tabanlıoğlu Onan; Nuran Allı

    2014-01-01

    Background and Design: The aim of our study was to determine the frequency of fibromyalgia syndrome in chronic urticaria patients. Materials and Methods: The study was carried out with the participation of 100 chronic urticaria patients and 61 control group patients. Chronic urticaria patients were investigated for the etiology of urticaria and the autologous serum skin test was performed in those patients. Both the chronic urticaria patients and the controls were evaluated for fibromyalgi...

  18. Connectivity graph analysis of the auditory resting state network in tinnitus.

    OpenAIRE

    Maudoux, Audrey; Lefèbvre, Philippe; Cabay, J.-E.; Demertzi, Athina; Vanhaudenhuyse, Audrey; Laureys, Steven; Soddu, Andrea

    2012-01-01

    Thirteen chronic tinnitus patients and fifteen age-matched healthy controls were studied on a 3T magnetic resonance imaging (MRI) scanner during resting condition (i.e. eyes closed, no task performance). The auditory resting-state component was selected using an automatic component selection approach. Functional connectivity (correlations/anti-correlations) in the extracted network was portrayed by integrating the independent component analysis (ICA) approach with a graph theory method. Tinni...

  19. Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury

    OpenAIRE

    James A. Henry, PhD; Tara L. Zaugg, AuD; Paula J. Myers, PhD; Caroline J. Schmidt, PhD; Susan Griest, MPH; Marcia W. Legro, PhD; Christine Kaelin, MBA; Emily J. Thielman, MS; Daniel M. Storzbach, PhD; Garnett P. McMillan, PhD;; Kathleen F. Carlson, PhD

    2012-01-01

    Tinnitus, or “ringing in the ears,” affects 10%-15% of adults; cases can be problematic and require lifelong management. Many people who have experienced traumatic brain injury (TBI) also experience tinnitus. We developed Progressive Tinnitus Management (PTM), which uses education and counseling to help patients learn how to self-manage their reactions to tinnitus. We adapted PTM by delivering the intervention via telephone and by adding cognitive-behavioral therapy. A pilot study was conduct...

  20. 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

  1. 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

  2. 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.

  3. Linking the Tinnitus Questionnaire and the subjective Clinical Global Impression: Which differences are clinically important?

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    Adamchic Ilya

    2012-07-01

    Full Text Available Abstract Background Development of new tinnitus treatments requires prospective placebo-controlled randomized trials to prove their efficacy. The Tinnitus Questionnaire (TQ is a validated and commonly used instrument for assessment of tinnitus severity and has been used in many clinical studies. Defining the Minimal Clinically Important Difference (MCID for TQ changes is an important step to a better interpretation of the clinical relevance of changes observed in clinical trials. In this study we aimed to estimate the minimum change of the TQ score that could be considered clinically relevant. Methods 757 patients with chronic tinnitus were pooled from the TRI database and the RESET study. An anchor-based approach using the Clinical Global Impression (CGI scale and distributional approaches were used to estimate MCID. Receiver Operating Characteristic (ROC curves were calculated to define optimal TQ change cutoffs discriminating between minimally changed and unchanged subjects. Results The relationship between TQ change scores and CGI ratings of change was good (r = 0.52, p  Conclusion Distribution and anchor-based methods yielded comparable results in identifying MCIDs. ΔTQ scores of −5 and +1 points were identified as the minimal clinically relevant change for improvement and worsening respectively. The asymmetry of the MCIDs for improvement and worsening may be related to expectation effects.

  4. 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

  5. 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. PMID:22750224

  6. Bilateral dorsal cochlear nucleus lesions prevent acoustic-trauma induced tinnitus in an animal model.

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    Brozoski, Thomas Jeffrey; Wisner, Kurt W; Sybert, Lauren T; Bauer, Carol A

    2012-02-01

    Animal experiments suggest that chronic tinnitus ("ringing in the ears") may result from processes that overcompensate for lost afferent input. Abnormally elevated spontaneous neural activity has been found in the dorsal cochlear nucleus (DCN) of animals with psychophysical evidence of tinnitus. However, it has also been reported that DCN ablation fails to reduce established tinnitus. Since other auditory areas have been implicated in tinnitus, the role of the DCN is unresolved. The apparently conflicting electrophysiological and lesion data can be reconciled if the DCN serves as a necessary trigger zone rather than a chronic generator of tinnitus. The present experiment used lesion procedures identical to those that failed to decrease pre-existing tinnitus. The exception was that lesions were done prior to tinnitus induction. Young adult rats were trained and tested using a psychophysical procedure shown to detect tinnitus. Tinnitus was induced by a single unilateral high-level noise exposure. Consistent with the trigger hypothesis, bilateral dorsal DCN lesions made before high-level noise exposure prevented the development of tinnitus. A protective effect stemming from disruption of the afferent pathway could not explain the outcome because unilateral lesions ipsilateral to the noise exposure did not prevent tinnitus and unilateral lesions contralateral to the noise exposure actually exacerbated the tinnitus. The DCN trigger mechanism may involve plastic circuits that, through loss of inhibition, or upregulation of excitation, increase spontaneous neural output to rostral areas such as the inferior colliculus. The increased drive could produce persistent pathological changes in the rostral areas, such as high-frequency bursting and decreased interspike variance, that comprise the chronic tinnitus signal. PMID:21969021

  7. Neural substrates predicting short-term improvement of tinnitus loudness and distress after modified tinnitus retraining therapy.

    Science.gov (United States)

    Kim, Shin Hye; Jang, Ji Hye; Lee, Sang-Yeon; Han, Jae Joon; Koo, Ja-Won; Vanneste, Sven; De Ridder, Dirk; Song, Jae-Jin

    2016-01-01

    Although tinnitus retraining therapy (TRT) is efficacious in most patients, the exact mechanism is unclear and no predictor of improvement is available. We correlated the extent of improvement with pre-TRT quantitative electroencephalography (qEEG) findings to identify neural predictors of improvement after TRT. Thirty-two patients with debilitating tinnitus were prospectively enrolled, and qEEG data were recorded before their initial TRT sessions. Three months later, these qEEG findings were correlated with the percentage improvements in the Tinnitus Handicap Inventory (THI) scores, and numeric rating scale (NRS) scores of tinnitus loudness and tinnitus perception. The THI score improvement was positively correlated with the pre-treatment activities of the left insula and the left rostral and pregenual anterior cingulate cortices (rACC/pgACC), which control parasympathetic activity. Additionally, the activities of the right auditory cortices and the parahippocampus, areas that generate tinnitus, negatively correlated with improvements in loudness. Improvements in the NRS scores of tinnitus perception correlated positively with the pre-TRT activities of the bilateral rACC/pgACC, areas suggested to form the core of the noise-canceling system. The current study supports both the classical neurophysiological and integrative models of tinnitus; our results serve as a milestone in the development of precision medicine in the context of TRT. PMID:27381994

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

    Directory of Open Access Journals (Sweden)

    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

  9. The enigma of the tinnitus-free dream state in a Bayesian world.

    Science.gov (United States)

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

    2014-01-01

    There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of these 74 claim not to perceive tinnitus during their dreams (97%). This can be most easily explained by a predictive Bayesian brain model. That is, during the awake state the brain constantly makes predictions about the environment. Tinnitus is hypothesized to be the result of a prediction error due to deafferentation, and missing input is filled in by the brain. The heuristic explanation then is that in the dream state there is no interaction with the environment and therefore no updating of the prediction error, resulting in the absence of tinnitus. PMID:25097788

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Characteristics and Spontaneous Recovery of Tinnitus Related to Idiopathic Sudden Sensorineural Hearing Loss

    Science.gov (United States)

    Mühlmeier, Guido; Baguley, David; Cox, Tony; Suckfüll, Markus; 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 thirteen adult patients of which 65 with hearing loss ≥30 dB (Study A) and 48 with persistent acute tinnitus (Study B) at baseline. Interventions: Intratympanic (i.t.) injection of placebo gel in single dose or in triple dose during 3 consecutive days. Main Outcome Measures: Frequency of tinnitus, subjective tinnitus loudness, rates of complete tinnitus remission, and complete hearing recovery during 3 months follow-up. Results: In acute ISSNHL, tinnitus loudness decreased rapidly in cases of mild-moderate hearing loss, and tinnitus had completely resolved in two-thirds of patients after 3 months. Hearing recovery preceded tinnitus resolution. When associated with severe-profound hearing loss, tinnitus improved significantly less. Complete hearing recovery and full tinnitus remission were both about three times more frequent in mild-moderate hearing loss patients than in severe-profound cases. Improvement in tinnitus loudness over time can be approximated by a negative exponential function. Conclusions: Prognosis for ISSNHL-related tinnitus is relatively poor in case of severe-profound hearing loss and the longer it has persisted. Alleviation or management of tinnitus should be a key therapeutic objective especially in pronounced ISSNHL cases. PMID:27228021

  13. Design of a placebo-controlled, randomized study of the efficacy of repetitive transcranial magnetic stimulation for the treatment of chronic tinntius

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    Eichhammer Peter

    2008-04-01

    Full Text Available Abstract Background Chronic tinnitus is a frequent condition, which can have enormous impact on patient's life and which is very difficult to treat. Accumulating data indicate that chronic tinnitus is related to dysfunctional neuronal activity in the central nervous system. Repetitive transcranial magnetic stimulation (rTMS is a non-invasive method which allows to focally modulate neuronal activity. An increasing amount of studies demonstrate reduction of tinnitus after repeated sessions of low-frequency rTMS and indicate that rTMS might represent a new promising approach for the treatment of tinnitus. However available studies have been mono-centric and are characterized by small sample sizes. Therefore, this multi-center trial will test the efficacy of rTMS treatment in a large sample of chronic tinnitus patients. Methods/Design This is a randomized, placebo-controlled, double-blind multi-center trial of two weeks 1 Hz rTMS-treatment in chronic tinnitus patients. Eligible patients will be randomized to either 2 weeks real or sham rTMS treatment. Main eligibility criteria: male or female individuals aged 18–70 years with chronic tinnitus (duration > 6 months, tinnitus-handicap-inventory-score ≥ 38, age-adjusted normal sensorineural hearing (i.e. not more than 5 dB below the 10% percentile of the appropriate age and gender group (DIN EN ISO 7029, conductive hearing loss ≤ 15dB. The primary endpoint is a change of tinnitus severity according to the tinnitus questionnaire of Goebel and Hiller (baseline vs. end of treatment period. A total of 138 patients are needed to detect a clinical relevant change of tinnitus severity (i.e. 5 points on the questionnaire of Goebel and Hiller; alpha = 0.05; 1-beta = 0.80. Assuming a drop-out rate of less than 5% until the primary endpoint, 150 patients have to be randomized to guarantee the target number of 138 evaluable patients. The study will be conducted by otorhinolaryngologists and psychiatrists of 7

  14. Resting-state functional connectivity density mapping of etiology confirmed unilateral pulsatile tinnitus patients: Altered functional hubs in the early stage of disease.

    Science.gov (United States)

    Han, L; Pengfei, Z; Zhaohui, L; Fei, Y; Ting, L; Cheng, D; Zhenchang, W

    2015-12-01

    Functional magnetic resonance imaging (fMRI) has been widely used to identify altered intrinsic local neural activities and global networks of tinnitus patients. In this study, functional connectivity density (FCD) mapping, a newly developed voxelwise data-driven method based on fMRI, was applied for the first time to measure the functional reorganization pattern in thirty-two unilateral pulsatile tinnitus (PT) patients in the early stage of disease (less than 48 months). FCD analysis was employed to compute short-range and long-range FCD values. A correlation analysis with clinical variables was also performed. Compared with normal controls, PT patients showed significantly increased short-range FCD, mainly in the precuneus (PCu), bilateral inferior frontal gyrus (IFG) and middle occipital gyrus (MOG), and increased long-range FCD in the PCu, posterior cingulate cortex (PCC), and bilateral middle frontal gyrus (MFG). In addition, correlation analysis showed positive correlations between PT duration and short-range FCD values in the right MOG. Positive correlations were also found between the disease duration and the long-range FCD value in the PCC. The increased short-/long-range FCD in bilateral dorsal visual areas indicated that the enhanced pathway between the auditory cortex and bilateral dorsal visual areas may have activated the "auditory occipital activations" (AOAs) pathway. The bilaterally altered FCD values in the dorsal visual areas reflected the cooperation of different brain areas. This study is a foundation of the connectivity research in PT patients. Our work may advance the understanding of the disrupted neural network of patients with PT. PMID:26384961

  15. 伴感音神经性聋的耳鸣患者临床表现及心理声学特点%Clinical and psychoacoustic characteristics of tinnitus patients with sensorineural hearing loss

    Institute of Scientific and Technical Information of China (English)

    陈秀兰; 秦兆冰

    2011-01-01

    OBJECTIVE To investigate the clinical and psychoacoustic characteristics of tinnitus patients with sensorineural hearing loss, the characteristics of tinnitus were identified in order to facilitate their further management.METHODS One hundred and fifty seven tinnitus sufferers were studied. All the patients were interviewed by the same investigator, using the same questionnaire. Data were collected and analyzed. RESULTS There was a slight predominance of males. The hearing impairment results were limited to the high frequencies in 53.50% of the patients, pitchmatching was limited to high frequencies in 70.70% of the patients with sensorineural hearing loss (SNHL), while 94.05%of the patients with high-frequency SNHL had a high-pitched tinnitus. CONCLUSION There is a significant relationship between high-pitched tinnitus and high-frequency SNHL.There is no significant correlation between tinnitus severity and tinnitus loudness.%目的 通过对157例伴感音神经性聋的主观性耳鸣患者分析,了解耳鸣的临床表现和心理声学特点,为耳鸣诊治提供科学依据.方法 采集157例伴感音神经性聋的主观性耳鸣患者的基本信息、既往史、临床表现、听力学及耳鸣检测结果资料,分析耳鸣的临床特点及各因素与耳鸣之间的关系.结果 157例患者男女比为1.6:1,听力下降以高频为主(53.50%),耳鸣大多数是高调蝉鸣样声音,耳鸣匹配的频率与纯音听阈升高最大的频率关系密切.结论 伴感音神经性聋的耳鸣患者中,以高调耳鸣为主,耳鸣匹配声音类型以纯音居多,耳鸣与听力损失最大的音频近似;耳鸣的响度与耳鸣的严重程度无相关性.

  16. 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. PMID:26747828

  17. Structural neuroanatomy of tinnitus and hyperacusis in semantic dementia

    OpenAIRE

    C.J. Mahoney; Rohrer, J.D.; Goll, J. C.; Fox, N C.; Rossor, M.N.; Warren, J D.

    2011-01-01

    Introduction Tinnitus and hyperacusis are common symptoms of excessive auditory perception in the general population; however, their anatomical substrates and disease associations continue to be defined. Patients with semantic dementia (SemD) frequently report tinnitus and hyperacusis but the significance and basis for these symptoms have not been elucidated. Methods 43 patients with a diagnosis of SemD attending a specialist cognitive disorders clinic were retrospectively studied. 14 patient...

  18. [Chronic cough: common problem, discontended patients].

    Science.gov (United States)

    Koskela, Heikki; Purokivi, Minna

    2014-01-01

    The prevalence of chronic cough is 10 to 15%. It has a strong negative impact on the patients' quality of life and it often causes depression. Many patients find medications unhelpful. Successful management of chronic cough requires the identification of the underlying condition like chronic rhinosinusitis, asthma, and asthma-like syndrome, and esophageal reflux disease. If the underlying condition cannot be identified or if the drug trials fail to help, the patient probably suffers from idiopathic chronic cough. A new paradigm has been introduced in which chronic cough is regarded as a primary condition. PMID:25558624

  19. Parallels between phantom pain and tinnitus.

    Science.gov (United States)

    Peker, Selcuk; Sirin, Alperen

    2016-06-01

    Phantom pain and tinnitus are diseases that cause patients great discomfort. Both are phantom sensations that have many connections with cerebral structures, but their underlying mechanisms are not fully understood. Several therapies have been suggested for these conditions over the years, but there is still no consensus on how to treat either one. Comparison of these two phenomena reveals many similarities, including what is known about their underlying mechanisms, associated brain areas, and responses to therapeutic agents and methods. These similarities need to be evaluated in greater depth, as this could improve our understanding of tinnitus and phantom pain, and thereby improve management strategies for these conditions. PMID:27142154

  20. 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

  1. Pre-Treatment Objective Diagnosis and Post-Treatment Outcome Evaluation in Patients with Vascular Pulsatile Tinnitus Using Transcanal Recording and Spectro-Temporal Analysis

    Science.gov (United States)

    Choi, Inyong; Koo, Ja-Won; Lee, Kyogu

    2016-01-01

    Objective Although vascular pulsatile tinnitus (VPT) has been classified as “objective”, VPT is not easily recognizable or documentable in most cases. In response to this, we have developed transcanal sound recording (TSR) and spectro-temporal analysis (STA) for the objective diagnosis of VPT. By refining our initial method, we were able to apply TSR/STA to post-treatment outcome evaluation, as well as pre-treatment objective diagnosis. Methods TSR was performed on seven VPT patients and five normal controls before and after surgical or interventional treatment. VPT was recorded using an inserted microphone with the subjects placed in both upright and supine positions with 1) a neutral head position, 2) head rotated to the tinnitus side, 3) head rotated to the non-tinnitus side, and 4) a neutral position with ipsi-lesional manual cervical compression. The recorded signals were analyzed in both time and time-frequency domains by performing a short-time Fourier transformation. Results The pre-treatment ear canal signals of all VPT patients demonstrated pulse-synchronous periodic structures and acoustic characteristics that were representative of their presumptive vascular pathologies, whereas those the controls exhibited smaller peaks and weak periodicities. Compared with the pre-treatment signals, the post-treatment signals exhibited significantly reduced peak- and root mean square amplitudes upon time domain analysis. Additionally, further sub-band analysis confirmed that the pulse-synchronous signal of all subjects was not identifiable after treatment and, in particular, that the signal decrement was statistically significant at low frequencies. Moreover, the post-treatment signals of the VPT subjects revealed no significant differences when compared to those of the control group. Conclusion We reconfirmed that the TSR/STA method is an effective modality to objectify VPT. In addition, the potential role of the TSR/STA method in the objective evaluation of

  2. 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. PMID:25968009

  3. Tinnitus is associated with reduced sound level tolerance in adolescents with normal audiograms and otoacoustic emissions

    Science.gov (United States)

    Sanchez, Tanit Ganz; Moraes, Fernanda; Casseb, Juliana; Cota, Jaci; Freire, Katya; Roberts, Larry E.

    2016-01-01

    Recent neuroscience research suggests that tinnitus may reflect synaptic loss in the cochlea that does not express in the audiogram but leads to neural changes in auditory pathways that reduce sound level tolerance (SLT). Adolescents (N = 170) completed a questionnaire addressing their prior experience with tinnitus, potentially risky listening habits, and sensitivity to ordinary sounds, followed by psychoacoustic measurements in a sound booth. Among all adolescents 54.7% reported by questionnaire that they had previously experienced tinnitus, while 28.8% heard tinnitus in the booth. Psychoacoustic properties of tinnitus measured in the sound booth corresponded with those of chronic adult tinnitus sufferers. Neither hearing thresholds (≤15 dB HL to 16 kHz) nor otoacoustic emissions discriminated between adolescents reporting or not reporting tinnitus in the sound booth, but loudness discomfort levels (a psychoacoustic measure of SLT) did so, averaging 11.3 dB lower in adolescents experiencing tinnitus in the acoustic chamber. Although risky listening habits were near universal, the teenagers experiencing tinnitus and reduced SLT tended to be more protective of their hearing. Tinnitus and reduced SLT could be early indications of a vulnerability to hidden synaptic injury that is prevalent among adolescents and expressed following exposure to high level environmental sounds. PMID:27265722

  4. 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...

  5. 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

    Directory of Open Access Journals (Sweden)

    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

  6. 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

  7. Vibrotactile suppression of tinnitus

    Science.gov (United States)

    Lenhardt, Martin L.

    2002-05-01

    At the Society's 142nd meeting, the efficacy of high frequency bone conducted stimulation in suppressing tinnitus was presented. The hypothesized mechanism was the reprogramming of frequency tuning of auditory neurons in the central nervous system, secondarily to peripheral hearing loss. This mechanism is unlikely in cases of tinnitus in the presence of normal audiometric sensitivity. There is the possibility that hearing loss above 10 kHz can play a role in tinnitus, an association not thoroughly explored. Somatomotor stimulation influencing the quality of tinnitus has been reported, as have interconnections of the auditory and somatosensory systems. There would appear to be an evolutionary advantage of linking the sensorimotor organization of the external ear and the auditory function of the brainstem in sound localization. Thus, stimulation of the pinna and post auricular area may be a means of suppressing tinnitus. To that end a thin aluminum ceramic bimorph was constructed to fit on the inner surface of the pinna. When driven by low (10 kHz) frequencies multiplied by MHz carriers, demodulation in the skin resulted in vibrotactile stimulation. Tactile stimulation was an adjunct to the high frequencies resulting in a multimodal suppressive effect in a small pilot study.

  8. 利多卡因-氯硝西泮联合治疗耳鸣13例分析%Clinical Analysis of Lidocaine Combined with Clonazepam in Treating 13 Patients with Tinnitus

    Institute of Scientific and Technical Information of China (English)

    吴天宇

    2015-01-01

    Objective To analyze and explore the lidocaine- clonazepam joint clinical treatment methods and treatment ef ect for the treatment of tinnitus. Methods 13 patients randomly selected in from January 2014 to December 2014 in our hospital for patients with tinnitus treatment, wil be randomly divided into two groups,Control group were treated by conventional methods tinnitus treatment in the form of the experimental group patients in the conventional treatment for the patients on the basis of intravenous lidocaine-input glucose injection, oral clonazepam treatment. Results:the patients' hearing recovery, tinnitus symptoms improve conditions are bet er than the control group, control group patients with tinnitus recovery is more than the experimental group. Conclusion lidocaine-clonazepam joint is ef ective in the treatment of tinnitus and treatment ef ect is good, is worth popularizing in each big hospital in clinical practice.%目的:分析与探究利多卡因-氯硝西泮联合治疗耳鸣的临床治疗方法与治疗效果。方法随机选出13例于2014年1月~12月在我:进行耳鸣治疗的患者,将其随机分为两组。对照组患者采用常规方式方式进行耳鸣治疗,实验组患者在常规方式治疗的基础上为患者进行静脉输入利多卡因-葡萄糖注射液,口服氯硝西泮进行治疗。结果实验组患者听力恢复情况、耳鸣症状改善情况均好于对照组,对照组患者耳鸣恢复用时多于实验组。结论利多卡因-氯硝西泮联合能有效治疗耳鸣且治疗效果较好,值得在各大医:的临床实践中推广。

  9. 耳鸣对患者日常影响调查及耳鸣活动问卷的信度检验%Investigation of the influence of tinnitus to patients in their daily life and the reliability test of tinnitus activity questionnaire

    Institute of Scientific and Technical Information of China (English)

    潘滔; Richard Tyler; 宋昱; 王宇; 柯嘉; 马芙蓉

    2011-01-01

    OBJECTIVE To investigate the influence of tinnitus on daily life activities and to provide reference for individualized tinnitus counseling. To determine the reliability of Tinnitus Activity Questionnaire (TAQ) .METHODS 195 tinnitus patients who were seen in our ENT clinics from 2008 to 2010 and whose tinnitus lasted longer than 3 months were administered the TAQ. Factor analysis was used to explore the relationship among questions on the TAQ. RESULTS The average scores for the four subscales of the TAQ were: emotion 47, attention 27, hearing 28, and sleeping 32. Thus, the largest complaints was on emotion. Factors analysis found 4 factors which explained the percentage of variance 47.2%, 11.9%, 6.3%, 5.2% respectively. The accumulation of the total variance was 70.5%. The results of factor analysis were close to the original subscales of the questionnaire, but not perfect. CONCLUSION The influence of tinnitus to daily life included attention, sleeping, hearing and emotion. Emotional problem was the largest concern. The tinnitus counseling should focus on this area. Factor analysis showed that the reliability of the TAQ was good.%目的 调查耳鸣对患者日常影响,为耳鸣咨询提供参考和依据.检验耳鸣活动问卷(tinnitus activity questionnaire,TAQ)的可信度(reliability),为TAQ的应用提供依据.方法 我院2008~2010年门诊耳鸣患者,耳鸣持续时间长于3个月者195例接受TAQ调查,以了解耳鸣对患者日常生活的影响.对195例耳鸣患者的耳鸣活动问卷进行因子分析(factor analysis).结果 耳鸣对患者的影响包括:TAQ得分:情绪状况47,注意力27,听力28,睡眠32.情绪状态是耳鸣对患者影响的最主要方面.对TAQ问卷因子分析的结果得出4个因子:分别解释的变异百分比为47.2%、11.9%、6.3%、5.2%,累计解释总体变异70.5%.因子分析的结果比较接近问卷设计的注意力、睡眠、听力、情绪4个方面,但是符合性并不完善.结论

  10. Stapedial reflex and recruitment: What is the relationship with tinnitus?

    Directory of Open Access Journals (Sweden)

    Fernando Laffitte Fernandes

    2014-01-01

    Full Text Available Tinnitus is characterized by an auditory perception of sound, with no stimuli from the external environment. Tinnitus is an increasingly significant complaint, affecting 10-17% of the world population. As a symptom, it should always be considered with pathology in the auditory system. Our study aims to assess the relationship of this symptom with the presence of a stapedial reflex and the phenomenon of recruitment. Medical records of patients complaining of subjective tinnitus during their first consultation in the Outpatient Clinic of the Unicamp Teaching Hospital, in Brazil, between 2011 and 2012 were analyzed. We carried out a study with 65 non-randomized tinnitus individuals using questionnaires, clinical and audiological evaluations. The visual analogue scale was used to characterize the degree of disturbance caused by tinnitus. Statistical tests were performed using the IBM SPSS Statistics 19. No association was found between tinnitus and the presence of acoustic reflex or phenomenon of recruitment. We concluded that there is no relationship between tinnitus, the phenomenon of recruitment or the presence of an acoustic reflex.

  11. Stapedial reflex and recruitment: what is the relationship with tinnitus?

    Science.gov (United States)

    Fernandes, Fernando Laffitte; Guimarães, Alexandre Caixeta; de Carvalho, Guilherme Machado; Mezzalira, Raquel; Stoler, Guita; Paschoal, Jorge Rizzato

    2014-01-01

    Tinnitus is characterized by an auditory perception of sound, with no stimuli from the external environment. Tinnitus is an increasingly significant complaint, affecting 10-17% of the world population. As a symptom, it should always be considered with pathology in the auditory system. Our study aims to assess the relationship of this symptom with the presence of a stapedial reflex and the phenomenon of recruitment. Medical records of patients complaining of subjective tinnitus during their first consultation in the Outpatient Clinic of the Unicamp Teaching Hospital, in Brazil, between 2011 and 2012 were analyzed. We carried out a study with 65 non-randomized tinnitus individuals using questionnaires, clinical and audiological evaluations. The visual analogue scale was used to characterize the degree of disturbance caused by tinnitus. Statistical tests were performed using the IBM SPSS Statistics 19. No association was found between tinnitus and the presence of acoustic reflex or phenomenon of recruitment. We concluded that there is no relationship between tinnitus, the phenomenon of recruitment or the presence of an acoustic reflex. PMID:25387539

  12. 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.

  13. 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.

  14. 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

  15. The relationship between tinnitus pitch and the audiogram.

    Science.gov (United States)

    Pan, Tao; Tyler, Richard S; Ji, Haihong; Coelho, Claudia; Gehringer, Anne K; Gogel, Stephanie A

    2009-05-01

    We studied the relationship between tinnitus pitch and the audiogram in 195 patients. Patients with tone-like tinnitus reported a higher pitch (mean = 5385 Hz) compared to those with a noise-like quality (mean = 3266 Hz). Those with a flat audiogram were more likely to report: a noise-like tinnitus, a unilateral tinnitus, and have a pitch or=8000 Hz. We failed to find a relationship between the pitch and the edge of a high frequency hearing loss. Some individuals did exhibit a pitch at the low frequency edge of a hearing loss, but we could find no similar characteristics among these subjects. It is possible that a relationship between pitch and audiogram is present only in certain subgroups. PMID:19842803

  16. Quantitative approach in treatment of tinnitus by acoustical stimulation

    Science.gov (United States)

    Banimostafa, Maryam; Sadjedi, Hamed

    2011-10-01

    Tinnitus is the perception of phantom sounds in the ears or in the head without external sound sources even in the completely silent environment. There is no known effective medical treatment for tinnitus and acoustical stimulation has provided patients with some measure of relief. In this paper treatment method with acoustical stimulation has been investigated and simulated by neural oscillator model, simulation results are confirmed by clinical and physiological reports.

  17. Tinnitus: A Large VBM-EEG Correlational Study

    OpenAIRE

    Vanneste, Sven; Van De Heyning, Paul; De Ridder, Dirk

    2015-01-01

    A surprising fact in voxel-based morphometry (VBM) studies performed in tinnitus is that not one single region is replicated in studies of different centers. The question then rises whether this is related to the low sample size of these studies, the selection of non-representative patient subgroups, or the absence of stratification according to clinical characteristics. Another possibility is that VBM is not a good tool to study functional pathologies such as tinnitus, in contrast to patholo...

  18. An Adaptation Level Theory of Tinnitus Audibility

    OpenAIRE

    Grant eSearchfield; Kei eKobayashi; Michael eSanders

    2012-01-01

    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 percep...

  19. 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

  20. 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

  1. Contralateral parahippocampal gamma-band activity determines noise-like tinnitus laterality: a region of interest analysis.

    Science.gov (United States)

    Vanneste, S; Heyning, P Van de; Ridder, D De

    2011-12-29

    Tinnitus is described as an auditory perception in the absence of any external sound source. Tinnitus loudness has been correlated to sustained high frequency gamma-band activity in auditory cortex. It remains unknown whether unilateral tinnitus is always generated in the left auditory cortex, irrespective of the side on which the tinnitus is perceived, or in the contralateral auditory cortex. In order to solve this enigma source localized electroencephalographic (EEG) recordings of a homogenous group of unilateral left and right-sided tinnitus patients presenting with noise-like tinnitus was analyzed. Based on a region of interest analysis, the most important result of this study is that tinnitus lateralization depended on the gamma-band activity of the contralateral parahippocampal area. As for the auditory cortex no differences were found between left-sided and right-sided tinnitus patients. However, in comparison to a control group both left and right-sided tinnitus patients had an increased gamma-band activity in both the left and right primary and secondary auditory cortex. Thus whereas in tinnitus the primary and secondary auditory cortices of both sides are characterized by increased gamma-band activity, the side on which the tinnitus is perceived relates to gamma-band activity in the contralateral parahippocampal area. PMID:21920411

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

    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

    后效抑制会影响THI得分。%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

  3. 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.

  4. 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 depression (p social functioning (p < 0.001), and 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. PMID:22566178

  5. Enhancing Inhibition-Induced Plasticity in Tinnitus – Spectral Energy Contrasts in Tailor-Made Notched Music Matter

    OpenAIRE

    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...

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

    OpenAIRE

    2014-01-01

    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 a...

  7. Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services

    Directory of Open Access Journals (Sweden)

    Adrian Davis

    2012-01-01

    Full Text Available The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6% over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools which were most likely to make significant improvements in diagnosing hearing loss, effective referrals and better patient outcomes. An audiometric screening device was used in GP surgeries to enable thresholds for effective referrals to be measured in the surgery. Revised referral criteria, the use of this device, new “assess and fit” technology in the audiology clinic, and direct access pathways can transform audiology service delivery so that patient outcomes are measurably better. This, in turn, changes the experience of GPs, so they are more likely to refer patients who can benefit from treatment. At the end of 2011, 51 GP practices in one of the audiology pilot areas had bought HearCheck screeners, a substantial development from the 4 practices who first engaged with the pilot.

  8. 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

  9. 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.

  10. 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....

  11. 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...... urea synthesis kinetics in CP patients in relation to glucagon secretion (study I) and during an increase in protein intake (study II)....

  12. The distressed brain: a group blind source separation analysis on tinnitus.

    Directory of Open Access Journals (Sweden)

    Dirk De Ridder

    Full Text Available BACKGROUND: Tinnitus, the perception of a sound without an external sound source, can lead to variable amounts of distress. METHODOLOGY: In a group of tinnitus patients with variable amounts of tinnitus related distress, as measured by the Tinnitus Questionnaire (TQ, an electroencephalography (EEG is performed, evaluating the patients' resting state electrical brain activity. This resting state electrical activity is compared with a control group and between patients with low (N = 30 and high distress (N = 25. The groups are homogeneous for tinnitus type, tinnitus duration or tinnitus laterality. A group blind source separation (BSS analysis is performed using a large normative sample (N = 84, generating seven normative components to which high and low tinnitus patients are compared. A correlation analysis of the obtained normative components' relative power and distress is performed. Furthermore, the functional connectivity as reflected by lagged phase synchronization is analyzed between the brain areas defined by the components. Finally, a group BSS analysis on the Tinnitus group as a whole is performed. CONCLUSIONS: Tinnitus can be characterized by at least four BSS components, two of which are posterior cingulate based, one based on the subgenual anterior cingulate and one based on the parahippocampus. Only the subgenual component correlates with distress. When performed on a normative sample, group BSS reveals that distress is characterized by two anterior cingulate based components. Spectral analysis of these components demonstrates that distress in tinnitus is related to alpha and beta changes in a network consisting of the subgenual anterior cingulate cortex extending to the pregenual and dorsal anterior cingulate cortex as well as the ventromedial prefrontal cortex/orbitofrontal cortex, insula, and parahippocampus. This network overlaps partially with brain areas implicated in distress in patients suffering from pain, functional somatic

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

    OpenAIRE

    Collins Luke; Hoare Derek J; Gander Phillip E; Smith Sandra; Hall Deborah A

    2011-01-01

    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 opinion...

  14. 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。

  15. 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.

  16. 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

  17. 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. PMID:26850646

  18. 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

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Alwina Stein

    Full Text Available 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.

  1. 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. PMID:25951605

  2. Psychoacoustic Assessment to Improve Tinnitus Diagnosis

    OpenAIRE

    Basile, Charles-Édouard; Fournier, Philippe; Hutchins, Sean; Hébert, Sylvie

    2013-01-01

    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 se...

  3. The efficacy of Arlevert therapy for vertigo and tinnitus.

    Science.gov (United States)

    Novotný, M; Kostrica, R; Círek, Z

    1999-01-01

    We were interested in determining the efficacy of Arlevert therapy in vertigo and tinnitus patients, especially as it compared to the efficacy of the drug's two component agents, dimenhydrinate and cinnarizine. We conducted a comparative, randomized, double blind, multicenter, parallel group study involving a group of patients (n = 122) with vertigo and tinnitus of peripheral or central origin. The three test groups, nearly equal in size, were administered three times daily for 4 weeks one of the three agents being evaluated. To evaluate therapeutic success, we studied patients' vertigo symptoms, concomitant vegetative symptoms, CCG parameters, and electronystagmographic and audiometric parameters. We also obtained subjective assessments of outcomes from the test patients. Our results led us to conclude that Arlevert is more effective than either of its component drugs alone in treating vertigo and tinnitus. The drug also was well tolerated. PMID:10753423

  4. 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...

  5. Psychophysical and neural correlates of noised-induced tinnitus in animals: Intra- and inter-auditory and non-auditory brain structure studies.

    Science.gov (United States)

    Zhang, Jinsheng; Luo, Hao; Pace, Edward; Li, Liang; Liu, Bin

    2016-04-01

    Tinnitus, a ringing in the ear or head without an external sound source, is a prevalent health problem. It is often associated with a number of limbic-associated disorders such as anxiety, sleep disturbance, and emotional distress. Thus, to investigate tinnitus, it is important to consider both auditory and non-auditory brain structures. This paper summarizes the psychophysical, immunocytochemical and electrophysiological evidence found in rats or hamsters with behavioral evidence of tinnitus. Behaviorally, we tested for tinnitus using a conditioned suppression/avoidance paradigm, gap detection acoustic reflex behavioral paradigm, and our newly developed conditioned licking suppression paradigm. Our new tinnitus behavioral paradigm requires relatively short baseline training, examines frequency specification of tinnitus perception, and achieves sensitive tinnitus testing at an individual level. To test for tinnitus-related anxiety and cognitive impairment, we used the elevated plus maze and Morris water maze. Our results showed that not all animals with tinnitus demonstrate anxiety and cognitive impairment. Immunocytochemically, we found that animals with tinnitus manifested increased Fos-like immunoreactivity (FLI) in both auditory and non-auditory structures. The manner in which FLI appeared suggests that lower brainstem structures may be involved in acute tinnitus whereas the midbrain and cortex are involved in more chronic tinnitus. Meanwhile, animals with tinnitus also manifested increased FLI in non-auditory brain structures that are involved in autonomic reactions, stress, arousal and attention. Electrophysiologically, we found that rats with tinnitus developed increased spontaneous firing in the auditory cortex (AC) and amygdala (AMG), as well as intra- and inter-AC and AMG neurosynchrony, which demonstrate that tinnitus may be actively produced and maintained by the interactions between the AC and AMG. PMID:26299842

  6. Electroacupuncture for Tinnitus: A Systematic Review.

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    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.

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

    Science.gov (United States)

    Stiles, Lucy; Darlington, Cynthia L.; Smith, Paul F.

    2014-01-01

    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. PMID:25162023

  8. Patient concerns regarding chronic hepatitis C infections.

    Science.gov (United States)

    Minuk, G Y; Gutkin, A; Wong, S G; Kaita, K D E

    2005-01-01

    Counselling of patients with chronic hepatitis C infections is often limited to discussions regarding how the virus is transmitted and what can be done to decrease the risk of transmission to others. The purpose of the present study was to document the principal concerns of newly diagnosed and follow-up patients with chronic hepatitis C, and thereby enhance counselling strategies and content. Seventy newly diagnosed and 115 follow-up patients with chronic hepatitis C virus (HCV) infection were initially asked in an open-ended manner (volunteered concerns) and then to prioritize from a prepared list of seven potential concerns (prioritized concerns), to identify those concerns that were of utmost importance to them. The most common volunteered concerns of newly diagnosed patients in decreasing order were: disease progression (27%), premature death (19%), infecting family members (13%), side-effects of treatment (11%) and miscellaneous others. In decreasing order, prioritized concerns included: infecting family members, development of liver cancer, infecting others, development of cirrhosis, social stigma of having liver disease, need for liver transplant and loss of employment. The principal volunteered and prioritized concerns of follow-up patients were similar to those of newly diagnosed patients. Volunteered and prioritized concerns were relatively consistent across the different genders, age groups, ethnic backgrounds, education level, marital status, employment, modes of viral acquisition and in the case of follow-up patients, duration of follow-up. These results indicate that health care providers who focus counselling efforts exclusively on viral transmission are unlikely to address other important concerns of newly diagnosed and follow-up patients with chronic HCV infection. PMID:15655048

  9. Malnutrition in patients with chronic renal failure

    OpenAIRE

    Qureshi, Abdul Rashid Tony

    2000-01-01

    Protein-energy malnutrition is common in patients with chronic renal failure (CRF) and may contribute to a poor clinical outcome. However, the role of nutrition in this regard has not been clearly defined. Malnutrition in patients with CRF may have many causes, including disturbances in protein and energy metabolism, hormonal derangements, as well as low food intake because of anorexia, caused by uremic toxicity, various superimposed illnesses and psychosocial problems. Alth...

  10. A Case of Pulsatile Tinnitus from the Atherosclerosis and Atheroma in Superior Labial Artery and Facial Artery

    OpenAIRE

    Kim, Jung Min; Kim, Choon Dong; Kim, Seung Woo

    2012-01-01

    Tinnitus is one of the most common symptoms in an audiologic field. It can be classified as either as subjective or objective; former referring to the sensation heard by both patient and examiner. Pulsatile tinnitus is perceived as sounds that vary in frequency, intensity and duration. The cause of pulsatile tinnitus include high jugular bulb, benign intracranial hypertension, glomus tumors, carotid artery stenosis, vascular lesions of the temporal bone, arteriovenous malformation, aneurysms,...

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

    Directory of Open Access Journals (Sweden)

    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. PMID:26572701

  13. Psychosocial interventions for patients with chronic disease

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    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

  14. A Case of Pulsatile Tinnitus from the Atherosclerosis and Atheroma in Superior Labial Artery and Facial Artery

    Science.gov (United States)

    Kim, Jung Min; Kim, Choon Dong

    2012-01-01

    Tinnitus is one of the most common symptoms in an audiologic field. It can be classified as either as subjective or objective; former referring to the sensation heard by both patient and examiner. Pulsatile tinnitus is perceived as sounds that vary in frequency, intensity and duration. The cause of pulsatile tinnitus include high jugular bulb, benign intracranial hypertension, glomus tumors, carotid artery stenosis, vascular lesions of the temporal bone, arteriovenous malformation, aneurysms, and Arnold-Chiari malformation. Vascular tinnitus is most common (7.6%). Recently, the authors experienced one case of the pulsatile tinnitus caused by atherosclerosis and atheroma in superior labial artery & facial artery. After surgery, the symptom had disappeared. We report a unique case regarding the objective tinnitus with the literature review. PMID:24653894

  15. Salicylate toxicity model of tinnitus

    OpenAIRE

    Daniel Stolzberg

    2012-01-01

    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 gener...

  16. 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.

  17. 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

  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. Effectiveness of Low Level Laser Irradiation on Tinnitus and Parameters of Electrocochleography and Distortion Product Otoacoustic Emissions

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    Saeed Mahmoudian

    2008-06-01

    Full Text Available Background and Aim: Tinnitus is the consciousness of sound that arises in the ear or head without any external sound origin. The efficacies of transmeatal low-level laser irradiation for tinnitus treatment were reported before. The aim of this study was to evaluate the effectiveness of low level laser therapy on tinnitus and ECochG and DPOAEs parameters. Materials and Methods: The study design was prospective, quasi experimental. This investigation conducted on 16 ears (10 patients with disabling tinnitus. All patients underwent ENT examination, complete audiological evaluation, tinnitus study, ECochG and DPOAEs, and finally completing tinnitus data sheet. The results were compared before and after irradiation. Results: Means of tinnitus loudness (LMT and CAP amplitudes were significant different before and after irradiation (p<0.005. There was no any other significant difference before and after low level laser irradiation in subjective loudness, pitch matching annoyance grade of tinnitus and DPOAEs and other ECochG parameters.Conclusion: Transmeatal low-power laser irradiation with 200 mW seems not to be effective for treatment of tinnitus. This paper is the research brief report. In clinical point of view, this study should be repeated with a greater sample size although our results were statistically important.

  20. Histamine H₄ Receptor Antagonists: A New Approach for Tinnitus Treatment?

    Science.gov (United States)

    Hagenow, Jens; Stark, Holger

    2015-01-01

    Tinnitus, a disorder with disruptive sound perception in the head without an external source, affects around 15 % of the worldwide adult population. Since there is no approved drug for the treatment for this symptom, novel strategies need to be developed to provide relief for the patient. A patent from the small French start-up company Sensorion suggests the use of histamine H4 receptor (H4R) inhibitors as potential treatment. Since histamine and its receptor subtypes are strongly involved in neuronal and inflammatory processes in vestibular areas, targeting the H4R could be a novel way to gain a treatment for tinnitus. Although mRNA and protein levels of H4R have been demonstrated on isolated spiral ganglion neurons from mice, the methods of receptor detection as well as the species relevance of the data are under discussion and require considerable further verification, especially on a disease with a high medical need like tinnitus. PMID:25909438

  1. Tinnitus assessment by means of standardized self-report questionnaires: Psychometric properties of the Tinnitus Questionnaire (TQ), the Tinnitus Handicap Inventory (THI), and their short versions in an international and multi-lingual sample

    OpenAIRE

    Zeman Florian; Koller Michael; Schecklmann Martin; Langguth Berthold; Landgrebe Michael

    2012-01-01

    Abstract Background Tinnitus research in an international context requires standardized and validated questionnaires in different languages. The aim of the present set of analyses was the reassessment of basic psychometric properties according to classical test theory of self-report instruments that are being used within the multicentre Tinnitus Research Initiative (TRI) database project. Methods 1318 patients of the TRI Database were eligible for the analyses. The basic psychometric properti...

  2. Psychological status of patients with chronic urticaria.

    Science.gov (United States)

    Pasaoglu, Gülden; Bavbek, Sevim; Tugcu, Handan; Abadoglu, Oznur; Misirligil, Zeynep

    2006-11-01

    Although chronic urticaria is the most common cutaneous disorder seen in our outpatient allergy clinics, to our knowledge, no study of psychiatric morbidity in allergy departments has been carried out in our country. For the present study, we used the Minnesota Multiphasic Personality Inventory (MMPI) to evaluate the personality traits and psychological status of patients with chronic idiopathic urticaria (CIU). Fifty-nine outpatients with CIU and 59 healthy control subjects were enrolled in the study. Patients were included if no specific cause for their urticaria could be identified by detailed history and appropriate investigations. Psychiatric evaluation for all patients and controls was conducted at the Department of Psychiatry by using MMPI. Analysis of the MMPI profile showed that the scores for hypochondriasis, depression, hysteria, psychopathic deviance, paranoia, psychasthenia, schizophrenia, and social introversion were higher in patients with CIU compared to the control group (P CIU seem to have more depressive, hysteric, touchy and suspicious personality traits with hypochondriac tendencies and in more conflict with their social environment. Attitudes such as perfectionism, need for approval, external control and need to be loved were also characteristics of the patient group. We believe that psychological status should be considered for effective management of patients with CIU. PMID:17073991

  3. 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.

  4. Psychoacoustic assessment to improve tinnitus diagnosis.

    Science.gov (United States)

    Basile, Charles-Édouard; Fournier, Philippe; Hutchins, Sean; Hébert, Sylvie

    2013-01-01

    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. PMID:24349414

  5. Psychoacoustic Assessment to Improve Tinnitus Diagnosis

    Science.gov (United States)

    Hutchins, Sean; Hébert, Sylvie

    2013-01-01

    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. PMID:24349414

  6. HBV Vaccination in Chronic Renal Failure Patients

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    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.

  7. 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

  8. 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...

  9. Radioisotope hepatography in patients with chronic bronchitis

    International Nuclear Information System (INIS)

    Examination carried out by means of radioisotope hepatography with bengal-rose-iodine 131 in 69 patients with chronic obstructive bronchitis associated with respiratory insufficiency of grades 1, 2, 3 at the phase of remission revealed disturbances of the absorptive-excretory function of the liver. A direct dependence was found between the intensity of disorder of the functionsl state of parenchymatous cells and degree of resperatory insufficiency in this category of patients. The disorders of the absorptive-excretory function of the liver were most pronounced in respiratory insufficiency of grade 3

  10. 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.

  11. Diagnosing Patients with Age-Related Hearing Loss and Tinnitus: Supporting GP Clinical Engagement through Innovation and Pathway Redesign in Audiology Services

    OpenAIRE

    Adrian Davis; Smith, Pauline A.; Michelle Booth; Margaret Martin

    2012-01-01

    The public health challenge of hearing impairment is growing, as age is the major determinant of hearing loss. Almost one in four (22.6%) over 75-year olds reports moderate or severe worry because of hearing problems. There is a 40% comorbidity of tinnitus and balance disorders. Good outcomes depend on early presentation and appropriate referral. This paper describes how the NHS Improvement Programme in England used service improvement methodologies to identify referral pathways and tools whi...

  12. 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.

  13. 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

  14. Multitarget surgical neuromodulation: Combined C2 and auditory cortex implantation for tinnitus.

    Science.gov (United States)

    De Ridder, Dirk; Vanneste, Sven

    2015-03-30

    Tinnitus, as a phantom sound can express itself as a pure tone and as a noise-like sound. It is notoriously difficult to treat, and in medically, psychologically and audiologically intractable tinnitus patients sometimes intracranial electrodes overlying the auditory cortex are implanted. In this case report, we describe a patient who had a complete resolution of the pure tone component of his tinnitus by an auditory cortex implant, without any beneficial effect on the noise-like aspect of his tinnitus, even after changing the stimulation design to burst stimulation, which is known to treat noise-like tinnitus better than tonic stimulation. After an initial successful treatment of his noise-like component with transcutaneus electrical nerve stimulation, a wire electrode is inserted subcutaneously and connected to his internal pulse generator. With the dual stimulation his pure tone tinnitus remains abolished after 5 years of stimulation and his noise-like tinnitus is improved by 50%, from 8/10 to 4/10. This case report suggests that multi-target stimulation might be better than single target implantation in selected cases. PMID:25703225

  15. Spiritual Needs of Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Harold G. Koenig

    2010-11-01

    Full Text Available For many patients confronted with chronic diseases, spirituality/religiosity is an important resource for coping. Patients often report unmet spiritual and existential needs, and spiritual support is also associated with better quality of life. Caring for spiritual, existential and psychosocial needs is not only relevant to patients at the end of their life but also to those suffering from long-term chronic illnesses. Spiritual needs may not always be associated with life satisfaction, but sometimes with anxiety, and can be interpreted as the patients’ longing for spiritual well-being. The needs for peace, health and social support are universal human needs and are of special importance to patients with long lasting courses of disease. The factor, Actively Giving, may be of particular importance because it can be interpreted as patients’ intention to leave the role of a `passive sufferer´ to become an active, self-actualizing, giving individual. One can identify four core dimensions of spiritual needs, i.e., Connection, Peace, Meaning/Purpose, and Transcendence, which can be attributed to underlying psychosocial, emotional, existential, and religious needs. The proposed model can provide a conceptual framework for further research and clinical practice. In fact, health care that addresses patients’ physical, emotional, social, existential and spiritual needs (referring to a bio-psychosocial-spiritual model of health care will contribute to patients’ improvement and recovery. Nevertheless, there are several barriers in the health care system that makes it difficult to adequately address these needs.

  16. [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. PMID:25515390

  17. 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...

  18. 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.

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

    Directory of Open Access Journals (Sweden)

    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

  20. Dynamic Adaptive Remote Health Monitoring for Patients with Chronic Disease

    OpenAIRE

    Suh, Myung-kyung

    2012-01-01

    Chronic diseases are the leading causes of death and disability in the United States. More than 70% of deaths among Americans are caused by chronic diseases and more than 133 million Americans have at least one chronic disease. Due to the prevalence of chronic disease-related issues, it is prudent to seek out methodologies that would facilitate the prevention, monitoring, and feedback for patients with chronic diseases.This dissertation describes WANDA (Weight and Activity with Other Vital Si...

  1. 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.)

  2. Behandlung des chronischen Tinnitus mit repetitiver transkranieller Magnetstimulation

    OpenAIRE

    Kleinjung, T

    2012-01-01

    Tinnitus ist eine Funktionsstörung des Hörsystems, die von verschiedenen Strukturen und Ebenen ausgehen kann. Tinnitus geht mit neuroplastischen Veränderungen im zentralen auditorischen System einher. Existenz eines „Tinnitus-Netzwerkes“.

  3. [Effectiveness of various non-medicinal therapeutic measures in tinnitus. A long-term study].

    Science.gov (United States)

    von Wedel, H; Strahlmann, U; Zorowka, P

    1989-05-01

    To compare the benefits of different therapeutic methods in patients suffering from tinnitus persisting for more than one year, the results of a study with 462 patients are presented. Transtympanal electrical stimulation at the promontory, iontophoresis of lidocaine, EMG biofeedback and masking by hearing aids or tinnitus maskers are compared with regard to their therapeutic efficiency directly after the test period and half a year later. The results indicate the importance of controlling for placebo effect in assessing the therapeutic value of the first three methods (electrical stimulation, iontophoresis and biofeedback). For these therapies an improvement by only less than 10% could be attained compared to success rates of 60% reported in the literature. About 30% of the patients could be successfully equipped with hearing aids or tinnitus maskers, 60% showing a stable benefit over a period of three years. To compare the benefits of the different methods the features of tinnitus (pitch, loudness, type and stability of masking, residual inhibition) and the subjective scaling of the therapeutic efficiency are examined. With regard to other even more recent therapies, the fitting of hearing aids in patients with tinnitus plus hearing loss seems to be of utmost importance in combatting tinnitus. PMID:2787155

  4. 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

  5. [Evidence and Lack of Evidence in the Treatment of Tinnitus].

    Science.gov (United States)

    Hesse, G

    2016-04-01

    A broad variety of therapeutic regimen is proposed, introduced and sold against tinnitus, but most of these approaches lack scientific validation and evidence. Up to date a causal, tinnitus eliminating therapy is not available. Most probably this will not be possible at all, as the mechanism of tinnitus generation are multiple and include peripheral as well as central or cortical reactions. Like in fashion and design however, therapeutic medical interventions against tinnitus come in waves again and again over the last decades, without being able to prove lasting and scientifically evident effects.This review presents, discusses and assesses almost all available therapies regarding their evidence. Evidence should include besides external evidence through publications and available data also internal evidence, e.g. including experience of the therapist and needs of the patients.Almost all interventions that try to influence the inner ear or the auditory cortex either pharmaceutically or by direct stimulation or modulation do not reach evidence. However, there are procedures that have proven to be effective and show at least certain degrees of evidence with proven strength of effect. These are habituation therapies and psychotherapeutic interventions like cognitive behavioural therapy, especially when they are combined with concrete measures to improve auditory perception like hearing-aids, cochlear implants or hearing-therapy. PMID:27128400

  6. Intradialytic Hypoxemia in Chronic Hemodialysis Patients.

    Science.gov (United States)

    Campos, Israel; Chan, Lili; Zhang, Hanjie; Deziel, Sheila; Vaughn, Cheryl; Meyring-Wösten, Anna; Kotanko, Peter

    2016-01-01

    When kidney failure occurs, patients are at risk for fluid overload states, which can cause pulmonary edema, pleural effusions, and upper airway obstruction. Kidney disease is also associated with impaired respiratory function, as in central sleep apnea or chronic obstructive pulmonary disease. Hence, respiratory and renal diseases are frequently coexisting. Hypoxemia is the terminal pathway of a multitude of respiratory pathologies. The measurement of oxygen saturation (SO2) is a basic and commonly used tool in clinical practice. Both arterial oxygen saturation (SaO2) and central venous oxygen saturation (ScvO2) can be easily obtained in hemodialysis (HD) patients, SaO2 from an arteriovenous access and ScvO2 from a central catheter. Here, we give a brief overview of the anatomy and physiology of the respiratory system, and the different technologies that are currently available to measure oxygen status in dialysis patients. We then focus on literature regarding intradialytic SaO2 and ScvO2. Lastly, we present clinical vignettes of intradialytic drops in SaO2 and ScvO2 in association with different symptoms and clinical scenarios with an emphasis on the pathophysiology of these cases. Given the fact that in the general population hypoxemia is associated with adverse outcomes, including increased mortality, cardiac arrhythmias and cardiovascular events, we posit that intradialytic SO2 may serve as a potential marker to identify HD patients at increased risk for morbidity and mortality. PMID:26765143

  7. Vestibular testing in patients with panic disorder and chronic dizziness

    OpenAIRE

    TEGGI, R.; D. Caldirola; BONDI, S.; Perna, G.; L. Bellodi; BUSSI, M.

    2007-01-01

    In order to investigate the relationship between chronic dizziness and vestibular function in patients with panic disorder, in the present study neurotologic findings in 15 patients with panic disorder and chronic dizziness were compared with those in 15 patients with chronic dizziness, without panic disorder. All underwent neurotologic screening for spontaneous, positional and positioning nystagmus with head-shaking and head-thrust tests, an audiometric examination and electronystagmography ...

  8. Use of the Internet by Patients with Chronic Illness

    OpenAIRE

    Richard W. Millard; Fintak, Patricia A.

    2002-01-01

    Objective: To understand how patients with chronic illness use the Internet to manage their health. Design and Participants: An online survey was conducted among 10 069 patients with chronic illnesses. Survey results were obtained from patients with 35 separate chronic conditions, with at least 50 respondents for each condition. The survey was administered online at a dedicated, password-protected web site. Data were analyzed to identify how online behavior varied by disease state and other d...

  9. Tinnitus Suppression by Intracochlear Electrical Stimulation in Single Sided Deafness – A Prospective Clinical Trial: Follow-Up

    Science.gov (United States)

    Arts, Remo A. G. J.; George, Erwin L. J.; Janssen, Miranda; Griessner, Andreas; Zierhofer, Clemens; Stokroos, Robert J.

    2016-01-01

    Introduction 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. Materials and Methods 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 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. Conclusion 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. Trial Registration TrialRegister.nl NTR3374 PMID:27111333

  10. Chronic Rhinosinusitis in Patients with Cystic Fibrosis.

    Science.gov (United States)

    Hamilos, Daniel L

    2016-01-01

    Chronic rhinosinusitis (CRS) is highly prevalent in patients with cystic fibrosis (CF) and accounts for significant morbidity and contribution to CF lung disease. Mutations of the cystic fibrosis transmembrane regulator gene occur with increased prevalence in patients with CRS without CF, suggesting some contribution to CRS pathophysiology. Nasal polyps (NPs) occur with increased prevalence in patients with CF of all ages and have a more neutrophilic appearance with fewer eosinophils and increased submucosal glandular elements in comparison to NPs from patients without CF. Mainstays of medical treatment include isotonic saline irrigations and topical intranasal glucocorticoids, with some evidence that topical intranasal glucocorticoids reduce NP size. Although inhaled hypertonic saline (7%) has been widely studied as a mucolytic agent for CF lung disease, there are no reports of its use in CF CRS. Mucolytics have also not been studied as a treatment for CRS in CF, and most evidence does not support their use for CF lung disease. Nasally nebulized dornase alfa (recombinant human deoxyribonuclease) following sinus surgery shows promise for treatment. Other unproven therapies include addition of baby shampoo to isotonic saline to potentially thin mucus and help prevent biofilm formation. There are no data to support the use of low-dose oral macrolide antibiotics or the use of prophylactic oral antibiotics for CRS in patients with CF. However, there is some support for the use of topical antibiotics, including colistimethate sodium or tobramycin, administered as a sinus irrigation or antral lavage in patients following sinus surgery when susceptible bacteria are cultured. Key components of CF sinus surgical management include extensive surgery to ensure that the maxillary, frontal, sphenoid, and ethmoid sinuses are all widely opened with smoothing of bony overhangs to prevent mucus retention and bacterial recolonization, postoperative meticulous daily nasal irrigations

  11. Clinical significance of changes of serum gastrin levels in patients with chronic eczema or chronic urticaria

    International Nuclear Information System (INIS)

    Objective: To study the clinical significance of changes of serum levels of gastrin in patients with chronic eczema or chronic urticaria. Methods: Serum gastrin levels were, 37 patients with chromic urticaria and 43 controls. Results: Serum gastrin levels in patients with chronic exzema (102.95 ± 27.33 ng/L) and patients with chronic urticaria (109.87 ± 33.64 ng/L) were both significantly higher than those in controls (61.72 ± 20.38 ng/L, both P<0.01). Difference between the levels in the two patients groups was not significant. Conclusion: The high gastrin levels in those patients might reflect the presence of helicobacter pylori infections; eradication of which might be helpful for treatment of these chronic dermatologic disorders. (authors)

  12. COMPARATIVE EVALUATION OF ACAMPROSATE WITH OTHER DR UGS IN CENTRAL TINNITUS

    Directory of Open Access Journals (Sweden)

    Sharanjit

    2013-03-01

    Full Text Available ABSTRACT: AIM: To compare the efficacy of acamprosate with other drugs to decrease the severity of sensorineural tinnitus. MATERIAL AND METHOD : The study was randomised double-blind, placebo controlled, crossover. Forty a dult subjects (>18 years of age, of either sex with tinnitus of sensorineural origin, were adminis tered either acamprosate 333 mg tds or matched placebo for a period of six weeks followed b y a washout period of one week. Drug therapy was switched for another six weeks in conson ance with the crossover design. The effect of acamprosate and placebo on subjective relief and o bjective improvement was evaluated by using modified tinnitus severity quality of life sc ores and audiometry with tinnitus matching in frequency and loudness. RESULTS: At the end of study the drug had shown a statistic ally significant improvement in reducing the tinnitus sco re in 92.5% of the patients and placebo with an improvement in 12.5% of the patients in contrast t o other drugs belonging to this group. CONCLUSION : Acamprosate is an effective drug in treating the severity of sensorineural tinnitus

  13. 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.

  14. 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

  15. Tratamento do zumbido com a trazodona Tinnitus treatment with Trazodone

    Directory of Open Access Journals (Sweden)

    Gabriel Cesar Dib

    2007-06-01

    Full Text Available O zumbido é um sintoma freqüente, definido como percepção sonora auditiva na ausência de estímulo sonoro. OBJETIVO: Avaliar se a Trazodona, antidepressivo modulador da serotonina nas vias neuronais centrais, atua positivamente no controle do zumbido. Forma de Estudo: Prospectivo, duplo-cego, randomizado, controlado com placebo. MATERIAL E MÉTODO: estudo realizado com pacientes com zumbido. Oitenta e cinco pacientes foram avaliados entre fevereiro e junho de 2005, sendo que 43 pacientes receberam droga e 42, placebo, pelo período de 60 dias. Os critérios de análise foram intensidade, efeito sobre a qualidade de vida e grau de incômodo devido ao zumbido, através de escala analógica com notas de 0 a 10 dadas pelos pacientes antes e após o uso da trazodona ou placebo. RESULTADOS: Em ambos os grupos houve melhora da intensidade, qualidade de vida e incômodo após o tratamento, porém não houve diferença significativa entre os grupos droga e placebo. Quando se avaliou os critérios clínicos na faixa etária maior ou igual a 60 anos, obteve-se melhora nos níveis de intensidade, incômodo e efeito sobre a qualidade de vida após o tratamento. CONCLUSÃO: A trazodona não foi eficiente no controle do zumbido dos pacientes avaliados na dose utilizada.Tinnitus is a common symptom, defined as a sound perception in absence of a sound stimulus. AIM: Evaluate if Trazodone, an antidepressant drug, which modulates serotonin at central neuronal pathways, is effective in controlling tinnitus. STUDY DESIGN : Prospective, double blind, randomized, placebo-controlled. Materials and Methods: Study performed with patients presenting tinnitus. 85 patients were analyzed between February and June of 2005. 43 received trazodone and 42 placebo, for 60 days. The clinical criteria of analysis were tinnitus intensity, discomfort and life quality impact by tinnitus, using an analogue scale varying between 0 and 10, scored by patients before and after drug or

  16. Gastric emptying in patients with chronic liver diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ishizu, Hirotaka; Shiomi, Susumu; Kawamura, Etsushi; Iwata, Yoshinori; Nishiguchi, Shuhei; Kawabe, Joji; Ochi, Hironobu [Osaka City Univ. (Japan). Graduate School of Medicine

    2002-05-01

    There have been a number of reports of gastric emptying in cirrhosis, all with unconfirmed results. Moreover, the mechanism for delayed emptying in cirrhotic patients in unclear. We evaluated gastric emptying in patients with chronic hepatitis and cirrhosis by means of gastric emptying scintigraphy. The subjects were 18 normal controls and 75 patients with chronic viral hepatitis (50 patients had chronic hepatitis and 25 patients had cirrhosis). Tc-99m diethyltriamine pentaacetic acid labeled solid meals were used to evaluate gastric emptying; the half-time (T 1/2) of which was calculated. Digestive symptom scores were determined at the time of gastric emptying tests. Fourteen (28%) of 50 patients with chronic hepatitis and 16 (64%) of 25 patients with cirrhosis had delayed gastric emptying. T 1/2 in patients with cirrhosis was significantly higher than that in normal controls and patients with chronic hepatitis (p=0.0001 and 0.0003, respectively). The difference between T 1/2 in patients with chronic hepatitis and that in normal controls was not significant. On regression analysis, two indices, the serum albumin level and platelet count, were found to be significantly related to delayed gastric emptying. Gastric emptying was more delayed in cirrhotic patients than in those with chronic hepatitis and normal controls. Delayed gastric emptying may be related to liver function and portal hypertension. (author)

  17. Alexithymia and anxiety in female chronic pain patients

    OpenAIRE

    Saatcioglu Omer; Celikel Feryal

    2006-01-01

    Abstract Objectives Alexithymia is highly prevalent among chronic pain patients. Pain is a remarkable cause for high levels of chronic anxiety. The purpose of this study was to investigate the prevalence of alexithymia and to determine anxiety levels among DSM-IV somatoform pain disorder (chronic pain) female patients and to examine the relationship between alexithymia and the self-reporting of pain. Methods Thirty adult females (mean age: 34,63 ± 10,62 years), who applied to the outpatient p...

  18. Physical Activity Recommendations in Patients with Chronic Obstructive Pulmonary Disease

    NARCIS (Netherlands)

    Hartman, Jorine E.; Boezen, H. Marike; Zuidema, Menno J.; de Greef, Mathieu H. G.; ten Hacken, Nick H. T.; Boezen, Hendrika

    2014-01-01

    Background: Physical activity recommendations are hardly studied in patients with chronic obstructive pulmonary disease (COPD), and specifically recommendations that are individualized to a patient's aerobic fitness level are not studied. Objectives: To compare individualized (relative) and nonindiv

  19. [Function in patients with chronic fibrocavernous tuberculosis].

    Science.gov (United States)

    Nefedov, V B; Popova, L A; Shergina, E A

    2008-01-01

    Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/VC%, PEF, MEF25, MEF50, MEF75, TLC, TGV, residual volume (RV), R(aw), R(in), R(ex), DLCO-SB, DLCO-SS, PaO2, and PaCO2 were determined in 62 patients with chronic fibrocavernous tuberculosis. Lung dysfunctions were detected in 96.8% of the patients. Changes in lung volumes and capacities were found in 90.3%, impaired bronchial patency was in 90.3%, and pulmonary gas exchange dysfunction was in 79.0%. The lung volume and capacity changes appeared as decreased VC and FVC, decreased and increased TLC, TGV, RV; impaired bronchial patency presented as decreased PEF, MEF25, MEF50, MEF75, and FEV1/VC%; and increased R(aw), R(in), R(ex); pulmonary gas exchange dysfunction manifested itself as reduced DLCO-SB, DLCO-SS, PaO2, and decreased and increased PaCO2. The magnitude of the observed functional changes ranges from slight to significant and drastic with a predominance of considerable and drastic changes in lung volumes and capacities and mild impairments of bronchial patency and pulmonary gas exchange function. PMID:18507144

  20. 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…

  1. 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...

  2. 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.

  3. 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.

  4. Pilot study to develop telehealth tinnitus management for persons with and without traumatic brain injury

    Directory of Open Access Journals (Sweden)

    James A. Henry, PhD

    2012-10-01

    Full Text Available Tinnitus, or “ringing in the ears,” affects 10%-15% of adults; cases can be problematic and require lifelong management. Many people who have experienced traumatic brain injury (TBI also experience tinnitus. We developed Progressive Tinnitus Management (PTM, which uses education and counseling to help patients learn how to self-manage their reactions to tinnitus. We adapted PTM by delivering the intervention via telephone and by adding cognitive-behavioral therapy. A pilot study was conducted to evaluate the feasibility and potential efficacy of this approach for individuals with and without TBI. Participants with clinically significant tinnitus were recruited into three groups: probable symptomatic mild TBI (n = 15, moderate to severe TBI (n = 9, and no symptomatic TBI (n = 12. Participants received telephone counseling (six sessions over 6 months by an audiologist and a psychologist. Questionnaires were completed at baseline, 12 weeks, and 24 weeks. All groups showed trends reflecting improvement in self-perceived functional limitations due to tinnitus. A follow-up randomized clinical study is underway.

  5. Animal Models of Subjective Tinnitus

    OpenAIRE

    2014-01-01

    Tinnitus is one of the major audiological diseases, affecting a significant portion of the ageing society. Despite its huge personal and presumed economic impact there are only limited therapeutic options available. The reason for this deficiency lies in the very nature of the disease as it is deeply connected to elementary plasticity of auditory processing in the central nervous system. Understanding these mechanisms is essential for developing a therapy that reverses the plastic changes und...

  6. Influence of chronic kidney disease on the outcome of patients with chronic total occlusion

    OpenAIRE

    Zhang, Qing-Bin; Chen, Li-Ming; Min LI; Cui, Yu-Qi; Zhao, Chuan-Yan; Cui, Lian-Qun

    2016-01-01

    Objective: Chronic kidney disease (CKD) predicted a poor prognosis in patients with coronary artery disease. There is a paucity of data on outcomes after revascularization in patients with chronic total occlusion (CTO) and CKD. This study aims to investigate the impact of CKD on the revascularization of CTO. Methods: This study enrolled 1,092 CTO patients received treatments in our hospital between February 2009 and January 2014. Major adverse cardiac and cerebrovascular events (MACCE) and al...

  7. Intensity, Duration, and Location of High-Definition Transcranial Direct Current Stimulation for Tinnitus Relief.

    Science.gov (United States)

    Shekhawat, Giriraj Singh; Sundram, Frederick; Bikson, Marom; Truong, Dennis; De Ridder, Dirk; Stinear, Cathy M; Welch, David; Searchfield, Grant D

    2016-05-01

    Background and Objective Tinnitus is the perception of a phantom sound. The aim of this study was to compare current intensity (center anode 1 mA and 2 mA), duration (10 minutes and 20 minutes), and location (left temporoparietal area [LTA] and dorsolateral prefrontal cortex [DLPFC]) using 4 × 1 high-definition transcranial direct current stimulation (HD-tDCS) for tinnitus reduction.Methods Twenty-seven participants with chronic tinnitus (>2 years) and mean age of 53.5 years underwent 2 sessions of HD-tDCS of the LTA and DLPFC in a randomized order with a 1 week gap between site of stimulation. During each session, a combination of 4 different settings were used in increasing dose (1 mA, 10 minutes; 1 mA, 20 minutes; 2 mA, 10 minutes; and 2 mA, 20 minutes). The impact of different settings on tinnitus loudness and annoyance was documented.Results Twenty-one participants (77.78%) reported a minimum of 1 point reduction on tinnitus loudness or annoyance scales. There were significant changes in loudness and annoyance for duration of stimulation,F(1, 26) = 10.08,P< .005, and current intensity,F(1, 26) = 14.24,P= .001. There was no interaction between the location, intensity, and duration of stimulation. Higher intensity (2 mA) and longer duration (20 minutes) of stimulation were more effective.Conclusions A current intensity of 2 mA for 20-minute duration was the most effective setting used for tinnitus relief. The stimulation of the LTA and DLPFC were equally effective for suppressing tinnitus loudness and annoyance. PMID:26180052

  8. 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

  9. Circulating endothelin-1 concentrations in patients with chronic hypoxia.

    OpenAIRE

    Ferri, C; C. Bellini; Angelis, C; De Siati, L; A. Perrone; Properzi, G; Santucci, A.

    1995-01-01

    AIMS--To evaluate the behavior of plasma endothelin-1 in patients with chronic hypoxia. METHODS--Fifteen male patients (mean age 52.1 +/- 3.1 years) with mild chronic obstructive pulmonary disease (COPD) were studied. Twelve healthy men (mean age 48.3 +/- 5.4 years) served as controls. Both patients and controls underwent standard pulmonary function tests, echocardiographic evaluation, and arterial blood gas evaluation. Blood samples for endothelin-1 assay were taken from a previously incannu...

  10. 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....

  11. Chronic cough in patients with sleep-disordered breathing.

    Science.gov (United States)

    Chan, K K Y; Ing, A J; Laks, L; Cossa, G; Rogers, P; Birring, S S

    2010-02-01

    Chronic cough can be the sole presenting symptom for patients with obstructive sleep apnoea. We investigated the prevalence, severity and factors associated with chronic cough in patients with sleep-disordered breathing (SDB). We invited 108 consecutive patients who had been referred for evaluation of SDB to complete a comprehensive questionnaire on respiratory and sleep health, which included the Leicester Cough Questionnaire (cough specific quality of life; LCQ), Epworth Sleepiness Scale (ESS) and the Mayo Clinic gastro-oesophageal questionnaire. Chronic cough was defined as cough for a duration of >2 months. 33% of patients with SDB reported a chronic cough. Patients with a chronic cough had impaired cough related-quality of life affecting all health domains (mean+/-sem LCQ score 17.7+/-0.7; normal = 21). Patients with SDB and chronic cough were predominantly females (61% versus 17%; p<0.001) and reported more nocturnal heartburn (28% versus 5%; p = 0.03) and rhinitis (44% versus 14%; p = 0.02) compared to those without SDB. There were no significant differences in ESS, respiratory disturbance index, body mass index, or symptoms of breathlessness, wheeze, snoring, dry mouth and choking between those with cough and those without. Chronic cough is prevalent in patients with SDB and is associated with female sex, symptoms of nocturnal heartburn and rhinitis. Further studies are required to investigate the impact of continuous positive airway pressure therapy on cough associated with SDB to explore the mechanism of this association. PMID:20123846

  12. 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.

  13. Does Tinnitus Distress Depend on Age of Onset?

    OpenAIRE

    Winfried Schlee; Tobias Kleinjung; Wolfgang Hiller; Gerhard Goebel; Iris-Tatjana Kolassa; Berthold Langguth

    2011-01-01

    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 studiesindicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depre...

  14. Does tinnitus distress depend on age of onset?

    OpenAIRE

    Schlee, Winfried; Kleinjung, Tobias; Hiller, Wolfgang; Goebel, Gerhard; Kolassa, Iris-Tatjana; Langguth, Berthold

    2012-01-01

    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 ...

  15. Tinnitus before and 6 Months after Cochlear Implantation

    OpenAIRE

    Kompis, M; Pelizzone, M.; Dillier, N; J. Allum; Demin, N; Senn, P.

    2012-01-01

    In this prospective multicenter study, tinnitus loudness and tinnitus-related distress were investigated in 174 cochlear implant (CI) candidates who underwent CI surgery at a Swiss cochlear implant center. All subjects participated in two session, one preoperatively and one 6 months after device activation. In both sessions, tinnitus loudness was assessed using a visual analogue scale and tinnitus distress using a standardized tinnitus questionnaire. The data were compared with unaided pre- a...

  16. Abnormal cross-frequency coupling in the tinnitus network

    OpenAIRE

    Adamchic, Ilya; Langguth, Berthold; Hauptmann, Christian; Peter A Tass

    2014-01-01

    Neuroimaging studies have identified networks of brain areas and oscillations associated with tinnitus perception. However, how these regions relate to perceptual characteristics of tinnitus, and how oscillations in various frequency bands are associated with communications within the tinnitus network is still incompletely understood. Recent evidence suggests that apart from changes of the tinnitus severity the changes of tinnitus dominant pitch also have modulating effect on the underlying n...

  17. Chronic Gastritis in Morbidly Obese Patients with Sleeve Gastrectomy

    OpenAIRE

    Makki, Ahmed Mohammad; Aldaqal, Saleh Mohammad; Alorabi, Shahad Hamadan; Nemri, Ismail Ahmed; Alajami, Maha Mohammad

    2016-01-01

    Introduction Obesity is a condition that has significant impact on public health. Recent exciting studies have linked chronic gastritis and H. pylori infection to obesity. Chronic gastritis has shown increased prevalence in obesity, more particularly H. pylori-related gastritis. This study aimed to determine the prevalence of chronic gastritis in morbidly obese patients who were subjected to sleeve gastrectomy, with focus on H. pylori-related gastritis. The aim was to demonstrate any influenc...

  18. 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. PMID:27208716

  19. Ovarian carcinoma in two patients with chronic liver disease

    Institute of Scientific and Technical Information of China (English)

    Mehlika Isildak; Gulay Sain Guven; Murat Kekilli; Yavuz Beyazit; Mustafa Erman

    2005-01-01

    Ascites is a common and debilitating complication of cirrhosis. However, patients with chronic liver disease are not spared from other causes of ascites and physicians should be careful not to miss an underlying malignancy.Ovarian cancer is an insidious disease, which is difficult to diagnose and it ranks first in mortality among all gynecological cancers. Here, we present two cases of patients with chronic liver disease that developed ascites not simply because of cirrhosis but as a manifestation of ovarian cancer. We would like to emphasize that the causes of ascites, other than the liver itself, should not be overlooked in patients with chronic liver disease.

  20. Analysis of electrocardiogram in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Lazović Biljana

    2013-01-01

    Full Text Available Introduction. Chronic obstructive pulmonary disease is the fourth leading cause of mortality worldwide. It is defined as a persistent airflow limitation usually progressive and not fully reversible to treatment. The diagnosis of chronic obstructive pulmonary disease and severity of disease is confirmed by spirometry. Chronic obstructive pulmonary disease produces electrical changes in the heart which shows characteristic electrocardiogram pattern. The aim of this study was to observe and evaluate diagnostic values of electrocardiogram changes in chronic obstructive pulmonary disease patients with no other comorbidity. Material and Methods. We analyzed 110 electrocardiogram findings in clinically stable chronic obstructive pulmonary disease patients and evaluated the forced expiratory volume in the first second, ratio of forces expiratory volume in the first second to the fixed vital capacity, chest radiographs and electrocardiogram changes such as p wave height, QRS axis and voltage, right bundle branch block, left bundle branch block, right ventricular hypertrophy, T wave inversion in leads V1-V3, S1S2S3 syndrome, transition zone in praecordial lead and QT interval. Results. We found electrocardiogram changes in 64% patients, while 36% had normal electrocardiogram. The most frequent electrocardiogram changes observed were transition zone (76.36% low QRS (50% and p pulmonale (14.54%. Left axis deviation was observed in 27.27% patients. Conclusion. Diagnostic values of electrocardiogram in patients with chronic obstructive pulmonary disease suggest that chronic obstructive pulmonary disease patients should be screened electrocardiographically in addition to other clinical investigations.

  1. Bile acid malabsorption in patients with chronic diarrhoea

    DEFF Research Database (Denmark)

    Wildt, S; Nørby Rasmussen, S; Lysgård Madsen, Jan; Rumessen, J J

    2003-01-01

    Bile acid malabsorption (BAM), a cause of chronic diarrhoea, can be diagnosed by the SeHCAT test. The purpose of this study was to evaluate the usefulness of SeHCAT testing by assessing the extent of BAM and describing the clinical characteristics in a group of patients with chronic diarrhoea. Cl....... Clinical outcome after treatment with cholestyramine was also evaluated....

  2. Ribavirin for Chronic Hepatitis Prevention among Patients with Hematologic Malignancies

    OpenAIRE

    Tavitian, Suzanne; Peron, Jean-Marie; Huguet, Françoise; Kamar, Nassim; Abravanel, Florence; Beyne-Rauzy, Odile; Oberic, Lucie; Faguer, Stanislas; Alric, Laurent; Roussel, Murielle; Gaudin, Clément; Ysebaert, Loïc; Huynh, Anne; Recher, Christian

    2015-01-01

    Findings among a cohort of 26 patients who had hematologic malignancies and hepatitis E virus (HEV) infection support that HEV can induce chronic hepatitis. However, a 3-month course of ribavirin can induce a rapid viral clearance, reducing the risk for chronic hepatitis and enabling continuation of cytotoxic treatments for underlying malignancies.

  3. 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

  4. Utility of ranolazine in chronic stable angina patients

    Directory of Open Access Journals (Sweden)

    Pawan D Patel

    2008-08-01

    Full Text Available Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding of myocardial ischemia have prompted evaluation of a number of new antianginal strategies. In this review we discuss the utility of ranolazine, a recently approved novel antianginal agent and its efficacy in the diabetic patient population. In addition to its antianginal action in diabetic patients with chronic angina, ranolazine may have favorable effects on glycated hemoglobin levels.Keywords: chronic stable angina, antianginal, ranolazine, diabetes mellitus, glycated hemoglobin

  5. Emotion dynamics and tinnitus: Daily life data from the "TrackYourTinnitus" application.

    Science.gov (United States)

    Probst, Thomas; Pryss, Rüdiger; Langguth, Berthold; Schlee, Winfried

    2016-01-01

    It is well established that emotions influence tinnitus, but the role of emotion dynamics remains unclear. The present study investigated emotion dynamics in N = 306 users of the "TrackYourTinnitus" application who completed the Mini-Tinnitus Questionnaire (Mini-TQ) at one assessment point and provided complete data on at least five assessment points for the following state variables: tinnitus loudness, tinnitus distress, arousal, valence. The repeated arousal and valence ratings were used for two operationalizations of emotion dynamics: intra-individual variability of affect intensity (pulse) as well as intra-individual variability of affect quality (spin). Pearson correlation coefficients showed that the Mini-TQ was positively correlated with pulse (r = 0.19; p emotion dynamics might be a potential target in the prevention and treatment of tinnitus. PMID:27488227

  6. Audiological and psychological characteristics of a group of tinnitus sufferers, prior to tinnitus management training.

    Science.gov (United States)

    Dineen, R; Doyle, J; Bench, J

    1997-02-01

    A profile of audiological and psychological characteristics, obtained before starting tinnitus management training, is presented for 96 subjects with tinnitus. Variability was marked in all measures. A history of headaches, neck or back pain, or balance problems was not related to the ability to cope with tinnitus. The coping strategies used to manage tinnitus were influenced by the beliefs held about tinnitus, but the coping strategies chosen were not necessarily effective. No gender differences were found in coping ability or overall stress levels, although there were gender differences on some psychological measures and stress influences. Subjects who had previously sought assistance differed from those who had not in the complexity of the tinnitus sounds, the level of emotional reaction and the use of coping behaviours. PMID:9056041

  7. SRSF2 mutation in patients with chronic myelomonocytic leukemia

    Institute of Scientific and Technical Information of China (English)

    杨向绸

    2014-01-01

    Objective To investigate SRSF2 mutations in patients with chronic myelomonocytic leukemia(CMML)and the clinical characteristics of patients with SRSF2mutants.Methods In this study,the frequency of SRSF2mutation in a cohort of 20 patients with CMML was detected by polymerase chain reaction(PCR)followed by direct

  8. Oral disorders in patients with chronic renal failure. Narrative review.

    OpenAIRE

    Carolina Hernández

    2016-01-01

    Chronic renal failure (CRF) is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, wh...

  9. Phenotypes selected during chronic lung infection in cystic fibrosis patients

    DEFF Research Database (Denmark)

    Ciofu, Oana; Mandsberg, Lotte F; Wang, Hengzhuang;

    2012-01-01

    During chronic lung infection of patients with cystic fibrosis, Pseudomonas aeruginosa can survive for long periods of time under the challenging selective pressure imposed by the immune system and antibiotic treatment as a result of its biofilm mode of growth and adaptive evolution mediated by...... importance of biofilm prevention strategies by early aggressive antibiotic prophylaxis or therapy before phenotypic diversification during chronic lung infection of patients with cystic fibrosis....

  10. Obstructive sleep apnea in chronic obstructive pulmonary disease patients.

    LENUS (Irish Health Repository)

    Lee, Ruth

    2011-03-01

    Chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSA) represent two of the most prevalent chronic respiratory disorders and cardiovascular diseases are major co-morbidities in both. Co-existence of both disorders (overlap syndrome) occurs in 1% of adults and overlap patients have worse nocturnal hypoxemia and hypercapnia than COPD and OSA patients alone. The present review discusses recent data concerning the pathophysiological and clinical significance of the overlap syndrome.

  11. Quality of life in patients with chronic kidney disease

    OpenAIRE

    Maria Carolina Cruz; Carolina Andrade; Milton Urrutia; Sergio Draibe; Luiz Antônio Nogueira-Martins; Ricardo de Castro Cintra Sesso

    2011-01-01

    AIM: To compare the dimensions of quality of life in the stages of chronic kidney disease and the influence of sociodemographic, clinical and laboratory data. INTRODUCTION: The information available on the quality of life of patients on conservative treatment and the relationship between the quality of life and glomerular filtration rate is limited. METHODS: 155 patients in stages 1-5 of chronic kidney disease and 36 in hemodialysis were studied. Quality of life was rated by the Medical Outco...

  12. Impaired vascular reactivity in patients with chronic kidney disease

    DEFF Research Database (Denmark)

    Tetzner, Fabian; Scholze, Alexandra; Wittstock, Antje;

    2008-01-01

    Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics.......Patients with chronic kidney disease (CKD) show increased cardiovascular morbidity. We hypothesized that vascular properties which can be routinely evaluated noninvasively are related to different stages of CKD and their clinical and biochemical characteristics....

  13. Cardiovascular disease in patients with chronic kidney disease

    OpenAIRE

    Julian Wright; Alastair Hutchison

    2009-01-01

    Julian Wright, Alastair HutchisonManchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester, UKAbstract: Patients with chronic kidney disease have a high burden of cardiovascular morbidity and mortality. The vast majority of patients with chronic kidney disease do not progress to end stage renal failure, but do have a significantly higher incidence of all cardiovascular co-morbidities. Traditional cardiovascular risk factors only partially account for this ...

  14. Utility of ranolazine in chronic stable angina patients

    OpenAIRE

    Patel, Pawan D; Arora, Rohit R

    2008-01-01

    Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding o...

  15. Disability and borderline personality disorder in chronic pain patients

    OpenAIRE

    Sansone, Randy A.; J David Sinclair; Wiederman, Michael W.

    2010-01-01

    BACKGROUND AND OBJECTIVE: Few studies have examined the relationship between disability and borderline personality symptomatology, and, among those that have, findings have been inconsistent. In the present study, the relationship between medical disability and borderline personality symptomatology was examined in a sample of chronic pain patients.METHODS: In a consecutive insured sample of male and female chronic pain patients (n=117), who were being initially evaluated by an outpatient pain...

  16. Health Related Quality of Life of Chronic Liver Patients: A Dutch Population-Based Study

    NARCIS (Netherlands)

    S.M. van der Plas (Simone)

    2004-01-01

    markdownabstract__Abstract__ Chronic illnesses form a spectrum of diseases. Some chronic illnesses are poorly understood and unpredictable, some are understood and manageable, some are progressively disabling and some are life threatening. Nevertheless, for all chronic patients chronic illnesses ha

  17. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    , incidence and prevalence of addiction in opioid treated pain patients, screening tools for assessing opioid addiction in chronic pain patients and recommendations regarding addiction problems in national and international guidelines for opioid treatment in cancer patients and chronic non-malignant pain...... patients. The review indicates that the prevalence of addiction varied from 0% up to 50% in chronic non-malignant pain patients, and from 0% to 7.7% in cancer patients depending of the subpopulation studied and the criteria used. The risk of addiction has to be considered when initiating long-term opioid...... treatment as addiction may result in poor pain control. Several screening tools were identified, but only a few were thoroughly validated with respect to validity and reliability. Most of the identified guidelines mention addiction as a potential problem. The guidelines in cancer pain management are...

  18. Temporomandibular Joint Disorder Complaints in Tinnitus: Further Hints for a Putative Tinnitus Subtype

    OpenAIRE

    Vielsmeier, Veronika; Sturtz, Jürgen; Kleinjung, Tobias; Schecklmann, Martin; Kreuzer, Peter M.; Landgrebe, Michael; Langguth, Berthold

    2012-01-01

    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 Da...

  19. Temporomandibular joint disorder complaints in tinnitus: Further hints for a putative tinnitus subtype

    OpenAIRE

    Vielsmeier, V; Strutz, J; Kleinjung, T; Schecklmann, M; Kreuzer, P M; Landgrebe, M; Langguth, B

    2012-01-01

    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 Data...

  20. A Scientific Cognitive-Behavioral Model of Tinnitus: Novel Conceptualizations of Tinnitus Distress

    OpenAIRE

    McKenna, Laurence; Handscomb, Lucy; Hoare, Derek J; Hall, Deborah A

    2014-01-01

    The importance of psychological factors in tinnitus distress has been formally recognized for almost three decades. The psychological understanding of why tinnitus can be a distressing condition posits that it becomes problematic when it acquires an emotive significance through cognitive processes. Principle therapeutic efforts are directed at reducing or removing the cognitive (and behavioral) obstacles to habituation. Here, the evidence relevant to a new psychological model of tinnitus is c...

  1. Transition theory and its relevance to patients with chronic wounds.

    Science.gov (United States)

    Neil, J A; Barrell, L M

    1998-01-01

    A wound, in the broadest sense, is a disruption of normal anatomic structure and function. Acute wounds progress through a timely and orderly sequence of repair that leads to the restoration of functional integrity. In chronic wounds, this timely and orderly sequence goes awry. As a result, people with chronic wounds often face not only physiological difficulties but emotional ones as well. The study of body image and its damage as a result of a chronic wound fits well with Selder's transition theory. This article describes interviews with seven patients with chronic wounds. The themes that emerged from those interviews were compared with Selder's theory to describe patients' experience with chronic wounds as a transition process that can be identified and better understood by healthcare providers. PMID:10223031

  2. Quality of life in chronic disease patients

    Directory of Open Access Journals (Sweden)

    Kalliopi Megari

    2013-09-01

    Full Text Available During the past decades there was an increasing predominance of chronic disorders, with a large number of people living with chronic diseases that can adversely affect their quality of life. The aim of the present paper is to study quality of life and especially Health-related quality of life (HRQoL in chronic diseases. HRQOL is a multidimensional construct that consists of at least three broad domains − physical, psychological, and social functioning − that are affected by one’s disease and/or treatment. HRQoL is usually measured in chronic conditions and is frequently impaired to a great extent. In addition, factors that are associated with good and poor HRQoL, as well as HRQoL assessment will be discussed. The estimation of the relative impact of chronic diseases on HRQoL is necessary in order to better plan and distribute health care resources aiming at a better HRQoL.[«All the people perceive the concept of living good or being well, that is the same as being happy». (Aristotle. 384-322 BC. Ethica Nichomachea

  3. Plasma lactoferrin levels in patients with chronic calcifying pancreatitis.

    Science.gov (United States)

    Figarella, C; Gaia, E; Piantino, P

    1983-01-01

    Lactoferrin is a nonenzymatic secretory protein of human pancreas specifically increased in the external pancreatic secretion of patients with chronic calcifying pancreatitis. The possibility of an elevated concentration of plasma lactoferrin level in these patients needed to be explored even if the low pancreatic concentration of the protein did not favor this hypothesis. As expected, no increase could be observed between the plasma lactoferrin level of 16 patients with chronic calcifying pancreatitis (131 +/- 15 micrograms/l), compared to 17 controls (166 +/- 11 micrograms/l) and 15 patients with different organic diseases (187 +/- 18 micrograms/l). PMID:6628844

  4. Patient-Staff Interactions and Mental Health in Chronic Dialysis Patients

    Science.gov (United States)

    Swartz, Richard D.; Perry, Erica; Brown, Stephanie; Swartz, June; Vinokur, Amiram

    2008-01-01

    Chronic dialysis imposes ongoing stress on patients and staff and engenders recurring contact and long-term relationships. Thus, chronic dialysis units are opportune settings in which to investigate the impact of patients' relationships with staff on patient well-being. The authors designed the present study to examine the degree to which…

  5. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy.

    OpenAIRE

    van Doorn, P. A.

    1994-01-01

    Intravenous immunoglobulin (IVIg) treatment is shown to be effective in a selected group of patients with a chronic inflammatory demyelinating polyneuropathy (CIDP). The proportion of patients that improve after IVIg treatment varies between studies. Because 40% of a group of IVIg treated CIDP patients needed intermittent IVIg infusions to maintain their improved clinical condition, it is expected that IVIg is effective, at least in this subgroup of patients. However, the proportion of patien...

  6. Enhanced emotional reactions in chronic head trauma patients.

    OpenAIRE

    Fordyce, D J; Roueche, J R; Prigatano, G P

    1983-01-01

    The emotional characteristics of head injury patients referred for neuropsychological testing were examined as a function of the time since injury. Patients referred more than 6 months from injury were more emotionally distressed on the MMPI and Katz Adjustment Scale (relatives form) compared to those tested 6 months or earlier. The more chronic head trauma patients were more anxious and depressed, more confused in their thinking, and more socially withdrawn compared to the acute patient grou...

  7. Glucose intolerance in Chinese patients with chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Liang-Kung Chen; Shinn-Jang Hwang; Shih-Tzer Tsai; Jiing-Chyuan Luo; Shou-Dong Lee; Full-Young Chang

    2003-01-01

    AIM: To investigate the prevalence and the risk factors of glucose intolerance in Chinese patients with chronic hepatitis C and to evaluate the relationship between interferon (IFN)treatment and glucose intolerance in these patients.METHODS: Prospective cross-sectional study was done to evaluate the prevalence of glucose intolerance in Chinese patients with chronic hepatitis C virus (HCV) infection from the outpatient clinic of Department of Family Medicine, Taipei Veterans General Hospital. Chronic hepatitis C was defined as persistent presence of anti-HCV and persistent elevation of liver transaminase for at least 1.5 folds for at least 6 months. Moreover, patients were further categorized into normal fasting glucose and glucose intolerance (diabetes mellitus (DM) and impaired fasting glucose) according to the diagnostic criteria of American Diabetic Association. RESULTS: Totally, 359 Chinese patients with chronic hepatitis C were enrolled (212 males and 147 females, mean age=58.1±13.0 years). One hundred and twenty-three patients (34.3 %) had various forms of IFN treatment. One hundred and twenty-five patients (34.6 %)had glucose intolerance, including 99 patients (27.6 %) with DM and 26 patients (7.0 %) with impaired fasting glucose.Tn comparison with those with normal fasting glucose levels,patients with chronic hepatitis C with glucose intolerance were significantly older, had a significantly higher body mass index, and they were more likely to suffer from obesity, to have family history of diabetes and to have had previous IFN treatment. Stepwise multivariate logistic regression revealed significantly that age ≥ 57 years, obesity,previous history of IFN treatment and the presence of family history of diabetes were independent risk factors associated with the presence of glucose intolerance in chronic hepatitis C patients.CONCLUSION: In conclusion, 34.6 % of Chinese patients with chronic hepatitis C had glucose intolerance. Chronic hepatitis C patients who

  8. Chronic patient care at North West Province clinics

    Directory of Open Access Journals (Sweden)

    Claire van Deventer

    2009-04-01

    Full Text Available Background: Chronic illnesses are a significant burden to the health services in South Africa. There is a specific national health plan whereby chronically ill patients who are acceptably controlled should be managed at clinic level. The perception has emerged that the management of primary care has not been optimal in the Southern District of the North West Province. This provided the motivation to initiate this research, namely consideration of chronic patient care at clinics in the North West Province of South Africa.Method: A cross-sectional descriptive study was carried out at four randomly selected clinics covering four sub-districts in the Southern District (North West Province. This was done using charts and registers at the clinics. Inclusion criteria were patients older than 18, and presenting with the following chronic illnesses: asthma/chronic obstructive airways disease (COAD, hypertension, diabetes and epilepsy. The major focus areas were the regular assessment of the patients, the level of control of the illness and the use of the Essential Drugs List and Standard Treatment Guidelines (EDL/STG.Results: In the cases of all the chronic illnesses it was found that regular assessments were poorly done, with asthma (peak flow measurements being the most poorly done. Control was generally less than 50% for all the illnesses, although the EDL was followed fairly well by the personnel at the clinics.Conclusion: In the light of the burden of chronic illness the results give cause for great concern about the quality of care for chronically ill patients, and reasons were sought for some of the poor results. A subsequent decision was taken to carry out comprehensive quality improvement projects on each of the illnesses over the following five years.

  9. Patient-Centered Medical Home in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Ortiz G

    2011-10-01

    Full Text Available Gabriel Ortiz1, Len Fromer21Pediatric Pulmonary Services, El Paso, TX; 2Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a progressive and debilitating but preventable and treatable disease characterized by cough, phlegm, dyspnea, and fixed or incompletely reversible airway obstruction. Most patients with COPD rely on primary care practices for COPD management. Unfortunately, only about 55% of US outpatients with COPD receive all guideline-recommended care. Proactive and consistent primary care for COPD, as for many other chronic diseases, can reduce hospitalizations. Optimal chronic disease management requires focusing on maintenance rather than merely acute rescue. The Patient-Centered Medical Home (PCMH, which implements the chronic care model, is a promising framework for primary care transformation. This review presents core PCMH concepts and proposes multidisciplinary team-based PCMH care strategies for COPD.Keywords: Patient-Centered Medical Home, chronic care model, chronic obstructive pulmonary disease, patient education, physician assistants, nurse practitioners

  10. Small intestinal bacterial overgrowth in patients with chronic hepatitis C

    OpenAIRE

    K. V. Zhdanov; D. A. Gusev; S. M. Zacharenko; K. V. Kozlov; A. S. Sigidayev; M. V. Kurtukov; V. S. Sukachev

    2014-01-01

    In order to estimate the frequency of detection of bacterial overgrowth syndrome in patients with chronic hepatitis C, find a possible relationship between development dysbiotic changes in the small intestine and over chronic hepatitis C were examined 80 patients (68 males and 12 females). In addition to standard laboratory tests for all patients was performed hydrogen breath test with a load of lactulose and fibrogastroduodenoscopy and hepatic biopsy with subsequent histological examination ...

  11. Role of Myeloperoxidase in Patients with Chronic Kidney Disease

    Science.gov (United States)

    Kisic, Bojana; Miric, Dijana; Dragojevic, Ilija; Rasic, Julijana; Popovic, Ljiljana

    2016-01-01

    Chronic kidney disease (CKD) is a worldwide public health problem. Patients with CKD have a number of disorders in the organism, and the presence of oxidative stress and systemic inflammation in these patients is the subject of numerous studies. Chronic inflammation joined with oxidative stress contributes to the development of numerous complications: accelerated atherosclerosis process and cardiovascular disease, emergence of Type 2 diabetes mellitus, development of malnutrition, anaemia, hyperparathyroidism, and so forth, affecting the prognosis and quality of life of patients with CKD. In this review we presented the potential role of the myeloperoxidase enzyme in the production of reactive/chlorinating intermediates and their role in oxidative damage to biomolecules in the body of patients with chronic kidney disease and end-stage renal disease. In addition, we discussed the role of modified lipoprotein particles under the influence of prooxidant MPO intermediates in the development of endothelial changes and cardiovascular complications in renal failure. PMID:27127544

  12. Herbal medicine use among Turkish patients with chronic diseases

    Directory of Open Access Journals (Sweden)

    Munevver Tulunay

    2015-09-01

    Conclusions: In this study herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines. [J Intercult Ethnopharmacol 2015; 4(3.000: 217-220

  13. Chronic obstructive pulmonary disease in patients admitted with heart failure

    DEFF Research Database (Denmark)

    Iversen, K K; Kjaergaard, J; Akkan, D;

    2008-01-01

    OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is an important differential diagnosis in patients with heart failure (HF). The primary aims were to determine the prevalence of COPD and to test the accuracy of self-reported COPD in patients admitted with HF. Secondary aims were to study a...

  14. Stereoselective pharmacokinetics of methadone in chronic pain patients

    DEFF Research Database (Denmark)

    Kristensen, K; Blemmer, T; Angelo, H R;

    1996-01-01

    Ten patients with chronic pain were randomized to an open, balanced, crossover study. Each patients received two different preparations of racemic methadone, i.e., tablets and intravenous infusion. The pharmacokinetic parameters of the R- and S-enantiomers of the racemate are reported. The...

  15. Research on stage of chronic kidney disease in elderly patients

    Institute of Scientific and Technical Information of China (English)

    陈莹

    2013-01-01

    Objective To explore the clinical value of glomerular filtration rate (GFR) 45 ml·min-1·1.73 m-2for the stage assessment in the elderly patients with chronic kidney disease (CKD) .Methods From June 2009 to December 2011,2258 patients were recruited and divided

  16. Sarcopenia and Physical Inactivity in Patients With Chronic Kidney Disease.

    Science.gov (United States)

    Hirai, Keiji; Ookawara, Susumu; Morishita, Yoshiyuki

    2016-05-01

    Sarcopenia and physical inactivity synergistically progress in patients with chronic kidney disease (CKD) and are strong predictors of mortality in this population. Exercise training and essential amino acids and vitamin D supplements may contribute to improving sarcopenia and physical inactivity in CKD patients. PMID:27570755

  17. [Cognitive disorders in patients with chronic mercury intoxication].

    Science.gov (United States)

    Katamanova, E V; Shevchenko, O I; Lakhman, O L; Denisova, I A

    2014-01-01

    To assess severity of cognitive disorders in chronic mercury intoxication, the authors performed claster and discrimination analysis of neuropsychologic and neurophysiologic research data from workers exposed to mercury during long length of service, from patients with early and marked stages of chronic mercurial intoxication. Cognitive disorders in chronic mercurial intoxication have three severity degrees, in the light degree disorders patients demonstrate lower amplitude of cognitive evoked potentials, poor long-term memory and associative thinking. Moderate cognitive disorders are characterized by decreased visual, long-term memory, concentration of attention, poor optic and spatial gnosis. Marked cognitive disorders with chronic mercurial intoxication present with more decreased long-term, short-term, picturesque memory, poor intellect, optic and spatial gnosis and associative thinking. PMID:25051667

  18. Serum endocan levels in patients with chronic liver disease

    OpenAIRE

    Tok, Duran; Ekiz, Fuat; Basar, Omer; Coban, Sahin; OZTURK, Gulfer

    2014-01-01

    Background and Aim: Early detection of fibrosis should be the main goal of treatment in liver cirrhosis. Endocan, previously called endothelial cell specific molecule-1, is expressed by endothelial cells, primarily in the lung, liver and kidney. In this study, we aimed to examine the correlation of liver fibrosis stage, histological activity and grade of steatosis between serum levels of endocan in patients with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non-alcoholic fatty live...

  19. MEMBRANOUS INTESTINAL DIGESTION CHARACTERISTICS IN PATIENTS WITH CHRONIC PANCREATITIS

    Directory of Open Access Journals (Sweden)

    О.А. Stгокоva

    2009-03-01

    Full Text Available The study of enzymes activity of membranous intestinal digestion has been carried out. The condition of ultrastructure of mucous membrane of a small bowel in patients with chronic pancreatitis taking into account duration of disease is presented. It is shown, that signs of lesion of a small bowel in case of chronic pancreatitis are caused by disturbances in the first stage of membranous intestinal digestion, observed at early stages of disease and begin to progress with the disease duration.

  20. Decreased Speech-In-Noise Understanding in Young Adults with Tinnitus

    Science.gov (United States)

    Gilles, Annick; Schlee, Winny; Rabau, Sarah; Wouters, Kristien; Fransen, Erik; Van de Heyning, Paul

    2016-01-01

    differ regarding audiometry, OAE, and ABR.However, tinnitus patients showed decreased speech-in-noise reception. The results are discussed in the light of previous findings suggestion NIT may occur in the absence of measurable peripheral damage as reflected in speech-in-noise deficits in tinnitus subjects. PMID:27445661

  1. Neurodegenerative properties of chronic pain: cognitive decline in patients with chronic pancreatitis.

    Directory of Open Access Journals (Sweden)

    Marijtje L A Jongsma

    Full Text Available 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, use of opioids, and premorbid alcohol abuse. The cognitive profiles of 16 patients with severe pain due to chronic pancreatitis were determined using an extensive neuropsychological test battery. Data from three cognitive domains (psychomotor performance, memory, executive functions were compared to data from healthy controls matched for age, gender and education. Multivariate multilevel analysis of the data showed decreased test scores in patients with chronic pancreatitis pain in different cognitive domains. Psychomotor performance and executive functions showed the most prominent decline. Interestingly, pain duration appeared to be the strongest predictor for observed cognitive decline. Depressive symptoms, sleep disturbance, opioid use and history of alcohol abuse provided additional explanations for the observed cognitive decline in some of the tests, but to a lesser extent than pain duration. The negative effect of pain duration on cognitive performance is compatible with the theory of neurodegenerative properties of chronic pain. Therefore, early and effective therapeutic interventions might reduce or prevent decline in cognitive performance, thereby improving outcomes and quality of life in these patients.

  2. Management of insomnia in patients with chronic pain conditions.

    Science.gov (United States)

    Stiefel, Frederic; Stagno, Daniele

    2004-01-01

    The management of insomnia in patients experiencing chronic pain requires careful evaluation, good diagnostic skills, familiarity with cognitive-behavioural interventions and a sound knowledge of pharmacological treatments. Sleep disorders are characterised by a circular interrelationship with chronic pain such that pain leads to sleep disorders and sleep disorders increase the perception of pain. Sleep disorders in individuals with chronic pain remain under-reported, under-diagnosed and under-treated, which may lead--together with the individual's emotional, cognitive and behavioural maladaptive responses--to the frequent development of chronic sleep disorders. The moderately positive relationship between pain severity and sleep complaints, and the specificity of pain-related arousal and mediating variables such as depression, illustrate that insomnia in relation to chronic pain is multifaceted and poorly understood. This may explain the limited success of the available treatments. This article discusses the evaluation of patients with chronic pain and insomnia and the available pharmacological and nonpharmacological interventions to manage the sleep disorder. Non-pharmacological interventions should not be considered as single interventions, but in association with one another. Some non-pharmacological interventions especially the cognitive and behavioural approaches, can be easily implemented in general practice (e.g. stimulus control, sleep restriction, imagery training and progressive muscle relaxation). Hypnotics are routinely prescribed in the medically ill, regardless of their adverse effects; however, their long-term efficacy is not supported by robust evidence. Antidepressants provide an interesting alternative to hypnotics, since they can improve pain perception as well as sleep disorders in selected patients. Sedative antipsychotics can be considered for sleep disturbances in those patients exhibiting psychotic features, or for those with

  3. Online Patient Education for Chronic Disease Management: Consumer Perspectives.

    Science.gov (United States)

    Win, Khin Than; Hassan, Naffisah Mohd; Oinas-Kukkonen, Harri; Probst, Yasmine

    2016-04-01

    Patient education plays an important role in chronic disease management. The aim of this study is to identify patients' preferences in regard to the design features of effective online patient education (OPE) and the benefits. A review of the existing literature was conducted in order to identify the benefits of OPE and its essential design features. These design features were empirically tested by conducting survey with patients and caregivers. Reliability analysis, construct validity and regression analysis were performed for data analysis. The results identified patient-tailored information, interactivity, content credibility, clear presentation of content, use of multimedia and interpretability as the essential design features of online patient education websites for chronic disease management. PMID:26846749

  4. Peripheral blood lymphocytes DNA in patients with chronic liver diseases

    Institute of Scientific and Technical Information of China (English)

    Vasiliy I Reshetnyak; Tatyana I Sharafanova; Ludmila U Ilchenko; Elena V Golovanova; Gennadiy G Poroshenko

    2001-01-01

    BACKGROUND Viral replication in blood cells with nucleuses may lead to the damage of lymphocytes genetic apparatus and the beginning of immunopathological reactions.AIM Of this investigation is to reveal the damage to peripheral blood lymphocytes (PBL)DNA in the patients with chronic liver diseases.MATERIALS AND METHODS Sixteen-ninepatients with chronic liver diseases (37 patients with chronic viral hepatitis, 2 patients with liver cirrhosis of mixed etiology (alcohol + virus G),30 women with primary biliary cirrhosis-PBC)were examined. The condition of DNA structure of PBL-was measured by the fluorescenceanalysis of DNA unwinding (FADU) technique with modification. Changes of fluorescence (in %) reflected the DNA distractions degree (thepresence of DNA single-stranded breaks and alkalinelabile sights).RESULTS AND CONCLUSION . The quantity of DNA single-stranded breaks and alkalinelabile sightsin DNA in all patients with chronic viral hepatitis .didnt differ from the control group,excluding the patients with chronic hepatitis (CH) C + G. Patients with HGV and TTV monoinfection had demonstrated the increase of the DNA single-stranded breaks PBL quantity.This fact may be connected with hypothesisabout the viruses replication in white blood cells discussed in the literature. Tendency to increase quantity of DNA PBL damages in the patients with primary biliary cirrhosis (PBC) accordingly to the alkaline phosphatase activity increase was revealed. Significant decrease of the DNA single-stranded breaks and alkalinelabile sights in the PBC patients that were treated with prednison was demonstrated. Probably, the tendency to increase the quantity of DNA singlestranded breaks and alkalinelabile sights in lymphocytes of the PBC patients was depended on the surplus of the blood bile acid content.

  5. Anxiety and depression in patients suffering from chronic low backache

    International Nuclear Information System (INIS)

    To determine the frequency of anxiety and depression in patients with chronic low backache and to document other co-morbidities among these patients presenting at rheumatology clinic of a tertiary care hospital in Islamabad. Study Design: Cross sectional study. Place and Duration of Study: Study was conducted at Pakistan Institute of Medical Sciences from July 2012 to April 2013. Methodology: A total of 170 chronic low backache patients were administered urdu translated Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scales. Scoring was done on Likert-type scale of 1-4 (based on these replies: a little of the time, some of the time, good part of the time, most of the time) with overall assessment by cumulative score ranging from 20 to 80, where 20-44 was normal range, 45-59 mildly depressed/anxious, 60-69 moderately depressed / anxious and 70 and above severely depressed / anxious. Results: Out of 170 patients, 157 patients above 18 years of age with male to female ratio 2:3 completed the study. Among study sample 72.2% had mild depression, 21.6% had mild anxiety, 32% had mixed mild anxiety and depression, 0.8% had severe depression, 1.6% had severe anxiety while 2.4% suffered from severe mixed symptoms. Overall, 125 (79.6%) patients were suffering from mild to severe form of depression and anxiety both alone or mixed. Obesity was present in 34 (21.66%) of patients with chronic backache and out of these 29 (85.3%) had psychological co-morbidity. Conclusion: Two thirds of the chronic backache patients reporting at rheumatology clinic of a tertiary care hospital were suffering from mild to severe degree of depression and anxiety. This worrying situation calls for thorough systematic evaluation of all chronic backache patient arriving at rheumatology clinic for mood disorders and psychological ailment. (author)

  6. Aureobasidium pullulans infection in a patient with chronic lymphocytic leukemia

    OpenAIRE

    Leonardo Rodrigues de Oliveira; Helio Moraes-Souza; Andre Luiz Maltos; Keila Cristina dos Santos; Rodrigo Juliano Molina; Cristina Hueb Barata

    2013-01-01

    Saprophytic fungi are being increasingly recognized as etiologic agents of mycoses in immunosuppressed patients. We report a case of subcutaneous infiltration by Aureobasidium pullulans, likely due to traumatic inoculation, in a neutropenic patient during chemotherapy for chronic lymphocytic leukemia. The patient was treated with amphotericin B deoxycholate but was subsequently switched to itraconazole, which improved the lesion. This case highlights the importance of considering unusual fung...

  7. Small intestinal bacterial overgrowth in patients with chronic lymphocytic leukaemia.

    OpenAIRE

    Smith, G M; Chesner, I M; Asquith, P; Leyland, M. J.

    1990-01-01

    As part of a study to assess the possible contribution of lymphoid infiltration of the gastrointestinal mucosa to occult blood loss or malabsorption 20 patients with chronic lymphocytic leukaemia (CLL) had a lactulose hydrogen breath test. In 10 cases (50%) a small intestinal peak was detected, suggesting small bowel bacterial overgrowth, and this was confirmed in seven patients by the positive culture of jejunal aspirate. Of the patients with a positive hydrogen breath test, radiological exa...

  8. The distressed (Type D) personality is independently associated with tinnitus

    DEFF Research Database (Denmark)

    Bartels, Hilke; Middel, Berrie; Pedersen, Susanne S.;

    2010-01-01

    Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population.......Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population....

  9. Quality of life and uncertainty in illness for chronic patients

    Directory of Open Access Journals (Sweden)

    Valeria Caruso

    2014-09-01

    Full Text Available The experience of chronic illness, together with physical impairment and hospitalization in some cases, can be a difficult occurrence to manage. Illness determines changes in patients’ life style and limitations, that often cause psychological distress. It may happen that patients neither understand the meaning of the events correlated with illness, nor can predict when such events will occur. This uncertainty augments the negative impact of the state of chronic illness on patients’ quality of life. The present study has the purpose to examine the correlations between uncertainty due to  chronic disease and patients’ quality of life, keeping into account the diverse coping strategies adopted and the anxiety/depression feelings developed during hospitalization. There is an inverse correlation between chronic patients’ quality of life and the diverse dimensions of uncertainty in illness as identified by the Mishel Uncertainty in Illness Scale. The paper suggests how uncertainty hampers the possibility that patients choose coping strategies, involving their active management of illness. The lower the uncertainty, the higher is the possibility of activate coping mechanisms based on the acceptance of illness, together with a reflexive attitude concerning the actions to be taken to reduce the risk of anxiety/depression during hospitalization. Finally, the present study presents some policy implications, suggesting how the medical staff should not only treat patients, but also help patients to elaborate problem solving strategies and to positively accept their chronic health state.

  10. Chronic pain and quality of life in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Jouce Gabriela de Almeida

    2013-03-01

    Full Text Available OBJECTIVE: To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS: Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia. Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief data were collected between June and September 2008. RESULTS: Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001. There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. Conclusion: Chronic pain was common in schizophrenic patients (similar to the general population of a similar age and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.

  11. Skin prick test in patients with chronic allergic skin disorders

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    Pooja Bains

    2015-01-01

    Full Text Available Background: Chronic allergic skin disorders are the inflammatory and proliferative conditions in which both genetic and environmental factors play important roles. Chronic idiopathic urticaria (CIU and atopic dermatitis (AD are among the most common chronic allergic skin disorders. These can be provoked by various food and aeroallergens. Skin prick tests (SPTs represent the cheapest and most effective method to diagnose type I hypersensitivity. Positive skin tests with a history suggestive of clinical sensitivity strongly incriminate the allergen as a contributor to the disease process. Aim s and Objectives: To determine the incidence of positive SPT in patients with chronic allergic skin disorders and to identify the various allergens implicated in positive SPT. Methods: Fifty patients of chronic allergic disorders were recruited in this study. They were evaluated by SPT with both food and aeroallergens. Results: In our study, SPT positivity in patients of CIU was 63.41% and in AD was 77.78%. Out of the 41 patients of CIU, the most common allergen groups showing SPT positivity were dust and pollen, each comprising 26.83% patients. SPT reaction was positive with food items (21.6%, insects (17.07%, fungus (12.20%, and Dermatophagoides farinae, that is, house dust mite (HDM (7.32%. The allergen which showed maximum positivity was grain dust wheat (19.51%. Among nine patients of AD, maximum SPT positivity was seen with Dermatophagoides farinae, pollen Amaranthus spinosus, grain dust wheat, and cotton mill dust; each comprising 22.22% of patients. Conclusion: Our study showed that a significant number of patients of CIU and AD showed sensitivity to dust, pollen, insects, Dermatophagoides farinae, and fungi on SPT. Thus, it is an important tool in the diagnosis of CIU and AD.

  12. Roentgenopneumopolygraphy of pulmonary respiration in patients with chronic pneumonia

    International Nuclear Information System (INIS)

    A study was made of the efficacy of roentgenopneumopolygra hy combined with other clinical and X-ray methods of examination of the respiratory organs in 50 patients with chronic pneumonia. This method helps to obtain quantitative and qualitative indices of a degree of pulmonary and bronchial respiratory disturbances, to reveal hypoventilation and imperfect aeration of the lung that is very important for recognition and differential diagnosis of chronic pneumonia. Roentgenopneumopolygraphic results permit one to judge the time course of pathological formation, reparation processes, functional capabillity of the organ and the state of the most important pulmonary compensatory mechanisms that should be taken into account during rehabilitation of patients

  13. Nursing the chronically critically ill patient.

    Science.gov (United States)

    Carasa, Miriam; Nespoli, Grace

    2002-07-01

    The provision of care to the CCI patient is complex, challenging, and unique. The advanced practice nursing model at Mount Sinai Hospital is one successful care delivery model that fills the needs of both CCI patients and the nurses who work with them. The following transferable aspects of the RCU add to the unit's successful outcomes: (1) an interdisciplinary approach assures that all aspects of care are included in the clinical plan; (2) clinical care pathways, algorithms, and standard protocols based on physician, NP, and clinical nurse collaboration are successful management strategies; (3) formal discharge planning meetings with participation of patients, families, NPs, and social workers provide a forum for discharge planning and an avenue to address ethical issues such as advance directives, resuscitation status, and patient self-determination decisions; (4) full participation by nurses in all aspects of the unit's activities is a cost-effective strategy for maximizing positive outcomes for patients and their families. RCU patients and their families are in great need of emotional support. Patients have survived catastrophic illnesses, and are facing the arduous task of pulmonary rehabilitation as the desired outcome. Those patients unable to wean need to plan for a life dependent on ventilatory support. Presently in New York, there are not enough facilities to care for ventilator-dependent patients or patients who are weaned but in need of further pulmonary care and rehabilitation. The RCU LOS reflects this situation. Although a cost-benefit analysis is an effective way to evaluate the RCU program, the human element must not be forgotten. This is the daily challenge for the RCU staff and other health professionals engaged in the care of the CCI patient. Although the aim of this paper is to share the experience of patients and health care providers in the RCU, the reader should be aware that the RCU operates in the context of health care delivery at an

  14. Alexithymia and Early Maladaptive Schemas in chronic pain patients.

    Science.gov (United States)

    Saariaho, Anita S; Saariaho, Tom H; Mattila, Aino K; Karukivi, Max; Joukamaa, Matti I

    2015-08-01

    Psychological factors have an impact on subjective pain experience. The aim of this study was to explore the occurrence of alexithymia and Early Maladaptive Schemas in a sample of 271 first visit chronic pain patients of six pain clinics. The patients completed the study questionnaire consisting of the Toronto Alexithymia Scale-20, the Finnish version of the Young Schema Questionnaire short form-extended, the Beck Depression Inventory-II, and pain variables. Alexithymic patients scored higher on Early Maladaptive Schemas and had more pain intensity, pain disability and depression than nonalexithymic patients. Both alexithymia and depression correlated significantly with most Early Maladaptive Schemas. The co-occurrence of alexithymia, Early Maladaptive Schemas and depression seems to worsen the pain experience. Screening of alexithymia, depression and Early Maladaptive Schemas may help to plan psychological treatment interventions for chronic pain patients. PMID:26040835

  15. Computerized spectral analyses of EEG in chronic schizophrenic patients

    International Nuclear Information System (INIS)

    This study was aimed at clarifying the EEG difference between chronic schizophrenic patients and normal controls by using the EEG method of spectral analyses. Twelve comparatively homogenous chronic schizophrenic patients and the 10 healthy controls were subjected to EEG investigations. 1) The EEG of schizophrenic patients had a slowing tendency of the frequency in the frontal pole, anterior temporal and central regions of the scalp compared with control subjects. 2) There was a decrease of mutual relation among the five electrodes' peak frequency in the schizophrenic patients. 3) The EEG of schizophrenic patients had more fast waves of β1 and β2 band than that of control subjects. 4) A slowing tendency of the frequency in the first half regions of the scalp was not found in 3 chronic schizophrenic patients which showed defective functions in the frontal area by positron emission tomography. 5) When mental arithmetic was given, the schizophrenic patients showed an increase of fast wave in the central, posterior temporal and occipital regions of the scalp. 6) When they opened their eyes, attenuation in the α band was not so marked in the schizophrenic patients. (author)

  16. Functional imaging of unilateral tinnitus using fMRI

    NARCIS (Netherlands)

    Lanting, C. P.; De Kleine, E.; Van Dijk, P.; Bartels, H.

    2008-01-01

    Conclusions. This article shows that the inferior colliculus plays a key role in unilateral subjective tinnitus. Objectives. The major aim of this study was to determine tinnitus-related neural activity in the central auditory system of unilateral tinnitus subjects and compare this to control subjec

  17. Audiological, psychological and cognitive characteristics of tinnitus sufferers

    Directory of Open Access Journals (Sweden)

    Noorain Alam

    2012-01-01

    Full Text Available Objective: Tinnitus is widespread amongst clients attending hearing clinics and has been associated with a range of physical and emotional disorders. This study was undertaken with the assumption that tinnitus has a negative impact on psychological well-being as well as on mental concentration of the person. Materials and Methods: Three groups were selected, comprising 10 participants each. Two groups consisted of subjects with tinnitus complaints. The first group had no hearing loss (Tinnitus group (TIG, the second group had mild hearing loss (PTA >25, <40 dBHL (Tinnitus group with hearing impairment (TWHIG, and the third group had no tinnitus or hearing loss (Normal control group (NCG. After an audiological assessment, the following questionnaires were administered: 1 nature of tinnitus questionnaire, 2 tinnitus reaction questionnaire, 3 the symptom checklist (SCL-90-R, and 4 cognitive failure questionnaire (CFQ. Out of these, four were administered to all tinnitus groups while only the last two were administered on NCG. The results of these tests were compared using a t- test. Results: Participants with tinnitus reported significantly more psychological distress symptoms and everyday cognitive failures than the control group. Conclusion: Our assumption about the potential negative impact of tinnitus on psychological well-being as well as on mental concentration is supported by our study results. Implication: The present study indicates that there is a greater need for providing counseling as well as psychological intervention to reduce stress and assistance in coping with the cognitive failures for persons with tinnitus.

  18. Prevalence of Obstructive Sleep Apnea in Patients with Chronic Wounds

    Science.gov (United States)

    Patt, Brian T.; Jarjoura, David; Lambert, Lynn; Roy, Sashwati; Gordillo, Gayle; Schlanger, Richard; Sen, Chandan K.; Khayat, Rami N.

    2010-01-01

    Study Objectives: Chronic non-healing wounds are a major human and economic burden. Obstructive sleep apnea (OSA) is prevalent in patients with obesity, diabetes, aging, and cardiovascular disease, all of which are risk factors for chronic wounds. We hypothesized that OSA would have more prevalence in patients of a wound center than the general middle-aged population. Methods: Consecutive patients of the Ohio State University Comprehensive Wound Center (CWC) were surveyed with the Berlin and Epworth questionnaires. In the second stage of the protocol, 50 consecutive unselected CWC patients with lower extremity wounds underwent home sleep studies. Results: In 249 patients of the CWC who underwent the survey study, OSA had been previously diagnosed in only 22%. The prevalence of high-risk status based on questionnaires for OSA was 46% (95% CI 40%, 52%). In the 50 patients who underwent home sleep studies, and using an apnea hypopnea index of 15 events per hour, the prevalence of OSA was 57% (95% CI 42%, 71%). There was no difference between the Berlin questionnaire score and weight between patients with OSA and those without. Conclusions: The prevalence of OSA in patients with chronic wounds exceeds the estimated prevalence of OSA in the general middle aged population. This study identifies a previously unrecognized population with high risk for OSA. Commonly used questionnaires were not sufficiently sensitive for the detection of high risk status for OSA in this patient population. Citation: Patt BT; Jarjoura D; Lambert L; Roy S; Gordillo G; Schlanger R; Sen CK; Khayat RN. Prevalence of obstructive sleep apnea in patients with chronic wounds. J Clin Sleep Med 2010;6(6):541-544. PMID:21206743

  19. Lung lobar volume in patients with chronic interstitial pneumonia

    International Nuclear Information System (INIS)

    We measured lung lobar volume by using helical computed tomography (HCT) in 23 patients with idiopathic interstitial pneumonia (IIP), 7 patients with chronic interstitial pneumonia associated with collagen vascular disease (CVD-IP), and 5 healthy volunteers HCT scanning was done at the maximal inspiratory level and the resting end-expiratory level. To measure lung lobar volume, we traced the lobar margin on HCT images with a digitizer and calculated the lobar volume with a personal computer. The lower lobar volume and several factors influencing it in chronic interstitial pneumonia were studied. At the maximal inspiratory level, the lower lobar volume as a percent of the whole lung volume was 46.8±4.13% (mean ± SD) in the volunteers, 39.5±6.19% in the patients with IIP, and 27.7±7. 86% in the patients with CVD-IP. The lower lobar volumes in the patients were significantly lower than in the volunteers. Patients with IIP in whom autoantibody tests were positive had lower lobar volumes that were very low and were similar to those of patients with CVD-IP. These data suggest that collagen vascular disease may develop in patients with interstitial pneumonia. The patients with IIP who had emphysematous changes on the CT scans had smaller decreases in total lung capacity and lower ratios of forced expiratory volume in one second to forced vital capacity than did those who had no emphysematous changes, those two groups did not differ in the ratio of lower lobar volume to whole lung volume. This suggests that emphysematous change is not factor influencing lower lobar volume in patients with chronic interstitial pneumonia. We conclude that chronic interstitial pneumonia together with very low values for lower lobar volume may be a pulmonary manifestation of collagen vascular disease. (author)

  20. Rationale for the tinnitus retraining therapy trial

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    Craig Formby

    2013-01-01

    Full Text Available The Tinnitus Retraining Therapy Trial (TRTT is a National Institutes of Health-sponsored, multi-centered, placebo-controlled, randomized trial evaluating the efficacy of tinnitus retraining therapy (TRT and its component parts, directive counseling and sound therapy, as treatments for subjective debilitating tinnitus in the military. The TRTT will enroll 228 individuals at an allocation ratio of 1:1:1 to: (1 directive counseling and sound therapy using conventional sound generators; (2 directive counseling and placebo sound generators; or (3 standard of care as administered in the military. Study centers include a Study Chair′s Office, a Data Coordinating Center, and six Military Clinical Centers with treatment and data collection standardized across all clinics. The primary outcome is change in Tinnitus Questionnaire (TQ score assessed longitudinally at 3, 6, 12, and 18-month follow-up visits. Secondary outcomes include: Change in TQ sub-scales, Tinnitus Handicap Inventory, Tinnitus Functional Index, and TRT interview visual analog scale; audiometric and psychoacoustic measures; and change in quality of life. The TRTT will evaluate TRT efficacy by comparing TRT (directive counseling and conventional sound generators with standard of care; directive counseling by comparing directive counseling plus placebo sound generators versus standard of care; and sound therapy by comparing conventional versus placebo sound generators. We hypothesize that full TRT will be more efficacious than standard of care, directive counseling and placebo sound generators more efficacious than standard of care, and conventional more efficacious than placebo sound generators in habituating the tinnitus awareness, annoyance, and impact on the study participant′s life.

  1. Chronic Lyme disease: misconceptions and challenges for patient management

    Directory of Open Access Journals (Sweden)

    Halperin JJ

    2015-05-01

    Full Text Available John J HalperinDepartment of Neurosciences, Overlook Medical Center, Summit, NJ, USAAbstract: Lyme disease, infection with the tick-borne spirochete Borrelia burgdorferi, causes both specific and nonspecific symptoms. In untreated chronic infection, specific manifestations such as a relapsing large-joint oligoarthritis can persist for years, yet subside with appropriate antimicrobial therapy. Nervous system involvement occurs in 10%–15% of untreated patients and typically involves lymphocytic meningitis, cranial neuritis, and/or mononeuritis multiplex; in some rare cases, patients have parenchymal inflammation in the brain or spinal cord. Nervous system infection is similarly highly responsive to antimicrobial therapy, including oral doxycycline. Nonspecific symptoms such as fatigue, perceived cognitive slowing, headache, and others occur in patients with Lyme disease and are indistinguishable from comparable symptoms occurring in innumerable other inflammatory states. There is no evidence that these nonspecific symptoms reflect nervous system infection or damage, or that they are in any way specific to or diagnostic of this or other tick-borne infections. When these symptoms occur in patients with Lyme disease, they typically also subside after antimicrobial treatment, although this may take time. Chronic fatigue states have been reported to occur following any number of infections, including Lyme disease. The mechanism underlying this association is unclear, although there is no evidence in any of these infections that these chronic posttreatment symptoms are attributable to ongoing infection with B. burgdorferi or any other identified organism. Available appropriately controlled studies indicate that additional or prolonged courses of antimicrobial therapy do not benefit patients with a chronic fatigue-like state after appropriately treated Lyme disease. Keywords: Lyme disease, Borrelia burgdorferi, chronic, diagnosis, treatment, chronic

  2. Quality of Life in Chronic Hepatitis B and C Patients

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    Abitin Heidarzadeh

    2007-08-01

    Full Text Available Background and Aims: Chronic hepatitis B and C are prevalent diseases, especially in developing countries. In many of the patients they cause limitations in physical and mental functions and finally cause reduction in their life quality. We wanted to assess the quality of life in these patients.Methods: This research was done on 74 chronic hepatitis B and C patients of Rasht which their diseases were confirmed by serologic and histologic methods and their hepatic enzymes including AST & ALT was two times more than normal range for at least 6 months. Cross-sectional questionnaire survey performed in October 2003 till Jully 2004 in Gastrointestinal & Liver Diseases Research Center of Rasht (north city of Iran, Razi hospital. The questionnaires consisted of 29 questions that were given to the patients and they were let free to complete it. Results: The individuals under survey consisted of 15 (20.27% chronic hepatitis B patients and 59 (79.72% chronic hepatitis C patients. 54 (72.79% ones were male and 20 (27.02% were female. Total adjusted score (up to 100 points of life quality was 54.4 ± 22.5. No meaningful difference was seen between two sexes based on total score of life quality. Also, in different fields of life quality no significant difference was seen between two genders, except the systemic signs that the average of adjusted score of females (43 ± 28 was less than males (63 ± 27 that means meaningful statistical difference (P < 0.007.Conclusions: Generally, it seems that chronic hepatitis B and C have untoward life qualities which could result from concern of decrease of social support or fear of society or decrease in patronage of the family or friends and it is mandate to be concerned when furnishing services to these patients.

  3. Remote patient monitoring in chronic heart failure.

    Science.gov (United States)

    Palaniswamy, Chandrasekar; Mishkin, Aaron; Aronow, Wilbert S; Kalra, Ankur; Frishman, William H

    2013-01-01

    Heart failure (HF) poses a significant economic burden on our health-care resources with very high readmission rates. Remote monitoring has a substantial potential to improve the management and outcome of patients with HF. Readmission for decompensated HF is often preceded by a stage of subclinical hemodynamic decompensation, where therapeutic interventions would prevent subsequent clinical decompensation and hospitalization. Various methods of remote patient monitoring include structured telephone support, advanced telemonitoring technologies, remote monitoring of patients with implanted cardiac devices such as pacemakers and defibrillators, and implantable hemodynamic monitors. Current data examining the efficacy of remote monitoring technologies in improving outcomes have shown inconsistent results. Various medicolegal and financial issues need to be addressed before widespread implementation of this exciting technology can take place. PMID:23018667

  4. Description of 34 patients with complicated cholesteatomatous chronic otitis media

    Directory of Open Access Journals (Sweden)

    Bento, Ricardo Ferreira

    2008-09-01

    Full Text Available Introduction: Cholesteatomas are cystic destructive lesions that affect any pneumatized area of the temporal bone. They can cause intracranial and extracranial complications. Objective: To register the patients with complicated cholesteatomatous chronic otitis media, who were interned in the otorhinolaryngology nursing of the Clinical Hospital of São Paulo, between the years of 2001 and 2008. Method: Retrospective study involving 34 patients with complicated cholesteatomatous chronic otitis media, who had been otorhinolaryngology nursing in the Clinical Hospital of the Medicine College of the University of São Paulo, from 2001 through 2008. Results: The age of the patients ranged from 7 to 83 years, with predominance of the masculine sex (76%. The extracranial complications were more frequent than the intracranial complications, and some patients presented both types of complication. All the patients received endovenous antibiotic, and only one patient was not submitted to surgical procedure. No patient died, and in the six-month follow-up no incapacitating severe neurological sequels occurred. Conclusion: The precocious and aggressive treatment of the complicated cholesteatomatous chronic otitis media diminishes the disease morbimortality.

  5. Questionnaire survey of chronic cough in asthmatic patients

    Institute of Scientific and Technical Information of China (English)

    魏为利; 邱忠民; 吕寒静; 杨忠民; 洪光朝; 王岚; 刘兴元; 郑桂芬

    2004-01-01

    @@ Wheezing is a common symptom of asthma and a main reason for most patients to seek medical care. Although wheezing has long been considered the essential symptom of asthma, clinical observations have shown that chronic cough is also an important symptom of asthma, even the sole presenting manifestation in cough variant asthma.1 As a special form of asthma, cough variant asthma probably represents the milder end of the spectrum of asthma or the forerunner of asthma, and may develop into typical asthma when the state of the illness progresses.2 Therefore, there may be a natural course from chronic cough to wheezing in the pathogenesis of asthma. However, there is currently no data to show how many patients with asthma present chronic cough before the first onset of wheezing. To investigate this question, we performed this questionnaire survey.

  6. Alexithymia and anxiety in female chronic pain patients

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    Saatcioglu Omer

    2006-08-01

    Full Text Available Abstract Objectives Alexithymia is highly prevalent among chronic pain patients. Pain is a remarkable cause for high levels of chronic anxiety. The purpose of this study was to investigate the prevalence of alexithymia and to determine anxiety levels among DSM-IV somatoform pain disorder (chronic pain female patients and to examine the relationship between alexithymia and the self-reporting of pain. Methods Thirty adult females (mean age: 34,63 ± 10,62 years, who applied to the outpatient psychiatry clinic at a public hospital with the diagnosis of chronic pain disorder (DSM-IV, were included in the study. Thirty seven healthy females (mean age: 34,46 ± 7,43 years, who matched for sociodemographic features with the patient group, consisted the control group. A sociodemographic data form, 26-item Toronto Alexithymia Scale (TAS-26, Spielberger Trait Anxiety Inventory (STAI were administered to each subject and information was obtained on several aspects of the patients' pain, including intensity (measured by VAS, and duration. Results Chronic pain patients were found significantly more alexithymic than controls. There was a positive correlation between TAS-26 scores and the duration of pain. The alexithymic and nonalexithymic group did not differ in their perception of pain. Neither positive correlation nor significant difference was found between alexithymia and trait anxiety in pain patients. Discussion Alexithymia may be important in addressing the diversity of subjective factors involved in pain. The conceptualization of alexithymia as a personality trait as well as a secondary state reaction is underlined by our data.

  7. Oral Tori in Chronic Peritoneal Dialysis Patients

    Science.gov (United States)

    Hsu, Chia-Lin; Hsu, Ching-Wei; Chang, Pei-Ching; Huang, Wen-Hung; Weng, Cheng-Hao; Yang, Huang-Yu; Liu, Shou-Hsuan; Chen, Kuan-Hsing; Weng, Shu-Man; Chang, Chih-Chun; Wang, I-Kuan

    2016-01-01

    Background The pathogenesis of oral tori has long been debated and is thought to be the product of both genetic and environmental factors, including occlusal forces. Another proposed mechanism for oral tori is the combination of biomechanical forces, particularly in the oral cavity, combined with cortical bone loss and trabecular expansion, as one might see in the early stages of primary hyperparathyroidism. This study investigated the epidemiology of torus palatinus (TP) and torus mandibularis (TM) in peritoneal dialysis patients, and analyzed the influences of hyperparathyroidism on the formation of oral tori. Method In total, 134 peritoneal dialysis patients were recruited between July 1 and December 31, 2015 for dental examinations for this study. Patients were categorized into two subgroups based on the presence or absence of oral tori. Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis. Results The prevalence of oral tori in our sample group was high at 42.5% (57 of 134), and most patients with oral tori were female (61.4%). The most common location of tori was TP (80.7%), followed by TP and TM (14.0%), then TM (5.3%). All 54 TP cases were at the midline, and most were <2 cm (59.3%), flat (53.7%), and located in the premolar region (40.7%). Of the 11 TM cases, all were bilateral and symmetric, mostly <2 cm (81.9%), lobular (45.4%), and located at premolar region (63.6%). Interestingly, patients with oral tori had slightly lower serum levels of intact parathyroid hormones than those without oral tori, but the difference was not statistically significant (317.3±292.0 versus 430.1±492.6 pg/mL, P = 0.126). In addition, patients with oral tori did not differ from patients without tori in inflammatory variables such as serum high sensitivity C-reactive protein levels (6.6±8.2 versus 10.3±20.2 mg/L, P = 0.147) or nutritional variables such as serum albumin levels (3.79±0.38 versus 3.77±0.45 g/dL, P = 0

  8. Oral Tori in Chronic Peritoneal Dialysis Patients.

    Directory of Open Access Journals (Sweden)

    Chia-Lin Hsu

    Full Text Available The pathogenesis of oral tori has long been debated and is thought to be the product of both genetic and environmental factors, including occlusal forces. Another proposed mechanism for oral tori is the combination of biomechanical forces, particularly in the oral cavity, combined with cortical bone loss and trabecular expansion, as one might see in the early stages of primary hyperparathyroidism. This study investigated the epidemiology of torus palatinus (TP and torus mandibularis (TM in peritoneal dialysis patients, and analyzed the influences of hyperparathyroidism on the formation of oral tori.In total, 134 peritoneal dialysis patients were recruited between July 1 and December 31, 2015 for dental examinations for this study. Patients were categorized into two subgroups based on the presence or absence of oral tori. Demographic, hematological, biochemical, and dialysis-related data were obtained for analysis.The prevalence of oral tori in our sample group was high at 42.5% (57 of 134, and most patients with oral tori were female (61.4%. The most common location of tori was TP (80.7%, followed by TP and TM (14.0%, then TM (5.3%. All 54 TP cases were at the midline, and most were <2 cm (59.3%, flat (53.7%, and located in the premolar region (40.7%. Of the 11 TM cases, all were bilateral and symmetric, mostly <2 cm (81.9%, lobular (45.4%, and located at premolar region (63.6%. Interestingly, patients with oral tori had slightly lower serum levels of intact parathyroid hormones than those without oral tori, but the difference was not statistically significant (317.3±292.0 versus 430.1±492.6 pg/mL, P = 0.126. In addition, patients with oral tori did not differ from patients without tori in inflammatory variables such as serum high sensitivity C-reactive protein levels (6.6±8.2 versus 10.3±20.2 mg/L, P = 0.147 or nutritional variables such as serum albumin levels (3.79±0.38 versus 3.77±0.45 g/dL, P = 0.790. Furthermore, there were no

  9. Comparison of Auditory Brainstem Response in Noise Induced Tinnitus and Non-Tinnitus Control Subjects

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    Ghassem Mohammadkhani

    2009-12-01

    Full Text Available Background and Aim: Tinnitus is an unpleasant sound which can cause some behavioral disorders. According to evidence the origin of tinnitus is not only in peripheral but also in central auditory system. So evaluation of central auditory system function is necessary. In this study Auditory brainstem responses (ABR were compared in noise induced tinnitus and non-tinnitus control subjects.Materials and Methods: This cross-sectional, descriptive and analytic study is conducted in 60 cases in two groups including of 30 noise induced tinnitus and 30 non-tinnitus control subjects. ABRs were recorded ipsilateraly and contralateraly and their latencies and amplitudes were analyzed.Results: Mean interpeak latencies of III-V (p= 0.022, I-V (p=0.033 in ipsilatral electrode array and mean absolute latencies of IV (p=0.015 and V (p=0.048 in contralatral electrode array were significantly increased in noise induced tinnitus group relative to control group. Conclusion: It can be concluded from that there are some decrease in neural transmission time in brainstem and there are some sign of involvement of medial nuclei in olivery complex in addition to lateral lemniscus.

  10. Invasive fungal infections in patients with chronic granulomatous disease

    NARCIS (Netherlands)

    Henriet, S.S.V.; Verweij, P.E.; Holland, S.M.; Warris, A.

    2013-01-01

    Invasive fungal infections are a major threat for chronic granulomatous disease (CGD) patients. The present study provides a comprehensive overview of published invasive fungal infections in the CGD host through an extensive review of epidemiological, clinical, diagnostic and therapeutic data. In ad

  11. Ibrutinib-induced lymphocytosis in patients with chronic lymphocytic leukemia

    DEFF Research Database (Denmark)

    Herman, S E M; Niemann, C U; Farooqui, M;

    2014-01-01

    Ibrutinib and other targeted inhibitors of B-cell receptor signaling achieve impressive clinical results for patients with chronic lymphocytic leukemia (CLL). A treatment-induced rise in absolute lymphocyte count (ALC) has emerged as a class effect of kinase inhibitors in CLL and warrants further...

  12. Chronic Melioidosis in a Patient with Cystic Fibrosis

    OpenAIRE

    Schülin, Tanja; Steinmetz, Ivo

    2001-01-01

    Burkholderia pseudomallei, the causative agent of melioidosis, is endemic in Southeast Asia and northern Australia, where it can be found in soil and surface water. We report a case of chronic pulmonary melioidosis in a patient with cystic fibrosis who had traveled to an area where B. pseudomallei is endemic.

  13. [Health maintenance, relaxation and hypnosis for chronic pain patients].

    Science.gov (United States)

    Boiron, Clare

    2014-10-01

    The treatment of chronic pain patients integrates more and more complementary therapies such as relaxation and hypnosis, implemented by specially trained nurses. These techniques are offered on the basis of nurses' diagnoses carried out in the framework of a clinical approach. PMID:25518140

  14. Diagnostic stability among chronic patients with functional psychoses

    DEFF Research Database (Denmark)

    Jakobsen, Klaus D; Hansen, Thomas; Werge, Thomas

    2007-01-01

    Diagnostic stability and illness course of chronic non-organic psychoses are complex phenomena and only few risk factors or predictors are known that can be used reliably. This study investigates the diagnostic stability during the entire course of illness in patients with non-organic psychoses and...

  15. Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the "TrackYourTinnitus" application.

    Science.gov (United States)

    Probst, Thomas; Pryss, Rüdiger; Langguth, Berthold; Schlee, Winfried

    2016-01-01

    The psychological process how tinnitus loudness leads to tinnitus distress remains unclear. This cross-sectional study investigated the mediating role of the emotional state "stress level" and of the two components of the emotional state "arousal" and "valence" with N = 658 users of the "TrackYourTinnitus" smartphone application. Stress mediated the relationship between tinnitus loudness and tinnitus distress in a simple mediation model and even in a multiple mediation model when arousal and valence were held constant. Arousal mediated the loudness-distress relationship when holding valence constant, but not anymore when controlling for valence as well as for stress. Valence functioned as a mediator when controlling for arousal and even when holding arousal and stress constant. The direct effect of tinnitus loudness on tinnitus distress remained significant in all models. This study demonstrates that emotional states affect the process how tinnitus loudness leads to tinnitus distress. We thereby could show that the mediating influence of emotional valence is at least equally strong as the influence of stress. Implications of the findings for future research, assessment, and clinical management of tinnitus are discussed. PMID:26853815

  16. Aureobasidium pullulans infection in a patient with chronic lymphocytic leukemia

    Directory of Open Access Journals (Sweden)

    Leonardo Rodrigues de Oliveira

    2013-09-01

    Full Text Available Saprophytic fungi are being increasingly recognized as etiologic agents of mycoses in immunosuppressed patients. We report a case of subcutaneous infiltration by Aureobasidium pullulans, likely due to traumatic inoculation, in a neutropenic patient during chemotherapy for chronic lymphocytic leukemia. The patient was treated with amphotericin B deoxycholate but was subsequently switched to itraconazole, which improved the lesion. This case highlights the importance of considering unusual fungal infections in critically ill patients such as those who are immunosuppressed due to chemotherapy. Diagnostic techniques and effective antifungal therapy have improved the prognosis of these cases.

  17. Increased Circulating Cathepsin K in Patients with Chronic Heart Failure

    OpenAIRE

    Guangxian Zhao; Yuzi Li; Lan Cui; Xiang Li; Zhenyi Jin; Xiongyi Han; Ennan Fang; Yihua Gao; Dongmei Zhou; Haiying Jiang; Xueying Jin; Guanghao Piao; Xiangshan Li; Guang Yang; Jiyong Jin

    2015-01-01

    Cysteinyl cathepsin K (CatK) is one of the most potent mammalian collagenases involved in cardiovascular disease. Here, we investigated the clinical predictive value of serum CatK levels in patients with chronic heart failure (CHF). We examined 134 patients with CHF, measuring their serum CatK, troponin I, high-sensitive C-reactive protein, and pre-operative N-terminal pro-brain natriuretic peptide levels. The patients were divided into two groups: the 44 patients who showed a left ventricula...

  18. Endovascular Treatment of Chronic Mesenteric Ischemia: Results in 14 Patients

    International Nuclear Information System (INIS)

    We evaluated immediate and long-term results of percutaneous transluminal angioplasty (PTA) and stent placement to treat stenotic and occluded arteries in patients with chronic mesenteric ischemia. Fourteen patients were treated by 3 exclusive celiac artery (CA) PTAs (2 stentings), 3 cases with both Superior Mesenteric Artery (SMA) and CA angioplasties, and 8 exclusive SMA angioplasties (3 stentings). Eleven patients had atheromatous stenoses with one case of an early onset atheroma in an HIV patient with antiphospholipid syndrome. The other etiologies of mesenteric arterial lesions were Takayashu arteritis (2 cases) and a postradiation stenoses (1 case). Technical success was achieved in all cases. Two major complications were observed: one hematoma and one false aneurysm occurring at the brachial puncture site (14.3%). An immediate clinical success was obtained in all patients. During a follow-up of 1-83 months (mean: 29 months), 11 patients were symptom free; 3 patients had recurrent pain; in one patient with inflammatory syndrome, pain relief was obtained with medical treatment; in 2 patients abdominal pain was due to restenosis 36 and 6 months after PTA, respectively. Restenosis was treated by PTA (postirradiation stenosis), and by surgical bypass (atheromatous stenosis). Percutaneous endovascular techniques are safe and accurate. They are an alternative to surgery in patients with chronic mesenteric ischemia due to short and proximal occlusive lesions of SMA and CA

  19. Phosphate diabetes in patients with chronic fatigue syndrome.

    OpenAIRE

    Lorenzo, F.; Hargreaves, J.; Kakkar, V V

    1998-01-01

    Phosphate depletion is associated with neuromuscular dysfunction due to changes in mitochondrial respiration that result in a defect of intracellular oxidative metabolism. Phosphate diabetes causes phosphate depletion due to abnormal renal re-absorption of phosphate be the proximal renal tubule. Most of the symptoms presented by patients with phosphate diabetes such as myalgia, fatigue and mild depression, are also common in patients with chronic fatigue syndrome, but this differential diagno...

  20. Urinary Peptide Levels in Patients with Chronic Renal Failure

    OpenAIRE

    Mungli Prakash; Phani, Nagaraj M; Kavya R; Supriya M

    2010-01-01

    Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF) patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary pepti...

  1. Influenza Vaccination Reduces Dementia Risk in Chronic Kidney Disease Patients

    OpenAIRE

    Liu, Ju-Chi; Hsu, Yi-Ping; Kao, Pai-Feng; Hao, Wen-Rui; Liu, Shing-Hwa; Lin, Chao-Feng; Sung, Li-Chin; Wu, Szu-Yuan

    2016-01-01

    Abstract Taiwan has the highest prevalence of chronic kidney disease (CKD) worldwide. CKD, a manifestation of vascular diseases, is associated with a high risk of dementia. Here, we estimated the association between influenza vaccination and dementia risk in patients with CKD. Data from the National Health Insurance Research Database of Taiwan were used in this study. The study cohort included all patients diagnosed with CKD (according to International Classification of Disease, Ninth Revisio...

  2. Perioperative Outcome of Dyssomnia Patients on Chronic Methylphenidate Use

    OpenAIRE

    Stoicea, Nicoleta; Ellis, Thomas; Moran, Kenneth; Ackermann, Wiebke; Wilson, Thomas; Quevedo, Eduardo; Bergese, Sergio

    2014-01-01

    Methylphenidate is frequently prescribed for attention deficit hyperactivity disorder, narcolepsy, and other sleep disorders requiring psychostimulants. Our report is based on 2 different clinical experiences of patients with chronic methylphenidate use, undergoing general anesthesia. These cases contrast different strategies of taking versus withholding the drug treatment on the day of surgery. From the standpoint of anesthetic management and patient safety, the concerns for perioperative me...

  3. Experiences of air travel in patients with chronic heart failure

    OpenAIRE

    Ingle, Lee; Hobkirk, James; Damy, Thibaud; Nabb, Samantha; Clark, Andrew L.; Cleland, John G F

    2012-01-01

    Aim To conduct a survey in a representative cohort of ambulatory patients with stable, well managed chronic heart failure (CHF) to discover their experiences of air travel. Methods An expert panel including a cardiologist, an exercise scientist, and a psychologist developed a series of survey questions designed to elicit CHF patients' experiences of air travel (Appendix 1). The survey questions, information sheets and consent forms were posted out in a self-addressed envelope to 1293 CHF pati...

  4. [Chronic Salmonella typhimurium diarrhea in an immunocompetent patient].

    Science.gov (United States)

    Mellado-Ferreiro, M; Jarne-Betrán, V; Arteaga-Mazuelas, M; Abínzano-Guillén, M L

    2016-01-01

    Chronic diarrhea caused by infection in immunocompetent patients is an infrequent condition in developed countries, although certain pathogens,generally parasites (Giardia lamblia, Isospora belli,Cryptosporidium, Cyclospora, Strongyloides, Ameba,Trichuris and Schistosoma) and some bacteria (Aeromonas,Plesiomonas, Campylobacter, Clostridium difficile, Salmonella or Mycobacterium tuberculosis)can cause persistent diarrhea.We present the case of a patient who showed Salmonella typhimurium in his stool culture and recovered following treatment with levofloxacin for 7 days. PMID:27125610

  5. Vitamin B status in patients with chronic fatigue syndrome.

    OpenAIRE

    Heap, L C; Peters, T. J.; Wessely, S

    1999-01-01

    Some patients with chronic fatigue syndrome say they benefit from taking vitamin supplements. We assessed functional status for the B vitamins pyridoxine, riboflavin and thiamine in 12 vitamin-untreated CFS patients and in 18 healthy controls matched for age and sex. Vitamin-dependent activities--aspartate aminotransferase (AST) for pyridoxine, glutathione reductase (GTR) for riboflavin, transketolase (TK) for thiamine--were measured in erythrocyte haemolysates before and after in-vitro addit...

  6. The Expert Patient and Chronic Respiratory Diseases

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2016-01-01

    Full Text Available The concept of “expert patient” has been developed in the last two decades to define a patient who has a significant knowledge of his/her disease and treatment in addition to self-management skills. However, this concept has evolved over the last years, and these patients are now considered, not only to be more efficient in the management of their own condition and communicating effectively with health professionals, but to also act as educators for other patients and as resources for the last, provide feedback on care delivery, and be involved in the production and implementation of practice guidelines, as well as in the development and conduct of research initiatives. There are some barriers, however, to the integration of this new contributor to the health care team, and specific requirements need to be considered for an individual to be considered as an expert. This new player has, however, a potentially important role to improve current care, particularly in respiratory health.

  7. Patient-Specific Airway Wall Remodeling in Chronic Lung Disease.

    Science.gov (United States)

    Eskandari, Mona; Kuschner, Ware G; Kuhl, Ellen

    2015-10-01

    Chronic lung disease affects more than a quarter of the adult population; yet, the mechanics of the airways are poorly understood. The pathophysiology of chronic lung disease is commonly characterized by mucosal growth and smooth muscle contraction of the airways, which initiate an inward folding of the mucosal layer and progressive airflow obstruction. Since the degree of obstruction is closely correlated with the number of folds, mucosal folding has been extensively studied in idealized circular cross sections. However, airflow obstruction has never been studied in real airway geometries; the behavior of imperfect, non-cylindrical, continuously branching airways remains unknown. Here we model the effects of chronic lung disease using the nonlinear field theories of mechanics supplemented by the theory of finite growth. We perform finite element analysis of patient-specific Y-branch segments created from magnetic resonance images. We demonstrate that the mucosal folding pattern is insensitive to the specific airway geometry, but that it critically depends on the mucosal and submucosal stiffness, thickness, and loading mechanism. Our results suggests that patient-specific airway models with inherent geometric imperfections are more sensitive to obstruction than idealized circular models. Our models help to explain the pathophysiology of airway obstruction in chronic lung disease and hold promise to improve the diagnostics and treatment of asthma, bronchitis, chronic obstructive pulmonary disease, and respiratory failure. PMID:25821112

  8. Early diagnosis saves lives: focus on patients with chronic kidney disease

    OpenAIRE

    Ecder, Tevfik

    2013-01-01

    Chronic kidney disease is a global public health problem. Patients with chronic kidney disease have an increased risk of developing end-stage kidney disease and its complications. Early identification and management of patients with chronic kidney disease is important in order to decrease the morbidity and mortality. Early detection of chronic kidney disease is possible with screening programs targeting high-risk patients, such as patients with diabetes mellitus, hypertension, elderly patient...

  9. Helicobacter Pylori in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    B Allahverdi

    2004-07-01

    Full Text Available Background: Helicobacter pylori (H.Pylori is considered to cause gastritis and peptic ulcer. In dialysis patients this study was done in order to determine the role of H pylori in gastrointestinal symptoms in patients with end stage renal disease (ESRD. Methods: Upper digestive tract endoscopy was conducted on 69 patients with ESRD. Gimsa staining and pathology evaluation were performed on Specimen of antrum for H pylori evaluation. Results: sixty five patients (94.2% had pathologic defect in endoscopy and 57 patients (82.6% had gastrointestinal symptoms. Prevalence of H pylori positive was 21.7% (15 patients. H pylori was positive in 21% patients with gastrointestinal symptoms. Conclusion: Chronic renal failure and dialysis had no effect on prevalence of H pylori.

  10. Brain perfusion abnormality in patients with chronic pain

    International Nuclear Information System (INIS)

    We performed single photon emission computed tomography (SPECT) of the brain in 15 patients with chronic pain (males, 7; females, 8; average age 49.1±17.9 years) and identified the locus of cerebral blood flow reduction by a new analytical method (easy Z-score Imaging System: eZIS) to clarify the functional neuroanatomical basis of chronic pain. Of the 15 patients, 6 had backache, 2 neck pain, 2 gonalgia, and 5 pain at other sites, with an average Visual analog scale of pain (VAS) value of 6.1±1.9. In comparison with a information on a data base on physically unimpaired persons, the dorsolateral prefrontal area (both sides, right dominant), medial prefrontal area (both sides), dorsal aspect of the anterior cingulate gyrus nociceptive cortex (both sides) and the lateral part of the orbitofrontal cortex (right side) were found to have blood flow reduction in the group of patients with chronic pain. As for chronic pain and its correlation with clinical features such as a depressive state, anticipation anxiety, post-traumatic stress disorder (PTSD), and conversion hysteria, the mechanism in the brain that was suggested by this study should be followed-up by functional neuroimaging studies. (author)

  11. 77 FR 59929 - Guidance for Industry on Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With...

    Science.gov (United States)

    2012-10-01

    ... August 22, 2008 (73 FR 49684), which in turn revised the draft guidance for industry entitled ``Acute... ``Acute Bacterial Exacerbations of Chronic Bronchitis in Patients With Chronic Obstructive Pulmonary... treatment of acute bacterial exacerbations of chronic bronchitis in patients with chronic...

  12. The impact of chronic heamodialysis on the personality of patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Evgenia Vlachu D.

    2009-07-01

    Full Text Available People with chronic diseases, deal with permanent changes in their everyday life. At the same time these patients appear to have different pathological behavior and personality disturbances as aresult of the disorders of their biological functions.AIM: The aim of this study is the examination of the psychological behavior of patients with chronic renal failure who submit themselves to recurrent heamodialysis (CRH.MATERIAL METHODS:The research was based on the completion of a questionnaire which has been used on foreigners and Greek patients who complained about chronic diseases. This questionnaire guarantees the highest reliability of all so that it will be possible to specify the negative influence of their disease upon the different sides of their life. Emphasis should be given on the fact that the personality questionnaire of Eysenck has been intensively evaluated on the Greek population as very trustworthy for secure conclusions. It included 84 questions in four different disorders (psychotism, neurotism, ex/introversion and check inversion for inaccuracies. The questionnaire has been proved very useful for the evaluation of the influence of the different interventions upon the quality of life of patients under heamodialysis. It appeared also that it was more reliable in comparison with the Sickness Impact Profile and with a test, whhb ic was aout the exercise under stress conditions. RESULTS: It has been discovered that all the three scales of control of the personality disturbances have systematically been influenced according to the control group of 138 persons from different age and sex groups. Furthermore, it has been found that the men patients underthe CRH were in lower region of the scale of neurotism while women patients appeared to be lower in the scale of psychotism. The T‐test shows that there is no important statistic difference between the two sexes according to the quality of their job. There is also no important difference

  13. Occurrence of chronic lymphocytic leukemia in patients with chronic myelogenous leukemia

    Directory of Open Access Journals (Sweden)

    Pritish K Bhattacharyya

    2013-01-01

    Full Text Available Chronic lymphocytic leukemia (CLL is the most common leukemia of adults in the western world and constitutes about 33% of all leukemia′s. The incidence of CLL increases with age and are more common in older population. Chronic myeloid leukemia (CML on the contrary occurs in both young adults and elderly and is a chronic myeloproliferative disease that originates from abnormal pluripotent stem cells and results in involvement of multiple hematopoietic lineages, but predominantly myeloid and less commonly lymphoid. Association between CLL and myeloid malignancies (CML, acute myeloid leukemia and MDS, myelodysplastic syndrome is rare. In literature documenting CLL and CML in same patients, occur either simultaneously or CML is preceded by CLL.

  14. Neurocognitive performance in first-episode and chronic schizophrenic patients.

    Science.gov (United States)

    Moritz, Steffen; Andresen, Burghard; Perro, Christian; Schickel, Marc; Krausz, Micheal; Naber, Dieter

    2002-02-01

    Previous research on neuropsychological disturbances in first-episode and chronic schizophrenic patients has provided mixed results which can be partially attributed to methodological inconsistencies. For the present study, 70 schizophrenic patients (40 with chronic and 30 with first-episode schizophrenia) were compared to 30 healthy controls on a large battery of neuropsychological tests. Special attention was paid to potential confounds such as differences in psychopathology, age and educational level between the schizophrenic sub-samples. Healthy controls performed better than both first-episode and chronic patients in almost all cognitive domains (P < 0.01), while the patient samples did not differ in any of the tasks. Results were confirmed in a second series of analyses in which patient subgroups were equated for sociodemographic background variables. The present results confirm recent data collected in longitudinal studies, thus, lending further support for a neurodevelopmental model of schizophrenia. It is suggested that neuropsychological disturbances occur early in schizophrenia and do not worsen in the course beyond age-related decrement. Possible reasons why previous research has produced contradictory findings are discussed. PMID:12056580

  15. Small intestinal bacterial overgrowth in patients with chronic hepatitis C

    Directory of Open Access Journals (Sweden)

    K. V. Zhdanov

    2011-01-01

    Full Text Available In order to estimate the frequency of detection of bacterial overgrowth syndrome in patients with chronic hepatitis C, find a possible relationship between development dysbiotic changes in the small intestine and over chronic hepatitis C were examined 80 patients (68 males and 12 females. In addition to standard laboratory tests for all patients was performed hydrogen breath test with a load of lactulose and fibrogastroduodenoscopy and hepatic biopsy with subsequent histological examination of biopsy. It was found that bacterial overgrowth syndrome, according to the hydrogen breath test detected 40% of patients with chronic hepatitis C, and the severity of it increases with the progression of the pathological process in the liver tissue. urthermore, in patients with endoscopic signs of catarrhal duodenitis according fibrogastroduodenoscopy, the level of molecular hydrogen when the hydrogen breath test at the appropriate stages of measurement was significantly lower, which may be due to the lack of saccharolytic and / or the predominance of proteolytic flora in the development of bacterial overgrowth syndrome.

  16. LIPID METABOLISM DISORDERS IN PATIENTS WITH CHRONIC HEPATITIS C

    Directory of Open Access Journals (Sweden)

    L. I. Tkachenko

    2015-01-01

    Full Text Available Purpose of the study. To study lipid metabolism in chronic hepatitis C and to assess its impact on the formation of insulin resistance, steatosis and progression of liver fibrosis.Materials and methods. The study included 205 patients with chronic hepatitis C (CHC. Conducts research, depending on the genotype C, viral load and body mass index (BMI of the patients.Results. CHC patients revealed a combined hyperlipoproteinemia on the background of op-pression synthesis of apolipoproteins A1 and B. Formation of hepatic steatosis was associated with HCV genotype 3 virus-induced viral load at ≥ 6 log10 IU/ml and metabolic in VL < 6 log10 IU/ml. In patients with chronic hepatitis C genotype 1, high viral load leads to inhibition of protein synthesis conveyor ApoA1 and increased synthesis of cholesterol, accompanied by abdominal obesity and the formation of insulin resistance. CHC patients with BMI < 25 kg/m2 viral load ≥ 6 log10 ME/ml was associated with dyslipidemia IV type on D. Fredriskson (1970, hyperglycemia, insulin resistance and diabetes. The advanced stage of liver fi brosis (F ≥ 3 on a scale METAVIR and non-response to treatment were associated with a decrease in HDL cholesterol below normal. With an increase in viral load > 5 log10 ME/ml signifi cantly increased the risk of lipid and carbohydrate metabolism.

  17. Quality of life in patients with chronic renal failure

    Directory of Open Access Journals (Sweden)

    Petrović Lada

    2006-01-01

    Full Text Available Introduction. Hemodialysis and transplantation are performed not only to replace renal function, but also to improve patients' quality of life. The aim of our investigation was to compare the quality of life in patients with chronic renal failure (CRF before and after the introduction of active therapy. Material and methods. We tested 76 patients (pts: 20 pts on conservative therapy (CT, 21 pts on chronic hemodialysis and 35 pts with renal transplantation. A questionnaire (combining two questionnaires was used to investigate the physical, emotional and social aspects of health. Results. In regard to physical health of transplantation patients (TP it was established that work capacity and activities were less damaged, whereas physical activity was highest in pts on CT. Social activity was limited in a higher percentage in TP (40% than in hemodialysis patients (HD (19%, while family relationships were most damaged in pts on HD (28.57%. Discomforts were most common in pts on HD. The highest percentage of pts estimated their health status as good or average, but their health status improved after transplantation in 82.86% that is in 57.14% after HD. It was similar with the quality of life: 28.57% of kidney transplant patients rated their quality of life as very good, and 54.28% rated it as good; 38.09% of HD patients rated their quality of life as very good, whereas only 5% of CT patients rated it as very good, and 20% as good. .

  18. Patient Education in Chronic Skin Diseases: A Systematic Review

    OpenAIRE

    Bes, de, L.M.; Legierse, C.M.; Prinsen, C.A.C.; Korte, MR

    2011-01-01

    The negative impact of skin disease on quality of life (QoL) has been described in many studies. Patient education as an adjunct to treatment, with the aim of improving QoL and reducing disease severity, is a relatively new technique in dermatology. The objective of this article is to analyse and summarise evidence concerning the effects of patient education on QoL and disease severity in patients with chronic skin diseases. All source material was identified through searches in MEDLINE and E...

  19. Anti-Brucella Antibodies in Chronic Hemodialysis Patients

    Directory of Open Access Journals (Sweden)

    Esmaeli H

    2013-03-01

    Full Text Available Abstract Background and objective: Brucellosis is a zoonosis that can affect all the systems and organs in the body. Although brucellae have been recovered from the urine of patients with brucellosis, renal involvement appears to be uncommon. In this study, anti brucella antibodies were investigated among hemodialysis patients of Qom. Material & methods: Blood samples were obtained from 200 patients undergoing chronic hemodialysis in Kamkar Hospital, Qom city. All serum samples were tested by rose Bengal initially. Positive Samples in this test were examined by writing tests, 2 mercaptoethanol (2-ME and Coombs. Results: In this study, the Rose Bengal test of 6 patients (3 male and 3 female of these 200 patients, were positive. Wright and Coombs test was positive for 5 patients. Conclusion: Considering the significant prevalence of the disease in the country, especially in endemic areas, it is suggested further research in this area continues.

  20. Expression of AQP3 gene in chronic atrophic and chronic superficial gastritis patients

    Directory of Open Access Journals (Sweden)

    Shijun Zhang

    2007-12-01

    Full Text Available BACKGROUND: Most studies about aquaporin 3 (AQP3 in the gastrointestinal tract were carried out on both in vivo and in vitro. The role of AQP3-mediated water transport in human gastrointestinal tract is still unclear. Our aim in this study was to explore the expression of AQP3 gene in chronic atrophic gastritis (CAG and chronic superficial gastritis (CSG atients and to determine its possible function in the development of gastritis.
    METHODS: Twenty-two outpatients diagnosed as CSG and 12 outpatients diagnosed as CAG were selected randomly. Ten cases of healthy individuals were selected as normal control group. In all cases, AQP3 gene expression of gastric mucosa was detected by fluorescence quantitative polymerase chain reaction (FQ-PCR.
    RESULTS: The AQP3 gene expression was significantly higher in gastric mucosa of CSG and healthy individuals than that in CAG (P<0.01. However, there was no significant difference in the AQP3 gene expression between helicobacter pylori positive patients and helicobacter pylori negative patients (P>0.05.
    CONCLUSIONS: AQP3 expression might play certain role in the occurrence and development of gastritis.
    KEY WORDS: Aquaporin 3, chronic superficial gastritis, chronic atrophic gastritis.

  1. 耳鸣的心理评估及干预%Psychological assessment and intervention of tinnitus

    Institute of Scientific and Technical Information of China (English)

    刘桂荣

    2014-01-01

    tinnitus refers to an external sound source stimulation, and the ear or head subjectively have the symptoms of a sound perception. tinnitus may make the patient to produce anxiety, depression in patients with psychological, affect the normal work and life. The assessment of patients and timely psychological intervention has important significance on the treatment of tinnitus.%耳鸣指无外界声源刺激,而耳内或头部主观上有声音感觉的一种症状。耳鸣会使患者产生焦躁、抑郁的心理,影响患者正常的工作与生活。对患者进行相应的评估并及时进行心理干预对治疗耳鸣有着重要意义。

  2. Bile acid malabsorption in patients with chronic diarrhoea

    Energy Technology Data Exchange (ETDEWEB)

    Eusufzai, S. (Karolinska Inst., Huddinge Univ. Hospital, Stockholm (Sweden))

    1993-10-01

    The presence of bile acid malabsorption was studied in 24 patients with chronic diarrhoea without established cause despite extensive investigations. Bile acid absorption was evaluated with the [sup 75]Se-homocholic acid taurine (SeHCAT) test. A therapeutic trial of cholestyramine was performed in 11 patients. 14 of the patients showed evidence of bile acid malabsorption. Of the 11 patients who were treated with cholestyramine, 3 has no improvement of their diarrhoea and also had a normal SeHCAT test result. Of the other 8 patients, who also had pathologic SeHCAT test result, 5 improved on treatment, whereas 3 had no change of their diarrhoea. 7 of the 24 patients had a previous history of cholecystectomy. 4 of them showed bile acid malabsorption; 3 of these were treated with cholestyramine and responded favourably. The results suggest that bile acid malabsorption may be common in chronic diarrhoea patients, but may not always be the primary cause of diarrhoea. 28 refs., 2 tabs.

  3. Bile acid malabsorption in patients with chronic diarrhoea

    International Nuclear Information System (INIS)

    The presence of bile acid malabsorption was studied in 24 patients with chronic diarrhoea without established cause despite extensive investigations. Bile acid absorption was evaluated with the 75Se-homocholic acid taurine (SeHCAT) test. A therapeutic trial of cholestyramine was performed in 11 patients. 14 of the patients showed evidence of bile acid malabsorption. Of the 11 patients who were treated with cholestyramine, 3 has no improvement of their diarrhoea and also had a normal SeHCAT test result. Of the other 8 patients, who also had pathologic SeHCAT test result, 5 improved on treatment, whereas 3 had no change of their diarrhoea. 7 of the 24 patients had a previous history of cholecystectomy. 4 of them showed bile acid malabsorption; 3 of these were treated with cholestyramine and responded favourably. The results suggest that bile acid malabsorption may be common in chronic diarrhoea patients, but may not always be the primary cause of diarrhoea. 28 refs., 2 tabs

  4. Managing a chronic pain patient in the perioperative period.

    Science.gov (United States)

    Kopf, Andreas

    2013-12-01

    The chronic pain patient with and without chronic opioid medication is at risk for under- and overtreatment perioperatively. Careful planning of the perioperative period by the anesthesiologist, the pain service and the surgeon is crucial. Epidural analgesia requires reduction of preoperative opioid doses to a maximum of 50% to avoid withdrawal as well as continuous postanesthesia care unit-monitoring for the first 24 hours. Brief cognitive behavioral interventions pre- and postoperatively contribute to successful pain management. The perioperative period may be used to re-evaluate the patient's opioid requirements. A follow-up by an experienced pain management service should be available after discharge of the chronic pain patient. Individualized assessment by a pain management team is necessary for this increasing group of patients. This report is adapted from paineurope 2013; Issue 2, ©Haymarket Medical Publications Ltd., and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD. and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication. PMID:24303836

  5. Iron metabolism in chronic hepatitis C patients on antiviral treatment

    Directory of Open Access Journals (Sweden)

    K. V. Zhdanov

    2009-01-01

    Full Text Available Purpose of the present research studying dynamics of the parameters describing a metabolism of iron at chronic hepatitis С patients on a combined antiviral therapy peg-interferon-2а and ribavirin. Has served 50 patients chronic hepatitis C (anti-HCV “+”, РНК HCV “+”, 1b genotype in the age from 18 till 59 years, on the average 33±1,5years, at various stages of disease and stages of monitoring antiviral treatments. To patients the parameters describing a metabolism of iron (serum iron, transferrin, ferritin, haptoglobin, ceruplasmin, total iron binding capacity, transferrin saturation by iron were defined. The sustain virology response (SVR was estimated - definition RNA HCV in half a year after end of treatment (72 week. It was carried out liver biopsy with the subsequent estimation of a degree of inflammatory activity and fibrosis on system METAVIR. Therapy peg-interferon-2а and ribavirin was accompanied by decrease serum iron, transferrin, ferritin, ceruplasmin, haptoglobin, transferrin saturation by iron irrespective of the answer to treatment. Thus, SVR directly correlated with higher level of iron and ceruplasmin of blood before therapy, on its background and during supervision. Normalization of biochemical activity chronic hepatitis C and positive morphological dynamics correspond with the parameters describing changes in a metabolism of iron at its patients, possibly, were compensatory-adaptive and to some extent endogen antiviral reaction of an organism of the person on HCV - infection. 

  6. Serum Hepcidin Evaluation in Patients with Chronic Dialysis

    Directory of Open Access Journals (Sweden)

    V. Manolov

    2015-06-01

    Full Text Available The aim of our study was to quantify serum hepcidin levels in Bulgarian patients with chronic kidney disease (CKD. Expected high values of peptide hormones might provide a new therapeutic choice for anemia of chronic disease. We looked for correlation between serum hepcidin levels and some iron metabolism parameters in CKD patients. Results: The sandwich ELISA is highly specific for hepcidin-25. We found statistically significant differences in serum hepcidin levels in patients of the control group, with CKD stages II to IV and CKD stage V (on chronic dialysis: 12.7±8.7μg/L, 90.74±21.1μg/L, and 282.49±81.1μg/L, respectively. Significant correlation between serum hepcidin and transferrin saturation (r=0.340, P<0.05 was found in the group of patients with CKD stage V. Conclusion: The use of 2 monoclonal antibodies in a sandwich ELISA format provides a reliable, reproducible, and inexpensive method for measuring serum concentrations of the bioactive form of hepcidin in Bulgarian laboratory practice.

  7. Comparison of Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients

    OpenAIRE

    Zhang, Chuan; Yamada, Nobutaka; Wu, Yun-Lin; Wen, Min; Matsuhisa, Takeshi; Matsukura, Norio

    2005-01-01

    AIM: To compare Helicobacter pylori infection and gastric mucosal histological features of gastric ulcer patients with chronic gastritis patients in different age groups and from different biopsy sites.

  8. Mortality in patients with chronic and cleared hepatitis C viral infection: a nationwide cohort study

    DEFF Research Database (Denmark)

    Omland, Lars Haukali; Krarup, Henrik; Jepsen, Peter; Georgsen, Jørgen; Harritshøj, Lene Holm; Riisom, Kirsten; Jacobsen, Svend Erik Hove; Schouenborg, Per; Christensen, Peer Brehm; Sørensen, Henrik Toft; Obel, Niels; Bangsborg, Jette Marie

    2010-01-01

    It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies.......It is unknown whether mortality differs between patients with chronic hepatitis C virus (HCV) replication and those who cleared the virus after infection. We examined the impact of chronic HCV replication on mortality among Danish patients testing positive for HCV antibodies....

  9. Prevalence of anemia in predialysis chronic kidney disease patients

    Directory of Open Access Journals (Sweden)

    FAM Shaheen

    2011-01-01

    Full Text Available To evaluate the prevalence of anemia in a large cohort that comprises patients in different stages of chronic kidney disease (CKD in the kingdom of Saudi Arabia (KSA, we conducted a multi-center cross-sectional study of a cohort of CKD patients who have not started dialysis. The study patients were recruited from the nephrology clinics in 11 different medical centers distributed all over the regions of the KSA. For the estimated glomerular filtration rate (GFR, we used the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI equation. There were 250 study patients who fulfilled the criteria for the study. The patients were stratified according to their GFR as follows: stage 1: 19 patients, stage 2: 35 patients, stage 3: 67 patients, stage 4: 68 patients, and stage 5: 61 patients. The composite of proteinuria and abnormal imaging in stages 1 and 2 was satisfied in 100% of the cases. The prevalence of anemia was elevated for the hemoglobin levels below 12 g/dL (the level at which the evaluation of anemia in CKD should be initiated in the different stages of CKD, that is, 42%, 33%, 48%, 71%, and 82% in the stages from 1 to 5, respectively. The prevalence was also elevated for the hemoglobin levels below 11 g/dL (the minimum hemoglobin level at which therapy should be initiated with erythropoietin, that is, 21%, 17%, 31%, 49%, and 72%, respectively for stages from 1 to 5. In conclusion, we found a large prevalence of anemia among the CKD population in Saudi Arabia, and the burden of patients who require treatment with erythropoietin is considerably large. However, the response to therapy will not require large doses according to the availability of long-acting erythropoiesis stimulating agents, which will render the therapy more convenient and less expensive.

  10. Interstitial Lung Disease in a Patient with Chronic Granulomatous Disease

    Directory of Open Access Journals (Sweden)

    Mozhgan Moghtaderi

    2012-03-01

    Full Text Available Background: Chronic granulomatous disease (CGD is an inherited phagocytes defect, characterized by defects of NADPH-oxidase and inability of bacterial killing, which leads to recurrent life-threatening infections. Respiratory problems, which are the major cause of morbidity in CGD, usually result from recurrent severe infections; however, vigorous inflammatory response could also cause respiratory diseases.Case Presentation: Herein, an 11 year-old patient with CGD is presented who suffered from chronic cough and dyspnea for 7 years. Considering the results of chest X-ray, high-resolution computed tomography, and pulmonary function test, the diagnosis of interstitial lung disease was made.Conclusion: Early recognition of manifestations associated with CGD and appropriate treatment could prevent further complications and reduce morbidity and mortality in this group of patients.

  11. HEARING ASSESSMENT IN CHRONIC RENAL FAILURE PATIENTS UNDERGOING HEMODIALYSIS

    Directory of Open Access Journals (Sweden)

    Arjun Singh

    2014-01-01

    Full Text Available The auditory sensitivity of 63 patient of chronic renal failure on hemodialysis was assessed in order to know the effect of dialysis on hearing threshold. All selected patient were non diabetic with normal tympanic membrane and with no history of ototoxic drug and any hereditary hearing problems. Pure tone audiometry was done before and after dialys is and all cases were followed for 3 month. A high incidence of high frequency sensorineural hearing loss was obtained which could not be attributed to age , noise exposure and ottotoxicity. An association between high frequency sensorineural hearing loss a nd hemodialysis is thus suggested KEYWORDS: Hemodialysis ; Pure tone audiometry ; High frequency sensorineural hearing loss ; Duration of disease ; Chronic renal failure

  12. [Osteoporosis treatment for patients with chronic kidney disease].

    Science.gov (United States)

    Konishi, Yoshio

    2015-10-01

    Osteoporosis is defined as a condition of impairment in bone strength and predisposes individuals to an increased risk of fractures. The risk of fragility fracture is shown to be high in patients with chronic kidney disease (CKD). Osteoporosis treatment for patients with CKD G1-3 should not differ from treatment for patients without CKD, as long as there are no accompanying hyperparathyroidism and hyperphosphatemia that indicate the co-existence of CKD -mineral and bone disorder. However, there are few published data on osteoporosis treatment for patients with CKD G4, 5. So, considerations for current pharmacologic therapy (such as bisphosphonate, denosumab, teriparatide, and raloxifene) should be a thoughtful and open discussion with these patients. PMID:26529937

  13. Urinary Peptide Levels in Patients with Chronic Renal Failure

    Directory of Open Access Journals (Sweden)

    Mungli Prakash

    2010-10-01

    Full Text Available Introduction: Peptide levels in urine are found to be decreased in renal failure. In the current study urinary peptide levels were determined in chronic renal failure (CRF patients. Method: 86 CRF patients and 80 healthy controls were selected for the study. Urinary proteins and peptide levels were determined by spectrophotometer based Lowry and Bradford methods. Urinary creatinine levels were determined by clinical chemistry analyzer. Results: There was significant decrease in urinary peptide levels in CRF patients and Urinary % peptides were significantly decreased in CRF patients as compared to healthy controls. Urinary % peptides correlated negatively with proteinuria. Conclusion: we have found decrease in urinary peptides and % urinary peptides in CRF patients and possibly measurement of % urinary peptides may possibly serve as better indicator in early detection of impairment in renal function.

  14. Valvular and perivalvular involvement in patients with chronic kidney disease

    Institute of Scientific and Technical Information of China (English)

    Neelavathi Senkottaiyan; Saad Hafidh; Farrin A. Manian; Martin A. Alpert

    2005-01-01

    Abstract Mitral annular calcification (MAC) and aortic valve alcification (AVC) are the most common valvular and perivalvular bnormalities in patients with chronic kidney disease (CKD). Both MAC and AVC occur at a younger age in CKD patients than in the general population. AVC progresses to aortic stenosis and mild aortic stenosis progresses to severe aortic stenosis at a more rapid rate in patients with CKD than in the general population. The use of calcium-free phosphate binders in such patients may reduce the calcium burden in valvular and perivalvular tructures and retard the rate of progression of aortic stenosis. Despite high rates of morbidity and mortality, the prognosis associated with valve surgery in patients with CKD is better than without valve surgery. Infective endocarditis remains an important complication of CKD, particularly in those treated with hemodialysis.

  15. The Prevalence of Allergic Rhinitis in Patients with Chronic Rhinosinusitis

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2014-10-01

    Full Text Available Introduction: Chronic rhinosinusitis (CRS is a multifactorial disease. Allergies are considered a predisposing factor to CRS; however, this remains controversial. The objective of this research was to investigate the prevalence of co-morbidities and allergic reaction, and to specify the most common allergens in patients with confirmed CRS.   Materials and Methods: One hundred patients with signs and symptoms of CRS who met the diagnostic endoscopic and radiologic criteria of chronic rhinosinusitis were selected. They filled out a questionnaire and underwent a skin prick test for the common inhalant allergens. Allergic rhinitis was diagnosed according to the history and positive skin prick tests.   Results: The mean age of patients was 34. Males were slightly more involved (54%. The prevalence of polypoid and none-polypoid rhinosinusitis was 54% and 46% respectively. The patients’ most common symptoms were nasal discharge (95%, blockage (94%, smell disorders (63%, cough (45%, halitosis (41%, lethargy (37%, and aural fullness (36%. Allergy to at least one allergen was noted in 64% of the CRS patients which is higher than general population in Mashhad, Iran with allergic rhinitis (22.4%. Salsola was the most common allergen. There was no significant difference in allergic reactions between polypoid and non-polypoid CRS patients.   Conclusion:  Allergic reactions was found in Iranian CRS patients with or without polyposis to be much higher than general population in Mashhad with allergic rhinitis alone.

  16. Oral disorders in patients with chronic renal failure. Narrative review.

    Directory of Open Access Journals (Sweden)

    Carolina Hernández

    2016-02-01

    Full Text Available Chronic renal failure (CRF is one of the best known renal diseases. It is characterized by a deterioration in the overall renal function and is associated with other conditions such as hypertension, diabetes mellitus, uropathy, chronic glomerulonephritis and autoimmune diseases. Patients with CRF show alterations of the masticatory system that are specific to the disease and other type of disorders as a result of treatment. Oral health in dialysis and transplant patients tends to be poor, which makes them more likely to develop pathological conditions in the oral cavity, potentially increasing morbidity, mortality and affecting the quality of life of patients. Among the lesions we can find dysgeusia, periodontitis, candidiasis, gingival bleeding, petechiae, and joint alterations. Gingivitis and xerostomia associated to long-term use medications can cause oral lesions. Children with CRF show two oral conditions of interest: high incidence of dental anomalies and low caries activity. In patients receiving a kidney transplant, previous dental treatment is critical because the immune status of the patient will be affected not only by the toxemia, but by the immunosuppressive drugs used to prevent organ rejection. Therefore, the dentist plays an important role in training parents and/or guardians, doctors and paramedics on the treatment of oral lesions in these patients.

  17. Disparities in Periodontitis Prevalence among Chronic Kidney Disease Patients

    OpenAIRE

    Ioannidou, E; Swede, H.

    2011-01-01

    Because of adverse effects of uremia in the innate and adaptive immune systems, we hypothesized that chronic kidney disease (CKD) patients would have higher prevalence of moderate periodontitis compared with individuals without CKD. We examined this hypothesis using the NHANES III dataset, including 12,081 adults stratified by Race-Ethnicity. We followed the American Academy of Periodontology/Centers for Disease Control and Prevention definition for moderate periodontitis. Estimated glomerula...

  18. Big data and IoT for chronic patients monitoring

    OpenAIRE

    Gachet Páez, Diego; Aparicio Galisteo, Fernando; Buenaga Rodríguez, Manuel de; Ascanio, Juan Ramón

    2014-01-01

    Developed countries are characterized by aging population and economical crisis, so it is desirable to reduce the costs of public and private healthcare systems. It is necessary to streamline the health system resources leading to the development of new medical services based on telemedicine, remote monitoring of chronic patients, personalized health services, new services for dependants, etc. New medical applications based on remote monitoring will significantly increasing the volume of heal...

  19. Chronic patients monitoring using wireless sensors and big data processing

    OpenAIRE

    Gachet Páez, Diego; Aparicio Galisteo, Fernando; Buenaga Rodríguez, Manuel de; Ascanio, Juan Ramón

    2014-01-01

    Developed countries are characterized by aging population and economical crisis, so it is desirable to reduce the costs of public and private healthcare systems. It is necessary to streamline the health system resources leading to the development of new medical services based on telemedicine, remote monitoring of chronic patients, personalized health services, new services for dependants, etc. New medical applications based on remote monitoring will significantly increasing the vo...

  20. Magnetic Resonance Imaging of Patients With Chronic Lateral Epicondylitis

    OpenAIRE

    Qi, Liang; Zhang, Yu-Dong; Yu, Rong-Bin; Shi, Hai-Bin

    2016-01-01

    Abstract The aim of the study is to determine the inter-reliability and intra-observer reliability of magnetic resonance imaging (MRI) for lateral epicondylitis and investigate whether there is a potential relationship between MRI abnormalities of the common extensor tendon (CET) and its clinical symptom. The study group comprised 96 consecutive patients (46 men and 50 women) with a clinical diagnosis of chronic lateral epicondylitis, which were examined on 3.0 T MR. An MRI scoring system was...

  1. Impaired renal function in relatives of chronic kidney disease patients

    OpenAIRE

    Pradip Kumar Dutta; Md Shafiul Haider; Abul Kashem

    2015-01-01

    Background: Chronic kidney disease (CKD) is now a public health burden. If simple screening tests like the glomerular filtration rate (GFR) and presence of albuminuria are done in asymptomatic persons, CKD can be diagnosed earlier that will help in halting the disease and not let it progress to end-stage renal disease (ESRD). Aim: This study was conducted to see the proportion of renal function abnormality in the relatives of CKD patients. Settings and Design: This was a cross-sectional compa...

  2. Intervention treatments for chronic pain syndrome in cancer patients

    OpenAIRE

    V. V. Bryuzgin

    2010-01-01

    Noninvasive treatments for chronic pain syndrome benefit in 80-90% of cancer patients. Invasive, intervention procedures for analgesia should be used in other cases. These include neuroablative and neuromodulatory measures. Neuroablation is defined as the physical suspension of painful impulse transmission pathways by a surgical, chemical, or thermal method and comprises lytic and other blocks. Neuromodulation is the dynamic and functional suppression of pain impulse pathways by the intraspin...

  3. Intimate Partner Aggression Perpetration in Primary Care Chronic Pain Patients

    OpenAIRE

    Taft, Casey; Schwartz, Sonia; Liebschutz, Jane M.

    2010-01-01

    This study examined the prevalence and correlates of partner aggression perpetration in 597 primary care chronic pain patients. Approximately 30% of participants reported perpetrating low-level aggression, 12% reported injuring their partner, and 5% reported engaging in sexual coercion. Women reported more low-level aggression perpetration than men, and men reported more engagement in sexual coercion than women. Substance use disorders (SUD) were associated with all outcomes, and both aggress...

  4. Core strength training for patients with chronic low back pain

    OpenAIRE

    Chang, Wen-Dien; Lin, Hung-Yu; Lai, Ping-Tung

    2015-01-01

    [Purpose] Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness ...

  5. Tinnitus and neural plasticity of the brain

    NARCIS (Netherlands)

    Bartels, Hilke; Staal, Michiel J.; Albers, Frans W. J.

    2007-01-01

    Objective: To describe the current ideas about the manifestations of neural plasticity in generating tinnitus. Data Sources: Recently published source articles were identified using MEDLINE, PubMed, and Cochrane Library according to the key words mentioned below. Study Selection: Review articles and

  6. Addiction to opioids in chronic pain patients: a literature review

    DEFF Research Database (Denmark)

    Højsted, Jette; Sjøgren, Per

    2007-01-01

    Opioids have proven very useful for treatment of acute pain and cancer pain, and in the developed countries opioids are increasingly used for treatment of chronic non-malignant pain patients as well. This literature review aims at giving an overview of definitions, mechanisms, diagnostic criteria...... concerned with the fact that pain may be under treated because of fear of addiction, and the guidelines in management of non-malignant pain patients include warnings of addiction. According to the literature, it seems appropriate and necessary to be aware of the problems associated with addiction during...

  7. Basophil Activation Test with Food Additives in Chronic Urticaria Patients

    OpenAIRE

    Kang, Min-Gyu; Song, Woo-Jung; Park, Han-Ki; Lim, Kyung-Hwan; Kim, Su-Jung; Lee, Suh-Young; Kim, Sae-Hoon; Cho, Sang-Heon; Min, Kyung-Up; Chang, Yoon-Seok

    2014-01-01

    The role of food additives in chronic urticaria (CU) is still under investigation. In this study, we aimed to explore the association between food additives and CU by using the basophil activation test (BAT). The BAT using 15 common food additives was performed for 15 patients with CU who had a history of recurrent urticarial aggravation following intake of various foods without a definite food-specific IgE. Of the 15 patients studied, two (13.3%) showed positive BAT results for one of the te...

  8. Neurophysiological Changes in Patients with Chronic Obstructive Pulmonary Diseases

    OpenAIRE

    Demir, Recep; ÖZEL, Lütfi; Özdemir, Gökhan; KOCATÜRK, İdris; Ulvi, Hızır

    2014-01-01

    Peripheral neuropathy commonly occurs in patients with chronic obstructive lung disease (COPD). The aim of our study was to investigate the possible effects of COPD on the peripheral nervous system. We enrolled 31 patients (16 women and 15 men), mean age 66.12, with COPD into the study. Arterial oxygen tension (PaO2)> or = 65 mmHg was considered as the cut-off value designating tissue hypoxia. According to this cut-off value, the subjects were divided into two groups: Group I (n=16), PaO2&...

  9. Classification and identification of opioid addiction in chronic pain patients

    DEFF Research Database (Denmark)

    Højsted, Jette; Nielsen, Per Rotbøll; Guldstrand, Sally Kendall;

    2010-01-01

    Addiction is a feared consequence of long-term opioid treatment of chronic pain patients. The ICD-10 and DSM-IV diagnostic addiction criteria may not be appropriate in these patients. Therefore Portenoy's criteria (PC) were launched. The aim was to estimate the prevalence of addiction, to...... investigate whether PC were applicable and to compare these criteria with the ICD-10 criteria. The study was cross-sectional and included 253 patients with chronic pain at a tertiary pain centre. Patients were screened for addiction by a physician and a nurse. The addiction prevalence was 14.4% according to...... ICD-10 and 19.3% according to PC. A significant difference between the prevalence of addiction according to ICD-10 and to PC was found. The inter-rater reliability was 0.95 for ICD-10 and 0.93 for PC. The sensitivity of PC was 0.85 and the specificity was 0.96. According to PC patients classified as...

  10. Skin cancer in patients with chronic radiation dermatitis

    Energy Technology Data Exchange (ETDEWEB)

    Davis, M.M.; Hanke, C.W.; Zollinger, T.W.; Montebello, J.F.; Hornback, N.B.; Norins, A.L.

    1989-04-01

    The cases of 76 patients with chronic radiation dermatitis resulting from low-dose ionizing radiation for benign disease were reviewed retrospectively for risk factors leading to the development of neoplasia. The patients were studied with respect to original hair color, eye color, sun reactive skin type, benign disease treated, area treated, age at treatment, and age at development of first skin cancer. Analysis of data showed 37% of patients had sun-reactive skin type I, 27% had type II, and 36% had type III. Types IV through VI were not represented. There appeared to be an overrepresentation of types I and II. Increased melanin pigmentation may therefore be either directly or indirectly protective against the development of skin cancers in patients who have received low-dose superficial ionizing radiation for benign disease. The sun-reactive skin type of patients with chronic radiation dermatitis may be used as a predictor of skin cancer risk when the total dose of ionizing radiation is not known.

  11. Cryoglobulinemia in elderly patients with HCV-related chronic hepatitis

    Institute of Scientific and Technical Information of China (English)

    Francesco; Giuseppe; Foschi; Anna; Chiara; Dall’Aglio; Arianna; Lanzi; Giorgio; Marano; Sara; Savini; Pietro; Andreone; Mauro; Bernardi; Giuseppe; Francesco; Stefanini

    2010-01-01

    Hepatitis C virus(HCV) infection affects about 3% of the world’s population and often leads to chronic liver disease.In some industrialized countries,HCV prevalence increases with age,but the optimal management of older patients has not been accurately defined.HCV infection can also lead to lymphoproliferative disorders,the most common being mixed cryoglobulinemia(MC),and also for this condition that frequently affects elderly patients,the optimal therapeutic strategy is still debated.We report the case of a 77-year-old Caucasian woman with HCV-related chronic hepatitis and cutaneous manifestations consisting of urticaria and pruritus related to MC resistant to antihistamines.The patient underwent a treatment with interferon and ribavirin.Such a treatment led to early biochemical and virological response associated with the resolution of cryoglobulinemia and cutaneous symptoms.After the end of treatment,HCV replication relapsed,but cryoglobulinemia and cutaneous symptoms did not recur.In the absence of definite treatment guidelines in this particular context,our experience suggests that the presence of symptoms related to HCV-infection that deeply affect patient quality of life warrants antiviral therapy even beyond the age limits that currently exclude patients from treatment.

  12. [Concept analysis of medication adherence in patients with chronic disease].

    Science.gov (United States)

    Huang, Jen-Ying; Chen, Hsing-Mei

    2014-06-01

    Pharmacotherapy plays an important role in the management of chronic diseases. However, many patients with chronic disease do not adhere to their medication regimen. This results in worsening symptoms and frequent re-hospitalizations. As a result, healthcare providers may view these patients as bad. Medication adherence is a complex concept. Analyzing this concept may assist nurses to improve patient-centered care. This paper uses Walker & Avant's method to conduct a concept analysis of medication adherence. Results show the defining attributes of medication adherence as: (1) knowing and agreeing to the medication; (2) communicating and negotiating the regimen; and (3) active, continuous involvement in and appraisal of the treatment effect. Identified antecedents of medication adherence included the patient having: (1) a prescribed medication regimen; (2) cognitive and action abilities in her / his role as a patient; and (3) level of preparation for medication treatment. Identified consequences of medication adherence include: (1) improving symptom control; (2) decreasing re-hospitalizations and mortality; (3) reducing medical care costs; (4) restoring self-esteem; and (5) diminishing depression. It is hoped that this concept analysis provides a reference for nurses to achieve a better understanding of medication adherence and further improve nursing practice. PMID:24899565

  13. Longitudinal study of leptin levels in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Averbukh Zhan

    2011-06-01

    Full Text Available Abstract Background The influence of serum leptin levels on nutritional status and survival in chronic hemodialysis patients remained to be elucidated. We conducted a prospective longitudinal study of leptin levels and nutritional parameters to determine whether changes of serum leptin levels modify nutritional status and survival in a cohort of prevalent hemodialysis patients. Methods Leptin, dietary energy and protein intake, biochemical markers of nutrition and body composition (anthropometry and bioimpedance analysis were measured at baseline and at 6, 12, 18 and 24 months following enrollment, in 101 prevalent hemodialysis patients (37% women with a mean age of 64.6 ± 11.5 years. Observation of this cohort was continued over 2 additional years. Changes in repeated measures were evaluated, with adjustment for baseline differences in demographic and clinical parameters. Results Significant reduction of leptin levels with time were observed (linear estimate: -2.5010 ± 0.57 ng/ml/2y; p Conclusions Thus leptin levels reflect fat mass depots, rather than independently contributing to uremic anorexia or modifying nutritional status and/or survival in chronic hemodialysis patients. The importance of such information is high if leptin is contemplated as a potential therapeutic target in hemodialysis patients.

  14. Prevalence of psychiatric comorbidities in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Shyam Chand Chaudhary

    2016-01-01

    Full Text Available Introduction: Psychiatric disorders, especially anxiety and depression have been reported to have an increased prevalence in chronic obstructive pulmonary disease (COPD patients, but there is a paucity of data from India. Aims and Objectives: Aim of our study is to study the frequency of psychiatric comorbidities in COPD patients and their correlation with severity of COPD, as per global initiative for obstructive lung disease guidelines. Materials and Methods: This study was conducted in outpatient department of a tertiary care hospital (King George's Medical University. A total of 74 COPD patients were included in this study and compared with 74 controls. The diagnosis and severity of COPD were assessed by spirometry. Psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview questionnaire. Results: The frequency of psychiatric comorbidities was significantly higher (P < 0.05 in COPD patients (28.4% as compared to controls (2.7%. As regards to severity, the frequency was significantly increased in severe and very severe COPD. The frequency of psychiatric comorbidities in COPD patients increased significantly with the increase in duration of symptoms being present in 67% of patients with duration of symptoms more than 10 years and only 23% of patients with duration of symptoms ≤5 years. Conclusion: The frequency of psychiatric comorbidities is increased in COPD patients as compared to controls. We recommend that all patients with COPD should be screened for psychiatric comorbidity, if any.

  15. Prevalence of psychiatric comorbidities in chronic obstructive pulmonary disease patients

    Science.gov (United States)

    Chaudhary, Shyam Chand; Nanda, Satyan; Tripathi, Adarsh; Sawlani, Kamal Kumar; Gupta, Kamlesh Kumar; Himanshu, D; Verma, Ajay Kumar

    2016-01-01

    Introduction: Psychiatric disorders, especially anxiety and depression have been reported to have an increased prevalence in chronic obstructive pulmonary disease (COPD) patients, but there is a paucity of data from India. Aims and Objectives: Aim of our study is to study the frequency of psychiatric comorbidities in COPD patients and their correlation with severity of COPD, as per global initiative for obstructive lung disease guidelines. Materials and Methods: This study was conducted in outpatient department of a tertiary care hospital (King George's Medical University). A total of 74 COPD patients were included in this study and compared with 74 controls. The diagnosis and severity of COPD were assessed by spirometry. Psychiatric comorbidities were assessed using the Mini International Neuropsychiatric Interview questionnaire. Results: The frequency of psychiatric comorbidities was significantly higher (P < 0.05) in COPD patients (28.4%) as compared to controls (2.7%). As regards to severity, the frequency was significantly increased in severe and very severe COPD. The frequency of psychiatric comorbidities in COPD patients increased significantly with the increase in duration of symptoms being present in 67% of patients with duration of symptoms more than 10 years and only 23% of patients with duration of symptoms ≤5 years. Conclusion: The frequency of psychiatric comorbidities is increased in COPD patients as compared to controls. We recommend that all patients with COPD should be screened for psychiatric comorbidity, if any. PMID:27051106

  16. Prevalence of Actinomyces spp. in patients with chronic periodontitis.

    Science.gov (United States)

    Vielkind, Paul; Jentsch, Holger; Eschrich, Klaus; Rodloff, Arne C; Stingu, Catalina-Suzana

    2015-10-01

    This study investigated the prevalence of Actinomyces spp. in shallow, deep and very deep pockets of patients with chronic periodontitis compared to healthy controls and correlated the results with clinical status. Twenty patients with chronic periodontitis and 15 healthy subjects were enrolled in this study. Clinical indices were recorded in a six-point measurement per tooth. From each patient samples of supra and subgingival plaque were taken separately from teeth with shallow, deep and very deep pockets. Samples of supragingival plaque and sulcular microflora were collected from the healthy subjects. All the samples were cultivated on different media at 37̊C in an anaerobic atmosphere for 7 days. All the suspect colonies were identified using a rapid ID 32 A system (bioMèrieux) and MALDI-TOF-MS analysis using an Autoflex II Instrument (Bruker Daltonics) together with in house developed identification software and a reference spectra database. A total of 977 strains were identified as Actinomyces. Actinomyces naeslundii/oris/johnsonii (430 isolates) was the most prevalent species and was found in all patients and in almost all of the healthy subjects. Significant differences (p=0.003) between the groups were found for Actinomyces odontolyticus/meyeri and Actinomyces israelii which were associated with periodontitis patients. Actinomyces dentalis was found in higher percentage (p=0.015) in the periodontitis group. Actinomyces gerencseriae and Actinomyces massiliensis were significantly more often found supragingivally than subgingivally (p=0.004, p=0.022, respectively) in the periodontitis group. Whether some Actinomyces species, definitely important plaque formers, are actively involved in the pathogenicity of chronic periodontitis needs further investigation. PMID:26324012

  17. Assessment of diet in chronic kidney disease female predialysis patients

    Directory of Open Access Journals (Sweden)

    Dariusz Włodarek

    2014-11-01

    Full Text Available [b]introduction and objective[/b]. Nutrition is important in the therapy of predialysis patients. The aim of the presented single-centre descriptive study was to assess the diet in chronic kidney disease female predialysis patients with no previous dietary intervention, in comparison with recommendations, as well as the analysis of the energy, protein and phosphate intake in correlation with chosen laboratory measurements. [b]materials and methods.[/b] The research was carried out in 31 female predialysis patients with CKD of different etiology, aged 29–79 years (GFR: 19.4±9.7ml/min/1.73m [sup]2[/sup] . Main outcome measures were self-reported data from three-day dietary recall. Nutrients content and energy value of diet were compared with guidelines for chronic kidney disease patients or, in case of nutrients when they are not settled, with the recommendations for healthy women. [b]results[/b]. All patients had a lower energy intake than the recommended level. At the same time, 35.8% of patients were characterised by improper protein intake – too low or too high. The majority of patients had low intake of most of vitamins and minerals. The total, animal and plant protein were positively correlated with the energy value of diet and with amount of most of the nutrients. Values of GFR were positively correlated with animal protein intake, while phosphate and creatinine in blood were negatively correlated with total and animal protein intake. [b]conclusions[/b]. The study highlights that diet of CKD predialysis patients with no previous dietary intervention is not properly balanced.

  18. The validity and precision of the leicester cough questionnaire in COPD patients with chronic cough

    OpenAIRE

    Berkhof Farida F; Boom Lisenka N; ten Hertog Nynke E; Uil Steven M; Kerstjens Huib AM; van den Berg Jan WK

    2012-01-01

    Abstract Background A validated instrument to assess the effects of chronic cough on health status in patients with chronic obstructive pulmonary disease (COPD) is currently not available. The Leicester Cough Questionnaire (LCQ) is a cough-specific health status questionnaire which is originally validated for a population of general patients presenting with chronic cough. We examined the psychometric performance of the LCQ in patients with COPD and chronic productive cough. Methods Concurrent...

  19. Distinguishing patients with chronic fatigue from those with chronic fatigue syndrome: a diagnostic study in UK primary care.

    OpenAIRE

    Darbishire, L; Ridsdale, L.; Seed, P. T.

    2003-01-01

    BACKGROUND: Chronic fatigue syndrome (CFS) has been defined, but many more patients consult in primary care with chronic fatigue that does not meet the criteria for CFS. General practitioners (GPs) do not generally use the CFS diagnosis, and have some doubt about the validity of CFS as an illness. AIM: To describe the proportion of patients consulting their GP for fatigue that met the criteria for CFS, and to describe the social, psychological, and physical differences between patients with C...

  20. The impact of tinnitus on daily activities in adult tinnitus sufferers: A pilot study

    Directory of Open Access Journals (Sweden)

    Nomfundo F. Moroe

    2014-06-01

    Full Text Available Background: Few South African studies have been published on the impact of tinnitus on quality of life of tinnitus sufferers, although evidence suggests that a large portion of the general population suffers from tinnitus.Objectives: The current study aimed at describing the effects of tinnitus on the quality of life of the participants as measured by the Tinnitus Handicap Inventory (THI.Method: In a cross-sectional descriptive study design, 27 participants took part in the study by completing a self-administered THI questionnaire and participating in a semi-structured interview. Descriptive and inferential statistics were used to analyse the data. Descriptively, content analysis was used to organise and convey results from the interviews.Results: Participants reported a wide range of perceived disability on the THI. Results ranged from mild to catastrophic, with functional disability being most prominent in all participants, although there were differences when results were analysed according to gender. There was an association between gender and the type of perceived disability, although this was statistically non-significant (p > 0.05. Only 26% of the participants reported no effect on occupational performance and quality of life, with the remainder of the participants reporting a significant effect. Limited effective management strategies were reported to have been implemented – a significant implication for the audiologists.Conclusion: The results have implications for audiologists as they suggest that audiologists should take a detailed case history to determine the extent to which tinnitus affects the individual. Furthermore, audiologists should administer a scale such as the THI in the management of tinnitus.