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Berger JI, Billig AJ, Sedley W, Kumar S, Griffiths TD, Gander PE. What is the role of the hippocampus and parahippocampal gyrus in the persistence of tinnitus? Hum Brain Mapp 2024; 45:e26627. [PMID: 38376166 PMCID: PMC10878198 DOI: 10.1002/hbm.26627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/12/2024] [Accepted: 02/04/2024] [Indexed: 02/21/2024] Open
Abstract
The hippocampus and parahippocampal gyrus have been implicated as part of a tinnitus network by a number of studies. These structures are usually considered in the context of a "limbic system," a concept typically invoked to explain the emotional response to tinnitus. Despite this common framing, it is not apparent from current literature that this is necessarily the main functional role of these structures in persistent tinnitus. Here, we highlight a different role that encompasses their most commonly implicated functional position within the brain-that is, as a memory system. We consider tinnitus as an auditory object that is held in memory, which may be made persistent by associated activity from the hippocampus and parahippocampal gyrus. Evidence from animal and human studies implicating these structures in tinnitus is reviewed and used as an anchor for this hypothesis. We highlight the potential for the hippocampus/parahippocampal gyrus to facilitate maintenance of the memory of the tinnitus percept via communication with auditory cortex, rather than (or in addition to) mediating emotional responses to this percept.
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Affiliation(s)
- Joel I. Berger
- Department of NeurosurgeryUniversity of IowaIowa CityIowaUSA
| | | | | | | | | | - Phillip E. Gander
- Department of NeurosurgeryUniversity of IowaIowa CityIowaUSA
- Department of RadiologyUniversity of IowaIowa CityIowaUSA
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Husain FT, Khan RA. Review and Perspective on Brain Bases of Tinnitus. J Assoc Res Otolaryngol 2023; 24:549-562. [PMID: 37919556 PMCID: PMC10752862 DOI: 10.1007/s10162-023-00914-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
In advancing our understanding of tinnitus, some of the more impactful contributions in the past two decades have come from human brain imaging studies, specifically the idea of both auditory and extra-auditory neural networks that mediate tinnitus. These networks subserve both the perception of tinnitus and the psychological reaction to chronic, continuous tinnitus. In this article, we review particular studies that report on the nodes and links of such neural networks and their inter-network connections. Innovative neuroimaging tools have contributed significantly to the increased understanding of anatomical and functional connections of attention, emotion-processing, and default mode networks in adults with tinnitus. We differentiate between the neural correlates of tinnitus and those of comorbid hearing loss; surprisingly, tinnitus and hearing loss when they co-occur are not necessarily additive in their impact and, in rare cases, additional tinnitus may act to mitigate the consequences of hearing loss alone on the brain. The scale of tinnitus severity also appears to have an impact on brain networks, with some of the alterations typically attributed to tinnitus reaching significance only in the case of bothersome tinnitus. As we learn more about comorbid conditions of tinnitus, such as depression, anxiety, hyperacusis, or even aging, their contributions to the network-level changes observed in tinnitus will need to be parsed out in a manner similar to what is currently being done for hearing loss or severity. Together, such studies advance our understanding of the heterogeneity of tinnitus and will lead to individualized treatment plans.
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Affiliation(s)
- Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, 901 S. Sixth Street, Champaign, IL, 61820, USA.
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA.
| | - Rafay A Khan
- Neuroscience Program, University of Illinois Urbana-Champaign, 2355/57 Beckman Institute, 405 North Mathews Avenue, Urbana, IL, 61801, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, 405 North Mathews Avenue, Urbana, IL, 61801, USA
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3
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Xiong B, Liu Z, Li J, Huang X, Yang J, Xu W, Chen YC, Cai Y, Zheng Y. Abnormal Functional Connectivity Within Default Mode Network and Salience Network Related to Tinnitus Severity. J Assoc Res Otolaryngol 2023; 24:453-462. [PMID: 37436592 PMCID: PMC10504230 DOI: 10.1007/s10162-023-00905-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 06/19/2023] [Indexed: 07/13/2023] Open
Abstract
BACKGROUND Previous studies have demonstrated that tinnitus is associated with neural changes in the cerebral cortex. This study is aimed at investigating the central nervous characteristics of tinnitus patients with different severity by using a rs-EEG. PARTICIPANTS AND METHODS rs-EEG was recorded in fifty-seven patients with chronic tinnitus and twenty-seven healthy controls. Tinnitus patients were divided into moderate-to-severe tinnitus group and slight-to-mild tinnitus group based on their Tinnitus Handicap Inventory (THI) scores. Source localization and functional connectivity analyses were used to measure the changes in central levels and examine the altered network patterns. The correlation between functional connectivity and tinnitus severity was analyzed. RESULT Compared to the healthy controls, all tinnitus patients showed significant activation in the auditory cortex (middle temporal lobe, BA 21), while moderate-to-severe tinnitus group showed enhanced connectivity between the parahippocampus and posterior cingulate gyrus. Moreover, the moderate-to-severe tinnitus group had enhanced functional connectivity between auditory cortex and insula compared to the slight-to-mild tinnitus group. The connections between the insula and the parahippocampal and posterior cingulate gyrus were positively correlated with THI scores. CONCLUSION The current study reveals that patients with moderate-to-severe tinnitus demonstrate greater changes in the central brain areas, including the auditory cortex, insula, parahippocampus and posterior cingulate gyrus. In addition, enhanced connections were found between the insula and the auditory cortex, as well as the posterior cingulate gyrus and the parahippocampus, which suggests abnormality in the auditory network, salience network, and default mode network. Specifically, the insula is the core region of the neural pathway that is composed of the auditory cortex, insula, and parahippocampus/posterior cingulate gyrus. This suggests that the severity of tinnitus is affected by multiple brain regions.
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Affiliation(s)
- Binbin Xiong
- Zhuhai Hospital Affiliated with Jinan University, Zhuhai, Guangdong, 519000, China
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Zhao Liu
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Jiahong Li
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China
| | - Xiayin Huang
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China
| | - Jing Yang
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Wenqiang Xu
- Center for Hearing and Balance, Zhuhai Hospital of Integrated of Traditional Chinese Medicine and Western Medicine, Zhuhai, Guangdong, 519000, China
| | - Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuexin Cai
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China.
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
| | - Yiqing Zheng
- The First Clinical Medical College of Jinan University, Guangzhou, 510630, China.
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, 510120, Guangzhou, China.
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou City, Guangdong Province, China.
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Zhang Y, Zha B, Shi H, Cheng L, Fan Y, Zhang W, Rong Z, Jin Z, Gao N, Yang J, Zhang Q. Acupuncture decreases amygdala functional connectivity in subjective tinnitus. Front Neurol 2022; 13:986805. [DOI: 10.3389/fneur.2022.986805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022] Open
Abstract
IntroductionSubjective tinnitus is a common and intractable ear disease. The effectiveness of acupuncture in the treatment of subjective tinnitus has been confirmed, but its mechanism of action is not clear. The structures of the amygdala (AMYG) are mainly closely related to emotion in the human brain. This study aimed to investigate the changes in functional connectivity (FC) of AMYG in subjective tinnitus to elucidate the neural mechanism of acupuncture.MethodsCorrelation scale scores of 26 patients with subjective tinnitus were collected, including Tinnitus Evaluation Questionnaire (TEQ), Tinnitus Handicap Inventory (THI) and Visual Analog Scale (VAS). Meanwhile, rs-fMRI data were collected before and after acupuncture treatment in the patients, and in healthy controls (HC) matching the patient's gender and age. Then, AMYG was selected as region of interest to perform FC analysis. Finally, FC patterns of AMYG were first compared between patients with subjective tinnitus and HC, and then within subjects pre-acupuncture and post-acupuncture. Simple linear regression models between correlation scale scores and FC-values were established as well.ResultsAcupuncture treatment relieved the severity of tinnitus. With the acupuncture treatment, the total THI score, TEQ score, and VSA score of patients were significantly lower than before (p < 0.05). Compared with HC, FC of tinnitus patients between AMYG and right inferior temporal gyrus and right precuneus significantly decreased before acupuncture (voxel p < 0.001, cluster p < 0.05, corrected with GRF), while FC of tinnitus patients between AMYG and left superior frontal gyrus and right superior temporal gyrus significantly decreased after acupuncture treatment (voxel p < 0.001, cluster p < 0.05, corrected with GRF). FC of tinnitus patients between the AMYG and right superior frontal gyrus and left paracingulate gyrus showed significant decrease after acupuncture treatment (voxel p < 0.001, cluster p < 0.05, corrected with GRF). Besides, the linear regression models of the effect of THI on FC and VAS on FC performed were statistically significant (p < 0.05).DiscussionThe findings demonstrate that acupuncture can decrease FC of AMYG, which could be positively correlated with the relief of tinnitus symptoms. This result suggests that acupuncture stimulation can effectively relieve the severity of tinnitus by decreasing FC of AMYG in subjective tinnitus patients.
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Billig AJ, Lad M, Sedley W, Griffiths TD. The hearing hippocampus. Prog Neurobiol 2022; 218:102326. [PMID: 35870677 PMCID: PMC10510040 DOI: 10.1016/j.pneurobio.2022.102326] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 06/08/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022]
Abstract
The hippocampus has a well-established role in spatial and episodic memory but a broader function has been proposed including aspects of perception and relational processing. Neural bases of sound analysis have been described in the pathway to auditory cortex, but wider networks supporting auditory cognition are still being established. We review what is known about the role of the hippocampus in processing auditory information, and how the hippocampus itself is shaped by sound. In examining imaging, recording, and lesion studies in species from rodents to humans, we uncover a hierarchy of hippocampal responses to sound including during passive exposure, active listening, and the learning of associations between sounds and other stimuli. We describe how the hippocampus' connectivity and computational architecture allow it to track and manipulate auditory information - whether in the form of speech, music, or environmental, emotional, or phantom sounds. Functional and structural correlates of auditory experience are also identified. The extent of auditory-hippocampal interactions is consistent with the view that the hippocampus makes broad contributions to perception and cognition, beyond spatial and episodic memory. More deeply understanding these interactions may unlock applications including entraining hippocampal rhythms to support cognition, and intervening in links between hearing loss and dementia.
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Affiliation(s)
| | - Meher Lad
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - William Sedley
- Translational and Clinical Research Institute, Newcastle University Medical School, Newcastle upon Tyne, UK
| | - Timothy D Griffiths
- Biosciences Institute, Newcastle University Medical School, Newcastle upon Tyne, UK; Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK; Human Brain Research Laboratory, Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, USA
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Mazurek B, Hesse G, Sattel H, Kratzsch V, Lahmann C, Dobel C. S3 Guideline: Chronic Tinnitus : German Society for Otorhinolaryngology, Head and Neck Surgery e. V. (DGHNO-KHC). HNO 2022; 70:795-827. [PMID: 36227338 PMCID: PMC9581878 DOI: 10.1007/s00106-022-01207-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - Gerhard Hesse
- Tinnitus-Klinik, KH Bad Arolsen, Große Allee 50, 34454, Bad Arolsen, Germany.
- Universität Witten/Herdecke, Witten, Germany.
| | - Heribert Sattel
- Klinikum rechts der Isar, Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Technical University of Munich, Langerstr. 3, 81675, Munich, Germany
| | - Volker Kratzsch
- Abt. Hörbehinderung, Tinnitus und Schwindelerkrankungen, VAMED Rehaklinik Bad Grönenbach, Sebastian-Kneipp-Allee 3-5, 87730, Bad Grönenbach, Germany
| | - Claas Lahmann
- Klinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Freiburg, Hauptstr. 8, 79104, Freiburg, Germany
| | - Christian Dobel
- Klinik für Hals-, Nasen- und Ohrenheilkunde, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany
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7
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Fuksa J, Profant O, Tintěra J, Svobodová V, Tóthová D, Škoch A, Syka J. Functional changes in the auditory cortex and associated regions caused by different acoustic stimuli in patients with presbycusis and tinnitus. Front Neurosci 2022; 16:921873. [PMID: 36340777 PMCID: PMC9626994 DOI: 10.3389/fnins.2022.921873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/31/2022] [Indexed: 09/30/2023] Open
Abstract
Presbycusis and tinnitus are the two most common hearing related pathologies. Although both of these conditions presumably originate in the inner ear, there are several reports concerning their central components. Interestingly, the onset of presbycusis coincides with the highest occurrence of tinnitus. The aim of this study was to identify age, hearing loss, and tinnitus related functional changes, within the auditory system and its associated structures. Seventy-eight participants were selected for the study based on their age, hearing, and tinnitus, and they were divided into six groups: young controls (Y-NH-NT), subjects with mild presbycusis (O-NH-NT) or expressed presbycusis (O-HL-NT), young subjects with tinnitus (Y-NH-T), subjects with mild presbycusis and tinnitus (O-NH-T), and subjects with expressed presbycusis and tinnitus (O-HL-T). An MRI functional study was performed with a 3T MRI system, using an event related design (different types of acoustic and visual stimulations and their combinations). The amount of activation of the auditory cortices (ACs) was dependent on the complexity of the stimuli; higher complexity resulted in a larger area of the activated cortex. Auditory stimulation produced a slightly greater activation in the elderly, with a negative effect of hearing loss (lower activation). The congruent audiovisual stimulation led to an increased activity within the default mode network, whereas incongruent stimulation led to increased activation of the visual cortex. The presence of tinnitus increased activation of the AC, specifically in the aged population, with a slight prevalence in the left AC. The occurrence of tinnitus was accompanied by increased activity within the insula and hippocampus bilaterally. Overall, we can conclude that expressed presbycusis leads to a lower activation of the AC, compared to the elderly with normal hearing; aging itself leads to increased activity in the right AC. The complexity of acoustic stimuli plays a major role in the activation of the AC, its support by visual stimulation leads to minimal changes within the AC. Tinnitus causes changes in the activity of the limbic system, as well as in the auditory AC, where it is bound to the left hemisphere.
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Affiliation(s)
- Jakub Fuksa
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Faculty Hospital Královské Vinohrady, Charles University, Prague, Czechia
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
| | - Oliver Profant
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Faculty Hospital Královské Vinohrady, Charles University, Prague, Czechia
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
| | - Jaroslav Tintěra
- MR Unit, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Veronika Svobodová
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czechia
| | - Diana Tóthová
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czechia
| | - Antonin Škoch
- MR Unit, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Josef Syka
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
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Ma X, Chen N, Wang F, Zhang C, Dai J, Ding H, Yan C, Shen W, Yang S. Surface-based functional metrics and auditory cortex characteristics in chronic tinnitus. Heliyon 2022; 8:e10989. [PMID: 36276740 PMCID: PMC9582700 DOI: 10.1016/j.heliyon.2022.e10989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 06/11/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022] Open
Abstract
Abnormal auditory cortex (AC) neuronal activity is thought to be a primary cause of the auditory disturbances perceived by individuals suffering from tinnitus. The present study was designed to test that possibility by evaluating auditory cortical characteristics (volume, curvature, surface area, thickness) and surface-based functional metrics in chronic tinnitus patients. In total, 63 chronic tinnitus patients and 36 age-, sex- and education level-matched healthy control (HC) patients were enrolled in this study. Hearing levels in these two groups were comparable, and following magnetic resonance imaging (MRI) of these individuals, the DPABISurf software was used to compute cerebral cortex curvature, thickness, and surface area as well as surface-based functional metrics. The Tinnitus Handicap Inventory (THI), Tinnitus Handicap Questionary (THQ), and Visual Analogue Scales (VAS) were used to gauge participant tinnitus severity, while correlation analyses were conducted to evaluate associations between these different analyzed parameters. A significant increase in the regional homogeneity (ReHo) of the right secondary AC was detected in the tinnitus group relative to the HC group. There were also significant reductions in the cortical volume and surface area of the right secondary AC in the tinnitus group relative to the HC group (all P < 0.05). In addition, significant negative correlations between tinnitus pitch and the cortical area and volume of the right secondary AC were observed in the tinnitus group.
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Affiliation(s)
- Xiaoyan Ma
- The First Affiliated Hospital of Xi'an, Jiaotong University, Shanxi, China,Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Ningxuan Chen
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Center for Cognitive Science of Language, Beijing Language and Culture University, Beijing, China
| | - Fangyuan Wang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Chi Zhang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Jing Dai
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Haina Ding
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China
| | - Chaogan Yan
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China,Magnetic Resonance Imaging Research Center, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,International Big-Data Center for Depression Research, Chinese Academy of Sciences, Beijing, China,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China,Center for Cognitive Science of Language, Beijing Language and Culture University, Beijing, China,Department of Child and Adolescent Psychiatry, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA,Corresponding author.
| | - Weidong Shen
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China,Corresponding author.
| | - Shiming Yang
- Medical School of Chinese PLA, Beijing, China,Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China,National Clinical Research Center for Otolaryngologic Diseases, Beijing, China,Key Lab of Hearing Science, Ministry of Education, Beijing, China,Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing, China,Corresponding author.
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9
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The blinking eye as a window into tinnitus: A new animal model of tinnitus in the macaque. Hear Res 2022; 420:108517. [DOI: 10.1016/j.heares.2022.108517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/16/2022] [Accepted: 05/10/2022] [Indexed: 11/22/2022]
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10
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Zhang H, Tao Y, Xu H, Zou S, Deng F, Huang L, Zhang H, Wang X, Tang X, Dong Z, Wang Y, Fu X, Yin L. Associations between childhood chronic stress and dynamic functional connectivity in drug-naïve, first-episode adolescent MDD. J Affect Disord 2022; 299:85-92. [PMID: 34822920 DOI: 10.1016/j.jad.2021.11.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/14/2021] [Accepted: 11/16/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND We explored the associations between chronic stress and dynamic working patterns of the whole brain using resting state MRI data in drug-naïve, first-episode adolescents with major depressive disorder (MDD). METHODS We compared dynamic functional connectivity (dyn-FC) and screen out networks with difference in whole brain between 45 healthy controls (HC) and 60 adolescent MDD patients using dynamic independent components analysis. In each of these networks with difference between groups, hub brain regions were selected as functionally connected to more than 30 brain regions at the same time. Then we extracted the dyn-FC coefficients of each hub brain region with other brain regions in each component at different time points and calculated the average value of the entire scan time. Finally, we explored correlations between these average values of the entire scan time and scores on the Childhood Chronic Stress Questionnaire (CCSQ). RESULTS We found three networks as well as some hub brain regions with different dyn-FC patterns between adolescent MDD and HC. Scores on the CCSQ were found to correlate with dynamic FC between hub brain areas and certain other brain areas in MDD patients. LIMITATIONS our cross-sectional study design does not allow us to speculate about causality between chronic stress and depression. Prospective cohort studies should explore in detail how the changes in dynamic FC appear and evolve during MDD. CONCLUSIONS Chronic stress is related with the brain dynamic working patterns in adolescent MDD.
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Affiliation(s)
- Hang Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Yuanmei Tao
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Hanmei Xu
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Shoukang Zou
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Fang Deng
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Lijuan Huang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Hong Zhang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Xiaolan Wang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Xiaowei Tang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Zaiquan Dong
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Yanping Wang
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Xia Fu
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China
| | - Li Yin
- Department of Psychiatry, West China Hospital of Sichuan University, No. 28 Dianxin South Street, Chengdu, Sichuan 610041, China; Frontier Science Center for Disease-related Molecular Networks, Chengdu, Sichuan 610041, China; Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, Sichuan 610041, China.
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11
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Wei Y, Zhang W, Li Y, Liu X, Zha B, Hu S, Wang Y, Wang X, Yu X, Yang J, Qiu B. Acupuncture Treatment Decreased Temporal Variability of Dynamic Functional Connectivity in Chronic Tinnitus. Front Neurosci 2022; 15:737993. [PMID: 35153654 PMCID: PMC8835346 DOI: 10.3389/fnins.2021.737993] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/03/2021] [Indexed: 11/13/2022] Open
Abstract
Acupuncture is recommended for the relief of chronic tinnitus in traditional Chinese medicine, but the underlying neural mechanism remains unclear. The human brain is a dynamic system, and it’s unclear about acupuncture’s effects on the dynamic functional connectivity (DFC) of chronic tinnitus. Therefore, this study based on resting-state functional magnetic resonance imaging (fMRI) investigates abnormal DFC in chronic tinnitus patients and the neural activity change evoked by acupuncture treatment for tinnitus. In this study, 17 chronic tinnitus patients and 22 age- and sex-matched normal subjects were recruited, and their tinnitus-related scales and hearing levels were collected. The fMRI data were measured before and after acupuncture, and then sliding-window and k-means clustering methods were used to calculate DFC and perform clustering analysis, respectively. We found that, compared with the normal subjects, chronic tinnitus patients had higher temporal variability of DFC between the supplementary motor area and medial part of the superior frontal gyrus, and it positively correlated with hearing loss. Clustering analysis showed higher transition probability (TP) between connection states in chronic tinnitus patients, and it was positively correlated with tinnitus severity. Furthermore, the findings showed that acupuncture treatment might improve tinnitus. DFC between the posterior cingulate gyrus and angular gyrus in chronic tinnitus patients after acupuncture showed significantly decreased, and it positively correlated with the improvement of tinnitus. Clustering analysis showed that acupuncture treatment might promote chronic tinnitus patients under lower DFC state, and it also positively correlated with the improvement of tinnitus. This study suggests that acupuncture as an alternative therapy method might decrease the tinnitus severity by decreasing the time variability of DFC in chronic tinnitus patients.
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Affiliation(s)
- Yarui Wei
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- Department of Magnetic Resonance Imaging, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Wanlin Zhang
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yu Li
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiangwei Liu
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Bixiang Zha
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Sheng Hu
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- School of Medical Information Engineering, Anhui University of Traditional Chinese Medicine, Hefei, China
| | - Yanming Wang
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiaoxiao Wang
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
| | - Xiaochun Yu
- Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing, China
- Xiaochun Yu,
| | - Jun Yang
- Department of Acupuncture and Rehabilitation, The First Affiliated Hospital of Anhui University of Traditional Chinese Medicine, Hefei, China
- Jun Yang,
| | - Bensheng Qiu
- Hefei National Lab for Physical Sciences at the Microscale and the Center for Biomedical Engineering, University of Science and Technology of China, Hefei, China
- *Correspondence: Bensheng Qiu,
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12
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Huang B, Wang X, Wei F, Sun Q, Sun J, Liang Y, Chen H, Zhuang H, Xiong G. Notched Sound Alleviates Tinnitus by Reorganization Emotional Center. Front Hum Neurosci 2022; 15:762492. [PMID: 35153700 PMCID: PMC8832119 DOI: 10.3389/fnhum.2021.762492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundTinnitus is a common disease, and sound therapy is an effective method to alleviate it. Previous studies have shown that notched sound not only changes levels of cortical blood oxygen, but affects blood oxygen in specific cerebral cortical areas, such as Brodmann area 46 (BA46), which is associated with emotion. Extensive evidence has confirmed that tinnitus is closely related to emotion. Whether notched sound plays a role in regulating the emotional center is still unclear.MethodsThis study included 29 patients with newly diagnosed chronic tinnitus who were treated with notched sound. Functional near-infrared spectroscopy (fNIRS) was conducted before and after treatment to observe bilateral changes in cortical blood oxygen in the cerebral hemispheres. We compared the changes in connectivity between the two regions of interest (the superior temporal gyrus and BA46), as wells as other cortical regions before and after treatment.ResultsThe results showed (1) That global connectivity between the bilateral auditory cortex of the superior temporal sulcus and the ipsilateral cortex did not change significantly between baseline and the completion of treatment, and (2) That the connectivity between channel 14 and the right superior temporal sulcus decreased after treatment. The overall connectivity between the right BA46 region and the right cortex decreased after treatment, and decreases in connectivity after treatment were specifically found for channels 10 and 14 in the right parietal lobe and channels 16, 20, 21, and 22 in the frontal lobe, while there was no significant change on the left side. There were no significant changes in the questionnaire measures of tinnitus, anxiety, or depression before and after treatment.ConclusionThe results of the study indicate that cerebral cortex reorganization occurs in tinnitus patients after submitted to treatment with notched sound for 1 month, and that notched sound decreases the connectivity between the auditory cortex and specific brain regions.SignificanceNotched sound not only regulates the auditory center through lateral inhibition, but also alleviates tinnitus by reorganizing the emotional control center.
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Affiliation(s)
- Bixue Huang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Xianren Wang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
- *Correspondence: Xianren Wang,
| | - Fanqing Wei
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Qiyang Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Jincangjian Sun
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Yue Liang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Huiting Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Huiwen Zhuang
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
| | - Guanxia Xiong
- Department of Otorhinolaryngology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Institute of Otorhinolaryngology, Sun Yat-sen University, Guangzhou, China
- Guanxia Xiong,
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13
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Li Z, Wang X, Shen W, Yang S, Zhao DY, Hu J, Wang D, Liu J, Xin H, Zhang Y, Li P, Zhang B, Cai H, Liang Y, Li X. Objective Recognition of Tinnitus Location Using Electroencephalography Connectivity Features. Front Neurosci 2022; 15:784721. [PMID: 35058742 PMCID: PMC8764239 DOI: 10.3389/fnins.2021.784721] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/16/2021] [Indexed: 11/26/2022] Open
Abstract
Purpose: Tinnitus is a common but obscure auditory disease to be studied. This study will determine whether the connectivity features in electroencephalography (EEG) signals can be used as the biomarkers for an efficient and fast diagnosis method for chronic tinnitus. Methods: In this study, the resting-state EEG signals of tinnitus patients with different tinnitus locations were recorded. Four connectivity features [including the Phase-locking value (PLV), Phase lag index (PLI), Pearson correlation coefficient (PCC), and Transfer entropy (TE)] and two time-frequency domain features in the EEG signals were extracted, and four machine learning algorithms, included two support vector machine models (SVM), a multi-layer perception network (MLP) and a convolutional neural network (CNN), were used based on the selected features to classify different possible tinnitus sources. Results: Classification accuracy was highest when the SVM algorithm or the MLP algorithm was applied to the PCC feature sets, achieving final average classification accuracies of 99.42 or 99.1%, respectively. And based on the PLV feature, the classification result was also particularly good. And MLP ran the fastest, with an average computing time of only 4.2 s, which was more suitable than other methods when a real-time diagnosis was required. Conclusion: Connectivity features of the resting-state EEG signals could characterize the differentiation of tinnitus location. The connectivity features (PCC and PLV) were more suitable as the biomarkers for the objective diagnosing of tinnitus. And the results were helpful for clinicians in the initial diagnosis of tinnitus.
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Affiliation(s)
| | - Xinzui Wang
- Jihua Laboratory, Foshan, China.,Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Weidong Shen
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, Institute of Otolaryngology, Beijing, China
| | - Shiming Yang
- Department of Otolaryngology, Head and Neck Surgery, Chinese PLA General Hospital, Institute of Otolaryngology, Beijing, China
| | | | - Jimin Hu
- Jiangsu Testing and Inspection Institute for Medical Devices, Nanjing, China
| | - Dawei Wang
- Jiangsu Testing and Inspection Institute for Medical Devices, Nanjing, China
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14
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Symptom dimensions to address heterogeneity in tinnitus. Neurosci Biobehav Rev 2022; 134:104542. [PMID: 35051524 DOI: 10.1016/j.neubiorev.2022.104542] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 01/10/2023]
Abstract
Tinnitus, the auditory phantom percept, is a well-known heterogenous disorder with multiple subtypes. Researchers and clinicians have tried to classify these subtypes according to clinical profiles, aetiologies, and response to treatment with little success. The occurrence of overlapping tinnitus subtypes suggests that the disorder exists along a continuum of severity, with no clear distinct boundaries. In this perspective, we propose a neuro-mechanical framework, viewing tinnitus as a dimensional disorder which is a complex interplay of its behavioural, biological and neurophysiological phenotypes. Moreover, we explore the potential of these dimensions as interacting networks without a common existing cause, giving rise to tinnitus. Considering tinnitus as partially overlapping, dynamically changing, interacting networks, each representing a different aspect of the unified tinnitus percept, suggests that the interaction of these networks determines the phenomenology of the tinnitus, ultimately leading to a dimensional spectrum, rather than a categorical subtyping. A combination of a robust theoretical framework and strong empirical evidence can advance our understanding of the functional mechanisms underlying tinnitus and ultimately, improve treatment strategies.
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15
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Evaluating the efficacy of hearing aids for tinnitus therapy - A Positron emission tomography study. Brain Res 2022; 1775:147728. [PMID: 34793755 DOI: 10.1016/j.brainres.2021.147728] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 11/10/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022]
Abstract
Brain imaging studies have revealed neural changes in chronic tinnitus patients that are not restricted to auditory brain areas; rather, the engagement of limbic system structures, attention and memory networks are has been noted. Hearing aids (HA) provide compensation for comorbid hearing loss and may decrease tinnitus-related perception and annoyance. Using resting state positron emission tomography our goal was to analyze metabolic and functional brain changes after six months of effective HA use by patients with chronic tinnitus and associated sensorineural hearing loss. 33 age and hearing loss matched participants with mild/moderate hearing loss were enrolled in this study: 19 with tinnitus, and 14 without tinnitus. Participants with tinnitus of more than 6 months with moderate/severe Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores composed the tinnitus group. A full factorial 2X2 ANOVA was conducted for imaging analysis, with group (tinnitus and controls) and time point (pre-intervention and post-intervention) as factors. Six months after HA fitting, tinnitus scores reduced statistically and clinically. Analysis revealed increased glycolytic metabolism in the left orbitofrontal cortex, right temporal lobe and right hippocampus, and reduced glycolytic metabolism in the left cerebellum and inferior parietal lobe within the tinnitus group. The hearing loss control group showed no significant metabolic changes in the analysis. Parsing out the contribution of tinnitus independent of hearing loss, allowed us to identify areas implicated in declines in tinnitus handicap as a result of the intervention. Brain regions implicated in the present study may be part of chronic tinnitus-specific network.
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16
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Barth SW, Lehner MD, Dietz GPH, Schulze H. Pharmacologic treatments in preclinical tinnitus models with special focus on Ginkgo biloba leaf extract EGb 761®. Mol Cell Neurosci 2021; 116:103669. [PMID: 34560255 DOI: 10.1016/j.mcn.2021.103669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/26/2021] [Accepted: 09/17/2021] [Indexed: 02/09/2023] Open
Abstract
Tinnitus is defined as the perception of sound in the absence of external acoustic stimuli. Frequent comorbidities or associated factors are depression, anxiety, concentration problems, insomnia, resignation, helplessness, headache, bruxism, or social isolation, just to name a few. Although many therapeutic approaches have already been tested with varying success, there still is no cure available for tinnitus. The search for an effective treatment has been hampered by the fact that the mechanisms of tinnitus development are still not fully understood, although several models are available and discussed in this review. Our review will give a brief overview about preclinical models, presenting the heterogeneity of tinnitus sub-types depending on the different inner ear and brain structures involved in tinnitus etiology and pathogenesis. Based on these models we introduce the different target structures and transmitter systems implicated in tinnitus development and provide an extensive overview on preclinical drug-based therapeutic approaches that have been explored in various animal models. As the special extract from Ginkgo biloba leaves EGb 761® has been the most widely tested drug in both non-clinical tinnitus models as well as in clinical trials, a special focus will be given to EGb 761®. The efficacy of terpene lactones, flavone glycosides and proanthocyanidines with their distinct contribution to the overall efficacy profile of the multi-constituent drug EGb 761® will be discussed.
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Affiliation(s)
- Stephan W Barth
- Department of Global Medical Affairs, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany.
| | - Martin D Lehner
- Department of Preclinical Research & Development, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany.
| | - Gunnar P H Dietz
- Department of Global Medical Affairs, Dr. Willmar Schwabe GmbH & Co. KG, Karlsruhe, Germany.
| | - Holger Schulze
- Experimental Otolaryngology, ENT-Hospital, Head and Neck Surgery, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany.
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17
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Durai M, Doborjeh Z, Sanders PJ, Vajsakovic D, Wendt A, Searchfield GD. Behavioral Outcomes and Neural Network Modeling of a Novel, Putative, Recategorization Sound Therapy. Brain Sci 2021; 11:554. [PMID: 33925762 PMCID: PMC8146945 DOI: 10.3390/brainsci11050554] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 02/07/2023] Open
Abstract
The mechanisms underlying sound's effect on tinnitus perception are unclear. Tinnitus activity appears to conflict with perceptual expectations of "real" sound, resulting in it being a salient signal. Attention diverted towards tinnitus during the later stages of object processing potentially disrupts high-order auditory streaming, and its uncertain nature results in negative psychological responses. This study investigated the benefits and neurophysiological basis of passive perceptual training and informational counseling to recategorize phantom perception as a more real auditory object. Specifically, it examined underlying psychoacoustic correlates of tinnitus and the neural activities associated with tinnitus auditory streaming and how malleable these are to change with targeted intervention. Eighteen participants (8 females, 10 males, mean age = 61.6 years) completed the study. The study consisted of 2 parts: (1) An acute exposure over 30 min to a sound that matched the person's tinnitus (Tinnitus Avatar) that was cross-faded to a selected nature sound (Cicadas, Fan, Water Sound/Rain, Birds, Water and Bird). (2) A chronic exposure for 3 months to the same "morphed" sound. A brain-inspired spiking neural network (SNN) architecture was used to model and compare differences between electroencephalography (EEG) patterns recorded prior to morphing sound presentation, during, after (3-month), and post-follow-up. Results showed that the tinnitus avatar generated was a good match to an individual's tinnitus as rated on likeness scales and was not rated as unpleasant. The five environmental sounds selected for this study were also rated as being appropriate matches to individuals' tinnitus and largely pleasant to listen to. There was a significant reduction in the Tinnitus Functional Index score and subscales of intrusiveness of the tinnitus signal and ability to concentrate with the tinnitus trial end compared to baseline. There was a significant decrease in how strong the tinnitus signal was rated as well as ratings of how easy it was to ignore the tinnitus signal on severity rating scales. Qualitative analysis found that the environmental sound interacted with the tinnitus in a positive way, but participants did not experience change in severity, however, characteristics of tinnitus, including pitch and uniformity of sound, were reported to change. The results indicate the feasibility of the computational SNN method and preliminary evidence that the sound exposure may change activation of neural tinnitus networks and greater bilateral hemispheric involvement as the sound morphs over time into natural environmental sound; particularly relating to attention and discriminatory judgments (dorsal attention network, precentral gyrus, ventral anterior network). This is the first study that attempts to recategorize tinnitus using passive auditory training to a sound that morphs from resembling the person's tinnitus to a natural sound. These findings will be used to design future-controlled trials to elucidate whether the approach used differs in effect and mechanism from conventional Broadband Noise (BBN) sound therapy.
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Affiliation(s)
- Mithila Durai
- Section of Audiology, School of Population Health, The University of Auckland, Auckland 1023, New Zealand; (M.D.); (Z.D.); (P.J.S.); (D.V.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Zohreh Doborjeh
- Section of Audiology, School of Population Health, The University of Auckland, Auckland 1023, New Zealand; (M.D.); (Z.D.); (P.J.S.); (D.V.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Philip J. Sanders
- Section of Audiology, School of Population Health, The University of Auckland, Auckland 1023, New Zealand; (M.D.); (Z.D.); (P.J.S.); (D.V.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Dunja Vajsakovic
- Section of Audiology, School of Population Health, The University of Auckland, Auckland 1023, New Zealand; (M.D.); (Z.D.); (P.J.S.); (D.V.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
| | - Anne Wendt
- Knowledge Engineering & Discovery Research Institute, Auckland University of Technology, Auckland 1010, New Zealand;
| | - Grant D. Searchfield
- Section of Audiology, School of Population Health, The University of Auckland, Auckland 1023, New Zealand; (M.D.); (Z.D.); (P.J.S.); (D.V.)
- Eisdell Moore Centre, Auckland 1023, New Zealand
- Centre for Brain Research, The University of Auckland, Auckland 1023, New Zealand
- Brain Research New Zealand—Rangahau Roro Aotearoa, The University of Auckland, Auckland 1142, New Zealand
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18
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Altered functional connectivity of the thalamus in tinnitus patients is correlated with symptom alleviation after sound therapy. Brain Imaging Behav 2021; 14:2668-2678. [PMID: 31900891 DOI: 10.1007/s11682-019-00218-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Altered functional connectivity (FC) of the thalamus has been proven to be an important finding in tinnitus patients. Tinnitus can be effectively desensitized by sound therapy. However, it is still unclear whether and how sound therapy affects the FC of the thalamus. Resting-state functional magnetic resonance imaging data and anatomical data were longitudinally collected from 25 idiopathic tinnitus patients before and after 12 weeks of sound therapy by using adjusted narrow band noise and from 25 matched healthy controls at the same time interval without any intervention. The FC of bilateral thalami were analyzed by setting the left and right thalamus as the regions of interest. Significant main effect of group on the FC of the thalamus were found mainly in the key components of the default mode network, limbic network, salience network, cognitive control network, auditory network and occipital region. FC values between the thalamus, inferior frontal gyrus (IFG), and anterior cingulate cortex (ACC) featured higher values in the tinnitus group at baseline compared to the healthy controls and restoration in tinnitus patients after treatment. Decreased Tinnitus Handicap Inventory (THI) scores and decreased FC values between the right thalamus and right IFG were positively correlated (r = 0.476, P = 0.016). Abnormal FC of the thalamus is associated with multiple brain networks. Sound therapy has a normalizing effect on the enhanced FC of the thalamus-IFG and thalamus-ACC, representing decreased tinnitus attention control and less involvement of the noise-canceling system.
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19
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Refat F, Wertz J, Hinrichs P, Klose U, Samy H, Abdelkader RM, Saemisch J, Hofmeier B, Singer W, Rüttiger L, Knipper M, Wolpert S. Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care. Front Neurol 2021; 12:627522. [PMID: 33815254 PMCID: PMC8012887 DOI: 10.3389/fneur.2021.627522] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 02/22/2021] [Indexed: 12/14/2022] Open
Abstract
Although tinnitus represents a major global burden, no causal therapy has yet been established. Ongoing controversies about the neuronal pathophysiology of tinnitus hamper efforts in developing advanced therapies. Hypothesizing that the unnoticed co-occurrence of hyperacusis and differences in the duration of tinnitus may possibly differentially influence the neural correlate of tinnitus, we analyzed 33 tinnitus patients without (T-group) and 20 tinnitus patients with hyperacusis (TH-group). We found crucial differences between the T-group and the TH-group in the increase of annoyance, complaints, tinnitus loudness, and central neural gain as a function of tinnitus duration. Hearing thresholds did not differ between T-group and TH-group. In the TH-group, the tinnitus complaints (total tinnitus score) were significantly greater from early on and the tinnitus intensity distinctly increased over time from ca. 12 to 17 dB when tinnitus persisted more than 5 years, while annoyance responses to normal sound remained nearly constant. In contrast, in the T-group tinnitus complaints remained constant, although the tinnitus intensity declined over time from ca. 27 down to 15 dB beyond 5 years of tinnitus persistence. This was explained through a gradually increased annoyance to normal sound over time, shown by a hyperacusis questionnaire. Parallel a shift from a mainly unilateral (only 17% bilateral) to a completely bilateral (100%) tinnitus percept occurred in the T-group, while bilateral tinnitus dominated in the TH-group from the start (75%). Over time in the T-group, ABR wave V amplitudes (and V/I ratios) remained reduced and delayed. By contrast, in the TH-group especially the ABR wave III and V (and III/I ratio) continued to be enhanced and shortened in response to high-level sound stimuli. Interestingly, in line with signs of an increased co-occurrence of hyperacusis in the T-group over time, ABR wave III also slightly increased in the T-group. The findings disclose an undiagnosed co-occurrence of hyperacusis in tinnitus patients as a main cause of distress and the cause of complaints about tinnitus over time. To achieve urgently needed and personalized therapies, possibly using the objective tools offered here, a systematic sub-classification of tinnitus and the co-occurrence of hyperacusis is recommended.
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Affiliation(s)
- Fatma Refat
- Audio-Vestibular Unit, Department of Ear Nose Throat, Minia University, Minia, Egypt.,Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Jakob Wertz
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Pauline Hinrichs
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Uwe Klose
- Department of Diagnostic and Interventional Neuroradiology, University of Tübingen, Tübingen, Germany
| | - Hesham Samy
- Audio-Vestibular Unit, Department of Ear Nose Throat, Minia University, Minia, Egypt
| | | | - Jörg Saemisch
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Benedikt Hofmeier
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Wibke Singer
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Lukas Rüttiger
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Marlies Knipper
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
| | - Stephan Wolpert
- Tübingen Hearing Research Centre, Department of Otolaryngology, Head and Neck Surgery, University of Tübingen, Tübingen, Germany
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20
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Altered brain responses to emotional facial expressions in tinnitus patients. PROGRESS IN BRAIN RESEARCH 2021; 262:189-207. [PMID: 33931179 DOI: 10.1016/bs.pbr.2021.01.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
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.
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21
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Kreuzer PM, Poeppl TB, Vielsmeier V, Schecklmann M, Langguth B, Lehner A. The more the merrier? Preliminary results regarding treatment duration and stimulation frequency of multisite repetitive transcranial magnetic stimulation in chronic tinnitus. PROGRESS IN BRAIN RESEARCH 2021; 262:287-307. [PMID: 33931185 DOI: 10.1016/bs.pbr.2021.01.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The current study examines two different protocols of repetitive transcranial magnetic stimulation (rTMS) targeting three key hubs of cortical tinnitus networks. Patients chose whether they preferred to undergo rTMS treatment for 10 or 20 sessions and were randomized to the different rTMS protocols thereafter. Ninety patients were enrolled in the study with a total dropout rate of 10%. Both rTMS protocols were well tolerated by the patients without any serious adverse events. Overall treatment effects were small both for 2 weeks and 4 weeks of treatment. There was no significant interaction effect between measurement time point and treatment group for neither of the outcome measures nor any differences regarding the applied treatment regimens. The effects of this study contradict former observations suggesting multisite rTMS protocols as promising neuromodulatory strategies. This lack of effect could not be enhanced by increasing the number of treatment sessions in our study.
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Affiliation(s)
- Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
| | - Timm B Poeppl
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
| | - Veronika Vielsmeier
- Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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22
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Mohagheghian F, Khajehpour H, Samadzadehaghdam N, Eqlimi E, Jalilvand H, Makkiabadi B, Deevband MR. Altered effective brain network topology in tinnitus: An EEG source connectivity analysis. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal). PROGRESS IN BRAIN RESEARCH 2021; 260:1-25. [PMID: 33637213 DOI: 10.1016/bs.pbr.2020.12.002] [Citation(s) in RCA: 115] [Impact Index Per Article: 38.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: "Tinnitus" for the former and "Tinnitus Disorder" for the latter. The proposed definition then becomes "Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder "when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability.". In other words "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.
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Zimmerman BJ, Schmidt SA, Khan RA, Tai Y, Shahsavarani S, Husain FT. Decreased resting perfusion in precuneus and posterior cingulate cortex predicts tinnitus severity. CURRENT RESEARCH IN NEUROBIOLOGY 2021; 2:100010. [PMID: 36246506 PMCID: PMC9559103 DOI: 10.1016/j.crneur.2021.100010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/23/2021] [Accepted: 03/24/2021] [Indexed: 11/19/2022] Open
Abstract
Functional magnetic resonance imaging has been increasingly used to understand the mechanisms involved in subjective tinnitus; however, researchers have struggled to reach a consensus about a primary mechanistic model to explain tinnitus. While many studies have used functional connectivity of the BOLD signal to understand how patterns of activity change with tinnitus severity, there is much less research on whether there are differences in more fundamental physiology, including cerebral blood flow, which may help inform the BOLD measures. Here, arterial spin labeling was used to measure perfusion in four regions-of-interest, guided by current models of tinnitus, in a sample of 60 tinnitus patients and 31 control subjects. We found global reductions in cerebral perfusion in tinnitus compared with controls. Additionally, we observed a significant negative correlation between tinnitus severity and perfusion. These results demonstrate that examining perfusion from the whole brain may present a complementary tool for studying tinnitus. More research will help better understand the physiology underlying these differences in perfusion. Global cerebral blood flow is reduced in tinnitus. Tinnitus severity is negatively correlated with cerebral blood flow globally. Tinnitus severity is negatively correlated with cerebral blood flow in the precuneus and posterior cingulate cortex. Hearing loss predicted reduced cerebral blood flow in the precuneus in participants without tinnitus. The presence or absence of hearing loss did not affect the correlation between tinnitus severity and cerebral blood flow.
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Affiliation(s)
- Benjamin J. Zimmerman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Sara A. Schmidt
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Rafay A. Khan
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Yihsin Tai
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Speech Pathology and Audiology, Ball State University, Muncie, IN, USA
| | - Somayeh Shahsavarani
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Biomedical Engineering, Columbia University, New York, NY, USA
- Mortimer B. Zuckerman Institute for Mind Brain and Behavior, Columbia University, New York, NY, USA
| | - Fatima T. Husain
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Speech and Hearing Science, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Corresponding author. Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
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25
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Zhang J, Huang S, Nan W, Zhou H, Wang J, Wang H, Salvi R, Yin S. Switching Tinnitus-On: Maps and source localization of spontaneous EEG. Clin Neurophysiol 2020; 132:345-357. [PMID: 33450557 DOI: 10.1016/j.clinph.2020.10.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 10/05/2020] [Accepted: 10/11/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To identify the spectrotemporal changes and sources in patients that could "turn on" tinnitus with multichannel electroencephalography (EEG) system. METHODS Multichannel EEG was recorded from six patients during the Tinnitus-On and Tinnitus-Off states. The EEG power spectrum and eLORETA-based sources were measured. RESULTS There was a global increase in delta and theta during Tinnitus-On plus large changes in alpha 1 and alpha 2. During the Tinnitus-On state, many new sources in delta, theta, alpha 1 and gamma bands emerged in the opposite hemisphere in the inferior temporal gyrus (Brodmann area, BA 20), middle temporal gyrus (BA 21), lateral perirhinal cortex (BA 36), ventral entorhinal cortex (BA 28) and anterior pole of the temporal gyrus (BA 38). CONCLUSIONS The emergence of new delta, theta and gamma band sources in the inferior temporal gyrus (BA 20), middle temporal gyrus (BA 21) and lateral perirhinal cortex (BA 36) plus the appearance of new delta and theta sources in the ventral entorhinal cortex (BA28) and anterior pole of the temporal lobe (BA 38) may comprise a network capable of evoking the phantom sound of tinnitus by simultaneously engaging brain regions involved in memory, sound recognition, and distress which together contribute to tinnitus severity. SIGNIFICANCE The sudden appearance of new sources of activity in the opposite hemisphere within the inferior temporal gyrus, middle temporal gyrus and perirhinal cortex may initiate the perception of tinnitus perception.
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Affiliation(s)
- Jiajia Zhang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Shujian Huang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
| | - Wenya Nan
- Department of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Huiqun Zhou
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Jian Wang
- School of Communication Science and Disorders, Dalhousie University, Halifax, Canada
| | - Hui Wang
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China.
| | - Richard Salvi
- SUNY Distinguished Professor Center for Hearing and Deafness, 137 Cary Hall, University at Buffalo, Buffalo, NY, USA
| | - Shankai Yin
- Department of Otolaryngology-Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, China; Otolaryngology Institute of Shanghai Jiao Tong University, Shanghai 200233, China; Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai 200233, China
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26
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Single nucleotide polymorphisms in tinnitus patients exhibiting severe distress. Sci Rep 2020; 10:13023. [PMID: 32747715 PMCID: PMC7398919 DOI: 10.1038/s41598-020-69467-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/01/2020] [Indexed: 11/08/2022] Open
Abstract
The association between distress caused by tinnitus and psychological factors such as depression and anxiety has been examined and reported. However, prognostic factors remain poorly understood because there are only a few reports on genetic associations. We theorized there might be an association between the grade of tinnitus distress and the genetic background related to psychological factors which might lead us to identify prognostic markers. We enrolled 138 patients who had suffered from tinnitus for over 3 months. Using Tinnitus Handicap Inventory (THI) scores, we examined the association between tinnitus distress and a genetic background related to depression or anxiety. A significant association between single nucleotide polymorphism rs131702 of the Breakpoint Cluster Region (BCR) gene and the severe THI score was identified. In addition, there was an association with the severity of the State-Trait Anxiety Inventory, an index of state anxiety severity. No association was found with the Self-Rating Depression Scale, an index of depression severity. It is reported that rs131702 of BCR in Japanese patients are related to bipolar II depression characterized by fluctuation between abnormal mood states of mania and depression. Our results indicate that rs131702 of BCR is independent of depression in this study and is, therefore, a prognostic factor unique to tinnitus. We conclude that the severity of tinnitus is associated with genes related to depression.
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Abstract
This article reviews the use of human neuroimaging for chronic subjective tinnitus. Evidence-based guidance on the clinical use of imaging to identify relevant auditory lesions when evaluating tinnitus patients is given. After introducing the anatomy and imaging modalities most pertinent to the neuroscience of tinnitus, the article reviews tinnitus-associated alterations in key auditory and nonauditory networks in the central nervous system. Emphasis is placed on how these findings support proposed models of tinnitus and how this line of investigation is relevant to practicing clinicians.
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Affiliation(s)
- Meredith E Adams
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, 420 Delaware Street Southeast, MMC 395, Minneapolis, MN 55455, USA.
| | - Tina C Huang
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, 420 Delaware Street Southeast, MMC 395, Minneapolis, MN 55455, USA
| | - Srikantan Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Avenue S362, San Francisco, CA 94143-0628, USA; Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2233 Post Street Suite 341, San Francisco, CA 94115-1225, USA
| | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2233 Post Street Suite 341, San Francisco, CA 94115-1225, USA
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28
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Verma R, Jha A, Singh S. Functional Near-Infrared Spectroscopy to Probe tDCS-Induced Cortical Functioning Changes in Tinnitus. J Int Adv Otol 2020; 15:321-325. [PMID: 31347512 DOI: 10.5152/iao.2019.6022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
There are limited treatment options for successful management of tinnitus, which is highly prevalent worldwide. The pathogenetic role of auditory cortex activation changes in tinnitus has been reported by various functional studies that suggest that the emerging neuromodulation techniques may pave way toward better treatment response. The current case report depicts the use of functional near-infrared spectroscopy (fNIRS) based on the assessment of improvement in auditory cortex functioning in chronic tinnitus by transcranial direct current stimulation (tDCS).
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Affiliation(s)
- Rohit Verma
- Department of Psychiatry, Brain Stimulation Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Jha
- Department of Psychiatry, Brain Stimulation Unit, All India Institute of Medical Sciences, New Delhi, India
| | - Shuchita Singh
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, New Delhi, India
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29
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Searchfield GD, Poppe TNER, Durai M, Jensen M, Kennedy MA, Maggo S, Miller AL, Park J, Russell BR, Shekhawat GS, Spiegel D, Sundram F, Wise K. A proof-of-principle study of the short-term effects of 3,4-methylenedioxymethamphetamine (MDMA) on tinnitus and neural connectivity. Int J Neurosci 2020; 130:671-682. [PMID: 31814488 DOI: 10.1080/00207454.2019.1702544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: This study was conducted to investigate the short-term behavioural and neurophysiological effects of 3,4-methylenedioxymethamphetamine (MDMA) on tinnitus perception.Methods: A double-blind randomized controlled cross-over design. Part 1. Behavioural measures of tinnitus following 30 mg MDMA or placebo administration (N = 5 participants) and Part 2. Behavioural measures of tinnitus and correlations between pairs of apriori regions of interest (ROI) using resting-state functional magnetic resonance imaging (rs-fMRI) before and after 70 mg of MDMA or placebo (N = 8 participants).Results: The results to MDMA were similar to placebo. For the 70 mg dose, there was a significant reduction after 4 h in annoyance and ignore ratings. RsMRI showed decreased connectivity compared with placebo administration between the left hippocampal, right hippocampal, left amygdala and right amygdala regions, and between the right posterior parahippocampal cortex and the left amygdala after two hours of 70 mg MDMA administration. Increased connectivity compared to placebo administration was found post MDMA between the right post-central gyrus and right posterior and superior temporal gyrus, and between the thalamus and frontoparietal network.Conclusions: Following 70 mg of MDMA two tinnitus rating scales significantly improved. There was, however, a placebo effect. Compared with placebo the rsMRI following the MDMA showed reductions in connectivity between the amygdala, hippocampus and parahippocampal gyrus. There is sufficient proof of concept to support future investigation of MDMA as a treatment for tinnitus.
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Affiliation(s)
- G D Searchfield
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
| | - T N E R Poppe
- Biomedical Engineering and Imaging Sciences, Kings College London, London, UK
| | - M Durai
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand.,Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - M Jensen
- Pharmacy, Whakatane Hospital, Bay of Plenty, School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - M A Kennedy
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - S Maggo
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - A L Miller
- Department of Pathology and Biomedical Science, University of Otago, Christchurch, New Zealand
| | - J Park
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - B R Russell
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - G S Shekhawat
- Auckland University of Technology, Auckland, New Zealand
| | - D Spiegel
- Eisdell Moore Centre & Audiology Section, The University of Auckland, Auckland, New Zealand
| | - F Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - K Wise
- Auckland University of Technology, Auckland, New Zealand
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30
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Cortical thickness of left Heschl’s gyrus correlates with hearing acuity in adults – A surface-based morphometry study. Hear Res 2019; 384:107823. [DOI: 10.1016/j.heares.2019.107823] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 10/10/2019] [Accepted: 10/16/2019] [Indexed: 01/22/2023]
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31
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Zhou GP, Shi XY, Wei HL, Qu LJ, Yu YS, Zhou QQ, Yin X, Zhang H, Tao YJ. Disrupted Intraregional Brain Activity and Functional Connectivity in Unilateral Acute Tinnitus Patients With Hearing Loss. Front Neurosci 2019; 13:1010. [PMID: 31607851 PMCID: PMC6761222 DOI: 10.3389/fnins.2019.01010] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/05/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose The present study combined fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and functional connectivity (FC) to explore brain functional abnormalities in acute tinnitus patients (AT) with hearing loss. Methods We recruited twenty-eight AT patients and 31 healthy controls (HCs) and ran resting-state functional magnetic resonance imaging (fMRI) scans. fALFF, ReHo, and FC were conducted and compared between AT patients and HCs. After that, we calculated correlation analyses among abnormal fALFF, ReHo, FC, and clinical data in AT patients. Results Compared with HCs, AT showed increased fALFF values in the right inferior temporal gyrus (ITG). In contrast, significantly decreased ReHo values were observed in the cerebellar vermis, the right calcarine cortex, the right precuneus, the right supramarginal gyrus (SMG), and the right middle frontal gyrus (MFG). Based on the differences in the fALFF and ReHo maps, the latter of which we defined as region-of-interest (ROI) for FC analysis, the right ITG exhibited increased connectivity with the right precentral gyrus. In addition, the right MFG demonstrated decreased connectivity with both the bilateral anterior cingulate cortex (ACC) and the left precentral gyrus. Conclusion By combining ReHo, fALFF, and FC analyses, our work indicated that AT with hearing loss had abnormal intraregional neural activity and disrupted connectivity in several brain regions which mainly involving the non-auditory area, and these regions are major components of default mode network (DMN), attention network, visual network, and executive control network. These findings will help us enhance the understanding of the neuroimaging mechanism in tinnitus populations. Moreover, these abnormalities remind us that we should focus on the early stages of this hearing disease.
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Affiliation(s)
- Gang-Ping Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Xin-Yi Shi
- Department of ENT, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Heng-Le Wei
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Li-Jie Qu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yu-Sheng Yu
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Qing-Qing Zhou
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Hong Zhang
- Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Yue-Jin Tao
- Department of ENT, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
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32
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Kandeepan S, Maudoux A, Ribeiro de Paula D, Zheng JY, Cabay JE, Gómez F, Chronik BA, Ridder D, Vanneste S, Soddu A. Tinnitus distress: a paradoxical attention to the sound? J Neurol 2019; 266:2197-2207. [DOI: 10.1007/s00415-019-09390-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/15/2019] [Accepted: 05/17/2019] [Indexed: 12/19/2022]
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33
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Han L, Yawen L, Hao W, Chunli L, Pengfei Z, Zhengyu Z, Zhaodi W, Zhenghan Y, Shusheng G, Zhenchang W. Effects of sound therapy on resting‐state functional brain networks in patients with tinnitus: A graph‐theoretical‐based study. J Magn Reson Imaging 2019; 50:1731-1741. [PMID: 31095830 DOI: 10.1002/jmri.26796] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/30/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Lv Han
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Liu Yawen
- School of Biological Science and Medical EngineeringBeihang University Beijing China
| | - Wang Hao
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Liu Chunli
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical University Beijing China
- Department of OtolaryngologyAffiliated Hospital of Chengde Medical College Hebei China
| | - Zhao Pengfei
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Zhang Zhengyu
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Wang Zhaodi
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Yang Zhenghan
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
| | - Gong Shusheng
- School of Biological Science and Medical EngineeringBeihang University Beijing China
| | - Wang Zhenchang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical University Beijing China
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Sherwood MS, Parker JG, Diller EE, Ganapathy S, Bennett KB, Esquivel CR, Nelson JT. Self-directed down-regulation of auditory cortex activity mediated by real-time fMRI neurofeedback augments attentional processes, resting cerebral perfusion, and auditory activation. Neuroimage 2019; 195:475-489. [PMID: 30954710 DOI: 10.1016/j.neuroimage.2019.03.078] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 02/23/2019] [Accepted: 03/31/2019] [Indexed: 12/18/2022] Open
Abstract
In this work, we investigated the use of real-time functional magnetic resonance imaging (fMRI) with neurofeedback training (NFT) to teach volitional down-regulation of the auditory cortex (AC) using directed attention strategies as there is a growing interest in the application of fMRI-NFT to treat neurologic disorders. Healthy participants were separated into two groups: the experimental group received real feedback regarding activity in the AC; the control group was supplied sham feedback yoked from a random participant in the experimental group and matched for fMRI-NFT experience. Each participant underwent five fMRI-NFT sessions. Each session contained 2 neurofeedback runs where participants completed alternating blocks of "rest" and "lower" conditions while viewing a continuously-updated bar representing AC activation and listening to continuous noise. Average AC deactivation was extracted from each closed-loop neuromodulation run and used to quantify the control over AC (AC control), which was found to significantly increase across training in the experimental group. Additionally, behavioral testing was completed outside of the MRI on sessions 1 and 5 consisting of a subjective questionnaire to assess attentional control and two quantitative tests of attention. No significant changes in behavior were observed; however, there was a significant correlation between changes in AC control and attentional control. Also, in a neural assessment before and after fMRI-NFT, AC activity in response to continuous noise stimulation was found to significantly decrease across training while changes in AC resting perfusion were found to be significantly greater in the experimental group. These results may be useful in formulating effective therapies outside of the MRI, specifically for chronic tinnitus which is often characterized by hyperactivity of the primary auditory cortex and altered attentional processes. Furthermore, the modulation of attention may be useful in developing therapies for other disorders such as chronic pain.
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Affiliation(s)
- Matthew S Sherwood
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA.
| | - Jason G Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University, IN, USA
| | - Emily E Diller
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University, IN, USA; College of Health and Human Services, Purdue University, West Lafayette, IN, USA
| | - Subhashini Ganapathy
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA; Department of Trauma Care, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Kevin B Bennett
- Department of Psychology, Wright State University, Dayton, OH, USA
| | - Carlos R Esquivel
- Department of Defense Hearing Center of Excellence, JBSA-Lackland, USA
| | - Jeremy T Nelson
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University, IN, USA; Department of Defense Hearing Center of Excellence, JBSA-Lackland, USA; Ho-Chunk Inc., Alexandria, VA, USA
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35
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Wu C, Bao W, Yi B, Wang Q, Wu X, Qian M, Zuo C, Huang Z. Increased metabolic activity and hysteretic enhanced GABA A receptor binding in a rat model of salicylate-induced tinnitus. Behav Brain Res 2019; 364:348-355. [PMID: 30797852 DOI: 10.1016/j.bbr.2019.02.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/20/2019] [Accepted: 02/21/2019] [Indexed: 11/16/2022]
Abstract
Tinnitus is relevant to neural hyperactivity in the central nervous system (CNS). Normal quantity and functioning of the γ-aminobutyric acid (GABA) receptor are crucial for maintaining the balance between excitation and inhibition in the brain. In this study, we applied a rat model of tinnitus via long-term salicylate administration. The combination of the gap pre-pulse inhibition of acoustic startle (GPIAS) and pre-pulse inhibition (PPI) tests were used to detect tinnitus-like behavior, and rats receiving 7 or 14 consecutive days of salicylate administration showed evidence of tinnitus. After positron emission tomography (PET) scan, we found that the metabolic activity was increased after salicylate treatment followed by enhanced GABAA receptor binding with cessation of salicylate administration in the auditory cortex (AC), medial prefrontal cortex (mPFC), hippocampus (HP), cingulate cortex (CiC) and insular (InC). The inferior colliculus (IC) showed an elevated metabolic activity with no change in the GABAA receptor binding. All the alterations returned to baseline several days after cessation of salicylate treatment despite a mismatch between the time-course of them. By contrast, we found alterations in neither the metabolic activity nor the GABAA receptor binding in the amygdala (AMY) and cerebellum (CRB). These findings indicate that enhanced neural activity in the auditory and limbic system may contribute to the development of tinnitus, while the hysteretic increase of GABAA receptor binding in specific areas of the CNS may be a compensation for hyperactivity, which may be involved in tinnitus relieving.
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Affiliation(s)
- Cong Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Weiqi Bao
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Bin Yi
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Qixuan Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Xu Wu
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Minfei Qian
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
| | - Chuantao Zuo
- PET Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Zhiwu Huang
- Department of Otorhinolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Laboratoryof Auditory Neuroscience, Ear Institute, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai, China.
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Zheng W, Peng Z, Pengfei Z, Jing L, Heyu D, Hongxia Y, Yawen L, Zhengyu Z, Shusheng G, Zhenghan Y, Han L, Zhenchang W. Long-term reactions to pulsatile tinnitus are marked by weakened short-range functional connectivity within a brain network in the right temporal lobe. J Magn Reson Imaging 2018; 49:1629-1637. [PMID: 30575157 DOI: 10.1002/jmri.26545] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 09/29/2018] [Accepted: 10/02/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There have been recent efforts to characterize brain functional activity features in patients with pulsatile tinnitus (PT). These efforts have revealed evidence of aberrant functional connectivity (FC) of the right middle temporal gyrus (MTG) in PT patients with prolonged disease duration. PURPOSE To assess the possible predictive effect of aberrant FC of MTG in PT patients with prolonged disease duration. STUDY TYPE Retrospective. POPULATION Thirty-four patients with recent-onset PT (RPTIN), 24 patients with long-term PT (LPTIN), and 35 age-, gender-, and education-matched healthy controls were enrolled. FIELD STRENGTH/SEQUENCE 3.0T MRI system and echo-planar imaging (EPI) sequence, 3D brain volume imaging (BRAVO) sequence. ASSESSMENT Functional MRI data preprocessing was performed in Data Processing & Analysis for Brain Imaging (DPABI) and Statistical Parametric Mapping (SPM) 8. The FC analyses were conducted using the software REST. STATISTICAL TESTS One-way analysis of covariance was conducted between three groups with age and gender as covariates, and post-hoc analysis was used to identify the sources of group effects. Pearson's correlation analysis was conducted for the z-values of altered FC strength in the PT group and the clinical data. RESULTS Among hubs belonging to the executive control network, the default mode network (DMN), and limbic network, the strength of FC was mainly decreased in the patient groups compared with normal controls (P < 0.05). Relative to RPTIN patients and normal controls, LPTIN patients were further characterized by significantly decreased FC between several short-range brain regions adjacent to the seed (P < 0.05). Finally, disease duration was negatively correlated with decreased FC between the seed and right fusiform gyrus/parahippocampal gyrus, right inferior frontal gyrus, and right MTG (a brain area adjacent to the seed region). DATA CONCLUSION Long-term reactions to PT mainly involved weakened short-range FC, especially within a functional network in the right temporal lobe. LEVEL OF EVIDENCE 4 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Wang Zheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Zhang Peng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Zhao Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Li Jing
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Ding Heyu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Yin Hongxia
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Liu Yawen
- School of Biological Science and Medical Engineering, Beihang University, Beijing, P.R. China
| | - Zhang Zhengyu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Gong Shusheng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Yang Zhenghan
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Lv Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
| | - Wang Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China
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Yakunina N, Kim SS, Nam EC. BOLD fMRI effects of transcutaneous vagus nerve stimulation in patients with chronic tinnitus. PLoS One 2018; 13:e0207281. [PMID: 30485375 PMCID: PMC6261575 DOI: 10.1371/journal.pone.0207281] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 10/29/2018] [Indexed: 12/25/2022] Open
Abstract
Objective Vagus nerve stimulation (VNS) is a neuromodulation method used for treatment of epilepsy and depression. Transcutaneous VNS (tVNS) has been gaining popularity as a noninvasive alternative to VNS. Previous tVNS neuroimaging studies revealed brain (de)activation patterns that involved multiple areas implicated in tinnitus generation and perception. In this study, functional magnetic resonance imaging (fMRI) was used to explore the effects of tVNS on brain activity in patients with tinnitus. Methods Thirty-six patients with chronic tinnitus received tVNS to the inner tragus, cymba conchae, and earlobe (sham stimulation). Results The locus coeruleus and nucleus of the solitary tract in the brainstem were activated in response to stimulation of both locations compared with the sham stimulation. The cochlear nuclei were also activated, which was not observed in healthy subjects with normal hearing. Multiple auditory and limbic structures, as well as other brain areas associated with generation and perception of tinnitus, were deactivated by tVNS, particularly the parahippocampal gyrus, which was recently speculated to cause tinnitus in hearing-impaired patients. Conclusions tVNS via the inner tragus or cymba conchae suppressed neural activity in the auditory, limbic, and other tinnitus-related non-auditory areas through auditory and vagal ascending pathways in tinnitus patients. The results from this study are discussed in the context of several existing models of tinnitus. They indicate that the mechanism of action of tVNS might be involved in multiple brain areas responsible for the generation of tinnitus, tinnitus-related emotional annoyance, and their mutual reinforcement.
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Affiliation(s)
- Natalia Yakunina
- Institute of Medical Science, Kangwon National University, School of Medicine, Chuncheon, Republic of Korea
- Neuroscience Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Sam Soo Kim
- Neuroscience Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea
- Department of Radiology, Kangwon National University, School of Medicine, Chuncheon, Republic of Korea
| | - Eui-Cheol Nam
- Neuroscience Research Institute, Kangwon National University Hospital, Chuncheon, Republic of Korea
- Department of Otolaryngology, Kangwon National University, School of Medicine, Chuncheon, Republic of Korea
- * E-mail:
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38
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Fan X, Chen Y, Li L, Wang Y, Zhang Y, Lu S, Zhu D, Sheng M. Efficacy of Chinese herb Cistanche Yishen granules in treatment of tinnitus for patients with chronic nephritis. J Cell Biochem 2018; 120:5505-5509. [PMID: 30474893 DOI: 10.1002/jcb.27833] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 09/14/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE This study aimed to investigate the efficacy of Chinese herb Cistanche Yishen granules (CYG) in the treatment of tinnitus for patients with chronic nephritis. METHODS A total of 89 adult patients were diagnosed with chronic glomerulonephritis from January 2016 to December 2017. All the patients were randomly divided into two groups, such as the control group and the CYG group. The efficacy of tinnitus was determined using tinnitus handicap inventory (THI), Pittsburgh sleep quality index (PSQI), pure tone audiometry (PTA), speech reception threshold (SRT), and visual analog scale (VAS) for tinnitus loudness and annoyance. RESULTS In both these two groups of patients, values of THI, PSQI, PTA, SRT, and VAS for tinnitus loudness and annoyance were significantly decreased after the treatment compared with those before treatment. However, all values in CYG group after the treatment were significantly lower than those in the control group. CONCLUSION CYG could apparently release the tinnitus symptoms in the patients with chronic nephritis. This study might give more clinical evidence for Cistanche in the treatment of tinnitus and give a new treatment method for the patients with tinnitus.
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Affiliation(s)
- Xiaoli Fan
- The First School of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yue Chen
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Li Li
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Wang
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Shan Lu
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Danyang Zhu
- Department of TÇM, Tongren Hospital Shanghai, Jiao Tong University School of Medicine, Shanghai, China
| | - Meixiao Sheng
- Department of Nephrology, Jiangsu Province Hospital of TCM, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Sherwood MS, Parker JG, Diller EE, Ganapathy S, Bennett K, Nelson JT. Volitional down-regulation of the primary auditory cortex via directed attention mediated by real-time fMRI neurofeedback. AIMS Neurosci 2018; 5:179-199. [PMID: 32341960 PMCID: PMC7179344 DOI: 10.3934/neuroscience.2018.3.179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 06/25/2018] [Indexed: 02/03/2023] Open
Abstract
The present work assessed the efficacy of training volitional down-regulation of the primary auditory cortex (A1) based on real-time functional magnetic resonance imaging neurofeedback (fMRI-NFT). A1 has been shown to be hyperactive in chronic tinnitus patients, and has been implicated as a potential source for the tinnitus percept. 27 healthy volunteers with normal hearing underwent 5 fMRI-NFT sessions: 18 received real neurofeedback and 9 sham neurofeedback. Each session was composed of a simple auditory fMRI followed by 2 runs of A1 fMRI-NFT. The auditory fMRI alternated periods of no auditory with periods of white noise stimulation at 90 dB. A1 activity, defined from a region using the activity during the preceding auditory run, was continuously updated during fMRI-NFT using a simple bar plot, and was accompanied by white noise (90 dB) stimulation for the duration of the scan. Each fMRI-NFT run alternated “relax” periods with “lower” periods. Subjects were instructed to watch the bar during the relax condition and actively reduce the bar by decreasing A1 activation during the lower condition. Average A1 de-activation, representative of the ability to volitionally down-regulate A1, was extracted from each fMRI-NFT run. A1 de-activation was found to increase significantly across training and to be higher in those receiving real neurofeedback. A1 de-activation in sessions 2 and 5 were found to be significantly greater than session 1 in only the group receiving real neurofeedback. The most successful subjects reportedly adopted mindfulness tasks associated with directed attention. For the first time, fMRI-NFT has been applied to teach volitional control of A1 de-activation magnitude over more than 1 session. These are important findings for therapeutic development as the magnitude of A1 activity is altered in tinnitus populations and it is unlikely a single fMRI-NFT session will reverse the effects of tinnitus.
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Affiliation(s)
- Matthew S Sherwood
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA
| | - Jason G Parker
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University, IN, USA
| | - Emily E Diller
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indiana University, IN, USA.,School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Subhashini Ganapathy
- Department of Biomedical, Industrial & Human Factors Engineering, Wright State University, Dayton, OH, USA.,Department of Trauma Care, Boonshoft School of Medicine, Wright State University, Dayton, OH, USA
| | - Kevin Bennett
- Department of Psychology, Wright State University, Dayton, OH, USA
| | - Jeremy T Nelson
- Department of Defense Hearing Center of Excellence, JBSA-Lackland, USA
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40
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Manipulation of Auditory Inputs as Rehabilitation Therapy for Maladaptive Auditory Cortical Reorganization. Neural Plast 2018; 2018:2546250. [PMID: 29887880 PMCID: PMC5985139 DOI: 10.1155/2018/2546250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 03/08/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022] Open
Abstract
Neurophysiological and neuroimaging data suggest that the brains of not only children but also adults are reorganized based on sensory inputs and behaviors. Plastic changes in the brain are generally beneficial; however, maladaptive cortical reorganization in the auditory cortex may lead to hearing disorders such as tinnitus and hyperacusis. Recent studies attempted to noninvasively visualize pathological neural activity in the living human brain and reverse maladaptive cortical reorganization by the suitable manipulation of auditory inputs in order to alleviate detrimental auditory symptoms. The effects of the manipulation of auditory inputs on maladaptively reorganized brain were reviewed herein. The findings obtained indicate that rehabilitation therapy based on the manipulation of auditory inputs is an effective and safe approach for hearing disorders. The appropriate manipulation of sensory inputs guided by the visualization of pathological brain activities using recent neuroimaging techniques may contribute to the establishment of new clinical applications for affected individuals.
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41
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MRI Verification of a 10-20 Targeting Protocol Used During Transcranial Magnetic Stimulation Sessions for Tinnitus. Brain Topogr 2018; 31:690-699. [PMID: 29464519 PMCID: PMC5999188 DOI: 10.1007/s10548-018-0636-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 02/06/2018] [Indexed: 01/19/2023]
Abstract
Langguth et al. (2006) described a method for targeting primary auditory cortex (PAC) during transcranial magnetic stimulation (TMS) using the 10–20 electroencephalography system. Study aims were to measure the degree of accuracy in placing the TMS coil on the scalp overlying PAC using the 10–20 method and determine the extent to which accuracy depends on the hemisphere of the coil placement. Twelve participants underwent anatomical magnetic resonance imaging (MRI) of their head in a 3T scanner. Before imaging, a fiducial marker was placed on their scalp corresponding to the TMS coil position. MRI scans were analyzed to determine the distance from the fiducial marker to PAC for each participant. On average, the 10–20 method resulted in distances in the medial–lateral, anterior-posterior, and inferior-superior dimensions that were within a few millimeters (~ 4 mm) of each other between the left and right hemispheres. The fiducial marker was, on average, 10.4 mm superior and 10.8 mm posterior to the optimal scalp location that minimized the distance to PAC. Individual asymmetries and other systematic differences found in this study raise important considerations to keep in mind that might necessitate using an MRI-guided method of coil-positioning when targeting PAC for TMS.
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42
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Ergen B, Baykara M, Polat C. Determination of the relationship between internal auditory canal nerves and tinnitus based on the findings of brain magnetic resonance imaging. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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43
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Chen YC, Liu S, Lv H, Bo F, Feng Y, Chen H, Xu JJ, Yin X, Wang S, Gu JP. Abnormal Resting-State Functional Connectivity of the Anterior Cingulate Cortex in Unilateral Chronic Tinnitus Patients. Front Neurosci 2018; 12:9. [PMID: 29410609 PMCID: PMC5787069 DOI: 10.3389/fnins.2018.00009] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 01/05/2018] [Indexed: 12/28/2022] Open
Abstract
Purpose: The anterior cingulate cortex (ACC) has been suggested to be involved in chronic subjective tinnitus. Tinnitus may arise from aberrant functional coupling between the ACC and cerebral cortex. To explore this hypothesis, we used resting-state functional magnetic resonance imaging (fMRI) to illuminate the functional connectivity (FC) network of the ACC subregions in chronic tinnitus patients. Methods: Resting-state fMRI scans were obtained from 31 chronic right-sided tinnitus patients and 40 healthy controls (age, sex, and education well-matched) in this study. Rostral ACC and dorsal ACC were selected as seed regions to investigate the intrinsic FC with the whole brain. The resulting FC patterns were correlated with clinical tinnitus characteristics including the tinnitus duration and tinnitus distress. Results: Compared with healthy controls, chronic tinnitus patients showed disrupted FC patterns of ACC within several brain networks, including the auditory cortex, prefrontal cortex, visual cortex, and default mode network (DMN). The Tinnitus Handicap Questionnaires (THQ) scores showed positive correlations with increased FC between the rostral ACC and left precuneus (r = 0.507, p = 0.008) as well as the dorsal ACC and right inferior parietal lobe (r = 0.447, p = 0.022). Conclusions: Chronic tinnitus patients have abnormal FC networks originating from ACC to other selected brain regions that are associated with specific tinnitus characteristics. Resting-state ACC-cortical FC disturbances may play an important role in neuropathological features underlying chronic tinnitus.
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Affiliation(s)
- Yu-Chen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shenghua Liu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Fan Bo
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yuan Feng
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Shukui Wang
- Department of Clinical Laboratory, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Jian-Ping Gu
- Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
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Chen YC, Chen H, Bo F, Xu JJ, Deng Y, Lv H, Cai Y, Xia W, Yin X, Gu JP, Lu G. Tinnitus distress is associated with enhanced resting-state functional connectivity within the default mode network. Neuropsychiatr Dis Treat 2018; 14:1919-1927. [PMID: 30122924 PMCID: PMC6078076 DOI: 10.2147/ndt.s164619] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The default mode network (DMN) has been confirmed to be involved in chronic tinnitus perception. Tinnitus distress may be associated with abnormal functional connectivity (FC) within the DMN regions. The goal of this study was to determine whether tinnitus disrupted the FC patterns within the DMN as measured by using resting-state functional magnetic resonance imaging approach. PATIENTS AND METHODS Resting-state functional magnetic resonance imaging scans were acquired from 40 chronic bilateral tinnitus patients and 41 healthy controls. Both were age, sex, and education well-matched with normal hearing. Two important DMN regions, the anterior cingulate cortex and posterior cingulate cortex, were chosen as seed regions to detect the FC patterns within the DMN and then determine whether these changes were linked to clinical measures of tinnitus such as tinnitus duration and tinnitus severity. RESULTS Compared with healthy controls, chronic tinnitus patients manifested significantly enhanced FC between the anterior cingulate cortex and left precuneus, which was correlated with the tinnitus duration (r=0.451, p=0.007). Moreover, enhanced FC between the posterior cingulate cortex and right medial prefrontal cortex in tinnitus patients was positively correlated with the tinnitus distress (r=0.411, p=0.014). CONCLUSION Chronic tinnitus patients showed disrupted FC patterns within the DMN regions which are correlated with tinnitus distress. Increased resting-state connectivity pattern of the DMN may play a pivotal role in neuropathological features underlying chronic tinnitus.
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Affiliation(s)
- Yu-Chen Chen
- Department of Medical Imaging, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China, .,Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,
| | - Huiyou Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,
| | - Fan Bo
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,
| | - Jin-Jing Xu
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Yi Deng
- Department of Otolaryngology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yuexin Cai
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Wenqing Xia
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xindao Yin
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,
| | - Jian-Ping Gu
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China,
| | - Guangming Lu
- Department of Medical Imaging, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, China,
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45
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Poeppl TB, Langguth B, Lehner A, Frodl T, Rupprecht R, Kreuzer PM, Landgrebe M, Schecklmann M. Brain stimulation-induced neuroplasticity underlying therapeutic response in phantom sounds. Hum Brain Mapp 2017; 39:554-562. [PMID: 29064602 DOI: 10.1002/hbm.23864] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 12/25/2022] Open
Abstract
Noninvasive brain stimulation can modify phantom sounds for longer periods by modulating neural activity and putatively inducing regional neuroplastic changes. However, treatment response is limited and there are no good demographic or clinical predictors for treatment outcome. We used state-of-the-art voxel-based morphometry (VBM) to investigate whether transcranial magnetic stimulation-induced neuroplasticity determines therapeutic outcome. Sixty subjects chronically experiencing phantom sounds (i.e., tinnitus) received repetitive transcranial magnetic stimulation (rTMS) of left dorsolateral prefrontal and temporal cortex according to a protocol that has been shown to yield a significantly higher number of treatment responders than sham stimulation and previous stimulation protocols. Structural magnetic resonance imaging was performed before and after rTMS. In VBM whole-brain analyses (P < 0.05, FWE corrected), we assessed longitudinal gray matter changes as well as structural connectivity between the ensuing regions. We observed longitudinal mesoscopic gray matter changes of left dorsolateral prefontal (DLPFC), left operculo-insular, and right inferior temporal cortex (ITC) in responders (N = 22) but not nonresponders (N = 38), as indicated by a group × time interaction and post-hoc tests. These results were neither influenced by age, sex, hearing loss nor by tinnitus laterality, duration, and severity at baseline. Furthermore, we found robust DLPFC-insula and insula-ITC connectivity in responders, while only relatively weak DLPFC-insula connectivity and no insula-ITC connectivity could be demonstrated in nonresponders. Our results reinforce the implication of nonauditory brain regions in phantom sounds and suggest the dependence of therapeutic response on their neuroplastic capabilities. The latter in turn may depend on (differences in) their individual structural connectivity. Hum Brain Mapp 39:554-562, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Thomas Frodl
- Department of Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Department of Psychiatry, Psychotherapy and Psychosomatics, Lech Mangfall Hospital, Agatharied, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,Tinnitus Center, University of Regensburg, Regensburg, Germany
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Tinnitus Suppression After Auditory Brainstem Implantation in Patients With Neurofibromatosis Type-2. Otol Neurotol 2017; 38:118-122. [PMID: 27755361 DOI: 10.1097/mao.0000000000001230] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate whether an auditory brainstem implant (ABI) can impact levels of tinnitus in neurofibromatosis type-2 (NF2) patients who have undergone translabyrinthine craniotomy for vestibular schwannoma (VS) removal and to evaluate the burden of tinnitus in these patients. STUDY DESIGN A retrospective case series and patient survey. SETTING Tertiary neurotologic referral center. PATIENTS NF2 patients who underwent translabyrinthine removal of VS and ABI placement between 1994 and 2015. INTERVENTIONS A survey, retrospective review and two validated tinnitus handicap questionnaires (tinnitus handicap inventory [THI] and tinnitus visual analogue scale [VAS]) were used to characterize the degree of tinnitus in NF2 patients and whether an ABI can alter tinnitus levels. MAIN OUTCOME MEASURES(S) Survey results, THI and VAS scores. RESULTS One hundred twelve ABI users were contacted and 43 patients (38.3)% responded to our survey. Tinnitus was reported in 83.7% of patients. The THI score for responders was 17.8 ± 20.5 standard deviation (SD). For survey participants, the ABI reduced tinnitus levels (mean VAS: Off = 3.5; On 1-h = 2.1; p = 0.048). For patients who subjectively reported that the ABI reduced tinnitus loudness, tinnitus levels were immediately reduced on ABI activation and after 1 hour of use (mean VAS: Off = 4.8; On = 2.4; On 1-h = 1.8; p < 0.01). Suppression did not continue after the device was turned off. Audiological performance with the ABI did not correlate with tinnitus suppression. CONCLUSION NF2 patients who have undergone removal of VS have a significant tinnitus handicap and benefit from tinnitus suppression through utilization of an ABI possibly through masking or electrical stimulation of the auditory brainstem.
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47
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Sherwood MS, Diller EE, Ey E, Ganapathy S, Nelson JT, Parker JG. A Protocol for the Administration of Real-Time fMRI Neurofeedback Training. J Vis Exp 2017. [PMID: 28872110 PMCID: PMC5614365 DOI: 10.3791/55543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Neurologic disorders are characterized by abnormal cellular-, molecular-, and circuit-level functions in the brain. New methods to induce and control neuroplastic processes and correct abnormal function, or even shift functions from damaged tissue to physiologically healthy brain regions, hold the potential to dramatically improve overall health. Of the current neuroplastic interventions in development, neurofeedback training (NFT) from functional Magnetic Resonance Imaging (fMRI) has the advantages of being completely non-invasive, non-pharmacologic, and spatially localized to target brain regions, as well as having no known side effects. Furthermore, NFT techniques, initially developed using fMRI, can often be translated to exercises that can be performed outside of the scanner without the aid of medical professionals or sophisticated medical equipment. In fMRI NFT, the fMRI signal is measured from specific regions of the brain, processed, and presented to the participant in real-time. Through training, self-directed mental processing techniques, that regulate this signal and its underlying neurophysiologic correlates, are developed. FMRI NFT has been used to train volitional control over a wide range of brain regions with implications for several different cognitive, behavioral, and motor systems. Additionally, fMRI NFT has shown promise in a broad range of applications such as the treatment of neurologic disorders and the augmentation of baseline human performance. In this article, we present an fMRI NFT protocol developed at our institution for modulation of both healthy and abnormal brain function, as well as examples of using the method to target both cognitive and auditory regions of the brain.
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Affiliation(s)
- Matthew S Sherwood
- Office of the Vice President for Research and Graduate Studies, Wright State University; Department of Biomedical, Industrial and Human Factors Engineering, Wright State University;
| | - Emily E Diller
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University
| | - Elizabeth Ey
- Pediatric Radiology and Medical Imaging, Dayton Children's Hospital
| | - Subhashini Ganapathy
- Department of Biomedical, Industrial and Human Factors Engineering, Wright State University; Department of Trauma Care and Surgery, Boonshoft School of Medicine, Wright State University
| | - Jeremy T Nelson
- Department of Defense Hearing Center of Excellence, JBSA-Lackland
| | - Jason G Parker
- Office of the Vice President for Research and Graduate Studies, Wright State University; Department of Neurology, Boonshoft School of Medicine, Wright State University
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48
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Song JJ, Kim K, Sunwoo W, Mertens G, Van de Heyning P, De Ridder D, Vanneste S, Lee SY, Park KJ, Choi H, Choi JW. A Quantitative Electroencephalography Study on Cochlear Implant-Induced Cortical Changes in Single-Sided Deafness with Tinnitus. Front Hum Neurosci 2017; 11:210. [PMID: 28572760 PMCID: PMC5435818 DOI: 10.3389/fnhum.2017.00210] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 04/10/2017] [Indexed: 11/13/2022] Open
Abstract
The mechanism of tinnitus suppression after cochlear implantation (CI) in single-sided deafness (SSD) is not fully understood. In this regard, by comparing pre- and post-CI quantitative electroencephalography (qEEG), we explored cortical changes relevant to tinnitus improvement. In SSD patients who underwent CI, qEEG data were collected: (1) before CI, (2) 6 months post-operatively with CI-on, and (3) 30 min after CI-off and source-localized cortical activity/functional connectivity analyses were performed. Compared to the pre-operative baseline, the CI-on condition demonstrated significantly decreased activity in the right auditory- and orbitofrontal cortices (OFC) for the delta frequency band as well as decreased connectivity between the auditory cortex/posterior cingulate cortex for the delta/beta2 bands. Meanwhile, compared to the CI-off condition, the CI-on condition displayed decreased activity in the right auditory cortices/OFC for the delta band, and in bilateral auditory cortices, left inferior frontal cortex/OFC for the gamma band. However, qEEG analyses showed no significant differences between the CI-off and baseline conditions. CI induced overall decreased cortical activity and functional connectivity. However, judging from no differences between the CI-off and baseline conditions, CI-induced cortical activity and functional connectivity changes are not by cortical plastic changes, but by dynamic peripheral reafferentation.
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Affiliation(s)
- Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Kyungsoo Kim
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Woongsang Sunwoo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Griet Mertens
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital AntwerpEdegem, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital AntwerpEdegem, Belgium
| | - Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of OtagoDunedin, New Zealand
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, RichardsonTX, USA
| | - Sang-Youp Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University HospitalSeoul, South Korea
| | - Kyung-Joon Park
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Hongsoo Choi
- Department of Robotics Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
| | - Ji-Woong Choi
- Department of Information and Communication Engineering, Daegu Gyeongbuk Institute of Science and TechnologyDaegu, South Korea
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49
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Micarelli A, Chiaravalloti A, Viziano A, Danieli R, Schillaci O, Alessandrini M. Early cortical metabolic rearrangement related to clinical data in idiopathic sudden sensorineural hearing loss. Hear Res 2017; 350:91-99. [PMID: 28460253 DOI: 10.1016/j.heares.2017.04.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/13/2017] [Accepted: 04/23/2017] [Indexed: 12/11/2022]
Abstract
Results in studies concerning cortical changes in idiopathic sudden sensorineural hearing loss (ISSNHL) are not homogeneous, in particular due to the different neuroimaging techniques implemented and the diverse stages of ISSNHL studied. Considering the recent advances in state-of-the-art positron emission tomography (PET) cameras, the aim of this study was to gain more insight into the neuroanatomical differences associated with the earliest stages of unilateral ISSNHL and clinical-perceptual performance changes. After an audiological examination including the mean auditory threshold (mean AT), mean speech discrimination score (mean SDS) and Tinnitus Handicap Inventory (THI), 14 right-handed ISSNHL patients underwent brain [18F]fluorodeoxyglucose (FDG)-PET within 72 h of the onset of symptoms. When compared to an homogeneous group of 35 healthy subjects by means of statistical parametric mapping, a relative increase in FDG uptake was found in the right superior and medial frontal gyrus as well as in the right anterior cingulate cortex in ISSNHL patients. Conversely, the same group showed a significant relative decrease in FDG uptake in the right middle temporal, precentral and postcentral gyrus as well as in the left posterior cingulate cortex, left lingual, superior, middle temporal and middle frontal gyrus and in the left insula. Regression analysis showed a positive correlation between mean THI and glucose consumption in the right anterior cingulate cortex and a positive correlation between mean SDS and glucose consumption in the left precentral gyrus. The relative changes in FDG uptake found in these brain regions and the positive correlation with mean SDS and THI scores in ISSNHL could possibly highlight new aspects of cerebral rearrangement, contributing to further explain changes in those functions that support speech recognition during the sudden impairment of unilateral auditory input.
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Affiliation(s)
- Alessandro Micarelli
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy; University of Rome Tor Vergata, Department of Systems Medicine, Neuroscience Unit, Italy.
| | - Agostino Chiaravalloti
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy
| | - Andrea Viziano
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy
| | - Roberta Danieli
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy
| | - Orazio Schillaci
- University of Rome Tor Vergata, Department of Biomedicine and Prevention, Nuclear Medicine Unit, Italy; IRCCS Neuromed, Pozzilli, Italy
| | - Marco Alessandrini
- University of Rome Tor Vergata, Department of Clinical Sciences and Translational Medicine, Otolaryngology Unit, Italy
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50
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Kreuzer PM, Poeppl TB, Rupprecht R, Vielsmeier V, Lehner A, Langguth B, Schecklmann M. Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus? Front Neurol 2017; 8:126. [PMID: 28428769 PMCID: PMC5382205 DOI: 10.3389/fneur.2017.00126] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Prefrontal and temporo-parietal repetitive transcranial magnetic stimulation (rTMS) in patients suffering from chronic tinnitus have shown significant but only moderate effectiveness with high interindividual variability in treatment response. This open-label pilot study was designed to examine the general feasibility of an individualized fronto-temporal rTMS protocol and to explore what criteria are needed for a more detailed evaluation in randomized clinical studies. METHODS During the first session of a 2-week rTMS protocol, we applied different rTMS protocols to the left and right temporo-parietal and dorsolateral prefrontal cortex (DLPFC) in 25 tinnitus patients. Short trains of 1, 5, 10, and 20 Hz and continuous theta burst stimulation were applied, and patients were asked for immediate tinnitus reductions after each train. If a patient reported such improvements, rTMS treatment was applied over nine sessions with a combined protocol consisting of the most effective frontal and the most effective temporo-parietal stimulation protocol. Those patients who did not improve after the test session were treated with a standard prefrontal plus temporo-parietal protocol (20 Hz over left DLPFC + 1 Hz over temporo-parietal cortex). RESULTS Almost half of the patients (12 of 25) reported immediate tinnitus reductions during the test session. In this group, the mean pre- to post-treatment amelioration in the tinnitus questionnaire was higher (medium to high effect sizes) in contrast to the patients who did not respond to the test session. Treatment outcome remained stable over a follow-up period of 10 weeks. DISCUSSION Individualized rTMS was shown to be feasible and effective in chronic tinnitus. The results obtained from this study provide tentative evidence in support of an individualized rTMS treatment approach and might provide a basis for a "tailored" application of rTMS in tinnitus and other neuropsychiatric disorders.
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Affiliation(s)
- Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Timm B. Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Veronika Vielsmeier
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
- Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
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