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Molaug I, Aarhus L, Mehlum IS, Stokholm ZA, Kolstad HA, Engdahl B. Occupational noise exposure and tinnitus: the HUNT Study. Int J Audiol 2024; 63:917-924. [PMID: 37210627 DOI: 10.1080/14992027.2023.2211735] [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] [Received: 12/15/2022] [Revised: 05/02/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE We aimed to assess the association between occupational noise exposure and tinnitus. Further, to assess whether the association depends on hearing status. DESIGN In this cross-sectional study, tinnitus (>1 h daily) was regressed on job exposure matrix (JEM)-based or self-reported occupational noise exposure, adjusted for confounders. STUDY SAMPLE The 14,945 participants (42% men, 20-59 years) attended a population-based study in Norway (HUNT4, 2017-2019). RESULTS JEM-based noise exposure, assessed as equivalent continuous sound level normalised to 8-h working days (LEX 8 h), over the working career or as minimum 5 years ≥85 dB) was not associated with tinnitus. Years of exposure ≥80 dB (minimum one) was not associated with tinnitus. Self-reported high noise exposure (>15 h weekly ≥5 years) was associated with tinnitus overall and among persons with elevated hearing thresholds (prevalence ratio (PR) 1.3, 1.0-1.7), however not statistically significantly among persons with normal thresholds (PR 1.1, 0.8-1.5). CONCLUSIONS Our large study showed no association between JEM-based noise exposure and tinnitus. This may to some extent reflect successful use of hearing protection. High self-reported noise exposure was associated with tinnitus, but not among normal hearing persons. This supports that noise-induced tinnitus to a large extent depends on audiometric hearing loss.
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Affiliation(s)
- Ina Molaug
- Department of Occupational Medicine and Epidemiology, The National Institute of Occupational Health in Norway, Oslo, Norway
| | - Lisa Aarhus
- Department of Occupational Medicine and Epidemiology, The National Institute of Occupational Health in Norway, Oslo, Norway
| | - Ingrid Sivesind Mehlum
- Department of Occupational Medicine and Epidemiology, The National Institute of Occupational Health in Norway, Oslo, Norway
- The Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Zara Ann Stokholm
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik A Kolstad
- Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
- Institute of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Bo Engdahl
- Department of Physical Health and Ageing, The Norwegian Institute of Public Health, Oslo, Norway
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Ihler F, Brzoska T, Altindal R, Dziemba O, Völzke H, Busch CJ, Ittermann T. Prevalence and risk factors of self-reported hearing loss, tinnitus, and dizziness in a population-based sample from rural northeastern Germany. Sci Rep 2024; 14:17739. [PMID: 39085387 PMCID: PMC11291685 DOI: 10.1038/s41598-024-68577-3] [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: 12/21/2023] [Accepted: 07/25/2024] [Indexed: 08/02/2024] Open
Abstract
A close anatomical and physiological relationship is known between the senses of hearing and balance, while an additional pathophysiological interaction is supposed. The mechanisms underlying this association are not yet fully understood, especially in individuals without a known specific otologic disorder. In particular, only scarce information on the combined occurrence of audiovestibular sensory impairment is available so far. Therefore, this study aims to provide further insight into the prevalence and co-prevalence of the audiovestibular symptoms hearing loss, tinnitus and dizziness. Additionally, the influence of potential risk factors from lifestyle habits as well as cardiovascular and metabolic conditions on the development of those symptoms is studied. Data was analyzed from 8134 individuals from the population-based Study of Health in Pomerania (SHIP). SHIP pursues a broad and comprehensive examination program in chronologically separated cohorts with longitudinal follow-up. Cohorts are sampled from Western Pomerania, a rural region of north-eastern Germany. The study population represents a cross-sectional analysis from the cohorts SHIP-START (recruited 1997-2001) and SHIP-TREND (recruited 2008-2012), sampled for baseline investigations (SHIP-START-0 and SHIP-TREND-0) at the age of 20-79 years. Audiovestibular symptoms as outcome variables were assessed by structured questionnaires. Additionally, individuals were comprehensively characterized regarding modifiable lifestyle factors as well as cardiovascular and metabolic disorders, allowing the assessment of their role as exposure variables. We calculated a weighted prevalence of 14.2% for hearing loss, 9.7% for tinnitus, and 13.5% for dizziness in the population. Prevalence increased with age and differed among the sexes. A considerable share of 28.0% of the investigated individuals reported more than one symptom at once. The prevalence of hearing loss as well as tinnitus increased between the two cohorts. A moderate positive correlation was found between the occurrence of hearing loss and tinnitus (phi-coefficient 0.318). In multivariable regression analyses, education was identified as a significant protective factor while only smoking was significantly associated with all three symptoms. Furthermore, several cardiovascular risk factors contributed to both hearing loss and dizziness. In conclusion, audiovestibular symptoms are highly prevalent in the investigated population. A considerable but complex influence of risk factors points towards a relation with neuronal as well as cardiovascular disease processes. To clarify the underlying mechanisms, the interaction between the senses of hearing and balance as well as the mode of action of the risk factors should be evaluated in more detail in the future.
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Affiliation(s)
- Friedrich Ihler
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany.
| | - Tina Brzoska
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Reyhan Altindal
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Oliver Dziemba
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Chia-Jung Busch
- Department of Otorhinolaryngology, Head and Neck Surgery, Greifswald University Medicine, Fleischmannstrasse 8, 17475, Greifswald, Germany
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
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Shetty HN, S V. Development and Validation of Self-Management Manual for Acute Tinnitus. Indian J Otolaryngol Head Neck Surg 2024; 76:2654-2659. [PMID: 38883543 PMCID: PMC11169203 DOI: 10.1007/s12070-024-04504-2] [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: 06/24/2023] [Accepted: 01/04/2024] [Indexed: 06/18/2024] Open
Abstract
The aim of the study was to develop a self-management manual for tinnitus. The study was carried out in three phases. In phase-1, an evidence-based approach was considered by reviewing the literature to select intervention strategies that had proven to reduce tinnitus percept. Further, health literacy recommendations were used to convey the information in the manual to the patient. Phase-2 included expert committee scrutiny and assessing the understandability and actionability of the prepared self-management manual using the Patient Education Material Assessment Tool (PEMAT). In Phase-3, the self-management manual was validated from tinnitus patients. The expert committee mainly gave suggestions regarding the content, word choice and grammatical errors. PEMAT scores from patients and the expert committee revealed that activities provided in the manual are understandable and actionable. The THI and TFI scores were reduced after one month of short-term intervention. The self-management manual effectively reduced tinnitus percept and associated problems.
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Affiliation(s)
| | - Varalakshmi S
- JSS Institute of Speech and Hearing , Mysuru, Karnataka India
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Wadhwa S, Jain S, Patil N. The Role of Diet and Lifestyle in the Tinnitus Management: A Comprehensive Review. Cureus 2024; 16:e59344. [PMID: 38817510 PMCID: PMC11137645 DOI: 10.7759/cureus.59344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
Tinnitus, the perception of noise or ringing in the ears without an external source, affects a significant portion of the global population. While there is no definitive cure, emerging research suggests that diet and lifestyle factors may play a role in tinnitus management. This comprehensive review explores the relationship between diet, lifestyle, and tinnitus, examining the existing evidence and potential mechanisms. The key findings highlight the influence of dietary patterns, hydration, stress management, physical activity, and sleep hygiene on tinnitus severity and frequency. Personalized approaches to tinnitus management are emphasized, recognizing the diverse nature of tinnitus symptoms and individual responses to interventions. Healthcare professionals are encouraged to integrate discussions about diet and lifestyle into tinnitus management protocols, while individuals affected by tinnitus are urged to adopt healthy habits and actively participate in their care. By addressing the multifaceted nature of tinnitus, healthcare professionals and individuals can collaborate toward optimizing symptom management and enhancing overall well-being.
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Affiliation(s)
- Smriti Wadhwa
- Otolaryngology - Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Shraddha Jain
- Otolaryngology - Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nimisha Patil
- Otolaryngology - Head and Neck Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Gao J, Tan P, Liu Y, Chen S, Liu J. Association Between Sleep Apnea and Tinnitus: A Meta-Analysis. EAR, NOSE & THROAT JOURNAL 2024:1455613241226853. [PMID: 38321723 DOI: 10.1177/01455613241226853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Objective: It remains unclear whether sleep apnea (SA) is associated with tinnitus in adults. Based on a systematic review and meta-analysis of observational studies, we investigated the association between SA and tinnitus in adult population. Methods: Observational studies relevant to our research were identified by searching PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Results: Eight case-control or cross-sectional studies, including 132,292 adults were included, and 1556 of them had SA. It was shown that SA was related to a higher prevalence of tinnitus (odds ratio [OR]: 1.65, 95% confidence interval: 1.14-2.39, P < .001) with moderate heterogeneity (P for Cochrane Q test = 0.04, I2 = 53%). Seven studies reported the association between obstructive SA and tinnitus, while the other one study reported the association between overall SA and tinnitus. Subgroup analyses showed that the association was not significant for mild (OR: 1.80, P = .17) or moderate (OR: 1.25, P = .53), but significant for severe SA (OR: 2.25, P = .008). In addition, the association between SA and tinnitus seemed to be stronger in studies from Italy or United States as compared to those from China (OR: 2.91 vs 1.35, P for subgroup difference = .02). The association was not significantly affected by study design, mean age, proportion of men, methods for diagnosis of SA, and controlling of age and sex (P for subgroup difference all > .05). Conclusion: Severe SA may be related to tinnitus in adults.
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Affiliation(s)
- Jing Gao
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Ping Tan
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Yunliang Liu
- Department of Otolaryngology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, Fujian Province, P.R. China
| | - Shoujian Chen
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
| | - Jianqing Liu
- Health Medicine Department, The 900th Hospital of the Chinese PLA Joint Logistics Support Force, Fuzhou, Fujian Province, P.R. China
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Taghavi Shirazi M, Arabi M. Tinnitus in Avicenna's Canon of Medicine. IRANIAN JOURNAL OF MEDICAL SCIENCES 2023; 48:433-435. [PMID: 37456205 PMCID: PMC10349155 DOI: 10.30476/ijms.2022.96829.2845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 10/29/2022] [Accepted: 12/03/2022] [Indexed: 07/18/2023]
Affiliation(s)
- Maryam Taghavi Shirazi
- Department of Persian Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Arabi
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Serum Vitamin D Concentration Is Lower in Patients with Tinnitus: A Meta-Analysis of Observational Studies. Diagnostics (Basel) 2023; 13:diagnostics13061037. [PMID: 36980345 PMCID: PMC10047354 DOI: 10.3390/diagnostics13061037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Background: Tinnitus is a highly prevalent and frequently disabling condition, such that the identification of possible causal mechanisms would yield significant clinical and social benefits. Since vitamin D (Vit D) is involved in the pathogenesis of several ear disturbances, we review here the current scientific literature addressing the relationship between Vit D status and tinnitus. Methods: An electronic search was conducted in PubMed, Scopus and Web of Science with the keywords “tinnitus” and “Vitamin D” or “Vit D” or “25OH-D” or “cholecalciferol” or “ergocalciferol” or “hydroxycholecalciferol”, without date (i.e., up to 8 February 2023) or language restrictions, in accordance with a protocol based on the transparent reporting of systematic reviews and meta-analysis (PRISMA) 2020 checklist, for identifying studies which assayed serum Vit D concentration in patients with or without tinnitus. Results: Three observational, case-control studies encompassing four cohorts and totaling 468 patients with (n = 268) or without tinnitus (n = 200) were included in this meta-analysis. Pooled analysis with quality effects models evidenced significantly reduced serum Vit D levels in patients with tinnitus compared to those without (weighted mean difference [WMD], −6.2 ng/mL; 95% CI, −10.3 to −2.1 ng/mL; I2, 56%). Serum Vit D was found to be 22% lower in patients with tinnitus compared to those without. Conclusions: Lower serum Vit D levels may be associated with tinnitus, thus paving the way to plan future trials aimed at exploring whether Vit D supplementation may aid in preventing and/or improving tinnitus.
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Biswas R, Genitsaridi E, Trpchevska N, Lugo A, Schlee W, Cederroth CR, Gallus S, Hall DA. Low Evidence for Tinnitus Risk Factors: A Systematic Review and Meta-analysis. J Assoc Res Otolaryngol 2023; 24:81-94. [PMID: 36380120 PMCID: PMC9971395 DOI: 10.1007/s10162-022-00874-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 09/14/2022] [Indexed: 11/16/2022] Open
Abstract
AIMS/HYPOTHESIS Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new interventions. This study reports the first comprehensive systematic review of analytical observational studies able to provide information about causality (i.e., case-control and cohort designs). METHODS A literature search of four electronic databases identified epidemiological studies published on tinnitus and different exposures. Independent raters screened all studies, extracted data, and evaluated study quality using the Newcastle-Ottawa Scale. Reported relative risks (RR), hazard ratios (HR), odds ratios (OR), and prevalence ratios (PR) with 95% confidence intervals (CI) were used to compute crude estimates of RR for tinnitus risk factors. RESULTS From 2389 records identified, a total of 374 articles were read as full text (24 reviews, 301 cross-sectional studies, 42 cohort studies, and 7 case-control studies). However, from 49 case-control and cohort studies, only 25 adequately reported risk ratios. Using the findings from these studies, positive causal associations were found for various hearing-related factors (i.e., unspecified hearing loss, sensorineural hearing loss, occupational noise exposure, ototoxic platinum therapy, and otitis media). Evidence was also found for a number of non-otological risk factors including temporo-mandibular joint disorder, depression, chronic obstructive pulmonary disease, and hyperlipidemia. Negative associations indicating preventative effects were found for diabetes and high alcohol consumption. No associations were found for low alcohol consumption, body mass index, head injury, heart failure, hypertension, leisure noise exposure, migraine, rheumatoid arthritis, sex, smoking, stroke, and whiplash. However, with the exception of unspecified hearing loss, these findings resulted from pooling no more than 4 studies, illustrating that the vast majority of the associations still remain inconclusive. CONCLUSIONS These systematic review and meta-analysis confirm a number of otological and non-otological risk factors for tinnitus. By highlighting major gaps in knowledge, our synthesis can help provide direction for future research that will shed light on the pathophysiology, improve management strategies, and inform more effective preventions.
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Affiliation(s)
- Roshni Biswas
- Hearing Sciences, School of Medicine, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Eleni Genitsaridi
- Hearing Sciences, School of Medicine, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Natalia Trpchevska
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Christopher R Cederroth
- Hearing Sciences, School of Medicine, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK.
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK.
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Deborah A Hall
- Hearing Sciences, School of Medicine, Mental Health and Clinical Neurosciences, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
- School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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9
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Bhatt IS, Wilson N, Dias R, Torkamani A. A genome-wide association study of tinnitus reveals shared genetic links to neuropsychiatric disorders. Sci Rep 2022; 12:22511. [PMID: 36581688 PMCID: PMC9800371 DOI: 10.1038/s41598-022-26413-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022] Open
Abstract
Tinnitus, a phantom perception of sound in the absence of any external sound source, is a prevalent health condition often accompanied by psychiatric comorbidities. Recent genome-wide association studies (GWAS) highlighted a polygenic nature of tinnitus susceptibility. A shared genetic component between tinnitus and psychiatric conditions remains elusive. Here we present a GWAS using the UK Biobank to investigate the genetic processes linked to tinnitus and tinnitus-related distress, followed by gene-set enrichment analyses. The UK Biobank sample comprised 132,438 individuals with tinnitus and genotype data. Among the study sample, 38,525 individuals reported tinnitus, and 26,889 participants mentioned they experienced tinnitus-related distress in daily living. The genome-wide association analyses were conducted on tinnitus and tinnitus-related distress. We conducted enrichment analyses using FUMA to further understand the genetic processes linked to tinnitus and tinnitus-related distress. A genome-wide significant locus (lead SNP: rs71595470) for tinnitus was obtained in the vicinity of GPM6A. Nineteen independent loci reached suggestive association with tinnitus. Fifteen independent loci reached suggestive association with tinnitus-related distress. The enrichment analysis revealed a shared genetic component between tinnitus and psychiatric traits, such as bipolar disorder, feeling worried, cognitive ability, fast beta electroencephalogram, and sensation seeking. Metabolic, cardiovascular, hematological, and pharmacological gene sets revealed a significant association with tinnitus. Anxiety and stress-related gene sets revealed a significant association with tinnitus-related distress. The GWAS signals for tinnitus were enriched in the hippocampus and cortex, and for tinnitus-related distress were enriched in the brain and spinal cord. This study provides novel insights into genetic processes associated with tinnitus and tinnitus-related distress and demonstrates a shared genetic component underlying tinnitus and psychiatric conditions. Further collaborative attempts are necessary to identify genetic components underlying the phenotypic heterogeneity in tinnitus and provide biological insight into the etiology.
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Affiliation(s)
- Ishan Sunilkumar Bhatt
- grid.214572.70000 0004 1936 8294Department of Communication Sciences & Disorders, University of Iowa, 250 Hawkins Dr, Iowa City, IA 52242 USA
| | - Nicholas Wilson
- Department of Integrative Structural and Computational Biology Scripps Science Institute, La Jolla, CA 92037 USA
| | - Raquel Dias
- grid.15276.370000 0004 1936 8091Department of Microbiology and Cell Science, University of Florida, Gainesville, FL 32608 USA
| | - Ali Torkamani
- Department of Integrative Structural and Computational Biology Scripps Science Institute, La Jolla, CA 92037 USA
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Marcrum SC, Engelke M, Goedhart H, Langguth B, Schlee W, Vesala M, Simoes JP. The Influence of Diet on Tinnitus Severity: Results of a Large-Scale, Online Survey. Nutrients 2022; 14:nu14245356. [PMID: 36558515 PMCID: PMC9784733 DOI: 10.3390/nu14245356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022] Open
Abstract
Optimization of dietary intake is an essential component in the multidimensional effort to prevent and manage chronic disease. Recently, demand has increased for nutrition-focused management strategies for chronic tinnitus. The primary aim of this study was to evaluate 10 dietary items for their association with changes in subjective tinnitus severity. A secondary aim was to develop an algorithm to better identify those individuals who might benefit from dietary modification strategies. A total of 5017 anonymous users of the TinnitusTalk forum completed an online survey regarding how various dietary items affected the severity of their tinnitus. Results suggest that, while intake of caffeine [positive effect (PE): 0.4%; negative effect (NE): 16.2%], alcohol (PE: 2.7%; NE: 13.3%, and salt (PE: 0.1%; NE: 9.9%) was most likely to influence tinnitus severity, it did so only for a small proportion of participants and reported effects were most commonly mild. Further, though a classification algorithm was able to leverage participant demographic, comorbidity, and tinnitus characteristics to identify those individuals most likely to benefit from dietary modification above chance levels, further efforts are required to achieve significant clinical utility. Taken together, these results do not support dietary modification as a primary treatment strategy for chronic tinnitus in the general population, though clinically meaningful effects might be observable in certain individuals.
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Affiliation(s)
- Steven C. Marcrum
- Department of Otolaryngology, University Hospital Regensburg, 93053 Regensburg, Germany
- Correspondence: ; Tel.: +49-941-944-9462
| | - Milena Engelke
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
| | | | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
- Institute for Information and Process Management, Eastern University of Applied Sciences, 9000 St. Gallen, Switzerland
| | | | - Jorge P. Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Bezirksklinikum Regensburg, 93053 Regensburg, Germany
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Jarach CM, Lugo A, Scala M, van den Brandt PA, Cederroth CR, Odone A, Garavello W, Schlee W, Langguth B, Gallus S. Global Prevalence and Incidence of Tinnitus: A Systematic Review and Meta-analysis. JAMA Neurol 2022; 79:888-900. [PMID: 35939312 PMCID: PMC9361184 DOI: 10.1001/jamaneurol.2022.2189] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 06/13/2022] [Indexed: 12/23/2022]
Abstract
Importance To date, no systematic review has taken a meta-analytic approach to estimating the prevalence and incidence of tinnitus in the general population. Objective To provide frequency estimates of tinnitus worldwide. Data Sources An umbrella review followed by a traditional systematic review was performed by searching PubMed-MEDLINE and Embase from inception through November 19, 2021. Study Selection Research data from the general population were selected, and studies based on patients or on subgroups of the population with selected lifestyle habits were excluded. No restrictions were applied according to date, age, sex, and country. Data Extraction and Synthesis Relevant extracted information included type of study, time and location, end point, population characteristics, and tinnitus definition. The study followed the Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline. Main Outcomes and Measures Pooled prevalence estimates of any tinnitus, severe tinnitus, chronic tinnitus, and diagnosed tinnitus as well as incidence of tinnitus were obtained using random-effects meta-analytic models; heterogeneity between studies was controlled using the χ2 test, and inconsistency was measured using the I2 statistic. Results Among 767 publications, 113 eligible articles published between 1972 and 2021 were identified, and prevalence estimates from 83 articles and incidence estimates from 12 articles were extracted. The pooled prevalence of any tinnitus among adults was 14.4% (95% CI, 12.6%-16.5%) and ranged from 4.1% (95% CI, 3.7%-4.4%) to 37.2% (95% CI, 34.6%-39.9%). Prevalence estimates did not significantly differ by sex (14.1% [95% CI, 11.6%-17.0%] among male individuals; 13.1% [95% CI, 10.5%-16.2%] among female individuals), but increased prevalence was associated with age (9.7% [95% CI, 7.4%-12.5%] among adults aged 18-44 years; 13.7% [95% CI, 11.0%-17.0%] among those aged 45-64 years; and 23.6% [95% CI, 19.4%-28.5%] among those aged ≥65 years; P < .001 among age groups). The pooled prevalence of severe tinnitus was 2.3% (95% CI, 1.7%-3.1%), ranging from 0.5% (95% CI, 0.3%-0.7%) to 12.6% (95% CI, 11.1%-14.1%). The pooled prevalence of chronic tinnitus was 9.8% (95% CI, 4.7%-19.3%) and the pooled prevalence of diagnosed tinnitus was 3.4% (95% CI, 2.1%-5.5%). The pooled incidence rate of any tinnitus was 1164 per 100 000 person-years (95% CI, 479-2828 per 100 000 person-years). Conclusions and Relevance Despite the substantial heterogeneity among studies, this comprehensive systematic review on the prevalence and incidence of tinnitus suggests that tinnitus affects more than 740 million adults globally and is perceived as a major problem by more than 120 million people, mostly aged 65 years or older. Health policy makers should consider the global burden of tinnitus, and greater effort should be devoted to boost research on tinnitus.
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Affiliation(s)
- Carlotta M. Jarach
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandra Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Marco Scala
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Piet A. van den Brandt
- GROW–School for Oncology and Developmental Biology, Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
- Care and Public Health Research Institute–School for Public Health and Primary Care, Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Christopher R. Cederroth
- Laboratory of Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham University Hospitals National Health Service Trust, Nottingham, United Kingdom
- Division of Clinical Neuroscience, Hearing Sciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Anna Odone
- School of Medicine, University Vita-Salute San Raffaele, Milan, Italy
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Werner Garavello
- School of Medicine and Surgery, Department of Otorhinolaryngology, University of Milan–Bicocca, Milan, Italy
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Silvano Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
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Biswas R, Lugo A, Akeroyd M, Schlee W, Gallus S, Hall D. Tinnitus prevalence in Europe: a multi-country cross-sectional population study. THE LANCET REGIONAL HEALTH. EUROPE 2022; 12:100250. [PMID: 34950918 PMCID: PMC8671623 DOI: 10.1016/j.lanepe.2021.100250] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
BACKGROUND Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare resource use and hearing difficulty with tinnitus symptoms. METHODS Between 2017-2018, a cross-sectional European Tinnitus Survey (ETS) was conducted in 12 European Union nations (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain), using a standardised set of tinnitus-related questions and response options in country-specific languages. We recruited 11,427 adults aged ≥18 years. FINDINGS Prevalence of any tinnitus was 14·7% (14·0% in men and 15·2% in women), ranging from 8·7% in Ireland to 28·3% in Bulgaria. Severe tinnitus was found in 1·2% participants (1·0% in men and 1·4% in women), ranging from 0·6% in Ireland to 4·2% in Romania. Tinnitus prevalence significantly increased with increasing age and worsening of hearing status. Healthcare resource use for tinnitus increased with increasing tinnitus symptom severity. INTERPRETATION This is the first multinational report of Pan-European tinnitus prevalence using standardised questions. The overall prevalence estimates refine previous findings, although widespread inter-country heterogeneity was noted. The results indicate that more than 1 in 7 adults in the EU have tinnitus. Extrapolating to the overall population, approximately 65 million adults in EU28 have tinnitus, 26 million have bothersome tinnitus and 4 million have severe tinnitus. FUNDING National Institute for Health Research, European Union's Horizon 2020, Medical Research Council, and GENDER-Net Co-Plus Fund.
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Affiliation(s)
- R. Biswas
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - A. Lugo
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - M.A. Akeroyd
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
| | - W. Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - S. Gallus
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - D.A. Hall
- Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham. UK
- School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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13
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Biswas R, Schiller A, Casolani C, Daoud E, Dode A, Genitsaridi E, Jacquemin L, Liyanage N, Lourenco M, Makani P, Parameshwarappa V, Riha C, L Santacruz J, Shabbir M, Simoes J, Trpchevska N, Schoisswohl S. Doctoral Studies as part of an Innovative Training Network (ITN): Early Stage Researcher (ESR) experiences. OPEN RESEARCH EUROPE 2021; 1:34. [PMID: 37645158 PMCID: PMC10446088 DOI: 10.12688/openreseurope.13094.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 08/31/2023]
Abstract
Background: The Marie-Skłodowska-Curie Actions' (MSCA) Innovative Training Network (ITN) is a doctoral training programme jointly implemented by academic institutions and industries from countries across Europe and beyond. To our knowledge no study has examined the experience of students participating in MSCA-ITNs. This study aims to evaluate and report MSCA-ITN Early Stage Researcher (ESR) experiences. Methods: The Innovative Training Network - Evaluation Questionnaire (ITN-EQ) was developed to assess supervision, training, collaborations and experiences of ESRs and forwarded to two tinnitus-related ITNs and seven ITNs of other disciplines. Results: Key advantages identified included better career prospects, multidisciplinary research opportunities/collaborations, international exposure, personal/professional development, plus generous salaries and research budgets. However, lack of a common EU framework resulted in the experience being largely dependent on the host institution, country and supervisor. Moreover, managing the dual requirements of ITNs and host institutions while completing a three-year PhD seemed challenging for most ESRs. ESR involvement in workshop and training school planning was desirable. More than 80% of ESRs rated the overall ITN experience favourably and 98.3% would recommend the same to prospective PhD students. Conclusions: This report could provide valuable insights in planning and management of future ITNs and could assist prospective students in their decision of joining an ITN for their PhD.
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Affiliation(s)
- Roshni Biswas
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Axel Schiller
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Chiara Casolani
- Tinnitus Assessment Causes Treatments (TIN-ACT), Groningen, The Netherlands
- Hearing System Section, Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
- Oticon A/S, DK-2765 Smørum, Denmark
- Interacoustics Research Unit, DK-2800 Lyngby, Denmark
| | - Elza Daoud
- Tinnitus Assessment Causes Treatments (TIN-ACT), Groningen, The Netherlands
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Albi Dode
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
| | - Eleni Genitsaridi
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham, UK
| | - Laure Jacquemin
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Dept. of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Nuwan Liyanage
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- University of Zurich, Zurich, Switzerland
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Matheus Lourenco
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Experimental Health Psychology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Health Psychology Research Group, Faculty of Psychology and Educational Sciences,, University of Leuven, Leuven, Belgium
| | - Punitkumar Makani
- Tinnitus Assessment Causes Treatments (TIN-ACT), Groningen, The Netherlands
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Vinay Parameshwarappa
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Centre National de la Recherche Scientifique, Aix-Marseille University, Marseille, France
| | - Constanze Riha
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Department of Neuropsychology, University of Zurich, Zurich, Switzerland
| | - Jose L Santacruz
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- 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 Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, The Netherlands
| | - Maryam Shabbir
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Tinnitus Assessment Causes Treatments (TIN-ACT), Groningen, The Netherlands
| | - Jorge Simoes
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Natalia Trpchevska
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Experimental Audiology, Department of Physiology and Pharmacology, Biomedicum, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Schoisswohl
- European School on Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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14
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Preface. PROGRESS IN BRAIN RESEARCH 2021. [PMID: 34243894 DOI: 10.1016/s0079-6123(21)00144-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register]
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