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Schulze H, Schilling A, Krauss P, Tziridis K. [The Erlangen model of tinnitus development-New perspective and treatment strategy]. HNO 2023; 71:662-668. [PMID: 37715002 PMCID: PMC10520106 DOI: 10.1007/s00106-023-01355-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/17/2023]
Abstract
BACKGROUND About one sixth of the population of western industrialized nations suffers from chronic, subjective tinnitus, causing socioeconomic treatment and follow-up costs of almost 22 billion euros per year in Germany alone. According to the prevailing view, tinnitus develops as a consequence of a maladaptive neurophysiological process in the brain triggered by hearing loss. OBJECTIVES The Erlangen model of tinnitus development presented here is intended to propose a comprehensive neurophysiological explanation for the initial occurrence of the phantom sound after hearing loss. Based on the model, a new treatment strategy will be developed. MATERIALS AND METHODS The model summarized here is based on various animal and human physiological studies conducted in recent years. RESULTS The Erlangen model considers subjective tinnitus as a side effect of a physiological mechanism that permanently optimizes information transmission into the auditory system by means of stochastic resonance (SR) even in the healthy auditory system. In fact, hearing-impaired patients with tinnitus hear better on average than those without tinnitus. This unfamiliar perspective on the phantom percept may already help affected patients to cope better with their suffering. In addition, based on the model, low intensity noise tinnitus suppression (LINTS) has been developed as a new, individually adapted treatment strategy for tonal tinnitus and has already been successfully tested in patients. CONCLUSIONS A possible limiting factor for the model and treatment strategy is the pitch of the tinnitus percept, which may require adjustments to the treatment strategy for frequencies above about 5 kHz.
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Affiliation(s)
- Holger Schulze
- Experimentelle HNO-Heilkunde, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland.
| | - Achim Schilling
- Experimentelle HNO-Heilkunde, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
| | - Patrick Krauss
- Experimentelle HNO-Heilkunde, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
| | - Konstantin Tziridis
- Experimentelle HNO-Heilkunde, Hals-Nasen-Ohren-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
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2
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Schilling A, Krauss P. Tinnitus is associated with improved cognitive performance and speech perception-Can stochastic resonance explain? Front Aging Neurosci 2022; 14:1073149. [PMID: 36589535 PMCID: PMC9800600 DOI: 10.3389/fnagi.2022.1073149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Affiliation(s)
- Achim Schilling
- Neuroscience Lab, University Hospital Erlangen, Erlangen, Germany
- Cognitive Computational Neuroscience Group, University of Erlangen-Nurnberg, Erlangen, Germany
| | - Patrick Krauss
- Neuroscience Lab, University Hospital Erlangen, Erlangen, Germany
- Cognitive Computational Neuroscience Group, University of Erlangen-Nurnberg, Erlangen, Germany
- Linguistics Lab, University of Erlangen-Nurnberg, Erlangen, Germany
- Pattern Recognition Lab, University of Erlangen-Nurnberg, Erlangen, Germany
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Tziridis K, Friedrich J, Brüeggemann P, Mazurek B, Schulze H. Estimation of Tinnitus-Related Socioeconomic Costs in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610455. [PMID: 36012089 PMCID: PMC9407899 DOI: 10.3390/ijerph191610455] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/01/2022] [Accepted: 08/12/2022] [Indexed: 05/14/2023]
Abstract
Despite the high prevalence of tinnitus in Germany of nearly 12% of the general population, there have been no systematic studies on the socioeconomic costs for German society caused by tinnitus so far. Here we analyzed data from 258 chronic tinnitus patients-namely tinnitus severity and health utility index (HUI)-and correlated them with their tinnitus-related public health care costs, private expenses, and economic loss due to their tinnitus percept as assessed by questionnaires. We found correlations of the HUI with health care costs and calculated the mean socioeconomic costs per tinnitus patient in Germany. According to our most conservative estimate, these sum up to EUR 4798.91 per year. Of that EUR 2206.95 account for the public health care, EUR 290.45 are carried by the patient privately and the remaining EUR 2301.51 account for economical loss due to sick leave. With a prevalence of 5.5% with at least bothersome tinnitus, this sums up to 21.9 billion Euro per year and with 25.82 sick leave days; tinnitus patients miss work more than double the time of the average German employee (10.9 days). The findings fit within the cost ranges of studies from other European countries and the USA and show that the socioeconomic burden of this disease-like symptom is a global problem. In comparison with the costs of other major chronic diseases in Germany-such as chronic obstructive pulmonary diseases (ca. 16 billion Euro) or diabetes mellitus (ca. 42 billion Euro)-the relevance of the 'symptom' tinnitus for the German social economy becomes even more obvious.
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Affiliation(s)
- Konstantin Tziridis
- Experimental Otolaryngology, University of Erlangen-Nuremberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Jana Friedrich
- Experimental Otolaryngology, University of Erlangen-Nuremberg, Waldstrasse 1, 91054 Erlangen, Germany
| | - Petra Brüeggemann
- Tinnitus Center, Charité University Medicine Berlin, Luisenstrasse 13, 10117 Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité University Medicine Berlin, Luisenstrasse 13, 10117 Berlin, Germany
| | - Holger Schulze
- Experimental Otolaryngology, University of Erlangen-Nuremberg, Waldstrasse 1, 91054 Erlangen, Germany
- Correspondence: ; Tel.: +49-9131-8543045; Fax: +49-9131-8534778
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Wang S, Cha X, Li F, Li T, Wang T, Wang W, Zhao Z, Ye X, Liang C, Deng Y, Liu H. Associations between sleep disorders and anxiety in patients with tinnitus: A cross-sectional study. Front Psychol 2022; 13:963148. [PMID: 35992459 PMCID: PMC9389284 DOI: 10.3389/fpsyg.2022.963148] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo investigate the characteristics of sleep disorders and anxiety in patients with tinnitus, their influencing factors, and the role of sleep disorders as mediators.MethodsThe general conditions and disease characteristics of 393 patients with tinnitus presented to the Changzheng Hospital of the Naval Medical University from 2018 to 2021 were collected. All patients accepted questionnaires such as Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI) and Self-rating Anxiety Scale (SAS), and then the characteristics and the influencing factors of sleep disorders and anxiety were analyzed.ResultsAmong the 393 tinnitus patients, 213 cases (54.19%) were diagnosed with sleep disorders, and 78 cases (19.85%) were diagnosed with anxiety, including 25 men (32.1%) and 53 women (67.9%). Binary regression showed that gender, hearing loss, tinnitus severity, and sleep disorders severity were positively associated with anxiety. Multiple logistic regression analysis showed that female gender (OR = 2.526, P = 0.008), hearing loss (OR = 2.901, P = 0.003, tinnitus severity (OR = 1.863, P = 0.003) and sleep disorders (OR = 2.510, P = 0.001) were the independent risk factors of anxiety. The mediating effect of sleep disorders between tinnitus severity and anxiety accounted for 27.88% of the total effect size.ConclusionFemales patients with hearing loss, moderate to severe tinnitus, and sleep disorders were at greater risk for anxiety, with sleep disorders partially mediating the anxiety associated with tinnitus.
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Affiliation(s)
- Shenglei Wang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Xudong Cha
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Fengzhen Li
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Tengfei Li
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Tianyu Wang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Wenwen Wang
- Department of Neurology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Zhengqing Zhao
- Department of Neurology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Xiaofei Ye
- Department of Health Statistics, Naval Medical University (Second Military Medical University), Shanghai, China
| | - Caiquan Liang
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- *Correspondence: Caiquan Liang
| | - Yue Deng
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- Yue Deng
| | - Huanhai Liu
- Department of Otolaryngology, Changzheng Hospital, Naval Medical University (Second Military Medical University), Shanghai, China
- Huanhai Liu
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Tziridis K, Schulze H. Preventive Effects of Ginkgo-Extract EGb 761 ® on Noise Trauma-Induced Cochlear Synaptopathy. Nutrients 2022; 14:3015. [PMID: 35893868 PMCID: PMC9330013 DOI: 10.3390/nu14153015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022] Open
Abstract
Noise trauma-induced loss of ribbon synapses at the inner hair cells (IHC) of the cochlea may lead to hearing loss (HL), resulting in tinnitus. We are convinced that a successful and sustainable therapy of tinnitus has to treat both symptom and cause. One of these causes may be the mentioned loss of ribbon synapses at the IHC of the cochlea. In this study, we investigated the possible preventive and curative effects of the Ginkgo biloba extract EGb 761® on noise-induced synaptopathy, HL, and tinnitus development in Mongolian gerbils (Meriones unguiculatus). To this end, 37 male animals received EGb 761® or placebo orally 3 weeks before (16 animals) or after (21 animals) a monaural acoustic noise trauma (2 kHz, 115 dB SPL, 75 min). Animals' hearing thresholds were determined by auditory brainstem response (ABR) audiometry. A possible tinnitus percept was assessed by the gap prepulse inhibition acoustic startle reflex (GPIAS) response paradigm. Synaptopathy was quantified by cochlear immunofluorescence histology, counting the ribbon synapses of 15 IHCs at 11 different cochlear frequency locations per ear. We found a clear preventive effect of EGb 761® on ribbon synapse numbers with the surprising result of a significant increase in synaptic innervation on the trauma side relative to placebo-treated animals. Consequently, animals treated with EGb 761® before noise trauma did not develop a significant HL and were also less affected by tinnitus compared to placebo-treated animals. On the other hand, we did not see a curative effect (EGb 761® treatment after noise trauma) of the extract on ribbon synapse numbers and, consequently, a significant HL and no difference in tinnitus development compared to the placebo-treated animals. Taken together, EGb 761® prevented noise-induced HL and tinnitus by protecting from noise trauma-induced cochlear ribbon synapse loss; however, in our model, it did not restore lost ribbon synapses.
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Affiliation(s)
| | - Holger Schulze
- Experimental Otolaryngology, ENT Clinic Head and Neck Surgery, University Hospital Erlangen, 91054 Erlangen, Germany;
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Schilling A, Gerum R, Metzner C, Maier A, Krauss P. Intrinsic Noise Improves Speech Recognition in a Computational Model of the Auditory Pathway. Front Neurosci 2022; 16:908330. [PMID: 35757533 PMCID: PMC9215117 DOI: 10.3389/fnins.2022.908330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/09/2022] [Indexed: 01/05/2023] Open
Abstract
Noise is generally considered to harm information processing performance. However, in the context of stochastic resonance, noise has been shown to improve signal detection of weak sub- threshold signals, and it has been proposed that the brain might actively exploit this phenomenon. Especially within the auditory system, recent studies suggest that intrinsic noise plays a key role in signal processing and might even correspond to increased spontaneous neuronal firing rates observed in early processing stages of the auditory brain stem and cortex after hearing loss. Here we present a computational model of the auditory pathway based on a deep neural network, trained on speech recognition. We simulate different levels of hearing loss and investigate the effect of intrinsic noise. Remarkably, speech recognition after hearing loss actually improves with additional intrinsic noise. This surprising result indicates that intrinsic noise might not only play a crucial role in human auditory processing, but might even be beneficial for contemporary machine learning approaches.
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Affiliation(s)
- Achim Schilling
- Laboratory of Sensory and Cognitive Neuroscience, Aix-Marseille University, Marseille, France
- Neuroscience Lab, University Hospital Erlangen, Erlangen, Germany
- Cognitive Computational Neuroscience Group, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Richard Gerum
- Department of Physics and Center for Vision Research, York University, Toronto, ON, Canada
| | - Claus Metzner
- Neuroscience Lab, University Hospital Erlangen, Erlangen, Germany
- Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
| | - Patrick Krauss
- Neuroscience Lab, University Hospital Erlangen, Erlangen, Germany
- Cognitive Computational Neuroscience Group, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
- Pattern Recognition Lab, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
- Linguistics Lab, Friedrich-Alexander-University Erlangen-Nuremberg (FAU), Erlangen, Germany
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7
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Grimm J, Schulze H, Tziridis K. Circadian Sensitivity of Noise Trauma-Induced Hearing Loss and Tinnitus in Mongolian Gerbils. Front Neurosci 2022; 16:830703. [PMID: 35720709 PMCID: PMC9204100 DOI: 10.3389/fnins.2022.830703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 05/09/2022] [Indexed: 11/13/2022] Open
Abstract
Noise-induced hearing loss (HL) has a circadian component: In nocturnal mice, hearing thresholds (HT) have a significantly stronger effect to acoustic trauma when induced during the night compared to rather mild effects on hearing when induced during daytime. Here, we investigate whether such effects are also present in diurnal Mongolian gerbils and determined whether trauma-induced HL correlated with the development of a tinnitus percept in these animals. In particular, we investigated the effects of acoustic trauma (2 kHz, 115 dB SPL, 75 min) on HT and tinnitus development in 34 male gerbils exposed either at 9 AM, 1 PM, 5 PM, or 12 PM. HT was measured by acoustic brainstem response audiometry at defined times 1 day before and 1 week after the trauma. Possible tinnitus percepts were assessed behaviorally by the gap prepulse inhibition of the acoustic startle response at defined times 1 day before and 1 week after the trauma. We found daytime-dependent changes due to trauma in mean HT in a frequency-dependent manner comparable to the results in mice, but the results temporally shifted according to respective activity profiles. Additionally, we found linear correlations of these threshold changes with the strength of the tinnitus percept, with the most prominent correlations in the 5 PM trauma group. Taken together, circadian sensitivity of the HT to noise trauma can also be found in gerbils, and tinnitus strength correlates most strongly with HL only when the trauma is applied at the most sensitive times, which seem to be the evening.
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8
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Tziridis K, Brunner S, Schilling A, Krauss P, Schulze H. Spectrally Matched Near-Threshold Noise for Subjective Tinnitus Loudness Attenuation Based on Stochastic Resonance. Front Neurosci 2022; 16:831581. [PMID: 35431789 PMCID: PMC9005796 DOI: 10.3389/fnins.2022.831581] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 02/23/2022] [Indexed: 12/29/2022] Open
Abstract
Recently, we proposed a model of tinnitus development based on a physiological mechanism of permanent optimization of information transfer from the auditory periphery to the central nervous system by means of neuronal stochastic resonance utilizing neuronal noise to be added to the cochlear input, thereby improving hearing thresholds. In this view, tinnitus is a byproduct of this added neuronal activity. Interestingly, in healthy subjects auditory thresholds can also be improved by adding external, near-threshold acoustic noise. Based on these two findings and a pilot study we hypostatized that tinnitus loudness (TL) might be reduced, if the internally generated neuronal noise is substituted by externally provided individually adapted acoustic noise. In the present study, we extended the data base of the first pilot and further optimized our approach using a more fine-grained adaptation of the presented noise to the patients' audiometric data. We presented different spectrally filtered near-threshold noises (-2 dB to +6 dB HL, 2 dB steps) for 40 s each to 24 patients with tonal tinnitus and a hearing deficit not exceeding 40 dB. After each presentation, the effect of the noise on the perceived TL was obtained by patient's response to a 5-scale question. In 21 out of 24 patients (13 women) TL was successfully subjectively attenuated during acoustic near-threshold stimulation using noise spectrally centered half an octave below the individual's tinnitus pitch (TP). Six patients reported complete subjective silencing of their tinnitus percept during stimulation. Acoustic noise is able to reduce TL, but the TP has to be taken into account. Based on our findings, we speculate about a possible future treatment of tinnitus by near-threshold bandpass filtered acoustic noise stimulation, which could be implemented in hearing aids with noise generators.
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Affiliation(s)
| | | | | | | | - Holger Schulze
- Experimental Otolaryngology, University of Erlangen-Nuremberg, Erlangen, Germany
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9
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Lanaia V, Tziridis K, Schulze H. Salicylate-Induced Changes in Hearing Thresholds in Mongolian Gerbils Are Correlated With Tinnitus Frequency but Not With Tinnitus Strength. Front Behav Neurosci 2021; 15:698516. [PMID: 34393736 PMCID: PMC8363116 DOI: 10.3389/fnbeh.2021.698516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/07/2021] [Indexed: 11/21/2022] Open
Abstract
Tinnitus is an auditory phantom percept without external sound sources. Despite the high prevalence and tinnitus-associated distress of affected patients, the pathophysiology of tinnitus remains largely unknown, making prevention and treatments difficult to develop. In order to elucidate the pathophysiology of tinnitus, animal models are used where tinnitus is induced either permanently by noise trauma or transiently by the application of salicylate. In a model of trauma-induced tinnitus, we have suggested a central origin of tinnitus-related development of neuronal hyperactivity based on stochastic resonance (SR). SR refers to the physiological phenomenon that weak subthreshold signals for given sensors (or synapses) can still be detected and transmitted if appropriate noise is added to the input of the sensor. The main objective of this study was to characterize the neurophysiological and behavioral effects during salicylate-induced tinnitus and compare these to the conditions within the trauma model. Our data show, in line with the pharmacokinetics, that hearing thresholds generally increase 2 h after salicylate injections. This increase was significantly stronger within the region of best hearing compared to other frequencies. Furthermore, animals showed behavioral signs of tinnitus during that time window and frequency range as assessed by gap prepulse inhibition of the acoustic startle reflex (GPIAS). In contrast to animals with noise trauma-induced tinnitus, salicylate-induced tinnitus animals showed no correlation between hearing thresholds and behavioral signs of tinnitus, indicating that the development of tinnitus after salicylate injection is not based on SR as proposed for the trauma model. In other words, salicylate-induced tinnitus and noise trauma-induced tinnitus are not based on the same neurophysiological mechanism.
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Affiliation(s)
- Veralice Lanaia
- Experimental Otolaryngology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Konstantin Tziridis
- Experimental Otolaryngology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Holger Schulze
- Experimental Otolaryngology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Tziridis K, Forster J, Buchheidt-Dörfler I, Krauss P, Schilling A, Wendler O, Sterna E, Schulze H. Tinnitus development is associated with synaptopathy of inner hair cells in Mongolian gerbils. Eur J Neurosci 2021; 54:4768-4780. [PMID: 34061412 DOI: 10.1111/ejn.15334] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/22/2021] [Accepted: 05/14/2021] [Indexed: 02/06/2023]
Abstract
Human hearing loss (HL) is often accompanied by comorbidities like tinnitus, which is affecting up to 15% of the adult population. Rodent animal studies could show that tinnitus may not only be a result of apparent HL due to cochlear hair cell damage but can also be a consequence of synaptopathy at the inner hair cells (IHCs) already induced by moderate sound traumata. Here, we investigate synaptopathy previously shown in mice in our animal model, the Mongolian gerbil, and relate it to behavioral signs of tinnitus. Tinnitus was induced by a mild monaural acoustic trauma leading to monaural noise induced HL in the animals, quantified by auditory brainstem response (ABR) audiometry. Behavioral signs of tinnitus percepts were detected by measurement of prepulse inhibition of the acoustic startle response in a gap-noise paradigm. Fourteen days after trauma, the cochleae of both ears were isolated, and IHC synapses were counted within several spectral regions of the cochlea. Behavioral signs of tinnitus were only found in animals with IHC synaptopathy, independent of type of HL. On the other hand, animals with apparent HL but without behavioral signs of tinnitus showed a reduction in amplitudes of ABR waves I&II but no significant changes in the number of synapses at the IHC. We conclude-in line with the literature-that HL is caused by damage to the IHC or by other reasons but that the development of tinnitus, at least in our animal model, is closely linked to synaptopathy at the IHC.
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Affiliation(s)
- Konstantin Tziridis
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Jan Forster
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Isabelle Buchheidt-Dörfler
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Patrick Krauss
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Achim Schilling
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Olaf Wendler
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Elisabeth Sterna
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Holger Schulze
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
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11
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Schilling A, Tziridis K, Schulze H, Krauss P. The stochastic resonance model of auditory perception: A unified explanation of tinnitus development, Zwicker tone illusion, and residual inhibition. PROGRESS IN BRAIN RESEARCH 2021; 262:139-157. [PMID: 33931176 DOI: 10.1016/bs.pbr.2021.01.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stochastic resonance (SR) has been proposed to play a major role in auditory perception, and to maintain optimal information transmission from the cochlea to the auditory system. By this, the auditory system could adapt to changes of the auditory input at second or even sub-second timescales. In case of reduced auditory input, somatosensory projections to the dorsal cochlear nucleus would be disinhibited in order to improve hearing thresholds by means of SR. As a side effect, the increased somatosensory input corresponding to the observed tinnitus-associated neuronal hyperactivity is then perceived as tinnitus. In addition, the model can also explain transient phantom tone perceptions occurring after ear plugging, or the Zwicker tone illusion. Vice versa, the model predicts that via stimulation with acoustic noise, SR would not be needed to optimize information transmission, and hence somatosensory noise would be tuned down, resulting in a transient vanishing of tinnitus, an effect referred to as residual inhibition.
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Affiliation(s)
- Achim Schilling
- Neuroscience Lab, Experimental Otolaryngology, University Hospital Erlangen, Erlangen, Germany; Cognitive Computational Neuroscience Group at the Chair of English Philology and Linguistics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Konstantin Tziridis
- Neuroscience Lab, Experimental Otolaryngology, University Hospital Erlangen, Erlangen, Germany
| | - Holger Schulze
- Neuroscience Lab, Experimental Otolaryngology, University Hospital Erlangen, Erlangen, Germany
| | - Patrick Krauss
- Neuroscience Lab, Experimental Otolaryngology, University Hospital Erlangen, Erlangen, Germany; Cognitive Computational Neuroscience Group at the Chair of English Philology and Linguistics, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; FAU Linguistics Lab, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany; Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
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12
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Schilling A, Krauss P, Hannemann R, Schulze H, Tziridis K. [Reducing tinnitus intensity : Pilot study to attenuate tonal tinnitus using individually spectrally optimized near-threshold noise]. HNO 2020; 69:891-898. [PMID: 33185745 PMCID: PMC8545742 DOI: 10.1007/s00106-020-00963-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2020] [Indexed: 12/02/2022]
Abstract
Hintergrund Tinnitus betrifft ca. 15 % der Bevölkerung, jedoch existiert noch immer kein echtes Heilverfahren. Ein von uns entwickeltes neuartiges Erklärungsmodell erlaubt nun die Erprobung einer gezielten, an den Ursachen der Tinnitusentstehung ansetzenden Behandlung. Diese basiert auf stochastischen Resonanzphänomenen an bestimmten synaptischen Verbindungen im Hörsystem, welche gezielt durch extern zugeführtes schwellennahes Rauschen induziert werden sollen. Fragestellung Die vorliegende Pilotstudie soll zeigen, ob ein spektral individuell angepasstes Rauschen erfolgreich chronischen tonalen/schmalbandigen Tinnitus während der Stimulation abschwächen kann. Material und Methoden Bei 22 volljährigen Tinnituspatienten (46.6±16.3 Jahre; 4 Frauen) wurden Hörverlust (HV) sowie Tinnitusfrequenzen (TF) und -lautstärken (TL) audiometrisch bestimmt. Darauf basierend wurden bis zu 8 verschiedene Rauschstimuli (RS) mit je 5 Lautstärken (−20 bis +20 dB SL) erzeugt. Diese wurden über audiologische Kopfhörer in einer Schallkammer für jeweils 40 s präsentiert. Nach jeder Präsentation wurde mithilfe einer 5‑stufigen Bewertungsskala (−2 bis +2) ermittelt, ob sich die TL verändert hat. Ergebnisse Es fanden sich Patienten ohne Verbesserung der TL (n = 6) und solche mit Verbesserung (n = 16), wobei hier RS um die TF besonders effektiv waren. Die Gruppen zeigten post hoc deutliche Unterschiede in den Audiogrammen: Offenbar ist das hier getestete Verfahren insbesondere bei normalhörenden Tinnituspatienten und solchen mit geringgradigem HV effektiv. Schlussfolgerung Die subjektiv wahrgenommene TL war bei 16 von 22 Probanden für die Dauer der Stimulation reduziert. Für den möglichen Erfolg einer zukünftigen Therapie scheint der HV relevant zu sein.
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Affiliation(s)
- A Schilling
- Experimentelle HNO-Heilkunde, HNO-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
| | - P Krauss
- Experimentelle HNO-Heilkunde, HNO-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
| | - R Hannemann
- WSAudiology, Sivantos GmbH, R&D AAA SA ERL, Erlangen, Deutschland
| | - H Schulze
- Experimentelle HNO-Heilkunde, HNO-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland
| | - K Tziridis
- Experimentelle HNO-Heilkunde, HNO-Klinik, Kopf- und Halschirurgie, Universitätsklinikum Erlangen, Waldstraße 1, 91054, Erlangen, Deutschland.
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