Investigation on chronic tinnitus efficacy of combination of non-repetitive preferred music and educational counseling: a preliminary study

The results of short-course acoustic test could act as an effective predictor of the efficacy of customized music therapy for chronic tinnitus

Objectives

The aim of our study is to explore the predictive value of the short-course acoustic test in determining the efficacy of customized music therapy for chronic subjective tinnitus.

Design

Patients with tinnitus as one of the core complaints were included from October 2022 to June 2024. According to the short-course acoustic test results, the participants were divided into three groups: tinnitus disappeared group, tinnitus relieved group and tinnitus unchanged group. All the participants indiscriminately underwent the 10-months of customized music therapy (CMT) and follow-up visits.

Results

Before therapy, only the duration of tinnitus was significantly different among the three groups (p < 0.001). After 10-months of CMT treatment, the Tinnitus Loudness Visual Analogue Scale (THI), Hospital Anxiety Scale (HADS-A) and Tinnitus Loudness Visual Analogue Scale (VAS) scores of the three groups showed a decreasing trend (p < 0.05), and the treatment efficacy rate of the tinnitus disappeared group was higher than that of the tinnitus relieved group, while the treatment efficacy rate of the tinnitus relieved group was higher than that of the tinnitus unchanged group. The logistic regression results showed that the results of the short-course acoustic test, baseline THI scores, and the presence of hearing loss had significant effects on the efficacy of CMT.

Conclusion

The short-course acoustic test to some extent can predict the efficacy of CMT in patients with chronic subjective tinnitus and can be used to guide clinical therapy.

The efficacy of notched music therapy vs conventional music therapy for chronic subjective tinnitus patients: a systematic review and meta-analysis

PURPOSE

The etiology and mechanism of chronic subjective tinnitus (CST) are still unclear, thus there is no specific treatment yet. The notched music therapy (NMT) has been found to relieve patients' tinnitus symptoms, but its efficacy is still controversial. This study aims to resolve the controversy through meta pooling method.

METHODS

By searching Embase, Pubmed, Elsevier, WOS, CNKI, and CBM (China Biology Medicine disc) databases, relevant literature on "notch music therapy" and "tinnitus" was obtained, and suitable clinical controlled trials were screened. Cochrane ROB v2.0 was used to assess the risk of literature bias, and the efficacy after treatment was evaluated by pooling the effect size of tinnitus handicap inventory (THI) and visual analog scale (VAS) between intervention group and control group.

RESULTS

A total of 14 randomized controlled trial studies were included for quantitative analysis, with a total of 793 CST patients participating, including 395 patients in the intervention group and 398 patients in the control group. Among them, five studies were evaluated as biased with "some concerns of risk". The meta-analysis results showed a pooling effect size of THI score of patients after 3 months of treatment (MD = - 8.62, 95% CI (- 17.01, - 0.23), Z = - 2.01, P = 0.044) and VAS score of tinnitus after 3 months of treatment (MD = - 1.13, 95% CI (- 2.49, - 0.11), Z = - 2.14, P = 0.003) between NMT and conventional music therapy (CMT). Heterogeneity investigation and regression analysis found that notch frequency range, publication year, and patient age were not specific factors affecting the merged results. The sensitivity analysis results showed that the comprehensive effect size was stable and reliable, with no significant publication bias (P > 0.05).

CONCLUSION

Compared to traditional music therapy, notched music therapy can significantly reduce the scores of the tinnitus disability scale and tinnitus loudness score for patients after treatment. It is a good non-pharmacological treatment that is worthy of clinical promotion.

Impact of emotional states on tinnitus sound therapy efficacy based on ECG signals and emotion recognition model

BACKGROUND

Diagnosis and severity assessment of tinnitus are mostly based on the patient's descriptions and subjective questionnaires, which lacks objective means of diagnosis and assessment bases, the accuracy of which fluctuates with the clarity of the patient's description. This complicates the timely modification of treatment strategies or therapeutic music to improve treatment efficacy.

NEW METHOD

We employed a novel random convolutional kernel-based method for electrocardiogram (ECG) signal analysis to identify patients' emotional states during Music Tinnitus Sound Therapy (Music-TST) sessions. Then analyzed correlations between emotional changes in different treatment phase and Tinnitus Handicap Inventory (THI) score differences to determine the impact of emotions on tinnitus treatment efficacy.

RESULTS

This study revealed a significant correlation between patients' emotion changes during Music-TST and the therapy's effectiveness. Changes in arousal and dominance dimension, were strongly linked to THI variations. These findings highlight the substantial impact of emotional responses on sound therapy's efficacy, offering a new perspective for understanding and optimizing tinnitus treatment.

COMPARISON WITH EXISTING METHODS

Compared to existing methods, we proposed an objective indicator to assess the progress of sound therapy, the indicator could also be used to provide feedback to optimize sound therapy music.

CONCLUSIONS

This study revealed the critical role of emotion changes in tinnitus sound therapy. By integrating objective ECG-based emotion analysis with traditional subjective scale like THI, we present an innovative approach to assess and potentially optimize therapy effectiveness. This finding could lead to more personalized and effective treatment strategies for tinnitus sound therapy.

Non-invasive treatments improve patient outcomes in chronic tinnitus: a systematic review and network meta-analysis

OBJECTIVE

To investigate the relative effectiveness of various Non-Invasive Treatment Techniques (NITs) in chronic tinnitus management.

METHODS

We searched PubMed, Embase and Cochrane Library databases from the time of data construction to December 31, 2022. According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, NITs were evaluated, including Aacceptance and commitment therapy (A), Cognitive behavioral therapy (C), Sound therapy (S), Transcranial magnetic stimulation (T), Electrical stimulation therapy (E), Virtual reality therapy (V), tinnitus Retraining therapy (R), general psychotherapy (D), and Placebo (P). The outcome indicators included the Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Hospital Anxiety and Depression Scale-anxiety-Depression (HADS-D), Insomnia Severity Index (ISI), Visual Analogue Scales-Loudness (VAS-L), and Visual Analogue Scales-Distress (VAS-D). Statistical analysis was performed using Stata 14.0 for NMA.

RESULTS

This systematic review and meta-analysis included 22 randomized controlled trials comprising 2,354 patients. The treatment effects varied on each scale. For THI, S (86.9%) was the most effective, whereas P (6.5%) was the worst. For TQ, C (89.5%) was the most effective, whereas D (25.4%) was the worst. For HADS-D, A (82.4%) was the most effective, whereas D (9.47%) was the worst. For ISI, A (83.2%) was the most effective, whereas R (20.6%) was the worst. For VAS-L, S (73.5%) was the most effective, whereas E (18.9%) was the worst. For VAS-D, C (84.7%) was the most effective, whereas P (18.1%) was the worst.

CONCLUSIONS

The combination of acoustics and cognitive behavioral therapy may be an effectively treat patients with chronic tinnitus.

LEVEL OF EVIDENCE

How common is the problem? Level 2. Is this diagnostic or monitoring test accurate? (Diagnosis) Level 1. What will happen if we do not add a therapy? (Prognosis) Level 1. Does this intervention help? (Treatment Benefits) Level 1. What are the COMMON harms? (Treatment Harms) Level 1. What are the RARE harms? (Treatment Harms) Level 1. Is this (early detection) test worthwhile? (Screening) Level 1I.

Hearing Aids Combined With Educational Counseling Versus Educational Counseling Alone for Tinnitus Treatment in Patients With Hearing Loss: A Longitudinal Follow-Up Study

PURPOSE

The effect of hearing aids (HAs) and educational counseling (EC) or their combination on tinnitus is ambiguous. This study aimed to investigate whether the combined use of HAs and EC is more effective than EC alone on tinnitus relief.

METHOD

A total of 72 adults with chronic, bothersome tinnitus and coexisting sensorineural hearing loss completed at least 1-month and 3-month follow-up. After receiving EC and HA prescriptions, 21 participants selected to purchase HAs (i.e., the HA + EC group), whereas the remaining 51 refused to use HAs despite recommendations (i.e., the EC group). Tinnitus severity was measured by Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), and Visual Analog Scale (VAS) for loudness. The primary outcome measure was THI, and tinnitus relief was defined as a 20-point or more reduction in THI. A generalized linear mixed model was used to confirm that the heterogeneity in baseline characteristics between groups did not interfere with the results.

RESULTS

The THI, TEQ, and VAS scores decreased significantly after treatments, and both groups yielded a similar trend of reduction. There were no significant differences in the incidence of tinnitus relief and time-to-event curves between the two groups. In addition, the length of follow-up did not affect treatment effectiveness.

CONCLUSION

There was insufficient evidence to support the superiority of the combined use of HA and EC for tinnitus over EC with no device.

Short- and Long-Term Effect of Cochlear Implantation on Disabling Tinnitus in Single-Sided Deafness Patients: A Systematic Review

Patients with single-sided deafness can experience an ipsilateral disabling tinnitus that has a major impact on individuals' social communication and quality of life. Cochlear implants appear to be superior to conventional treatments to alleviate tinnitus in single-sided deafness. We conducted a systematic review to evaluate the effectiveness of cochlear implants in single-sided deafness with disabling tinnitus when conventional treatments fail to alleviate tinnitus (PROSPERO ID: CRD42022353292). All published studies in PubMed/MEDLINE and SCOPUS databases until December 2021 were included. A total of 474 records were retrieved, 31 studies were included and were divided into two categories according to whether tinnitus was assessed as a primary complaint or not. In all studies, cochlear implantation, evaluated using subjective validated tools, succeeded in reducing tinnitus significantly. Objective evaluation tools were less likely to be used but showed similar results. A short-(3 months) and long-(up to 72 months) term tinnitus suppression was reported. When the cochlear implant is disactivated, complete residual tinnitus inhibition was reported to persist up to 24 h. The results followed a similar pattern in studies where tinnitus was assesed as a primary complaint or not. In conclusion, the present review confirmed the effectiveness of cochlear implantation in sustainably reducing disabling tinnitus in single-sided deafness patients.