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Sample records for del tinnitus neurosensorial

  1. 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, ...

  2. 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

  3. Tinnitus

    Science.gov (United States)

    ... the day, or to fall asleep at night. Wearable sound generators are small electronic devices that fit ... may be available at drugstores and on the Internet as an alternative remedy for tinnitus, but none ...

  4. Análisis Molecular de las Mutaciones 2299delG y C759F en Individuos Colombianos con Retinitis Pigmentosa e Hipoacusia Neurosensorial

    OpenAIRE

    López, Greizy; Gelvez, Nancy Yaneth; Urrego, Luisa Fernanda; Florez, Silvia; Medina, David; Rodríguez, Vicente; Tamayo, Marta Lucía

    2014-01-01

    Objetivo: Determinar la presencia de las mutaciones 2299delG y C759F en 37 individuos colombianos no relacionados con asociación de RP e hipoacusia neurosensorial. Materiales y métodos: análisis de secuencia directa del exón 13 del gen USH2A en todos los individuos seleccionados para el estudio. Resultados: la mutación 2299delG fue observada únicamente en individuos con Síndrome de Usher tipo II, mientras que la mutación C759F, no fue observada en ninguno de los individuos del estudio. Obj...

  5. Hipoacusia neurosensorial infantil

    OpenAIRE

    Santos Santos, Saturnino

    2004-01-01

    En nuestro medio existe un déficit de información acerca de la importancia de los factores de riesgo implicados en la aparición de hipoacusia neurosensorial infantil y de las etiologías encontradas. Se estudió retrospectivamente una población de 2.656 niños enviados a nuestro centro para valoración auditiva por presentar factores de riesgo. 481 niños fueron diagnosticados de hipoacusia neurosensorial uni o bilateral de cualquier grado. La edad media al diagnóstico de hipoacusia neurosensorial...

  6. Comportamiento de la hipoacusia neurosensorial en niños

    OpenAIRE

    Álvarez Amador, Héctor Eduardo; Vega Ulloa, Nuris; Castillo Toledo, Luis; Santana Álvarez, Jorge; Betancourt Camargo, María de los Ángeles; Miranda Ramos, María de los Ángeles

    2011-01-01

    Fundamento: la hipoacusia neurosensorial en el niño produce graves consecuencias en la adquisición del lenguaje, atributo importante para un aprendizaje y desempeño social adecuados. Objetivo: estudiar el comportamiento de la hipoacusia neurosensorial en niños en la provincia de Camagüey. Método: se realizó un estudio descriptivo sobre el comportamiento de la hipoacusia neurosensorial en niños de la provincia de Camagüey en el período comprendido de enero de 2007 a diciembre de 2009. El unive...

  7. An?lisis Molecular de las Mutaciones 2299delG y C759F en Individuos Colombianos con Retinitis Pigmentosa e Hipoacusia Neurosensorial

    OpenAIRE

    L?pez, Greizy; Gelvez, Nancy Yaneth; Urrego, Luisa Fernanda; Florez, Silvia; Medina, David; Rodr?guez, Vicente; Tamayo, Marta Luc?a

    2014-01-01

    Objective: To determine the presence of 2299delG and C759F mutations in 37 non-related subjects from Colom?bia suffering from RP and sensorineural deafness. Materials and methods:Exon 13 of USH2A gene was directly sequenced in all subjects selected for the study. Results: In this work, the 2299delG mutation was only observed in subjects suffering from Usher syndrome type II while the C759F mutation was not detected in any subject.

  8. 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.

  9. 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.

  10. [Management of sudden neurosensory hearing loss in a Primary Care Centre].

    Science.gov (United States)

    Muñoz-Proto, F; Carnevale, C; Bejarano-Panadés, N; Ferrán-de la Cierva, L; Mas-Mercant, S; Sarría-Echegaray, P

    2014-04-01

    Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  11. Conference on the treatment of tinnitus and hyperacusis - Postponed

    CERN Multimedia

    GS Department

    2010-01-01

    Please note that the conference on the treatment of tinnitus and hyperacusis initially scheduled for Thursday, 3 March 2010 has been postponed to Monday, 2 May 2010 It will take place from 2.30 p.m. to 4.30 p.m. in the IT Auditorium - Building 31 3-004 Sylviane Chéry-Croze, Honorary Research Director at the CNRS and Ange Bidan, Vice-President of the French Association of Tinnitus Sufferers Do you suffer from tinnitus or hyperacusis? The CERN Medical Service and UNIQA Assurances SA, Geneva, invite you to a conference organised by the French Association of Tinnitus Sufferers. The conference will start with an introduction devoted to the destabilising experiences of people suffering from these symptoms and to the reactions that they induce. This introduction will be followed by a presentation of what are universally assumed in the medical research world to be the causes of the most frequently encountered forms of tinnitus (neurosensorial tinnitus). The presentation will also describe the mu...

  12. [Electrophysical effects in combined treatment of neurosensory hypoacusis].

    Science.gov (United States)

    Morenko, V M; Enin, I P

    2002-01-01

    The authors consider different methods of electrobiophysical impacts on the body in the treatment of neurosensory hypoacusis: laser beam, laser puncture, electrostimulation, magnetotherapy, magnetolasertherapy, electrophoresis, etc. These methods find more and more intensive application in modern medicine. Further success of physiotherapy for neurosensory hypoacusis depends on adequate knowledge about mechanisms of action of each physical method used and introduction of novel techniques.

  13. Conference on the treatment of tinnitus and hyperacusis

    CERN Multimedia

    GS Department

    2010-01-01

    Thursday, 4 March 2010 from 2.30 p.m. to 4.30 p.m. – Building 40 S2 A01 Sylviane Chéry-Croze, Honorary Research Director at the CNRS, and Ange Bidan, Vice-President of the French Association of Tinnitus Sufferers Do you suffer from tinnitus or hyperacusis? The CERN Medical Service and UNIQA Assurances SA, Geneva, invite you to a conference organised by the French Association of Tinnitus Sufferers. The conference will start with an introduction devoted to the destabilising experiences of people suffering from these symptoms and to the reactions that they induce. This introduction will be followed by a presentation of what are universally assumed in the medical research world to be the causes of the most frequently encountered forms of tinnitus (neurosensorial tinnitus). The presentation will also describe the multidisciplinary treatment that is currently regarded as the most effective means of initially managing the symptoms and then of eliminating them and that similarly targets th...

  14. Conference on the treatment of tinnitus and hyperacusis

    CERN Multimedia

    GS Department

    2010-01-01

    Monday 3 May 2010 from 2.30 p.m. to 4.30 p.m IT Auditorium - Bldg. 31-3-004 Sylviane Chéry-Croze, Honorary Research Director at the CNRS and Ange Bidan, Vice-President of the French Association of Tinnitus Sufferers Do you suffer from tinnitus or hyperacusis? The CERN Medical Service and UNIQA Assurances SA, Geneva, invite you to a conference organised by the French Association of Tinnitus Sufferers. The conference will start with an introduction devoted to the destabilising experiences of people suffering from these symptoms and to the reactions that they induce. This introduction will be followed by a presentation of what are universally assumed in the medical research world to be the causes of the most frequently encountered forms of tinnitus (neurosensorial tinnitus). The presentation will also describe the multidisciplinary treatment that is currently regarded as the most effective means of initially managing the symptoms and then of eliminating them and that similarly targets these ass...

  15. Tinnitus retraining therapy.

    Science.gov (United States)

    Jastreboff, P J

    2007-01-01

    Tinnitus retraining therapy (TRT) is a specific clinical method based on the neurophysiological model of tinnitus described by Jastreboff (Jastreboff, P.J. (1990). Neurosci. Res., 8: 221-254). The method is aimed at habituation of reactions evoked by tinnitus, and subsequently habituation of the tinnitus perception. Several other methods have been suggested for habituation of tinnitus, but in TRT two components that strictly follow the principles of the neurophysiological model of tinnitus are implemented and necessary: (1) counseling, aimed at reclassification of tinnitus to a category of a neutral signals and (2) sound therapy, aimed at weakening tinnitus-related neuronal activity as suggested by Jastreboff and Hazell (Jastreboff, P.J. and Hazell, J.W.P. (2004). Cambridge University Press, Cambridge). This chapter outlines the theoretical basis of TRT as well as comments on the clinical outcome of the use of TRT for different kinds of tinnitus.

  16. Tinnitus Patient Navigator

    Science.gov (United States)

    ... Cure About Us Initiatives News & Events Professional Resources Tinnitus Patient Navigator Want to get started on the ... unique and may require a different treatment workflow. Tinnitus Health-Care Providers If you, or someone you ...

  17. Tinnitus: Understanding the Facts

    Science.gov (United States)

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

  18. Hipoacusia neurosensorial en un síndrome de Noonan y secuencia Poland Neurosensory hypoacusis in a Noonan's syndrome and Poland's sequence

    Directory of Open Access Journals (Sweden)

    Julianis Loraine Quintero Noa

    2010-09-01

    Full Text Available Se calcula que el 50 % de los casos de sordera profunda en la infancia puede ser de origen genético. Se presenta el caso de un niño de 9 años, atendido en los Servicios de Otorrinolaringología y Genética del Hospital Pediátrico Docente «William Soler», por presentar hipoacusia neurosensorial grave unilateral y displasia congénita de Mondini en el oído izquierdo, del lado contrario a la hipoplasia del músculo pectoral mayor, lo cual coincide con un síndrome de Noonan y secuencia de Poland, que resulta de especial interés. Se constató la hipoacusia con audiometría tonal y potencial evocado auditivo de tallo cerebral. En la tomografía del oído se observó una hipoplasia coclear con agenesia de la espira apical. Se destacan las manifestaciones clínicas y la importancia del estudio otológico e imaginólogico en el diagnóstico de la pérdida auditiva.It is estimated that the 50% of cases of deep deafness during childhood may be or genetic origin. This is the case of a child aged 9 seen in Otorhinolaryngology and Genetics Services of the "Wiliam Soler" Teaching Children Hospital due to a unilateral severe neurosensory hypoacusis and Mondini's congenital dysplasia in left ear contralateral to the major pectoral muscle hypoplasia, an interesting situation. Hypoacusis was confirmed using tone audiometry and auditory evoked potential of brain stem. Ear tomography demonstrated a cochlear hypoplasia with agenesis of apical spiral. The clinical manifestations and the significance of the ontological and imaging study in diagnosis of auditory loss are emphasized.

  19. 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

  20. Bothersome tinnitus : Cognitive behavioral perspectives

    NARCIS (Netherlands)

    Cima, R F F

    Tinnitus is not traceable to a single disease or pathology, but merely a symptom, which is distressing to some but not all individuals able to perceive it. The experience of tinnitus does not equate to tinnitus distress. Tinnitus suffering might be understood as a function of tinnitus-related

  1. Somatic tinnitus prevalence and treatment with tinnitus retraining therapy.

    Science.gov (United States)

    Ostermann, K; Lurquin, P; Horoi, M; Cotton, P; Hervé, V; Thill, M P

    2016-01-01

    Somatic tinnitus originates from increased activity of the dorsal cochlear nucleus, a cross-point between the somatic and auditory systems. Its activity can be modified by auditory stimulation or somatic system manipulation. Thus, sound enrichment and white noise stimulation might decrease tinnitus and associated somatic symptoms. The present uncontrolled study sought to determine somatic tinnitus prevalence among tinnitus sufferers, and to investigate whether sound therapy with counselling (tinnitus retraining therapy; TRT) may decrease tinnitus-associated somatic symptoms. To determine somatic tinnitus prevalence, 70 patients following the TRT protocol completed the Jastreboff Structured Interview (JSI) with additional questions regarding the presence and type of somatic symptoms. Among 21 somatic tinnitus patients, we further investigated the effects of TRT on tinnitus-associated facial dysesthesia. Before and after three months of TRT, tinnitus severity was evaluated using the Tinnitus Handicap Inventory (THI), and facial dysesthesia was assessed with an extended JSI-based questionnaire. Among the evaluated tinnitus patients, 56% presented somatic tinnitus-including 51% with facial dysesthesia, 36% who could modulate tinnitus by head and neck movements, and 13% with both conditions. Self-evaluation indicated that TRT significantly improved tinnitus and facial dysesthesia in 76% of patients. Three months of TRT led to a 50% decrease in mean THI and JSI scores regarding facial dysesthesia. Somatic tinnitus is a frequent and underestimated condition. We suggest an extension of the JSI, including specific questions regarding somatic tinnitus. TRT significantly improved tinnitus and accompanying facial dysesthesia, and could be a useful somatic tinnitus treatment.

  2. When Your Child Has Tinnitus

    Science.gov (United States)

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

  3. [Tinnitus and psychiatric comorbidities].

    Science.gov (United States)

    Goebel, G

    2015-04-01

    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. The perceived severity of tinnitus correlates more closely to psychological and general health factors than to audiometric parameters. Together with limbic structures in the ventral striatum, the prefrontal cortex forms an internal "noise cancelling system", which normally helps to block out unpleasant sounds, including the tinnitus signal. If this pathway is compromised, chronic tinnitus results. Patients with chronic tinnitus show increased functional connectivity in corticolimbic pathways. Psychiatric comorbidities are common in patients who seek help for tinnitus or hyperacusis. Clinicians need valid screening tools in order to identify patients with psychiatric disorders and to tailor treatment in a multidisciplinary setting.

  4. [Tinnitus and deafness].

    Science.gov (United States)

    Dauman, R

    2000-01-15

    The relationships between tinnitus and hearing loss are studied from a clinical prospect. Five critical points are discussed. 1. Some degree of hearing loss is found in the vast majority of tinnitus patients; but an individual may well have a sensorineural hearing loss and no tinnitus at all. 2. A minor adjunction to the neurophysiological model of Jastreboff is proposed to take account of the association between tinnitus and hearing loss. 3. Tinnitus appears to cause more distress when hearing loss is marked. 4. Self-reported hearing loss should be considered when implementing habituation sound therapy. 5. According to McKinney, the rate of success on tinnitus that can be expected with habituation sound therapy is not significantly affected by hearing level.

  5. Noise and Tinnitus

    Directory of Open Access Journals (Sweden)

    Mansoureh Adel Ghahraman

    1999-03-01

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

  6. Evaluación auditiva neurosensorial en un grupo de prematuros del programa madre conguro Sensorineural auditory evaluation in a group of preterm neonates from the "Kangaroo mother" program

    Directory of Open Access Journals (Sweden)

    Gabriel Hernández

    1997-01-01

    Full Text Available Entre agosto de 1989 y diciembre de 1991 se buscó asociación entre algunos factores de riesgo comunes a los prematuros con peso menor de 1.500 g al nacer y el hecho de presentar disminución de la agudeza auditiva, medida con los potenciales evocados del tallo cerebral a los 4 meses y luego entre los 8 y los 14 meses. Los factores de riesgo tenidos en cuenta en 133 prematuros del ";Programa madre canguro"; del Instituto de los Seguros Sociales, en Medellín, fueron: Peso inferior a 1.500 g, hiperbilirrubinemia superior a 10 mg/ml, sufrimiento fetal, membranas hialinas, uso de aminoglicósidos, hipoglucemia, hemorragia del tercer trimestre e hipertensión arterial materna. Se halló pérdida de la agudeza auditiva en la evaluación inicial en 54 nifíos (40.6% mientras en la final sólo la presentaban 10 (7.5%; no pudo detectarse asociación entre los factores de riesgo y la disminución de la agudeza auditiva en la evaluación inicial ni en la final. La mejoría de resultados de agudeza auditiva entre las pruebas iniciales y las finales puede explicarse, entre otras razones, por la maduración cerebral del prematuro. Se debe investigar más la razón de los déficits finales y, ojalá, establecer programas de seguimiento con pruebas auditivas en este grupo de niños en riesgo. A study was carried out to investigate the association between risk factors commonly found in preterm neonates with very low birth-weight (Iess than 1.500 g and decreased auditory acuteness; the latter was measured according to brain stem evoked potentiaJs (BERA test In 133 preterm neonates belonging to the "Kangaroo mother program", in 'Medellín,Colombla. The following risk factors we~ evaluated: Hyperbilirrubinemia, hyaline membrane, birth weight lower than 1.500g, fetal distress, hypoglycemia, use of aminoglycosldes, thlrd trimester hemorrhage, and maternal high blood presssure. Abnormal results in BERA test were found in 54 cases (40.6% at 4 months and in only 10 (7

  7. Tinnitus and leisure noise.

    Science.gov (United States)

    Williams, Warwick; Carter, Lyndal

    2017-04-01

    To study the relationship of life-time noise exposure and experience of tinnitus. Audiometric measures included otoscopy, pure tone air- and bone-conduction hearing threshold levels (HTL) and otoacoustic emissions (OAEs). Participants completed questionnaires including demographic information, past hearing health, history of participation in loud leisure activities, and attitudes to noise. A representative sample (1435) of the young (11-35 years old) Australian population. Of the sample, 63% indicated they experienced tinnitus in some form. There was no correlation of tinnitus experience with HTL or OAE amplitudes. Although median octave band HTLs for those who experienced tinnitus "all the time" were slightly higher for those who did not, neither group exhibited HTLs outside clinically-normal values. Of those who experienced tinnitus a direct correlation was found between frequency of experience of tinnitus and increasing cumulative, life-time noise exposure. Those who experienced tinnitus were more likely to report noticing deterioration in their hearing ability over time and to report difficulty hearing in quiet and/or noisy situations. Experience of tinnitus was found throughout this young population but not associated with HTLs or variation in OAE amplitudes. Males experienced 'permanent' tinnitus at significantly greater rate than females.

  8. 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

  9. Tinnitus Multimodal Imaging

    Science.gov (United States)

    2016-12-01

    those next steps, we can start to unravel how alterations in connectivity affect perceptual, attentional, and emotional aspects of tinnitus among...Coleman Memorial and Hearing Research, Inc, endowment funds. REFERENCES Ashburner, J. (2007). A fast diffeomorphic image registration algorithm. Neuroimage...Jiao, Y., et al. (2015). Tinnitus and hyperacusis involve hyperactivity and enhanced connectivity in auditory- limbic- arousal -cerebellar network

  10. Tinnitus-Induced Suicide

    Directory of Open Access Journals (Sweden)

    Serhan Derin

    2015-04-01

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

  11. Tinnitus retraining therapy: a different view on tinnitus.

    Science.gov (United States)

    Jastreboff, Pawel J; Jastreboff, Margaret M

    2006-01-01

    Tinnitus retraining therapy (TRT) is a method for treating tinnitus and decreased sound tolerance, based on the neurophysiological model of tinnitus. This model postulates involvement of the limbic and autonomic nervous systems in all cases of clinically significant tinnitus and points out the importance of both conscious and subconscious connections, which are governed by principles of conditioned reflexes. The treatments for tinnitus and misophonia are based on the concept of extinction of these reflexes, labeled as habituation. TRT aims at inducing changes in the mechanisms responsible for transferring signal (i.e., tinnitus, or external sound in the case of misophonia) from the auditory system to the limbic and autonomic nervous systems, and through this, remove signal-induced reactions without attempting to directly attenuate the tinnitus source or tinnitus/misophonia-evoked reactions. As such, TRT is effective for any type of tinnitus regardless of its etiology. TRT consists of: (1) counseling based on the neurophysiological model of tinnitus, and (2) sound therapy (with or without instrumentation). The main role of counseling is to reclassify tinnitus into the category of neutral stimuli. The role of sound therapy is to decrease the strength of the tinnitus signal. It is crucial to assess and treat tinnitus, decreased sound tolerance, and hearing loss simultaneously. Results from various groups have shown that TRT can be an effective method of treatment. Copyright (c) 2006 S. Karger AG, Basel.

  12. Imaging in pulsatile tinnitus

    International Nuclear Information System (INIS)

    Madani, G.; Connor, S.E.J.

    2009-01-01

    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

  13. 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.

  14. [Some aspects of tinnitus].

    Science.gov (United States)

    Reiss, M; Reiss, G

    1999-09-16

    Tinnitus is the sensation of sound, a sensation generated by the auditory system because of a pathology, without any external acoustic or electrical stimulation. Most often, it is associated with a sensorineural hearing loss. Tinnitus is still one of the most frequent symptoms encountered by the otorhinolaryngologist and other doctors. Diagnosis and therapy are demanding due to complex etiology and secondary symptoms. Tinnitus is a symptom and not a disease. Therefore a thorough diagnosis is necessary. First of all one has to evaluate whether there is a treatable underlying organic disease possibly responsible for symptoms like tinnitus. The evaluation of the patient includes the history, ENT-status, audiological and vestibular findings, investigative imaging and examinations by other specialists. The therapeutic aim is the compensation of tinnitus. There is no universal medical or surgical treatment. Acute tinnitus is treated like sudden deafness. For chronic forms, the analysis of the causes is particularly important for developing an individual consultation and therapy plan. Providing information to the patient is the first step for a sensible treatment of the symptoms. Supportive therapy includes a psychosomatic therapy and the use of medication or instrumentation.

  15. Anticonvulsants for tinnitus.

    Science.gov (United States)

    Hoekstra, Carlijn El; Rynja, Sybren P; van Zanten, Gijsbert A; Rovers, Maroeska M

    2011-07-06

    Tinnitus is the perception of sound or noise in the absence of an external or internal acoustic stimulation. It is a common and potentially distressing symptom for which no adequate therapy exists. To assess the effectiveness of anticonvulsants in patients with chronic tinnitus. We searched the Cochrane Ear, Nose and Throat Disorders Group Specialised Register, CENTRAL (2010, Issue 2), MEDLINE, EMBASE, bibliographies and additional sources for published and unpublished trials. The date of the most recent search was 26 May 2010. We selected randomised controlled trials in patients with chronic tinnitus comparing orally administered anticonvulsants with placebo. The primary outcome was improvement in tinnitus measured with validated questionnaires. Secondary outcomes were improvement in tinnitus measured with self-assessment scores, improvement in global well-being or accompanying symptoms, and adverse drug effects. Three authors assessed risk of bias and extracted data independently. Seven trials (453 patients) were included in this review. These studies investigated four different anticonvulsants: gabapentin, carbamazepine, lamotrigine and flunarizine. The risk of bias of most studies was 'high' or 'unclear'. Three studies included a validated questionnaire (primary outcome). None of them showed a significant positive effect of anticonvulsants. One study showed a significant negative effect of gabapentin compared to placebo with an increase in Tinnitus Questionnaire (TQ) score of 18.4 points (standardised mean difference (SMD) 0.82, 95% confidence interval (CI) 0.07 to 1.58). A second study showed a positive, non-significant effect of gabapentin with a difference compared to placebo of 2.4 points on the Tinnitus Handicap Inventory (THI) (SMD -0.11, 95% CI -0.48 to 0.25). When the data from these two studies are pooled no effect of gabapentin is found (SMD 0.07, 95% CI -0.26 to 0.40). A third study reported no differences on the THI after treatment with gabapentin

  16. Some psychological aspects of tinnitus.

    Science.gov (United States)

    Reiss, M; Reiss, G

    1999-06-01

    Tinnitus rarely can be cured. The patient, however, needs help to avoid countless ineffective treatments and considerable cost. The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. After all medical and audiological treatments have failed, tinnitus patients often are advised to "learn to live with it." The aim of psychosocial treatment is assisting patients in the identification of aggravating factors in tinnitus and teaching them various coping skills.

  17. Sound therapies for tinnitus management.

    Science.gov (United States)

    Jastreboff, Margaret M

    2007-01-01

    Many people with bothersome (suffering) tinnitus notice that their tinnitus changes in different acoustical surroundings, it is more intrusive in silence and less profound in the sound enriched environments. This observation led to the development of treatment methods for tinnitus utilizing sound. Many of these methods are still under investigation in respect to their specific protocol and effectiveness and only some have been objectively evaluated in clinical trials. This chapter will review therapies for tinnitus using sound stimulation.

  18. 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.)

  19. 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.)

  20. The radiologic evaluation of tinnitus

    International Nuclear Information System (INIS)

    Branstetter, Barton F.; Weissman, Jane L.

    2006-01-01

    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.)

  1. 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

  2. Personality of the tinnitus patient.

    Science.gov (United States)

    House, P R

    1981-01-01

    Personality and coping mechanisms are related to patients' perceptions of their tinnitus. Although the occurrence of tinnitus is not unusual, its nature varies from infrequent, barely noticeable sound to an unrelenting, absorbing disturbance of critical significance. Tinnitus is a subjective complaint: the same level of tinnitus may be described by one patient as intolerable and by another as barely noticeable. Stress is intricately related to tinnitus: persons with severe tinnitus experience excessive stress. This has debilitating effects on their defences and coping can become very difficult. Patients may demonstrate a cluster of hysterical defences or a serious degree of depression. Many tinnitus patients focus on their problem, objectifying it and thus intensifying the disturbance. Most tinnitus patients can be helped by psychological intervention. A small percentage of tinnitus patients can be classified as disturbed, with borderline personalities. These patients are usually not suitable for therapy or biofeedback training. Tinnitus can be stress-related disorder. As a person is faced with conflict, physiological changes occur as a result of the "fight or flight" reaction. This state of stress can be responsible for the onset or exacerbation of a tinnitus episode. Treatment by management of stress can be successful, promoting relief through a shift of focus, repose from a state of tension, and support of constructive defences.

  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. [Tinnitus and psychological comorbidities].

    Science.gov (United States)

    Zirke, N; Goebel, G; Mazurek, B

    2010-07-01

    Comorbidity is the presence of one or more disorders in addition to the main disorder. Comorbidities negatively influence the development of the main disease. For patients with tinnitus a comorbidity is an additional component complicating the habituation of ear noise and patients with decompensated tinnitus often have psychological comorbidities, e.g. affective, somatoform or anxiety disorders. At the time of first presentation and also during further follow-up, it is essential to pay particular attention to the presence of potential comorbid mental disorders. This is of special importance for patients with decompensated ear noise (severity grades 3 and 4). For ENT specialists it is important that the mental discomfort of patients must be taken seriously and should be identified through a targeted diagnosis. Effective treatment of the co-symptoms using cognitive behavior therapy (CBT) in conjunction with medication often reduces the severity of tinnitus perception and discomfort.

  5. [Tinnitus and implants].

    Science.gov (United States)

    Despreaux, G; Tison, P; Van Den Abbeele, T; Moine, A; Frachet, B

    1990-01-01

    The experience with cochlear implantation at Avicenne hospital prompted us to carry out a retrospective study on tinnitus in a population of operated patients. Improvement or disappearance of the symptoms was noted in all cases. These results, which partly match those found in the literature, are probably produced by rehabilitation inhibiting the "deafferentation" mechanisms in analogy with pain phenomena. In some precise cases, which are described, they led us to proposing implantation even though the main, if not sole, complaint of the patient was tinnitus.

  6. Outcomes of clinical trial: tinnitus masking versus tinnitus retraining therapy.

    Science.gov (United States)

    Henry, James A; Schechter, Martin A; Zaugg, Tara L; Griest, Susan; Jastreboff, Pawel J; Vernon, Jack A; Kaelin, Christine; Meikle, Mary B; Lyons, Karen S; Stewart, Barbara J

    2006-02-01

    A controlled clinical study was conducted to evaluate prospectively the clinical efficacy of tinnitus masking (TM) and tinnitus retraining therapy (TRT) in military veterans having clinically significant tinnitus. Qualifying patients were placed into the two groups in an alternating manner (to avoid selection bias), and treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index) and the verbally administered TRT interview forms. Findings are presented from the three written questionnaires, and from two of the interview questions (percentage time aware of, and annoyed by, tinnitus). Outcomes were analyzed on an intent-to-treat basis, using a multilevel modeling approach. Of the 123 patients enrolled, 118 were included in the analysis. Both groups showed significant declines (improvements) on these measures, with the TRT decline being significantly greater than for TM. The greater declines in TRT compared to TM occurred most strongly in patients who began treatment with a "very big" tinnitus problem. When patients began treatment with a "moderate" tinnitus problem, the benefits of TRT compared to TM were more modest.

  7. Multisensory attention training for treatment of tinnitus.

    Science.gov (United States)

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

    2015-05-28

    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 randomized between two groups receiving 20 daily sessions of either integration (attempting to reduce salience to tinnitus by binding with multisensory stimuli) or attention diversion (multisensory stimuli opposite side to tinnitus) training. The training resulted in small but statistically significant reductions in Tinnitus Functional Index and Tinnitus Severity Numeric Scale scores and improved attentional abilities. No statistically significant improvements in tinnitus were found between the training groups. This study demonstrated that a short period of multisensory attention training reduced unilateral tinnitus, but directing attention toward or away from the tinnitus side did not differentiate this effect.

  8. Assessing outcomes of tinnitus intervention.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A; Jacobson, Gary P

    2014-01-01

    It has been estimated that as many as 50 million Americans do experience or have experienced tinnitus. For approximately 12 million of these individuals, tinnitus makes it impossible for them to carry out normal everyday activities without limitation. These are the patients that present to audiology clinics for assessment and management. The tinnitus evaluation includes the measurement of acoustical characteristics of tinnitus and the impact that this impairment has on health-related quality of life (HRQoL). Tinnitus is a disorder that often occurs as a result of auditory system impairment. The impairment for some can impart an activity limitation and a participation restriction (i.e., tinnitus-related disability or handicap, respectively). The goal of tinnitus management is to reduce, or eliminate, activity limitations and participation restrictions by reducing or eliminating a patient's perception of tinnitus or their reaction to tinnitus. Implicit in this statement is the assumption that there exist standardized measures for quantifying the patient's tinnitus perception and their reaction to it. If there existed stable and responsive standardized tinnitus measures, then it would be possible to compare a patient's tinnitus experience at different time points (e.g., before and after treatment) to assess, for example, treatment efficacy. The purposes of the current review are to (1) describe psychometric standards used to select outcome measurement tools; (2) discuss available measurement techniques and their application to tinnitus evaluation and treatment-related assessment within the domains established by the World Health Organization's International Classification of Functioning, Disability and Health; (3) list and briefly describe self-report tinnitus questionnaires; (4) describe how valuation of tinnitus treatment can be assessed using economic models of treatment effectiveness; and (5) provide future directions including the development of a tinnitus

  9. Neurophysiological approach to tinnitus patients.

    Science.gov (United States)

    Jastreboff, P J; Gray, W C; Gold, S L

    1996-03-01

    The principal postulate of the neurophysiological model of tinnitus is that all levels of the auditory pathways and several nonauditory systems play essential roles in each case of tinnitus, stressing the dominance of nonauditory systems in determining the level of tinnitus annoyance. Thus it has been proposed to treat tinnitus by inducing and facilitating habituation to the tinnitus signal. The goal is to reach the stage at which, although patients may perceive tinnitus as unchanged when they focus on it, they are otherwise not aware of tinnitus. Furthermore, even when perceived, tinnitus does not evoke annoyance. Habituation is achieved by directive counseling combined with low-level, broad-band noise generated by wearable generators, and environmental sounds, according to a specific protocol. For habituation to occur, it is imperative to avoid masking tinnitus by these sounds. Since 1991, > 500 tinnitus patients have been seen in our center. About 40% exhibited hyperacusis to varying degrees. A survey of > 100 patients revealed > 80% of significant improvement in groups of patients treated with the full protocol involving counseling and the use of noise generators. Notably, in patients who received counseling only, the success rate was < 20%. The improvement in hyperacusis was observed in approximately 90% of treated patients.

  10. Anticonvulsants for tinnitus.

    NARCIS (Netherlands)

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

    2011-01-01

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

  11. Characterization of tinnitus in Nigeria.

    Science.gov (United States)

    Sogebi, Olusola Ayodele

    2013-08-01

    This study aimed to characterize tinnitus in middle aged and elderly out-patients attending a specialized clinic in a developing country. A cross sectional study of patients attending the ear, nose and throat (ENT) clinic of Olabisi Onabanjo University Teaching Hospital, OOUTH Sagamu, Nigeria. Data was collected with the use of a structured questionnaire. Data collected included socio demographics, medical history including experience of tinnitus, PTAs, BMI and BP. Data was analyzed using SPSS version 17.0. 79 patients had complaints of tinnitus thus making a crude prevalence of 14.5%, the prevalence increased steadily along the age groups. 51.9% of patients experienced tinnitus for a short period. 53.2% of the patients had symptoms referable to only one ear, while 54.4% had discrete as opposed to multiple types of tinnitus. Occurrence of intermittent symptoms was experienced by 75.9% of the patients and 70.9% were non-pulsatile in nature. Tinnitus was significantly associated with abnormal audiographic pattern, global increased hearing thresholds, high tone hearing loss, vertigo, hypertension and obesity. Tinnitus character was majorly short term, unilateral, discrete, intermittent, and non-pulsatile in nature, and it is associated with otological, audiological, anthropometric and cardiovascular anomalies. The characteristics of tinnitus in Nigerian patients were similar to those described in developed countries, but the major risk factors for tinnitus except hearing impairment, may be different from the latter. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  12. Tinnitus: considerations for nursing practice.

    Science.gov (United States)

    Truscott, Gill

    2016-11-09

    Tinnitus is a common condition characterised by a subjective, and less commonly objective, noise sensation that is often described as ringing heard in one or both ears by the individual. The exact cause of tinnitus is not known, but it is related to physiological changes in the auditory system and is closely linked to psychological well-being. Tinnitus can have a significant effect on the lives of people who experience it on a continuous basis. Although there is no cure for tinnitus, various strategies are available to support individuals to manage the condition on a daily basis; these management strategies are discussed in this article.

  13. Risk factors of neurosensory disturbance following orthognathic surgery.

    Science.gov (United States)

    Alolayan, Albraa Badr; Leung, Yiu Yan

    2014-01-01

    To report the incidence of objective and subjective neurosensory disturbance (NSD) after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery. A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo neurosensory tests with subjective and 3 objective assessments. Possible risk factors of NSD including subjects' age and gender, surgical procedures and surgeons' experience were analyzed. 238 patients with 476 sides were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months) but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients and surgeons' experience were not found to be risk factors of NSD after orthognathic surgery. The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more). Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery.

  14. Risk factors of neurosensory disturbance following orthognathic surgery.

    Directory of Open Access Journals (Sweden)

    Albraa Badr Alolayan

    Full Text Available OBJECTIVES: To report the incidence of objective and subjective neurosensory disturbance (NSD after orthognathic surgery in a major orthognathic centre in Hong Kong, and to investigate the risk factors that contributed to the incidence of NSD after orthognathic surgery. MATERIALS AND METHODS: A retrospective cross-sectional study on NSD after orthognathic surgery in a local major orthognathic centre. Patients who had bimaxillary orthognathic surgery reviewed at post-operative 6 months, 12 months or 24 months were recruited to undergo neurosensory tests with subjective and 3 objective assessments. Possible risk factors of NSD including subjects' age and gender, surgical procedures and surgeons' experience were analyzed. RESULTS: 238 patients with 476 sides were recruited. The incidences of subjective NSD after maxillary procedures were 16.2%, 13% and 9.8% at post-operative 6 months, 12 months and 24 months, respectively; the incidences of subjective NSD after mandibular procedures were 35.4%, 36.6% and 34.6% at post-operative 6 months, 12 months and 24 months, respectively. Increased age was found to be a significant risk factor of NSD after orthognathic surgery at short term (at 6 months and 12 months but not at 24 months. SSO has a significantly higher risk of NSD when compared to VSSO. SSO in combination with anterior mandibular surgery has a higher risk of NSD when compared to VSSO in combination with anterior mandibular surgery or anterior mandibular surgery alone. Gender of patients and surgeons' experience were not found to be risk factors of NSD after orthognathic surgery. CONCLUSION: The incidence of NSD after maxillary and mandibular orthognathic procedures at post-operative 6 months, 12 months and 24 months was reported. Increased age was identified as a risk factor of short term post-operative NSD but not in long term (24 months or more. Specific mandibular procedures were related to higher incidence of NSD after orthognathic surgery.

  15. Neurofeedback for treating tinnitus

    OpenAIRE

    Dohrmann, Katalin; Weisz, Nathan; Schlee, Winfried; Hartmann, Thomas; Elbert, Thomas

    2007-01-01

    Many individuals with tinnitus have abnormal oscillatory brain activity. Led by this finding, we have developed a way to normalize such pathological activity by neurofeedback techniques (Weisz et al. (2005). PLoS Med., 2: e153). This is achieved mainly through enhancement of tau activity, i.e., oscillatory activity produced in perisylvian regions within the alpha frequency range (8 12 Hz) and concomitant reduction in delta power range (0.5 4 Hz). This activity is recorded from electrodes plac...

  16. Clinical trial to compare tinnitus masking and tinnitus retraining therapy.

    Science.gov (United States)

    Henry, J A; Schechter, M A; Zaugg, T L; Griest, S; Jastreboff, P J; Vernon, J A; Kaelin, C; Meikle, M B; Lyons, K S; Stewart, B J

    2006-12-01

    Both tinnitus masking (TM) and tinnitus retraining therapy (TRT) can be effective therapies for amelioration of tinnitus. TM may be more effective for patients in the short term, but with continued treatment TRT may produce the greatest effects. Although TM and TRT have been used for many years, research has not documented definitively the efficacy of these methods. The present study was a controlled clinical trial to prospectively evaluate the clinical efficacy of these two methods for US military veterans with severe tinnitus. Over 800 veterans were screened to ensure that enrolled patients had tinnitus of sufficient severity to justify 18 months of individualized treatment. Qualifying patients (n=123) were placed quasi-randomly (alternating placement) into treatment with either TM or TRT. Treatment was administered at 0, 3, 6, 12, and 18 months. Outcomes of treatment were evaluated primarily using three self-administered tinnitus questionnaires (Tinnitus Handicap Inventory, Tinnitus Handicap Questionnaire, Tinnitus Severity Index). Findings are presented from the three written questionnaires with respect to three categories of patients: describing tinnitus as a 'moderate,' 'big,' and 'very big' problem at baseline. Based on effect sizes, both groups showed considerable improvement overall. In general, TM effects remained fairly constant over time while TRT effects improved incrementally. For the patients with a 'moderate' and 'big' problem, TM provided the greatest benefit at 3 and 6 months; benefit to these TRT patients was slightly greater at 12 months, and much greater at 18 months. For patients with a 'very big' problem, TM provided the greatest benefit at 3 months. For these latter patients, results were about the same between groups at 6 months, and improvement for TRT was much greater at 12 months, with further gains at 18 months.

  17. 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.

  18. An animal model for tinnitus.

    Science.gov (United States)

    Jastreboff, P J; Brennan, J F; Sasaki, C T

    1988-03-01

    Subjective tinnitus remains obscure, widespread, and without apparent cure. In the absence of a suitable animal model, past investigations took place in humans, resulting in studies that were understandably restricted by the nature of human investigation. Within this context, the development of a valid animal model would be considered a major breakthrough in this field of investigation. Our results showed changes in the spontaneous activity of single neurons in the inferior colliculus, consistent with abnormally increased neuronal activity within the auditory pathways after manipulations known to produce tinnitus in man. A procedure based on a Pavlovian conditioned suppression paradigm was recently developed that allows us to measure tinnitus behaviorally in conscious animals. Accordingly, an animal model of tinnitus is proposed that permits tests of hypotheses relating to tinnitus generation, allowing the accommodation of interventional strategies for the treatment of this widespread auditory disorder.

  19. Body schema building during childhood and adolescence: a neurosensory approach.

    Science.gov (United States)

    Assaiante, C; Barlaam, F; Cignetti, F; Vaugoyeau, M

    2014-01-01

    In order to perceive and act in its environment, the individual's body and its interactions with the sensory and social environment are represented in the brain. This internal representation of the moving body segments is labeled the body schema. Throughout life, body schema develops based on the sensory information used by the moving body and by its interactions with the environment including other people. Internal representations including body schema and representations of the outside world develop with learning and actions throughout ontogenesis and are constantly updated based on different sensory inputs. The aim of this review is to present some concepts and experimental data about body schema, internal representations and updating process during childhood and adolescence, as obtained using a neurosensory approach. From our developmental studies, it was possible to explore the slow maturation of the sensorimotor representations by examining the anticipatory control. By manipulating proprioceptive and visual information, which are at the heart of the construction of body schema, we wished to highlight notable differences between adolescents and young adults on both a postural and perceptual level, which confirms the late maturation of multisensory integration for central motor control. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  20. Audiometric asymmetry and tinnitus laterality.

    Science.gov (United States)

    Tsai, Betty S; Sweetow, Robert W; Cheung, Steven W

    2012-05-01

    To identify an optimal audiometric asymmetry index for predicting tinnitus laterality. Retrospective medical record review. Data from adult tinnitus patients (80 men and 44 women) were extracted for demographic, audiometric, tinnitus laterality, and related information. The main measures were sensitivity, specificity, positive predictive value (PPV), and receiver operating characteristic (ROC) curves. Three audiometric asymmetry indices were constructed using one, two, or three frequency elements to compute the average interaural threshold difference (aITD). Tinnitus laterality predictive performance of a particular index was assessed by increasing the cutoff or minimum magnitude of the aITD from 10 to 35 dB in 5-dB steps to determine its ROC curve. Single frequency index performance was inferior to the other two (P .05). Two adjoining frequency elements with aITD ≥ 15 dB performed optimally for predicting tinnitus laterality (sensitivity = 0.59, specificity = 0.71, and PPV = 0.76). Absolute and relative magnitudes of hearing loss in the poorer ear were uncorrelated with tinnitus distress. An optimal audiometric asymmetry index to predict tinnitus laterality is one whereby 15 dB is the minimum aITD of two adjoining frequencies, inclusive of the maximal ITD. Tinnitus laterality dependency on magnitude of interaural asymmetry may inform design and interpretation of neuroimaging studies. Monaural acoustic tinnitus therapy may be an initial consideration for asymmetric hearing loss meeting the criterion of aITD ≥ 15 dB. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  1. Tinnitus sensitization: a neurophysiological pathway of chronic complex tinnitus.

    Science.gov (United States)

    Zenner, Hans P

    2006-01-01

    A novel neuro- and psychophysiological pathway for central cognition of tinnitus, i.e. tinnitus sensitization, is presented here. As a complement to the neurophysiological pathway for the conditioned reflex according to Jastreboff, which permits therapeutic procedures to bring about an extinction of the tinnitus (e.g. by the acoustic tinnitus retraining therapy), sensitization can be treated with procedures that act at the cognitive level. Since on the one hand therapeutic extinction procedures (e.g. the therapeutic application of sound) are still to be proven effective in controlled studies, while on the other cognitive interventions such as cognitive behavioral therapies have in fact acquired evidence level IIa in prospective studies, it is indeed appropriate to discuss whether the earlier neurophysiological model of a conditioned reflex is sufficient on its own, and whether in fact it needs to be complemented with the sensitization model.

  2. [Tinnitus: algorithm of diagnostics and clinical management].

    Science.gov (United States)

    Boiko, N V

    Hearing of sound, or tinnitus, can be a symptom of different diseases. The differential diagnosis should be based on the identification of subgroups with confirmed causes of the disease. Subjective and objective tinnitus groups should be isolated. Objective tinnitus can be vascular or muscular. In making a diagnosis of tinnitus, it is important to know its characteristics, laterality, circumstances of onset, duration, comorbidity with other symptoms: headache, hearing decline, dizziness, depression, etc. Urgent diagnostic and treatment measures are needed after the identification of 'red flags': acute pulsatile tinnitus, in particular after the brain injury, combination of tinnitus with acute hearing loss and depression.

  3. Tinnitus with temporomandibular joint disorders: a specific entity of tinnitus patients?

    Science.gov (United States)

    Vielsmeier, Veronika; Kleinjung, Tobias; Strutz, Jürgen; Bürgers, Ralf; Kreuzer, Peter Michael; Langguth, Berthold

    2011-11-01

    Tinnitus is frequently associated with temporomandibular joint (TMJ) dysfunction. However, the nature of the relationship is not fully understood. Here the authors compared 30 patients with a confirmed diagnosis of temporomandibular joint dysfunction and tinnitus to a group of 61 patients with tinnitus but without any subjective complaints of TMJ dysfunction with respect to clinical and demographic characteristics. Case-control study. Tertiary referral center. Tinnitus patients with and without TMJ dysfunction presenting at the Department of Prosthetic Dentistry and th: Tinnitus Clinic at the University of Regensburg. Tinnitus patients with TMJ disorder had better hearing function (P neck movements (P = .001). Classical risk factors for tinnitus (age, male gender, hearing loss) are less relevant in tinnitus patients with TMJ disorder, suggesting a causal role of TMJ pathology in the generation and maintenance of tinnitus. Based on this finding, treatment of TMJ disorder may represent a causally oriented treatment strategy for tinnitus.

  4. [An assessment of tinnitus retraining therapy].

    Science.gov (United States)

    von Wedel, H; von Wedel, U C

    2000-12-01

    Based on the neurophysiological model of tinnitus developed by Jastreboff and Hazell [39] there have been some important developments in understanding and therapy of tinnitus over the last decade. The clinical applications of this model are known as "tinnitus retraining therapy", which has the objective of reducing both the distress associated with tinnitus and the tinnitus perception itself. As a form of systematic, repeated and skilled counselling over a long period of up to 2 years supported by sound therapy (hearing aid or noise generator) the evidence for their high degree of effectiveness is overwhelming. On the basis of a "German concept" of tinnitus retraining therapy developed and proposed by the ADANO (Arbeitsgemeinschaft deutschsprachiger Audiologen und Neurootologen) the current status of this treatment will be briefly reviewed including some actual studies of Goebel et al. [14] that confirm the world wide critical comments on the recent developments in the management of tinnitus especially with regard to tinnitus retraining therapy [79].

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

    OpenAIRE

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

    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. Depressive stress disorder in tinnitus patient

    OpenAIRE

    Yesilkus, Nursel

    2013-01-01

    Psychiatric comorbidities have a negative influence on tinnitus development and processing. Research has shown a high prevalence of depressive symptoms in patients with chronic Tinnitus. This work evaluates the depressive distress in Tinnitus outpatients. 500 patients suffering from tinnitus were examined on the first day of admission at the outpatient clinic of the Charité University Hospital in Berlin. Besides the assessment of audiometric data, the depression variables a...

  7. 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

  8. [The psychological analysis of patients with tinnitus].

    Science.gov (United States)

    Cai, Qing; Li, Jun; Tao, Zezhang; Huang, Zhiwu; Ma, Zhelan; Cao, Yongmao

    2004-04-01

    To investigate the psychological factor of tinnitus and assess the possible influenced aspects. To inspect the 95 cases with tinnitus by SCL-90, the 9 items were divided to 10 factors and compared to the Chinese normalizations. There were significant difference between 4 factors including: somatization, depression, anxiety, compel symptom and normalization (Ppsychological dysfunction of tinnitus. Psychoprophylaxis is the important factors to tinnitus, and the major influenced aspects are age, educational level and emotional stability.

  9. Comparison of tinnitus and psychological aspects between the younger and older adult patients with tinnitus.

    Science.gov (United States)

    Park, So Young; Han, Jung Ju; Hwang, Jae Hyung; Whang, Eul Sung; Yeo, Sang Won; Park, Shi Nae

    2017-04-01

    To explore the differences in various tinnitus-related features and psychological aspects between the younger and older adult patients with tinnitus. We retrospectively reviewed the clinical data of the adult patients who visited our tinnitus clinic in 2013 and completed full tinnitus assessment including audiometry, tinnitus matching, standardized tinnitus questionnaires, and psychometric questionnaires. The younger group included patients aged 20-45 years (n=64), and the older group, those older than 65 years (n=76). Clinical features, hearing levels, matched tinnitus pitches and loudness, self-report tinnitus severity scores, Beck depression inventory scores, and stress scores were compared between the groups. Tinnitus duration was longer in the older group (p=0.002). Mean PTAs were 16dB HL in the younger, and 38dB HL in the older groups (ptinnitus loudness was greater in the older group (64dB HL vs. 36dB HL, ptinnitus, depression, and stress scores did not differ between the groups. The older patients seemed to be more receptive to tinnitus. The majority of older tinnitus patients had concomitant hearing loss, and thus hearing rehabilitation should be considered preferentially for tinnitus management in this age group. Subjective tinnitus severity, depressive symptoms, and the stress levels were similar between the younger and older tinnitus patients. Therefore, treatment could be planned based upon the comprehensive understanding of the tinnitus characteristics and psychological aspects in each patient irrespective of age. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. 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 to...

  11. 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

  12. A neurophysiological approach to tinnitus: clinical implications.

    Science.gov (United States)

    Jastreboff, P J; Hazell, J W

    1993-02-01

    This paper presents a neurophysiological approach to tinnitus and discusses its clinical implications. A hypothesis of discordant damage of inner and outer hair cells systems in tinnitus generation is outlined. A recent animal model has facilitated the investigation of the mechanisms of tinnitus and has been further refined to allow for the measurement of tinnitus pitch and loudness. The analysis of the processes involved in tinnitus detection postulates the involvement of an abnormal increase of gain within the auditory system. Moreover, it provides a basis for treating patients with hyperacusis, which we are considering to be a pre-tinnitus state. Analysis of the process of tinnitus perception allows for the possibility of facilitating the process of tinnitus habituation for the purpose of its alleviation. The combining of theoretical analysis with clinical findings has resulted in the creation of a multidisciplinary Tinnitus Centre. The foundation of the Centre focuses on two goals: the clinical goal is to remove tinnitus perception from the patient's consciousness, while directing research toward finding a mechanism-based method for the suppression of tinnitus generators and processes responsible for enhancement of tinnitus-related neuronal activity.

  13. 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.

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

    Science.gov (United States)

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

    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-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. PMID:22529921

  15. Phenotypic characteristics of hyperacusis in tinnitus.

    Directory of Open Access Journals (Sweden)

    Martin Schecklmann

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

  16. Tinnitus (Phantom Sound: Risk coming for future

    Directory of Open Access Journals (Sweden)

    Suresh Rewar

    2015-01-01

    Full Text Available The word 'tinnitus' comes from the Latin word tinnire, meaning “to ring” or “a ringing.” Tinnitus is the cognition of sound in the absence of any corresponding external sound. Tinnitus can take the form of continuous buzzing, hissing, or ringing, or a combination of these or other characteristics. Tinnitus affects 10% to 25% of the adult population. Tinnitus is classified as objective and subjective categories. Subjective tinnitus is meaningless sounds that are not associated with a physical sound and only the person who has the tinnitus can hear it. Objective tinnitus is the result of a sound that can be heard by the physician. Tinnitus is not a disease in itself but a common symptom, and because it involves the perception of sound or sounds, it is commonly associated with the hearing system. In fact, various parts of the hearing system, including the inner ear, are often responsible for this symptom. Tinnitus patients, which can lead to sleep disturbances, concentration problems, fatigue, depression, anxiety disorders, and sometimes even to suicide. The evaluation of tinnitus always begins with a thorough history and physical examination, with further testing performed when indicated. Diagnostic testing should include audiography, speech discrimination testing, computed tomography angiography, or magnetic resonance angiography should be performed. All patients with tinnitus can benefit from patient education and preventive measures, and oftentimes the physician's reassurance and assistance with the psychologic aftereffects of tinnitus can be the therapy most valuable to the patient. There are no specific medications for the treatment of tinnitus. Sedatives and some other medications may prove helpful in the early stages. The ultimate goal of neuro-imaging is to identify subtypes of tinnitus in order to better inform treatment strategies.

  17. Association between tinnitus retraining therapy and a tinnitus control instrument.

    Science.gov (United States)

    Ito, Mari; Soma, Keiko; Ando, Reiko

    2009-10-01

    Tinnitus retraining therapy (TRT), which is an adaptation therapy for tinnitus based on the neurophysiological model proposed by Jastreboff in 1990,consists of directive counseling and acoustic therapy with a tinnitus control instrument (TCI) or other devices. For the past 5 years, our hospital has administered TRT characterized by the use of a TCI. In this study, we reviewed the clinical course of patients with tinnitus who presented to our outpatient clinic for tinnitus and hearing loss during the 3-year period from April 2004 to March 2007 and underwent TRT with a TCI. Among 188 patients with tinnitus (105 males and 83 females), 88 patients (51 males and 37 females, excluding dropouts) who purchased a TCI and continued therapy were included in the study. Significant improvement in Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores was found as early as 1 month of treatment and later compared with those on initial examination, suggesting that TRT with a TCI may be an effective treatment for tinnitus. Among the noises generated by the TCI, the sound pressure output from the TCI was set at just below tinnitus loudness level both of the first adjustment and the second adjustment. Speech noise and white noise were frequently selected, whereas high-frequency noise and pink noise were infrequently selected. Speech noise was most frequently selected at the first adjustment, and the number of patients selecting white noise increased at the second adjustment. The results that we compared the two also revealed that the mean hearing level and tinnitus loudness levels were higher in the white noise group than in the speech noise group, which suggested that the inner ear disorder was more harder in the white noise group. Both the THI score and VAS grade improved after 1 month of treatment in the speech noise group, whereas improvement in these parameters was observed in the white noise group after 6 months of treatment. These results suggest that it took

  18. [Current aspects of tinnitus and depression].

    Science.gov (United States)

    Kratzsch, V; Goebel, G

    2018-03-01

    Health authorities underestimate the negative influence of emotional factors such as depression, anxiety disorders, or somatoform disorders in the development of tinnitus and their contribution to a poor prognosis. This can lead to underestimation of the impairment suffered by tinnitus patients and, consequently, a possibly incorrect treatment approach or belated initiation of therapy. Mental disorders play a large role in the S3AWMF "Tinnitus" guidelines. Thus, the somatic and psychiatric approaches for treatment of chronic tinnitus patients are combined. Starting with taking chronic tinnitus patients' case history, special attention should be paid to comorbid mental disorders.

  19. Factors influencing tinnitus loudness and annoyance.

    Science.gov (United States)

    Hiller, Wolfgang; Goebel, Gerhard

    2006-12-01

    To evaluate the 2 major components of tinnitus severity, loudness and annoyance, and their degree of dependence on characteristics of tinnitus manifestation, history, and etiology. Cross-sectional survey performed during the first months of 2004. Nonclinical population. A total of 4995 members of the German Tinnitus League. Comprehensive screening questionnaire, including the Klockhoff and Lindblom loudness grading system and the miniversion of the Tinnitus Questionnaire. A moderate correlation of 0.45 was found between tinnitus loudness and annoyance. Both factors were generally higher in men, those older than 50 years, those with binaural and centrally perceived tinnitus, those with increased noise sensitivity, and those who had continuous tinnitus without interruptions. Tinnitus that lasted 12 months or less had a stronger influence on annoyance (odds ratio [OR], 1.96) than on loudness (OR, 0.45), whereas the contrary was found for tinnitus of more than 5 years' duration (ORs, 0.72 and 2.11, respectively). Loudness and annoyance were increased in subjects with coexisting hearing loss, vertigo, and hyperacusis. The impact of hyperacusis on annoyance was clearly stronger than on loudness (ORs, 21.91 vs 9.47). Several clinical factors of tinnitus influence perceived loudness and annoyance. Both are distinguishable components of tinnitus severity.

  20. 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.

  1. Passing otoacustic emissions as a complementar method in the topodiagnosis of the neurosensories hearing loss

    Directory of Open Access Journals (Sweden)

    Franceschi, Cacineli Marion de

    2010-03-01

    Full Text Available Introduction: To evaluate the otoacustic emissions (EOAETs in patients with neurosensory hearing loss do not belong to the clinical routine. However it would obtain valuables information concerning the topodiagnosis. Objective: To identify signs of retro cochlear alteration in individuals with neurosensory dysacusis diagnosis. Method: A transversal, observational, quantitative and, prospective study. Were analyzed 34 patients' records of users of the Speech Therapy Attendance Service. In the study were included individuals with neurosensory hearing loss of moderate to deep degree. An evaluation of Passing Otoacustic Emissions (EOAETs was performed in all the individuals of the sample. Those that do not presented EOAETs had the external and middle ear' condition evaluates through meatoscopy and tympanometry to eliminate ears with sings of conductive alteration. Results: Before that the exclusion criteria were applied, they have remained 13 individuals, totalizing 26 ears: four with hearing loss of moderate degree (15%, four with moderately severe degree (15%, two with severe degree (8%, 15 with deep degree (58% and, one with deafness (4%. The tympanometric curves found were 22 (85% Type A and, four (15% Type C. It was verified the presence of EOAETs in only two ears (8% of a same individual. Conclusion: It was verified the predominance of the EOAETs absence in individuals with neurosensory hearing loss of moderate to deep degree. In one case the EOAETs were registered, that suggest retrocochlear alteration. Raising suspicion of retrocochlear alterations.

  2. Applied neuroanatomy elective to reinforce and promote engagement with neurosensory pathways using interactive and artistic activities.

    Science.gov (United States)

    Dao, Vinh; Yeh, Pon-Hsiu; Vogel, Kristine S; Moore, Charleen M

    2015-01-01

    One in six Americans is currently affected by neurologic disease. As the United States population ages, the number of neurologic complaints is expected to increase. Thus, there is a pressing need for more neurologists as well as more neurology training in other specialties. Often interest in neurology begins during medical school, so improving education in medical neural courses is a critical step toward producing more neurologists and better neurology training in other specialists. To this end, a novel applied neuroanatomy elective was designed at the University of Texas Health Science Center at San Antonio (UTHSCSA) to complement the traditional first-year medical neuroscience course and promote engagement and deep learning of the material with a focus on neurosensory pathways. The elective covered four neurosensory modalities (proprioception/balance, vision, auditory, and taste/olfaction) over four sessions, each with a short classroom component and a much longer activity component. At each session, students reviewed the neurosensory pathways through structured presentations and then applied them to preplanned interactive activities, many of which allowed students to utilize their artistic talents. Students were required to complete subjective pre-course and post-course surveys and reflections. The survey results and positive student comments suggest that the elective was a valuable tool when used in parallel with the traditional medical neuroscience course in promoting engagement and reinforcement of the neurosensory material. © 2014 American Association of Anatomists.

  3. Treatment of severe tinnitus.

    Science.gov (United States)

    Laurikainen, E; Johansson, R; Akaan-Penttilä, E; Haapaniemi, J

    2000-01-01

    In 1995-96 we selected a group of 26 patients who were suffering from severe invalidating idiopathic tinnitus (IT) in order to evaluate the efficacy of rehabilitation and some alternative therapies. All patients were assessed thoroughly by means of audiology and radiology regarding any objective cause for the symptom. In order to help patients control their symptom by increasing knowledge and adding supportive elements, they were given basic education (presentations of the anatomy and physiology of the ear and hearing system, psychological and social aspects of IT, guided and non-guided group discussions, relaxation therapy, physiotherapy, music therapy) for 4 months, comprising one 2-h session bi-weekly. This type of group therapy was found to be extremely helpful, although no objective evaluation revealed effects on IT sensation (VAS) or psychometric measures (SLC-90). In a second limb of the study, the same patients attended a 6-day intensive course in a spa. The purpose was to evaluate the possible usefulness of the widely recommended alternative therapies for IT. All patients had an opportunity to sample the treatments. Six months later only a few had tried any of these treatments, but all reported that the lessons were the most helpful in association with supportive group discussions. The results indicated that none of these therapies can be recommended, based on rational medical practise.

  4. 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

  5. Psychoacoustic Tinnitus Loudness and Tinnitus-Related Distress Show Different Associations with Oscillatory Brain Activity

    Science.gov (United States)

    Balkenhol, Tobias; Wallhäusser-Franke, Elisabeth; Delb, Wolfgang

    2013-01-01

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

  6. 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“.

  7. Reduced volume of Heschl's gyrus in tinnitus.

    Science.gov (United States)

    Schneider, Peter; Andermann, Martin; Wengenroth, Martina; Goebel, Rainer; Flor, Herta; Rupp, André; Diesch, Eugen

    2009-04-15

    The neural basis of tinnitus is unknown. Recent neuroimaging studies point towards involvement of several cortical and subcortical regions. Here we demonstrate that tinnitus may be associated with structural changes in the auditory cortex. Using individual morphological segmentation, the medial partition of Heschl's gyrus (mHG) was studied in individuals with and without chronic tinnitus using magnetic resonance imaging. Both the tinnitus and the non-tinnitus group included musicians and non-musicians. Patients exhibited significantly smaller mHG gray matter volumes than controls. In unilateral tinnitus, this effect was almost exclusively seen in the hemisphere ipsilateral to the affected ear. In bilateral tinnitus, mHG volume was substantially reduced in both hemispheres. The tinnitus-related volume reduction was found across the full extent of mHG, not only in the high-frequency part usually most affected by hearing loss-induced deafferentation. However, there was also evidence for a relationship between volume reduction and hearing loss. Correlations between volume and hearing level depended on the subject group as well as the asymmetry of the hearing loss. The volume changes observed may represent antecedents or consequences of tinnitus and tinnitus-associated hearing loss and also raise the possibility that small cortical volume constitutes a vulnerability factor.

  8. Cochlear changes in presbycusis with tinnitus.

    Science.gov (United States)

    Terao, Kyoichi; Cureoglu, Sebahattin; Schachern, Patricia A; Morita, Norimasa; Nomiya, Shigenobu; Deroee, Armin F; Doi, Katsumi; Mori, Kazunori; Murata, Kiyotaka; Paparella, Michael M

    2011-01-01

    The pathophysiology of tinnitus is obscure and its treatment is therefore elusive. Significant progress in this field can only be achieved by determining the mechanisms of tinnitus generation, and thus, histopathologic findings of the cochlea in presbycusis with tinnitus become crucial. We revealed the histopathologic findings of the cochlea in subjects with presbycusis and tinnitus. The subjects were divided into 2 groups, presbycusis with tinnitus (tinnitus) group and presbycusis without tinnitus (control) group, with each group comprising 8 temporal bones from 8 subjects. We quantitatively analyzed the number of spiral ganglion cells, loss of cochlear inner and outer hair cells, and areas of the stria vascularis and spiral ligament. There was a significantly greater loss of outer hair cells in the tinnitus group compared with the control group in the basal and upper middle turns. The stria vascularis was more atrophic in the tinnitus group compared with the control group in the basal turn. Tinnitus is more common in patients with presbycusis who have more severe degeneration of outer hair cells and stria vascularis. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2001-06-01

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

  10. Potential Audiological and MRI Markers of Tinnitus.

    Science.gov (United States)

    Gopal, Kamakshi V; Thomas, Binu P; Nandy, Rajesh; Mao, Deng; Lu, Hanzhang

    2017-09-01

    Subjective tinnitus, or ringing sensation in the ear, is a common disorder with no accepted objective diagnostic markers. The purpose of this study was to identify possible objective markers of tinnitus by combining audiological and imaging-based techniques. Case-control studies. Twenty adults drawn from our audiology clinic served as participants. The tinnitus group consisted of ten participants with chronic bilateral constant tinnitus, and the control group consisted of ten participants with no history of tinnitus. Each participant with tinnitus was closely matched with a control participant on the basis of age, gender, and hearing thresholds. Data acquisition focused on systematic administration and evaluation of various audiological tests, including auditory-evoked potentials (AEP) and otoacoustic emissions, and magnetic resonance imaging (MRI) tests. A total of 14 objective test measures (predictors) obtained from audiological and MRI tests were subjected to statistical analyses to identify the best predictors of tinnitus group membership. The least absolute shrinkage and selection operator technique for feature extraction, supplemented by the leave-one-out cross-validation technique, were used to extract the best predictors. This approach provided a conservative model that was highly regularized with its error within 1 standard error of the minimum. The model selected increased frontal cortex (FC) functional MRI activity to pure tones matching their respective tinnitus pitch, and augmented AEP wave N₁ amplitude growth in the tinnitus group as the top two predictors of tinnitus group membership. These findings suggest that the amplified responses to acoustic signals and hyperactivity in attention regions of the brain may be a result of overattention among individuals that experience chronic tinnitus. These results suggest that increased functional MRI activity in the FC to sounds and augmented N₁ amplitude growth may potentially be the objective diagnostic

  11. When Your Child Has Tinnitus

    Science.gov (United States)

    ... tinnitus occurs on a regular basis, with sound therapy the child’s nervous system can adapt to the condition. The sound can be environmental, such as a fan or quiet background music. Have hearing-impaired children wear hearing aids. A ...

  12. Cognitive behavioural therapy for tinnitus.

    Science.gov (United States)

    Martinez Devesa, P; Waddell, A; Perera, R; Theodoulou, M

    2007-01-24

    Tinnitus is an auditory perception that can be described as the experience of sound, in the ear or in the head, in the absence of external acoustic stimulation (not usually audible to anyone else). At present no specific therapy for tinnitus is acknowledged to be satisfactory in all patients. Cognitive behavioural therapy (CBT) uses relaxation, cognitive restructuring of the thoughts and exposure to exacerbating situations in order to promote habituation and may benefit tinnitus patients, as may the treatment of associated psychological conditions. To assess whether cognitive behavioural therapy is effective in the management of patients suffering from tinnitus. Our search included the Cochrane ENT Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2006), MEDLINE and EMBASE. The last search date was June 2006. Randomised controlled trials in which patients with unilateral or bilateral tinnitus as main symptom received cognitive behavioural treatment. One review author (PMD) assessed every report identified by the search strategy. The four review authors assessed the methodological quality, applied inclusion/exclusion criteria and extracted data. Six trials comprising 285 participants were included. 1. subjective tinnitus loudness. CBT compared to a waiting list control group: we found no significant difference (Standardised Mean Difference (SMD) 0.06 (95% CI -0.25 to 0.37)). CBT compared to another intervention (Yoga, Education, Minimal Contact - Education and Education): we found no significant difference (SMD 0.1 (95% CI -0.22 to 0.42)).2. a) Depression. CBT compared to a waiting list control group: we found no significant difference in either group (SMD 0.29 (95%CI -0.04 to 0.63)). CBT compared to another intervention (Yoga, Education and Minimal Contact - Education): we found no significant difference (SMD 0.01 (95% CI -0.43 to 0.45)). b) Quality of life: CBT compared to a waiting list control

  13. Outpatient Tinnitus Clinic, Self-Help Web Platform, or Mobile Application to Recruit Tinnitus Study Samples?

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    Thomas Probst

    2017-04-01

    Full Text Available For understanding the heterogeneity of tinnitus, large samples are required. However, investigations on how samples recruited by different methods differ from each other are lacking. In the present study, three large samples each recruited by different means were compared: N = 5017 individuals registered at a self-help web platform for tinnitus (crowdsourcing platform Tinnitus Talk, N = 867 users of a smart mobile application for tinnitus (crowdsensing platform TrackYourTinnitus, and N = 3786 patients contacting an outpatient tinnitus clinic (Tinnitus Center of the University Hospital Regensburg. The three samples were compared regarding age, gender, and duration of tinnitus (month or years perceiving tinnitus; subjective report using chi-squared tests. The three samples significantly differed from each other in age, gender and tinnitus duration (p < 0.05. Users of the TrackYourTinnitus crowdsensing platform were younger, users of the Tinnitus Talk crowdsourcing platform had more often female gender, and users of both newer technologies (crowdsourcing and crowdsensing had more frequently acute/subacute tinnitus (<3 months and 4–6 months as well as a very long tinnitus duration (>20 years. The implications of these findings for clinical research are that newer technologies such as crowdsourcing and crowdsensing platforms offer the possibility to reach individuals hard to get in contact with at an outpatient tinnitus clinic. Depending on the aims and the inclusion/exclusion criteria of a given study, different recruiting strategies (clinic and/or newer technologies offer different advantages and disadvantages. In general, the representativeness of study results might be increased when tinnitus study samples are recruited in the clinic as well as via crowdsourcing and crowdsensing.

  14. Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

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    Berthold Langguth

    2017-08-01

    Full Text Available BackgroundBoth clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics.MethodThe Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches.ResultsData from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general, and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache.ConclusionThe observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.

  15. [Good practices with tinnitus in adult].

    Science.gov (United States)

    Le Pajolec, Christine; Ohresser, Martine; Nevoux, Jérome

    2017-11-01

    The interrogation is essential to trace the genesis of the tinnitus and to appreciate its repercussion. Clinical examination should look for a local, vascular or cervical cause. The ENT consultation with audiogram and tinnitus evaluation is essential to know the characteristics of the tinnitus and to consider the treatment. If tinnitus is accompanied by a decrease in hearing, then wearing hearing aids can correct deafness and decrease the tinnitus. The psychological impact of tinnitus must always be taken into account and the use of a multidisciplinary team is an interesting solution. Medical treatments are not very effective; on the other hand psychotherapies (CBT, TRT and sophrology) bring a real improvement. The doctor's speech must always be supportive and provide therapeutic hope. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Evaluación de la hiperbilirrubinemia como factor de riesgo de hipoacusia neurosensorial en el programa de screening universal de hipoacusia infantil del Complejo Hospitalario Universitario Universitario Insular Materno Infantil de Gran Canaria ente los años 2007 al 2011

    OpenAIRE

    Corujo Santana, Cándido

    2014-01-01

    Programa de doctorado: Avances en Traumatología, Medicina del Deporte y Cuidados de Heridas. [ES] La bilirrubina es un pigmento altamente tóxico para los sitemas biológicos, especialmente para el sistema nervioso. El Joint Committee on Infant Heraing, en 1994, establece la lista de patologías en las que la incidencia de hipoacusia es mayor que las de la población general. En España, la CODEPEH ha confeccionado una lista de indicadores de riesgo (actualizada en 2010) que, cuando estén prese...

  17. Somatosensory tinnitus: Current evidence and future perspectives

    Science.gov (United States)

    Greco, Antonio; Turchetta, Rosaria; Altissimi, Giancarlo; de Vincentiis, Marco; Cianfrone, Giancarlo

    2017-01-01

    In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach. PMID:28553764

  18. History of the Tinnitus Research Consortium.

    Science.gov (United States)

    Snow, James B

    2016-04-01

    This article describes the creation and accomplishments of the Tinnitus Research Consortium (TRC), founded and supported through philanthropy and intended to enrich the field of tinnitus research. Bringing together a group of distinguished auditory researchers, most of whom were not involved in tinnitus research, over the fifteen years of its life it developed novel research approaches and recruited a number of new investigators into the field. The purpose of this special issue is to highlight some of the significant accomplishments of the investigators supported by the TRC. This article is part of a Special Issue entitled "Tinnitus". Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Somatosensory tinnitus: Current evidence and future perspectives.

    Science.gov (United States)

    Ralli, Massimo; Greco, Antonio; Turchetta, Rosaria; Altissimi, Giancarlo; de Vincentiis, Marco; Cianfrone, Giancarlo

    2017-06-01

    In some individuals, tinnitus can be modulated by specific maneuvers of the temporomandibular joint, head and neck, eyes, and limbs. Neuroplasticity seems to play a central role in this capacity for modulation, suggesting that abnormal interactions between the sensory modalities, sensorimotor systems, and neurocognitive and neuroemotional networks may contribute to the development of somatosensory tinnitus. Current evidence supports a link between somatic disorders and higher modulation of tinnitus, especially in patients with a normal hearing threshold. Patients with tinnitus who have somatic disorders seems to have a higher chance of modulating their tinnitus with somatic maneuvers; consistent improvements in tinnitus symptoms have been observed in patients with temporomandibular joint disease following targeted therapy for temporomandibular disorders. Somatosensory tinnitus is often overlooked by otolaryngologists and not fully investigated during the diagnostic process. Somatic disorders, when identified and treated, can be a valid therapeutic target for tinnitus; however, somatic screening of subjects for somatosensory tinnitus is imperative for correct selection of patients who would benefit from a multidisciplinary somatic approach.

  20. Quinine-induced tinnitus in rats.

    Science.gov (United States)

    Jastreboff, P J; Brennan, J F; Sasaki, C T

    1991-10-01

    Quinine ingestion reportedly induces tinnitus in humans. To expand our salicylate-based animal model of tinnitus, a series of conditioned suppression experiments was performed on 54 male-pigmented rats using quinine injections to induce tinnitus. Quinine induced changes in both the extent of suppression and recovery of licking, which followed a pattern that paralleled those produced after salicylate injections, and which may be interpreted as the result of tinnitus perception in animals. These changes depended on the dose and time schedule of quinine administration. Additionally, the calcium channel blocker, nimodipine, abolished the quinine-induced effect in a dose-dependent manner.

  1. Transition from Acute to Chronic Tinnitus: Predictors for the Development of Chronic Distressing Tinnitus

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    Elisabeth Wallhäusser-Franke

    2017-11-01

    Full Text Available BackgroundAcute tinnitus and its transition to chronic tinnitus are poorly investigated, and factors associated with amelioration versus exacerbation are largely unknown. Aims of this study were to identify early predictors for the future development of tinnitus severity.MethodPatients with tinnitus of no longer than 4 weeks presenting at an otolaryngologist filled out questionnaires at inclusion (T1, as well as 3 (T3, and 6 months (T4 after tinnitus onset. 6 weeks after onset, an interview was conducted over the phone (T2. An audiogram was taken at T1, perceived tinnitus loudness, and tinnitus-related distress were assessed separately and repeatedly together with oversensitivity to external sounds and the levels of depression and anxiety. Furthermore, coping strategies with illness were recorded.ResultsComplete remission until T4 was observed in 11% of the 47 participants, while voiced complaints at onset were stable in the majority. In the subgroup with a relevant level of depression at T1, tinnitus-related distress worsened in 30% until T4. For unilateral tinnitus, perceived loudness in the chronic condition correlated strongly with hearing loss at 2 kHz on the tinnitus ear, while a similar correlation was not found for tinnitus located to both ears or within the head.ConclusionResults suggest early manifestation of tinnitus complaints, and stress the importance of screening all patients presenting with acute tinnitus for levels of depression and tinnitus-related distress. Furthermore, hearing levels should be monitored, and use of hearing aids should be considered to reduce tinnitus loudness after having ascertained that sound sensitivity is within normal range.

  2. Does stapes surgery improve tinnitus in patients with otosclerosis?

    Science.gov (United States)

    Ismi, Onur; Erdogan, Osman; Yesilova, Mesut; Ozcan, Cengiz; Ovla, Didem; Gorur, Kemal

    Otosclerosis (OS) is the primary disease of the human temporal bone characterized by conductive hearing loss and tinnitus. The exact pathogenesis of tinnitus in otosclerosis patients is not known and factors affecting the tinnitus outcome in otosclerosis patients are still controversial. To find the effect of stapedotomy on tinnitus for otosclerosis patients. Fifty-six otosclerosis patients with preoperative tinnitus were enrolled to the study. Pure tone average Air-Bone Gap values, preoperative tinnitus pitch, Air-Bone Gap closure at tinnitus frequencies were evaluated for their effect on the postoperative outcome. Low pitch tinnitus had more favorable outcome compared to high pitch tinnitus (p=0.002). Postoperative average pure tone thresholds Air-Bone Gap values were not related to the postoperative tinnitus (p=0.213). There was no statistically significant difference between postoperative Air-Bone Gap closure at tinnitus frequency and improvement of high pitch tinnitus (p=0.427). There was a statistically significant difference between Air-Bone Gap improvement in tinnitus frequency and low pitch tinnitus recovery (p=0.026). Low pitch tinnitus is more likely to be resolved after stapedotomy for patients with otosclerosis. High pitch tinnitus may not resolve even after closure of the Air-Bone Gap at tinnitus frequencies. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. 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

  4. Relationship between Audiometric Slope and Tinnitus Pitch in Tinnitus Patients: Insights into the Mechanisms of Tinnitus Generation

    Science.gov (United States)

    Schecklmann, Martin; Vielsmeier, Veronika; Steffens, Thomas; Landgrebe, Michael; Langguth, Berthold; Kleinjung, Tobias

    2012-01-01

    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 affect this

  5. [Cerebral hemodynamics in patients with neurosensory hearing loss before and after magnetotherapy].

    Science.gov (United States)

    Morenko, V M; Enin, I P

    2001-01-01

    Magnetotherapy effects on cerebral hemodynamics were studied using rheoencephalography (REG). When the treatment results and changes in cerebral hemodynamics were compared it was evident that normalization or improvement of vascular status in vertebrobasilar and carotid territories registered at REG results in better hearing. This confirms the role of vascular factor in pathogenesis of neurosensory hypoacusis of different etiology and effectiveness of magnetotherapy in such patients.

  6. Association between sleep disorders, hyperacusis and tinnitus: Evaluation with tinnitus questionnaires

    Directory of Open Access Journals (Sweden)

    Alessandra B Fioretti

    2013-01-01

    Full Text Available Patients with tinnitus are heterogeneous and several factors influence the impact of this symptom on the quality of life. The aim of the study is to evaluate the relationship between age, gender, sleep disorders, hyperacusis and tinnitus annoyance and to demonstrate the utility of tinnitus questionnaires as screening tools for sleep disorders and hyperacusis in patients with tinnitus. 37 consecutive patients (18 males and 19 females with subjective tinnitus lasting over 3 months were evaluated with a complete interview, otological examination, pure tone audiometry, Italian version of tinnitus sample case history (TSCH and tinnitus handicap inventory (THI. Statistical analysis was performed with the Wilcoxon′s rank sum test, the Spearman′s rho non-parametric correlation and the logistic regression analysis. THI grades were slight (16%, mild (32%, moderate (30%, severe (19% and catastrophic (3%. Based on the answers to TSCH 20 patients reported sleep disorders (54% and 20 patients reported hyperacusis (54%. 11 patients (30% reported sleep disorders and hyperacusis. No significant correlation was found between the severity of tinnitus and patients′ age and gender. Significant correlation was found between sleep disorders (P = 0.0009 and tinnitus annoyance and between hyperacusis (P = 0.03 and tinnitus annoyance. TSCH and THI may be considered as screening tools in the clinical practice to evidence sleep disorders and hyperacusis in patients with tinnitus.

  7. Neurosensory sequelae assessed by thermal and vibrotactile perception thresholds after local cold injury.

    Science.gov (United States)

    Carlsson, Daniel; Burström, Lage; Lilliesköld, Victoria Heldestad; Nilsson, Tohr; Nordh, Erik; Wahlström, Jens

    2014-01-01

    Local freezing cold injuries are common in the north and sequelae to cold injury can persist many years. Quantitative sensory testing (QST) can be used to assess neurosensory symptoms but has previously not been used on cold injury patients. To evaluate neurosensory sequelae after local freezing cold injury by thermal and vibrotactile perception thresholds and by symptom descriptions. Fifteen patients with a local freezing cold injury in the hands or feet, acquired during military training, were studied with QST by assessment of vibrotactile (VPT), warmth (WPT) and cold (CPT) perception thresholds 4 months post-injury. In addition, a follow-up questionnaire, focusing on neurovascular symptoms, was completed 4 months and 4 years post-injury. QST demonstrated abnormal findings in one or both affected hands for VPT in 6 patients, for WPT in 4 patients and for CPT in 1 patient. In the feet, QST was abnormal for VPT in one or both affected feet in 8 patients, for WPT in 6 patients and for CPT in 4 patients. Freezing cold injury related symptoms, e.g. pain/discomfort when exposed to cold, cold sensation and white fingers were common at 4 months and persisted 4 years after the initial injury. Neurosensory sequelae after local freezing cold injury, in terms of abnormal thermal and/or vibration perception thresholds, may last at least 4 months after the initial injury. Symptoms such as pain/discomfort at cold exposure, cold sensations and white fingers may persist at least 4 years after the initial injury.

  8. Evaluation of a compact tinnitus therapy by electrophysiological tinnitus decompensation measures.

    Science.gov (United States)

    Low, Yin Fen; Argstatter, Heike; Bolay, Hans Volker; Strauss, Daniel J

    2008-01-01

    Large-scale neural correlates of the tinnitus decompensation have been identified by using wavelet phase stability criteria of single sweep sequences of auditory late responses (ALRs). Our previous work showed that the synchronization stability in ALR sequences might be used for objective quantification of the tinnitus decompensation and attention which link to Jastreboff tinnitus model. In this study, we intend to provide an objective evaluation for quantifying the effect of music therapy in tinnitus patients. We examined neural correlates of the attentional mechanism in single sweep sequences of ALRs in chronic tinnitus patients who underwent compact therapy course by using the maximum entropy auditory paradigm. Results by our measure showed that the extent of differentiation between attended and unattended conditions improved significantly after the therapy. It is concluded that the wavelet phase synchronization stability of ALRs single sweeps can be used for the objective evaluation of tinnitus therapies, in this case the compact tinnitus music therapy.

  9. Tinnitus sensitization: Sensory and psychophysiological aspects of a new pathway of acquired centralization of chronic tinnitus.

    Science.gov (United States)

    Zenner, Hans P; Pfister, Markus; Birbaumer, Niels

    2006-12-01

    Acquired centralized tinnitus (ACT) is the most frequent form of chronic tinnitus. The proposed ACT sensitization (ACTS) assumes a peripheral initiation of tinnitus whereby sensitizing signals from the auditory system establish new neuronal connections in the brain. Consequently, permanent neurophysiological malfunction within the information-processing modules results. Successful treatment has to target these malfunctioning information processing. We present in this study the neurophysiological and psychophysiological aspects of a recently suggested neurophysiological model, which may explain the symptoms caused by central cognitive tinnitus sensitization. Although conditioned reflexes, as a causal agent of chronic tinnitus, respond to extinction procedures, sensitization may initiate a vicious circle of overexcitation of the auditory system, resisting extinction and habituation. We used the literature database as indicated under "References" covering English and German works. For the ACTS model we extracted neurophysiological hypotheses of the auditory stimulus processing and the neuronal connections of the central auditory system with other brain regions to explain the malfunctions of auditory information processing. The model does not assume information-processing changes specific for tinnitus but treats the processing of tinnitus signals comparable with the processing of other external stimuli. The model uses the extensive knowledge available on sensitization of perception and memory processes and highlights the similarities of tinnitus with central neuropathic pain. Quality, validity, and comparability of the extracted data were evaluated by peer reviewing. Statistical techniques were not used. According to the tinnitus sensitization model, a tinnitus signal originates (as a type I-IV tinnitus) in the cochlea. In the brain, concerned with perception and cognition, the 1) conditioned associations, as postulated by the tinnitus model of Jastreboff, and the 2

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

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    Peter M Kreuzer

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

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

    Science.gov (United States)

    Kreuzer, Peter M; Landgrebe, Michael; Schecklmann, Martin; Staudinger, Susanne; Langguth, Berthold

    2012-01-01

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

  12. 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.

  13. The cochlear implant as a tinnitus treatment.

    Science.gov (United States)

    Vallés-Varela, Héctor; Royo-López, Juan; Carmen-Sampériz, Luis; Sebastián-Cortés, José M; Alfonso-Collado, Ignacio

    2013-01-01

    Tinnitus is a symptom of high prevalence in patients with cochlear pathology. We studied the evolution of tinnitus in patients undergoing unilateral cochlear implantation for treatment of profound hearing loss. This was a longitudinal, retrospective study of patients that underwent unilateral cochlear implantation and who had bilateral tinnitus. Tinnitus was assessed quantitatively and qualitatively before surgery and at 6 and 12 months after surgery. We evaluated 20 patients that underwent unilateral cochlear implantation with a Nucleus(®) CI24RE Contour Advance™ electrode device. During the periods in which the device was in operation, improvement or disappearance of tinnitus was evidenced in the ipsilateral ear in 65% of patients, and in the contralateral ear, in 50%. In periods in which the device was disconnected, improvement or disappearance of tinnitus was found in the ipsilateral ear in 50% of patients, and in the ear contralateral to the implant in 45% of the patients. In 10% of the patients, a new tinnitus appeared in the ipsilateral ear. The patients with profound hearing loss and bilateral tinnitus treated with unilateral cochlear implantation improved in a high percentage of cases, in the ipsilateral ear and in the contralateral ear. Copyright © 2012 Elsevier España, S.L. All rights reserved.

  14. The Role of Trace Elements in Tinnitus.

    Science.gov (United States)

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

    2017-03-01

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

  15. Using therapeutic sound with progressive audiologic tinnitus management.

    Science.gov (United States)

    Henry, James A; Zaugg, Tara L; Myers, Paula J; Schechter, Martin A

    2008-09-01

    Management of tinnitus generally involves educational counseling, stress reduction, and/or the use of therapeutic sound. This article focuses on therapeutic sound, which can involve three objectives: (a) producing a sense of relief from tinnitus-associated stress (using soothing sound); (b) passively diverting attention away from tinnitus by reducing contrast between tinnitus and the acoustic environment (using background sound); and (c) actively diverting attention away from tinnitus (using interesting sound). Each of these goals can be accomplished using three different types of sound-broadly categorized as environmental sound, music, and speech-resulting in nine combinations of uses of sound and types of sound to manage tinnitus. The authors explain the uses and types of sound, how they can be combined, and how the different combinations are used with Progressive Audiologic Tinnitus Management. They also describe how sound is used with other sound-based methods of tinnitus management (Tinnitus Masking, Tinnitus Retraining Therapy, and Neuromonics).

  16. TINNITUS WHAT AND WHERE: AN ECOLOGICAL FRAMEWORK

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    Grant Donald Searchfield

    2014-12-01

    Full Text Available Tinnitus is an interaction of the environment, cognition and plasticity. The connection between the individual with tinnitus and their world seldom receives attention in neurophysiological research. As well as changes in cell excitability, an individual’s culture and beliefs, work and social environs may all influence how tinnitus is perceived. In this review an ecological framework for current neurophysiological evidence is considered. The model defines tinnitus as the perception of an auditory object in the absence of an acoustic event. It is hypothesized that following deafferentation: adaptive feature extraction, schema and semantic object formation processes lead to tinnitus in a manner predicted by Adaptation Level Theory (1, 2. Evidence from physiological studies are compared to the tenants of the proposed ecological model. The consideration of diverse events within an ecological context may unite seemingly disparate neurophysiological models.

  17. Behavioral measures of tinnitus in laboratory animals.

    Science.gov (United States)

    Turner, Jeremy G

    2007-01-01

    The fact that so little is currently known about the pathophysiology of tinnitus is no doubt partly due to the relatively slow development of an animal model. Not until the work of Jastreboff et al. (1988a, b) did tinnitus researchers have at their disposal a method of determining whether their animals experienced tinnitus. Since then, a variety of additional animal models have been developed. Each of these models will be summarized in this chapter. It is becoming increasingly clear that in order to study tinnitus effectively, researchers need some verification that a drug, noise exposure or other manipulation is causing tinnitus in their animals. As this review will highlight, researchers now have a variety of behavioral options available to them.

  18. Does tinnitus distress depend on age of onset?

    OpenAIRE

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

    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...

  19. 22B. Integrative Therapy for Patients With Severe Tinnitus

    OpenAIRE

    Kosey, Julie; Wolever, Ruth

    2013-01-01

    Focus Area: Integrative Approaches to Care Tinnitus is a common problem for which there is no universally effective treatment. The best available estimates indicate that 10% to 15% of adults report having tinnitus symptoms, but only 20% of those who report tinnitus suffer from it and subsequently seek treatment. Individuals with persistent severe tinnitus are unable to habituate to the tinnitus sound that most likely originates in the central auditory system (CAS) in response to peripheral in...

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Circulating steroids negatively correlate with tinnitus.

    Science.gov (United States)

    Chrbolka, Pavel; Palúch, Zoltán; Hill, Martin; Alušík, Štefan

    2017-07-01

    While not a disease entity in itself; symptoms of tinnitus (from Latin tinnio - clink) accompany a number of diseases. Tinnitus prevalence increases with age, deteriorates one's quality of life, and may even result in suicidal behavior. Tinnitus develops in response to a variety of risk factors, otoxic substances, noise exposure, hearing disorders, and psychological alterations. Tinnitus is closely related to mood, depression, and psychological state. In the present study, we focused on alterations of the steroid metabolome and particularly neuroactive, neuroprotective, and immunomodulatory steroids in patients with tinnitus. The study group consisted of 28 patients without evidence of an organic cause of tinnitus as well as without associated diseases or the effect of ototoxic medications. All patients underwent a complete audiological assessment and laboratory tests including routine biochemical markers and quantification of circulating steroids using gas chromatography/mass spectrometry and immunoassays. To rule out a pathology in the cerebellopontine angle area, CT scan or MRI were performed. To diagnose stem lesions, evoked potentials were also measured. Pearson's correlations and multivariate regression were used to assess any links between tinnitus intensity and frequency on the one hand, and steroid levels on the other. Results indicated a significant and consistent negative correlation between tinnitus indices and intensity of adrenal steroidogenesis. The circulating steroid metabolome including hormones and neuroactive, neuroprotective, and immunomodulatory steroids negatively correlates with the degree of tinnitus due to hypothalamo-pituitary-adrenal axis malfunction. Our results may help explain the pathophysiology of tinnitus and improve its diagnosis. However, further studies are needed to verify our postulation. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Improving the Reliability of Tinnitus Screening in Laboratory Animals.

    Science.gov (United States)

    Jones, Aikeen; May, Bradford J

    2017-02-01

    Behavioral screening remains a contentious issue for animal studies of tinnitus. Most paradigms base a positive tinnitus test on an animal's natural tendency to respond to the "sound" of tinnitus as if it were an actual sound. As a result, animals with tinnitus are expected to display sound-conditioned behaviors when no sound is present or to miss gaps in background sounds because tinnitus "fills in the gap." Reliable confirmation of the behavioral indications of tinnitus can be problematic because the reinforcement contingencies of conventional discrimination tasks break down an animal's tendency to group tinnitus with sound. When responses in silence are rewarded, animals respond in silence regardless of their tinnitus status. When responses in silence are punished, animals stop responding. This study introduces stimulus classification as an alternative approach to tinnitus screening. Classification procedures train animals to respond to the common perceptual features that define a group of sounds (e.g., high pitch or narrow bandwidth). Our procedure trains animals to drink when they hear tinnitus and to suppress drinking when they hear other sounds. Animals with tinnitus are revealed by their tendency to drink in the presence of unreinforced probe sounds that share the perceptual features of the tinnitus classification. The advantages of this approach are illustrated by taking laboratory rats through a testing sequence that includes classification training, the experimental induction of tinnitus, and postinduction screening. Behavioral indications of tinnitus are interpreted and then verified by simulating a known tinnitus percept with objective sounds.

  3. 25 years of tinnitus retraining therapy.

    Science.gov (United States)

    Jastreboff, P J

    2015-04-01

    This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment is aimed to work above the tinnitus source, and at connections linking the auditory and other systems in the brain, the etiology of tinnitus is irrelevant. Any type of tinnitus, as well as somatosounds, can be successfully treated by TRT. Over 100 publications can be found on Medline when using "tinnitus retraining therapy" as a search term. The majority of these publications indicate TRT offers significant help for about 80 % of patients. A randomized clinical trial showing the effectiveness of TRT has been published and another large study is in progress. The principles of the neurophysiological model of tinnitus, and consequently TRT, have not changed in over 25 years of use, but a number of changes have been introduced in TRT implementation. These changes include the recognition of the importance of conditioned reflexes and the dominant role of the subconscious pathways; the introduction of the concept of misophonia (i.e., negative reactions to specific patterns of sound) and the implementation of specific protocols for its treatment; greater emphasis on the concurrent treatment of tinnitus, hyperacusis, misophonia, and hearing loss; extensive modification of counseling; and refinements in sound therapy. The

  4. [Chronic tinnitus in children and adolescents].

    Science.gov (United States)

    Rosanowski, F; Hoppe, U; Pröschel, U; Eysholdt, U

    1997-11-01

    The problem of tinnitus in adults is reviewed systematically in nearly all standard otolaryngology reference works, whereas textbooks and monographs that focus on pediatric otorhinolaryngology or audiology and hearing in children and adolescents provide only little information concerning the epidemiology, etiology and therapy of tinnitus. The purpose of this study was to evaluate the psychosomatic aspects of chronic tinnitus in this younger age group. A rational diagnostic approach is discussed as to which diagnostic measures are necessary in the pediatric group for deciding which therapeutic option to chose. The therapeutic outcome of tinnitus counselling in non-severe cases and of parenteral lidocaine infusions in cases of a troublesome tinnitus is presented. From January 1992 to December 1995, 31 children and adolescents in the age range from 6 to 17 years were treated for a chronic tinnitus without a measurable hearing loss. In 20 cases the tinnitus was bilateral; in 11 cases it was unilateral, without side preference. In 24 patients the case history gave no hint of a major annoyance by the tinnitus or significant psychological components. In these cases tinnitus counselling was carried out. In 7 cases-3 girls and 4 boys in the age range from 10 to 17 years-the kind and grade of symptom satisfied the ICD-10 criteria of a depressive episode. These patients were hospitalized for 10 days and a lidocaine infusion therapy (2 mg/kg Xylocain Cor in 500 ml HAES 6%) was performed as treatment for the somatic component of the disorder. Data were analyzed catamnestically using the patients' files. In all cases normal hearing threshold and speech intelligibility were ascertained by pure-tone and speech audiometry. Auditory evoked brainstem potentials gave no further information. The measurement of transient evoked otoacoustic emissions gave no consistent results in either of the two groups. Tinnitus measurement and audiometric masking could only be carried out in patients

  5. Tinnitus: Network pathophysiology-network pharmacology

    Directory of Open Access Journals (Sweden)

    Ana Belen eElgoyhen

    2012-01-01

    Full Text Available Tinnitus, the phantom perception of sound, is a prevalent disorder. One in 10 adults has clinically significant subjective tinnitus, and for 1 in 100, tinnitus severely affects their quality of life. Despite the significant unmet clinical need for a safe and effective drug targeting tinnitus relief, there is currently not a single FDA-approved drug on the market. The search for drugs that target tinnitus is hampered by the lack of a deep knowledge of the underlying neural substrates of this pathology. Recent studies are increasingly demonstrating that, as described for other central nervous system disorders, tinnitus is a pathology of brain networks. The application of graph theoretical analysis to brain networks has recently provided new information concerning their topology, their robustness and their vulnerability to attacks. Moreover, the philosophy behind drug design and pharmacotherapy in central nervous system pathologies is changing from that of magic bullets that target individual chemoreceptors or disease-causing genes into that of magic shotguns, promiscuous or dirty drugs that target disease-causing networks, also known as network pharmacology. In the present work we provide some insight into how this knowledge could be applied to tinnitus pathophysiology and pharmacotherapy.

  6. Tinnitus: network pathophysiology-network pharmacology.

    Science.gov (United States)

    Elgoyhen, Ana B; Langguth, Berthold; Vanneste, Sven; De Ridder, Dirk

    2012-01-01

    Tinnitus, the phantom perception of sound, is a prevalent disorder. One in 10 adults has clinically significant subjective tinnitus, and for one in 100, tinnitus severely affects their quality of life. Despite the significant unmet clinical need for a safe and effective drug targeting tinnitus relief, there is currently not a single Food and Drug Administration (FDA)-approved drug on the market. The search for drugs that target tinnitus is hampered by the lack of a deep knowledge of the underlying neural substrates of this pathology. Recent studies are increasingly demonstrating that, as described for other central nervous system (CNS) disorders, tinnitus is a pathology of brain networks. The application of graph theoretical analysis to brain networks has recently provided new information concerning their topology, their robustness and their vulnerability to attacks. Moreover, the philosophy behind drug design and pharmacotherapy in CNS pathologies is changing from that of "magic bullets" that target individual chemoreceptors or "disease-causing genes" into that of "magic shotguns," "promiscuous" or "dirty drugs" that target "disease-causing networks," also known as network pharmacology. In the present work we provide some insight into how this knowledge could be applied to tinnitus pathophysiology and pharmacotherapy.

  7. [Neurofeedback therapy in the treatment of tinnitus].

    Science.gov (United States)

    Zhao, Z Q; Lei, G X; Li, Y L; Zhang, D; Shen, W D; Yang, S M; Qiao, Y H

    2018-02-01

    Neurofeedback therapy is a fast-growing field of tinnitus treatment, which is a new type of biofeedback therapy. In the past, the "muscle tone" and "blood flow" were used as feedback signals in biofeedback therapy to treat tinnitus, however there was no long-term follow-up report. Instead, neurofeedback therapy utilizes EEG (electroencephalogram) as the feedback signal, which is also called EEG biofeedback therapy. At present, most treatments of tinnitus only record subjective measures of patients as evaluation indicators, whereas neurofeedback therapy is more convincing for using comprehensive evaluation including changes of brain wave as objective indicators and subjective measures of patients. A significant number of tinnitus patients have varying degree of hearing loss. As neurofeedback therapy takes advantage of EEG as feedback signal that is delivered to the patients through visual information, it has unique advantages of being not affected by the degree of hearing loss compared to the sound masking or other sound treatment. Long-term follow-up results showed that the efficacy of neurofeedback therapy was stable after half a year of short-term treatment. This paper summarizes the progress of the various types of biofeedback therapy in the treatment of tinnitus, and focuses on the neurofeedback therapy for the mechanism, indication, process, efficacy evaluation, defect and prospect of neurofeedback therapy in tinnitus treatment in order to help promote the development of domestic clinical neurofeedback therapy in tinnitus.

  8. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress.

    OpenAIRE

    McKenna, L.; Handscomb, L. E.; Hoare, D.; Hall, D.

    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...

  9. A scientific cognitive behavioral model of tinnitus: novel conceptualizations of tinnitus distress

    OpenAIRE

    Laurence eMcKenna; Lucy eHandscomb; Lucy eHandscomb; Lucy eHandscomb; Derek eHoare; Derek eHoare; Deborah eHall; Deborah eHall

    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...

  10. 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...

  11. Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus.

    Science.gov (United States)

    Gun, Taylan; Özkan, Selçuk; Yavuz, Bunyamin

    2018-04-23

    Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1-5). This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason.

  12. Effects of serum zinc level on tinnitus.

    Science.gov (United States)

    Berkiten, Güler; Kumral, Tolgar Lütfi; Yıldırım, Güven; Salturk, Ziya; Uyar, Yavuz; Atar, Yavuz

    2015-01-01

    The aim of this study was to assess zinc levels in tinnitus patients, and to evaluate the effects of zinc deficiency on tinnitus and hearing loss. One-hundred patients, who presented to an outpatient clinic with tinnitus between June 2009 and 2014, were included in the study. Patients were divided into three groups according to age: Group I (patients between 18 and 30years of age); Group II (patients between 31 and 60years of age); and Group III (patients between 61 and 78years of age). Following a complete ear, nose and throat examination, serum zinc levels were measured and the severity of tinnitus was quantified using the Tinnitus Severity Index Questionnaire (TSIQ). Patients were subsequently asked to provide a subjective judgment regarding the loudness of their tinnitus. The hearing status of patients was evaluated by audiometry and high-frequency audiometry. An average hearing sensitivity was calculated as the mean value of hearing thresholds between 250 and 20,000Hz. Serum zinc levels between 70 and 120μg/dl were considered normal. The severity and loudness of tinnitus, and the hearing thresholds of the normal zinc level and zinc-deficient groups, were compared. Twelve of 100 (12%) patients exhibited low zinc levels. The mean age of the zinc-deficient group was 65.41±12.77years. Serum zinc levels were significantly lower in group III (p<0.01). The severity and loudness of tinnitus were greater in zinc-deficient patients (p=0.011 and p=0.015, respectively). Moreover, the mean thresholds of air conduction were significantly higher in zinc-deficient patients (p=0.000). We observed that zinc levels decrease as age increases. In addition, there was a significant correlation between zinc level and the severity and loudness of tinnitus. Zinc deficiency was also associated with impairments in hearing thresholds. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Therapy of unspecific tinnitus without organic cause.

    Science.gov (United States)

    Frank, Wilhelm; Konta, Brigitte; Seiler, Gerda

    2006-08-30

    There is a variety of medical and non-medical therapies in practice, which were not evaluated regarding its effectiveness by any systematic evidence oriented investigation. A number of therapies of medical and non-medical type try to treat the different types of tinnitus. The evidence in the scientific literature also had to be cleared in the field of diagnosis and classification as well as medical/psychiatric/psychological procedures of existing medical therapy. The HTA report had to investigate the following questions: Which evidence do diagnostic methods in recognition of tinnitus have? Which types of therapy show medical effectiveness at the acute or chronic tinnitus without an organic cause? Which consequences (need for further research, future procedures) can be drawn? In the following databases "tinnitus" was searched according to the search string: HTA97; INAHTA; CDAR94; CDSR93; CCTR93; ME66; ME0A; HT83; SM78; CA66; CB85; BA70; BA93; EM74; IS74; ET80; EB94; IA70; AZ72; CV72; GE79; EU93; HN69; ED93; EA08 1932 studies, unsorted after assessment in accordance with EBM criterions, selection: 409 studies. Due to the completely heterogeneous representation modes of the therapeutic approaches at the treatment of the chronic tinnitus no quantitative synthesis method could be performed. Therefore the methodology of a qualitative overview has been carried out. The diagnostic confirmation of the non-specific tinnitus without organic cause meets with the problem of the assurance of the diagnosis tinnitus. According to the current opinion the stepwise diagnostics is carried out also in the case of the so called subjective tinnitus. Nothing can be said about the evidence of these procedures since no publication was found about that. A study concerning the evidence of the diagnostic questionnaires from Goebel and Hiller [1] comes to the end that the tinnitus questionnaire frequently used (TF) [2] is the best evaluated procedure. The number of therapies which treat

  14. The use of flupirtine in treatment of tinnitus.

    Science.gov (United States)

    Salembier, L; De Ridder, D; Van de Heyning, P H

    2006-12-01

    Flupirtine, a functional NMDA antagonist, does not seem to be efficacious in the treatment of tinnitus. The purpose of this study was to investigate whether flupirtine has any beneficial effect on tinnitus perception. Twenty-four patients were selected (6 female and 18 male patients) with continuous subjective tinnitus. Eight patients suffered left-sided tinnitus, 4 right-sided tinnitus and 12 bilateral tinnitus. We assessed the burden of the tinnitus by loudness visual analogue scale (VAS) and tinnitus questionnaire (TQ) according to Hallam et al., and Hiller and Goebel. All patients were treated with a 2 x 100 mg daily dosage of oral flupirtine for 3 weeks in an open prospective design. There was no statistical effect on VAS and TQ of the treatment with flupirtine. Only one patient (4.2%) experienced a positive effect on the tinnitus but discontinued the treatment because of amnesia and concentration disorders.

  15. Factors related to tinnitus and hyperacusis handicap in older people.

    Science.gov (United States)

    Aazh, Hashir; Lammaing, Karen; Moore, Brian C J

    2017-09-01

    The aim was to assess factors related to tinnitus and hyperacusis handicap in older people. Retrospective cross-sectional. Data were gathered for 184 patients with an average age of 69 years. Tinnitus handicap as measured via the Tinnitus Handicap Inventory (THI) was significantly predicted by tinnitus annoyance as measured via the visual analogue scale (VAS) (regression coefficient, b = 2.9, p tinnitus on the patient's life as measured via the VAS (b = 3.9, p tinnitus annoyance significantly predicts tinnitus handicap, it is important to explore factors associated with annoyance that may be useful in designing appropriate rehabilitative interventions aimed at reducing tinnitus handicap in older people. Future studies should explore whether hyperacusis and insomnia in older people with tinnitus need to be managed in conjunction with treatment for depression.

  16. The prognostic value of histopathology on lingual nerve neurosensory recovery after micro-neurosurgery

    DEFF Research Database (Denmark)

    Hørberg, Mette; Reibel, Jesper; Kragelund, Camilla

    2016-01-01

    OBJECTIVE: Micro-neurosurgical repair is considered in permanent nerve damage but the outcome is unpredictable. We examined if histopathologic parameters of traumatic neuromas have a prognostic value for recovery in relation to lingual nerve micro-neurosurgery. MATERIALS AND METHODS: Retrospective...... case study on neurosensory recovery after micro-neurosurgery. Outcome variables were as follows: pain perception, two-point discrimination, and sum score of perception, before and 12 months after micro-neurosurgery. Predictive histopathology variables included size, nerve tissue, and inflammation...

  17. A mitochondrial tRNA(His) gene mutation causing pigmentary retinopathy and neurosensorial deafness.

    Science.gov (United States)

    Crimi, M; Galbiati, S; Perini, M P; Bordoni, A; Malferrari, G; Sciacco, M; Biunno, I; Strazzer, S; Moggio, M; Bresolin, N; Comi, G P

    2003-04-08

    We have identified a heteroplasmic G to A mutation at position 12,183 of the mitochondrial transfer RNA Histidine (tRNA(His)) gene in three related patients. These phenotypes varied according to mutation heteroplasmy: one had severe pigmentary retinopathy, neurosensorial deafness, testicular dysfunction, muscle hypotrophy, and ataxia; the other two had only retinal and inner ear involvement. The mutation is in a highly conserved region of the T(psi)C stem of the tRNA(His) gene and may alter secondary structure formation. This is the first described pathogenic, maternally inherited mutation of the mitochondrial tRNA(His) gene.

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

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    Henning Teismann

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

  19. Does tinnitus distress depend on age of onset?

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    Winfried Schlee

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

  20. Does tinnitus distress depend on age of onset?

    Science.gov (United States)

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

    2011-01-01

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

  1. Does Tinnitus Distress Depend on Age of Onset?

    Science.gov (United States)

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

    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 studies indicate that the amount of tinnitus distress is associated with many factors including comorbid anxiety, comorbid depression, personality, the psychosocial situation, the amount of the related hearing loss and the loudness of the tinnitus. Furthermore, theoretical considerations suggest an impact of the age at tinnitus onset influencing tinnitus distress. Methods Based on a sample of 755 normal hearing tinnitus patients we tested this assumption. All participants answered a questionnaire on the amount of tinnitus distress together with a large variety of clinical and demographic data. Results Patients with an earlier onset of tinnitus suffer significantly less than patients with an onset later in life. Furthermore, patients with a later onset of tinnitus describe their course of tinnitus distress as more abrupt and distressing right from the beginning. Conclusion We argue that a decline of compensatory brain plasticity in older age accounts for this age-dependent tinnitus decompensation. PMID:22125612

  2. Neural plasticity and its initiating conditions in tinnitus.

    Science.gov (United States)

    Roberts, L E

    2018-03-01

    Deafferentation caused by cochlear pathology (which can be hidden from the audiogram) activates forms of neural plasticity in auditory pathways, generating tinnitus and its associated conditions including hyperacusis. This article discusses tinnitus mechanisms and suggests how these mechanisms may relate to those involved in normal auditory information processing. Research findings from animal models of tinnitus and from electromagnetic imaging of tinnitus patients are reviewed which pertain to the role of deafferentation and neural plasticity in tinnitus and hyperacusis. Auditory neurons compensate for deafferentation by increasing their input/output functions (gain) at multiple levels of the auditory system. Forms of homeostatic plasticity are believed to be responsible for this neural change, which increases the spontaneous and driven activity of neurons in central auditory structures in animals expressing behavioral evidence of tinnitus. Another tinnitus correlate, increased neural synchrony among the affected neurons, is forged by spike-timing-dependent neural plasticity in auditory pathways. Slow oscillations generated by bursting thalamic neurons verified in tinnitus animals appear to modulate neural plasticity in the cortex, integrating tinnitus neural activity with information in brain regions supporting memory, emotion, and consciousness which exhibit increased metabolic activity in tinnitus patients. The latter process may be induced by transient auditory events in normal processing but it persists in tinnitus, driven by phantom signals from the auditory pathway. Several tinnitus therapies attempt to suppress tinnitus through plasticity, but repeated sessions will likely be needed to prevent tinnitus activity from returning owing to deafferentation as its initiating condition.

  3. Tinnitus: an epidemiologic study in Iranian population.

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    Maryam Jalessi

    2013-12-01

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

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

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    David Riedl

    2015-01-01

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

  5. 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.

  6. 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.

  7. Tinnitus and its radiological diagnosis and therpy

    International Nuclear Information System (INIS)

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

    1987-01-01

    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. (orig.) [de

  8. Resolution of neurosensory deficit after mandibular orthognathic surgery: A prospective longitudinal study.

    Science.gov (United States)

    Alolayan, Albraa Badr; Leung, Yiu Yan

    2017-05-01

    To investigate the longitudinal resolution of neurosensory deficit (NSD) and the possible risk factors that might contribute to NSD following mandibular orthognathic procedures. A prospective longitudinal observational study on patients who had mandibular orthognathic procedures was performed. Standardized neurosensory assessments were performed. The 2 years longitudinal resolution and risk factors of NSD including patients' age and gender, specific mandibular procedures and surgeons' experience were analyzed. 66 patients (44 females) with 132 sides of mandibular procedures were enrolled in the study. Surgical procedures included mandibular ramus surgery, anterior mandibular surgery, or the combination of the two. The overall occurrences of subjective NSD improved from 78.8% at postoperative 2 weeks to 13.8% at post-operative 2 years. Combinations of ramus surgery and anterior mandibular surgery increased the risk of NSD at the first three post-operative months (p orthognathic surgery. The occurrence of NSD after mandibular orthognathic procedures reduced progressively within the post-operative 2 years. Combination of mandibular ramus surgery and anterior mandibular surgery increased the risk of NSD in the early post-operative period. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  9. Neurosensory and vascular function after 14 months of military training comprising cold winter conditions.

    Science.gov (United States)

    Carlsson, Daniel; Pettersson, Hans; Burström, Lage; Nilsson, Tohr; Wahlström, Jens

    2016-01-01

    This study aimed to examine the effects of 14 months of military training comprising cold winter conditions on neurosensory and vascular function in the hands and feet. Military conscripts (N=54) were assessed with quantitative sensory testing comprising touch, temperature, and vibration perception thresholds and finger systolic blood pressure (FSBP) after local cooling and a questionnaire on neurosensory and vascular symptoms at both baseline and follow-up. Ambient air temperature was recorded with body worn temperature loggers. The subjects showed reduced sensitivity to perception of touch, warmth, cold and vibrations in both the hands and feet except from vibrotactile perception in digit two of the right hand (right dig 2). Cold sensations, white fingers, and pain/discomfort when exposed to cold as well as pain increased in both prevalence and severity. There were no statistically significant changes in FSBP after local cooling. Fourteen months of winter military training comprising cold winter conditions reduced sensation from touch, warmth, cold, and vibrotactile stimulus in both hands and feet and increased the severity and prevalence of symptoms and pain. The vascular function in the hands, measured by FSBP after local cooling, was not affected.

  10. Tinnitus and Sleep Difficulties After Cochlear Implantation.

    Science.gov (United States)

    Pierzycki, Robert H; Edmondson-Jones, Mark; Dawes, Piers; Munro, Kevin J; Moore, David R; Kitterick, Pádraig T

    To estimate and compare the prevalence of and associations between tinnitus and sleep difficulties in a sample of UK adult cochlear implant users and those identified as potential candidates for cochlear implantation. The study was conducted using the UK Biobank resource, a population-based cohort of 40- to 69-year olds. Self-report data on hearing, tinnitus, sleep difficulties, and demographic variables were collected from cochlear implant users (n = 194) and individuals identified as potential candidates for cochlear implantation (n = 211). These "candidates" were selected based on (i) impaired hearing sensitivity, inferred from self-reported hearing aid use and (ii) impaired hearing function, inferred from an inability to report words accurately at negative signal to noise ratios on an unaided closed-set test of speech perception. Data on tinnitus (presence, persistence, and related distress) and on sleep difficulties were analyzed using logistic regression models controlling for gender, age, deprivation, and neuroticism. The prevalence of tinnitus was similar among implant users (50%) and candidates (52%; p = 0.39). However, implant users were less likely to report that their tinnitus was distressing at its worst (41%) compared with candidates (63%; p = 0.02). The logistic regression model suggested that this difference between the two groups could be explained by the fact that tinnitus was less persistent in implant users (46%) compared with candidates (72%; p reported difficulties with sleep were similar among implant users (75%) and candidates (82%; p = 0.28), but participants with tinnitus were more likely to report sleep difficulties than those without (p explanation is supported by the similar prevalence of sleep problems among implant users and potential candidates for cochlear implantation, despite differences between the groups in tinnitus persistence and related emotional distress. Cochlear implantation may therefore not be an appropriate intervention

  11. Tinnitus: clinical experience of the psychosomatic connection

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    Salviati M

    2014-02-01

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

  12. Interaction of tinnitus suppression and hearing ability after cochlear implantation.

    Science.gov (United States)

    Wang, Qian; Li, Jia-Nan; Lei, Guan-Xiong; Chen, Dai-Shi; Wang, Wei-Ze; Chen, Ai-Ting; Mong, Meng-Di; Li, Sun; Jiao, Qing-Shan; Yang, Shi-Ming

    2017-10-01

    To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on. Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients' satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score. With CI 'OFF', 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI 'ON' in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI 'ON' in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p tinnitus. The tinnitus loudness may affect patients' satisfaction with the use of CI.

  13. 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.

    2016-01-01

    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, we used two resting-state functional connectivity (RSFC) approaches 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. PMID:27091485

  14. Electrical stimulation and tinnitus: neuroplasticity, neuromodulation, neuroprotection.

    Science.gov (United States)

    Abraham, Shulman; Barbara, Goldstein; Arnold, Strashun

    2013-01-01

    Neuroplasticity (NPL), neuromodulation (NM), and neuroprotection (NPT) are ongoing biophysiological processes that are linked together in sensory systems, the goal being the maintenance of a homeostasis of normal sensory function in the central nervous system. It is hypothesized that when the balance between excitatory - inhibitory action is broken in sensory systems, predominantly due to neuromodulatory activity with reduced induced inhibition and excitation predominates, sensory circuits become plastic with adaptation at synaptic levels to environmental inputs(1). Tinnitus an aberrant auditory sensation, for all clinical types, is clinically considered to reflect a failure of NPL, NM, and NPT to maintain normal auditory function at synaptic levels in sensory cortex and projected to downstream levels in the central auditory system in brain and sensorineural elements in ear. Clinically, the tinnitus sensation becomes behaviorally manifest with varying degrees of annoyance, reflecting a principle of sensory physiology that each sensation has components, i.e. sensory, affect/behavior, psychomotor and memory. Modalities of tinnitus therapies, eg instrumentation, pharmacology, surgery, target a particular component of tinnitus, with resultant activation of neuromodulators at multiple neuromodulatory centers in brain and ear. Effective neuromodulation at sensory neuronal synaptic levels results in NPL in sensory cortex, NPT and tinnitus relief. Functional brain imaging, metabolic (PET brain) and electrophysiology quantitative electroencephalography (QEEG) data in a cochlear implant soft failure patient demonstrates what is clinically considered to reflect NPL, NM, NPT. The reader is provided with a rationale for tinnitus diagnosis and treatment, with a focus on ES, reflecting the biology underlying NPL, NM, NPT.

  15. Tinnitus Retraining Therapy (TRT) as a method for treatment of tinnitus and hyperacusis patients.

    Science.gov (United States)

    Jastreboff, P J; Jastreboff, M M

    2000-03-01

    The aim of this paper is to provide information about the neurophysiologic model of tinnitus and Tinnitus Retraining Therapy (TRT). With this overview of the model and therapy, professionals may discern with this basic foundation of knowledge whether they wish to pursue learning and subsequently implement TRT in their practice. This paper provides an overview only and is insufficient for the implementation of TRT.

  16. Tinnitus. I: Auditory mechanisms: a model for tinnitus and hearing impairment.

    Science.gov (United States)

    Hazell, J W; Jastreboff, P J

    1990-02-01

    A model is proposed for tinnitus and sensorineural hearing loss involving cochlear pathology. As tinnitus is defined as a cortical perception of sound in the absence of an appropriate external stimulus it must result from a generator in the auditory system which undergoes extensive auditory processing before it is perceived. The concept of spatial nonlinearity in the cochlea is presented as a cause of tinnitus generation controlled by the efferents. Various clinical presentations of tinnitus and the way in which they respond to changes in the environment are discussed with respect to this control mechanism. The concept of auditory retraining as part of the habituation process, and interaction with the prefrontal cortex and limbic system is presented as a central model which emphasizes the importance of the emotional significance and meaning of tinnitus.

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

    Science.gov (United States)

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

    2007-01-01

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

  18. 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....

  19. Characteristics of tinnitus in adolescents and association with psychoemotional factors.

    Science.gov (United States)

    Kim, So Young; Jeon, Yung Jin; Lee, Jun-Young; Kim, Young Ho

    2017-09-01

    The characteristics and underlying mechanisms of tinnitus remain more elusive in the pediatric population than in adults. We investigated the prevalence of tinnitus, its characteristics, and associated factors, with a focus on psychoemotional problems in adolescents. Cross-sectional study METHODS: In total, 962 adolescents were surveyed for tinnitus and possibly related otologic and socioeconomic factors. The participants completed a visual analog scale (VAS) pertaining to various aspects of tinnitus, as well as the Tinnitus Handicap Inventory, Children's Depression Inventory (CDI), State Anxiety Inventory for Children, Trait Anxiety Inventory for Children (TAIC), Internet Addiction Test, Conners' Abbreviated Parent Rating Scale, and a learning disability score. Characteristics of tinnitus were analyzed, and psychoemotional and other factors were compared between tinnitus and nontinnitus groups. Approximately one-third of subjects reported experiencing tinnitus. A family history of tinnitus, subjective hearing loss, dizziness, and CDI and TAIC abnormalities were significantly associated with tinnitus. In the tinnitus-always group, tinnitus showed significant relationships with subjective hearing loss, bilateral tinnitus, and VAS, CDI, and TAIC scores. The results suggest that about one-third of adolescents experience tinnitus, which may be related to psychoemotional factors. In particular, anxiety and depression may be important factors to consider in managing tinnitus in adolescents. Further study of tinnitus in adolescents, including efforts toward diagnosis and management, is needed to determine whether there is a causal relationship with anxiety and depression, and the extent to which adverse outcomes may be associated with these psychoemotional factors. 4 Laryngoscope, 127:2113-2119, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Prevention and Treatment of Noise-Induced Tinnitus

    Science.gov (United States)

    2014-09-01

    Tinnitus PRINCIPAL INVESTIGATOR: Dr. Richard A. Altschuler CONTRACTING ORGANIZATION: University of Michigan REPORT DATE: 2014...3 Ju 2014 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Prevention and Treatment of Noise-Induced Tinnitus 5b. GRANT NUMBER 5c. PROGRAM...prevent or treat noise induced tinnitus . Our studies showed a military relevant small arms fire-like noise will induce tinnitus in approximately 33

  1. Continued expression of GATA3 is necessary for cochlear neurosensory development.

    Directory of Open Access Journals (Sweden)

    Jeremy S Duncan

    Full Text Available Hair cells of the developing mammalian inner ear are progressively defined through cell fate restriction. This process culminates in the expression of the bHLH transcription factor Atoh1, which is necessary for differentiation of hair cells, but not for their specification. Loss of several genes will disrupt ear morphogenesis or arrest of neurosensory epithelia development. We previously showed in null mutants that the loss of the transcription factor, Gata3, results specifically in the loss of all cochlear neurosensory development. Temporal expression of Gata3 is broad from the otic placode stage through the postnatal ear. It therefore remains unclear at which stage in development Gata3 exerts its effect. To better understand the stage specific effects of Gata3, we investigated the role of Gata3 in cochlear neurosensory specification and differentiation utilizing a LoxP targeted Gata3 line and two Cre lines. Foxg1(Cre∶Gata3(f/f mice show recombination of Gata3 around E8.5 but continue to develop a cochlear duct without differentiated hair cells and spiral ganglion neurons. qRT-PCR data show that Atoh1 was down-regulated but not absent in the duct whereas other hair cell specific genes such as Pou4f3 were completely absent. In addition, while Sox2 levels were lower in the Foxg1(Cre:Gata3(f/f cochlea, Eya1 levels remained normal. We conclude that Eya1 is unable to fully upregulate Atoh1 or Pou4f3, and drive differentiation of hair cells without Gata3. Pax2-Cre∶Gata3(f/f mice show a delayed recombination of Gata3 in the ear relative to Foxg1(Cre:Gata3(f/f . These mice exhibited a cochlear duct containing patches of partially differentiated hair cells and developed only few and incorrectly projecting spiral ganglion neurons. Our conditional deletion studies reveal a major role of Gata3 in the signaling of prosensory genes and in the differentiation of cochlear neurosenory cells. We suggest that Gata3 may act in combination with Eya1, Six1, and

  2. Characteristics of somatic tinnitus patients with and without hyperacusis.

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    Massimo Ralli

    Full Text Available Determine if somatic tinnitus patients with hyperacusis have different characteristics from those without hyperacusis.172 somatic tinnitus patients with (n = 82 and without (n = 90 hyperacusis referred to the Tinnitus Unit of Sapienza University of Rome between June 2012 and June 2016 were compared for demographic characteristics, tinnitus features, self-administered questionnaire scores, nature of somatic modulation and history.Compared to those without hyperacusis, patients with somatic tinnitus and hyperacusis: (a were older (43.38 vs 39.12 years, p = 0.05, (b were more likely to have bilateral tinnitus (67.08% vs 55.56%, p = 0.04, (c had a higher prevalence of somatic modulation of tinnitus (53.65% vs 36.66%, p = 0.02 and (d scored significantly worse on tinnitus annoyance (39.34 vs 22.81, p<0.001 and subjective hearing level (8.04 vs 1.83, p<0.001.Our study shows significantly higher tinnitus modulation and worse self-rating of tinnitus and hearing ability in somatic tinnitus patients with hyperacusis versus somatic tinnitus patients without hyperacusis. These differences could prove useful in developing a better understanding of the pathophysiology and establishing a course of treatment for these two groups of patients.

  3. Cluster Analysis to Identify Possible Subgroups in Tinnitus Patients

    NARCIS (Netherlands)

    van den Berge, Minke J. C.; Free, Rolien H.; Arnold, Rosemarie; de Kleine, Emile; Hofman, Rutger; van Dijk, J. Marc C.; van Dijk, Pim

    2017-01-01

    Introduction: In tinnitus treatment, there is a tendency to shift from a "one size fits all" to a more individual, patient-tailored approach. Insight in the heterogeneity of the tinnitus spectrum might improve the management of tinnitus patients in terms of choice of treatment and identification of

  4. 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

  5. 77 FR 22324 - Scientific Information Request on Treatment of Tinnitus

    Science.gov (United States)

    2012-04-13

    ... Information Request on Treatment of Tinnitus AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS... Tinnitus, which is currently being conducted by the Evidence-based Practice Centers for the AHRQ Effective... effectiveness review of the evidence for evaluation and treatment of tinnitus. The EHC Program is dedicated to...

  6. Psychological and audiological correlates of perceived tinnitus severity.

    Science.gov (United States)

    Erlandsson, S I; Hallberg, L R; Axelsson, A

    1992-01-01

    Beliefs and attitudes towards tinnitus have been found to play an important role in the process of rehabilitation. The relationship between audiological, psychological and psychosomatic factors (self-assessment of vertigo and headache and the perceived severity of tinnitus) was investigated in a clinical population of 163 subjects. Audiological descriptives comprised pure-tone average (dB HL), etiology of hearing loss, duration of tinnitus and tinnitus localisation. Perceived severity of tinnitus was assessed with a questionnaire focusing on tinnitus impact on aspects of quality of life, concentration and sleep. A 28-item handicap and support questionnaire was used and factor analysed, resulting in three factors: perceived attitudes, social support and disability/handicap. Tinnitus severity was significantly related to perceived attitudes. The influence of social support on tinnitus severity did not seem to be crucial. The results showed that significantly more women than men complained about vertigo. Unilateral tinnitus localisation was also more prevalent in females. The subjects with multiple tinnitus localisations were older and had significantly more sleep disturbance than subjects with tinnitus localized to the ears only. In accordance with previously reported observations, the frequency of headaches was strongly correlated with the severity of tinnitus.

  7. Clinical characteristics of patients with tinnitus evaluated with the Tinnitus Sample Case History Questionnaire in Japan: A case series.

    Directory of Open Access Journals (Sweden)

    Takashi Kojima

    Full Text Available The Tinnitus Sample Case History Questionnaire was determined as a standardized questionnaire for obtaining patient case histories and for characterizing patients into subgroups at the Tinnitus Research Initiative in 2006. In this study, we developed a Japanese version of this questionnaire for evaluating the clinical characteristics of patients with tinnitus. The Japanese version of the questionnaire will be available for evaluating treatments for tinnitus and for comparing data on tinnitus in research centers.To evaluate the clinical characteristics of patients with tinnitus in Japan using a newly developed Japanese version of Tinnitus Sample Case History Questionnaire.This was a prospective study based on patient records.University hospitals, general hospitals, and clinics.We collected patient data using a Japanese translated version of the Tinnitus Sample Case History Questionnaire. In total, 584 patients who visited our institutions in Japan between August 2012 and March 2014 were included (280 males and 304 females; age 13-92 years; mean age, 60.8. We examined patients after dividing them into two groups according to the presence or absence of hyperacusis. The collected results were compared with those from the Tinnitus Research Initiative database.Compared with the TRI database, there were significantly more elderly female patients and fewer patients with trauma-associated tinnitus. There was a statistically lower ratio of patients with hyperacusis. We found that patients with tinnitus in addition to hyperacusis had greater tinnitus severity and exhibited higher rates of various complications.The Japanese version of the Tinnitus Sample Case History Questionnaire developed in this study can be a useful tool for evaluating patients with tinnitus in Japan. The results of this multicenter study reflect the characteristics of patients with tinnitus who require medical care in Japan. Our data provides a preliminary basis for an international

  8. Tinnitus

    Science.gov (United States)

    ... be improved by a course of counseling with cognitive behavioral therapy (CBT), which usually involves a series of weekly ... with ear buds. It is difficult for a parent to monitor the level of sound exposure to ...

  9. Tinnitus

    Science.gov (United States)

    ... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  10. Change in functional connectivity in tinnitus and its relation with tinnitus laterality

    Energy Technology Data Exchange (ETDEWEB)

    Song, Eun Jee; Kim, Eui Jong; Choi, Woo Suk [Dept. of Radiology, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Ryu, Chang Woo; Jahang, Geon Ho; Park, Moon Suh; Byun, Jae Yong; Park, Soon Chan [Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

    2016-12-15

    To identify potential differences in resting-state networks according to laterality of tinnitus using resting-state functional MRI (fMRI). A total of 83 age-matched subjects consisting of 19 patients with right-sided tinnitus (Rt-T), 22 patients with left-sided tinnitus (Lt-T), 22 patients with bilateral tinnitus (Bil-T), and 20 healthy controls underwent resting-state blood oxygenation-level dependent fMRI scans. Independent component analysis was used to obtain the functional connectivities in the auditory network (AN) and the default mode network (DMN), which were compared between each group using the voxel-wise one-way ANOVA. In addition, lateralization of the auditory cortex was assessed within each group using a region of interest (ROI). Comparisons between tinnitus groups showed unusual clusters with different functional connectivities in the AN and the DMN. The Rt-T group had large clusters with higher functional connectivity in the right middle temporal gyrus and temporopolar area compared with the Lt-/Bil-T and control groups. ROI analysis showed that the Rt-/Lt-T groups had dominant functional connectivity in the right auditory cortex and the Bil-T and control groups had left-dominant auditory connectivity. These results suggest that chronic tinnitus is related to aberrant laterality of the auditory cortex. These findings help clarify the neural mechanism of tinnitus and specify the targets for localization of treatment.

  11. A scientific cognitive behavioral model of tinnitus: novel conceptualizations of tinnitus distress

    Directory of Open Access Journals (Sweden)

    Laurence eMcKenna

    2014-10-01

    Full Text Available 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 critically reviewed. The model posits that patients’ interpretations of tinnitus and the changes in behavior that result are given a central role in creating and maintaining distress. The importance of selective attention and the possibility that this leads to distorted perception of tinnitus is highlighted. From this body of evidence, we propose a coherent cognitive behavioral model of tinnitus distress that is more in keeping with contemporary psychological theories of clinical problems (particularly that of insomnia and which postulates a number of behavioral processes that are seen as cognitively mediated. This new model provides testable hypotheses to guide future research to unravel the complex mechanisms underpinning tinnitus distress. It is also well suited to define individual symptomatology and to provide a framework for the delivery of cognitive behavior therapy.

  12. Change in functional connectivity in tinnitus and its relation with tinnitus laterality

    International Nuclear Information System (INIS)

    Song, Eun Jee; Kim, Eui Jong; Choi, Woo Suk; Ryu, Chang Woo; Jahang, Geon Ho; Park, Moon Suh; Byun, Jae Yong; Park, Soon Chan

    2016-01-01

    To identify potential differences in resting-state networks according to laterality of tinnitus using resting-state functional MRI (fMRI). A total of 83 age-matched subjects consisting of 19 patients with right-sided tinnitus (Rt-T), 22 patients with left-sided tinnitus (Lt-T), 22 patients with bilateral tinnitus (Bil-T), and 20 healthy controls underwent resting-state blood oxygenation-level dependent fMRI scans. Independent component analysis was used to obtain the functional connectivities in the auditory network (AN) and the default mode network (DMN), which were compared between each group using the voxel-wise one-way ANOVA. In addition, lateralization of the auditory cortex was assessed within each group using a region of interest (ROI). Comparisons between tinnitus groups showed unusual clusters with different functional connectivities in the AN and the DMN. The Rt-T group had large clusters with higher functional connectivity in the right middle temporal gyrus and temporopolar area compared with the Lt-/Bil-T and control groups. ROI analysis showed that the Rt-/Lt-T groups had dominant functional connectivity in the right auditory cortex and the Bil-T and control groups had left-dominant auditory connectivity. These results suggest that chronic tinnitus is related to aberrant laterality of the auditory cortex. These findings help clarify the neural mechanism of tinnitus and specify the targets for localization of treatment

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Therapy of unspecific tinnitus without organic cause

    Directory of Open Access Journals (Sweden)

    Seiler, Gerda

    2006-08-01

    Full Text Available Introduction: There is a variety of medical and non-medical therapies in practice, which were not evaluated regarding its effectiveness by any systematic evidence oriented investigation. A number of therapies of medical and non-medical type try to treat the different types of tinnitus. The evidence in the scientific literature also had to be cleared in the field of diagnosis and classification as well as medical/psychiatric/psychological procedures of existing medical therapy. Question: The HTA report had to investigate the following questions: * Which evidence do diagnostic methods in recognition of tinnitus have? * Which types of therapy show medical effectiveness at the acute or chronic tinnitus without an organic cause? * Which consequences (need for further research, future procedures can be drawn? Methodology: In the following databases "tinnitus" was searched according to the search string:HTA97; INAHTA; CDAR94; CDSR93; CCTR93; ME66; ME0A; HT83; SM78; CA66; CB85; BA70; BA93; EM74; IS74; ET80; EB94; IA70; AZ72; CV72; GE79; EU93; HN69; ED93; EA08 Result: 1932 studies, unsorted after assessment in accordance with EBM criterions, selection: 409 studies. Due to the completely heterogeneous representation modes of the therapeutic approaches at the treatment of the chronic tinnitus no quantitative synthesis method could be performed. Therefore the methodology of a qualitative overview has been carried out. Results: The diagnostic confirmation of the non-specific tinnitus without organic cause meets with the problem of the assurance of the diagnosis tinnitus. According to the current opinion the stepwise diagnostics is carried out also in the case of the so called subjective tinnitus. Nothing can be said about the evidence of these procedures since no publication was found about that. A study concerning the evidence of the diagnostic questionnaires from Goebel and Hiller [1] comes to the end that the tinnitus questionnaire frequently used (TF [2

  15. ACR Appropriateness Criteria® Tinnitus.

    Science.gov (United States)

    Kessler, Marcus M; Moussa, Marwan; Bykowski, Julie; Kirsch, Claudia F E; Aulino, Joseph M; Berger, Kevin L; Choudhri, Asim F; Fife, Terry D; Germano, Isabelle M; Kendi, A Tuba; Kim, Jeffrey H; Luttrull, Michael D; Nunez, Diego; Shah, Lubdha M; Sharma, Aseem; Shetty, Vilaas S; Symko, Sophia C; Cornelius, Rebecca S

    2017-11-01

    Tinnitus is the perception of sound in the absence of an external source. It is a common symptom that can be related to hearing loss and other benign causes. However, tinnitus may be disabling and can be the only symptom in a patient with a central nervous system process disorder. History and physical examination are crucial first steps to determine the need for imaging. CT and MRI are useful in the setting of pulsatile tinnitus to evaluate for an underlying vascular anomaly or abnormality. If there is concomitant asymmetric hearing loss, neurologic deficit, or head trauma, imaging should be guided by those respective ACR Appropriateness Criteria ® documents, rather than the presence of tinnitus. Imaging is not usually appropriate in the evaluation of subjective, nonpulsatile tinnitus that does not localize to one ear. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Does multi-modal cervical physical therapy improve tinnitus in patients with cervicogenic somatic tinnitus?

    Science.gov (United States)

    Michiels, S; Van de Heyning, P; Truijen, S; Hallemans, A; De Hertogh, W

    2016-12-01

    Tinnitus can be related to many different aetiologies such as hearing loss or a noise trauma, but it can also be related to the somatosensory system of the cervical spine, called cervicogenic somatic tinnitus (CST). Case studies suggest a positive effect of cervical spine treatment on tinnitus complaints in patients with CST, but no experimental studies are available. To investigate the effect of a multimodal cervical physical therapy treatment on tinnitus complaints in patients with CST. Randomized controlled trial. Patients with a combination of severe subjective tinnitus (Tinnitus Functional Index (TFI): 25-90 points) and neck complaints (Neck Bournemouth Questionnaire (NBQ) > 14 points). All patients received cervical physical therapy for 6 weeks (12 sessions). Patients were randomized in an immediate-start therapy group (n = 19) and a 6-week delayed-start therapy group (n = 19). TFI and NBQ-scores were documented at baseline, after the wait-and-see period in the delayed-start group, after treatment and after 6 weeks follow-up. The Global Perceived Effect (GPE) was documented at all measuring moments, except at baseline. In all patients (n = 38) TFI and NBQ-scores decreased significantly after treatment (p = 0.04 and p tinnitus. This effect was maintained in 24% of patients after follow-up at six weeks. Cervical physical therapy can have a positive effect on subjective tinnitus complaints in patients with a combination of tinnitus and neck complaints. Larger studies, using more responsive outcome measures, are however necessary to prove this effect. NCT02016313. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. [Tinnitus and temporomandibular joint: State of the art].

    Science.gov (United States)

    Lina-Granade, G; Truy, E; Ionescu, E; Garnier, P; Thai Van, H

    2016-12-01

    Tinnitus has been described in temporomandibular joint dysfunction for a long time. Yet, other disorders, such as hearing loss, stress, anxiety and depression, play a major role in the pathophysiology of tinnitus. Temporomandibular joint dysfunctions seem to increase the risk of tinnitus in patients with other predisposing factors. Especially somatosensory tinnitus, which is characterized by sound modulations with neck or mandible movements, is frequently associated with temporomandibular joint dysfunction, but it is not pathognomonic of such a disorder. In such cases, functional therapy of the temporomandibular joint should be part of the multidisciplinary rehabilitation of patients with tinnitus. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Lifetime leisure music exposure associated with increased frequency of tinnitus.

    Science.gov (United States)

    Moore, David R; Zobay, Oliver; Mackinnon, Robert C; Whitmer, William M; Akeroyd, Michael A

    2017-04-01

    Tinnitus has been linked to noise exposure, a common form of which is listening to music as a leisure activity. The relationship between tinnitus and type and duration of music exposure is not well understood. We conducted an internet-based population study that asked participants questions about lifetime music exposure and hearing, and included a hearing test involving speech intelligibility in noise, the High Frequency Digit Triplets Test. 4950 people aged 17-75 years completed all questions and the hearing test. Results were analyzed using multinomial regression models. High exposure to leisure music, hearing difficulty, increasing age and workplace noise exposure were independently associated with increased tinnitus. Three forms of music exposure (pubs/clubs, concerts, personal music players) did not differ in their relationship to tinnitus. More males than females reported tinnitus. The objective measure of speech reception threshold had only a minimal relationship with tinnitus. Self-reported hearing difficulty was more strongly associated with tinnitus, but 76% of people reporting usual or constant tinnitus also reported little or no hearing difficulty. Overall, around 40% of participants of all ages reported never experiencing tinnitus, while 29% reported sometimes, usually or constantly experiencing tinnitus that lasted more than 5 min. Together, the results suggest that tinnitus is much more common than hearing loss, but that there is little association between the two, especially among the younger adults disproportionately sampled in this study. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  19. Role of hearing AIDS in tinnitus intervention: a scoping review.

    Science.gov (United States)

    Shekhawat, Giriraj Singh; Searchfield, Grant D; Stinear, Cathy M

    2013-09-01

    Tinnitus can have a devastating impact on the quality of life of the sufferer. Although the mechanisms underpinning tinnitus remain uncertain, hearing loss is often associated with its onset, and hearing aids are among the most commonly used tools for its management. To conduct a scoping review to explore the role of hearing aids in tinnitus management. Scoping review based on the six-stage framework of Arksey and O'Malley (2005). Relevant studies were identified using various databases (Scopus, Google Scholar, SpringerLink, and PubMed) and hand searching of journals and a reference list of articles. Out of 277 shortlisted articles, 29 studies (18 research studies and 11 reviews) were chosen for charting of data based on their abstracts. Tinnitus assessment measures used in studies were recorded along with changes in their scores. Measures used in studies included the Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionnaire (THQ), Tinnitus Severity Index (TSI), Tinnitus Reaction Questionnaire (TRQ), German version of Tinnitus Questionnaire (TQ), Beck Depression Inventory (BDI), and visual analogue scale (VAS) of tinnitus intensity. Where possible Cohen's d effect size statistic was calculated. Although the quality of evidence for hearing aids' effect on tinnitus is not strong, the weight of evidence (17 research studies for, 1 against) suggests merit in using hearing aids for tinnitus management. The majority of studies reviewed support the use of hearing aids for tinnitus management. Clinicians should feel reassured that some evidence shows support for the use of hearing aids for treating tinnitus, but there is still a need for stronger methodology and randomized control trials. American Academy of Audiology.

  20. Sound therapy and aural rehabilitation for tinnitus: a person centred therapy framework based on an ecological model of tinnitus.

    Science.gov (United States)

    Searchfield, Grant D; Linford, Tania; Durai, Mithila

    2018-03-23

    Tinnitus is a common oto-neurological complaint often accompanying hearing loss. In this perspective on rehabilitation we describe a framework for sound therapy and aural rehabilitation of tinnitus based on the ecological model of tinnitus. A thematic network analysis-based approach was used to relate aural rehabilitation methods to the ecological model of tinnitus and the client-oriented scale of improvement in tinnitus. Aural rehabilitation methods were mapped to concepts of: (1) Context, (2) presence of sound and (3) reaction to sound. A global theme was: adaptation to sound. The framework is the result of an iterative and cumulative research program exploring tinnitus as the outcome of the relationship between individual psychoacoustics and psychosocial factors including context of perception. The intent of this framework is to help guide audiologists managing tinnitus. The framework has been useful in our clinic as illustrated by a case study. The benefits of this approach relative to standard care needs to be independently ascertained. Implications for Rehabilitation Tinnitus is a common oto-neurological complaint that when severe can be very disabling. Tinnitus is very heterogeneous as a consequence of this no one treatment is suitable for everyone. The sound therapy and aural rehabilitation for tinnitus framework is designed to assist audiologists in clinical planning that addresses individual needs. The framework is the result of an iterative and cumulative research program exploring tinnitus as the outcome of the relationship between individual psychoacoustics and psychosocial factors including context of perception.

  1. Tinnitus after administration of sublingual immunotherapy

    DEFF Research Database (Denmark)

    Juel, Jacob

    2017-01-01

    , for example, itching, swelling, irritation, ulceration of the oropharynx and nausea, abdominal pain, diarrhoea, and vomiting. More severe side effects are dominated by systemic and respiratory tract manifestations. RESULTS: In this clinical case, the author reports a right-sided transient tinnitus lasting...... for 48 h after administration of sublingual immunotherapy for house dust mite in allergic rhinitis. CONCLUSIONS: This case provide important insights for clinical practice, as tinnitus has not been previously reported as a side effect of sublingual immunotherapy with house dust mite allergens....

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

    Directory of Open Access Journals (Sweden)

    Winfried Schlee

    2016-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Martin Meyer

    2014-01-01

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

  4. Tinnitus in Temporomandibular Joint Disorders: Is it a Specific Somatosensory Tinnitus Subtype?

    Science.gov (United States)

    Algieri, Giuseppe Maria Antonio; Leonardi, Alessandra; Arangio, Paolo; Vellone, Valentino; Paolo, Carlo Di; Cascone, Piero

    2017-04-19

    The most significant otologic symptoms, consisting of ear pain, tinnitus, dizziness, hearing loss and auricolar "fullness", generally arise within the auditory system, often are associated with extra auricolar disorders, particularly disorder of the temporo-mandibular joint. In our study we examined a sample of 200 consecutive patients who had experienced severe disabling symptom. The patiens came to maxillofacial specialist assessment for temporomandibular disorder. Each patient was assessed by a detailed anamnestic and clinical temporomandibular joint examination and they are divided into five main groups according classification criteria established by Wilkes; tinnitus and subjective indicators of pain are evaluated. The results of this study provide a close correlation between the joint pathology and otologic symptoms, particularly regarding tinnitus and balance disorders, and that this relationship is greater the more advanced is the stage of joint pathology. Moreover, this study shows that TMD-related tinnitus principally affects a younger population (average fifth decade of life) and mainly women (more than 2/3 of the cases). Such evidence suggests the existence of a specific tinnitus subtype that may be defined as "TMD-related somatosensory tinnitus".

  5. Impact of identifying factors which trigger bothersome tinnitus on the treatment outcome in tinnitus retraining therapy.

    Science.gov (United States)

    Molini, Egisto; Faralli, Mario; Calzolaro, Lucia; Ricci, Giampietro

    2014-01-01

    The aim of this work was to ascertain any differences in the effectiveness of rehabilitation therapy in relation to the presence or absence of a known negative reinforcement responsible for the tinnitus-related pathology. Between 1 January 2001 and 31 December 2008, we recruited 294 subjects suffering from incapacitating tinnitus and/or hyperacusis. The patients underwent tinnitus retraining therapy (TRT) according to the methods described by Jastreboff and Hazell [Tinnitus Retraining Therapy: Implementing the Neurophysiological Model. Cambridge, Cambridge University Press, 2004, pp 121-133]. We clinically assessed the presence or absence of known phenomena of associative learning, regarding the presence of adverse events temporally correlated with tinnitus and the treatment outcome. The separate analysis of the 2 subgroups shows a statistically significant difference in the improvement rate between the group with a known triggering factor and the group without a triggering factor, with a preponderance of the former with a 91% improvement rate versus approximately 56% for the latter. In our study, the inability to identify factors triggering bothersome tinnitus negatively affected the treatment outcome in TRT. © 2014 S. Karger AG, Basel.

  6. Tinnitus-provoking salicylate treatment triggers social impairments in mice.

    Science.gov (United States)

    Guitton, Matthieu J

    2009-09-01

    Tinnitus (perception of sound in silence) strongly affects the quality of life of sufferers. Tinnitus sufferers and their relatives frequently complain about major social impairments. However, it is not known whether this impairment directly results from the occurrence of tinnitus or is the indirect expression of a preexisting psychological vulnerability. Using the well-characterized animal model of salicylate-induced tinnitus, we investigate in mice whether the occurrence of tinnitus can trigger social impairments. Experiments were performed on 32 male Balb/C mice. Tinnitus was induced in mice using salicylate treatment. Social behavior was assessed in experimental and control animals using social interaction paradigm. Interaction time, number of social events, and number of nonsocial events were assessed in all animals. We demonstrate for the first time that treatment known to induce tinnitus triggers complex social impairments in mice. While salicylate-treated animals present a massive decrease in their overall social interactions compared to control untreated animals, they also display a paradoxal increase in the number of conspecific followings. Tinnitus can thus trigger a complex set of modifications of behavior, which will not only find their expression at the individual level, but also at the social level. Our results suggest that tinnitus can directly be a cause of psychosocial impairment in human and have strong implications for the clinical management of tinnitus sufferers.

  7. Medio-lateral postural instability in subjects with tinnitus

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    Zoi eKapoula

    2011-05-01

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

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

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    Maura Regina Laureano

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

  9. 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.

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

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    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.

  11. Tinnitus and neural plasticity of the brain

    NARCIS (Netherlands)

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

    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

  12. Theoretical Tinnitus framework: A Neurofunctional Model

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    Iman Ghodratitoostani

    2016-08-01

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

  13. Theoretical Tinnitus Framework: A Neurofunctional Model.

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    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

  14. A psychometric study of complaints in chronic tinnitus.

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    Hiller, W; Goebel, G

    1992-05-01

    Dimensions of psychological complaints due to chronic and disabling tinnitus were investigated by means of the Tinnitus Questionnaire (TQ), administered to a sample of 138 tinnitus sufferers who had been admitted to a psychosomatic hospital. Factor analysis revealed that tinnitus-related patterns of emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbances, and somatic complaints can be differentiated. Cognitive distortions and inappropriate attitudes towards the tinnitus and it's personal consequences were found to be highly intercorrelated forming a subgroup within a broader and more general distress factor. The stability of the factor solution obtained was examined by systematically varying the number of factors to be extracted. Based on the results of this method, scales are proposed for the questionnaire which can be used in clinical and scientific work to specifically assess major areas of tinnitus-related distress and their degree of severity. Implications for a further evaluation of the instrument are discussed.

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

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    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

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

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    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

  17. [Differential aspects of subjective burden of tinnitus aurium].

    Science.gov (United States)

    Perrig-Chiello, P; Gusset, S

    1996-01-01

    This study focuses on psychological variables, which could influence the subjectively perceived strain of tinnitus. They concern personality traits such as self-attentiveness, control beliefs and different dimensions of psychological health. Two groups of tinnitus patients were compared, one with low subjectively perceived strain (n = 20), the other with high subjectively perceived strain (n = 30). Results reveal that people with high subjectively perceived strain do not only perceive their tinnitus more often, but they are more self-centered and report significantly more general somatic complaints than people with low subjectively perceived strain. They obviously pay more attention to themselves and as a consequence also to their tinnitus. However, we didn't find any relationship between control beliefs and subjectively perceived tinnitus strain. Furthermore, duration of the noises, their loudness, their localisation and the knowledge of the cause of tinnitus also seem to affect the perception of the noises.

  18. Evidence of psychosomatic influences in compensated and decompensated tinnitus.

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    Stobik, Corinna; Weber, Rainer K; Münte, Thomas F; Walter, Marc; Frommer, Jörg

    2005-06-01

    The purpose of this study was to evaluate the role and interaction of individual factors on decompensated tinnitus. Subjects consisted of 53 adult patients with chronic tinnitus. They were selected and assigned to two groups, compensated (n = 28) and decompensated (n = 25), according to the results of an established tinnitus questionnaire. Both groups were evaluated and compared. The patients with decompensated tinnitus suffered from more pronounced social disabilities, were more prone to depression, and used less effective techniques to cope with their illness. They showed a higher degree of somatic multimorbidity, with particularly strong correlations between tinnitus and the incidence of cardiovascular diseases and hypoacusis. As a consequence, in the psychosomatic tinnitus therapy, greater attention should be given to the treatment of the somatic complaints in addition to psychological and psychosocial aspects.

  19. Tinnitus retraining therapy--the experiences in Slovakia.

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    Suchova, L

    2005-01-01

    Since Mai 1999 Tinnitus Retraining Therapy (TRT) according to Jastreboff has been used in the management of 55 patients with tinnitus of various origin. Tinnitus isn't a disease, it is only a symptom. Therefore we needed to do an exact examination of the patient. We needed to apply causal therapy whenever it was possible. After six months of continuous therapy more than 50% patients reported improvement of tinnitus or it has disappeared. Concomitantly, we found hyperacusis, hypersensitivity to loud sounds. We could not assert that it was the cause or the consequence of the tinnitus. Considering these findings, it would appear TRT can be useful for extending the possibilities of tinnitus treatment. (Tab. 5, Fig. 1, Ref. 13.)

  20. Characteristics of the tinnitus and hyperacusis in normal hearing individuals

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    Daila Urnau1,

    2011-10-01

    Full Text Available Introduction: The tinnitus has become a common otological complaint. Another complaint is found in bearers of the tinnitus is the hyperacusis. Objective: Analyze the characteristics of tinnitus and hyperacusis in normal hearing individuals with associated complaints of tinnitus and hyperacusis. Method: 25 normal hearing individuals who complained of hyperacusis and tinnitus were surveyed in this form of cross-sectional study. They were questioned about the location and type of the tinnitus. The evaluation of the tinnitus was made using the Brazilian Tinnitus Handicap Inventory and acuphenometry. A questionnaire was made about the hyperacusis covering aspects such as: sounds considered uncomfortable, sensations in the presence of such sounds, and difficulty understanding speech in noise. Results: Of the 25 individuals, 64% were women and 36% men. Regarding tinnitus, 84% referred to bilateral location and 80% high pitch. The most common degree found was light (44%. The women presented tinnitus degree statistically superior to those of men. The strong intensity sounds and the reactions of irritation, anxiety and the need to move away from the sound were the most mentioned. From the analyzed individuals, 68% referred to difficulty understanding speech in noise and 12% reported using hearing protection. The most found frequencies at the acuphenometry were 6 and 8 KHz. Conclusion: Normal hearing individuals who complain of tinnitus and hyperacusis present mainly high pitch tinnitus, located bilaterally and light degree. The sounds considered uncomfortable were the high intensity ones and the most cited reaction to sound was irritation. The difficulty to understand speech in noise was reported by most of the individuals.

  1. 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

  2. Default, Cognitive, and Affective Brain Networks in Human Tinnitus

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-13-1-0491 TITLE: Default, Cognitive, and Affective Brain Networks in Human Tinnitus PRINCIPAL INVESTIGATOR: Jennifer R...SUBTITLE 5a. CONTRACT NUMBER Default, Cognitive and Affective Brain Networks in Human Tinnitus 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6...Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Tinnitus is a major health problem among those currently and formerly in military

  3. [The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire].

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    Goebel, G; Hiller, W

    1994-03-01

    The clinical examination of patients with severe and chronic tinnitus must include associated psychological disturbances. The present paper describes traditional diagnostic methods of ENT practice as well as the Tinnitus Questionnaire (TQ) which has been evaluated in a number of studies. This instrument differentiates between emotional and cognitive distress, auditory perceptual difficulties and self-experienced intrusiveness produced by the tinnitus. The results of a German multicenter study are presented which show that the TQ can be used to demonstrate differences of tinnitus distress under different clinical conditions (e.g., ENT clinic vs psychosomatic clinic and in- vs out-patient care). The TQ can be employed for comparative studies in different tinnitus-related institutions and for the evaluation of the relative effects of different treatment approaches.

  4. [The role of the cervical spine and the craniomandibular system in the pathogenesis of tinnitus. Somatosensory tinnitus].

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    Biesinger, E; Reisshauer, A; Mazurek, B

    2008-07-01

    The causes of tinnitus, vertigo, and hearing disturbances may be pathological processes in the cervical spine and temporomaxillary joint. In these cases, tinnitus is called somatosensory tinnitus (SST). For afferences of the cervical spine, projections of neuronal connections in the cochlear nucleus were found. A reflex-like impact of the cervical spine on the cochlear nucleus can be assumed. The tinnitus treatment concept of the Charité University Hospital in Berlin involves the cooperation of ENT specialists with many other disciplines in an outpatient clinic. A standardized examination protocol has been established, and physical therapy has been integrated into the interdisciplinary tinnitus treatment. For tinnitus-modulating therapy of muscular trigger points, local anesthetics as well as self-massage or treatment by a physiotherapist or osteopath are useful.

  5. Neuro-Music Therapy for Recent-Onset Tinnitus

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    Miriam Grapp

    2013-05-01

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

  6. [Factors influencing the pitch and loudness of tinnitus].

    Science.gov (United States)

    Ueda, S; Asoh, S; Watanabe, Y

    1992-11-01

    Pitch match and loudness balance tests were given to 397 cases with tinnitus. The factors which influenced tinnitus pitch and loudness were analyzed statistically from the clinical point of view. The results obtained were as follows: 1) Onomatopoeia of tinnitus, either [Keeeen] or [Jeeeen], were observed in a majority of cases. 2) Significantly sharp sounding onomatopoeia such as [Keeeen] or [Meeeen] had high pitches, over 4kHz, and dull sounds like [Gooooh] or [Buuuun] had low pitches, below 500Hz. 3) Acute stage tinnitus, within one month of onset, had a significantly depressed pitch and walked loudness, above 6dB. 4) The pitches observed in cases with Meniere's disease and chronic otitis media were distributed evenly from low frequencies to high. In other cases, especially presbyacusis and noise deafness, high pitch tinnitus (above 4kHz) was frequently noted. The loudness of tinnitus without hearing loss was significantly greater than in other diseases. 5) As a rule the more deteriorated the hearing level was, the lower the frequency of the pitch, and the smaller the loudness in tinnitus. 6) A high pitch of tinnitus nearly corresponded with hearing type, that is, the pitch of tinnitus was also in accordance with the disturbed frequency in the hearing threshold.

  7. Evaluation of Ecological Momentary Assessment for Tinnitus Severity.

    Science.gov (United States)

    Goldberg, Rachel L; Piccirillo, Marilyn L; Nicklaus, Joyce; Skillington, Andrew; Lenze, Eric; Rodebaugh, Thomas L; Kallogjeri, Dorina; Piccirillo, Jay F

    2017-07-01

    Existing patient-reported outcome measures of tinnitus assess the severity and disability retrospectively, which may result in adequate reliability, but cannot capture the fluctuating and individualized nature of tinnitus. Experience sampling may provide an alternative. To use an ecological momentary assessment (EMA) to measure tinnitus disability and associated constructs. Forty adults with tinnitus provided self-report of their tinnitus bother using 5 questions measured by EMA, as well as standard retrospective outcome measures. In this 6-week longitudinal observational study conducted from July 15 to December 22, 2014, participants provided EMA data for 2 weeks (part 1); then after a 2-week break, they provided EMA data for an additional 2 weeks (part 2). A text message with a link to the EMA survey was sent for a total of 56 assessments during each 2-week assessment period. Ecological momentary assessment responses were evaluated using multilevel confirmatory factor analysis to assess the fluctuating nature of bothersome tinnitus across the group and within the pool of individuals over time. Ecological momentary assessment questions measured tinnitus disability and associated constructs. Compliance in each study part was assessed based on response rates. The Tinnitus Functional Index and the Overall Global Rating of Bother Scale were assessed at the beginning and end of each 2-week assessment period to explore the effect of the frequent EMAs on the perceived level of bother from tinnitus. Of the 40 participants in the study (10 women and 30 men; mean [SD] age, 60.0 [10.5] years), the median survey response rate was high (49 responses to 56 surveys sent [88%] for part 1 and 47 responses of 56 surveys sent [84%] for part 2). The latent factor identified by the 2-level confirmatory factor analysis models demonstrates that within-individual tinnitus bother, loudness, and stress vary together over time. In addition, tinnitus bother, feeling, and stress symptoms all

  8. Medium-level laser in chronic tinnitus treatment.

    Science.gov (United States)

    Dejakum, K; Piegger, J; Plewka, C; Gunkel, A; Thumfart, W; Kudaibergenova, S; 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 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.

  9. 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.

  10. Can animal models contribute to understanding tinnitus heterogeneity in humans?

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    Jos J Eggermont

    2016-11-01

    Full Text Available The brain activity of humans with tinnitus of various etiologies is typically studied with EEG/MEG and fMRI-based imaging techniques. Consequently, they measure population responses and mostly from the neocortex. The latter also underlies changes in neural networks that may be attributed to tinnitus. However, factors not strictly related to tinnitus such as hearing loss and hyperacusis, as well as other co-occurring disorders play a prominent role in these changes. Different types of tinnitus can often not be resolved with these brain-imaging techniques. In animal models of putative behavioral signs of tinnitus, neural activity ranging from auditory nerve to auditory cortex, is studied largely by single unit recordings, augmented by local field potentials (LFPs, and the neural correlates of tinnitus are mainly based on spontaneous neural activity, such as spontaneous firing rates (SFR and pair-wise spontaneous spike-firing correlations. Neural correlates of hyperacusis rely on measurement of stimulus-evoked activity and are measured as increased driven firing rates and LFP amplitudes. Connectivity studies would rely on correlated neural activity between pairs of neurons or LFP amplitudes, but are only recently explored. In animal models of tinnitus only two etiologies are extensively studied; tinnitus evoked by salicylate application and by noise exposure. It appears that they have quite different neural biomarkers. The unanswered question then is: does this different etiology also result in different tinnitus?

  11. Behavioral models of tinnitus and hyperacusis in animals

    Directory of Open Access Journals (Sweden)

    Sarah H Hayes

    2014-09-01

    Full Text Available The phantom perception of tinnitus and reduced sound level tolerance associated with hyperacusis, have a high comorbidity and can be debilitating conditions for which there are no widely accepted treatments. One factor limiting the development of treatments for tinnitus and hyperacusis is the lack of reliable animal behavioral models of these disorders. Therefore, the purpose of this review is to highlight the current animal models of tinnitus and hyperacusis, and to detail the advantages and disadvantages of each paradigm. To date, this is the first review to include models of both tinnitus and hyperacusis.

  12. Pitch and Loudness Tinnitus in Individuals with Presbycusis.

    Science.gov (United States)

    Seimetz, Bruna Macangnin; Teixeira, Adriane Ribeiro; Rosito, Leticia Petersen Schmidt; Flores, Leticia Sousa; Pappen, Carlos Henrique; Dall'igna, Celso

    2016-10-01

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

  13. Pitch and Loudness Tinnitus in Individuals with Presbycusis

    Directory of Open Access Journals (Sweden)

    Seimetz, Bruna Macangnin

    2016-02-01

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

  14. Prevalence of tinnitus in workers exposed to noise and organophosphates

    Directory of Open Access Journals (Sweden)

    Delecrode, Camila Ribas

    2012-01-01

    Full Text Available Introduction: Research on the workplace has emphasized the effects of noise exposure on workers' hearing, but has not considered the effects of agrochemicals. Aim: To evaluate and correlate the hearing level and tinnitus of workers exposed simultaneously to noise and organophosphates in their workplace and to measure tinnitus distress on their quality of life. Method: A retrospective clinical study. We evaluated 82 organophosphate sprinklers from the São Paulo State Regional Superintendence who were active in the fight against dengue and who were exposed to noise and organophosphates. We performed pure tone audiometry and applied the translated THI (Tinnitus Handicap Inventory questionnaire. Results: Of the sample, 28.05% reported current tinnitus or had presented tinnitus, and the workers with tinnitus had an increased incidence of abnormal audiometry. The average hearing threshold for the 4-8-kHz frequency range of the workers with current tinnitus was higher than that of the others, and was most affected at the 4-kHz frequency. The THI score ranged 0-84, with an average score of 13.1. Twelve (52.17% workers had THI scores consistent with discrete handicap. Conclusion: There is an increased incidence of abnormal pure tone audiometry in workers with tinnitus, and its impact on the workers' quality of life was discrete. The correlation between average hearing threshold and tinnitus distress was weak.

  15. Paraflocculus plays a role in salicylate-induced tinnitus.

    Science.gov (United States)

    Du, Yali; Liu, Junxiu; Jiang, Qin; Duan, Qingchuan; Mao, Lanqun; Ma, Furong

    2017-09-01

    Tinnitus impairs quality of life of about 1-2% of the whole population. In most severe situation, tinnitus may cause social isolation, depression and suicide. Drug treatments for tinnitus are generally ineffective, and the mechanisms of tinnitus are still undetermined. Accumulating evidence suggests that tinnitus is related to changes of widespread brain networks. Recent studies propose that paraflocculus (PFL), which is indirectly connected to various cortical regions, may be a gating zone of tinnitus. So we examined the electrophysiological changes and neurotransmitter alterations of the PFL in a rat model of sodium salicylate (SS)-induced tinnitus. We found that spontaneous firing rate (SFR) of the putative excitatory interneurons of the PFL was significantly increased. The level of glutamic acid, which is the main excitatory neurotransmitter in the nervous system, was also dramatically increased in the PFL after SS treatment. These results confirmed the hyperactivity of PFL in the rats with SS-treatment, which might be due to the increased glutamic acid. Then we examined the SFR of the auditory cortex (AC), the center for auditory perception, before and after electrical stimulation of the PFL. 71.4% (105/147) of the recorded neurons showed a response to the stimulation of the PFL. The result demonstrated that stimulation of the PFL could modulate the activity of the AC. Our study suggests a role of PFL in SS-induced tinnitus and AC as a potential target of PFL in the process of tinnitus. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Genetic susceptibility to bilateral tinnitus in a Swedish twin cohort.

    Science.gov (United States)

    Maas, Iris Lianne; Brüggemann, Petra; Requena, Teresa; Bulla, Jan; Edvall, Niklas K; Hjelmborg, Jacob V B; Szczepek, Agnieszka J; Canlon, Barbara; Mazurek, Birgit; Lopez-Escamez, Jose A; Cederroth, Christopher R

    2017-09-01

    Genetic contributions to tinnitus have been difficult to determine due to the heterogeneity of the condition and its broad etiology. Here, we evaluated the genetic and nongenetic influences on self-reported tinnitus from the Swedish Twin Registry (STR). Cross-sectional data from the STR was obtained. Casewise concordance rates (the risk of one twin being affected given that his/her twin partner has tinnitus) were compared for monozygotic (MZ) and dizygotic (DZ) twin pairs (N = 10,464 concordant and discordant twin pairs) and heritability coefficients (the proportion of the total variance attributable to genetic factors) were calculated using biometrical model fitting procedures. Stratification of tinnitus cases into subtypes according to laterality (unilateral versus bilateral) revealed that heritability of bilateral tinnitus was 0.56; however, it was 0.27 for unilateral tinnitus. Heritability was greater in men (0.68) than in women (0.41). However, when female pairs younger than 40 years of age were selected, heritability of 0.62 was achieved with negligible effects of shared environment. Unlike unilateral tinnitus, bilateral tinnitus is influenced by genetic factors and might constitute a genetic subtype. Overall, our study provides the initial evidence for a tinnitus phenotype with a genetic influence.Genet Med advance online publication 23 March 2017.

  17. Cochlear implantation for single-sided deafness and tinnitus suppression.

    Science.gov (United States)

    Holder, Jourdan T; O'Connell, Brendan; Hedley-Williams, Andrea; Wanna, George

    To quantify the potential effectiveness of cochlear implantation for tinnitus suppression in patients with single-sided deafness using the Tinnitus Handicap Inventory. The study included 12 patients with unilateral tinnitus who were undergoing cochlear implantation for single-sided deafness. The Tinnitus Handicap Inventory was administered at the patient's cochlear implant candidacy evaluation appointment prior to implantation and every cochlear implant follow-up appointment, except activation, following implantation. Patient demographics and speech recognition scores were also retrospectively recorded using the electronic medical record. A significant reduction was found when comparing Tinnitus Handicap Inventory score preoperatively (61.2±27.5) to the Tinnitus Handicap Inventory score after three months of cochlear implant use (24.6±28.2, p=0.004) and the Tinnitus Handicap Inventory score beyond 6months of CI use (13.3±18.9, p=0.008). Further, 45% of patients reported total tinnitus suppression. Mean CNC word recognition score improved from 2.9% (SD 9.4) pre-operatively to 40.8% (SD 31.7) by 6months post-activation, which was significantly improved from pre-operative scores (p=0.008). The present data is in agreement with previously published studies that have shown an improvement in tinnitus following cochlear implantation for the large majority of patients with single-sided deafness. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Measuring the Moment-to-Moment Variability of Tinnitus: The TrackYourTinnitus Smart Phone App.

    Science.gov (United States)

    Schlee, Winfried; Pryss, Rüdiger C; Probst, Thomas; Schobel, Johannes; Bachmeier, Alexander; Reichert, Manfred; Langguth, Berthold

    2016-01-01

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

  19. Role of preoperative air-bone gap in tinnitus outcome after tympanoplasty for chronic otitis media with tinnitus.

    Science.gov (United States)

    Kim, Hong Chan; Jang, Chul Ho; Kim, Young Yoon; Seong, Jong Yuap; Kang, Sung Hoon; Cho, Yong Beom

    Previous reports indicated that middle ear surgery might partially improve tinnitus after surgery. However, until now, no influencing factor has been determined for tinnitus outcome after middle ear surgery. The purpose of this study was to investigate the association between preoperative air-bone gap and tinnitus outcome after tympanoplasty type I. Seventy-five patients with tinnitus who had more than 6 months of symptoms of chronic otitis media on the ipsilateral side that were refractory to medical treatment were included in this study. All patients were evaluated through otoendoscopy, pure tone/speech audiometer, questionnaire survey using the visual analog scale and the tinnitus handicap inventory for tinnitus symptoms before and 6 months after tympanoplasty. The influence of preoperative bone conduction, preoperative air-bone-gap, and postoperative air-bone-gap on tinnitus outcome after the operation was investigated. The patients were divided into two groups based on preoperative bone conduction of less than 25dB (n=50) or more than 25dB (n=25). The postoperative improvement of tinnitus in both groups showed statistical significance. Patients whose preoperative air-bone-gap was less than 15dB showed no improvement in postoperative tinnitus using the visual analog scale (p=0.889) and the tinnitus handicap inventory (p=0.802). However, patients whose preoperative air-bone-gap was more than 15dB showed statistically significant improvement in postoperative tinnitus using the visual analog scale (ptinnitus handicap inventory (p=0.016). Postoperative change in tinnitus showed significance compared with preoperative tinnitus using visual analog scale (p=0.006). However, the correlation between reduction in the visual analog scale score and air-bone-gap (p=0.202) or between reduction in tinnitus handicap inventory score and air-bone-gap (p=0.290) was not significant. We suggest that the preoperative air-bone-gap can be a predictor of tinnitus outcome after

  20. Neurosensory analysis of tooth sensitivity during at-home dental bleaching: a randomized clinical trial

    Science.gov (United States)

    Briso, André Luiz Fraga; Rahal, Vanessa; de Azevedo, Fernanda Almeida; Gallinari, Marjorie de Oliveira; Gonçalves, Rafael Simões; dos Santos, Paulo Henrique; Cintra, Luciano Tavares Angelo

    2018-01-01

    Abstract Objective The objective of this study was to evaluate dental sensitivity using visual analogue scale, a Computerized Visual Analogue Scale (CoVAS) and a neurosensory analyzer (TSA II) during at-home bleaching with 10% carbamide peroxide, with and without potassium oxalate. Materials and Methods Power Bleaching 10% containing potassium oxalate was used on one maxillary hemi-arch of the 25 volunteers, and Opalescence 10% was used on the opposite hemi-arch. Bleaching agents were used daily for 3 weeks. Analysis was performed before treatment, 24 hours later, 7, 14, and 21 days after the start of the treatment, and 7 days after its conclusion. The spontaneous tooth sensitivity was evaluated using the visual analogue scale and the sensitivity caused by a continuous 0°C stimulus was analyzed using CoVAS. The cold sensation threshold was also analyzed using the TSA II. The temperatures obtained were statistically analyzed using ANOVA and Tukey's test (α=5%). Results The data obtained with the other methods were also analyzed. 24 hours, 7 and 14 days before the beginning of the treatment, over 20% of the teeth presented spontaneous sensitivity, the normal condition was restored after the end of the treatment. Regarding the cold sensation temperatures, both products sensitized the teeth (p0.05). In addition, when they were compared using CoVAS, Power Bleaching caused the highest levels of sensitivity in all study periods, with the exception of the 14th day of treatment. Conclusion We concluded that the bleaching treatment sensitized the teeth and the product with potassium oxalate was not able to modulate tooth sensitivity. PMID:29742258

  1. [Psychosomatic stress factors in compensated and decompensated tinnitus].

    Science.gov (United States)

    Stobik, Corinna; Weber, Rainer K; Münte, Thomas F; Frommer, Jörg

    2003-08-01

    In modern medical practice, chronic decompensated tinnitus is defined as a complex psychosomatic process in which mental and social factors are considered to have a determining effect on the patient's subjective response to the impairment of otological or other somatic functions attributed to tinnitus. What is still largely unknown is the interaction of the individual factors and their impact on the patient's ability to cope with tinnitus. The impact of psycho-social and somatic factors on the subjective experience of patients with compensated and decompensated tinnitus is evaluated. 53 patients with chronic tinnitus were divided into two groups, compensated and decompensated, on the basis of their subjective experience of the disorder, established according to the tinnitus questionnaire published by Goebel and Hiller. Self-assessment instruments and a survey of symptoms of somatic stress disorders were used to compare the two groups in terms of differences in the patients' mental and psycho-social behaviour, in their strategies for coping with tinnitus and in the incidence of co-morbidity. The patients with decompensated tinnitus suffered from more pronounced mental and social disabilities, were more prone to depression and used less effective techniques to cope with their illness. The principal difference between the two groups, however, appeared to lie in a significantly higher degree of somatic multi-morbidity, where a particularly strong correlation was found between tinnitus and the incidence of cardiovascular diseases and hypacusis. 81 percent of the total sample of patients suffered from impaired hearing. Patients with decompensated tinnitus experienced greater communication difficulties as a result of their auditory impairment. In the diagnosis and therapy of tinnitus, in addition to psychic and psycho-social aspects greater attention ought to be paid to somatic factors, influencing the patient's ability to cope with the disorder.

  2. Electroacupuncture for Tinnitus: A Systematic Review

    Science.gov (United States)

    Liu, Yang; Zhong, Juan; Jiang, Luyun; Liu, Ying; Chen, Qing; Xie, Yan; Zhang, Qinxiu

    2016-01-01

    Background Treatment effects of electroacupuncture for patients with subjective tinnitus has yet to be clarified. Objectives To assess the effect of electroacupuncutre for alleviating the symptoms of subjective tinnitus. Methods 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. Conclusions 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. PMID:26938213

  3. Central gain control in tinnitus and hyperacusis

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    Benjamin D Auerbach

    2014-10-01

    Full Text Available Sensorineural hearing loss induced by noise or ototoxic drug exposure reduces the neural activity transmitted from the cochlea to the central auditory system. Despite a reduced cochlear output, neural activity from more central auditory structures is paradoxically enhanced at suprathreshold intensities. This compensatory increase in the central auditory activity in response to the loss of sensory input is referred to as central gain enhancement. Enhanced central gain is hypothesized to be a potential mechanism that gives rise to hyperacusis and tinnitus, two debilitating auditory perceptual disorders that afflict millions of individuals. This review will examine the evidence for gain enhancement in the central auditory system in response to cochlear damage. Further, it will address the potential cellular and molecular mechanisms underlying this enhancement and discuss the contribution of central gain enhancement to tinnitus and hyperacusis. Current evidence suggests that multiple mechanisms with distinct temporal and spectral profiles are likely to contribute to central gain enhancement. Dissecting the contributions of these different mechanisms at different levels of the central auditory system is essential for elucidating the role of central gain enhancement in tinnitus and hyperacusis and, most importantly, the development of novel treatments for these disorders.

  4. Clinical Characteristics of Troublesome Pediatric Tinnitus

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    Annett Szibor

    2017-10-01

    Full Text Available Objectives: The frequency of tinnitus in children and adults is practically the same. However, although adults reveal their symptoms and seek for medical aid, the suffering often remains unrecognized in the young. This is due to both the inability of children to properly describe their symptoms and the lack of recognition. Materials and methods: Among 5768 patients entering our department with complaints of tinnitus between 2010 and 2015, there were only 112 children. A full clinical history and medical status had been determined at the time of presentation and were analyzed retrospectively. Results: The average duration from first complain to clinical presentation was approximately 12 months. A normal hearing capability of less than 25 dB was measured in 80% of the cases. Only 23 patients presented with a hearing impairment. The causes ranged from hearing loss, previous orthodontic treatment, noise trauma, middle ear aeration, muscular neck tension, and skull base fracture. Typical co-morbidities such as sleeping disorders, concentration disorders, and hyperacusis were observed. Conclusions: This retrospective study shows that recognition of tinnitus in the childhood is generally delayed. A better characterization of complaints and triggers, however, is a prerequisite to sensitize medical personnel and caretakers for the suffering and to avoid developmental impairments.

  5. Central Gain Control in Tinnitus and Hyperacusis

    Science.gov (United States)

    Auerbach, Benjamin D.; Rodrigues, Paulo V.; Salvi, Richard J.

    2014-01-01

    Sensorineural hearing loss induced by noise or ototoxic drug exposure reduces the neural activity transmitted from the cochlea to the central auditory system. Despite a reduced cochlear output, neural activity from more central auditory structures is paradoxically enhanced at suprathreshold intensities. This compensatory increase in the central auditory activity in response to the loss of sensory input is referred to as central gain enhancement. Enhanced central gain is hypothesized to be a potential mechanism that gives rise to hyperacusis and tinnitus, two debilitating auditory perceptual disorders that afflict millions of individuals. This review will examine the evidence for gain enhancement in the central auditory system in response to cochlear damage. Further, it will address the potential cellular and molecular mechanisms underlying this enhancement and discuss the contribution of central gain enhancement to tinnitus and hyperacusis. Current evidence suggests that multiple mechanisms with distinct temporal and spectral profiles are likely to contribute to central gain enhancement. Dissecting the contributions of these different mechanisms at different levels of the central auditory system is essential for elucidating the role of central gain enhancement in tinnitus and hyperacusis and, most importantly, the development of novel treatments for these disorders. PMID:25386157

  6. Tinnitus: development of a neurophysiologic correlate

    International Nuclear Information System (INIS)

    Sasaki, C.T.; Babitz, L.; Kauer, J.S.

    1981-01-01

    Although tinnitus severely afflicts 7.2 million Americans, the pathophysiology of this problem remains obscure because there presently exists no good animal model in which to study the phenomenon. We have examined changes in activity in the guinea pig auditory pathway using an autoradiographic method of functional brain mapping after short-term and long-term cochlear ablations which can, in humans, initiate the occurrence of tinnitus. With this method we have observed a reduction in activity in various nuclei in the auditory pathway between 4 hrs and 10 days after unilateral cochlear ablation. In contrast to these findings we have found a return of activity in these same nuclei if they are observed from 12 to 48 days following the lesion. These preliminary data suggest that this return of activity in the absence of sensory input may be a valid experimental analogue for tinnitus in humans. Such evidence for auditory plasticity may represent a significant first step toward understanding this common and profound otologic symptom

  7. Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance.

    Science.gov (United States)

    Jastreboff, Pawel J; Jastreboff, Margaret M

    2003-04-01

    Our experience has revealed the following: (1) TRT is applicable for all types of tinnitus, as well as for decreased sound tolerance, with significant improvement of tinnitus occurring in over 80% of the cases, and at least equal success rate for decreased sound tolerance. (2) TRT can provide cure for decreased sound tolerance. (3) TRT does not require frequent clinic visits and has no side effects; however, (4) Special training of health providers involved in this treatment is required for this treatment to be effective.

  8. Patients' Perception of a Symptomatic Tinnitus among Nigerians: A ...

    African Journals Online (AJOL)

    Tinnitus is a very common otologic symptom presented by patients worldwide yet it's a poorly understood disorder. This study is aimed at assessing the perception of patients of their tinnitus. A multi-center prospective study carried out in Ear, Nose and Throat Department of two tertiary health institutions in Nigeria over a ...

  9. Atorvastatin in the management of tinnitus with hyperlipidemias

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    Hameed, M. K.; Sheikh, Z. A.; Ahmed, A. [Armed Forces Inst. of Pathology, Rawalpindi (Pakistan). Dept. of Pathology

    2014-12-15

    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)

  10. Atorvastatin in the management of tinnitus with hyperlipidemias

    International Nuclear Information System (INIS)

    Hameed, M.K.; Sheikh, Z.A.; Ahmed, A.

    2014-01-01

    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)

  11. Incidence of tinnitus in mp3 player users.

    Science.gov (United States)

    Figueiredo, Ricardo Rodrigues; Azevedo, Andreia Aparecida de; Oliveira, Patrícia Mello de; Amorim, Sandro Pereira Vasconcellos; Rios, Artur Guedes; Baptista, Vanderlei

    2011-06-01

    Exposure to loud noise is one of the main causes of tinnitus. To analyze the incidence of tinnitus in mp3 player users and non-users. One hundred subjects aged from 15 to 30 years were enrolled, 54 of them were regular mp3 player users and 46 were not. Patients with continuous tinnitus for at least 6 months completed the Tinnitus Handicap Inventory (THI) and were tested with high frequency audiometry and transient-evoked otoacoustic emissions (TAOE). A cross-sectional cohort study. The incidence of tinnitus in non-users was about 8 %; in mp3 player users it was about 28 %, a statistically significant difference. Hearing thresholds at 8 kHz were significantly higher in tinnitus patients that used mp3 portable players.TAOE were reduced at 2 kHz in the users group. No statistically significant difference was found in the THI scores between the two groups. Tinnitus was more frequent in teenagers and young adults who regularly listen to mp3 music in players. Moreover, the incidence of tinnitus among mp3 player users was associated with higher hearing thresholds at 8 kHz and lower TOAE at 2 kHz.

  12. [Integrated intensive treatment of tinnitus: method and initial results].

    Science.gov (United States)

    Mazurek, B; Georgiewa, P; Seydel, C; Haupt, H; Scherer, H; Klapp, B F; Reisshauer, A

    2005-07-01

    In recent years, no major advances have been made in understanding the mechanisms underlying the development of tinnitus. Hence, the present therapeutic strategies aim at decoupling the subconscious from the perception of tinnitus. Mindful of the lessons drawn from existing tinnitus retraining and desensitisation therapies, a new integrated day hospital strategy of treatment lasting 7-14 days has been developed at the Charité Hospital and is presented in the present paper. The strategy for treating tinnitus in the proximity of patient domicile is designed for patients who feel disturbed in their world of perception and their efficiency due to tinnitus and give evidence of mental and physical strain. In view of the etiologically non-uniform and multiple events connected with tinnitus, consideration was also given to the fact that somatic and psychosocial factors are equally involved. Therefore, therapy should aim at diagnosing and therapeutically influencing those psychosocial factors that reduce the hearing impression to such an extent that the affected persons suffer from strain. The first results of therapy-dependent changes of 46 patients suffering from chronic tinnitus are presented. The data were evaluated before and after 7 days of treatment and 6 months after the end of treatment. Immediately after the treatment, the scores of both the tinnitus questionnaire (Goebel and Hiller) and the subscales improved significantly. These results were maintained during the 6-month post-treatment period and even improved.

  13. 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.

  14. Personality Traits in Patients with Subjective Idiopathic Tinnitus

    Directory of Open Access Journals (Sweden)

    Mahboobeh Adami Dehkordi

    2015-09-01

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

  15. Differences Among Patients That Make Their Tinnitus Worse or Better

    Science.gov (United States)

    Tyler, Richard S.; Ji, Haihong; Coelho, Claudia; Gogel, Stephanie A.

    2015-01-01

    Purpose Our objective was to identify activities that influence tinnitus and to determine if conditional probabilities exist among such variables. Method Two hundred fifty-eight patients were asked the following two questions: “When you have your tinnitus, which of the following makes it worse?” and “Which of the following reduces your tinnitus?” Results Things that made tinnitus better included noise (31%) and relaxation (15%). Things that made tinnitus worse included being in a quiet place (48%), stress (36%), being in a noisy place (32%), and lack of sleep (27%). Almost 6% of patients suggested coffee/tea and 4% said certain foods made their tinnitus worse. Conditional probabilities indicated that for those whose tinnitus is not worse in quiet, it is usually not reduced by noise. For those whose tinnitus is not worse in noise, it is usually not reduced in quiet. Conclusion There are dramatic differences among patients. Such differences need to be considered in planning treatments. PMID:26649850

  16. The effectiveness of hypnotherapy in the treatment of subjective tinnitus

    Directory of Open Access Journals (Sweden)

    Shirin Moghtaderi

    2012-12-01

    Full Text Available Background and Aim: Tinnitus is an annoying disease cause major problems including insomnia, impaired concentration, and reduced quality of life. This study aimed to investigate the effectiveness of hypnotherapy in the treatment of subjective tinnitus.Methods: This was a pilot experimental study with pre- and post-test method. 20 people suffered from subjective tinnitus were divided equally in two groups of experimental and control. The two groups were matched according to age and severity of tinnitus. They completed tinnitus clinical questionnaires before and after the test and the severity of their tinnitus was recorded by a number from one to ten. Experimental group went under hypnotherapy for 10 sessions. The control group did not perform any psychological treatment. The gathered data were statistically analyzed using Student's t-test (independent and dependent.Results: There were significant differences between the pre-test and post-test scores of each group and also, between the post-test scores of experimental and control groups (p = 0.001 for all.Conclusion: The results showed that hypnotherapy could effectively reduce the seventy of tinnitus in patients in the experimental group; in other words, the results confirm the effectiveness of medical hypnosis in the treatment of subjective tinnitus.

  17. An animal model of tinnitus: a decade of development.

    Science.gov (United States)

    Jastreboff, P J; Sasaki, C T

    1994-01-01

    Although tinnitus affects approximately 9 million people in the United States, a cure remains elusive and the mechanisms of its origin are speculative. The crucial obstacle in tinnitus research has been the lack of an animal model. Over the last decade we have been creating such a model by combining a variety of methodologies, including a behavioral component, to allow for the detection of tinnitus perception. Initially, 2-deoxyglucose had been used to map changes in the metabolic activity after unilateral destruction of the cochlea. It has been found that the initial decrease of the metabolic rate in the auditory nuclei recovered to preoperative values, which could be attributable to the development of tinnitus. The spontaneous activity of single units recorded from the inferior colliculus before and after salicylate administration revealed an increase of discharges, which might reflect the presence of salicylate-induced tinnitus. Recent data have confirmed, and further elaborated this observation, including the discovery of abnormal, epileptic-like, neuronal activity. Finally, the authors have developed a behavioral model of tinnitus, tested it extensively, and used it to measure tinnitus pitch and loudness. The model is presently used for investigating the hypotheses for the mechanisms of tinnitus.

  18. Positive and Negative Thinking in Tinnitus: Factor Structure of the Tinnitus Cognitions Questionnaire.

    Science.gov (United States)

    Handscomb, Lucy E; Hall, Deborah A; Shorter, Gillian W; Hoare, Derek J

    Researchers and clinicians consider thinking to be important in the development and maintenance of tinnitus distress, and altering thoughts or thinking style is an object of many forms of psychological therapy for tinnitus. Those working with people with tinnitus require a reliable, psychometrically robust means of measuring both positive and negative thinking related to it. The Tinnitus Cognitions Questionnaire (TCQ) was designed as such a measure and its authors showed it to be reliable, with good psychometric properties. However, no research teams have yet carried out independent validation. This study aimed to use the TCQ to investigate thinking amongst members of the general population with both bothersome and nonbothersome tinnitus and also to verify its factor structure. Three hundred forty-two members of the public with tinnitus completed the TCQ online or on paper. They also rated their tinnitus on a scale as "not a problem," "a small problem," "a moderate problem," "a big problem," or a "very big problem." The authors tested the original factor structure of the TCQ using confirmatory factor analysis and then calculated the mean scores for each item, comparing mean total scores across "problem categories" for the full questionnaire and for the positive and negative subscales. The original two-factor structure of the TCQ was a good fit to the data when the correlation between positive and negative factors was fixed at zero (root mean square error of approximation = 0.064, 90% confidence interval = 0.058 to 0.070). Items pertaining to wishing the tinnitus would go away and despairing that it would ever get better had the highest mean scores. The mean total score for the "no problem" group (M = 31.17, SD = 16.03) was not significantly different from the mean total score for the "small problem" group (M = 34.00, SD = 12.44, p = 0.99). Differences between mean scores for all other groups were statistically significant. For the negative subscale, differences

  19. Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation.

    Science.gov (United States)

    Ramakers, Geerte G J; Kraaijenga, Véronique J C; Smulders, Yvette E; van Zon, Alice; Stegeman, Inge; Stokroos, Robert J; Free, Rolien H; Frijns, Johan H M; Huinck, Wendy J; Van Zanten, Gijsbert A; Grolman, Wilko

    2017-01-01

    There is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus. To investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years). This study is a secondary analysis as part of a multicenter randomized controlled trial. Thirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs) because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ). The prevalence of preoperative tinnitus was 42% (16/38). One year after bilateral implantation, there was a median difference of -8 (inter-quartile range (IQR): -28 to 4) in THI score and -9 (IQR: -17 to -9) in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group, four patients had an additional benefit of the second CI: a total

  20. Validation of Online Versions of Tinnitus Questionnaires Translated into Swedish

    Science.gov (United States)

    Müller, Karolina; Edvall, Niklas K.; Idrizbegovic, Esma; Huhn, Robert; Cima, Rilana; Persson, Viktor; Leineweber, Constanze; Westerlund, Hugo; Langguth, Berthold; Schlee, Winfried; Canlon, Barbara; Cederroth, Christopher R.

    2016-01-01

    Background: Due to the lack of objective measures for assessing tinnitus, its clinical evaluation largely relies on the use of questionnaires and psychoacoustic tests. A global assessment of tinnitus burden would largely benefit from holistic approaches that not only incorporate measures of tinnitus but also take into account associated fears, emotional aspects (stress, anxiety, and depression), and quality of life. In Sweden, only a few instruments are available for assessing tinnitus, and the existing tools lack validation. Therefore, we translated a set of questionnaires into Swedish and evaluated their reliability and validity in a group of tinnitus subjects. Methods: We translated the English versions of the Tinnitus Functional Index (TFI), the Fear of Tinnitus Questionnaire (FTQ), the Tinnitus Catastrophizing Scale (TCS), the Perceived Stress Questionnaire (PSQ-30), and the Tinnitus Sample Case History Questionnaire (TSCHQ) into Swedish. These translations were delivered via the internet with the already existing Swedish versions of the Tinnitus Handicap Inventory (THI), the Hospital Anxiety and Depression Scale (HADS), the Hyperacusis Questionnaire (HQ), and the World Health Organization Quality of Life questionnaire (WHOQoL-BREF). Psychometric properties were evaluated by means of internal consistency [Cronbach's alpha (α)] and test–retest reliability across a 9-week interval [Intraclass Correlation Coefficient (ICC), Cohen's kappa] in order to establish construct as well as clinical validity using a sample of 260 subjects from a population-based cohort. Results: Internal consistency was acceptable for all questionnaires (α > 0.7) with the exception of the “social relationships” subscale of the WHOQoL-BREF. Test–retest reliability was generally acceptable (ICC > 0.70, Cohens kappa > 0.60) for the tinnitus-related questionnaires, except for the TFI “sense of control” subscale and 15 items of the TSCHQ. Spearmen rank correlations showed that

  1. Tinnitus after Simultaneous and Sequential Bilateral Cochlear Implantation

    Directory of Open Access Journals (Sweden)

    Geerte G. J. Ramakers

    2017-11-01

    Full Text Available ImportanceThere is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.ObjectiveTo investigate tinnitus outcomes 1 year after bilateral cochlear implantation. Secondarily, to compare tinnitus outcomes between simultaneous and sequential bilateral cochlear implantation and to investigate long-term follow-up (3 years.Study designThis study is a secondary analysis as part of a multicenter randomized controlled trial.MethodsThirty-eight postlingually deafened adults were included in the original trial, in which the presence of tinnitus was not an inclusion criterion. All participants received cochlear implants (CIs because of profound hearing loss. Nineteen participants received bilateral CIs simultaneously and 19 participants received bilateral CIs sequentially with an inter-implant interval of 2 years. The prevalence and severity of tinnitus before and after simultaneous and sequential bilateral cochlear implantation were measured preoperatively and each year after implantation with the Tinnitus Handicap Inventory (THI and Tinnitus Questionnaire (TQ.ResultsThe prevalence of preoperative tinnitus was 42% (16/38. One year after bilateral implantation, there was a median difference of −8 (inter-quartile range (IQR: −28 to 4 in THI score and −9 (IQR: −17 to −9 in TQ score in the participants with preoperative tinnitus. Induction of tinnitus occurred in five participants, all in the simultaneous group, in the year after bilateral implantation. Although the preoperative and also the postoperative median THI and TQ scores were higher in the simultaneous group, the median difference scores were equal in both groups. In the simultaneous group, tinnitus scores fluctuated in the 3 years after implantation. In the sequential group

  2. Validation of online versions of tinnitus questionnaires translated into Swedish

    Directory of Open Access Journals (Sweden)

    Karolina Müller

    2016-11-01

    Full Text Available BackgroundDue to the lack of objective measures for assessing tinnitus, its clinical evaluation largely relies on the use of questionnaires and psychoacoustic tests. A global assessment of tinnitus burden would largely benefit from holistic approaches that not only incorporate measures of tinnitus but also take into account associated fears, emotional aspects (stress, anxiety, and depression, and quality of life. In Sweden, only a few instruments are available for assessing tinnitus, and the existing tools lack validation. Therefore, we translated a set of questionnaires into Swedish and evaluated their reliability and validity in a group of tinnitus subjects. MethodsWe translated the English versions of the Tinnitus Functional Index (TFI, the Fear of Tinnitus Questionnaire (FTQ, the Tinnitus Catastrophizing Scale (TCS, the Perceived Stress Questionnaire (PSQ-30, and the Tinnitus Sample Case History Questionnaire (TSCHQ into Swedish. These translations were delivered via the internet with the already existing Swedish versions of the Tinnitus Handicap Inventory (THI, the Hospital Anxiety and Depression Scale (HADS, the Hyperacusis Questionnaire (HQ, and the World Health Organization Quality of Life questionnaire (WHOQoL-BREF. Psychometric properties were evaluated by means of internal consistency (Cronbach’s alpha α and test-retest reliability across a 9-week interval (Intraclass Correlation Coefficient ICC, Cohen’s kappa in order to establish construct as well as clinical validity using a sample of 260 subjects from a population-based cohort.ResultsInternal consistency was acceptable for all questionnaires (α >0.7 with the exception of the ‘social relationships’ subscale of the WHOQoL-BREF. Test-retest reliability was generally acceptable (ICC >.70, Cohens Kappa >.60 for the tinnitus-related questionnaires, except for the TFI ‘sense of control’ subscale and 15 items of the TSCHQ. Spearmen rank correlations showed that almost all

  3. Tinnitus: Prospects for Pharmacological Interventions With a Seesaw Model.

    Science.gov (United States)

    Tetteh, Hannah; Lee, Minseok; Lau, C Geoffrey; Yang, Sunggu; Yang, Sungchil

    2017-10-01

    Chronic tinnitus, the perception of lifelong constant ringing in ear, is one capital cause of disability in modern society. It is often present with various comorbid factors that severely affect quality of life, including insomnia, deficits in attention, anxiety, and depression. Currently, there are limited therapeutic treatments for alleviation of tinnitus. Tinnitus can involve a shift in neuronal excitation/inhibition (E/I) balance, which is largely modulated by ion channels and receptors. Thus, ongoing research is geared toward pharmaceutical approaches that modulate the function of ion channels and receptors. Here, we propose a seesaw model that delineates how tinnitus-related ion channels and receptors are involved in homeostatic E/I balance of neurons. This review provides a thorough account of our current mechanistic understanding of tinnitus and insight into future direction of drug development.

  4. Genetic susceptibility to bilateral tinnitus in a Swedish twin cohort

    DEFF Research Database (Denmark)

    Maas, Iris Lianne; Brüggemann, Petra; Requena, Teresa

    2017-01-01

    PURPOSE: Genetic contributions to tinnitus have been difficult to determine due to the heterogeneity of the condition and its broad etiology. Here, we evaluated the genetic and nongenetic influences on self-reported tinnitus from the Swedish Twin Registry (STR). METHODS: Cross-sectional data from...... the STR was obtained. Casewise concordance rates (the risk of one twin being affected given that his/her twin partner has tinnitus) were compared for monozygotic (MZ) and dizygotic (DZ) twin pairs (N = 10,464 concordant and discordant twin pairs) and heritability coefficients (the proportion of the total...... variance attributable to genetic factors) were calculated using biometrical model fitting procedures. RESULTS: Stratification of tinnitus cases into subtypes according to laterality (unilateral versus bilateral) revealed that heritability of bilateral tinnitus was 0.56; however, it was 0.27 for unilateral...

  5. Evaluating the loudness of phantom auditory perception (tinnitus) in rats.

    Science.gov (United States)

    Jastreboff, P J; Brennan, J F

    1994-01-01

    Using our behavioral paradigm for evaluating tinnitus, the loudness of salicylate-induced tinnitus was evaluated in 144 rats by comparing their behavioral responses induced by different doses of salicylate to those induced by different intensities of a continuous reference tone mimicking tinnitus. Group differences in resistance to extinction were linearly related to salicylate dose and, at moderate intensities, to the reference tone as well. Comparison of regression equations for salicylate versus tone effects permitted estimation of the loudness of salicylate-induced tinnitus. These results extend the animal model of tinnitus and provide evidence that the loudness of phantom auditory perception is expressed through observable behavior, can be evaluated, and its changes detected.

  6. 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....

  7. Hvordan kan mindfulness-basert behandling hjelpe for pasienter med tinnitus?

    OpenAIRE

    Valle, Linda

    2014-01-01

    Tinnitus is a common and severe disorder presenting big health issues for the many people affected. The fact that not all people are affected by their tinnitus, have been a puzzle for scientists. This has led to an expanded psychological view of tinnitus over time. Tinnitus as a functional disorder, is first of all a medical disorder, and treatment has been oriented from an audiological perspective. Studies and neurophysiology has shown tinnitus to be a transdiagnostic disorder, which mean th...

  8. Innovations in Doctoral Training and Research on Tinnitus: The European School on Interdisciplinary Tinnitus Research (ESIT) Perspective.

    Science.gov (United States)

    Schlee, Winfried; Hall, Deborah A; Canlon, Barbara; Cima, Rilana F F; de Kleine, Emile; Hauck, Franz; Huber, Alex; Gallus, Silvano; Kleinjung, Tobias; Kypraios, Theodore; Langguth, Berthold; Lopez-Escamez, José A; Lugo, Alessandra; Meyer, Martin; Mielczarek, Marzena; Norena, Arnaud; Pfiffner, Flurin; Pryss, Rüdiger C; Reichert, Manfred; Requena, Teresa; Schecklmann, Martin; van Dijk, Pim; van de Heyning, Paul; Weisz, Nathan; Cederroth, Christopher R

    2017-01-01

    Tinnitus is a common medical condition which interfaces many different disciplines, yet it is not a priority for any individual discipline. A change in its scientific understanding and clinical management requires a shift toward multidisciplinary cooperation, not only in research but also in training. The European School for Interdisciplinary Tinnitus research (ESIT) brings together a unique multidisciplinary consortium of clinical practitioners, academic researchers, commercial partners, patient organizations, and public health experts to conduct innovative research and train the next generation of tinnitus researchers. ESIT supports fundamental science and clinical research projects in order to: (1) advancing new treatment solutions for tinnitus, (2) improving existing treatment paradigms, (3) developing innovative research methods, (4) performing genetic studies on, (5) collecting epidemiological data to create new knowledge about prevalence and risk factors, (6) establishing a pan-European data resource. All research projects involve inter-sectoral partnerships through practical training, quite unlike anything that can be offered by any single university alone. Likewise, the postgraduate training curriculum fosters a deep knowledge about tinnitus whilst nurturing transferable competencies in personal qualities and approaches needed to be an effective researcher, knowledge of the standards, requirements and professionalism to do research, and skills to work with others and to ensure the wider impact of research. ESIT is the seed for future generations of creative, entrepreneurial, and innovative researchers, trained to master the upcoming challenges in the tinnitus field, to implement sustained changes in prevention and clinical management of tinnitus, and to shape doctoral education in tinnitus for the future.

  9. Tinnitus en arbeid. Een onderzoek naar de invloed van stressoren op tinnitus en de mogelijkheid tot werken

    NARCIS (Netherlands)

    Nienke Riemersma, [No Value

    2010-01-01

    Het al dan niet kunnen werken heeft te maken met stressoren die de tinnitus en/of de mogelijkheid tot werken negatief beïnvloeden. Welke stressoren van invloed zijn is in opdracht van de commissie Tinnitus en Hyperacusis van de Nederlandse Vereniging Voor Slechthorenden (NVVS) door de

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

    Directory of Open Access Journals (Sweden)

    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.

  11. [Preliminary investigation of psychologic factors in 76 tinnitus patients].

    Science.gov (United States)

    Mao, Kunhua; Jiang, Wen; Feng, Yong

    2011-08-01

    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 clinically. All patients were detected their frequency and loudness of tinnitus. Then they were evaluated by symptom checklist 90 (SCL-90), life satisfaction scale, Pittsburgh sleep quality index (PSQI) and tinnitus handicap inventory (THI). All data were analyzed with statistical software SPSS11.0. (1)There was no straight line correlation between frequency, loudness of tinnitus and the patient's scores from SCL-90, life satisfaction rating scale (LSR), life satisfaction index A (LSIA), LSIB, PSQI, THI. (2) To 76 tinnitus patients, some factors of SCL-90 were higher than internal nom. Compared with internal nom, tinnitus 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. (3) Grouping 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 about sleep disorder was higher than internal nom. There is no straight line correlation between frequency, loudness of tinnitus and the patient's scores from SCL-90, LSR, LSIA, LSIB, PSQ1, THI. Grouping based on the score of THI, the groups of THI four grade and THI five grade are approved that they have psychologic obstacle obviously, they should be paid close attention.

  12. 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.

  13. Predictors of Preoperative Tinnitus in Unilateral Sporadic Vestibular Schwannoma

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    Georgios Naros

    2017-08-01

    Full Text Available ObjectiveNearly two-thirds of patients with vestibular schwannoma (VS are reporting a significantly impaired quality of life due to tinnitus. VS-associated tinnitus is attributed to an anatomical and physiological damage of the hearing nerve by displacing growth of the tumor. In contrast, the current pathophysiological concept of non-VS tinnitus hypothesizes a maladaptive neuroplasticity of the central nervous system to a (hidden hearing impairment resulting in a subjective misperception. However, it is unclear whether this concept fits to VS-associated tinnitus. This study aims to determine the clinical predictors of VS-associated tinnitus to ascertain the compatibility of both pathophysiological concepts.MethodsThis retrospective study includes a group of 478 neurosurgical patients with unilateral sporadic VS evaluated preoperatively regarding the occurrence of ipsilateral tinnitus depending on different clinical factors, i.e., age, gender, tumor side, tumor size (T1–T4 according to the Hannover classification, and hearing impairment (Gardner–Robertson classification, GR1–5, using a binary logistic regression.Results61.8% of patients complain about a preoperative tinnitus. The binary logistic regression analysis identified male gender [OR 1.90 (1.25–2.75; p = 0.002] and hearing impairment GR3 [OR 1.90 (1.08–3.35; p = 0.026] and GR4 [OR 8.21 (2.29–29.50; p = 0.001] as positive predictors. In contrast, patients with large T4 tumors [OR 0.33 (0.13–0.86; p = 0.024] and complete hearing loss GR5 [OR 0.36 (0.15–0.84; p = 0.017] were less likely to develop a tinnitus. Yet, 60% of the patients with good clinical hearing (GR1 and 25% of patients with complete hearing loss (GR5 suffered from tinnitus.ConclusionThese data are good accordance with literature about non-VS tinnitus indicating hearing impairment as main risk factor. In contrast, complete hearing loss appears a negative predictor for tinnitus. For the first

  14. [Chronic complex tinnitus: therapeutic results of inpatient treatment in a tinnitus clinic].

    Science.gov (United States)

    Hesse, G; Rienhoff, N K; Nelting, M; Laubert, A

    2001-09-01

    In-patient treatment of patients with chronic tinnitus is necessary only when these patients have a severe psychosomatic co-morbidity and suffer severely. However this therapeutic approach has to be supervised and evaluated properly. We present data and results of 1841 patients suffering from chronic tinnitus. Due to the severity of the symptom and psycho-neurotic side effects in-patient treatment was necessary. Therapy lasted 5 - 6 weeks, the main aspect was an intensive psychotherapeutic evaluation and stabilisation next to retraining and habituation programmes. Relaxation techniques were taught. Patients suffered from their tinnitus more than six month; 95 % further suffered from hearing-loss, mainly in high frequencies. The study evaluates results of patients from October 1994 until June 2000. Basis of the study was the evaluation of a specific tinnitus-questionnaire (TQ), published by Hallam in the UK and translated by Goebel and Hiller in Germany. Data was recorded at registration in our clinic, 4 - 6 months later during admission and at the end of the therapy. Final data was gained during a special meeting or questioning 6 months after dismissal from the clinic. Patients that suffered most showed the greatest improvement; directly after therapy there was a highly significant improvement in the TQ for an average of 13.01 points. Highly significant improvements were found in all the TQ-subscales respectively. Only 10 % of the patients did not show any improvement at all. Therapy of most severe cases of chronic tinnitus is possible, using an integrated concept of otologic and psychosomatic treatments. With large numbers of patients and sufficient data a thorough and necessary evaluation of this therapy can be achieved.

  15. Effects of acoustical stimuli delivered through hearing aids on tinnitus.

    Science.gov (United States)

    Sweetow, Robert W; Sabes, Jennifer Henderson

    2010-01-01

    The use of acoustic signals to mask, mix with, or ease the distress associated with tinnitus has been clinically employed for decades. It has been proposed that expanding acoustic options for tinnitus sufferers due to personal preferences is desirable. Fractal tones incorporate many useful characteristics of music while avoiding certain features that could be distracting to some individuals. To assess the effects on relaxation, tinnitus annoyance, tinnitus handicap, and tinnitus reaction from the use of a hearing aid that incorporates combinations of amplification, fractal tones, and white noise. Participants listened to experimental hearing aids containing several acoustic options and were asked to rate the signals in terms of their effect on relaxation and tinnitus annoyance. They subsequently wore the hearing aids for 6 mo and completed tinnitus handicap and reaction scales. Fourteen hearing-impaired adults with primary complaints of subjective tinnitus. Participants were tested wearing hearing aids containing several programs including amplification only, fractal tones only, and a combination of amplification, noise, and/or fractal tones. The fractal tones (now commercially available as the "Zen" feature) were generated by the Widex Mind hearing aid. Rating procedures were conducted in the laboratory, and tinnitus reaction and handicap were assessed during and following a 6 mo field trial. Data were collected at the initial visit, one week, 1 mo, 3 mo, and 6 mo. Nonparametric statistics included Wilcoxon matched-pairs signed-rank, chi(2), and repeated-measures analyses of variance. Thirteen of 14 participants reported that their tinnitus annoyance, as measured by the Tinnitus Annoyance Scale, was reduced for at least one of the amplified conditions (with or without fractal tones or noise), relative to the unaided condition. Nine assigned a lower tinnitus annoyance rating when listening to fractal tones alone versus the amplification-alone condition. There was a

  16. Thalamocortical dysrhythmia: a theoretical update in tinnitus

    Directory of Open Access Journals (Sweden)

    Dirk eDe Ridder

    2015-06-01

    Full Text Available Tinnitus is the perception of a sound in the absence of an external sound source. Pathophysiologically it has been attributed to bottom up deafferentation and/or top down noise-cancelling deficit. Both mechanisms are proposed to alter auditory thalamocortical signal transmission resulting in thalamocortical dysrhythmia (TCD. In deafferentation, TCD is characterized by a slowing down of resting state alpha to theta activity associated with an increase in surrounding gamma activity, resulting in persisting cross-frequency coupling between theta and gamma activity. Theta burst-firing increases network synchrony and recruitment, a mechanism which might enable long range synchrony, which in turn could represent a means for finding the missing thalamocortical information and for gaining access to consciousness. Theta oscillations could function as a carrier wave to integrate the tinnitus related focal auditory gamma activity in a consciousness enabling network, as envisioned by the global workspace model. This model suggests that focal activity in the brain does not reach consciousness, except if the focal activity becomes functionally coupled to a consciousness enabling network, aka the global workspace. In limited deafferentation the missing information can be retrieved from the auditory cortical neighborhood, decreasing surround inhibition, resulting in TCD. When the deafferentation is too wide in bandwidth it is hypothesized that the missing information is retrieved from theta mediated parahippocampal auditory memory. This suggests that based on the amount of deafferentation TCD might change to parahippocampo-cortical persisting and thus pathological theta-gamma rhythm. From a Bayesian point of view, in which the brain is conceived as a prediction machine that updates its memory-based predictions through sensory updating, tinnitus is the result of a prediction error between the predicted and sensed auditory input. The decrease in sensory updating

  17. Somatoform disorders in patients with chronic subjective tinnitus.

    Science.gov (United States)

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

    2016-11-01

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

  18. Association between painful temporomandibular disorders, sleep bruxism and tinnitus

    Directory of Open Access Journals (Sweden)

    Giovana Fernandes

    2014-01-01

    Full Text Available The present cross-sectional study was designed to investigate the association between sleep bruxism (SB, tinnitus and temporomandibular disorders (TMD. The sample consisted of 261 women (mean age of 37.0 years. The Research Diagnostic Criteria for Temporomandibular Disorders were used to classify TMD and self-reported tinnitus. SB was diagnosed by clinical criteria proposed by the American Academy of Sleep Medicine. The results showed an association between painful TMD and tinnitus (OR = 7.3; 95%CI = 3.50-15.39; p < 0.001. With regard to SB, the association was of lower magnitude (OR = 1.9; 95%CI = 1.16-3.26; p < 0.0163. When the sample was stratified by the presence of SB and painful TMD, only SB showed no association with tinnitus. The presence of painful TMD without SB was significantly associated with tinnitus (OR = 6.7; 95%CI = 2.64-17.22; p < 0.0001. The concomitant presence of painful TMD and SB was associated with a higher degree of tinnitus severity (OR = 7.0; 95%CI = 3.00-15.89; p < 0.0001. It may be concluded that there is an association between SB, painful TMD and self-reported tinnitus; however, no relationship of a causal nature could be established.

  19. Assessment of temporomandibular and cervical spine disorders in tinnitus patients.

    Science.gov (United States)

    Björne, Assar

    2007-01-01

    In treating patients with temporomandibular joint (TMJ) dysfunction it was noticed that tinnitus and vertigo were common in such patients and there was also muscular tension in jaw and neck. During treatment of these patients it was also noted that injection of lidocaine in a jaw muscle (m. pt. lat.) reduced not only their muscular problems but also that the tinnitus was reduced while the local anesthetic was active. Evaluation of 39 patients with disabling tinnitus, and all suffered from tinnitus, revealed that 10 of them had bilateral tinnitus and TMJ disorders revealed that pain in the face, temples or jaw occurred often among these patients. Many of such patients had also symptoms of cervical spine disorders, head, neck and shoulder pain, and limitations in side bending and rotation were also frequent complaints. One-third of these patients could influence tinnitus by jaw movements and 75% could trigger vertigo by head or neck movements. Treatment of jaw and neck disorders in 24 patients with Ménière's disease had a beneficial effect on not only their episodic vertigo but also on their tinnitus and aural fullness. At the 3-year follow-up, intensity of all symptoms were significantly reduced (p<0.001).

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

    Science.gov (United States)

    Medeiros, Luisa Nascimento; Sanchez, Tanit Ganz

    2016-01-01

    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. The aim of this study was to evaluate the available evidence about the possible causal association between tinnitus and exposure to electromagnetic waves. 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. 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. There are already reasonable evidences to suggest caution for using mobile phones to prevent auditory damage and the onset or worsening of tinnitus. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  1. Novel technique for rapid screening of tinnitus in rats

    Science.gov (United States)

    Turner, Jeremy G.; Brozoski, Thomas J.; Parrish, Jennifer L.; Bauer, Carol A.; Hughes, Larry F.; Caspary, Donald M.

    2005-04-01

    Measuring tinnitus in laboratory animals is difficult, involving weeks or months of operant training. Preliminary data suggest that rapid screening for tinnitus in rats can be accomplished using an unconditioned acoustic startle reflex. In control animals, a gap in an otherwise constant acoustic background inhibits a subsequent startle response to a sound impulse. If, however, the background signal is qualitatively similar to the animal's tinnitus, poorer detection of the gap and less inhibition of the startle might be expected. Fourteen animals with putative tinnitus at 10 kHz and 13 control animals were tested for gap detection using three different background signals: broadband noise, and filtered bandpass noise centered either at 16 kHz (15.5-16.5 kHz) or at their suspected tinnitus locus of 10 kHz (9.5-10.5 kHz). As predicted, animals with evidence of tinnitus exhibited significantly worse gap detection at 10 kHz, and were not significantly different than control animals at 16 kHz and broadband noise. These results suggest a new methodology for rapidly detecting tinnitus in individual animals. Equipment donated by Hamilton-Kinder Inc Behavioral Testing Systems in the memory of SIU graduate Dorothy Jean Kinder (Walker). [Work supported by NIH grants AG023910-01 (JT), DC4830 (TB & CB), and DC00151 (DC).

  2. Neurofeedback for Tinnitus Treatment - Review and Current Concepts.

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  3. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Directory of Open Access Journals (Sweden)

    Dominik Güntensperger

    2017-12-01

    Full Text Available An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB, a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  4. Phantom auditory perception (tinnitus): mechanisms of generation and perception.

    Science.gov (United States)

    Jastreboff, P J

    1990-08-01

    Phantom auditory perception--tinnitus--is a symptom of many pathologies. Although there are a number of theories postulating certain mechanisms of its generation, none have been proven yet. This paper analyses the phenomenon of tinnitus from the point of view of general neurophysiology. Existing theories and their extrapolation are presented, together with some new potential mechanisms of tinnitus generation, encompassing the involvement of calcium and calcium channels in cochlear function, with implications for malfunction and aging of the auditory and vestibular systems. It is hypothesized that most tinnitus results from the perception of abnormal activity, defined as activity which cannot be induced by any combination of external sounds. Moreover, it is hypothesized that signal recognition and classification circuits, working on holographic or neuronal network-like representation, are involved in the perception of tinnitus and are subject to plastic modification. Furthermore, it is proposed that all levels of the nervous system, to varying degrees, are involved in tinnitus manifestation. These concepts are used to unravel the inexplicable, unique features of tinnitus and its masking. Some clinical implications of these theories are suggested.

  5. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically. PMID:29249959

  6. Underlying Mechanisms of Tinnitus: Review and Clinical Implications

    Science.gov (United States)

    Henry, James A.; Roberts, Larry E.; Caspary, Donald M.; Theodoroff, Sarah M.; Salvi, Richard J.

    2016-01-01

    Background The study of tinnitus mechanisms has increased tenfold in the last decade. The common denominator for all of these studies is the goal of elucidating the underlying neural mechanisms of tinnitus with the ultimate purpose of finding a cure. While these basic science findings may not be immediately applicable to the clinician who works directly with patients to assist them in managing their reactions to tinnitus, a clear understanding of these findings is needed to develop the most effective procedures for alleviating tinnitus. Purpose The goal of this review is to provide audiologists and other health-care professionals with a basic understanding of the neurophysiological changes in the auditory system likely to be responsible for tinnitus. Results It is increasingly clear that tinnitus is a pathology involving neuroplastic changes in central auditory structures that take place when the brain is deprived of its normal input by pathology in the cochlea. Cochlear pathology is not always expressed in the audiogram but may be detected by more sensitive measures. Neural changes can occur at the level of synapses between inner hair cells and the auditory nerve and within multiple levels of the central auditory pathway. Long-term maintenance of tinnitus is likely a function of a complex network of structures involving central auditory and nonauditory systems. Conclusions Patients often have expectations that a treatment exists to cure their tinnitus. They should be made aware that research is increasing to discover such a cure and that their reactions to tinnitus can be mitigated through the use of evidence-based behavioral interventions. PMID:24622858

  7. Analysis of mental disorders in tinnitus patients performed with Composite International Diagnostic Interview.

    Science.gov (United States)

    Zirke, N; Seydel, C; Arsoy, D; Klapp, B F; Haupt, H; Szczepek, A J; Olze, H; Goebel, G; Mazurek, B

    2013-10-01

    Known association between tinnitus and psychological distress prompted us to examine patients with chronic tinnitus by using the Composite International Diagnostic Interview (CIDI), which is a standardized and reliable method used for the diagnosis of mental disorders. One hundred patients with chronic tinnitus admitted to the Tinnitus Center, Charité-Universitätsmedizin Berlin, were included in this study. Data were collected between February 2008 and February 2009. Besides CIDI, the Tinnitus Questionnaire according to Goebel and Hiller, the Hospital Anxiety Depression Scale, and the General Anxiety Disorder-7 were used. Using CIDI, we have identified one or more mental disorders in 46 tinnitus patients. In that group, we found persistent affective disorders (37 %), anxiety disorders (32 %), and somatoform disorders (27 %). Those patients who had affective or anxiety disorders were more distressed by tinnitus and were more anxious and more depressed than tinnitus patients without mental disorders. Psychological impairment positively correlated with tinnitus distress: Patients with decompensated tinnitus had significantly more affective and anxiety disorders than patients with compensated tinnitus. In the present study, we have detected a high rate (almost half of the cases) of psychological disorders occurring in patients with chronic tinnitus. The patients diagnosed with psychological disorders were predominantly affected by affective and anxiety disorders. Psychological disorders were associated with severity of tinnitus distress. Our findings imply a need for routine comprehensive screening of mental disorders in patients with chronic tinnitus.

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

    Science.gov (United States)

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

    2011-05-01

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

  9. Medium-Level Laser in Chronic Tinnitus Treatment

    OpenAIRE

    Dejakum, K.; Piegger, J.; Plewka, C.; Gunkel, A.; Thumfart, W.; Kudaibergenova, S.; 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...

  10. Radiologic diagnostic and therapeutic options in patients with pulsatile tinnitus

    International Nuclear Information System (INIS)

    Wanke, Isabel; Universitaetsklinikum Essen; Forsting, Michael

    2010-01-01

    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.)

  11. The tinnitus intensive therapy habituation program: a 2-year follow-up pilot study on subjective tinnitus.

    Science.gov (United States)

    Bessman, Peter; Heider, Tom; Watten, Veslemøy P; Watten, Reidulf G

    2009-05-01

    To explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. A follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. There were 25 participants with a mean age 50.1 years (SD = 16.1); 10 women (52.7 years; SD = 16.8) and 15 men (48.3 years; SD = 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. There was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD = 14.5) and the final scores were 14.2 (SD = 5.9). In total, the clinical improvement over the follow-up period was 72.1%. The TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognitive factors should also be taken into account. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Evidence and evidence gaps in tinnitus therapy

    Science.gov (United States)

    Hesse, Gerhard

    2016-01-01

    A nearly endless number of procedures has been tried and in particular sold for the treatment of tinnitus, unfortunately they have not been evaluated appropriately in an evidence-based way. A causal therapy, omitting the tinnitus still does not exist, actually it cannot exist because of the various mechanisms of its origin. However or perhaps because of that, medical interventions appear and reappear like fashion trends that can never be proven by stable and reliable treatment success. This contribution will discuss and acknowledge all current therapeutic procedures and the existing or non-existing evidence will be assessed. Beside external evidence, the term of evidence also encompasses the internal evidence, i.e. the experience of the treating physician and the patient’s needs shall be included. While there is no evidence for nearly all direct procedures that intend modulating or stimulating either the cochlea or specific cervical regions such as the auditory cortex, there are therapeutic procedures that are acknowledged in clinical practice and have achieved at least a certain degree of evidence and generate measurable effect sizes. Those are in particular habituation therapy and psychotherapeutic measures, especially if they are combined with concrete measures for improved audio perception (hearing aids, CI, hearing therapies). PMID:28025604

  14. Chronisch-dekompensierter Tinnitus: ein heterogenes Krankheitsbild mit Auswirkungen auf den Behandlungserfolg

    OpenAIRE

    Ivansic, D; Müller, B; Dobel, C; Guntinas-Lichius, O

    2017-01-01

    Einleitung: Bei etwa 5% der Patienten mit chronischem Tinnitus gehen die Ohrgeräusche mit erheblichem Leidensdruck, häufig auch mit psychiatrischen Störung einher. Da es aktuell keine wirksame Behandlung gibt, welche zu Beseitigung des chronischen Tinnitus führt, ist das Therapieziel die Reduktion der Tinnitus-Belastung. Methodik: Es wurden von 7/13 bis 12/14 308 Patienten mit chronischen Tinnitus tagesklinisch interdisziplinär behandelt. Die Tinnitus-Belastung wurde mit Tinnitus-Fragebogen...

  15. Outcomes of long-term outpatient tinnitus-coping therapy: psychometric changes and value of tinnitus-control instruments.

    Science.gov (United States)

    Caffier, Philipp P; Haupt, Heidemarie; Scherer, Hans; Mazurek, Birgit

    2006-12-01

    Increasing tinnitus compliance and coping are desirable aims of successful treatment in chronic tinnitus. However, application of established procedures such as tinnitus retraining therapy (TRT) is often relatively short. In addition, the value of tinnitus control instruments (TCI) is questionable, especially for minor severity levels of tinnitus, and the comparability of treatment results is low. To evaluate long-term changes of tinnitus-related distress, defined psychometric data were collected in patients with compensated tinnitus (cT) or decompensated tinnitus (dT) during a standardized 2-yr outpatient tinnitus-coping therapy (TCT). In a prospective clinical investigation, the data of 70 tinnitus patients were recorded at the beginning and at 6-mo intervals, with a final investigation after 24 mo. The first group consisted of 40 patients with cT and dT who were randomly assigned to a treatment group and a waiting-list control group. After a period of 12 mo without treatment, the control group was treated similarly. The tinnitus questionnaire (TQ) of Goebel and Hiller, visual analog scales (VAS), and a severity questionnaire for tinnitus-associated complaints were used as psychodiagnostic instruments. Therapy components consisted of counseling, fitting patients with TCIs (TCI provision), auditory and relaxation training, and psychosomatic care if necessary. A second group of 30 patients with cT receiving TCT without TCI devices was investigated to evaluate the additive efficacy of TCI in cT. The initial TQ score did not differ between the treatment group and the waiting-list control group. After 12 mo, the control group did not show any significant changes, but the treatment group had improved significantly. During TCT, the combined data of both groups showed a statistically significant decrease of the TQ score in dT (59.1 to 34.8) and cT (32.8 to 24.0). These changes were especially reflected by the subscales of cognitive and emotional distress and also by the

  16. Prevalence of tinnitus and hyperacusis in children and adolescents

    DEFF Research Database (Denmark)

    Rosing, Susanne Nemholt; Schmidt, Jesper Hvass; Wedderkopp, Niels

    2016-01-01

    OBJECTIVES: To systematically review studies of the epidemiology of tinnitus and hyperacusis in children and young people, in order to determine the methodological differences implicated in the variability of prevalence estimates and the influence of population characteristics on childhood tinnitus...... studies, only narrative synthesis of the results was carried out. RESULTS: Having identified 1032 publications, 131 articles were selected and 25 articles met the inclusion criteria and had sufficient methodological consistency to be included. Prevalence estimates of tinnitus range from 4.7% to 46.......1%. CONCLUSIONS: Data on prevalence vary considerably according to the study design, study population and the research question posed. The age range of children studied was varied and a marked degree of variation between definitions (tinnitus, hyperacusis) and measures (severity, perception, annoyance...

  17. The effectiveness of bibliotherapy in alleviating tinnitus-related distress.

    Science.gov (United States)

    Malouff, John M; Noble, William; Schutte, Nicola S; Bhullar, Navjot

    2010-03-01

    The present study examined the efficacy of bibliotherapy in assisting individuals experiencing distress related to tinnitus. One hundred sixty-two tinnitus sufferers from Australia participated in a study designed to examine the effectiveness of a cognitive-behaviorally based self-help book in reducing distress. To maximize the ecological validity of the findings, we excluded no individuals interested in treatment for tinnitus-related distress. The experimental condition lost 35% of participants at postassessment, compared to 10% in the control group. In an analysis of participants who completed postintervention assessment, those assigned to the intervention condition, who received a tinnitus self-help book, showed significantly less tinnitus-related distress and general distress 2 months later compared to those assigned to the waiting list control condition. The intervention group's reduction in tinnitus-related distress and general distress from preintervention to postintervention 2 months later was significant, and these participants maintained a significant reduction in distress on follow-up 4 months after they received the tinnitus self-help book. A long-term follow-up of all participants, who at that time had received the book at least a year previously, showed a significant reduction in tinnitus distress. Although these group differences and pre-post changes were significant, effect sizes were small. Intention-to-treat analyses showed no significant effect for between-groups analyses, but did show a significant effect for the 1-year follow-up pre-post analysis. Information on the effectiveness of using a self-help book, without therapist assistance, in alleviating distress is important, as bibliotherapy can provide inexpensive treatment that is not bound by time or place. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Tinnitus in Context : A Contemporary Contextual Behavioral Approach

    OpenAIRE

    Hesser, Hugo

    2013-01-01

    Tinnitus is the experience of sounds in the ears without any external auditory source and is a common, debilitating, chronic symptom for which we have yet to develop sufficiently efficacious interventions. Cognitive behavioral therapy (CBT) has evolved over the last 20 years to become the most empirically supported treatment for treating the adverse effects of tinnitus. Nevertheless, a significant proportion of individuals do not benefit from CBT-based treatments. In addition, the theoretical...

  19. Imaging findings of pulsatile tinnitus caused by sigmoid sinus abnormalities

    International Nuclear Information System (INIS)

    Liang Xihong; Wang Zhenchang; Gong Shusheng; Xia Yin; Wang Zhengyu; Yang Bentao; Yan Fei; Li Jing; Xian Junfang; Chen Guangli

    2010-01-01

    Objective: To study a rare CT finding of pulsatile tinnitus (PT) caused by sigmoid sinus abnormalities. Methods: The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients (15 female). The median age was 45 years (24 to 63 years). The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years (median time, 2.0 years). The tinnitus was at left side in 5 patients and right side in 10 patients. Fifteen patients underwent HRCT of the temporal bone. Of them, 12 patients underwent cerebral CT angiography and CT venogram (CTA/CTV), and 9 patients underwent cerebral digital subtraction angiography (DSA). Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus. Of them, the tinnitus was at left side in 2 patients and right side in 7 patients. Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results: On HRCT, foca bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients. On CTA/CTV, the sigmoid sinus focally protuded into the adjacent mastoid air cells and formed diverticulum in 10 patients. The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients. The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6 (41.5-96.2)mm 2 , it was 77.0 (92.1-122.4)mm 2 in the nonmal side (Z=2.158, P=0.031). Conclusion: Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus, which can be easily identified by imaging examination. (authors)

  20. Imaging findings of pulsatile tinnitus caused by sigmoid sinus abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Xihong, Liang; Zhenchang, Wang; Shusheng, Gong; Yin, Xia; Zhengyu, Wang; Bentao, Yang; Fei, Yan; Jing, Li; Junfang, Xian; Guangli, Chen [Department of Radiology, Beijing Tongren Hospital, Capital University of Medical Science, Beijing (China)

    2010-04-15

    Objective: To study a rare CT finding of pulsatile tinnitus (PT) caused by sigmoid sinus abnormalities. Methods: The imaging data of PT caused by sigmoid sinus abnormalities were analyzed retrospectively in 15 patients (15 female). The median age was 45 years (24 to 63 years). The duration of persistence pulsatile tinnitus was from 0.5 year to 36.0 years (median time, 2.0 years). The tinnitus was at left side in 5 patients and right side in 10 patients. Fifteen patients underwent HRCT of the temporal bone. Of them, 12 patients underwent cerebral CT angiography and CT venogram (CTA/CTV), and 9 patients underwent cerebral digital subtraction angiography (DSA). Nine patients underwent transmastoid reconstruction surgery of the sigmoid sinus. Of them, the tinnitus was at left side in 2 patients and right side in 7 patients. Paired rank sum test was used to compare the cross-sectional area of the sigmoid sinus of the tinnitus side and normal side.Results: On HRCT, foca bony coarse defect is shown in the anterior sigmoid wall in 11 patients and anterolateral sigmoid wall in 4 patients. On CTA/CTV, the sigmoid sinus focally protuded into the adjacent mastoid air cells and formed diverticulum in 10 patients. The pulsatile tinnitus disappeared immediately after transmastoid reconstruction surgery of the sigmoid sinus in all 9 patients. The cross-sectional area of the sigmoid sinus of the tinnitus side was 100.6 (41.5-96.2)mm{sup 2}, it was 77.0 (92.1-122.4)mm{sup 2} in the nonmal side (Z=2.158, P=0.031). Conclusion: Focal bony defect of the sigmoid wall with sigmoid sinus diverticula is one of the causes which lead to pulsatile tinnitus, which can be easily identified by imaging examination. (authors)

  1. Tinnitus and hyperacusis: Contributions of paraflocculus, reticular formation and stress.

    Science.gov (United States)

    Chen, Yu-Chen; Chen, Guang-Di; Auerbach, Benjamin D; Manohar, Senthilvelan; Radziwon, Kelly; Salvi, Richard

    2017-06-01

    Tinnitus and hyperacusis are common and potentially serious hearing disorders associated with noise-, age- or drug-induced hearing loss. Accumulating evidence suggests that tinnitus and hyperacusis are linked to excessive neural activity in a distributed brain network that not only includes the central auditory pathway, but also brain regions involved in arousal, emotion, stress and motor control. Here we examine electrophysiological changes in two novel non-auditory areas implicated in tinnitus and hyperacusis: the caudal pontine reticular nucleus (PnC), involved in arousal, and the paraflocculus lobe of the cerebellum (PFL), implicated in head-eye coordination and gating tinnitus and we measure the changes in corticosterone stress hormone levels. Using the salicylate-induced model of tinnitus and hyperacusis, we found that long-latency (>10 ms) sound-evoked response components in both the brain regions were significantly enhanced after salicylate administration, while the short-latency responses were reduced, likely reflecting cochlear hearing loss. These results are consistent with the central gain model of tinnitus and hyperacusis, which proposes that these disorders arise from the amplification of neural activity in central auditory pathway plus other regions linked to arousal, emotion, tinnitus gating and motor control. Finally, we demonstrate that salicylate results in an increase in corticosterone level in a dose-dependent manner consistent with the notion that stress may interact with hearing loss in tinnitus and hyperacusis development. This increased stress response has the potential to have wide-ranging effects on the central nervous system and may therefore contribute to brain-wide changes in neural activity. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. A Conditioned Behavioral Paradigm for Assessing Onset and Lasting Tinnitus in Rats

    Science.gov (United States)

    Pace, Edward; Luo, Hao; Bobian, Michael; Panekkad, Ajay; Zhang, Xueguo; Zhang, Huiming; Zhang, Jinsheng

    2016-01-01

    Numerous behavioral paradigms have been developed to assess tinnitus-like behavior in animals. Nevertheless, they are often limited by prolonged training requirements, as well as an inability to simultaneously assess onset and lasting tinnitus behavior, tinnitus pitch or duration, or tinnitus presence without grouping data from multiple animals or testing sessions. To enhance behavioral testing of tinnitus, we developed a conditioned licking suppression paradigm to determine the pitch(s) of both onset and lasting tinnitus-like behavior within individual animals. Rats learned to lick water during broadband or narrowband noises, and to suppress licking to avoid footshocks during silence. After noise exposure, rats significantly increased licking during silent trials, suggesting onset tinnitus-like behavior. Lasting tinnitus-behavior, however, was exhibited in about half of noise-exposed rats through 7 weeks post-exposure tested. Licking activity during narrowband sound trials remained unchanged following noise exposure, while ABR hearing thresholds fully recovered and were comparable between tinnitus(+) and tinnitus(-) rats. To assess another tinnitus inducer, rats were injected with sodium salicylate. They demonstrated high pitch tinnitus-like behavior, but later recovered by 5 days post-injection. Further control studies showed that 1): sham noise-exposed rats tested with footshock did not exhibit tinnitus-like behavior, and 2): noise-exposed or sham rats tested without footshocks showed no fundamental changes in behavior compared to those tested with shocks. Together, these results demonstrate that this paradigm can efficiently test the development of noise- and salicylate-induced tinnitus behavior. The ability to assess tinnitus individually, over time, and without averaging data enables us to realistically address tinnitus in a clinically relevant way. Thus, we believe that this optimized behavioral paradigm will facilitate investigations into the mechanisms of

  3. Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part II: a Systematic Review of Neurosensory Complications

    Directory of Open Access Journals (Sweden)

    Boris Abayev

    2015-03-01

    Full Text Available Objectives: This article, the second in a two-part series, continues the discussion of inferior alveolar nerve lateralization/transposition for dental implant placement. The aim of this article is to review the scientific literature and clinical reports in order to analyse the neurosensory complications, risks and disadvantages of lateralization/transposition of the inferior alveolar nerve followed by implant placement in an edentulous atrophic posterior mandible. Material and Methods: A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC databases, as well as academic sites and books. The articles were searched from January 1997 to July 2014. Articles in English language, which included adult patients between 18 - 80 years of age who had minimal residual bone above the mandibular canal and had undergone inferior alveolar nerve (IAN repositioning, with minimum 6 months of follow-up, were included. Results: A total of 21 studies were included in this review. Ten were related to IAN transposition, 7 to IAN lateralization and 4 to both transposition and lateralization. The IAN neurosensory disturbance function was present in most patients (99.47% [376/378] for 1 to 6 months. In total, 0.53% (2/378 of procedures the disturbances were permanent. Conclusions: Inferior alveolar nerve repositioning is related to initial transient change in sensation in the majority of cases. The most popular causes of nerve damage are spatula-caused traction in the mucoperiosteal flap, pressure due to severe inflammation or retention of fluid around the nerve and subsequent development of transient ischemia, and mandibular body fracture.

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

    Science.gov (United States)

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

    2013-01-01

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

  5. The Mozart effect in patients suffering from tinnitus.

    Science.gov (United States)

    Attanasio, Giuseppe; Cartocci, Giulia; Covelli, Edoardo; Ambrosetti, Elena; Martinelli, Valentina; Zaccone, Mariagrazia; Ponzanetti, Alessandra; Gueli, Nicolò; Filipo, Roberto; Cacciafesta, Mauro

    2012-11-01

    The study suggests that Mozart therapy could be a valid alternative to the common sound therapy methods in tinnitus patients. The aim of the study was to evaluate the presence of the Mozart effect as indexed by a variation in tinnitus intensity and tolerability. Sixty-two individuals aged between 22 and 78 years, reporting tinnitus for at least 1 year, were enrolled for the study. All patients attended a 1 h cognitive behavioral counseling session and listened to Mozart's sonata k448 for 1 h per day for a month. Afterwards patients listened to Beethoven's Für Elise sonata for 1 h per day for a month. To evaluate the general stress level, the impact of tinnitus on patients' quality of life, and the intensity of tinnitus, patients were invited to participate in three tests: the Measure du Stress Psychologique (MSP) questionnaire, the Tinnitus Handicap Inventory (THI), and a 0 to 10 visual analog scale (VAS). For all the parameters investigated, MSP, THI, and intensity, there was a general significant improvement between the pre- and post-listening evaluation. A significant improvement, as regards THI and intensity, could already be appreciated after a single exposure to Mozart's sonata.

  6. Maladaptive plasticity in tinnitus-triggers, mechanisms and treatment

    Science.gov (United States)

    Shore, Susan E; Roberts, Larry E.; Langguth, Berthold

    2016-01-01

    Tinnitus is a phantom auditory sensation that reduces quality of life for millions worldwide and for which there is no medical cure. Most cases are associated with hearing loss caused by the aging process or noise exposure. Because exposure to loud recreational sound is common among youthful populations, young persons are at increasing risk. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state may play a role in tinnitus development and maintenance via top-down mechanisms. Thus, military in combat are particularly at risk due to combined hearing loss, somatosensory system disturbances and emotional stress. Neuroscience research has identified neural changes related to tinnitus that commence at the cochlear nucleus and extend to the auditory cortex and brain regions beyond. Maladaptive neural plasticity appears to underlie these neural changes, as it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures that may generate the phantom percept. This review highlights the links between animal and human studies, including several therapeutic approaches that have been developed, which aim to target the neuroplastic changes underlying tinnitus. PMID:26868680

  7. Innovations in Doctoral Training and Research on Tinnitus: The European School on Interdisciplinary Tinnitus Research (ESIT Perspective

    Directory of Open Access Journals (Sweden)

    Winfried Schlee

    2018-01-01

    Full Text Available Tinnitus is a common medical condition which interfaces many different disciplines, yet it is not a priority for any individual discipline. A change in its scientific understanding and clinical management requires a shift toward multidisciplinary cooperation, not only in research but also in training. The European School for Interdisciplinary Tinnitus research (ESIT brings together a unique multidisciplinary consortium of clinical practitioners, academic researchers, commercial partners, patient organizations, and public health experts to conduct innovative research and train the next generation of tinnitus researchers. ESIT supports fundamental science and clinical research projects in order to: (1 advancing new treatment solutions for tinnitus, (2 improving existing treatment paradigms, (3 developing innovative research methods, (4 performing genetic studies on, (5 collecting epidemiological data to create new knowledge about prevalence and risk factors, (6 establishing a pan-European data resource. All research projects involve inter-sectoral partnerships through practical training, quite unlike anything that can be offered by any single university alone. Likewise, the postgraduate training curriculum fosters a deep knowledge about tinnitus whilst nurturing transferable competencies in personal qualities and approaches needed to be an effective researcher, knowledge of the standards, requirements and professionalism to do research, and skills to work with others and to ensure the wider impact of research. ESIT is the seed for future generations of creative, entrepreneurial, and innovative researchers, trained to master the upcoming challenges in the tinnitus field, to implement sustained changes in prevention and clinical management of tinnitus, and to shape doctoral education in tinnitus for the future.

  8. Evaluating the Precision of Auditory Sensory Memory as an Index of Intrusion in Tinnitus.

    Science.gov (United States)

    Barrett, Doug J K; Pilling, Michael

    The purpose of this study was to investigate the potential of measures of auditory short-term memory (ASTM) to provide a clinical measure of intrusion in tinnitus. Response functions for six normal listeners on a delayed pitch discrimination task were contrasted in three conditions designed to manipulate attention in the presence and absence of simulated tinnitus: (1) no-tinnitus, (2) ignore-tinnitus, and (3) attend-tinnitus. Delayed pitch discrimination functions were more variable in the presence of simulated tinnitus when listeners were asked to divide attention between the primary task and the amplitude of the tinnitus tone. Changes in the variability of auditory short-term memory may provide a novel means of quantifying the level of intrusion associated with the tinnitus percept during listening.

  9. Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation

    NARCIS (Netherlands)

    Staal, M. J.; Holm, A. F.; Mooij, J. J. A.; Albers, F. W. J.; Bartels, H.

    2007-01-01

    Objective: Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by means of chronic electrical stimulation of the vestibulocochlear nerve. Patients: Inclusion criteria were severe, chronic, therapeutically refractory, unilateral tinnitus and severe hearing loss at the

  10. Adaptation of the Tinnitus Handicap Inventory into Polish and its testing on a clinical population of tinnitus sufferers.

    Science.gov (United States)

    Skarzynski, Piotr H; Raj-Koziak, Danuta; J Rajchel, Joanna; Pilka, Adam; Wlodarczyk, Andrzej W; Skarzynski, Henryk

    2017-10-01

    To describe how the Tinnitus Handicap Inventory (THI) was translated into Polish (THI-POL) and to present psychometric data on how well it performed in a clinical population of tinnitus sufferers. The original version of THI was adapted into Polish. The reliability of THI-POL was investigated using test-retest, Cronbach's alpha, endorsement rate and item-total correlation. Construct validity and convergent validity were also assessed based on confirmatory factor analysis, inter-item correlation and Pearson product-moment correlations using subscale A (Tinnitus) of the Tinnitus and Hearing Survey (THS-POL); divergent validity was checked using subscale B (Hearing) of THS-POL. A group of 167 adults filled in THI-POL twice over their three-day hospitalisation period. Test-retest reliability for the total THI-POL scores was strong (r = 0.91). Cronbach's alpha coefficient for the total score was high (r = 0.95), confirming the questionnaire's stability. Confirmatory factor analysis (CFA) and inter-item correlation did not confirm the three-factor model. Convergent validity from the Tinnitus subscale of THS showed a positive strong (r = 0.75) correlation. Divergent validity showed only a moderate correlation. All analyses were statistically significant (p tinnitus handicap of Polish-speaking patients to be effectively assessed.

  11. Joint medico-psychological consultation for patients suffering from tinnitus.

    Science.gov (United States)

    Degive, Colette; Kos, Maria-Izabel

    2006-01-01

    Because no effective treatment against tinnitus is available, all sorts of approaches have been developed. We believe the care of tinnitus patients concerns mainly ENT medical doctors. In order to take care of such patients, we started in 1993 a joint medico-psychological consultation (JMPC) to dispense adequate care for patients and training to the ENT residents. Every patient visiting our clinic for a tinnitus consultation benefits first from a comprehensive audiological examination. Once all objective causes of tinnitus are excluded, those patients who were not able to accept their auditory disorder or who insist on focusing on the annoyance caused by the perception of their tinnitus are invited by the doctor to the JMPC. The intolerance caused by tinnitus is enhanced by psychological and social aspects. These aspects are considered and discussed during the JMPC. The patients talk about their tinnitus bringing additional information on professional, familial and relational issues. In the JMPC, the therapists try to help the patients to void the affective irritation and the internal tension they clearly demonstrate. When the patients notice that the therapists accept their distress, they usually talk more calmly about their hearing irritation and even consider it tolerable. The medical and psychological information given during the JMPC helps the patients to understand the links between tinnitus and the disturbing elements of their current life. During the JMPC, the medical residents have been able to observe how somatic complaints can lead to complaints of another nature, to distress, to aggressive or angered behaviors. They have acknowledged the way the psychologist deals with the attitudes of these patients. This learning process became mandatory to all our residents specializing in ENT. At the end of their training they should have learned how to help the patient accept the tinnitus and the irritation it causes. They should be able to help tinnitus patients

  12. Examination of anxiety disorder and distress in patients with chronic 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...

  13. Do patient characteristics predict outcome in the outpatient treatment of chronic tinnitus?

    OpenAIRE

    Kr?ner-Herwig, Birgit; Zachriat, Claudia; Weigand, Doreen

    2006-01-01

    Various patient characteristics were assessed before offering a treatment to reduce tinnitus related distress to 57 individuals suffering from chronic idiopathic tinnitus. Patients were randomly assigned to a cognitive-behavioral tinnitus coping training (TCT) and a habituation-based training (HT) modelled after Tinnitus Retraining Therapy (TRT) as conceived by Jastreboff. Both trainings were conducted in groups. It was hypothesized that comorbidity regarding mental disorders or psychopatholo...

  14. The occlusal imaging and analysis system by T-scan III in tinnitus patients

    OpenAIRE

    Di Berardino, Federica; Filipponi, Eliana; Schiappadori, Massimo; Forti, Stella; Zanetti, Diego; Cesarani, Antonio

    2016-01-01

    Background: Several studies have demonstrated that the prevalence of temporomandibular disorders (TMDs) in tinnitus patients ranges from 7% to 95%, and it is reported in literature that idiopathic tinnitus patients should be referred to a dentist to define whether or not the tinnitus is associated with TMD. However, the possible pathophysiological relation between TMDs and tinnitus is not generally investigated in clinical practice. Methods: The patterns and forces of occlusal contacts hav...

  15. Original article New challenges for clinical health psychology in diagnosis and therapy of tinnitus

    OpenAIRE

    Monika Klepas; Eugeniusz Szymiec; Helena Sęk; Zofia Obrębowska; Anna Sowińska

    2014-01-01

    Background Tinnitus is becoming a social issue as the number of individuals suffering from this condition is still increasing. The aim of this study was to analyze the characteristics of tinnitus and related distress, as well as general psychiatric distress of affected individuals. Participants and procedure The study included 169 tinnitus patients aged between 22 and 88 years (mean 53.52). The duration of tinnitus ranged between 5 months and 30 years (mean 5.29 years). Th...

  16. Neural activity underlying tinnitus generation : Results from PET and fMRI

    NARCIS (Netherlands)

    Lanting, C. P.; de Kleine, E.; van Dijk, P.

    Tinnitus is the percept of sound that is not related to an acoustic source outside the body. For many forms of tinnitus, mechanisms in the central nervous system are believed to play an important role in the pathology. Specifically, three mechanisms have been proposed to underlie tinnitus: (1)

  17. Effect of Age, Gender and Hearing Loss on the Degree of Discomfort Due to Tinnitus

    Directory of Open Access Journals (Sweden)

    Maryam Noroozian

    2017-11-01

    Conclusion: The study findings suggests that tinnitus is not correlated with age, gender and hearing loss. Overall, tinnitus is a complicated clinical condition which its real impact and degree of discomfort are unclear. More investigation is needed to clarify the factors involving in tinnitus annoyance.

  18. Evaluation of Audiological Characteristics of Patients with Tinnitus ‎Referring to Otolaryngology Clinics of Babol

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    K Kiakojori

    2016-01-01

    Full Text Available BACKGROUND AND OBJECTIVE: Tinnitus is a common symptom associated with hearing loss and its related disorders. Awareness of audiological features is of paramount importance for effective management of tinnitus. This study aimed to evaluate audiological characteristics of tinnitus in patients referring to otolaryngology clinics of Babol, Iran. METHODS: This cross-sectional study was conducted on 120 patients with tinnitus (47 male, 73 female with mean age of 47.12±15.285 years referring to otolaryngology clinics of Babol, Iran. Patients were examined via pure tone audiometry at frequency of 250-8000 Hz to determine the location and type of tinnitus. FINDINGS: In this study, 104 patients (88.7% had hearing loss, 103 patients had tonal tinnitus with dizziness, 17 patients had loud tinnitus with no dizziness, 45 cases (37.5% had bilateral tinnitus, 75 patients (62.5% had unilateral tinnitus, and 17 patients had family history of tinnitus. Among female patients, two cases (1.7% experienced tinnitus during pregnancy, while in four patients (3.3%, it was reported immediately after pregnancy. CONCLUSION: According to the results of this study, bilateral sensorineural hearing loss has a higher prevalence among patients with tinnitus

  19. [Suppression of tinnitus by band noise masker--a study of 600 cases].

    Science.gov (United States)

    Watanabe, K; Kamio, T; Ohkawara, D; Aoki, H; Baba, S; Yagi, T

    1997-09-01

    We performed Band Noise Masker (BNM) therapy for the suppression of tinnitus in 600 patients and measured the pitch, loudness and masking level of tinnitus and residual inhibition (RI). We examined the efficiency of BNM therapy. The purpose of this study was to investigate the mechanism of suppression of tinnitus by BNM. Tinnitus was suppressed in 394 patients (66%) after BNM therapy. In the group of patients in whom we suppressed tinnitus, the loudness of tinnitus was reduced from 7.7 +/- 5.7dBSL to 7.5 +/- 5.5dBSL (p pitch of tinnitus did not exhibit a marked change. In the group of patients in whom we did not suppress tinnitus, the loudness and pitch of tinnitus did not exhibit a marked change. The efficiency of BNM therapy was high in the cases of presbyacusis and low in the cases of sudden deafness. There was no significant relationship between RI and the efficiency of BNM therapy. We examined these data and discussed the mechanism of suppression of tinnitus by BNM therapy. In all cases, after BNM therapy, the auditory threshold did not become worse. In 4 cases tinnitus became worse temporarily. In conclusion, BNM therapy is an effective mode for tinnitus control, is easily performed in our outpatient clinic or at home, and has no serious complications.

  20. Effect of stapedotomy on pre-operative tinnitus and its psychosomatic burden.

    Science.gov (United States)

    Bast, Florian; Mazurek, Birgit; Schrom, Thomas

    2013-12-01

    According to the literature, between 40 and 90% of otosclerosis patients suffering from hearing loss also suffer from tinnitus on the affected side. For a lot of these patients tinnitus represents a handicap that is just as debilitating as the hearing loss itself. The main goal of the surgical treatment of otosclerosis is a significant improvement in hearing loss, but frequent reports of reduced tinnitus after surgery suggest that this can be a positive side effect. All patients who underwent stapedotomy were initially included in the study. Retrospectively, the tinnitus questionnaire as compiled by Goebel and Hiller was sent to the patients, and 34 patients (37 ears) replied. The pre- and postoperative cases of tinnitus were divided into compensated and non-compensated tinnitus. In addition the following tinnitus-related factors were evaluated: emotional, cognitive and mental burden; intrusiveness of the tinnitus; hearing problems; somatic ailments; and sleep disturbances. Over 80% of the patients surveyed suffered from tinnitus pre-operation. The tinnitus disappeared or improved in over 60% of the cases after stapedotomy. In addition, the related factors surveyed also improved appreciably post surgery and reached a significant level in patients with compensated tinnitus. Besides a significant improvement in hearing loss the intensity and the psychosomatic burden of a pre-operative tinnitus can be reduced by stapedotomy. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. Factor Analysis of Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus

    Directory of Open Access Journals (Sweden)

    Hui Wang

    2016-01-01

    Full Text Available Objectives. We investigated factors that contribute to suppression of tinnitus after repetitive transcranial magnetic stimulation (rTMS. Methods. A total of 289 patients with tinnitus underwent active 1 Hz rTMS in the left temporoparietal region. A visual analog scale (VAS was used to assess tinnitus loudness. All participants were interviewed regarding age, gender, tinnitus duration, laterality and pitch, audiometric parameters, sleep, and so forth. The resting motor thresholds (RMTs were measured in all patients and 30 age- and gender-matched volunteers. Results. With respect to different factors that contribute to tinnitus suppression, we found improvement in the following domains: shorter duration, normal hearing (OR: 3.25, 95%CI: 2.01–5.27, p=0.001, and without sleep disturbance (OR: 2.51, 95%CI: 1.56–4.1, p=0.005 adjusted for age and gender. The patients with tinnitus lasting less than 1 year were more likely to show suppression of tinnitus (OR: 2.77, 95%CI: 1.48–5.19, p=0.002 compared to those with tinnitus lasting more than 5 years. Tinnitus patients had significantly lower RMTs compared with healthy volunteers. Conclusion. Active low-frequency rTMS results in a significant reduction in the loudness of tinnitus. Significant tinnitus suppression was shown in subjects with shorter tinnitus duration, with normal hearing, and without sleep disturbance.

  2. 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:

  3. Factor Analysis of Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus

    Science.gov (United States)

    Li, Bei; Wang, Meiye; Li, Ming; Yin, Shankai

    2016-01-01

    Objectives. We investigated factors that contribute to suppression of tinnitus after repetitive transcranial magnetic stimulation (rTMS). Methods. A total of 289 patients with tinnitus underwent active 1 Hz rTMS in the left temporoparietal region. A visual analog scale (VAS) was used to assess tinnitus loudness. All participants were interviewed regarding age, gender, tinnitus duration, laterality and pitch, audiometric parameters, sleep, and so forth. The resting motor thresholds (RMTs) were measured in all patients and 30 age- and gender-matched volunteers. Results. With respect to different factors that contribute to tinnitus suppression, we found improvement in the following domains: shorter duration, normal hearing (OR: 3.25, 95%CI: 2.01–5.27, p = 0.001), and without sleep disturbance (OR: 2.51, 95%CI: 1.56–4.1, p = 0.005) adjusted for age and gender. The patients with tinnitus lasting less than 1 year were more likely to show suppression of tinnitus (OR: 2.77, 95%CI: 1.48–5.19, p = 0.002) compared to those with tinnitus lasting more than 5 years. Tinnitus patients had significantly lower RMTs compared with healthy volunteers. Conclusion. Active low-frequency rTMS results in a significant reduction in the loudness of tinnitus. Significant tinnitus suppression was shown in subjects with shorter tinnitus duration, with normal hearing, and without sleep disturbance. PMID:27847647

  4. The gap detection test: can it be used to diagnose tinnitus?

    NARCIS (Netherlands)

    Boyen, Kris; Baskent, D.; van Dijk, P.

    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

  5. 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

  6. What progress have we made with tinnitus? The Tonndorf Lecture 2005.

    Science.gov (United States)

    Baguley, David M

    2006-12-01

    The field of tinnitus research is vibrant and active. Prospects for progress are high, but would be optimized by the growth of inter-disciplinary collaborations. Tinnitus remains a source of urgent scientific investigation, and truly effective treatments continue to be elusive. The Tonndorf Lecture of the International Tinnitus Seminars represents an opportunity to reflect upon progress to date regarding tinnitus, and the actions needed to further that progress in future. Progress regarding tinnitus mechanisms is reviewed, with particular regard to the conceptual distinction between ignition sites for tinnitus, and the physiological mechanisms that then promote the tinnitus through the central auditory pathway. The current status of both the Jastreboff neurophysiological model and the psychological model of tinnitus is reviewed. Some concerns regarding each model are raised, and the need for models that integrate the insights of both perspectives is identified as urgent. There are clear indications of progress in tinnitus, specifically regarding mechanisms, models and treatments. For knowledge to progress further, however, there is a pressing need for an inter-disciplinary approach to tinnitus, more involvement in teaching at a postgraduate level, and the development of experimental models of tinnitus that are both congruent with, and represent the complexity of, human experience of tinnitus.

  7. The comparison of acoustic and psychic parameters of subjective tinnitus.

    Science.gov (United States)

    Karatas, Erkan; Deniz, Murat

    2012-02-01

    We aim to assess the correlation between audiometric data, and psychotic and acoustic measures associated with subjective tinnitus (ST) and to clarify the importance of the psychological process in determining the degree of subjective annoyance and disability due to tinnitus. Fifty-four patients experiencing unilateral ST were allocated for the study. Acoustic assessment of patients including LDL (loudness discomfort levels), MML (minimum masking level) and RI (residual inhibition) was performed. Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI) and Visual Analog Scale (VAS) tests were performed for the psychological aspects of subjective annoyance. RI was positive in 23 patients with 13 frequency-matched stimuli at 8,000 Hz. Masking treatment response was successful in 16 RI-positive patients. Mean and standard deviation (SD) of THI scores were 38.77 ± 23.63. Ten patients (%18.51) with tinnitus had ≥ 17 points score, which was significant for BDI. Mean and SD were 5.01 ± 2.31 for VAS-1 scores (severity of tinnitus), 7.98 ± 2.79 for VAS-2 (frequency and duration of tinnitus), 5.77 ± 2.72 for VAS-3 (discomfort level), 3.56 ± 3.30 for VAS-4 (attention deficit) and 3.31 ± 3.31 for VAS-5 (sleep disorders). A significant correlation was found between the tinnitus duration time, age, gender and THI scores (P 0.05). RI might be largely frequency dependent and was found as an indicator for the masking treatment response. We did not notice statistically significant correlations between audiometric data and THI and BDI. There were correlations between with VAS and LDL and with MML and RI. VAS was simpler and easier for the assessment of ST. We should consider the psychological aspects of ST and assess it as a symptom separately with acoustic and psychotic tests.

  8. Noise-induced tinnitus using individualized gap detection analysis and its relationship with hyperacusis, anxiety, and spatial cognition.

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    Edward Pace

    Full Text Available Tinnitus has a complex etiology that involves auditory and non-auditory factors and may be accompanied by hyperacusis, anxiety and cognitive changes. Thus far, investigations of the interrelationship between tinnitus and auditory and non-auditory impairment have yielded conflicting results. To further address this issue, we noise exposed rats and assessed them for tinnitus using a gap detection behavioral paradigm combined with statistically-driven analysis to diagnose tinnitus in individual rats. We also tested rats for hearing detection, responsivity, and loss using prepulse inhibition and auditory brainstem response, and for spatial cognition and anxiety using Morris water maze and elevated plus maze. We found that our tinnitus diagnosis method reliably separated noise-exposed rats into tinnitus((+ and tinnitus((- groups and detected no evidence of tinnitus in tinnitus((- and control rats. In addition, the tinnitus((+ group demonstrated enhanced startle amplitude, indicating hyperacusis-like behavior. Despite these results, neither tinnitus, hyperacusis nor hearing loss yielded any significant effects on spatial learning and memory or anxiety, though a majority of rats with the highest anxiety levels had tinnitus. These findings showed that we were able to develop a clinically relevant tinnitus((+ group and that our diagnosis method is sound. At the same time, like clinical studies, we found that tinnitus does not always result in cognitive-emotional dysfunction, although tinnitus may predispose subjects to certain impairment like anxiety. Other behavioral assessments may be needed to further define the relationship between tinnitus and anxiety, cognitive deficits, and other impairments.

  9. Somatosensory Tinnitus: Correlation between Cranio-Cervico-Mandibular Disorder History and Somatic Modulation.

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    Ralli, Massimo; Altissimi, Giancarlo; Turchetta, Rosaria; Mazzei, Filippo; Salviati, Massimo; Cianfrone, Francesca; Orlando, Maria Patrizia; Testugini, Valeria; Cianfrone, Giancarlo

    2016-01-01

    In a subpopulation of patients, tinnitus can be modulated by movements of the jaw or head and neck due to complex somatosensory-auditory interactions. In some of these subjects, tinnitus could be related to an underlying temporomandibular (TMJ) or craniocervical (NECK) dysfunction that, if correctly identified, could streamline treatment and increase chances of tinnitus improvement. However, it is still unclear whether somatic modulation of tinnitus could be used as a screening tool for identifying such patients. In this study, we included 310 tinnitus patients with normal hearing, no psychiatric comorbidities, and a positive history of TMJ and/or NECK dysfunction and/or a positive modulation of tinnitus to evaluate the characteristics of somatic modulation, investigate the relationship between positive history and positive modulation, and identify factors most strongly associated with somatic modulation. Tinnitus modulation was present in 79.67% of the patients. We found a significant association within the same subjects between a positive history and a positive tinnitus modulation for the same region, mainly for TMJ in unilateral tinnitus patients and for TMJ + NECK in bilateral tinnitus patients. A strong correlation between history and modulation in the same somatic region within the same subgroups of subjects was also identified. Most TMJ maneuvers resulted in an increased loudness, while NECK maneuvers showed an increase in tinnitus loudness in about 59% of cases. High-pitched tinnitus and male gender were associated with a higher prevalence of modulation; no differences were found for tinnitus onset, Tinnitus Handicap Inventory score, and age. In this paper, we report a strong association between history and modulation for the same regions within the same patients; such an association should always be investigated to improve chances of a correct diagnosis of somatosensory tinnitus. © 2017 S. Karger AG, Basel.

  10. Assessing audiological, pathophysiological, and psychological variables in chronic tinnitus: a study of reliability and search for prognostic factors.

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    Hiller, W; Goebel, G

    1999-01-01

    The development and course of chronic tinnitus are determined by both biological and psychological factors. To combine these different sources of data, we developed a standardized interview to assess tinnitus history, summarize audiological findings, screen for etiological conditions, and explore tinnitus-related psychological complaints (Structured Tinnitus Interview). The results of a test-retest study with 65 tinnitus inpatients show that most of these components can be assessed with acceptable or high reliability. Further data based on 166 patients demonstrate that tinnitus annoyance was to some extent different from patterns of general psychological complaints, although there were medium intercorrelations with depression. Significant predictors of tinnitus annoyance were (a) continuous tinnitus without intervals, (b) hearing loss, (c) increasing tinnitus loudness over time, (d) poor maskability, (e) history of sudden hearing loss, and (f) associated craniomandibular disorder. Psychological distress was not significantly increased in patients whose tinnitus was associated to vascular disorder, cervical spine dysfunction, acoustic trauma, Menihre's disease, or neurological disorder.

  11. Biomarkers of Presbycusis and Tinnitus in a Portuguese Older Population

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    Haúla F. Haider

    2017-11-01

    Full Text Available Introduction: Presbycusis or age-related hearing loss (ARHL is a ubiquitous health problem. It is estimated that it will affect up to 1.5 billion people by 2025. In addition, tinnitus occurs in a large majority of cases with presbycusis. Glutamate metabotropic receptor 7 (GRM7 and N-acetyltransferase 2 (NAT2 are some of the genetic markers for presbycusis.Objectives: To explore patterns of hearing loss and the role of GRM7 and NAT2 as possible markers of presbycusis and tinnitus in a Portuguese population sample.Materials and Methods: Tonal and speech audiometry, tinnitus assessment, clinical interview, and DNA samples were obtained from patients aged from 55 to 75 with or without tinnitus. GRM7 analysis was performed by qPCR. Genotyping of single nucleotide polymorphisms (SNPs in NAT2 was performed by PCR amplification followed by Sanger sequencing or by qPCR.Results: We screened samples from 78 individuals (33 men and 45 women. T allele at GRM7 gene was the most observed (60.3% T/T and 33.3% A/T. Individuals with a T/T genotype have a higher risk for ARHL and 33% lower risk for tinnitus, compared to individuals with A/A and A/T genotype, respectively. Being a slow acetylator (53% was the most common NAT2 phenotype, more common in men (55.8%. Intermediate acetylator was the second most common phenotype (35.9% also more frequent in men (82.6%. Noise exposed individuals and individuals with ‘high frequency’ hearing loss seem to have a higher risk for tinnitus. Our data suggests that allele AT of GRM7 can have a statistically significant influence toward the severity of tinnitus.Conclusion: For each increasing year of age the chance of HL increases by 9%. The risk for ARHL was not significantly associated with GRM7 neither NAT2. However, we cannot conclude from our data whether the presence of T allele at GRM7 increases the odds for ARHL or whether the A allele has a protective effect. Genotype A/T at GRM7 could potentially be considered a

  12. Biomarkers of Presbycusis and Tinnitus in a Portuguese Older Population.

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    Haider, Haúla F; Flook, Marisa; Aparicio, Mariana; Ribeiro, Diogo; Antunes, Marilia; Szczepek, Agnieszka J; Hoare, Derek J; Fialho, Graça; Paço, João C; Caria, Helena

    2017-01-01

    Introduction: Presbycusis or age-related hearing loss (ARHL) is a ubiquitous health problem. It is estimated that it will affect up to 1.5 billion people by 2025. In addition, tinnitus occurs in a large majority of cases with presbycusis. Glutamate metabotropic receptor 7 ( GRM7 ) and N -acetyltransferase 2 ( NAT2 ) are some of the genetic markers for presbycusis. Objectives: To explore patterns of hearing loss and the role of GRM7 and NAT2 as possible markers of presbycusis and tinnitus in a Portuguese population sample. Materials and Methods: Tonal and speech audiometry, tinnitus assessment, clinical interview, and DNA samples were obtained from patients aged from 55 to 75 with or without tinnitus. GRM7 analysis was performed by qPCR. Genotyping of single nucleotide polymorphisms (SNPs) in NAT2 was performed by PCR amplification followed by Sanger sequencing or by qPCR. Results: We screened samples from 78 individuals (33 men and 45 women). T allele at GRM7 gene was the most observed (60.3% T/T and 33.3% A/T). Individuals with a T/T genotype have a higher risk for ARHL and 33% lower risk for tinnitus, compared to individuals with A/A and A/T genotype, respectively. Being a slow acetylator (53%) was the most common NAT2 phenotype, more common in men (55.8%). Intermediate acetylator was the second most common phenotype (35.9%) also more frequent in men (82.6%). Noise exposed individuals and individuals with 'high frequency' hearing loss seem to have a higher risk for tinnitus. Our data suggests that allele AT of GRM7 c an have a statistically significant influence toward the severity of tinnitus. Conclusion: For each increasing year of age the chance of HL increases by 9%. The risk for ARHL was not significantly associated with GRM7 neither NAT2 . However, we cannot conclude from our data whether the presence of T allele at GRM7 increases the odds for ARHL or whether the A allele has a protective effect. Genotype A/T at GRM7 could potentially be considered a

  13. [Validation of the German Version of Tinnitus Functional Index (TFI)].

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    Brüggemann, Petra; Szczepek, Agnieszka J; Kleinjung, Tobias; Ojo, Michael; Mazurek, Birgit

    2017-09-01

    Tinnitus belongs to seriously debilitating auditory conditions and is often complicated by comorbidities such as insomnia, difficulties with concentration, depression, frustration and irritability. To facilitate the grading of symptoms and the effects of therapeutic strategies, we validated a German-version Tinnitus Functional Index (TFI) in 229 subjects suffering from chronic tinnitus. Outcome validity was assessed using the Tinnitus Questionnaire (TQ, German adaptation by Goebel u. Hiller [1998]). Construct validity was assessed using the "Hamburger Allgemeine Depressionsskala" (HADS). The German TFI featured excellent internal consistency (total score Cronbach's α=0.93). Factor analysis disclosed eight TFI subscales as proposed earlier by Meikle et al. [2012]. Intercorrelations were strong both between the TFI and the TQ (r=0.83), and between the TFI and the HADS (depression r=0.49, anxiety r=0.51). The German-version TFI qualifies as a rapid and statistically robust tool for grading the impact of tinnitus on daily living and for the measurements of therapeutic effects. Regarding depressive symptomatology, sensitivity of the TFI was comparable to that of the TQ. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Validation of Screening Questions for Hyperacusis in Chronic Tinnitus

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    Martin Schecklmann

    2015-01-01

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

  15. A meta-analytic review of psychological treatments for tinnitus.

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    Andersson, G; Lyttkens, L

    1999-08-01

    Meta-analysis is a technique of combining results from different trials in order to obtain estimates of effects across studies. Meta-analysis has, as yet, rarely been used in audiological research. The aim of this paper was to conduct a meta-analysis on psychological treatment of tinnitus. The outcomes of 18 studies, including a total of 24 samples and up to 700 subjects, were included and coded. Included were studies on cognitive/cognitive-behavioural treatment, relaxation, hypnosis, biofeedback, educational sessions and problem-solving. Effect sizes for perceived tinnitus loudness, annoyance, negative affect (e.g. depression) and sleep problems were calculated for randomized controlled studies, pre-post-treatment design studies and follow-up results. Results showed strong to moderate effects on tinnitus annoyance for controlled studies (d = 0.86), pre-post designs (d = 0.5) and at follow-up (d = 0.48). Results on tinnitus loudness were weaker and disappeared at follow-up. Lower effect sizes were also obtained for measures of negative affect and sleep problems. Exploratory analyses revealed that cognitive-behavioural treatments were more effective on ratings of annoyance in the controlled studies. It is concluded that psychological treatment for tinnitus is effective, but that aspects such as depression and sleep problems may need to be targeted in future studies.

  16. The effects of neurofeedback on oscillatory processes related to tinnitus.

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

    2014-01-01

    Although widely used, no proof exists for the feasibility of neurofeedback for reinstating the disordered excitatory-inhibitory balance, marked by a decrease in auditory alpha power, in tinnitus patients. The current study scrutinizes the ability of neurofeedback to focally increase alpha power in auditory areas in comparison to the more common rTMS. Resting-state MEG was measured before and after neurofeedback (n = 8) and rTMS (n = 9) intervention respectively. Source level power and functional connectivity were analyzed with a focus on the alpha band. Only neurofeedback produced a significant decrease in tinnitus symptoms and-more important for the context of the study-a spatially circumscribed increase in alpha power in right auditory regions. Connectivity analysis revealed higher outgoing connectivity in a region ultimately neighboring the area in which power increases were observed. Neurofeedback decreases tinnitus symptoms and increases alpha power in a spatially circumscribed manner. In addition, compared to a more established brain stimulation-based intervention, neurofeedback is a promising approach to renormalize the excitatory-inhibitory imbalance putatively underlying tinnitus. This study is the first to demonstrate the feasibility of focally enhancing alpha activity in tinnitus patients by means of neurofeedback.

  17. [New aspects of complex chronic tinnitus. II: The lost silence: effects and psychotherapeutic possibilities in complex chronic tinnitus].

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    Goebel, G; Keeser, W; Fichter, M; Rief, W

    1991-01-01

    "Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins-Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

  18. [Research progress of functional magnetic resonance imaging in mechanism studies of tinnitus].

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    Ji, B B; Li, M; Zhang, J N

    2018-02-07

    Tinnitus is a subjective symptom of phantom sound in the ear or brain without sound or electrical stimulation in the environment. The mechanism of tinnitus is complicated and mostly unclear. Recent studies suggested that the abnormal peripheral auditory input lead to neuroplasticity changes in central nervous system followed by tinnitus. More research concerned on the tinnitus central mechanism. A rapid development of functional magnetic resonance imaging (fMRI) technique made it more widely used in tinnitus central mechanism research. fMRI brought new findings but also presented some shortages in technology and cognition in tinnitus study. This article summarized the outcomes of fMRI research on tinnitus in recent years, exploring its existing problems and application prospects.

  19. Tinnitus and its current treatment–Still an enigma in medicine

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    Santosh Kumar Swain

    2016-03-01

    Full Text Available 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.

  20. The Effectiveness of the Progression of Widex Zen Tinnitus Therapy: A Pilot Study.

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    Tyler, Richard S; Deshpande, Aniruddha K; Lau, Chi C; Kuk, Francis

    2017-09-18

    The aim of this study was to measure the progression of benefits to individuals with tinnitus from providing informational counseling, hearing aids, a brief tinnitus activities treatment and Zen therapy. Several magnitude estimation scales and tinnitus handicap scales were administered for the duration of the study to 20 participants. Results indicated that all participants benefited from this sequential approach of providing different components of this tinnitus treatment. Large benefits were observed following the tinnitus activities treatment and the Zen treatments. We conclude that the progressive approach of treatment demonstrated here should be of benefit to most individuals with tinnitus and that the Widex Zen sound therapy is a worthwhile treatment for many tinnitus sufferers.

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

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    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.

  2. [Integrated intensive treatment of tinnitus: decrease of the tinnitus-related distress during a one-year follow-up study].

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    Mazurek, B; Seydel, C; Haupt, H; Szczepek, A; Klapp, B F; Schrom, T

    2009-01-01

    The therapy of the chronic tinnitus is aimed at improving the way patients cope with their tinnitus and at reducing the tinnitus-related distress. The present study investigated the changes of psychometric parameters that occurred in patients with chronic tinnitus after 7-days outpatient multidisciplinary therapy. The changes were monitored for up to 1 year in order to evaluate the long-term efficiency. Main emphasis of the intensive tinnitus therapy applied was placed on tinnitus habituation and on teaching the patients how to apply coping strategies. The main elements of the multimodal concept included progressive muscle relaxation according to Jacobson, physiotherapy, educative seminars, training of selective attention and, lastly, the change of judgment, attitude and behaviour towards tinnitus. Psychometric parameters and tinnitus-related distress were assessed prior to and after the therapy (at 3, 6 and 12 months) using the tinnitus questionnaire (TQ) according to Goebel and Hiller. Furthermore, subjects waiting for therapy (waiting list) were recruited to the control group and compared with the therapy group which had received therapy 3 months earlier. The therapy group showed a significant reduction of the TQ total score after 3 months as compared to the control group. Moreover, we observed a long-term, progressive positive outcome during the one-year follow-up. The TQ total score was reduced by 10.9 points. There was an obvious decrease of the emotional and cognitive distress as well as of the intrusiveness of tinnitus, as per evaluation of TQ subscales. The outpatient intensive multidisciplinary tinnitus therapy with long-term aftercare has proved to be an effective method in the treatment of patients with chronic tinnitus. The outpatient setting enables the instant implementation of strategies learned during therapy in the patients' everyday life.

  3. Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation.

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    Nogami, Shinnosuke; Yamauchi, Kensuke; Shiiba, Shunji; Kataoka, Yoshihiro; Hirayama, Bunichi; Takahashi, Tetsu

    2015-03-01

    The purpose of this study was to evaluate the treatment modalities for neurosensory disturbances (NSDs) of the inferior alveolar nerve occurring after retromolar bone harvesting for bone augmentation procedures before implant placement. One hundred four patients, of which 49 and 55 exhibited vertical or horizontal alveolar ridge defects in the mandible and maxilla, respectively, were enrolled. Nineteen patients underwent block bone grafting, 38 underwent guided bone generation or autogenous bone grafting combined with titanium mesh reconstruction, and 47 underwent sinus floor augmentation. Using a visual analog scale, we examined subjective symptoms and discomfort related to sensory alteration within the area of the NSDs in these patients. NSDs were clinically investigated using a two-point discrimination test with blunt-tipped calipers. In addition, neurometry was used for evaluation of trigeminal nerve injury. We tested three treatment modalities for NSDs: follow-up observation (no treatment), medication, and stellate ganglion block (SGB). A week after surgery, 26 patients (25.0%) experienced NSDs. Five patients received no treatment, 10 patients received medication, and 11 patients received SGB. Three months after surgery, patients in the medication and SGB group achieved complete recovery. Current perception threshold values recovered to near-baseline values at 3 months: recovery was much earlier in this group than in the other two groups. SGB can accelerate recovery from NSDs. Our results justify SGB as a reasonable treatment modality for NSDs occurring after the harvesting of retromolar bone grafts. Wiley Periodicals, Inc.

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

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    Carl Christian Lein Størmer

    2015-01-01

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

  5. Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the “TrackYourTinnitus” application

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    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

  6. Neural plasticity expressed in central auditory structures with and without tinnitus

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    Larry E Roberts

    2012-05-01

    Full Text Available Sensory training therapies for tinnitus are based on the assumption that, notwithstanding neural changes related to tinnitus, auditory training can alter the response properties of neurons in auditory pathways. To address this question, we investigated whether brain changes induced by sensory training in tinnitus sufferers and measured by EEG are similar to those induced in age and hearing loss matched individuals without tinnitus trained on the same auditory task. Auditory training was given using a 5 kHz 40-Hz amplitude-modulated sound that was in the tinnitus frequency region of the tinnitus subjects and enabled extraction of the 40-Hz auditory steady-state response (ASSR and P2 transient response known to localize to primary and nonprimary auditory cortex, respectively. P2 amplitude increased with training equally in participants with tinnitus and in control subjects, suggesting normal remodeling of nonprimary auditory regions in tinnitus. However, training-induced changes in the ASSR differed between the tinnitus and control groups. In controls ASSR phase advanced toward the stimulus waveform by about ten degrees over training, in agreement with previous results obtained in young normal hearing individuals. However, ASSR phase did not change significantly with training in the tinnitus group, although some participants showed phase shifts resembling controls. On the other hand, ASSR amplitude increased with training in the tinnitus group, whereas in controls this response (which is difficult to remodel in young normal hearing subjects did not change with training. These results suggest that neural changes related to tinnitus altered how neural plasticity was expressed in the region of primary but not nonprimary auditory cortex. Auditory training did not reduce tinnitus loudness although a small effect on the tinnitus spectrum was detected.

  7. Using auditory steady state responses to outline the functional connectivity in the tinnitus brain.

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    Winfried Schlee

    Full Text Available BACKGROUND: Tinnitus is an auditory phantom perception that is most likely generated in the central nervous system. Most of the tinnitus research has concentrated on the auditory system. However, it was suggested recently that also non-auditory structures are involved in a global network that encodes subjective tinnitus. We tested this assumption using auditory steady state responses to entrain the tinnitus network and investigated long-range functional connectivity across various non-auditory brain regions. METHODS AND FINDINGS: Using whole-head magnetoencephalography we investigated cortical connectivity by means of phase synchronization in tinnitus subjects and healthy controls. We found evidence for a deviating pattern of long-range functional connectivity in tinnitus that was strongly correlated with individual ratings of the tinnitus percept. Phase couplings between the anterior cingulum and the right frontal lobe and phase couplings between the anterior cingulum and the right parietal lobe showed significant condition x group interactions and were correlated with the individual tinnitus distress ratings only in the tinnitus condition and not in the control conditions. CONCLUSIONS: To the best of our knowledge this is the first study that demonstrates existence of a global tinnitus network of long-range cortical connections outside the central auditory system. This result extends the current knowledge of how tinnitus is generated in the brain. We propose that this global extend of the tinnitus network is crucial for the continuos perception of the tinnitus tone and a therapeutical intervention that is able to change this network should result in relief of tinnitus.

  8. Tinnitus and Its Effect on the Quality of Life of Sufferers: A Nigerian Cohort Study.

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    Ukaegbe, Onyinyechi C; Orji, Foster T; Ezeanolue, Basil C; Akpeh, James O; Okorafor, Ijeoma A

    2017-10-01

    Objectives To evaluate the quality of life of patients with ongoing tinnitus. Study Design This was a cross-sectional study of patients with ongoing tinnitus. Setting The study was carried out in a tertiary hospital in southeastern Nigeria. Subjects and Methods Subjects are adults who presented to the otorhinolaryngology clinic with tinnitus as their primary complaint. Pure-tone audiometry, tinnitus pitch, and loudness matching were done. The Tinnitus Handicap Inventory (THI) questionnaire was used in assessing their quality of life. Results There were 63 participants within the age range of 16 to 74 years; 20 (31.7%) were male and 43 (68.3%) were female. The mean duration of tinnitus was 26.7 ± 38.1 months. Nineteen (30.2%) participants had bilateral tinnitus while 44 (69.8%) had unilateral tinnitus. The mean THI score was 36.6 ± 19.7. The most reported handicap was anxiety and difficulty with concentration followed by depression and irritability. There was no correlation between the disability shown by the THI score and the age, sex, duration of the tinnitus, the tinnitus pitch, tinnitus loudness, or the laterality of the tinnitus. There was a significant positive correlation between the grade of hearing loss and the level of disability reported in the THI ( P = .01). Conclusion Tinnitus sufferers appear to have poorer quality of life compared with nonsufferers. This quality-of-life affectation is likely to be worse in those with disabling hearing loss but does not appear to be related to their age, sex, symptom duration, or the loudness and pitch of their tinnitus.

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

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    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.

  10. The Personality Profile of Tinnitus Sufferers and a Nontinnitus Control Group.

    Science.gov (United States)

    Durai, Mithila; O'Keeffe, Mary G; Searchfield, Grant D

    2017-04-01

    Chronic tinnitus (phantom perception of sound) significantly disrupts quality of life in 15-20% of those who experience it. Understanding how certain personality traits impact tinnitus perception and distress can be beneficial for the development of interventions to improve the lives of tinnitus sufferers. Four key self-reported personality traits (social closeness, stress reaction, alienation, and self-control) were identified from previous research as being associated with tinnitus. These were compared between tinnitus and age-, gender-, and hearing level-matched nontinnitus controls to see whether underlying profile differences exist, and if personality traits levels correlate with various tinnitus characteristics assessed in typical clinical questionnaires. A Web-based personality survey was administered comprising of self-control, stress reaction, alienation, and social closeness subscale questions of the Multidimensional Personality Questionnaire, the Hearing Handicap Inventory-Screening Version, TFI, and the Tinnitus Case History Questionnaire. A total of 154 participants with tinnitus (81 males, 73 females, mean age = 62.6 yr) and 61 control (32 males, 29 females, mean age = 59.62 yr) participants were recruited via e-mail invitations to a tinnitus research clinic database, poster, and social media Web site advertising. Statistical analysis was conducted using parametric statistics and IBM SPSS ® Version 22 software. Tinnitus sufferers displayed higher levels of stress reaction, lower social closeness, lower self-control, and higher alienation than the control group (p Alienation was related to tinnitus pitch and self-reported hyperacusis measured using the Tinnitus Case History Questionnaire (p < 0.05). Stress reaction correlated with self-reported hyperacusis, whether tinnitus sufferers had sought other treatments, and whether loud sounds make the tinnitus worse (p < 0.05). The four personality traits examined in this study exhibited a consistent

  11. Assessment of patients for treatment with tinnitus retraining therapy.

    Science.gov (United States)

    Henry, James A; Jastreboff, Margaret M; Jastreboff, Pawel J; Schechter, Martin A; Fausti, Stephen A

    2002-01-01

    Clinical management for patients complaining of severe tinnitus has improved dramatically in the last 25 years. During that period of time, various methods of treatment have been introduced and are being used with varying degrees of success. One method that has received considerable attention is tinnitus retraining therapy (TRT). This method is being practiced by hundreds of clinicians worldwide, and retrospective clinical data indicate that TRT has been effective for the majority of patients. This article provides a guide for clinicians to evaluate their patients for treatment with TRT. Included in this guide is the expanded version of the TRT initial interview and specific instructions for the clinician administering the interview.

  12. 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.

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

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    Kathleen Joos

    2014-01-01

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

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

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    Flavia Alencar de Barros Suzuki

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

  15. Neuroanatomical correlates of tinnitus revealed by cortical thickness analysis and diffusion tensor imaging

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    Aldhafeeri, Faten M [The University of Liverpool, Department of Medical Imaging, School of Health Sciences, Liverpool (United Kingdom); King Khalid General Hospital, Ministry of Health, Radiology Department, Hafral-batin (Saudi Arabia); Mackenzie, Ian; Kay, Tony [Aintree University Hospitals NHS Foundation Trust, Liverpool (United Kingdom); Alghamdi, Jamaan [The University of Liverpool, Department of Medical Imaging, School of Health Sciences, Liverpool (United Kingdom); King Abdul Aziz University, Physics Department, Faculty of Sciences, Jeddah (Saudi Arabia); Sluming, Vanessa [The University of Liverpool, Department of Medical Imaging, School of Health Sciences, Liverpool (United Kingdom); Magnetic Resonance and Image Analysis Research Centre, Liverpool (United Kingdom)

    2012-08-15

    Tinnitus is a poorly understood auditory perception of sound in the absence of external stimuli. Convergent evidence proposes that tinnitus perception involves brain structural alterations as part of its pathophysiology. The aim of this study is to investigate the structural brain changes that might be associated with tinnitus-related stress and negative emotions. Using high-resolution magnetic resonance imaging and diffusion tensor imaging, we investigated grey matter and white matter (WM) alterations by estimating cortical thickness measures, fractional anisotropy and mean diffusivity in 14 tinnitus subjects and 14 age- and sex-matched non-tinnitus subjects. Significant cortical thickness reductions were found in the prefrontal cortex (PFC), temporal lobe and limbic system in tinnitus subjects compared to non-tinnitus subjects. Tinnitus sufferers were found to have disrupted WM integrity in tracts involving connectivity of the PFC, temporal lobe, thalamus and limbic system. Our results suggest that such neural changes may represent neural origins for tinnitus or consequences of tinnitus and its associations. (orig.)

  16. Neuroanatomical correlates of tinnitus revealed by cortical thickness analysis and diffusion tensor imaging

    International Nuclear Information System (INIS)

    Aldhafeeri, Faten M.; Mackenzie, Ian; Kay, Tony; Alghamdi, Jamaan; Sluming, Vanessa

    2012-01-01

    Tinnitus is a poorly understood auditory perception of sound in the absence of external stimuli. Convergent evidence proposes that tinnitus perception involves brain structural alterations as part of its pathophysiology. The aim of this study is to investigate the structural brain changes that might be associated with tinnitus-related stress and negative emotions. Using high-resolution magnetic resonance imaging and diffusion tensor imaging, we investigated grey matter and white matter (WM) alterations by estimating cortical thickness measures, fractional anisotropy and mean diffusivity in 14 tinnitus subjects and 14 age- and sex-matched non-tinnitus subjects. Significant cortical thickness reductions were found in the prefrontal cortex (PFC), temporal lobe and limbic system in tinnitus subjects compared to non-tinnitus subjects. Tinnitus sufferers were found to have disrupted WM integrity in tracts involving connectivity of the PFC, temporal lobe, thalamus and limbic system. Our results suggest that such neural changes may represent neural origins for tinnitus or consequences of tinnitus and its associations. (orig.)

  17. 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

  18. Quality of life in individuals with tinnitus with and without hearing loss

    Directory of Open Access Journals (Sweden)

    Gregorina Silva Ribeiro Rocha

    Full Text Available ABSTRACT Purpose: to evaluate the perception of the level of quality of life in subjects with tinnitus, with and without hearing loss. Methods: a cross-sectional quantitative study. A total of 189 subjects (mean age 53.06 years divided into four groups. Group 1: subjects with normal auditory thresholds without tinnitus complaint; Group 2: subjects with normal auditory thresholds and tinnitus complaint; Group 3: subjects with sensorineural hearing loss without tinnitus complaint; Group 4: subjects with sensorineural hearing loss and with tinnitus complaint. Levels of quality of life were investigated through the World Health Organization Quality Of Life (WHOQOL website - brief and psycho-emotional and functional aspects of patients with tinnitus through the Tinnitus Handicap Inventory (THI. Statistical analyzes, comparisons among groups and descriptive analysis were performed, considering a significance level of 5%. Results: the overall mean scores of quality of life in group 4 (56.07 were smaller than those of group 1 (64.67 (p<0.05. The subjects with tinnitus complaint presented a moderate level of disturbance of the symptom. Conclusion: tinnitus interferes in the quality of life of individuals who had preserved or altered auditory thresholds. Therefore, means to reduce the discomfort caused by tinnitus symptom should be developed, in order to improve patients' quality of life.

  19. Analysis of the prevalence and associated risk factors of tinnitus in adults.

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    Hyung-Jong Kim

    Full Text Available Tinnitus is a common condition in adults; however, the pathophysiology of tinnitus remains unclear, and no large population-based study has assessed the associated risk factors. The aim of this study was to analyze the prevalence and associated risk factors of tinnitus.We conducted a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, with 19,290 participants ranging in age from 20 to 98 years old, between 2009 and 2012. We investigated the prevalence of tinnitus using a questionnaire and analyzed various possible factors associated with tinnitus using simple and multiple logistic regression analysis with complex sampling.The prevalence of tinnitus was 20.7%, and the rates of tinnitus associated with no discomfort, moderate annoyance, and severe annoyance were 69.2%, 27.9%, and 3.0%, respectively. The prevalence of tinnitus and the rates of annoying tinnitus increased with age. The adjusted odds ratio (AOR of tinnitus was higher for females, those with a smoking history, those reporting less sleep (≤ 6 h, those with more stress, those in smaller households, those with a history of hyperlipidemia osteoarthritis, rheumatoid arthritis, asthma, depression, thyroid disease, an abnormal tympanic membrane, unilateral hearing loss, bilateral hearing loss, noise exposure from earphones, noise exposure at the workplace, noise exposure outside the workplace, and brief noise exposure. Additionally, unemployed individuals and soldiers had higher AORs for tinnitus. The AOR of annoying tinnitus increased with age, stress, history of hyperlipidemia, unilateral hearing loss, and bilateral hearing loss.Tinnitus is very common in the general population and is associated with gender, smoking, stress, sleep, hearing loss, hyperlipidemia, osteoarthritis, rheumatoid arthritis, asthma, depression, and thyroid disease history.

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

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    Eugen eDiesch

    2012-05-01

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

  1. Tinnitus- related distress: evidence from fMRI of an emotional stroop task

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    Dennis Golm

    2016-08-01

    Full Text Available Abstract Background Chronic tinnitus affects 5 % of the population, 17 % suffer under the condition. This distress seems mainly to be dependent on negative cognitive-emotional evaluation of the tinnitus and selective attention to the tinnitus. A well-established paradigm to examine selective attention and emotional processing is the Emotional Stroop Task (EST. Recent models of tinnitus distress propose limbic, frontal and parietal regions to be more active in highly distressed tinnitus patients. Only a few studies have compared high and low distressed tinnitus patients. Thus, this study aimed to explore neural correlates of tinnitus-related distress. Methods Highly distressed tinnitus patients (HDT, n = 16, low distressed tinnitus patients (LDT, n = 16 and healthy controls (HC, n = 16 underwent functional magnetic resonance imaging (fMRI during an EST, that used tinnitus-related words and neutral words as stimuli. A random effects analysis of the fMRI data was conducted on the basis of the general linear model. Furthermore correlational analyses between the blood oxygen level dependent response and tinnitus distress, loudness, depression, anxiety, vocabulary and hypersensitivity to sound were performed. Results Contradictory to the hypothesis, highly distressed patients showed no Stroop effect in their reaction times. As hypothesized HDT and LDT differed in the activation of the right insula and the orbitofrontal cortex. There were no hypothesized differences between HDT and HC. Activation of the orbitofrontal cortex and the right insula were found to correlate with tinnitus distress. Conclusions The results are partially supported by earlier resting-state studies and corroborate the role of the insula and the orbitofrontal cortex in tinnitus distress.

  2. Tinnitus, Anxiety, Depression and Substance Abuse in Rock Musicians a Norwegian Survey.

    Science.gov (United States)

    Stormer, Carl Christian Lein; Sorlie, Tore; Stenklev, Niels Christian

    2017-06-01

    Rock musicians are known to have an increased prevalence of hearing loss and tinnitus. The aims of the present study were to examine the distribution of anxiety and depression symptoms among rock musicians with or without tinnitus and how these mental health indicators and internal locus of control influenced upon their tinnitus symptom concerns and the degree to which the tinnitus affected their lives. The study was a questionnairebased cross-sectional survey of subjects selected from a cohort of rock musicians. We recruited 111 active musicians from the Oslo region, and a control group of 40 non-musicians from the student population at the University of Tromso. Among the rock musicians 19.8% reported permanent tinnitus vs. 0% among the controls. Musicians more often reported anxiety symptoms than controls (35.1% vs. 17.5%), however this prevalence was not different in musicians with and without tinnitus. Tinnitus-affected musicians reported depressive symptoms, significantly more than controls (13.6% vs. 5%). Rock musicians consumed more alcohol than controls, but alcohol consumption was unrelated to severity of tinnitus. Drug abuse was not more prevalent in rock musicians than in controls. Duration of tinnitus, internal locus of control, sleep disturbance and anxiety were significant predictors of how affected and how concerned musicians were about their tinnitus. Rock musicians are at risk for the development of chronic tinnitus, and they have an increased prevalence of anxiety. There is an association between chronic tinnitus and depressive symptoms in rock musicians, but our results are ambiguous. Although rock musicians have a chronic exposure to noise, noise-induced hearing loss is not the sole causative agent for the development of tinnitus.

  3. Psychosocial Effects of Tinnitus on the Elderly Individuals with ...

    African Journals Online (AJOL)

    The study sampled 130 elderly listeners comprising 68 males and 72 females, aged between 65 and 74 years and resident in both urban and rural areas of Ibadan metropolis as the participants for the study under a descriptive research design of the ex post facto type. A standardized Tinnitus Research Questionnaire (TRQ) ...

  4. [TRT and psychotherapy in the treatment of tinnitus].

    Science.gov (United States)

    Schaaf, H; Gieler, U

    2010-10-01

    Basic requirements and results of tinnitus retraining therapy (TRT) as well as other habituation therapies with psychotherapeutic approaches in the treatment of tinnitus are examined closely in this literature review. In German-speaking countries experts generally aim for involvement of psychotherapists beyond the classic TRT developed by Jastreboff and Hazell. On the basis of a validated diagnostic test such as the Tinnitus Questionnaire according to Hiller and Goebel (1998), such a therapy regime is more effective than the "classic" procedure. Under different treatment approaches, cognitive behavioural therapy elements have been proven to be effective-even as a component of the TRT-as well as integrated variants in psychodynamic therapies. We have to give consideration to the fact that in all studies about the selection and inclusion criteria selective test conditions were established which suggest that in each case diverse patient groups were studied. In the overall picture it becomes apparent that depending on the severity of the tinnitus and accompanying hearing problems a dysfunction-oriented and staged approach makes sense.

  5. [Acute hearing loss and tinnitus caused by amplified recreational music].

    Science.gov (United States)

    Metternich, F U; Brusis, T

    1999-11-01

    Hearing loss resulting from exposure to permanent or repeated amplified music in professional musicians and music consumers is described in literature. The risk of hearing loss does not exist only after prolonged exposure to music. Short-term exposure to very high sound levels, for example in concerts, can also cause hearing loss and tinnitus. The retrospective study includes 24 patients who required rheologic therapy between 1994 and 1997 due to a music related acoustic trauma. The type, intensity, and length of music exposure as well as the distance and the position to the source of noise were examined. The type of hearing damage and its development during rheological treatment was studied by pure-tone audiometry. In the majority of examined patients (67%) the hearing loss developed on the basis of one-time exposure at a rock concert or pop concert, followed by hearing loss from attending discotheques (17%) or parties (12%), and music exposure from personal cassette players (4%). The majority of patients showed a maximum hearing loss of 40-60 dB (A) in a frequency between 3 kHz and 4 kHz. Pure-tone audiometry in 58% of the patients exhibited a unilateral threshold in a frequency between 3 kHz and 4 kHz combined with ipsilateral tinnitus of the same frequency. Twenty-one percent of the patients showed a symmetric bilateral threshold and tinnitus between 3 kHz and 4 kHz. In 8% there was a unilateral tinnitus, and in 13% a bilateral tinnitus without any hearing loss. All patients improved their hearing loss during rheologic treatment. Improvement in the tinnitus was only achieved in 33% of the examined cases. The risk of permanent hearing loss resulting from short-term exposure to amplified music is low compared to the risk of continuous tinnitus. Given the lack of acceptance of personal ear protectors, the risk of acute hearing damage due to amplified music could be reduced by avoiding the immediate proximity to the speakers.

  6. Tinnitus functional index: validation of the German version for Switzerland.

    Science.gov (United States)

    Peter, Nicole; Kleinjung, Tobias; Jeker, Raphael; Meyer, Martin; Klaghofer, Richard; Weidt, Steffi

    2017-05-05

    Different standardized questionnaires are used to assess tinnitus severity, making comparisons across studies difficult. These questionnaires are also used to measure treatment-related changes in tinnitus although they were not designed for this purpose. To solve these problems, a new questionnaire - the Tinnitus Functional Index (TFI) - has been established. The TFI is highly responsive to treatment-related change and promises to be the new gold standard in tinnitus evaluation. The aim of the current study was to validate a German version of the TFI for a German-speaking population in Switzerland. At the ENT department of the University Hospital Zurich, 264 subjects completed an online survey including the German version for Switzerland of TFI, Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI) and sociodemographic variables. Internal consistency of the TFI was calculated with Cronbach's alpha coefficient. Pearson correlation coefficients were used for the test-retest reliability of the TFI and to investigate convergent and discriminant validity between the THI and the BDI and BAI, respectively. Factor analysis was assessed using a principal component analysis with oblique rotation. The different factors extracted were then compared with the original questionnaire. The German version of the TFI for Switzerland showed an excellent internal consistency (Cronbach's alpha of 0.97) and an excellent test-retest reliability of 0.91. The convergent validity with THI was high (r = 0.86). The discriminant validity with BAI and BDI showed moderate results (BAI: r = 0.60 and BDI: r = 0.65). In the factor analysis only five factors with one main factor could be extracted instead of eight factors as described in the original version. Nevertheless, relations to the original eight subscales could be demonstrated. The German version of the TFI for Switzerland is a suitable instrument for measuring the impact of tinnitus

  7. Tbx1 and Jag1 act in concert to modulate the fate of neurosensory cells of the mouse otic vesicle

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    Stephania Macchiarulo

    2017-10-01

    Full Text Available The domain within the otic vesicle (OV known as the neurosensory domain (NSD, contains cells that will give rise to the hair and support cells of the otic sensory organs, as well as the neurons that form the cochleovestibular ganglion (CVG. The molecular dynamics that occur at the NSD boundary relative to adjacent OV cells is not well defined. The Tbx1 transcription factor gene expression pattern is complementary to the NSD, and inactivation results in expansion of the NSD and expression of the Notch ligand, Jag1 mapping, in part of the NSD. To shed light on the role of Jag1 in NSD development, as well as to test whether Tbx1 and Jag1 might genetically interact to regulate this process, we inactivated Jag1 within the Tbx1 expression domain using a knock-in Tbx1Cre allele. We observed an enlarged neurogenic domain marked by a synergistic increase in expression of NeuroD and other proneural transcription factor genes in double Tbx1 and Jag1 conditional loss-of-function embryos. We noted that neuroblasts preferentially expanded across the medial-lateral axis and that an increase in cell proliferation could not account for this expansion, suggesting that there was a change in cell fate. We also found that inactivation of Jag1 with Tbx1Cre resulted in failed development of the cristae and semicircular canals, as well as notably fewer hair cells in the ventral epithelium of the inner ear rudiment when inactivated on a Tbx1 null background, compared to Tbx1Cre/− mutant embryos. We propose that loss of expression of Tbx1 and Jag1 within the Tbx1 expression domain tips the balance of cell fates in the NSD, resulting in an overproduction of neuroblasts at the expense of non-neural cells within the OV.

  8. Synchrotron microtomography of a Nothosaurus marchicus skull informs on nothosaurian physiology and neurosensory adaptations in early Sauropterygia.

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    Dennis F A E Voeten

    brain shape and accessory organs were achieved through heterochronic development of the cranium, particularly the braincase. In summary, the cranium of Nothosaurus marchicus reflects important physiological and neurosensory adaptations that enabled the group's explosive invasion of shallow marine habitats in the late Early Triassic.

  9. Combined Amplification and Sound Generation for Tinnitus: A Scoping Review.

    Science.gov (United States)

    Tutaj, Lindsey; Hoare, Derek J; Sereda, Magdalena

    In most cases, tinnitus is accompanied by some degree of hearing loss. Current tinnitus management guidelines recognize the importance of addressing hearing difficulties, with hearing aids being a common option. Sound therapy is the preferred mode of audiological tinnitus management in many countries, including in the United Kingdom. Combination instruments provide a further option for those with an aidable hearing loss, as they combine amplification with a sound generation option. The aims of this scoping review were to catalog the existing body of evidence on combined amplification and sound generation for tinnitus and consider opportunities for further research or evidence synthesis. A scoping review is a rigorous way to identify and review an established body of knowledge in the field for suggestive but not definitive findings and gaps in current knowledge. A wide variety of databases were used to ensure that all relevant records within the scope of this review were captured, including gray literature, conference proceedings, dissertations and theses, and peer-reviewed articles. Data were gathered using scoping review methodology and consisted of the following steps: (1) identifying potentially relevant records; (2) selecting relevant records; (3) extracting data; and (4) collating, summarizing, and reporting results. Searches using 20 different databases covered peer-reviewed and gray literature and returned 5959 records. After exclusion of duplicates and works that were out of scope, 89 records remained for further analysis. A large number of records identified varied considerably in methodology, applied management programs, and type of devices. There were significant differences in practice between different countries and clinics regarding candidature and fitting of combination aids, partly driven by the application of different management programs. Further studies on the use and effects of combined amplification and sound generation for tinnitus are

  10. Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

    Science.gov (United States)

    Wise, K; Rief, W; Goebel, G

    1998-06-01

    Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

  11. The relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions.

    Science.gov (United States)

    Keppler, H; Degeest, S; Dhooge, I

    2017-11-01

    Chronic tinnitus is associated with reduced auditory input, which results in changes in the central auditory system. This study aimed to examine the relationship between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. For audiometry, the parameters represented the edge frequency of hearing loss, the frequency of maximum hearing loss and the frequency range of hearing loss. For distortion product otoacoustic emissions, the parameters were the frequency of lowest distortion product otoacoustic emission amplitudes and the frequency range of reduced distortion product otoacoustic emissions. Sixty-seven patients (45 males, 22 females) with subjective chronic tinnitus, aged 18 to 73 years, were included. No correlation was found between tinnitus pitch and parameters of audiometry and distortion product otoacoustic emissions. However, tinnitus pitch fell mostly within the frequency range of hearing loss. The current study seems to confirm the relationship between tinnitus pitch and the frequency range of hearing loss, thus supporting the homeostatic plasticity model.

  12. 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

  13. Non-invasive neurosensory testing used to diagnose and confirm successful surgical management of lower extremity deep distal posterior compartment syndrome

    Directory of Open Access Journals (Sweden)

    Guyton Gregory P

    2009-05-01

    Full Text Available Abstract Background Chronic exertional compartment syndrome (CECS is characterized by elevated pressures within a closed space of an extremity muscular compartment, causing pain and/or disability by impairing the neuromuscular function of the involved compartment. The diagnosis of CECS is primarily made on careful history and physical exam. The gold standard test to confirm the diagnosis of CECS is invasive intra-compartmental pressure measurements. Sensory nerve function is often diminished during symptomatic periods of CECS. Sensory nerve function can be documented with the use of non-painful, non-invasive neurosensory testing. Methods Non-painful neurosensory testing of the myelinated large sensory nerve fibers of the lower extremity were obtained with the Pressure Specified Sensory Device™ in a 25 year old male with history and invasive compartment pressures consistent with CECS both before and after running on a tread mill. After the patient's first operation to release the deep distal posterior compartment, the patient failed to improve. Repeat sensory testing revealed continued change in his function with exercise. He was returned to the operating room where a repeat procedure revealed that the deep posterior compartment was not completely released due to an unusual anatomic variant, and therefore complete release was accomplished. Results The patient's symptoms numbness in the plantar foot and pain in the distal calf improved after this procedure and his repeat sensory testing performed before and after running on the treadmill documented this improvement. Conclusion This case report illustrates the principal that non-invasive neurosensory testing can detect reversible changes in sensory nerve function after a provocative test and may be a helpful non-invasive technique to managing difficult cases of persistent lower extremity symptoms after failed decompressive fasciotomies for CECS. It can easily be performed before and after

  14. 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.

  15. Translation, validity, and reliability of a persian version of the iowa tinnitus handicap questionnaire.

    Science.gov (United States)

    Arian Nahad, Homa; Rouzbahani, Masomeh; Jarollahi, Farnoush; Jalaie, Shohreh; Pourbakht, Akram; Mokrian, Helnaz; Mahdi, Parvane; Amali, Amin; Nodin Zadeh, Abdolmajid

    2014-04-01

    Tinnitus is a common otologic symptom that can seriously affect a patient's quality of life. The purpose of the present study was to translate and validate the Iowa Tinnitus Handicap Questionnaire (THQ) into the Persian language, and to make it applicable as a tool for determining the effects of tinnitus on a patient's life. The main version of the THQ was translated into the Persian language. The agreed Persian version was administered to 150 tinnitus patients. The validity of the Persian THQ was evaluated and internal reliability was confirmed using Cronbach's α-coefficient. Finally, the effect of independent variables such as age, mean patient threshold, gender, and duration of tinnitus were considered in order to determine the psychometric properties of tinnitus. After an exact translation process, the Persian THQ was found to exhibit face validity. In terms of content validity, content validity index in total questionnaire was 0.93. Further, in structural validity measurements, intermediate correlation with annoyance from tinnitus (r=0.49), low correlation with duration of tinnitus (r=0.34) and high correlation with the Tinnitus Handicap Inventory (THI) questionnaire (r=0.84) were demonstrated. Additionally, a negligible effect of gender and age was noted on degree of tinnitus handicap (P= 0.754, P= 0.573, respectively). In the internal reliability assessment for Factors 1, 2, 3, and the whole questionnaire, Cronbach`s α-coefficient was 0.95, 0.92, 0.25 and 0.88, respectively. The Persian version of the Iowa THQ demonstrates high validity and reliability and can be used for the determination of tinnitus handicap and for following-up in the intervention process in Persian tinnitus patients.

  16. Development of a Device for Objective Assessment of Tinnitus in Humans

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-14-2-0180 TITLE: Development of a Device for Objective Assessment of Tinnitus in Humans PRINCIPAL INVESTIGATOR: Jeremy G...SUBTITLE Development of a Device for Objective Assessment of Tinnitus in Humans 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-2-0180 5c. PROGRAM...briefly (one paragraph) describes the subject, purpose and scope of the research. Tinnitus is the perception of sound in the ears or head when no

  17. Mindfulness-Based Cognitive Therapy as a Treatment for Chronic Tinnitus: A Randomized Controlled Trial

    OpenAIRE

    McKenna, L.; Marks, E. M.; Hallsworth, C. A.; Schaette, R.

    2017-01-01

    BACKGROUND: Tinnitus is experienced by up to 15% of the population and can lead to significant disability and distress. There is rarely a medical or surgical target and psychological therapies are recommended. We investigated whether mindfulness-based cognitive therapy (MBCT) could offer an effective new therapy for tinnitus. METHODS: This single-site randomized controlled trial compared MBCT to intensive relaxation training (RT) for chronic, distressing tinnitus in adults. Both treatments in...

  18. When the ringing in the earsgetsunbearable : Illness representations, self-instructions and adjustment to tinnitus

    OpenAIRE

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

    2012-01-01

    ObjectiveChronic tinnitus can severely impair a person's quality of life. The degree of impairment, however, is not closely related to tinnitus loudness. Applying the common sense model (CSM) of self-regulation of health and illness, this study investigated to what extent psychological factors, i.e. illness representations and positive/negative self-instructions, are associated with the degree of tinnitus-related complaints.MethodsIn this cross-sectional study, 118 patients diagnosed with chr...

  19. Impact of reduction of tinnitus intensity on patients' quality of life.

    Science.gov (United States)

    Drexler, Daniel; López-Paullier, Matías; Rodio, Silvana; González, Manuela; Geisinger, Darío; Pedemonte, Marisa

    2016-01-01

    Assess the impact of a reduction of tinnitus intensity achieved through sound stimulation during sleep on the improvement in the patients' quality of life. Acoustic stimuli consisted of a highly customized sound that reproduced the spectral and intensity characteristics of the tinnitus in each patient. This stimulus was uploaded into a portable electronic device and delivered through customized ear buds during sleep, every night for three months. Twelve patients with subjective idiopathic chronic tinnitus were studied. Results were assessed through: (1) the measurement in dB SPL of tinnitus intensity reduction over time; (2) the results of three psychometric tests: Tinnitus handicap inventory (THI), Tinnitus reaction questionnaire (TRQ), Tinnitus functional index (TFI); and (3) a Visual analog scale (VAS) for tinnitus annoyance. After three months of treatment, we observed an average decrease in tinnitus intensity of 14.1 dB SPL (p < 0.001), implying a 62% reduction of the perceived sound. This improvement was followed by a statistically significant decrease of TRQ (78%), THI (65%), and TFI (77%). These results suggested that the intensity reduction achieved through the protocol used in this study had a direct impact on the improvement in the patients' quality of life.

  20. Ginkgo biloba in the treatment of tinnitus: An updated literature review.

    Science.gov (United States)

    Mahmoudian-Sani, Mohammad Reza; Hashemzadeh-Chaleshtori, Morteza; Asadi-Samani, Majid; Yang, Qian

    2017-06-01

    Tinnitus is one of the common diseases of the ear that is associated with numerous physical and mental disorders. One of the known mechanisms in the tinnitus area with unknown reason is oxidative events. Based on the prevalence and economic costs and physical- psychological side effects caused by tinnitus and the importance of finding a suitable solution for its prevention and treatment, the need for further studies becomes more obvious in this context. This review article aimed to review studies on the effectiveness of Ginkgo biloba as a medicinal plant on patients with tinnitus. Google Scholar, Directory of Open Access Journals (DOAJ), PubMed, LISTA (EBSCO) and Web of Science have been searched. There are many studies on the therapeutic effect of Ginkgo biloba on patients with tinnitus. Most findings are in contrast with each other so that some of studies reported that Ginkgo biloba is effective in the treatment of tinnitus and other studies referred to it as ineffective herbal medicine. Generally, according to the previous studies and the present study, it can mention that the Ginkgo biloba may somewhat improve tinnitus. Since tinnitus is multifactorial, it is recommended to evaluate patients individually based on the cause of tinnitus, treatment formulas, and different doses of Ginkgo biloba at the more extensive level in future studies.

  1. Suppression of Tinnitus in Chinese Patients Receiving Regular Cochlear Implant Programming.

    Science.gov (United States)

    Liu, Ying; Wang, Hong; Han, Dong Xu; Li, Ming Hua; Wang, Yu; Xiao, Yu Li

    2016-04-01

    To assess the clinical effect of cochlear implant programming on tinnitus. Tinnitus patients (n = 234) were divided into 3 groups: (1) preoperative tinnitus (n = 108), (2) postoperative tinnitus occurring before implant switch-on at week 4 (n = 88), and (3) tinnitus occurring more than 1 year postoperatively (n = 44). Patients in each group were randomly allocated into a programming subgroup that received programming for 12 weeks postoperatively or after tinnitus occurrence or a control subgroup. Impedance testing and the Tinnitus Handicap Inventory (THI) were performed preoperatively and at 4, 6, 8, and 12 weeks postoperatively (groups 1 and 2) or after tinnitus occurrence (group 3). Comparisons were performed using t tests and chi-square tests. Impedance was significantly lower in the programming subgroup than in the control subgroup in groups 1 and 2 at 8 and 12 weeks and in group 3 at 12 weeks. The THI scores decreased in both programming and control subgroups in all groups. However, this decrease was pronounced in the programming subgroup, whereas in the control subgroup, it occurred slowly over time. Cochlear implant programming decreases impedance and improves tinnitus symptoms. © The Author(s) 2015.

  2. Modulation of electrocortical brain activity by attention in individuals with and without tinnitus.

    Science.gov (United States)

    Paul, Brandon T; Bruce, Ian C; Bosnyak, Daniel J; Thompson, David C; Roberts, Larry E

    2014-01-01

    Age and hearing-level matched tinnitus and control groups were presented with a 40 Hz AM sound using a carrier frequency of either 5 kHz (in the tinnitus frequency region of the tinnitus subjects) or 500 Hz (below this region). On attended blocks subjects pressed a button after each sound indicating whether a single 40 Hz AM pulse of variable increased amplitude (target, probability 0.67) had or had not occurred. On passive blocks subjects rested and ignored the sounds. The amplitude of the 40 Hz auditory steady-state response (ASSR) localizing to primary auditory cortex (A1) increased with attention in control groups probed at 500 Hz and 5 kHz and in the tinnitus group probed at 500 Hz, but not in the tinnitus group probed at 5 kHz (128 channel EEG). N1 amplitude (this response localizing to nonprimary cortex, A2) increased with attention at both sound frequencies in controls but at neither frequency in tinnitus. We suggest that tinnitus-related neural activity occurring in the 5 kHz but not the 500 Hz region of tonotopic A1 disrupted attentional modulation of the 5 kHz ASSR in tinnitus subjects, while tinnitus-related activity in A1 distributing nontonotopically in A2 impaired modulation of N1 at both sound frequencies.

  3. Modulation of Electrocortical Brain Activity by Attention in Individuals with and without Tinnitus

    Directory of Open Access Journals (Sweden)

    Brandon T. Paul

    2014-01-01

    Full Text Available Age and hearing-level matched tinnitus and control groups were presented with a 40 Hz AM sound using a carrier frequency of either 5 kHz (in the tinnitus frequency region of the tinnitus subjects or 500 Hz (below this region. On attended blocks subjects pressed a button after each sound indicating whether a single 40 Hz AM pulse of variable increased amplitude (target, probability 0.67 had or had not occurred. On passive blocks subjects rested and ignored the sounds. The amplitude of the 40 Hz auditory steady-state response (ASSR localizing to primary auditory cortex (A1 increased with attention in control groups probed at 500 Hz and 5 kHz and in the tinnitus group probed at 500 Hz, but not in the tinnitus group probed at 5 kHz (128 channel EEG. N1 amplitude (this response localizing to nonprimary cortex, A2 increased with attention at both sound frequencies in controls but at neither frequency in tinnitus. We suggest that tinnitus-related neural activity occurring in the 5 kHz but not the 500 Hz region of tonotopic A1 disrupted attentional modulation of the 5 kHz ASSR in tinnitus subjects, while tinnitus-related activity in A1 distributing nontonotopically in A2 impaired modulation of N1 at both sound frequencies.

  4. Pitch and Loudness from Tinnitus in Individuals with Noise-induced Hearing Loss

    Directory of Open Access Journals (Sweden)

    Flores, Leticia Sousa

    2015-08-01

    Full Text Available Introduction Tinnitus is one of the symptoms that affects individuals suffering from noise induced hearing loss. This condition can be disabling, leading the affected individual to turn away from work. Objective This literature review aims to analyze the possible association between gender and tinnitus pitch and loudness, the degree of hearing loss and the frequencies affected in subjects with noise-induced hearing loss. Methods This contemporary cohort study was conducted through a cross-sectional analysis. The study sample consisted of adults with unilateral or bilateral tinnitus, who had been diagnosed with noise-induced hearing loss. The patients under analysis underwent an otorhinolaryngological evaluation, pure tone audiometry, and acuphenometry. Results The study included 33 subjects with noise-induced hearing loss diagnoses, of which 22 (66.7% were men. Authors observed no statistical difference between gender and loudness/pitch tinnitus and loudness/pitch in subjects with bilateral tinnitus. Authors found an inverse relation between tinnitus loudness with intensity greater hearing threshold and the average of the thresholds and the grade of hearing loss. The tinnitus pitch showed no association with higher frequency of hearing threshold. Conclusion Data analysis shows that, among the individuals evaluated, the greater the hearing loss, the lower the loudness of tinnitus. We did not observe an association between hearing loss and tinnitus pitch.

  5. [Effectiveness of partial and complete instrumental masking in chronic tinnitus. Studies with reference to retraining therapy].

    Science.gov (United States)

    von Wedel, H; von Wedel, U C; Streppel, M; Walger, M

    1997-09-01

    Jastreboff und Hazell [9] developed a neurophysiological approach to tinnitus perception, including the important role of the central nervous system in the maintenance and intrusiveness of tinnitus. They introduced tinnitus-retraining therapy, consisting of four different strategies: (1) directive and person-centered counseling; (2) hearing aids and/or noise generators and/or environmental sounds; (3) psychological therapy; (4) adjacent therapies. Tinnitus should not be masked as with a tinnitus-masker, but must be able to be heard in addition to the noise! A noise generator or hearing aid should be worn at least 6-8 h per day over a period of up to 18 months. In additions several clinical visits are required in order to reinforce the counseling. The actual results show complete tinnitus remission for about 20-30% and partial remission for 50-60% of the patients [6]. We report on a retrospective study in patients wearing hearing aids or tinnitus-maskers over a period of 3 years. We compared the results of patients using partial tinnitus masking to those using complete masking. The tinnitus-related and general psychological complaints were acquired by the 52-item tinnitus questionnaire developed by Hallam et al. [4] and modified by Goebel and Hiller [3]. To describe the dimensions of tinnitus-related distress the scales are labelled emotional distress, cognitive distress, emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbance and somatic complaints. Positive changes for the global tinnitus questionnaire score of more than 10 points are significant in the dimensions of tinnitus-related distress and are described as partial tinnitus-reduction. The group with partial masking effects can be compared to those performing retraining therapy to day because directive and personal centered counseling were integrated for all patients. Patients reporting partial masking effects through their aids (hearing aid or noise generator

  6. [Attention diversion in tinnitus therapy. Comparison of the effects of different treatment methods].

    Science.gov (United States)

    Eysel-Gosepath, K; Gerhards, F; Schicketanz, K-H; Teichmann, K; Benthien, M

    2004-05-01

    Diversion or distraction of auditory attention is a core principle of tinnitus retraining therapy as introduced by P. Jastreboff and J. Hazell. The aim of this study was to evaluate the effectiveness of a different form of attention diversion in tinnitus therapy. In a prospective and randomized study, 40 patients suffering from chronic tinnitus were assigned to two different groups, A or B. All patients received appropriate counselling and were instructed in relaxation training. Patients in group A learned to distract attention away from the tinnitus by using sound or music. White noise generators or hearing aids were applied in this group. Patients in group B were instructed to direct their attention away from the tinnitus using imagination that was facilitated by the use of light and warmth stimuli as distracters. Different standardized questionnaires were used for an evaluation of therapy effectiveness. In both groups, patients were significantly less annoyed and disabled by their tinnitus immediately after therapy and after 6 months. Tinnitus annoyance still proved to be reduced 1 year after the end of the therapy. There were no significant differences in the effects of each treatment. Attention diversion is an important method for decreasing tinnitus-related distress. Patients should be instructed to use not only auditory but also visual and thermal sensations in order to distract attention away from their tinnitus.

  7. The hearing benefit of cochlear implantation for individuals with unilateral hearing loss, but no tinnitus.

    Science.gov (United States)

    Skarzynski, Henryk; Lorens, Artur; Kruszynska, Marika; Obrycka, Anita; Pastuszak, Dorota; Skarzynski, Piotr Henryk

    2017-07-01

    Cochlear implants improve the hearing abilities of individuals with unilateral hearing loss and no tinnitus. The benefit is no different from that seen in patients with unilateral hearing loss and incapacitating tinnitus. To evaluate hearing outcomes after cochlear implantation in individuals with unilateral hearing loss and no tinnitus and compare them to those obtained in a similar group who had incapacitating tinnitus. Six cases who did not experience tinnitus before operation and 15 subjects with pre-operative tinnitus were evaluated with a structured interview, a monosyllabic word test under difficult listening situations, a sound localization test, and an APHAB (abbreviated profile of hearing aid benefit) questionnaire. All subjects used their cochlear implant more than 8 hours a day, 7 days a week. In 'no tinnitus' patients, mean benefit of cochlear implantation was 19% for quiet speech, 15% for speech in noise (with the same signal-to-noise ratio in the implanted and non-implanted ear), and 16% for a more favourable signal-to-noise ratio at the implanted ear. Sound localization error improved by an average of 19°. The global score of APHAB improved by 16%. The benefits across all evaluations did not differ significantly between the 'no tinnitus' and 'tinnitus' groups.

  8. Auditory adaptation testing as a tool for investigating tinnitus origin: two patients with vestibular schwannoma.

    Science.gov (United States)

    Silverman, Carol A; Silman, Shlomo; Emmer, Michele B

    2017-06-01

    To enhance the understanding of tinnitus origin by disseminating two case studies of vestibular schwannoma (VS) involving behavioural auditory adaptation testing (AAT). Retrospective case study. Two adults who presented with unilateral, non-pulsatile subjective tinnitus and bilateral normal-hearing sensitivity. At the initial evaluation, the otolaryngologic and audiologic findings were unremarkable, bilaterally. Upon retest, years later, VS was identified. At retest, the tinnitus disappeared in one patient and was slightly attenuated in the other patient. In the former, the results of AAT were positive for left retrocochlear pathology; in the latter, the results were negative for the left ear although a moderate degree of auditory adaptation was present despite bilateral normal-hearing sensitivity. Imaging revealed a small VS in both patients, confirmed surgically. Behavioural AAT in patients with tinnitus furnishes a useful tool for exploring tinnitus origin. Decrease or disappearance of tinnitus in patients with auditory adaptation suggests that the tinnitus generator is the cochlea or the cochlear nerve adjacent to the cochlea. Patients with unilateral tinnitus and bilateral, symmetric, normal-hearing thresholds, absent other audiovestibular symptoms, should be routinely monitored through otolaryngologic and audiologic re-evaluations. Tinnitus decrease or disappearance may constitute a red flag for retrocochlear pathology.

  9. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    International Nuclear Information System (INIS)

    Kuśmierska, Małgorzata; Gać, Paweł; Nahorecki, Artur; Szuba, Andrzej; JaŸwiec, Przemysław

    2013-01-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus

  10. Cranial dural arteriovenous fistula as a rare cause of tinnitus – case report

    Energy Technology Data Exchange (ETDEWEB)

    Kuśmierska, Małgorzata; Gać, Paweł [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland); Nahorecki, Artur [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Szuba, Andrzej [Department of Internal Diseases, 4th Military Clinical Hospital, Wrocław (Poland); Medical University, Wrocław (Poland); JaŸwiec, Przemysław [Department of Medical Radiology and Imaging Diagnostics, 4th Military Clinical Hospital, Wrocław (Poland)

    2013-07-01

    Tinnitus, occurring at least once in a lifetime in about 10–20% of the population, is an important clinical problem with complex etiology. Rare causes of tinnitus include cranial dural arteriovenous fistulas (DAVFs), which are usually small lesions consisting of abnormal connections between branches of dural arteries and venous sinuses or veins. Authors present a case of a 44-year-old woman with persistent, unilateral, treatment-resistant pulsatile tinnitus caused by a small dural arteriovenous fistula revealed in computed tomography angiography. Computed tomography angiography is a useful diagnostic method that in some cases allows for establishing the cause of unilateral, pulsatile tinnitus.

  11. 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....

  12. 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.

  13. 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.

  14. An operant-based detection method for inferring tinnitus in mice.

    Science.gov (United States)

    Zuo, Hongyan; Lei, Debin; Sivaramakrishnan, Shobhana; Howie, Benjamin; Mulvany, Jessica; Bao, Jianxin

    2017-11-01

    Subjective tinnitus is a hearing disorder in which a person perceives sound when no external sound is present. It can be acute or chronic. Because our current understanding of its pathology is incomplete, no effective cures have yet been established. Mouse models are useful for studying the pathophysiology of tinnitus as well as for developing therapeutic treatments. We have developed a new method for determining acute and chronic tinnitus in mice, called sound-based avoidance detection (SBAD). The SBAD method utilizes one paradigm to detect tinnitus and another paradigm to monitor possible confounding factors, such as motor impairment, loss of motivation, and deficits in learning and memory. The SBAD method has succeeded in monitoring both acute and chronic tinnitus in mice. Its detection ability is further validated by functional studies demonstrating an abnormal increase in neuronal activity in the inferior colliculus of mice that had previously been identified as having tinnitus by the SBAD method. The SBAD method provides a new means by which investigators can detect tinnitus in a single mouse accurately and with more control over potential confounding factors than existing methods. This work establishes a new behavioral method for detecting tinnitus in mice. The detection outcome is consistent with functional validation. One key advantage of mouse models is they provide researchers the opportunity to utilize an extensive array of genetic tools. This new method could lead to a deeper understanding of the molecular pathways underlying tinnitus pathology. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Treating chronic tinnitus: comparison of cognitive-behavioural and habituation-based treatments.

    Science.gov (United States)

    Zachriat, Claudia; Kröner-Herwig, Birgit

    2004-01-01

    Using a randomized control group trial the long-term efficacy of a habituation-based treatment as conceived by Jastreboff, and a cognitive-behavioural tinnitus coping training were compared. An educational intervention was administered as a control condition. Both treatments were conducted in a group format (habituation-based treatment, 5 sessions; tinnitus coping training, 11 sessions). Educational intervention was delivered in a single group session. Patients were categorized according to their level of disability due to tinnitus (low, high), age and gender and then randomly allocated to the treatment conditions (habituation-based treatment, n = 30; tinnitus coping training, n = 27; educational intervention, n = 20). Data assessment included follow-ups of up to 21 months. Several outcome variables including disability due to tinnitus were assessed either by questionnaire or diary. Findings reveal highly significant improvements in both tinnitus coping training and habituation-based treatment in comparison with the control group. While tinnitus coping training and habituation-based treatment do not differ significantly in reduction of tinnitus disability, improvement in general well-being and adaptive behaviour is greater in tinnitus coping training than habituation-based treatment. The decrease in disability remains stable throughout the last follow-up in both treatment conditions.

  16. Subjective tinnitus assessment and treatment in clinical practice: the necessity of personalized medicine.

    Science.gov (United States)

    Van de Heyning, Paul; Gilles, Annick; Rabau, Sarah; Van Rompaey, Vincent

    2015-10-01

    Subjective tinnitus can be triggered by a variety of causes, and therefore tinnitus patients constitute a very heterogeneous population difficult to manage. In this article, we reviewed the current literature to present our conceptual model of the conscious auditory percept and tinnitus - based on experimental research - in order to explain the clinical approach to the individual tinnitus patient. Fundamental research has provided evidence to support the neurophysiological model of tinnitus developed by Jastreboff. By manipulating the limbic, autonomic and auditory systems, tinnitus retraining therapy (TRT) aims to reduce the response to the abnormal stimulus. Evidence has confirmed the effectiveness of TRT and cognitive behavioral therapy in reducing the negative impact of subjective tinnitus on the patients' quality of life. Every patient with subjective tinnitus has its unique 'tinnitus profile' which provides a guide to the necessary combination of therapeutic actions. Evidence suggests the multidisciplinary approach combining etiological therapy as well as TRT, and cognitive behavioral therapy in specialized clinics is not only effective in reducing the patient's quality of life but also cost-effective from a healthcare and societal point of view.

  17. Objective quantification of the tinnitus decompensation by synchronization measures of auditory evoked single sweeps.

    Science.gov (United States)

    Strauss, Daniel J; Delb, Wolfgang; D'Amelio, Roberto; Low, Yin Fen; Falkai, Peter

    2008-02-01

    Large-scale neural correlates of the tinnitus decompensation might be used for an objective evaluation of therapies and neurofeedback based therapeutic approaches. In this study, we try to identify large-scale neural correlates of the tinnitus decompensation using wavelet phase stability criteria of single sweep sequences of late auditory evoked potentials as synchronization stability measure. The extracted measure provided an objective quantification of the tinnitus decompensation and allowed for a reliable discrimination between a group of compensated and decompensated tinnitus patients. We provide an interpretation for our results by a neural model of top-down projections based on the Jastreboff tinnitus model combined with the adaptive resonance theory which has not been applied to model tinnitus so far. Using this model, our stability measure of evoked potentials can be linked to the focus of attention on the tinnitus signal. It is concluded that the wavelet phase stability of late auditory evoked potential single sweeps might be used as objective tinnitus decompensation measure and can be interpreted in the framework of the Jastreboff tinnitus model and adaptive resonance theory.

  18. Low-level laser therapy for treatment of neurosensory disorders after orthognathic surgery: A systematic review of randomized clinical trials.

    Science.gov (United States)

    Bittencourt, M-A-V; Paranhos, L-R; Martins-Filho, P-R-S

    2017-11-01

    Low-level laser has been widely used in Dentistry and many studies have focused on its application in oral surgeries. This study was conducted with the aim of searching for scientific evidence concerning the effectiveness of laser to reduce pain or paresthesia related to orthognathic surgery. An electronic search was performed in PubMed, Scopus, Science Direct, LILACS, SciELO, CENTRAL, Google Scholar, OpenGrey, and ClinicalTrials.gov, up to November 2016, with no restrictions on language or year of publication. Additionally, a hand search of the reference list of the selected studies was carried out. The PICOS strategy was used to define the eligibility criteria and only randomized clinical trials were selected. Out of 1,257 identified citations, three papers fulfilled the criteria and were included in the systematic review. The risk of bias was assessed according to the Cochrane Guidelines for Clinical Trials and results were exposed based on a descriptive analysis. One study showed that laser therapy was effective to reduce postoperative pain 24 hours (P=0.007) and 72 hours (P=0.007) after surgery. Other study revealed the positive effect of laser to improve neurosensory recovery 60 days after surgery, evaluated also by the two-point discrimination (P=0.005) and sensory (P=0.008) tests. The third study reported an improvement for general sensibility of 68.75% for laser group, compared with 21.43% for placebo (P=0.0095), six months after surgery. Individual studies suggested a positive effect of low-level laser therapy on reduction of postoperative pain and acceleration of improvement of paresthesia related to orthognathic surgery. However, due to the insufficient number and heterogeneity of studies, a meta-analysis evaluating the outcomes of interest was not performed, and a pragmatic recommendation about the use of laser therapy is not possible. This systematic review was conducted according to the statements of PRISMA and was registered at PROSPERO under the

  19. Noise-Induced Tinnitus Using Individualized Gap Detection Analysis and Its Relationship with Hyperacusis, Anxiety, and Spatial Cognition

    Science.gov (United States)

    Pace, Edward; Zhang, Jinsheng

    2013-01-01

    Tinnitus has a complex etiology that involves auditory and non-auditory factors and may be accompanied by hyperacusis, anxiety and cognitive changes. Thus far, investigations of the interrelationship between tinnitus and auditory and non-auditory impairment have yielded conflicting results. To further address this issue, we noise exposed rats and assessed them for tinnitus using a gap detection behavioral paradigm combined with statistically-driven analysis to diagnose tinnitus in individual rats. We also tested rats for hearing detection, responsivity, and loss using prepulse inhibition and auditory brainstem response, and for spatial cognition and anxiety using Morris water maze and elevated plus maze. We found that our tinnitus diagnosis method reliably separated noise-exposed rats into tinnitus(+) and tinnitus(−) groups and detected no evidence of tinnitus in tinnitus(−) and control rats. In addition, the tinnitus(+) group demonstrated enhanced startle amplitude, indicating hyperacusis-like behavior. Despite these results, neither tinnitus, hyperacusis nor hearing loss yielded any significant effects on spatial learning and memory or anxiety, though a majority of rats with the highest anxiety levels had tinnitus. These findings showed that we were able to develop a clinically relevant tinnitus(+) group and that our diagnosis method is sound. At the same time, like clinical studies, we found that tinnitus does not always result in cognitive-emotional dysfunction, although tinnitus may predispose subjects to certain impairment like anxiety. Other behavioral assessments may be needed to further define the relationship between tinnitus and anxiety, cognitive deficits, and other impairments. PMID:24069375

  20. En nevrofysiologisk tilnærming til tinnitus : teorien bak og behandlingsprinsippene som følger

    OpenAIRE

    Schive, Øivind Beite

    2012-01-01

    The patogenesis of tinnitus has remained unknown despite a prevalence as high as 10-15% of the population. In 1990, Pavel Jastreboff presented a hypothesis that even though the tinnitus signal is generated in the chochlea and then amplified in subcortical centres, it´s the following processes - perception, psychological evaluation and classification - that generates the pathological perception of tinnitus. Based on this hypothesis he released a new type of treatment, Tinnitus Retraining Thera...

  1. Expectations for Tinnitus Treatment and Outcomes: A Survey Study of Audiologists and Patients.

    Science.gov (United States)

    Husain, Fatima T; Gander, Phillip E; Jansen, Jaclyn N; Shen, Sa

    2018-04-01

    Roughly 10-15% of the general population is affected by tinnitus and this percentage is estimated to rise in future. Because there is currently no cure for tinnitus, treatment is limited and is primarily achieved through management of symptoms and counseling. This study compared audiologists' and patients' responses to related survey questions about their expectations regarding tinnitus treatment. Two separate surveys were created, one for patients with tinnitus, and one for practicing audiologists who may treat such patients. The surveys included several related questions, such that comparison of the two could reveal where patients' and audiologists' expectations for tinnitus care were in agreement and areas in which they differed. The surveys for audiologists and adults with tinnitus were 31- and 38-item questionnaires, respectively. Both surveys comprised demographic questions followed by several tinnitus-related questions in either multiple-choice or Likert-scale format. We received 230 completed Patient Surveys and 68 completed Audiologist Surveys. All survey recruitment was completed online. Responses were collected via the Survey Monkey web tool (http://www.surveymonkey.com/). Responses were analyzed within and between surveys and grouped into topical categories (assessment, counseling, current available tinnitus information, satisfaction and expectations, improving tinnitus management). For data within each survey, descriptive statistics and correlation analyses were used. For selected comparisons between surveys, cross-tabulations were used. Hierarchical regression modeling was conducted to further explore (1) the perceived effectiveness of treatment received, and (2) how each group defined treatment success. Differences were noted between the two groups' responses to the question on the definition of treatment success; audiologists reported decreased awareness (77%), stress/anxiety relief (63%), and increased knowledge of tinnitus (63%) most commonly

  2. Stellate Ganglion Block, Compared With Xenon Light Irradiation, Is a More Effective Treatment of Neurosensory Deficits Resulting From Orthognathic Surgery, as Measured by Current Perception Threshold.

    Science.gov (United States)

    Nogami, Kentaro; Taniguchi, Shogo

    2015-07-01

    The aim of this study was to evaluate the relative effectiveness of stellate ganglion blockade (SGB) versus xenon light irradiation (XLI) for the treatment of neurosensory deficits resulting from orthognathic surgery as determined by a comparison of prospective measurements of electrical current perception thresholds (CPTs) and ranged CPTs (R-CPTs). CPT and R-CPT in the mental foramen area were measured during electrical stimulation at 98 different sites on the body in patients who had undergone orthognathic surgery. After surgery, patients were assigned to the SGB group or the XLI group. CPT and R-CPT of the 2 groups were measured at stimulation frequencies of 2,000, 250, and 5 Hz before surgery, 1 week after surgery, and after 10 treatment sessions. Furthermore, the influence of surgical factors, such as genioplasty and a surgically exposed inferior alveolar nerve (IAN), was examined in the 2 groups. Patients' CPT and R-CPT values indicated a considerable amount of sensory disturbance in most cases after surgery. The change in magnitude of all CPT and R-CPT values for the SGB group decreased considerably compared with that for the XLI group after treatment. There was no correlation between CPT or R-CPT values and surgical factors (eg, genioplasty and exposure of the IAN). SGB of the IAN could be an effective method for treating neurosensory deficits after orthognathic surgery on the IAN. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  3. 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

  4. Modulation of Perception or Emotion? A Scoping Review of Tinnitus Neuromodulation Using Transcranial Direct Current Stimulation.

    Science.gov (United States)

    Shekhawat, Giriraj Singh; Stinear, Cathy M; Searchfield, Grant D

    2015-10-01

    Tinnitus is the phantom perception of sound and can have negative effect on the quality of life. Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique, which can increase or decrease the cortical excitability in the brain region to which it is applied. tDCS has been used for tinnitus research since 2006. To investigate whether tDCS affects tinnitus perception, related emotion, or both, and the potential implications for tinnitus management. A scoping review was undertaken using the methods proposed by Arksey and O'Malley. After initial consideration of title relevance and reading abstracts, 15 studies were included in this review. The data from these studies were charted to investigate the impact of tDCS on tinnitus perception and emotions. tDCS results in transient suppression of tinnitus loudness and annoyance; however, it does not lead to long-term impact on tinnitus related emotion. Local stimulation of different sites of stimulation (left temporoparietal area, dorsolateral prefrontal cortex, and auditory cortex) might modulate tinnitus perception (loudness) and emotions differently; however, further research is needed to explore this hypothesis. This review has identified aspects of methodologies that require attention in upcoming tinnitus and tDCS trials to offer better insights. tDCS is an effective research tool for transient tinnitus neuromodulation. However, efforts should be invested in designing clinical trials using local and multiple sites of stimulation, optimized parameters, and objective outcome measures before it can be translated in to a clinical tool for tinnitus management. © The Author(s) 2015.

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

    International Nuclear Information System (INIS)

    Zhang, Jian; Chen, Yu-Chen; Feng, Xu; Yang, Ming; Liu, Bin; Qian, Cheng; Wang, Jian; Salvi, Richard; Teng, Gao-Jun

    2015-01-01

    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

  6. Original article New challenges for clinical health psychology in diagnosis and therapy of tinnitus

    Directory of Open Access Journals (Sweden)

    Monika Klepas

    2014-07-01

    Full Text Available Background Tinnitus is becoming a social issue as the number of individuals suffering from this condition is still increasing. The aim of this study was to analyze the characteristics of tinnitus and related distress, as well as general psychiatric distress of affected individuals. Participants and procedure The study included 169 tinnitus patients aged between 22 and 88 years (mean 53.52. The duration of tinnitus ranged between 5 months and 30 years (mean 5.29 years. The participants presented either with normal hearing or with hearing loss. The study was based on a standardized interview and examination with two psychometric instruments: the General Health Questionnaire (GHQ-28 and the Tinnitus Handicap Inventory (THI. Results Duration of tinnitus, its subjective severity, experiencing negative emotions and lack of social support turned out to be a composite measure determining the level of tinnitus-related distress. In turn, the level of psychiatric distress was determined by sex of the participants, presence of difficulties in life, subjective severity of tinnitus and lack of social support. Conclusions Characteristics of tinnitus and its psychological consequences affect various functional aspects and health of the affected patients. The diagnostic instruments used in the study (THI and GHQ-28 proved to be appropriate and identified a subset of tinnitus patients who required appropriate psychotherapeutic intervention. The complex situation of patients experiencing subjective signs of tinnitus points to a necessity of cooperation between specialists in laryngology and psychologists, as a vital component of multidisciplinary evaluation and the therapeutic process.

  7. Tinnitus-related dissociation between cortical and subcortical neural activity in humans with mild to moderate sensorineural hearing loss

    NARCIS (Netherlands)

    Boyen, Kris; de Kleine, Emile; van Dijk, Pim; Langers, Dave R. M.

    Tinnitus is a phantom sound percept that is strongly associated with peripheral hearing loss. However, only a fraction of hearing-impaired subjects develops tinnitus. This may be based on differences in the function of the brain between those subjects that develop tinnitus and those that do not. In

  8. Differences in the suppression of distortion product otoacoustic emissions by contralateral white noise between patients with acute or chronic tinnitus.

    Science.gov (United States)

    Riga, Maria; Komis, Agis; Marangoudakis, Pavlos; Naxakis, Stefanos; Ferekidis, Eleftherios; Kandiloros, Dimitrios; Danielides, Vasilios

    2017-08-01

    The mechanisms underlying the shift from acute tinnitus to chronic remain obscure. An association between tinnitus and medial olivocochlear bundle (MOCB) reflex dysfunction has been hypothesised by several studies. The differences between participants with acute and chronic tinnitus have not yet been investigated. Participants were examined with distortion product otoacoustic emissions (DPOAEs) suppression elicited by contralateral white noise. They were compared in terms of frequency regions with non-recordable DPOAEs, suppression amplitudes and the presence of DPOAE enhancement. Eighteen participants with acute tinnitus, 40 age-matched adults with chronic tinnitus and 17 controls were included. All participants (aged 34.7 ± 9.6years; mean ± Standard deviation) had normal hearing. Tinnitus was bilateral in 22 participants and unilateral in 36. Ears with chronic tinnitus presented significantly lower DPOAE suppression amplitudes than ears with acute tinnitus (p tinnitus ears present a high prevalence of enhancement, significantly different from controls (p tinnitus and control groups (p tinnitus becomes chronic, DPOAEs suppression presents changes that might reveal corresponding steps in tinnitus pathophysiology. Treatment implications are discussed.

  9. 0069 Psychosocial work factors, occupational noise exposure, common mental disorders, and the risk of tinnitus

    DEFF Research Database (Denmark)

    Winther Frederiksen, Thomas; Ramlau-Hansen, Cecilia H; Stokholm, Zara A

    2014-01-01

    OBJECTIVES: Tinnitus is common, can be disabling, and may impair concentration, hearing and sleep. Noise induced hearing loss, other subtypes of hearing loss and ototoxic drugs are well-documented risk factors for tinnitus. Psychosocial work factors, depression and anxiety may exacerbate tinnitus...

  10. 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.

  11. Tinnitus as an unusual presentation of Schneiderian papillomatosis.

    LENUS (Irish Health Repository)

    Ali, R B

    2012-02-01

    INTRODUCTION: Primary Schneiderian papillomatosis of the middle ear and mastoid cavity is extremely rare. It is frequently associated with intermittent unilateral otorrhoea and mass in the middle ear and mastoid cavity. METHODS: Case presentation, symptoms, diagnostic criteria, management and literature review are discussed. CONCLUSION: Schneiderian papillomatosis is an important differential diagnosis of mass in the middle ear and mastoid cavity, and tinnitus as a presenting symptom has not been reported before. Primary radical treatment is essential in preventing tumour recurrence.

  12. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    OpenAIRE

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily ...

  13. Metabolic disorders in vertigo, tinnitus, and hearing loss.

    Science.gov (United States)

    Kaźmierczak, H; Doroszewska, G

    2001-01-01

    Vertigo, tinnitus, and hearing loss are common complaints among populations of industrial countries, especially in persons older than 40 years. Numerous agents are known to incite vertigo, tinnitus, and hearing loss, among them hyperinsulinemia, diabetes mellitus, and hyperlipidemia. In this study, we proposed to assess the occurrence of hyperinsulinemia, diabetes mellitus, and hyperlipidemia in patients suffering from vertigo, tinnitus, or hearing loss of unknown origin. Results of various tests in 48 patients were compared to those in 31 control subjects. Assessments of body mass index, blood pressure, and laryngological, audiometric, and electronystagmographic parameters were performed in all study participants. An oral glucose tolerance test was used to evaluate insulin levels, and lipoprotein phenotyping served to determine cholesterol, triglyceride, and lipoprotein levels. Patients were found to be significantly more overweight (on the basis of body mass index) than were the control subjects. Hypertension was more common among patients than controls, but the difference was significant only between the men in the two groups. Disturbances of glucose metabolism were found in 27.1% of patients but in only 9.7% of controls. Diabetes mellitus was not present in any controls but was identified in four patients. Hyperinsulinemia was almost twice as common in patients as in controls. Only the occurrence of hyperlipoproteinemia seemed not to differ between patients and control subjects. We conclude that such disturbances of glucose metabolism as diabetes mellitus and hyperinsulinemia may be responsible for inner ear diseases, whereas the role of disturbances of lipid metabolism remains vague.

  14. [Role of hypnotherapy in the treatment of debilitating tinnitus].

    Science.gov (United States)

    Gajan, F; Pannetier, B; Cordier, A; Amstutz-Montadert, I; Dehesdin, D; Marie, J P

    2011-01-01

    Hypnotherapy is currently used for tinnitus therapy in our university hospital. The aim of this study was to evaluate its efficacy. This study was performed on 110 patients suffering from distressing tinnitus. They were treated during five sessions with hypnotherapy, supplemented by instruction on self-hypnotherapy. A subjective evaluation was done by the practitioner at the end of the sessions of hypnotherapy. Then a questionnaire on psychologic distress (Wilson 1991) was sent retrospectively to the patients. We received 65 responses which were used for this study. Before treatment, the mean value of the Wilson score was 54 (28-104). After treatment, it was: 31 (0-86). 69% of the patients felt an improvement > or = 5 points Wilson score. These results were compared with the evaluation carried out by the practitioner at the end of the sessions of hypnosis. There was a "significant correlation" between the evaluation of the felt benefice, analyzed by the practitioner at the end of the sessions of hypnosis, and by the patient questioned long after the treatment. These results had significant correlation with the evaluation made by the therapist at the end of the five sessions of hypnotherapy. They show, how effective (68% improvement) this therapeutic approach can be. Hypnotherapy can be regarded as an effective treatment against distressing tinnitus.

  15. 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.

  16. Gray matter in the brain : Differences associated with tinnitus and hearing loss

    NARCIS (Netherlands)

    Boyen, Kris; Langers, Dave R. M.; de Kleine, Emile; van Dijk, Pim

    Tinnitus, usually associated with hearing loss, is characterized by the perception of sound without an external sound source. The pathophysiology of tinnitus is poorly understood. In the present study, voxel-based morphometiy (VBM) was employed to identify gray matter differences related to hearing

  17. Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans.

    Science.gov (United States)

    Marks, Kendra L; Martel, David T; Wu, Calvin; Basura, Gregory J; Roberts, Larry E; Schvartz-Leyzac, Kara C; Shore, Susan E

    2018-01-03

    The dorsal cochlear nucleus is the first site of multisensory convergence in mammalian auditory pathways. Principal output neurons, the fusiform cells, integrate auditory nerve inputs from the cochlea with somatosensory inputs from the head and neck. In previous work, we developed a guinea pig model of tinnitus induced by noise exposure and showed that the fusiform cells in these animals exhibited increased spontaneous activity and cross-unit synchrony, which are physiological correlates of tinnitus. We delivered repeated bimodal auditory-somatosensory stimulation to the dorsal cochlear nucleus of guinea pigs with tinnitus, choosing a stimulus interval known to induce long-term depression (LTD). Twenty minutes per day of LTD-inducing bimodal (but not unimodal) stimulation reduced physiological and behavioral evidence of tinnitus in the guinea pigs after 25 days. Next, we applied the same bimodal treatment to 20 human subjects with tinnitus using a double-blinded, sham-controlled, crossover study. Twenty-eight days of LTD-inducing bimodal stimulation reduced tinnitus loudness and intrusiveness. Unimodal auditory stimulation did not deliver either benefit. Bimodal auditory-somatosensory stimulation that induces LTD in the dorsal cochlear nucleus may hold promise for suppressing chronic tinnitus, which reduces quality of life for millions of tinnitus sufferers worldwide. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

  18. Effects of frequency discrimination training on tinnitus: results from two randomised controlled trials.

    Science.gov (United States)

    Hoare, Derek J; Kowalkowski, Victoria L; Hall, Deborah A

    2012-08-01

    That auditory perceptual training may alleviate tinnitus draws on two observations: (1) tinnitus probably arises from altered activity within the central auditory system following hearing loss and (2) sound-based training can change central auditory activity. Training that provides sound enrichment across hearing loss frequencies has therefore been hypothesised to alleviate tinnitus. We tested this prediction with two randomised trials of frequency discrimination training involving a total of 70 participants with chronic subjective tinnitus. Participants trained on either (1) a pure-tone standard at a frequency within their region of normal hearing, (2) a pure-tone standard within the region of hearing loss or (3) a high-pass harmonic complex tone spanning a region of hearing loss. Analysis of the primary outcome measure revealed an overall reduction in self-reported tinnitus handicap after training that was maintained at a 1-month follow-up assessment, but there were no significant differences between groups. Secondary analyses also report the effects of different domains of tinnitus handicap on the psychoacoustical characteristics of the tinnitus percept (sensation level, bandwidth and pitch) and on duration of training. Our overall findings and conclusions cast doubt on the superiority of a purely acoustic mechanism to underpin tinnitus remediation. Rather, the nonspecific patterns of improvement are more suggestive that auditory perceptual training affects impact on a contributory mechanism such as selective attention or emotional state.

  19. Long-term effect of hyperbaric oxygenation treatment on chronic distressing tinnitus

    NARCIS (Netherlands)

    Tan, J.; Tange, R. A.; Dreschler, W. A.; vd Kleij, A.; Tromp, E. C.

    1999-01-01

    Tinnitus is still a phenomenon with an unknown pathophysiology with few therapeutic measures. During the last two decades, hyperbaric oxygenation therapy (HBO) has been used in the treatment of sudden deafness and chronic distressing tinnitus. In this study, we prescribed HBO to 20 patients who had

  20. Tinnitus in patients with temporo-mandibular joint disorder: Proposal for a new treatment protocol.

    Science.gov (United States)

    Attanasio, Giuseppe; Leonardi, Alessandra; Arangio, Paolo; Minni, Antonio; Covelli, Edoardo; Pucci, Resi; Russo, Francesca Yoshie; De Seta, Elio; Di Paolo, Carlo; Cascone, Piero

    2015-06-01

    The present study was designed to verify the correlation between tinnitus and temporomandibular joint dysfunction.86 consecutive patients were enrolled in the study, all affected by subjective tinnitus without hearing impairment, from both genders, age between 18 and 60 years old. The final number of patients included in the study was 55. All patients received a temporo-mandibular joint examination. All the patients were asked to rate the severity of their symptoms before and after treatment using a VAS scale and the Tinnitus Handicap Inventory (THI) and they followed a standardized protocol for the investigation of tinnitus. All the subjects were monitored by the same researcher and they underwent the same splint treatment. The comparison between pre- and posttreatment phase scores showed in patients with predisposition of TMD and with TMD a statistically significant decrease of THI and VAS values. The characteristics of tinnitus and the degree of response to treatment confirmed the relationship between tinnitus and TMD. The authors believe that, when the most common causes of tinnitus, such as otologic disorders and neurological diseases are excluded, it is correct to evaluate the functionality of the temporo-mandibular joint and eventually treat its pathology to obtain tinnitus improvement or even resolution. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  1. When tinnitus loudness and annoyance are discrepant: audiological characteristics and psychological profile.

    Science.gov (United States)

    Hiller, Wolfgang; Goebel, Gerhard

    2007-01-01

    This study evaluates sociodemographic and clinical characteristics of patients reporting discrepant levels of tinnitus loudness and annoyance. 4958 subjects recruited from a national tinnitus association completed a comprehensive screening questionnaire including Klockhoff and Lindblom's loudness grading system and the psychometric Mini-TQ (Tinnitus Questionnaire). There was a moderate correlation of 0.45 between loudness and annoyance. Of the subjects reporting very loud tinnitus, about one third had only mild or moderate annoyance scores. They were not different from those with high annoyance regarding age, gender and tinnitus duration, but annoyance was increased when subjects had additional hearing loss (OR = 1.71), vertigo/dizziness (OR = 1.94) or hyperacusis (OR = 4.96). Another significant predictor was history of neurological disease (OR = 3.16). Subjects reported low annoyance despite high loudness more often if not feeling low/depressed and not considering themselves as victims of their noises. A specific psychological profile was found to characterize annoyed tinnitus sufferers. Permanent awareness of the noises, decreased ability to ignore them and concentration difficulties were reported frequently even when overall annoyance scores were comparatively low. It is concluded that the coexistence of tinnitus with hearing loss, vertigo/dizziness and hyperacusis as complicating otological conditions seems to be of clinical relevance for the prediction of high annoyance levels. Tinnitus loudness and annoyance are not necessarily congruent and should be assessed separately. (c) 2007 S. Karger AG, Basel.

  2. Somatic memory and gain increase as preconditions for tinnitus: Insights from congenital deafness.

    Science.gov (United States)

    Eggermont, Jos J; Kral, Andrej

    2016-03-01

    Tinnitus is the conscious perception of sound heard in the absence of physical sound sources internal or external to the body. The characterization of tinnitus by its spectrum reflects the missing frequencies originally represented in the hearing loss, i.e., partially or completely deafferented, region. The tinnitus percept, despite a total hearing loss, may thus be dependent on the persisting existence of a somatic memory for the "lost" frequencies. Somatic memory in this context is the reference for phantom sensations attributed to missing sensory surfaces or parts thereof. This raises the question whether tinnitus can exist in congenital deafness, were somatic representations have not been formed. We review the development of tonotopic maps in altricial and precocial animals evidence for a lack of tinnitus in congenital deafness and the effects of cochlear implants on the formation of tonotopic maps in the congenitally deaf. The latter relates to the emergence of tinnitus in these subjects. The reviewed material is consistent with the hypothesis that tinnitus requires an established and actively used somatotopic map that leads to a corresponding somatic memory. The absence of such experience explains the absence of tinnitus in congenital bilateral and unilateral deafness. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  3. 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.

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

    NARCIS (Netherlands)

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

    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

  5. The impact of hyperacusis and hearing loss on tinnitus perception in German teachers

    Directory of Open Access Journals (Sweden)

    Sandra P Meuer

    2015-01-01

    Full Text Available Recent research indicates that a notable number of teachers are concerned with conditions of auditory impairment such as tinnitus, hyperacusis, and hearing loss. Studies focussing on characteristics and interdependencies of single hearing disorders (HD are rare. This explorative study examines tinnitus, hyperacusis, hearing loss, and all possible combinations (tinnitus + hyperacusis; tinnitus + hearing loss; hyperacusis + hearing loss; tinnitus, hyperacusis + hearing loss in German teachers. The impact of single HD on perceived distress, depending on the number and kind of comorbid HD, was of special interest. Information was collected via online survey and includes self-reported data as well as data from the Mini-Tinnitus Questionnaire (Mini-TQ. Results show that most of the 1468 participants (45% suffered from two HD in different combinations, and the fewest (25% were afflicted with only one HD. Considering the seven HD groups, most teachers (30% suffered from all three HD. Across all groups, tinnitus was present in 1096, hyperacusis in 988, and hearing loss in 937 teachers. Multiple intergroup comparisons revealed that self-rated tinnitus-related distress rose significantly with the increasing number of HD. No significant differences were found for distress ratings of hyperacusis between the four groups including hyperacusis and between the four groups with hearing loss. In the Mini-TQ, groups including hyperacusis scored considerably higher than those excluding hyperacusis. The frequent prevalence of HD in German teachers points to a need of better noise prevention in German schools as one priority of occupational safety.

  6. Electric field-navigated transcranial magnetic stimulation for chronic tinnitus: a randomized, placebo-controlled study.

    Science.gov (United States)

    Sahlsten, Hanna; Virtanen, Juuso; Joutsa, Juho; Niinivirta-Joutsa, Katri; Löyttyniemi, Eliisa; Johansson, Reijo; Paavola, Janika; Taiminen, Tero; Sjösten, Noora; Salonen, Jaakko; Holm, Anu; Rauhala, Esa; Jääskeläinen, Satu K

    2017-09-01

    Repetitive transcranial magnetic stimulation (rTMS) may alleviate tinnitus. We evaluated effects of electric field (E-field) navigated rTMS targeted according to tinnitus pitch. No controlled studies have investigated anatomically accurate E-field-rTMS for tinnitus. Effects of E-field-rTMS were evaluated in a prospective randomised placebo-controlled 6-month follow-up study on parallel groups. Patients received 10 sessions of 1 Hz rTMS or placebo targeted to the left auditory cortex corresponding to tonotopic representation of tinnitus pitch. Effects were evaluated immediately after treatment and at 1, 3 and 6 months. Primary outcome measures were visual analogue scores (VAS 0-100) for tinnitus intensity, annoyance and distress, and the Tinnitus Handicap Inventory (THI). Thirty-nine patients (mean age 50.3 years). The mean tinnitus intensity (F 3  = 15.7, p tinnitus, differences between active and placebo groups remained non-significant, due to large placebo-effect and wide inter-individual variation.

  7. 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.)

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

    International Nuclear Information System (INIS)

    Haller, Sven; Birbaumer, Niels; Veit, Ralf

    2010-01-01

    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.)

  9. The occlusal imaging and analysis system by T-scan III in tinnitus patients.

    Science.gov (United States)

    Di Berardino, Federica; Filipponi, Eliana; Schiappadori, Massimo; Forti, Stella; Zanetti, Diego; Cesarani, Antonio

    2016-04-01

    Several studies have demonstrated that the prevalence of temporomandibular disorders (TMDs) in tinnitus patients ranges from 7% to 95%, and it is reported in literature that idiopathic tinnitus patients should be referred to a dentist to define whether or not the tinnitus is associated with TMD. However, the possible pathophysiological relation between TMDs and tinnitus is not generally investigated in clinical practice. The patterns and forces of occlusal contacts have been studied by means of T-scan III in 47 tinnitus patients (23 suffering from idiopathic tinnitus and 24 affected by Ménière disease [MD]) and 13 healthy subjects. The center of force target was offset in the opposite direction in 15/23 idiopathic tinnitus and in 7/24 MD patients (p = 0.026). No significant variation was found in the occlusal force. Our data suggest that a diagnostic screening method for occlusal stability in the intercuspidal position might be clinically useful in idiopathic tinnitus patients. Copyright © 2016 Chang Gung University. Published by Elsevier B.V. All rights reserved.

  10. A Brain Centred View of Psychiatric Comorbidity in Tinnitus: From Otology to Hodology

    Science.gov (United States)

    Minichino, Amedeo; Panico, Roberta; Testugini, Valeria; Altissimi, Giancarlo; Cianfrone, Giancarlo

    2014-01-01

    Introduction. Comorbid psychiatric disorders are frequent among patients affected by tinnitus. There are mutual clinical influences between tinnitus and psychiatric disorders, as well as neurobiological relations based on partially overlapping hodological and neuroplastic phenomena. The aim of the present paper is to review the evidence of alterations in brain networks underlying tinnitus physiopathology and to discuss them in light of the current knowledge of the neurobiology of psychiatric disorders. Methods. Relevant literature was identified through a search on Medline and PubMed; search terms included tinnitus, brain, plasticity, cortex, network, and pathways. Results. Tinnitus phenomenon results from systemic-neurootological triggers followed by neuronal remapping within several auditory and nonauditory pathways. Plastic reorganization and white matter alterations within limbic system, arcuate fasciculus, insula, salience network, dorsolateral prefrontal cortex, auditory pathways, ffrontocortical, and thalamocortical networks are discussed. Discussion. Several overlapping brain network alterations do exist between tinnitus and psychiatric disorders. Tinnitus, initially related to a clinicoanatomical approach based on a cortical localizationism, could be better explained by an holistic or associationist approach considering psychic functions and tinnitus as emergent properties of partially overlapping large-scale neural networks. PMID:25018882

  11. A comparison of benefit and economic value between two sound therapy tinnitus management options.

    Science.gov (United States)

    Newman, Craig W; Sandridge, Sharon A

    2012-02-01

    Sound therapy coupled with appropriate counseling has gained widespread acceptance in the audiological management of tinnitus. For many years, ear level sound generators (SGs) have been used to provide masking relief and to promote tinnitus habituation. More recently, an alternative treatment device was introduced, the Neuromonics Tinnitus Treatment (NTT), which employs spectrally-modified music in an acoustic desensitization approach in order to help patients overcome the disturbing consequences of tinnitus. It is unknown, however, if one treatment plan is more efficacious and cost-effective in comparison to the other. In today's economic climate, it has become critical that clinicians justify the value of tinnitus treatment devices in relation to observed benefit. To determine perceived benefit from, and economic value associated with, two forms of sound therapy, namely, SGs and NTT. Retrospective between-subject clinical study. A sample of convenience comprised of 56 patients drawn from the Tinnitus Management Clinic at the Cleveland Clinic participated. Twenty-three patients selected SGs, and 33 patients selected NTT as their preferred sound therapy treatment option. Sound therapy benefit was quantified using the Tinnitus Handicap Inventory (THI). The questionnaire was administered before and 6 mo after initiation of tinnitus treatment. Prior to device fitting, all patients participated in a 1.5 hr group education session about tinnitus and its management. Economic value comparisons between sound therapy options were made using a cost-effectiveness analysis (CEA) and cost-utility analysis (CUA). THI scores indicated a significant improvement (p 0.05) between the treatment alternatives at baseline or 6 mo postfitting. The magnitude of improvement for both SGs and NTT was dependent on initial perceived tinnitus handicap. Based on the CEA and CUA economic analyses alone, it appears that the SGs may be the more cost-effective alternative; however, the magnitude of

  12. Examining the short term effects of emotion under an Adaptation Level Theory model of tinnitus perception.

    Science.gov (United States)

    Durai, Mithila; O'Keeffe, Mary G; Searchfield, Grant D

    2017-03-01

    Existing evidence suggests a strong relationship between tinnitus and emotion. The objective of this study was to examine the effects of short-term emotional changes along valence and arousal dimensions on tinnitus outcomes. Emotional stimuli were presented in two different modalities: auditory and visual. The authors hypothesized that (1) negative valence (unpleasant) stimuli and/or high arousal stimuli will lead to greater tinnitus loudness and annoyance than positive valence and/or low arousal stimuli, and (2) auditory emotional stimuli, which are in the same modality as the tinnitus, will exhibit a greater effect on tinnitus outcome measures than visual stimuli. Auditory and visual emotive stimuli were administered to 22 participants (12 females and 10 males) with chronic tinnitus, recruited via email invitations send out to the University of Auckland Tinnitus Research Volunteer Database. Emotional stimuli used were taken from the International Affective Digital Sounds- Version 2 (IADS-2) and the International Affective Picture System (IAPS) (Bradley and Lang, 2007a, 2007b). The Emotion Regulation Questionnaire (Gross and John, 2003) was administered alongside subjective ratings of tinnitus loudness and annoyance, and psychoacoustic sensation level matches to external sounds. Males had significantly different emotional regulation scores than females. Negative valence emotional auditory stimuli led to higher tinnitus loudness ratings in males and females and higher annoyance ratings in males only; loudness matches of tinnitus remained unchanged. The visual stimuli did not have an effect on tinnitus ratings. The results are discussed relative to the Adaptation Level Theory Model of Tinnitus. The results indicate that the negative valence dimension of emotion is associated with increased tinnitus magnitude judgements and gender effects may also be present, but only when the emotional stimulus is in the auditory modality. Sounds with emotional associations may be

  13. [A Method of Synthesizing Tinnitus Rehabilitation Sound Based on Pentatonic Scale and Chaos].

    Science.gov (United States)

    Chen, Jiemei; He, Peiyu; Pan, Fan

    2015-12-01

    Tinnitus is a common clinical symptom and its occurrence rate is high. It seriously affects life quality of the patients. Scientific researches show that listening some similar and none-repetitive music can relieve tinnitus to some extent. The overall music accorded with self-similarity character by the direct mapping method based on chaos. However, there were often the same tones continuous repeating a few times and tone mutations. To solve the problem, this paper proposes a new method for tinnitus rehabilitation sound synthesis based on pentatonic scale, chaos and musical instrument digital interface (MIDI). Experimental results showed that the tinnitus rehabilitation sounds were not only self-similar and incompletely reduplicate, but also no sudden changes. Thus, it has a referential significance for tinnitus treatment.

  14. [Neurofeedback for the treatment of chronic tinnitus : Review and future perspectives].

    Science.gov (United States)

    Kleinjung, T; Thüring, C; Güntensperger, D; Neff, P; Meyer, M

    2018-03-01

    Neurofeedback is a noninvasive neuromodulation technique employing real-time display of brain activity in terms of electroencephalography (EEG) signals to teach self-regulation of distinct patterns of brain activity or influence brain activity in a targeted manner. The benefit of this approach for control of symptoms in attention deficit disorders, hyperactivity, depression, and migraine has been proven. Studies in recent years have also repeatedly shown this treatment to improve tinnitus symptoms, although it has not become established as routine therapy. The primary focus of this review is the rational of EEG neurofeedback for tinnitus treatment and the currently available data from published studies. Furthermore, alternative neurofeedback protocols using real-time functional magnetic resonance imaging (fMRI) measurements for tinnitus control are considered. Finally, this article highlights how modern EEG analysis (source localization, connectivity) and the improving understanding of tinnitus pathology can contribute to development of more focused neurofeedback protocols for more sustainable control of tinnitus.

  15. Methodological optimization of tinnitus assessment using prepulse inhibition of the acoustic startle reflex.

    Science.gov (United States)

    Longenecker, R J; Galazyuk, A V

    2012-11-16

    Recently prepulse inhibition of the acoustic startle reflex (ASR) became a popular technique for tinnitus assessment in laboratory animals. This method confers a significant advantage over the previously used time-consuming behavioral approaches utilizing basic mechanisms of conditioning. Although this technique has been successfully used to assess tinnitus in different laboratory animals, many of the finer details of this methodology have not been described enough to be replicated, but are critical for tinnitus assessment. Here we provide detail description of key procedures and methodological issues that provide guidance for newcomers with the process of learning to correctly apply gap detection techniques for tinnitus assessment in laboratory animals. The major categories of these issues include: refinement of hardware for best performance, optimization of stimulus parameters, behavioral considerations, and identification of optimal strategies for data analysis. This article is part of a Special Issue entitled: Tinnitus Neuroscience. Copyright © 2012. Published by Elsevier B.V.

  16. [Research on fractal tones generating method for tinnitus rehabilitation based on musical instrument digital interface technology].

    Science.gov (United States)

    Wang, Lu; He, Peiyu; Pan, Fan

    2014-08-01

    Tinnitus is a subjective sensation of sound without external stimulation. It has become ubiquitous and has therefore aroused much attention in recent years. According to the survey, ameliorating tinnitus based on special music and reducing pressure have good effects on the treatment of it. Meantime, vicious cycle chains between tinnitus and bad feelings have been broken. However, tinnitus therapy has been restricted by using looping music. Therefore, a method of generating fractal tones based on musical instrument digital interface (MIDI) technology and pink noise has been proposed in this paper. The experimental results showed that the fractal fragments were self-similar, incompletely reduplicate, and no sudden changes in pitches and would have a referential significance for tinnitus therapy.

  17. Prevalence of tinnitus and/or hyperacusis in children and adolescents

    DEFF Research Database (Denmark)

    Nemholt, Susanne Steen; Schmidt, Jesper Hvass; Wedderkopp, Niels

    2015-01-01

    INTRODUCTION: There is some debate as to what extent epidemiological data for the prevalence of childhood tinnitus can be relied on. While indications are that the prevalence is relatively high, referral numbers for children with tinnitus are reported to be low and many of the studies have a number...... of methodological difficulties. We describe the protocol of a systematic review aimed at assessing the prevalence of tinnitus and/or hyperacusis in children and young people. METHODS AND ANALYSIS: We will include studies of any design (except case reports or case series) comparing the prevalence of tinnitus and...... is limited to English, German and Scandinavian languages. Primary and additional outcomes will be the prevalence of tinnitus/hyperacusis and the severity, respectively. ETHICS AND DISSEMINATION: No ethical issues are foreseen. The results will be published in a peer-reviewed journal and presented at national...

  18. Long-term tinnitus suppression with linear octave frequency transposition hearing AIDS.

    Directory of Open Access Journals (Sweden)

    Elisabeth Peltier

    Full Text Available Over the last three years of hearing aid dispensing, it was observed that among 74 subjects fitted with a linear octave frequency transposition (LOFT hearing aid, 60 reported partial or complete tinnitus suppression during day and night, an effect still lasting after several months or years of daily use. We report in more details on 38 subjects from whom we obtained quantified measures of tinnitus suppression through visual analog scaling and several additional psychoacoustic and audiometric measures. The long-term suppression seems independent of subject age, and of duration and subjective localization of tinnitus. A small but significant correlation was found with audiogram losses but not with high frequency loss slope. Long-term tinnitus suppression was observed for different etiologies, but with a low success rate for sudden deafness. It should be noted that a majority of subjects (23 had a history of noise exposure. Tinnitus suppression started after a few days of LOFT hearing aid use and reached a maximum after a few weeks of daily use. For nine subjects different amounts of frequency shifting were tried and found more or less successful for long-term tinnitus suppression, no correlation was found with tinnitus pitch. When the use of the LOFT hearing aid was stopped tinnitus reappeared within a day, and after re-using the LOFT aid it disappeared again within a day. For about one third of the 38 subjects a classical amplification or a non linear frequency compression aid was also tried, and no such tinnitus suppression was observed. Besides improvements in audiometric sensitivity to high frequencies and in speech discrimination scores, LOFT can be considered as a remarkable opportunity to suppress tinnitus over a long time scale. From a pathophysiological viewpoint these observations seem to fit with a possible re-attribution of activity to previously deprived cerebral areas corresponding to high frequency coding.

  19. Enhanced GABAA-Mediated Tonic Inhibition in Auditory Thalamus of Rats with Behavioral Evidence of Tinnitus.

    Science.gov (United States)

    Sametsky, Evgeny A; Turner, Jeremy G; Larsen, Deb; Ling, Lynne; Caspary, Donald M

    2015-06-24

    Accumulating evidence suggests a role for inhibitory neurotransmitter dysfunction in the pathology of tinnitus. Opposing hypotheses proposed either a pathologic decrease or increase of GABAergic inhibition in medial geniculate body (MGB). In thalamus, GABA mediates fast synaptic inhibition via synaptic GABAA receptors (GABAARs) and persistent tonic inhibition via high-affinity extrasynaptic GABAARs. Given that extrasynaptic GABAARs control the firing mode of thalamocortical neurons, we examined tonic GABAAR currents in MGB neurons in vitro, using the following three groups of adult rats: unexposed control (Ctrl); sound exposed with behavioral evidence of tinnitus (Tin); and sound exposed with no behavioral evidence of tinnitus (Non-T). Tonic GABAAR currents were evoked using the selective agonist gaboxadol. Months after a tinnitus-inducing sound exposure, gaboxadol-evoked tonic GABAAR currents showed significant tinnitus-related increases contralateral to the sound exposure. In situ hybridization studies found increased mRNA levels for GABAAR δ-subunits contralateral to the sound exposure. Tin rats showed significant increases in the number of spikes per burst evoked using suprathreshold-injected current steps. In summary, we found little evidence of tinnitus-related decreases in GABAergic neurotransmission. Tinnitus and chronic pain may reflect thalamocortical dysrhythmia, which results from abnormal theta-range resonant interactions between thalamus and cortex, due to neuronal hyperpolarization and the initiation of low-threshold calcium spike bursts (Walton and Llinás, 2010). In agreement with this hypothesis, we found tinnitus-related increases in tonic extrasynaptic GABAAR currents, in action potentials/evoked bursts, and in GABAAR δ-subunit gene expression. These tinnitus-related changes in GABAergic function may be markers for tinnitus pathology in the MGB. Copyright © 2015 the authors 0270-6474/15/359369-12$15.00/0.

  20. Limbic-Auditory Interactions of Tinnitus: An Evaluation Using Diffusion Tensor Imaging.

    Science.gov (United States)

    Gunbey, H P; Gunbey, E; Aslan, K; Bulut, T; Unal, A; Incesu, L

    2017-06-01

    Tinnitus is defined as an imaginary subjective perception in the absence of an external sound. Convergent evidence proposes that tinnitus perception includes auditory, attentional and emotional components. The aim of this study was to investigate the thalamic, auditory and limbic interactions associated with tinnitus-related distress by Diffusion Tensor Imaging (DTI). A total of 36 tinnitus patients, 20 healthy controls underwent an audiological examination, as well as a magnetic resonance imaging protocol including structural and DTI sequences. All participants completed the Tinnitus Handicap Inventory (THI) and Visual Analog Scales (VAS) related with tinnitus. The fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained for the auditory cortex (AC), inferior colliculus (IC), lateral lemniscus (LL), medial geniculate body (MGB), thalamic reticular nucleus (TRN), amygdala (AMG), hippocampus (HIP), parahippocampus (PHIP) and prefrontal cortex (PFC). In tinnitus patients the FA values of IC, MGB, TRN, AMG, HIP decreased and the ADC values of IC, MGB, TRN, AMG, PHIP increased significantly. The contralateral IC-LL and bilateral MGB FA values correlated negatively with hearing loss. A negative relation was found between the AMG-HIP FA values and THI and VAS scores. Bilateral ADC values of PHIP and PFC significantly correlated with the attention deficiency-VAS scores. In conclusion, this is the first DTI study to investigate the grey matter structures related to tinnitus perception and the significant correlation of FA and ADC with clinical parameters suggests that DTI can provide helpful information for tinnitus. Magnifying the microstructures in DTI can help evaluate the three faces of tinnitus nature: hearing, emotion and attention.

  1. Mindfulness-Based Cognitive Therapy as a Treatment for Chronic Tinnitus: A Randomized Controlled Trial.

    Science.gov (United States)

    McKenna, Laurence; Marks, Elizabeth M; Hallsworth, Christopher A; Schaette, Roland

    2017-01-01

    Tinnitus is experienced by up to 15% of the population and can lead to significant disability and distress. There is rarely a medical or surgical target and psychological therapies are recommended. We investigated whether mindfulness-based cognitive therapy (MBCT) could offer an effective new therapy for tinnitus. This single-site randomized controlled trial compared MBCT to intensive relaxation training (RT) for chronic, distressing tinnitus in adults. Both treatments involved 8 weekly, 120-min sessions focused on either relaxation (RT) or mindfulness meditation (MBCT). Assessments were completed at baseline and at treatment commencement 8 weeks later. The primary outcomes were tinnitus severity (Tinnitus Questionnaire) and psychological distress (Clinical Outcomes in Routine Evaluation - Non-Risk, CORE-NR), 16 weeks after baseline. The analysis utilized a modified intention-to-treat approach. A total of 75 patients were randomly allocated to MBCT (n = 39) or RT (n = 36). Both groups showed significant reductions in tinnitus severity and loudness, psychological distress, anxiety, depression, and disability. MBCT led to a significantly greater reduction in tinnitus severity than RT, with a mean difference of 6.3 (95% CI 1.3-11.4, p = 0.016). Effects persisted 6 months later, with a mean difference of 7.2 (95% CI 2.1-2.3, p = 0.006) and a standardized effect size of 0.56 (95% CI 0.16-0.96). Treatment was effective regardless of initial tinnitus severity, duration, or hearing loss. MBCT is effective in reducing tinnitus severity in chronic tinnitus patients compared to intensive RT. It also reduces psychological distress and disability. Future studies should explore the generalizability of this approach and how outcome relates to different aspects of the intervention. © 2017 The Author(s) Published by S. Karger AG, Basel.

  2. A Mixed-Methods Trial of Broad Band Noise and Nature Sounds for Tinnitus Therapy: Group and Individual Responses Modeled under the Adaptation Level Theory of Tinnitus.

    Science.gov (United States)

    Durai, Mithila; Searchfield, Grant D

    2017-01-01

    Objectives: A randomized cross-over trial in 18 participants tested the hypothesis that nature sounds, with unpredictable temporal characteristics and high valence would yield greater improvement in tinnitus than constant, emotionally neutral broadband noise. Study Design: The primary outcome measure was the Tinnitus Functional Index (TFI). Secondary measures were: loudness and annoyance ratings, loudness level matches, minimum masking levels, positive and negative emotionality, attention reaction and discrimination time, anxiety, depression and stress. Each sound was administered using MP3 players with earbuds for 8 continuous weeks, with a 3 week wash-out period before crossing over to the other treatment sound. Measurements were undertaken for each arm at sound fitting, 4 and 8 weeks after administration. Qualitative interviews were conducted at each of these appointments. Results: From a baseline TFI score of 41.3, sound therapy resulted in TFI scores at 8 weeks of 35.6; broadband noise resulted in significantly greater reduction (8.2 points) after 8 weeks of sound therapy use than nature sounds (3.2 points). The positive effect of sound on tinnitus was supported by secondary outcome measures of tinnitus, emotion, attention, and psychological state, but not interviews. Tinnitus loudness level match was higher for BBN at 8 weeks; while there was little change in loudness level matches for nature sounds. There was no change in minimum masking levels following sound therapy administration. Self-reported preference for one sound over another did not correlate with changes in tinnitus. Conclusions: Modeled under an adaptation level theory framework of tinnitus perception, the results indicate that the introduction of broadband noise shifts internal adaptation level weighting away from the tinnitus signal, reducing tinnitus magnitude. Nature sounds may modify the affective components of tinnitus via a secondary, residual pathway, but this appears to be less important

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

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    Weisz Nathan

    2010-03-01

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

  4. 10 Hz Amplitude Modulated Sounds Induce Short-Term Tinnitus Suppression

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    Patrick Neff

    2017-05-01

    Full Text Available Objectives: Acoustic stimulation or sound therapy is proposed as a main treatment option for chronic subjective tinnitus. To further probe the field of acoustic stimulations for tinnitus therapy, this exploratory study compared 10 Hz amplitude modulated (AM sounds (two pure tones, noise, music, and frequency modulated (FM sounds and unmodulated sounds (pure tone, noise regarding their temporary suppression of tinnitus loudness. First, it was hypothesized that modulated sounds elicit larger temporary loudness suppression (residual inhibition than unmodulated sounds. Second, with manipulation of stimulus loudness and duration of the modulated sounds weaker or stronger effects of loudness suppression were expected, respectively.Methods: We recruited 29 participants with chronic tonal tinnitus from the multidisciplinary Tinnitus Clinic of the University of Regensburg. Participants underwent audiometric, psychometric and tinnitus pitch matching assessments followed by an acoustic stimulation experiment with a tinnitus loudness growth paradigm. In a first block participants were stimulated with all of the sounds for 3 min each and rated their subjective tinnitus loudness to the pre-stimulus loudness every 30 s after stimulus offset. The same procedure was deployed in the second block with the pure tone AM stimuli matched to the tinnitus frequency, manipulated in length (6 min, and loudness (reduced by 30 dB and linear fade out. Repeated measures mixed model analyses of variance (ANOVA were calculated to assess differences in loudness growth between the stimuli for each block separately.Results: First, we found that all sounds elicit a short-term suppression of tinnitus loudness (seconds to minutes with strongest suppression right after stimulus offset [F(6, 1331 = 3.74, p < 0.01]. Second, similar to previous findings we found that AM sounds near the tinnitus frequency produce significantly stronger tinnitus loudness suppression than noise [vs. Pink

  5. Cannabinoid CB1 receptor agonists do not decrease, but may increase, acoustic trauma-induced tinnitus in rats

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    Yiwen eZheng

    2015-03-01

    Full Text Available Tinnitus has been suggested to arise from neuronal hyperactivity in auditory areas of the brain and anti-epileptic drugs are sometimes used to provide relief from tinnitus. Recently, the anti-epileptic properties of the cannabinoid drugs have gained increasing interest; however, the use of cannabinoids as a form of treatment for tinnitus is controversial. In the present study, we tested whether a combination of delta-9-tetrahydrocannabinol (delta-9-THC and cannabidiol (CBD, delivered in a 1:1 ratio, could affect tinnitus perception in a rat model of acoustic trauma-induced tinnitus. Following sham treatment or acoustic trauma, the animals were divided into the following groups: 1 sham (i.e. no acoustic trauma with vehicle treatment; 2 sham with drug treatment (i.e. delta-9-THC + CBD; 3 acoustic trauma-exposed exhibiting tinnitus, with drug treatment; and 4 acoustic trauma-exposed exhibiting no tinnitus, with drug treatment. The animals received either the vehicle or the cannabinoid drugs every day, 30 min before the tinnitus behavioural testing. Acoustic trauma caused a significant increase in the auditory brainstem response (ABR thresholds in the exposed animals, indicating hearing loss; however, there was a partial recovery over 6 months. Acoustic trauma did not always result in tinnitus; however among those that did exhibit tinnitus, some of them had tinnitus at multiple frequencies while others had it only at a single frequency. The cannabinoids significantly increased the number of tinnitus animals in the exposed-tinnitus group, but not in the sham group. The results suggest that cannabinoids may promote the development of tinnitus, especially when there is pre-existing hearing damage.

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

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    Weisz Nathan

    2008-01-01

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

  7. Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study

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    Dauman, Nicolas; Erlandsson, Soly I.; Albarracin, Dolorès; Dauman, René

    2017-01-01

    Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51–79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model

  8. The psychometric properties of the Tinnitus Handicap Questionnaire in a Dutch-speaking population.

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    Vanneste, S; To, W T; De Ridder, D

    2011-02-01

    The aim of the study is to translate and validate the tinnitus handicap questionnaire (THQ) for a Dutch-speaking population. The factor structure of the questionnaire, the reliability and the validity is determined. Furthermore, a statistical comparison with the original English version of the tinnitus handicap questionnaire is performed. We assessed 101 patients at the Tinnitus Research Initiative clinic of Antwerp University Hospital. Twenty-seven Dutch items from the tinnitus handicap questionnaire by Kuk et al. [(1990), Ear Hear11:434-45.] were obtained by the process of translation and back translation. The factor structure, internal consistency, was evaluated using Cronbach's alpha coefficient and item correlations were used to confirm reliability. The construct validity was confirmed with a visual analogue scale for loudness and distress, awareness, annoyance, the Tinnitus Questionnaire (TQ), the mini-Tinnitus Questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Beck Depression Inventory (BDI) and the Profile of Mood State (POMS), ensuring that this new instrument measures the tinnitus handicap. This study demonstrates that the Dutch version of the tinnitus handicap questionnaire is a reliable (Cronbach's alpha coefficient α = 0.93) and valid measure of self-perceived tinnitus-related distress [with visual analogue scale for loudness (r = 0.39) and distress (r =0.45), awareness (r = 0.39), annoyance (r = 0.57), the Tinnitus Questionnaire (r = 0.82), the mini-Tinnitus Questionnaire (r = 0.79), the Hospital Anxiety and Depression Scale (r = 0.62) and the Beck Depression Inventory (r = 0.32)]. The psychometric properties are in line with previous findings on the English version with regard to reliability and validity. However, the items in the subscales differ from the English version. While the English version has three subscales, our version has only two subscales. Yet, the English version reports that for the three factors, there is a low

  9. Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study.

    Science.gov (United States)

    Dauman, Nicolas; Erlandsson, Soly I; Albarracin, Dolorès; Dauman, René

    2017-01-01

    Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51-79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data ( n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: "Losing body ownership," "Lacking perspectives," and "Persevering through difficulties." Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a

  10. Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals: A Grounded Theory Study

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    Nicolas Dauman

    2017-08-01

    Full Text Available Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach.Methods: Twelve participants (six females, six males, aged 51–79 were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014, the second and third interviews were aimed at gathering rich data, by enhancing the participants' reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998.Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants' experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance. It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore

  11. Evidence for differential modulation of primary and nonprimary auditory cortex by forward masking in tinnitus.

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    Roberts, Larry E; Bosnyak, Daniel J; Bruce, Ian C; Gander, Phillip E; Paul, Brandon T

    2015-09-01

    It has been proposed that tinnitus is generated by aberrant neural activity that develops among neurons in tonotopic of regions of primary auditory cortex (A1) affected by hearing loss, which is also the frequency region where tinnitus percepts localize (Eggermont and Roberts 2004; Roberts et al., 2010, 2013). These models suggest (1) that differences between tinnitus and control groups of similar age and audiometric function should depend on whether A1 is probed in tinnitus frequency region (TFR) or below it, and (2) that brain responses evoked from A1 should track changes in the tinnitus percept when residual inhibition (RI) is induced by forward masking. We tested these predictions by measuring (128-channel EEG) the sound-evoked 40-Hz auditory steady-state response (ASSR) known to localize tonotopically to neural sources in A1. For comparison the N1 transient response localizing to distributed neural sources in nonprimary cortex (A2) was also studied. When tested under baseline conditions where tinnitus subjects would have heard their tinnitus, ASSR responses were larger in a tinnitus group than in controls when evoked by 500 Hz probes while the reverse was true for tinnitus and control groups tested with 5 kHz probes, confirming frequency-dependent group differences in this measure. On subsequent trials where RI was induced by masking (narrow band noise centered at 5 kHz), ASSR amplitude increased in the tinnitus group probed at 5 kHz but not in the tinnitus group probed at 500 Hz. When collapsed into a single sample tinnitus subjects reporting comparatively greater RI depth and duration showed comparatively larger ASSR increases after masking regardless of probe frequency. Effects of masking on ASSR amplitude in the control groups were completely reversed from those in the tinnitus groups, with no change seen to 5 kHz probes but ASSR increases to 500 Hz probes even though the masking sound contained no energy at 500 Hz (an "off-frequency" masking

  12. The differences in brain activity between narrow band noise and pure tone tinnitus.

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    Sven Vanneste

    Full Text Available BACKGROUND: Tinnitus is an auditory sensation characterized by the perception of sound or noise in the absence of any external sound source. Based on neurobiological research, it is generally accepted that most forms of tinnitus are attributable to maladaptive plasticity due to damage to auditory system. Changes have been observed in auditory structures such as the inferior colliculus, the thalamus and the auditory cortex as well as in non-auditory brain areas. However, the observed changes show great variability, hence lacking a conclusive picture. One of the reasons might be the selection of inhomogeneous groups in data analysis. METHODOLOGY: The aim of the present study was to delineate the differences between the neural networks involved in narrow band noise and pure tone tinnitus conducting LORETA based source analysis of resting state EEG. CONCLUSIONS: Results demonstrated that narrow band noise tinnitus patients differ from pure tone tinnitus patients in the lateral frontopolar (BA 10, PCC and the parahippocampal area for delta, beta and gamma frequency bands, respectively. The parahippocampal-PCC current density differences might be load dependent, as noise-like tinnitus constitutes multiple frequencies in contrast to pure tone tinnitus. The lateral frontopolar differences might be related to pitch specific memory retrieval.

  13. A Review of Medicinal Plants for the Treatment of Earache and Tinnitus in Iran.

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    Mahmoudian-Sani, Mohammad Reza; Hashemzadeh-Chaleshtori, Morteza; Asadi-Samani, Majid; Luther, Tahra

    2017-06-01

    Despite numerous trials, there has not yet been any definite strategy to reduce replicable long-term tinnitus and earache. Complementary and alternative medical approaches have been used to decrease the symptoms of tinnitus and earache. This study was conducted to report medicinal plants that are used to treat ear disorders, especially earache and tinnitus in different regions of Iran. Directory of Open Access Journals (DOAJ), Google Scholar, PubMed, LISTA (EBSCO), Embase, and Web of Science were searched using relevant search terms to retrieve eligible publications. Twenty-three species from sixteen families were used for the treatment of earache and tinnitus in Iran. Plants from families Asteraceae and Lamiaceae were the most commonly used plants for the treatment of earache. Ginkgo biloba was frequently reported for the treatment of tinnitus. This study shows the important role of medicinal plants in the treatment of earache and tinnitus in some regions of Iran. The medicinal plants reported in this review can be considered in treatments for earache and tinnitus if examined more extensively in clinical trials.

  14. Changes in the Response Properties of Inferior Colliculus Neurons Relating to Tinnitus

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    Berger, Joel I.; Coomber, Ben; Wells, Tobias T.; Wallace, Mark N.; Palmer, Alan R.

    2014-01-01

    Tinnitus is often identified in animal models by using the gap prepulse inhibition of acoustic startle. Impaired gap detection following acoustic over-exposure (AOE) is thought to be caused by tinnitus “filling in” the gap, thus, reducing its salience. This presumably involves altered perception, and could conceivably be caused by changes at the level of the neocortex, i.e., cortical reorganization. Alternatively, reduced gap detection ability might reflect poorer temporal processing in the brainstem, caused by AOE; in which case, impaired gap detection would not be a reliable indicator of tinnitus. We tested the latter hypothesis by examining gap detection in inferior colliculus (IC) neurons following AOE. Seven of nine unilaterally noise-exposed guinea pigs exhibited behavioral evidence of tinnitus. In these tinnitus animals, neural gap detection thresholds (GDTs) in the IC significantly increased in response to broadband noise stimuli, but not to pure tones or narrow-band noise. In addition, when IC neurons were sub-divided according to temporal response profile (onset vs. sustained firing patterns), we found a significant increase in the proportion of onset-type responses after AOE. Importantly, however, GDTs were still considerably shorter than gap durations commonly used in objective behavioral tests for tinnitus. These data indicate that the neural changes observed in the IC are insufficient to explain deficits in behavioral gap detection that are commonly attributed to tinnitus. The subtle changes in IC neuron response profiles following AOE warrant further investigation. PMID:25346722

  15. 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.

  16. Source-Space Cross-Frequency Amplitude-Amplitude Coupling in Tinnitus

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    Oliver Zobay

    2015-01-01

    Full Text Available The thalamocortical dysrhythmia (TCD model has been influential in the development of theoretical explanations for the neurological mechanisms of tinnitus. It asserts that thalamocortical oscillations lock a region in the auditory cortex into an ectopic slow-wave theta rhythm (4–8 Hz. The cortical area surrounding this region is hypothesized to generate abnormal gamma (>30 Hz oscillations (“edge effect” giving rise to the tinnitus percept. Consequently, the model predicts enhanced cross-frequency coherence in a broad range between theta and gamma. In this magnetoencephalography study involving tinnitus and control cohorts, we investigated this prediction. Using beamforming, cross-frequency amplitude-amplitude coupling (AAC was computed within the auditory cortices for frequencies (f1,f2 between 2 and 80 Hz. We find the AAC signal to decompose into two distinct components at low (f1,f230 Hz frequencies, respectively. Studying the correlation of AAC with several key covariates (age, hearing level (HL, tinnitus handicap and duration, and HL at tinnitus frequency, we observe a statistically significant association between age and low-frequency AAC. Contrary to the TCD predictions, however, we do not find any indication of statistical differences in AAC between tinnitus and controls and thus no evidence for the predicted enhancement of cross-frequency coupling in tinnitus.

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

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    Hauptmann, Christian; Ströbel, Armin; Williams, Mark; Patel, Nitesh; Wurzer, Hannes; von Stackelberg, Tatjana; Brinkmann, Uwe; Langguth, Berthold; Tass, Peter A.

    2015-01-01

    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. PMID:26568958

  18. Effects of Tumor Necrosis Factor Blocker on Salicylate-Induced Tinnitus in Mice.

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    Hwang, Juen-Haur; Huang, David Chang-Wei; Lu, Yin-Chang; Yang, Wei-Shiung; Liu, Tien-Chen

    2017-06-01

    Neuroinflammation is considered a novel mechanism for acute tinnitus. Here, we investigated the effects of a tumor necrosis factor (TNF) blocker on the gene expression of inflammatory-cytokine in the cochlea in a tinnitus animal model. Enbrel® (30 mg/kg, intraperitoneally (i.p.)) were administrated to the mice with the salicylate induced tinnitus for 3 days. Tinnitus score and mRNA expression levels of TNFR1, TNFR2, and N-methyl-d-aspartate receptor subunit 2B (NR2B) and its downstream regulatory element antagonist modulator (DREAM) in the cochlea of mice were measured and compared to the control. The tinnitus score significantly decreased in the Enbrel® treated group. The mRNA levels of both TNFR1 and TNFR2 were significantly lower in the treatment than in the control group. The mRNA levels of NR2B and DREAM followed a similar trend. we found that treatment with 30 mg/ kg Enbrel® decreased salicylate-induced behavior associated with tinnitus and reduced the mRNA expression levels of TNFR1/R2, NR2B, and DREAM in the cochlea of mice. These findings supported the hypothesis that neuroinflammation might be a novel mechanism for salicylate-induced tinnitus.

  19. An integrative model of auditory phantom perception: tinnitus as a unified percept of interacting separable subnetworks.

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    De Ridder, Dirk; Vanneste, Sven; Weisz, Nathan; Londero, Alain; Schlee, Winnie; Elgoyhen, Ana Belen; Langguth, Berthold

    2014-07-01

    Tinnitus is a considered to be an auditory phantom phenomenon, a persistent conscious percept of a salient memory trace, externally attributed, in the absence of a sound source. It is perceived as a phenomenological unified coherent percept, binding multiple separable clinical characteristics, such as its loudness, the sidedness, the type (pure tone, noise), the associated distress and so on. A theoretical pathophysiological framework capable of explaining all these aspects in one model is highly needed. The model must incorporate both the deafferentation based neurophysiological models and the dysfunctional noise canceling model, and propose a 'tinnitus core' subnetwork. The tinnitus core can be defined as the minimal set of brain areas that needs to be jointly activated (=subnetwork) for tinnitus to be consciously perceived, devoid of its affective components. The brain areas involved in the other separable characteristics of tinnitus can be retrieved by studies on spontaneous resting state magnetic and electrical activity in people with tinnitus, evaluated for the specific aspect investigated and controlled for other factors. By combining these functional imaging studies with neuromodulation techniques some of the correlations are turned into causal relationships. Thereof, a heuristic pathophysiological framework is constructed, integrating the tinnitus perceptual core with the other tinnitus related aspects. This phenomenological unified percept of tinnitus can be considered an emergent property of multiple, parallel, dynamically changing and partially overlapping subnetworks, each with a specific spontaneous oscillatory pattern and functional connectivity signature. Communication between these different subnetworks is proposed to occur at hubs, brain areas that are involved in multiple subnetworks simultaneously. These hubs can take part in each separable subnetwork at different frequencies. Communication between the subnetworks is proposed to occur at

  20. Auditive stimulation therapy as an intervention in subacute and chronic tinnitus: a prospective observational study.

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    Kusatz, Martin; Ostermann, Thomas; Aldridge, David

    2005-01-01

    Tinnitus is a noise, a ringing, or a roaring sound in the affected ear and is becoming an increasingly serious problem for health care systems. Integrative treatment concepts are currently regarded as promising therapeutic approaches for managing tinnitus. The aim of this study was to present the results of auditive stimulation therapy, a program of music therapy developed specifically for tinnitus treatment. We collected data on outpatient treatment results from 155 tinnitus patients and evaluated them in a prospective observational study with three defined times of measurement (start, end, and 6 months after the end of treatment). Apart from anamnestic data and subjective evaluation of treatment, the major outcome parameter was the score of the tinnitus questionnaire. To evaluate effectiveness of the therapy, we calculated effect sizes (according to Cohen). Fifty-one percent of the patients were male, and the mean patient age was 49 years. Of the 155 patients, 137 (88%) were capable of gainful employment, which means that they fell in the age range between 18 and 65 years. The duration of tinnitus was more than 6 months for 80% of patients, and 43% had been suffering from tinnitus for more than 3 years. In general, all subscales of the tinnitus questionnaire showed highly significant changes (t-test, p observe a reduction to the level prior to treatment. The values for the effect sizes mostly ranged between medium (> 0.5) and high (> 0.8). Closer investigations indicated that a combination of music therapy and psychological training rendered the best effect sizes. This study demonstrated that music therapy is an effective integrated treatment approach and offers a way to make progress in tinnitus treatment.

  1. 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

  2. Auditory thalamic circuits and GABAA receptor function: Putative mechanisms in tinnitus pathology.

    Science.gov (United States)

    Caspary, Donald M; Llano, Daniel A

    2017-06-01

    Tinnitus is defined as a phantom sound (ringing in the ears), and can significantly reduce the quality of life for those who suffer its effects. Ten to fifteen percent of the general adult population report symptoms of tinnitus with 1-2% reporting that tinnitus negatively impacts their quality of life. Noise exposure is the most common cause of tinnitus and the military environment presents many challenging high-noise situations. Military noise levels can be so intense that standard hearing protection is not adequate. Recent studies suggest a role for inhibitory neurotransmitter dysfunction in response to noise-induced peripheral deafferentation as a key element in the pathology of tinnitus. The auditory thalamus, or medial geniculate body (MGB), is an obligate auditory brain center in a unique position to gate the percept of sound as it projects to auditory cortex and to limbic structures. Both areas are thought to be involved in those individuals most impacted by tinnitus. For MGB, opposing hypotheses have posited either a tinnitus-related pathologic decrease or pathologic increase in GABAergic inhibition. In sensory thalamus, GABA mediates fast synaptic inhibition via synaptic GABA A receptors (GABA A Rs) as well as a persistent tonic inhibition via high-affinity extrasynaptic GABA A Rs and slow synaptic inhibition via GABA B Rs. Down-regulation of inhibitory neurotransmission, related to partial peripheral deafferentation, is consistently presented as partially underpinning neuronal hyperactivity seen in animal models of tinnitus. This maladaptive plasticity/Gain Control Theory of tinnitus pathology (see Auerbach et al., 2014; Richardson et al., 2012) is characterized by reduced inhibition associated with increased spontaneous and abnormal neuronal activity, including bursting and increased synchrony throughout much of the central auditory pathway. A competing hypothesis suggests that maladaptive oscillations between the MGB and auditory cortex

  3. Chronic tinnitus and unipolar brush cell alterations in the cerebellum and dorsal cochlear nucleus.

    Science.gov (United States)

    Brozoski, Thomas; Brozoski, Daniel; Wisner, Kurt; Bauer, Carol

    2017-07-01

    Animal model research has shown that the central features of tinnitus, the perception of sound without an acoustic correlate, include elevated spontaneous and stimulus-driven activity, enhanced burst-mode firing, decreased variance of inter-spike intervals, and distortion of tonotopic frequency representation. Less well documented are cell-specific correlates of tinnitus. Unipolar brush cell (UBC) alterations in animals with psychophysical evidence of tinnitus has recently been reported. UBCs are glutamatergic interneurons that appear to function as local-circuit signal amplifiers. UBCs are abundant in the dorsal cochlear nucleus (DCN) and very abundant in the flocculus (FL) and paraflocculus (PFL) of the cerebellum. In the present research, two indicators of UBC structure and function were examined: Doublecortin (DCX) and epidermal growth factor receptor substrate 8 (Eps8). DCX is a protein that binds to microtubules where it can modify their assembly and growth. Eps8 is a cell-surface tyrosine kinase receptor mediating the response to epidermal growth factor; it appears to have a role in actin polymerization as well as cytoskeletal protein interactions. Both functions could contribute to synaptic remodeling. In the present research UBC Eps8 and DCX immunoreactivity (IR) were determined in 4 groups of rats distinguished by their exposure to high-level sound and psychophysical performance: Unexposed, exposed to high-level sound with behavioral evidence of tinnitus, and two exposed groups without behavioral evidence of tinnitus. Compared to unexposed controls, exposed animals with tinnitus had Eps8 IR elevated in their PFL; other structures were not affected, nor was DCX IR affected. This was interpreted as UBC upregulation in animals with tinnitus. Exposure that failed to produce tinnitus did not increase either Eps8 or DCX IR. Rather Eps8 IR was decreased in the FL and DCN of one subgroup (Least-Tinnitus), while DCX IR decreased in the FL of the other subgroup (No-Tinnitus

  4. When the ringing in the ears gets unbearable: Illness representations, self-instructions and adjustment to tinnitus.

    Science.gov (United States)

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

    2012-08-01

    Chronic tinnitus can severely impair a person's quality of life. The degree of impairment, however, is not closely related to tinnitus loudness. Applying the common sense model (CSM) of self-regulation of health and illness, this study investigated to what extent psychological factors, i.e. illness representations and positive/negative self-instructions, are associated with the degree of tinnitus-related complaints. In this cross-sectional study, 118 patients diagnosed with chronic tinnitus filled in questionnaires assessing illness representations (IPQ-R), positive and negative self-instructions (TRSS), and tinnitus-related complaints (TQ). The regression analysis yielded a number of significant associations between illness representations and tinnitus-related complaints, particularly for the IPQ-R dimensions identity, consequences, coherence, and emotional representations. With regard to self-instructions and tinnitus-related complaints, significant effects were found only for negative self-instructions. Moreover, multiple mediation analyses revealed that the effects of consequences and emotional representations on tinnitus-related complaints were (partially) due to the use of negative self-instructions. Psychological factors are strongly related to the extent of tinnitus-related complaints. The findings provide an indication of which aspects should be targeted in psychological and psychotherapeutic tinnitus treatment. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. A Pilot Study of EEG Source Analysis Based Repetitive Transcranial Magnetic Stimulation for the Treatment of Tinnitus.

    Directory of Open Access Journals (Sweden)

    Hui Wang

    Full Text Available Repetitive Transcranial Magnetic Stimulation (rTMS is a novel therapeutic tool to induce a suppression of tinnitus. However, the optimal target sites are unknown. We aimed to determine whether low-frequency rTMS induced lasting suppression of tinnitus by decreasing neural activity in the cortex, navigated by high-density electroencephalogram (EEG source analysis, and the utility of EEG for targeting treatment.In this controlled three-armed trial, seven normal hearing patients with tonal tinnitus received a 10-day course of 1-Hz rTMS to the cortex, navigated by high-density EEG source analysis, to the left temporoparietal cortex region, and to the left temporoparietal with sham stimulation. The Tinnitus handicap inventory (THI and a visual analog scale (VAS were used to assess tinnitus severity and loudness. Measurements were taken before, and immediately, 2 weeks, and 4 weeks after the end of the interventions.Low-frequency rTMS decreased tinnitus significantly after active, but not sham, treatment. Responders in the EEG source analysis-based rTMS group, 71.4% (5/7 patients, experienced a significant reduction in tinnitus loudness, as evidenced by VAS scores. The target site of neuronal generators most consistently associated with a positive response was the frontal lobe in the right hemisphere, sourced using high-density EEG equipment, in the tinnitus patients. After left temporoparietal rTMS stimulation, 42.8% (3/7 patients experienced a decrease in tinnitus loudness.Active EEG source analysis based rTMS resulted in significant suppression in tinnitus loudness, showing the superiority of neuronavigation-guided coil positioning in dealing with tinnitus. Non-auditory areas should be considered in the pathophysiology of tinnitus. This knowledge in turn can contribute to investigate the pathophysiology of tinnitus.

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

    Directory of Open Access Journals (Sweden)

    Collins Luke

    2011-07-01

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

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

    Science.gov (United States)

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

    2016-12-01

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

  8. Right-Ear Advantage for Speech-in-Noise Recognition in Patients with Nonlateralized Tinnitus and Normal Hearing Sensitivity.

    Science.gov (United States)

    Tai, Yihsin; Husain, Fatima T

    2018-04-01

    Despite having normal hearing sensitivity, patients with chronic tinnitus may experience more difficulty recognizing speech in adverse listening conditions as compared to controls. However, the association between the characteristics of tinnitus (severity and loudness) and speech recognition remains unclear. In this study, the Quick Speech-in-Noise test (QuickSIN) was conducted monaurally on 14 patients with bilateral tinnitus and 14 age- and hearing-matched adults to determine the relation between tinnitus characteristics and speech understanding. Further, Tinnitus Handicap Inventory (THI), tinnitus loudness magnitude estimation, and loudness matching were obtained to better characterize the perceptual and psychological aspects of tinnitus. The patients reported low THI scores, with most participants in the slight handicap category. Significant between-group differences in speech-in-noise performance were only found at the 5-dB signal-to-noise ratio (SNR) condition. The tinnitus group performed significantly worse in the left ear than in the right ear, even though bilateral tinnitus percept and symmetrical thresholds were reported in all patients. This between-ear difference is likely influenced by a right-ear advantage for speech sounds, as factors related to testing order and fatigue were ruled out. Additionally, significant correlations found between SNR loss in the left ear and tinnitus loudness matching suggest that perceptual factors related to tinnitus had an effect on speech-in-noise performance, pointing to a possible interaction between peripheral and cognitive factors in chronic tinnitus. Further studies, that take into account both hearing and cognitive abilities of patients, are needed to better parse out the effect of tinnitus in the absence of hearing impairment.

  9. The importance of ambulatory blood pressure monitoring (ABPM) in patients with tinnitus.

    Science.gov (United States)

    Gaspar, L; Jurcova, D; Ocadlik, I; Makovnik, M; Hlinstakova, S; Bendzala, M; Gasparova, E; Fulleova, M; Dukat, A

    2011-01-01

    Arterial hypertension belongs to the most important factors of origin and lasting of tinnitus. We have studied 18 subjects suffering from tinnitus without the history of diagnosed or treated arterial hypertension. ABPM method was used for diagnosing arterial hypertension. 12 patients (66%) fulfilled the criteria for arterial hypertension. Our results illustrate that arterial hypertension diagnosis is devoted an insufficient attention in patients with tinnitus. ABPM should therefore be used in all patients with tinnitus, immediately after its manifestation and also repeatedly during its course. With early diagnosis and treatment of hypertension, some complications, such as myocardial infarction, stroke, heart and/or kidney failure can be thus prevented (Tab. 1, Fig. 5, Ref. 10). Full Text in free PDF www.bmj.sk.

  10. Seasonal trends in tinnitus symptomatology: evidence from Internet search engine query data.

    Science.gov (United States)

    Plante, David T; Ingram, David G

    2015-10-01

    The primary aim of this study was to test the hypothesis that the symptom of tinnitus demonstrates a seasonal pattern with worsening in the winter relative to the summer using Internet search engine query data. Normalized search volume for the term 'tinnitus' from January 2004 through December 2013 was retrieved from Google Trends. Seasonal effects were evaluated using cosinor regression models. Primary countries of interest were the United States and Australia. Secondary exploratory analyses were also performed using data from Germany, the United Kingdom, Canada, Sweden, and Switzerland. Significant seasonal effects for 'tinnitus' search queries were found in the United States and Australia (p search volume in the winter relative to the summer. Our findings indicate that there are significant seasonal trends for Internet search queries for tinnitus, with a zenith in winter months. Further research is indicated to determine the biological mechanisms underlying these findings, as they may provide insights into the pathophysiology of this common and debilitating medical symptom.

  11. Systematic review of evidence on the association between personality and tinnitus

    Directory of Open Access Journals (Sweden)

    Samantha Mucci

    2014-10-01

    Full Text Available INTRODUCTION: The scientific literature that personality traits are associated with the individual's adaptation to chronic diseases, becoming an important factor in the etiology and prognosis of physical illness. Some studies indicate that personality characteristics may influence the perception of tinnitus. OBJECTIVE: To assess the scientific evidence of the association between tinnitus and personality. METHODS: A systematic review in the following databases: PubMed, SciELO, LILACS and Web of knowledge. Were selected only studies with patients older than 18 years, published in English, Portuguese or Spanish who established an association between tinnitus and personality. RESULTS: Seventeen of the 77 articles found were selected: 13 cross-sectional studies, two longitudinal studies, one validation study, and one birth cohort study. The samples ranged from 27 to 970 patients. CONCLUSION: Some personality traits, especially neuroticism, psychasthenia, and schizoid aspects, may be associated with tinnitus perception and with the annoyance due to this symptom.

  12. Rapid assessment of tinnitus-related psychological distress using the Mini-TQ.

    Science.gov (United States)

    Hiller, Wolfgang; Goebel, Gerhard

    2004-01-01

    The aim of this study was to develop an abridged version of the Tinnitus Questionnaire (TQ) to be used as a quick tool for the assessment of tinnitus-related psychological distress. Data from 351 inpatients and 122 outpatients with chronic tinnitus were used to analyse item statistics and psychometric properties. Twelve items with an optimal combination of high item-total correlations, reliability and sensitivity in assessing changes were selected for the Mini-TQ. Correlation with the full TQ was >0.90, and test-retest reliability was 0.89. Validity was confirmed by associations with general psychological symptom patterns. Treatment effects indicated by the Mini-TQ were slightly greater than those indicated by the full TQ. The Mini-TQ is recommended as a psychometrically approved and solid tool for rapid and economical assessment of subjective tinnitus distress.

  13. Analysis of Changes in Auditory Nerve Signals Following Simulated Tinnitus for the Verification of Cochlear Model

    National Research Council Canada - National Science Library

    Yi, Y

    2001-01-01

    For an interpretation of the tinnitus phenomenon, reticular lamina which transmits energy in a cochlear was assumed as a mass and the components for the stiffness and control were added to the model...

  14. Customized Versus Noncustomized Sound Therapy for Treatment of Tinnitus: A Randomized Crossover Clinical Trial.

    Science.gov (United States)

    Mahboubi, Hossein; Haidar, Yarah M; Kiumehr, Saman; Ziai, Kasra; Djalilian, Hamid R

    2017-10-01

    To determine the effectiveness of a customized sound therapy and compare its effectiveness to that of masking with broadband noise. Subjects were randomized to receive either customized sound therapy or broadband noise for 2 hours per day for 3 months and then switched to the other treatment after a washout period. The outcome variables were tinnitus loudness (scored 0-10), Tinnitus Handicap Inventory (THI), Beck Anxiety Inventory (BAI), minimum masking levels (MML), and residual inhibition (RI). Eighteen subjects completed the study. Mean age was 53 ± 11 years, and mean tinnitus duration was 118 ± 99 months. With customized sound therapy, mean loudness decreased from 6.4 ± 2.0 to 4.9 ± 1.9 ( P = .001), mean THI decreased from 42.8 ± 21.6 to 31.5 ± 20.3 ( P tinnitus patients, and the results may be superior to broadband noise.

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

    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

    Objectives/HypothesisTo 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 DesignProspective study.

  16. A neuronal network model with simplified tonotopicity for tinnitus generation and its relief by sound therapy.

    Science.gov (United States)

    Nagashino, Hirofumi; Kinouchi, Yohsuke; Danesh, Ali A; Pandya, Abhijit S

    2013-01-01

    Tinnitus is the perception of sound in the ears or in the head where no external source is present. Sound therapy is one of the most effective techniques for tinnitus treatment that have been proposed. In order to investigate mechanisms of tinnitus generation and the clinical effects of sound therapy, we have proposed conceptual and computational models with plasticity using a neural oscillator or a neuronal network model. In the present paper, we propose a neuronal network model with simplified tonotopicity of the auditory system as more detailed structure. In this model an integrate-and-fire neuron model is employed and homeostatic plasticity is incorporated. The computer simulation results show that the present model can show the generation of oscillation and its cessation by external input. It suggests that the present framework is promising as a modeling for the tinnitus generation and the effects of sound therapy.

  17. Attenuation of salicylate-induced tinnitus by Ginkgo biloba extract in rats.

    Science.gov (United States)

    Jastreboff, P J; Zhou, S; Jastreboff, M M; Kwapisz, U; Gryczynska, U

    1997-01-01

    The effects of an extract from Ginkgo biloba, EGb 761, on tinnitus were tested using an animal model of tinnitus. Daily oral administration of EGb 761 in doses from 10 to 100 mg/ kg/day began 2 weeks before behavioral procedures and continued until the end of the experiment. Tinnitus was induced by daily administration of 321 mg/kg sodium salicylate s.c. (corresponding to 275 mg/kg/day of salicylate acid) in fourteen groups of pigmented rats, 6 animals/group. The results from salicylate- and EGb-761-treated animals were compared to control groups receiving either salicylate, saline, or EGb 761 only in doses of 100 mg/kg. Administration of EGb 761 resulted in a statistically significant decrease of the behavioral manifestation of tinnitus for doses of 25, 50 and 100 mg/kg/ day.

  18. Demographic data, referral patterns and interventions used for children and adolescents with tinnitus and hyperacusis in Denmark

    DEFF Research Database (Denmark)

    Rosing, Susanne Nemholt; Kapandais, Anestis; Schmidt, Jesper Hvass

    2016-01-01

    OBJECTIVES: To investigate whether children and adolescents with tinnitus and/or hyperacusis are seen in Ear-Nose-Throat (ENT) clinics and to report the clinical data, treatment and referral patterns of these children. To describe the population of children and adolescents with tinnitus and...... to February 2015. All children with a primary complaint of tinnitus and/or hyperacusis was reported. No changes in daily practice regarding diagnostics, treatment or referral were made. A retrospective case review was undertaken during a five-year period from 01/01/2009 to 31/12/2013 in each Danish.......5%) had been diagnosed with tinnitus as a primary complaint. Hyperacusis was the primary complaint in 9 cases (12.8%), and both tinnitus and hyperacusis were reported in 11 cases (15.7%). The findings of this study indicate that a majority of children with tinnitus and/or hyperacusis are seen in settings...

  19. Heidelberg Neuro-Music Therapy Enhances Task-Negative Activity in Tinnitus Patients

    Directory of Open Access Journals (Sweden)

    Christoph M. Krick

    2017-07-01

    Full Text Available Background: Suffering from tinnitus causes mental distress in most patients. Recent findings point toward a diminished activity of the brain's default-mode network (DMN in subjects with mental disorders including depression or anxiety and also recently in subjects with tinnitus-related distress. We recently developed a therapeutic intervention, namely the Heidelberg Neuro-Music Therapy (HNMT, which shows an effective reduction of tinnitus-related distress following a 1-week short-term treatment. This approach offers the possibility to evaluate the neural changes associated with the improvements in tinnitus distress. We previously reported gray matter (GM reorganization in DMN regions and in primary auditory areas following HNMT in cases of recent-onset tinnitus. Here we evaluate on the same patient group, using functional MRI (fMRI, the activity of the DMN following the improvements tinnitus-related distress related to the HNMT intervention.Methods: The DMN activity was estimated by the task-negative activation (TNA during long inter-trial intervals in a word recognition task. The level of TNA was evaluated twice, before and after the 1-week study period, in 18 treated tinnitus patients (“treatment group,” TG, 21 passive tinnitus controls (PTC, and 22 active healthy controls (AC. During the study, the participants in TG and AC groups were treated with HNMT, whereas PTC patients did not receive any tinnitus-specific treatment. Therapy-related effects on DMN activity were assessed by comparing the pairs of fMRI records from the TG and PTC groups.Results: Treatment of the TG group with HNMT resulted in an augmented DMN activity in the PCC by 2.5% whereas no change was found in AC and PTC groups. This enhancement of PCC activity correlated with a reduction in tinnitus distress (Spearman Rho: −0.5; p < 0.005.Conclusion: Our findings show that an increased DMN activity, especially in the PCC, underlies the improvements in tinnitus

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

    Directory of Open Access Journals (Sweden)

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

    Science.gov (United States)

    Schecklmann, Martin; Lehner, Astrid; Gollmitzer, Judith; Schmidt, Eldrid; Schlee, Winfried; Langguth, Berthold

    2015-01-01

    Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About 10 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 electroencephalography (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 1 Hz 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 5 min of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with 1 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

  2. EEG oscillatory power dissociates between distress- and depression-related psychopathology in subjective tinnitus.

    Science.gov (United States)

    Meyer, Martin; Neff, Patrick; Grest, Angelina; Hemsley, Colette; Weidt, Steffi; Kleinjung, Tobias

    2017-05-15

    Recent research has used source estimation approaches to identify spatially distinct neural configurations in individuals with chronic, subjective tinnitus (TI). The results of these studies are often heterogeneous, a fact which may be partly explained by an inherent heterogeneity in the TI population and partly by the applied EEG data analysis procedure and EEG hardware. Hence this study was performed to re-enact a formerly published study (Joos et al., 2012) to better understand the reason for differences and overlap between studies from different labs. We re-investigated the relationship between neural oscillations and behavioral measurements of affective states in TI, namely depression and tinnitus-related distress by recruiting 45 TI who underwent resting-state EEG. Comprehensive psychopathological (depression and tinnitus-related distress scores) and psychometric data (including other tinnitus characteristics) were gathered. A principal component analysis (PCA) was performed to unveil independent factors that predict distinct aspects of tinnitus-related pathology. Furthermore, we correlated EEG power changes in the standard frequency bands with the behavioral scores for both the whole-brain level and, as a post hoc approach, for selected regions of interest (ROI) based on sLORETA. Behavioral data revealed significant relationships between measurements of depression and tinnitus-related distress. Notably, no significant results were observed for the depressive scores and modulations of the EEG signal. However, akin to the former study we evidenced a significant relationship between a power increase in the β-bands and tinnitus-related distress. In conclusion, it has emerged that depression and tinnitus-related distress, even though they are assumed not to be completely independent, manifest in distinct neural configurations. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. EEG Driven tDCS Versus Bifrontal tDCS for Tinnitus

    OpenAIRE

    De Ridder, Dirk; Vanneste, Sven

    2012-01-01

    Tinnitus is the perception of a sound in the absence of any objective physical sound source. Transcranial Direct Current Stimulation (tDCS) induces shifts in membrane resting potentials depending on the polarity of the stimulation: under the anode gamma band activity increases, whereas under the cathode the opposite occurs. Both single and multiple sessions of tDCS over the dorsolateral prefrontal cortex (DLPFC; anode over right DLPFC) yield a transient improvement in tinnitus intensity and t...

  4. Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components

    OpenAIRE

    Thompson, Dean M.; Hall, Deborah A.; Walker, Dawn-Marie; Hoare, Derek J.

    2017-01-01

    Background: Tinnitus is associated with depression and anxiety disor- ders, severely and adversely affecting the quality of life and functional health status for some people. With the dearth of clinical psychologists embedded in audiology services and the cessation of training for hearing therapists in the UK, it is left to audiologists to meet the psychological needs of many patients with tinnitus. However, there is no universally standardized training or manualized intervention specifically...

  5. 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 (ERP 90-150 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 ERP 90-150 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. © 2016 S. Karger AG, Basel.

  6. [Pre- and posttreatment results of an inpatient neurotologic and psychosomatic tinnitus therapy].

    Science.gov (United States)

    Schaaf, H; Hesse, G

    2015-08-01

    Inpatient treatment of chronic complex tinnitus can be necessary for patients with a high symptomatic strain, mostly accompanied by a corresponding mental comorbidity, and/or for patients that can only perceive their psychogenic suffering through somatization into tinnitus. We report the results of 368 consecutively treated inpatients with chronic complex tinnitus. Patients' audiometric data were collected, and at the beginning and end of treatment, the Mini-Tinnitus Questionnaire (Mini-TQ12; Hiller und Goebel) was completed, as was the German version of the Hospitality Anxiety and Depression Score (HADS). Effect sizes were calculated for both questionnaires. Mean treatment duration was 38.8 days (standard deviation, SD: 13.6 days). The main therapeutic elements were intensive disorder-specific neurotologic counselling and psychoeducation; improvement of hearing by fitting of hearing aids, complemented by an individualized hearing therapy; and intensive individual and group-based psychotherapy. In addition to tinnitus, 82.1% of the patients had reduced hearing requiring rehabilitation with hearing aids. After hospitalization, a highly significant improvement in tinnitus strain could be demonstrated by the Mini-TQ12. Furthermore, a significant reduction in the depression and anxiety components of HADS was also achieved, with high effect sizes of 1.6 to 2.2. No reduction of tinnitus symptoms to a medium- or low-range level was experienced by 8.9% of patients. With corresponding symptomatic suffering, disorder-specific inpatient tinnitus treatment comprising neurotologic and psychosomatic alignment can achieve medium- to high-range therapeutic effects.

  7. Double Jeopardy: Hearing Loss and Tinnitus Among Noise-Exposed Workers.

    Science.gov (United States)

    Hong, OiSaeng; Chin, Dal Lae; Phelps, Stephanie; Joo, Yoonmee

    2016-06-01

    The purpose of this study was to determine the prevalence and characteristics of tinnitus and assess the rel