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Perez-Carpena P, Lopez-Escamez JA, Gallego-Martinez Á. A Systematic Review on the Genetic Contribution to Tinnitus. J Assoc Res Otolaryngol 2024; 25:13-33. [PMID: 38334885 PMCID: PMC10907330 DOI: 10.1007/s10162-024-00925-6] [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: 08/13/2023] [Accepted: 12/31/2023] [Indexed: 02/10/2024] Open
Abstract
PURPOSE To assess the available evidence to support a genetic contribution and define the role of common and rare variants in tinnitus. METHODS After a systematic search and quality assessment, 31 records including 383,063 patients were selected (14 epidemiological studies and 17 genetic association studies). General information on the sample size, age, sex, tinnitus prevalence, severe tinnitus distribution, and sensorineural hearing loss was retrieved. Studies that did not include data on hearing assessment were excluded. Relative frequencies were used for qualitative variables to compare different studies and to obtain average values. Genetic variants and genes were listed and clustered according to their potential role in tinnitus development. RESULTS The average prevalence of tinnitus estimated from population-based studies was 26.3% for any tinnitus, and 20% of patients with tinnitus reported it as an annoying symptom. One study has reported population-specific differences in the prevalence of tinnitus, the white ancestry being the population with a higher prevalence. Genome-wide association studies have identified and replicated two common variants in the Chinese population (rs2846071; rs4149577) in the intron of TNFRSF1A, associated with noise-induced tinnitus. Moreover, gene burden analyses in sequencing data from Spanish and Swede patients with severe tinnitus have identified and replicated ANK2, AKAP9, and TSC2 genes. CONCLUSIONS The genetic contribution to tinnitus is starting to be revealed and it shows population-specific effects in European and Asian populations. The common allelic variants associated with tinnitus that showed replication are associated with noise-induced tinnitus. Although severe tinnitus has been associated with rare variants with large effect, their role on hearing or hyperacusis has not been established.
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Affiliation(s)
- Patricia Perez-Carpena
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain.
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain.
- Department of Otolaryngology, Instituto de Investigación Biosanitaria Ibs.GRANADA, Hospital Universitario Virgen de Las Nieves, Granada, Spain.
| | - Jose A Lopez-Escamez
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain.
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain.
- Meniere's Disease Neuroscience Research Program, Faculty of Medicine & Health, School of Medical Sciences, The Kolling Institute, University of Sydney, Sydney, NSW, Australia.
| | - Álvaro Gallego-Martinez
- Otology and Neurotology Group CTS495, Division of Otolaryngology, Department of Surgery, Instituto de Investigación Biosanitaria, Ibs.GRANADA, Universidad de Granada, Granada, Spain
- Sensorineural Pathology Programme, Centro de Investigación Biomédica en Red en Enfermedades Raras, CIBERER, Madrid, Spain
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Prevalence of Common Alleles of Some Stress Resilience Genes among Adolescents Born in Different Periods Relative to the Socioeconomic Crisis of the 1990s in Russia. Curr Issues Mol Biol 2022; 45:51-65. [PMID: 36661490 PMCID: PMC9857244 DOI: 10.3390/cimb45010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
Social stress is common among people and is considered one of the causes of the declining birth rate. Predisposition to stress and stress-induced disorders is largely determined genetically. We hypothesized that due to differences in stress resistance, carriers of different genetic variants of genes associated with stress resilience and stress-induced diseases may have dissimilar numbers of offspring under conditions of long-term social stress. To test this hypothesis, a comparative analysis of frequencies of seven common polymorphic regions [exon 3 variable number of tandem repeats (VNTR) of the DRD4 gene, rs4680 of COMT, STin2 VNTR and the 5-HTTLPR (rs774676466) insertion/deletion polymorphism of SLC6A4, rs4570625 of TPH2, rs6265 of BDNF, and rs258747 of NR3C1] was performed on standardized groups of randomly selected adolescents born before, during, and after severe socioeconomic deprivation (the crisis of the 1990s in Russia). There were significant differences in frequencies of "long" alleles of the DRD4 gene (p = 0.020, χ2 = 5.492) and rs4680 (p = 0.022, χ2 = 5.289) in the "crisis" group as compared to the combined "noncrisis" population. It is possible that the dopaminergic system had an impact on the successful adaptation of a person to social stress.
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Costa RM, Campos P, Wiborg M, Rebôlo C, Wittmann M, Kornmeier J. Prevalence of visual snow and relation to attentional absorption. PLoS One 2022; 17:e0276971. [PMID: 36342911 PMCID: PMC9639836 DOI: 10.1371/journal.pone.0276971] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
Visual snow is a condition of unclear prevalence characterized by tiny flickering dots throughout the entire visual field. It appears to result from visual cortex hyperactivity and possibly correlates with propensity to be engrossed in sensory and imaginary experiences (absorption). The prevalence and correlates of visual snow, and emotional reactions to it, were explored in the general Portuguese population with three studies with online surveys. In Study 1, 564 participants were shown an animated graphic simulation of visual snow and asked to rate how frequently they have similar percepts on a scale anchored by 0% and 100% of their waking time. They also reported their degree of distress and fascination resulting from visual snow. Absorption was measured with the Modified Tellegen Absorption Scale. 44% of respondents reported they see visual snow at least 10% of the time, and 20% reported seeing it between 80% and 100% of the time. Similar to findings in clinical samples, the frequency of visual snow correlated with tinnitus frequency and entoptic phenomena, but not with ophthalmologic problems. It was confirmed that visual snow is related to absorption. Although distress caused by visual snow was generally absent or minimal in our samples, a substantial minority (28%) reported moderate to high levels of distress. High fascination with visual snow was reported by 9%. In Studies 2 and 3, visual snow was measured by means of verbal descriptions without graphic simulation (“visual field full of tiny dots of light” and “world seen with many dots of light”, respectively). The results were similar to those in Study 1, but seeing visual snow 80%-100% of the time was less frequent (6.5% in Study 2 and 3.6% in Study 3). Visual snow has been insufficiently investigated. More research is needed to uncover underlying neurophysiological mechanisms and psychological and behavioral correlates.
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Affiliation(s)
- Rui Miguel Costa
- William James Center for Research, Ispa–Instituto Universitário, Lisbon, Portugal
- * E-mail:
| | | | | | | | - Marc Wittmann
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
| | - Jürgen Kornmeier
- Institute for Frontier Areas of Psychology and Mental Health, Freiburg, Germany
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Medical Center—University of Freiburg, Freiburg, Germany
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Basso L, Boecking B, Neff P, Brueggemann P, Peters EMJ, Mazurek B. Hair-cortisol and hair-BDNF as biomarkers of tinnitus loudness and distress in chronic tinnitus. Sci Rep 2022; 12:1934. [PMID: 35121746 PMCID: PMC8817043 DOI: 10.1038/s41598-022-04811-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 12/21/2021] [Indexed: 12/23/2022] Open
Abstract
The role of stress and its neuroendocrine mediators in tinnitus is unclear. In this study, we measure cortisol as an indicator of hypothalamus–pituitary–adrenal (HPA) axis alterations and brain-derived neurotrophic factor (BDNF) as a marker of adaptive neuroplasticity in hair of chronic tinnitus patients to investigate relationships with tinnitus-related and psychological factors. Cross-sectional data from chronic tinnitus inpatients were analyzed. Data collection included hair sampling, pure tone audiometry, tinnitus pitch and loudness matching, and psychometric questionnaires. Elastic net regressions with n-fold cross-validation were performed for cortisol (N = 91) and BDNF (N = 87). For hair-cortisol (R2 = 0.10), the strongest effects were sampling in autumn and body-mass index (BMI) (positive), followed by tinnitus loudness (positive) and smoking (negative). For hair-BDNF (R2 = 0.28), the strongest effects were hearing aid use, shift work (positive), and tinnitus loudness (negative), followed by smoking, tinnitus-related distress (Tinnitus Questionnaire), number of experienced traumatic events (negative), and physical health-related quality of life (Short Form-12 Health Survey) (positive). These findings suggest that in chronic tinnitus patients, higher perceived tinnitus loudness is associated with higher hair-cortisol and lower hair-BDNF, and higher tinnitus-related distress with lower hair-BDNF. Regarding hair-BDNF, traumatic experiences appear to have additional stress-related effects, whereas hearing aid use and high physical health-related quality of life appear beneficial. Implications include the potential use of hair-cortisol and hair-BDNF as biomarkers of tinnitus loudness or distress and the need for intensive future research into chronic stress-related HPA axis and neuroplasticity alterations in chronic tinnitus.
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Affiliation(s)
- Laura Basso
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.,University Research Priority Program 'Dynamics of Healthy Aging', University of Zurich, Zurich, Switzerland.,Department of Psychology, Centre for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Petra Brueggemann
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eva M J Peters
- Psychoneuroimmunology Laboratory, Department of Psychosomatic Medicine and Psychotherapy, Justus-Liebig University Giessen, Giessen, Germany.,Psychosomatics and Psychotherapy, Charité Center 12 Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité - Universitätsmedizin Berlin, Berlin, Germany.
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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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Knipper M, Mazurek B, van Dijk P, Schulze H. Too Blind to See the Elephant? Why Neuroscientists Ought to Be Interested in Tinnitus. J Assoc Res Otolaryngol 2021; 22:609-621. [PMID: 34686939 PMCID: PMC8599745 DOI: 10.1007/s10162-021-00815-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/30/2021] [Indexed: 01/13/2023] Open
Abstract
A curative therapy for tinnitus currently does not exist. One may actually exist but cannot currently be causally linked to tinnitus due to the lack of consistency of concepts about the neural correlate of tinnitus. Depending on predictions, these concepts would require either a suppression or enhancement of brain activity or an increase in inhibition or disinhibition. Although procedures with a potential to silence tinnitus may exist, the lack of rationale for their curative success hampers an optimization of therapeutic protocols. We discuss here six candidate contributors to tinnitus that have been suggested by a variety of scientific experts in the field and that were addressed in a virtual panel discussion at the ARO round table in February 2021. In this discussion, several potential tinnitus contributors were considered: (i) inhibitory circuits, (ii) attention, (iii) stress, (iv) unidentified sub-entities, (v) maladaptive information transmission, and (vi) minor cochlear deafferentation. Finally, (vii) some potential therapeutic approaches were discussed. The results of this discussion is reflected here in view of potential blind spots that may still remain and that have been ignored in most tinnitus literature. We strongly suggest to consider the high impact of connecting the controversial findings to unravel the whole complexity of the tinnitus phenomenon; an essential prerequisite for establishing suitable therapeutic approaches.
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Affiliation(s)
- Marlies Knipper
- Molecular Physiology of Hearing, Tübingen Hearing Research Centre (THRC), Department of Otolaryngology, Head & Neck Surgery, University of Tübingen, Elfriede-Aulhorn-Straße 5, 72076, Tübingen, Germany.
| | - Birgit Mazurek
- Tinnitus Center Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Pim van Dijk
- Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Graduate School of Medical Sciences (Research School of Behavioural and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Holger Schulze
- Experimental Otolaryngology, Friedrich-Alexander Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Germany
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