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Chen Q, Lv H, Wang Z, Li X, Wang X, Huang Y, Zhao P, Yang Z, Gong S, Wang Z. Multimodal quantitative magnetic resonance imaging of the thalamus in tinnitus patients with different outcomes after sound therapy. CNS Neurosci Ther 2023; 29:4070-4081. [PMID: 37392024 PMCID: PMC10651975 DOI: 10.1111/cns.14330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/08/2023] [Accepted: 06/18/2023] [Indexed: 07/02/2023] Open
Abstract
AIMS This study systematically investigated structural and functional alterations in the thalamus and its subregions using multimodal magnetic resonance imaging (MRI) and examined its clinical relevance in tinnitus patients with different outcomes after sound therapy (narrowband noise). METHODS In total, 60 patients with persistent tinnitus and 57 healthy controls (HCs) were recruited. Based on treatment efficacy, 28 patients were categorized into the effective group and 32 into the ineffective group. Five MRI measurements of the thalamus and its seven subregions, including gray matter volume, fractional anisotropy, fractional amplitude of low-frequency fluctuation, and functional connectivity (FC), were obtained for each participant and compared between the groups. RESULTS Patients in both the groups exhibited widespread functional and diffusion abnormalities in the whole thalamus and several subregions, with more obvious changes observed in the effective group. All tinnitus patients had abnormal FC compared with the HCs; FC differences between the two patient groups were only observed in the striatal network, auditory-related cortex, and the core area of the limbic system. We combined the multimodal quantitative thalamic alterations and used it as an imaging indicator to evaluate prognosis before sound therapy and achieved a sensitivity of 71.9% and a specificity of 85.7%. CONCLUSION Similar patterns of thalamic alterations were identified in tinnitus patients with different outcomes, with more obvious changes observed in the effective group. Our findings support the tinnitus generation hypothesis of frontostriatal gating system dysfunction. A combination of multimodal quantitative thalamic properties may be used as indicators to predict tinnitus prognosis before sound therapy.
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Affiliation(s)
- Qian Chen
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Han Lv
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhaodi Wang
- Department of OtolaryngologyBeijing Jingmei Group General HospitalBeijingChina
| | - Xiaoshuai Li
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Xinghao Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | | | - Pengfei Zhao
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenghan Yang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck SurgeryBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
| | - Zhenchang Wang
- Department of RadiologyBeijing Friendship Hospital, Capital Medical UniversityBeijingChina
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Lin CT, Ghosh S, Hinkley LB, Dale CL, Souza ACS, Sabes JH, Hess CP, Adams ME, Cheung SW, Nagarajan SS. Multi-tasking deep network for tinnitus classification and severity prediction from multimodal structural MR images. J Neural Eng 2023; 20. [PMID: 36595270 DOI: 10.1088/1741-2552/acab33] [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: 07/13/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022]
Abstract
Objective:Subjective tinnitus is an auditory phantom perceptual disorder without an objective biomarker. Fast and efficient diagnostic tools will advance clinical practice by detecting or confirming the condition, tracking change in severity, and monitoring treatment response. Motivated by evidence of subtle anatomical, morphological, or functional information in magnetic resonance images of the brain, we examine data-driven machine learning methods for joint tinnitus classification (tinnitus or no tinnitus) and tinnitus severity prediction.Approach:We propose a deep multi-task multimodal framework for tinnitus classification and severity prediction using structural MRI (sMRI) data. To leverage complementary information multimodal neuroimaging data, we integrate two modalities of three-dimensional sMRI-T1 weighted (T1w) and T2 weighted (T2w) images. To explore the key components in the MR images that drove task performance, we segment both T1w and T2w images into three different components-cerebrospinal fluid, grey matter and white matter, and evaluate performance of each segmented image.Main results:Results demonstrate that our multimodal framework capitalizes on the information across both modalities (T1w and T2w) for the joint task of tinnitus classification and severity prediction.Significance:Our model outperforms existing learning-based and conventional methods in terms of accuracy, sensitivity, specificity, and negative predictive value.
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Affiliation(s)
- Chieh-Te Lin
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Sanjay Ghosh
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Leighton B Hinkley
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Corby L Dale
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Ana C S Souza
- Department of Telecommunication and Mechatronics Engineering, Federal University of Sao Joao del-Rei, Praca Frei Orlando, 170, Sao Joao del Rei 36307, MG, Brazil
| | - Jennifer H Sabes
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2380 Sutter St., San Francisco, CA 94115, United States of America
| | - Christopher P Hess
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America
| | - Meredith E Adams
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Phillips Wangensteen Building, 516 Delaware St., Minneapolis, MN 55455, United States of America
| | - Steven W Cheung
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2380 Sutter St., San Francisco, CA 94115, United States of America.,Surgical Services, Veterans Affairs, 4150 Clement St., San Francisco, CA 94121, United States of America
| | - Srikantan S Nagarajan
- Department of Radiology and Biomedical Imaging, University of California San Francisco, 513 Parnassus Ave, San Francisco, CA 94143, United States of America.,Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, 2380 Sutter St., San Francisco, CA 94115, United States of America.,Surgical Services, Veterans Affairs, 4150 Clement St., San Francisco, CA 94121, United States of America
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Siegbahn M, Engmér Berglin C, Moreno R. Automatic segmentation of the core of the acoustic radiation in humans. Front Neurol 2022; 13:934650. [PMID: 36212647 PMCID: PMC9539320 DOI: 10.3389/fneur.2022.934650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 09/19/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Acoustic radiation is one of the most important white matter fiber bundles of the human auditory system. However, segmenting the acoustic radiation is challenging due to its small size and proximity to several larger fiber bundles. TractSeg is a method that uses a neural network to segment some of the major fiber bundles in the brain. This study aims to train TractSeg to segment the core of acoustic radiation. Methods We propose a methodology to automatically extract the acoustic radiation from human connectome data, which is both of high quality and high resolution. The segmentation masks generated by TractSeg of nearby fiber bundles are used to steer the generation of valid streamlines through tractography. Only streamlines connecting the Heschl's gyrus and the medial geniculate nucleus were considered. These streamlines are then used to create masks of the core of the acoustic radiation that is used to train the neural network of TractSeg. The trained network is used to automatically segment the acoustic radiation from unseen images. Results The trained neural network successfully extracted anatomically plausible masks of the core of the acoustic radiation in human connectome data. We also applied the method to a dataset of 17 patients with unilateral congenital ear canal atresia and 17 age- and gender-paired controls acquired in a clinical setting. The method was able to extract 53/68 acoustic radiation in the dataset acquired with clinical settings. In 14/68 cases, the method generated fragments of the acoustic radiation and completely failed in a single case. The performance of the method on patients and controls was similar. Discussion In most cases, it is possible to segment the core of the acoustic radiations even in images acquired with clinical settings in a few seconds using a pre-trained neural network.
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Affiliation(s)
- Malin Siegbahn
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
- Medical Unit Ear, Nose, Throat and Hearing, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Engmér Berglin
- Division of Ear, Nose and Throat Diseases, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
- Medical Unit Ear, Nose, Throat and Hearing, Karolinska University Hospital, Stockholm, Sweden
| | - Rodrigo Moreno
- Department of Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden
- *Correspondence: Rodrigo Moreno
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Tinnitus Perception in Light of Parietal Operculo–Insular Involvement: A Review. Brain Sci 2022; 12:brainsci12030334. [PMID: 35326290 PMCID: PMC8946618 DOI: 10.3390/brainsci12030334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 12/07/2022] Open
Abstract
In tinnitus literature, researchers have increasingly been advocating for a clearer distinction between tinnitus perception and tinnitus-related distress. In non-bothersome tinnitus, the perception itself can be more specifically investigated: this has provided a body of evidence, based on resting-state and activation fMRI protocols, highlighting the involvement of regions outside the conventional auditory areas, such as the right parietal operculum. Here, we aim to conduct a review of available investigations of the human parietal operculo–insular subregions conducted at the microscopic, mesoscopic, and macroscopic scales arguing in favor of an auditory–somatosensory cross-talk. Both the previous literature and new results on functional connectivity derived from cortico–cortical evoked potentials show that these subregions present a dense tissue of interconnections and a strong connectivity with auditory and somatosensory areas in the healthy brain. Disrupted integration processes between these modalities may thus result in erroneous perceptions, such as tinnitus. More precisely, we highlight the role of a subregion of the right parietal operculum, known as OP3 according to the Jülich atlas, in the integration of auditory and somatosensory representation of the orofacial muscles in the healthy population. We further discuss how a dysfunction of these muscles could induce hyperactivity in the OP3. The evidence of direct electrical stimulation of this area eliciting auditory hallucinations further suggests its involvement in tinnitus perception. Finally, a small number of neuroimaging studies of therapeutic interventions for tinnitus provide additional evidence of right parietal operculum involvement.
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