Bladtsanders9546
The MML values obtained for the masking of tinnitus and for the mimicking external sounds were very similar. On the other hand, the MRILs were significantly different between the tinnitus and the mimicking external sounds within tinnitus participants. They were also different between the tinnitus participants and the controls. Overall, for both within and between comparisons, the MRIL values were much higher to produce a poststimulus suppression for the mimicking sound than for the tinnitus. Fadraciclib CDK inhibitor The results showed no significant differences between the diotic and dichotic conditions. These results corroborate other findings suggesting that the tinnitus-related neural activity is very different from the stimulus-related neural activity. The consequences of this last finding are discussed.Tinnitus is the auditory phantom perception of a sound that severely affects the quality of life of over 300,000 people in the United Kingdom alone. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation tool, which has been investigated as a potential tinnitus management option since 2006. This study aimed to investigate the impact of tDCS and high-definition transcranial direct current stimulation (HD-tDCS) on tinnitus perception. A scoping review was undertaken using the framework by Arksey and O'malley (2005). After consideration of relevance, 38 primary research studies were included in the data charting to examine the impact of (HD-)tDCS on tinnitus. Twenty-two of the primary research studies reported significant therapeutic effects of (HD)-tDCS on tinnitus perception. However, only eight of these included a sham-control condition. The tDCS protocols in the studies were highly heterogeneous and sample sizes were generally small. More double-blind, sham-controlled trials are needed that use similar protocols and outcome measures before definitive conclusions about the efficacy of (HD-)tDCS for tinnitus can be drawn.The Core Outcome Measures in Tinnitus (COMiT) initiative has recommended a minimum standard of five outcomes when designing a clinical trial to assess the efficacy of sound-based interventions. These are ability to ignore, concentration, quality of sleep, sense of control and tinnitus intrusiveness. The next stage is to consider what measurement instruments might be appropriate for assessing these constructs. The current study aimed to systematically gather existing instruments used to assess concentration. A total of 6240 potentially relevant records were identified. Duplicates and non-published works were removed, leaving a total of 3599 records. A procedure was developed to sample a subset of records, in order to identify relevant instruments without exhaustively reading all 3599 texts. Initially 559 records were identified by screening 1000 articles; 500 of which were randomly selected, and 500 were the most recent publications identified from the PubMed database. Using predefined criteria for data saturation, information about measures of concentration was extracted from the 559 full texts. However, data saturation was reached by 240. Thirteen candidate instruments were identified. The next step will be to assess content validity and feasibility of administration for all these candidate instruments. Findings will inform future recommendations for how to measure concentration in clinical trials to ensure results of trials can be easily compared, contrasted, and synthesized.Tinnitus, the phantom perception of sound, is a frequent disorder that can lead to severe distress and stress-related comorbidity. The pathophysiological mechanisms involved in the etiology of tinnitus are still under exploration. Electrophysiological and functional neuroimaging studies provide increasing evidence for abnormal functioning in auditory but also in non-auditory, e.g., emotional, brain areas. In order to elucidate alterations of affective processing in patients with chronic tinnitus, we used functional magnetic resonance imaging (fMRI) to measure neural responses to emotionally expressive and neutral faces. Twelve patients with chronic tinnitus and a group of 11 healthy controls, matched for age, sex, hearing loss and depressive symptoms were investigated. While viewing emotionally expressive faces compared to neutral faces brain activations in the tinnitus patients differed from those of the controls in a cluster that encompasses the amygdala, the hippocampus and the parahippocampal gyrus bilaterally. Whereas in controls affective faces induced higher brain activation in these regions than neutral faces, these regions in tinnitus patients were deactivated. Our results (1) provide evidence for alterations of affective processing of facial expressions in tinnitus patients indicating general domain-unspecific dysfunctions in emotion processing and (2) indicate the involvement of medial temporal areas in the pathophysiology of tinnitus.
Previous studies have shown that the attention given to tinnitus can be a determinant of tinnitus severity. Some of these studies have shown changes in the amplitude and/or latency parameters of the event-related auditory potentials (ERPs). One of the tools previously employed to investigate an individual's attention is the Event Related Potential (ERP), which reflects the amount of attention from the patient to the provided auditory stimuli.
To verify if the use of central and peripheral drugs tested for the treatment of tinnitus present changes in the measurable parameters of event-related potentials when compared to Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS).
Eighty-eight tinnitus patients were randomly sorted into two drug groups (1) drugs with a central action mechanism and (2) drug with peripheral action mechanism. Their effects upon the negative aspects caused by tinnitus symptoms were evaluated by the ERPs during three periods Premedication (T1), at Termination of the drug of a variety of psychopathological conditions such as obsessive-compulsive disorder may be associated with tinnitus in some patients and may be responsible for the severity of the symptom.
The use of ERPs with patients of chronic tinnitus who have been submitted to treatment using drugs having actions on both the CNS and peripheral auditory system did not present changes in either latency or amplitude of the waves throughout the treatment when compared to the THI questionnaire and VAS. The ERPs cannot be considered as criterion to evaluate the evolution of drug treatment in patients complaining of tinnitus. The statistically significant reduction in THI and VAS scores among all drugs used occurred with dopamine antagonists. Considering the possible antipsychotic effects, we can conclude that the concomitance of a variety of psychopathological conditions such as obsessive-compulsive disorder may be associated with tinnitus in some patients and may be responsible for the severity of the symptom.
Tinnitus suppression following acoustic stimulation is a well-known phenomenon also termed residual inhibition (RI). Some individuals may experience prolonged RI (PRI), which can last for several hours or even days, after a single short-term acoustic stimulation. Exact mechanisms of this phenomenon are unknown and current evidence anecdotal.
The aim of our report is to collect, present, and discuss cases of PRI from our studies on acoustic stimulation in tinnitus with the aim to better understand this phenomenon as well as its implications for individualized treatments.
We pooled cases of PRI from four of our studies with a total sample size of n = 130. The criterion was set on a PRI duration which is at least sustained twice as long as the acoustic stimulation duration.
We report a total number of about 5% of all participants experiencing some form of PRI, with rates of 3%-7% across the individual studies. PRI lasted from 20 min up to several days and was induced by the first stimulus in four out of six cases. Four out of six individuals experiencing PRI were female and PRI mostly occurred when acoustic stimuli were matched to the frequency or type of the tinnitus.
PTS seems to be elicitable in a small subset of tinnitus patients which could inform future individualized treatment options. Future studies should investigate if and how identified factors like stimulus type, position, sex, and chronification grade uphold experimental scrutiny. We propose that the set of methods is furthermore extended with neurophysiology in particular.
PTS seems to be elicitable in a small subset of tinnitus patients which could inform future individualized treatment options. Future studies should investigate if and how identified factors like stimulus type, position, sex, and chronification grade uphold experimental scrutiny. We propose that the set of methods is furthermore extended with neurophysiology in particular.Stochastic resonance (SR) has been proposed to play a major role in auditory perception, and to maintain optimal information transmission from the cochlea to the auditory system. By this, the auditory system could adapt to changes of the auditory input at second or even sub-second timescales. In case of reduced auditory input, somatosensory projections to the dorsal cochlear nucleus would be disinhibited in order to improve hearing thresholds by means of SR. As a side effect, the increased somatosensory input corresponding to the observed tinnitus-associated neuronal hyperactivity is then perceived as tinnitus. In addition, the model can also explain transient phantom tone perceptions occurring after ear plugging, or the Zwicker tone illusion. Vice versa, the model predicts that via stimulation with acoustic noise, SR would not be needed to optimize information transmission, and hence somatosensory noise would be tuned down, resulting in a transient vanishing of tinnitus, an effect referred to as residual inhibition.Tinnitus assessment is a precursor for individualized treatment and outcome measurement. In the recent years, several studies proposed two-alternative forced choice (2AFC) recursive matching as a method to determine tinnitus pitch-match frequency in a standardized reliable manner. Currently, pure tones are used as comparison stimuli to assess pitch-match frequency. In this study, we investigated the psychometric quality of the method comparing different sound types. We measured 20 chronic tinnitus patients in 2 runs on 3 days. To assess pitch-match frequency, we used 2AFC recursive matching and compared results between pure tones and narrow band noise (NBN). Test-retest reliability between runs and across sound types was high (α>0.9) and increased across days. Perceived matching difficulty and time to completion decreased over repetitions. Importantly, the difference of matched frequencies (DMF) between runs was significantly less for NBN. When patients matched the spectral bandwidth of a test tone to their tinnitus, consistency was high (α=0.86) and no patient indicated continuously a pure tone. In conclusion, we recommend using NBN sounds in 2AFC recursive matching to assess pitch-match frequency as a standardized reliable method. Such a procedure could be offered as smartphone-based application to monitor tinnitus symptomatology for individualized assessment and treatment outcome.