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Kim YL, Yu HJ, Kim MJ, Han JS, Lim JH, Park SY, Park I, Park SN. Tinnitus Generation and Behavioral Changes Caused by Chronic Stress: A Behavioral and Brain Study in a Rat Model. Laryngoscope 2025; 135:873-881. [PMID: 39411919 PMCID: PMC11725682 DOI: 10.1002/lary.31779] [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: 03/05/2024] [Revised: 07/29/2024] [Accepted: 08/19/2024] [Indexed: 01/14/2025]
Abstract
OBJECTIVES This study explores the connection between chronic stress and tinnitus, a phantom auditory perception, using an animal model. METHODS Rats were subjected to 2 h of daily restraint stress for 10 days. Tinnitus was assessed on the last day of stress exposure using the gap response of pre-pulse inhibition acoustic reflex, measured at 60 dB background sound level at 8, 16, and 20 kHz. Chronic stress-exposed rats were categorized into two groups: tinnitus (RTG) and non-tinnitus (RNTG). Various tests, including hearing assessments (distortion product otoacoustic emissions and auditory brainstem response), behavioral evaluations (elevated plus maze test and forced swimming test), and immunohistochemical studies in the auditory and limbic brain regions, were conducted to understand the relationship between chronic stress, tinnitus, and behavioral changes. RESULTS Following chronic restraint stress, 64.3% of the rats exhibited tinnitus with no audiometric changes. EPM and FST indicated an increase of anxiety- and depression-related behavior in RTG. Immunohistochemical analyses identified specific alterations in the expression of neurotransmitter receptors within brain regions implicated in tinnitus. Specifically, we observed a decrease in γ-aminobutyric acid A receptor α1 expression and an increase in glutamate receptor (N-methyl-D-aspartate receptor subunit 1 and receptor subunit 2B) expression in specific brain region. These changes suggest a reorganization of neural circuits associated with the tinnitus generation and behavioral changes of the rats after chronic stress exposure. CONCLUSION Chronic stress alone can be a causal factor for the generation of tinnitus and behavioral changes through altered neural activities in tinnitus-related brain networks. LEVEL OF EVIDENCE NA Laryngoscope, 135:873-881, 2025.
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Affiliation(s)
- Ye Lin Kim
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
- Department of Medical Sciences, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Hyo Jeong Yu
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
- Department of Medical Sciences, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Min Jung Kim
- Department of Vector Borne Disease, College of Korea Zoonosis Research InstituteThe Jeonbuk National UniversityIksanRepublic of Korea
| | - Jae Sang Han
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Ji Hyung Lim
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - So Young Park
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
| | - Ilyong Park
- Department of Biomedical Engineering, College of MedicineDankook UniversityCheonanRepublic of Korea
| | - Shi Nae Park
- Department of Otorhinolaryngology‐Head and Neck Surgery, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
- Department of Medical Sciences, College of MedicineThe Catholic University of KoreaSeoulRepublic of Korea
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Han JS, Park J, Kim YL, Park SY, Kim D, Zhang S, Chung YJ, Park SN. Stress-Induced Tinnitus in a Rat Model: Transcriptomics of the Prefrontal Cortex and Hippocampus. Laryngoscope 2025; 135:882-888. [PMID: 39319587 DOI: 10.1002/lary.31784] [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: 06/10/2024] [Revised: 08/31/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024]
Abstract
OBJECTIVES The molecular mechanisms by which stress leads to the development of tinnitus are not yet well understood. This study aimed to identify brain changes in a stress-induced tinnitus (ST) animal model through transcriptome analysis of the prefrontal lobe and hippocampus. METHODS Twenty Sprague-Dawley rats were subjected to restraint stress for 2 h. Following the gap prepulse inhibition of the acoustic startle (GPIAS) reflex test to assess tinnitus development, the prefrontal lobes and hippocampi of the brains were harvested from 15 rats: five with evident tinnitus (ST), five with noticeable non-tinnitus (stress-induced non-tinnitus; SNT), and five without stress (control group). Comparative RNA-seq analysis was conducted to examine gene expression profiles. RESULTS In comparison to the control group, the ST group exhibited 971 and 463 differentially expressed genes (DEGs) in the prefrontal lobe and hippocampus, respectively (FDR < 0.05). The SNT group showed a largely similar gene expression to the control group. Enrichment analysis of the prefrontal lobe revealed the downregulation of gene sets associated with neurotransmitter and synapse-related functions and the upregulation of cell cycle-related gene sets in the ST group. In the hippocampus, there were significantly downregulated gene sets associated with steroid production and upregulated gene sets related to the extracellular matrix in the ST group. Immune-related gene sets were upregulated in both the prefrontal lobe and hippocampus. CONCLUSION Our research presents evidence that differences in genetic expression in the prefrontal lobe and hippocampus after exposure to stress play a significant role in the development of tinnitus. LEVEL OF EVIDENCE NA Laryngoscope, 135:882-888, 2025.
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Affiliation(s)
- Jae S Han
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Junseong Park
- Cancer Evolution Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ye L Kim
- Department of Medical Sciences, Graduate School of The Catholic University of Korea, Seoul, Republic of Korea
| | - So Y Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dokyeong Kim
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Medical Sciences, Graduate School of The Catholic University of Korea, Seoul, Republic of Korea
| | - Songzi Zhang
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeun-Jun Chung
- Precision Medicine Research Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Microbiology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Shi N Park
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Montazeri K, Farhadi M, Majdabadi A, Akbarnejad Z, Fekrazad R, Shahbazi A, Mahmoudian S. Photobiomodulation therapy in improvement of harmful neural plasticity in sodium salicylate-induced tinnitus. PLoS One 2024; 19:e0296607. [PMID: 38626075 PMCID: PMC11020422 DOI: 10.1371/journal.pone.0296607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/18/2024] Open
Abstract
Tinnitus is a common annoying symptom without effective and accepted treatment. In this controlled experimental study, photobiomodulation therapy (PBMT), which uses light to modulate and repair target tissue, was used to treat sodium salicylate (SS)-induced tinnitus in a rat animal model. Here, PBMT was performed simultaneously on the peripheral and central regions involved in tinnitus. The results were evaluated using objective tests including gap pre-pulse inhibition of acoustic startle (GPIAS), auditory brainstem response (ABR) and immunohistochemistry (IHC). Harmful neural plasticity induced by tinnitus was detected by doublecortin (DCX) protein expression, a known marker of neural plasticity. PBMT parameters were 808 nm wavelength, 165 mW/cm2 power density, and 99 J/cm2 energy density. In the tinnitus group, the mean gap in noise (GIN) value of GPIAS test was significantly decreased indicated the occurrence of an additional perceived sound like tinnitus and also the mean ABR threshold and brainstem transmission time (BTT) were significantly increased. In addition, a significant increase in DCX expression in the dorsal cochlear nucleus (DCN), dentate gyrus (DG) and the parafloccular lobe (PFL) of cerebellum was observed in the tinnitus group. In PBMT group, a significant increase in the GIN value, a significant decrease in the ABR threshold and BTT, and also significant reduction of DCX expression in the DG were observed. Based on our findings, PBMT has the potential to be used in the management of SS-induced tinnitus.
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Affiliation(s)
- Katayoon Montazeri
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad Farhadi
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Abbas Majdabadi
- Dentistry Research Institute, Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Zainab Akbarnejad
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Shahbazi
- Faculty of Advanced Technologies in Medicine, Department of Neuroscience, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Saeid Mahmoudian
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Patil JD, Alrashid MA, Eltabbakh A, Fredericks S. The association between stress, emotional states, and tinnitus: a mini-review. Front Aging Neurosci 2023; 15:1131979. [PMID: 37207076 PMCID: PMC10188965 DOI: 10.3389/fnagi.2023.1131979] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Extensive literature supporting the view of tinnitus induced stress in patients is available. However, limited evidence has been produced studying the opposite, that is, does stress cause tinnitus? The hypothalamus pituitary adrenal axis, one of the main neuroendocrine systems involved in stress response, is commonly disturbed in tinnitus patients. Patients with chronic tinnitus have been shown to develop abnormal responses to psycho-social stress, where the hypothalamus pituitary adrenal axis response is weaker and delayed, suggesting chronic stress contributes to the development of chronic tinnitus. The sympathetic branch of the autonomic nervous system also plays a major role in stress response and its chronic hyperactivity seems to be involved in developing tinnitus. Psycho-social stress has been shown to share the same probability of developing tinnitus as occupational noise and contributes to worsening tinnitus. Additionally, exposure to high stress levels and occupational noise doubles the likelihood of developing tinnitus. Interestingly, short-term stress has been shown to protect the cochlea in animals, but chronic stress exposure has negative consequences. Emotional stress also worsens pre-existing tinnitus and is identified as an important indicator of tinnitus severity. Although there is limited body of literature, stress does seem to play a vital role in the development of tinnitus. This review aims to highlight the association between stress, emotional states, and the development of tinnitus while also addressing the neural and hormonal pathways involved.
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Affiliation(s)
- Jayaditya Devpal Patil
- Department of Surgery, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
- *Correspondence: Jayaditya Devpal Patil,
| | | | - Ayah Eltabbakh
- Royal College of Surgeons in Ireland, Al Muharraq, Bahrain
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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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Jeong Yu H, Lin Kim Y, Jung Kim M, Mee Park J, Young Park S, Nae Park S, Won Yang D. The Effect of Choline Alphoscerate on Non spatial memory and Neuronal Differentiation in a Rat Model of Dual Stress. Brain Res 2022; 1786:147900. [DOI: 10.1016/j.brainres.2022.147900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 03/18/2022] [Accepted: 03/29/2022] [Indexed: 12/30/2022]
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