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Brueggemann P, Goebel G, Boecking B, Hofrichter N, Rose M, Mazurek B. [Analysis of items on the short forms of the tinnitus questionnaire: Mini-TQ-12 and Mini-TQ-15]. HNO 2023; 71:708-718. [PMID: 37702795 PMCID: PMC10589196 DOI: 10.1007/s00106-023-01365-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND A brief but reliable measurement of tinnitus-related distress is crucial for understanding and treatment options for this often very limiting symptom. Several self-report questionnaires are used in German-speaking countries and several short versions exist for the German translation of the Tinnitus Questionnaire (TQ). OBJECTIVE In the present work, the frequently used Mini-TQ-12 questionnaire and the newly developed Mini-TQ-15 questionnaire will be investigated with regard to reliability, item difficulty, sensitivity (discriminatory power), and predictive power of the items in order to facilitate a decision for one or the other questionnaire in different examination contexts. METHODS Data from 1409 patients with chronic tinnitus who completed the German 52-item version of the TQ and additional psychological tests (ADS‑L, BSF, PHQ, ACSA and SWOP) at the Tinnitus Centre of the Charité Universitaetsmedizin Berlin, Germany, were retrospectively analyzed. We performed external validation of items from different versions of the TQ (original version, Mini-TQ-12, and Mini-TQ-15). RESULTS The items of the Mini-TQ-12 and the Mini-TQ-15 predicted specifically the total score. Both short questionnaires are of comparable quality in terms of reliability and item construction (difficulty, discriminatory power). CONCLUSION Both questionnaires have a very good item quality and are clinically more efficient to use than the long-form TQ. If a similarity of the factor structure to the original questionnaire is required for research questions, the use of the Mini-TQ-15 is recommended.
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Affiliation(s)
- Petra Brueggemann
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland
| | - Gerhard Goebel
- Tinnitus- und Hyperakusis-Zentrum, Neurozentrum Prien, Prien am Chiemsee, Deutschland
| | - Benjamin Boecking
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland
| | - Nienke Hofrichter
- Klinik für Innere Medizin und Psychosomatik, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Matthias Rose
- Klinik für Innere Medizin und Psychosomatik, Charité - Universitätsmedizin Berlin, Berlin, Deutschland
| | - Birgit Mazurek
- Tinnituszentrum, Charité - Universitätsmedizin Berlin, Luisenstraße 13, 10117, Berlin, Deutschland.
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Khan N, Lewis AT. Influence of Bone Conduction Hearing Device Implantation on Health-Related Quality of Life for Patients with and without Tinnitus. Audiol Res 2023; 13:573-585. [PMID: 37622926 PMCID: PMC10451704 DOI: 10.3390/audiolres13040050] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: Tinnitus, often related to hearing loss, is an addressable public health concern affecting health-related quality of life (HRQoL). This study aimed to explore the influence of bone conduction hearing aid (BCHA) implantation on HRQoL and hearing disability in patients with hearing loss suffering from tinnitus. (2) Methods: Data were collected from an international hearing implant registry. Health Utilities Index Mark 3 (HUI-3), Spatial and Qualities of Hearing- 49 Questionnaire (SSQ) and self-reported tinnitus burden data for adult patients implanted with a BCHA (n = 42) who provided baseline as well as follow-up data 1-year post-implantation were extracted from the registry. Wilcoxon signed rank tests and paired samples t-tests were used to analyse outcomes data. (3) Results: Patients, with or without tinnitus, demonstrated clinically important mean improvements in HUI-3 multi-attribute utility scores, HUI-3 hearing attribute and SSQ scores. Hearing loss patients with tinnitus presented with a lower HRQoL than patients without tinnitus. (4) Conclusions: These findings demonstrate the importance of hearing rehabilitation in improving the quality of life and hearing disability of patients with or without tinnitus and in providing tinnitus relief in some patients with hearing loss and tinnitus.
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Affiliation(s)
- Nasrene Khan
- School of Public Health and Community Medicine, University of Gothenburg, 40530 Gothenburg, Sweden;
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Reyes Orozco F, Lin M, Clark B, Doherty JK, Oghalai JS, Voelker CCJ, Choi JS. Association between Cannabis Use and Tinnitus in US Adults. Otol Neurotol 2023; 44:611-618. [PMID: 37254263 DOI: 10.1097/mao.0000000000003895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE Assess the association between cannabis use and tinnitus in a nationally representative sample of US adults. STUDY DESIGN Cross-sectional. SETTING Population-based. PATIENTS Adults aged 20 to 59 years who participated in 2011 to 2012 and 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) with available data on tinnitus, audiometry, and substance use. INTERVENTION None. MAIN OUTCOME MEASURE Tinnitus, demographic information, and medical history were obtained from NHANES questionnaires. Tinnitus was defined as bothersome tinnitus in the past year. Cannabis use was categorized as never use, low-volume use (1-2 pipes/joints per day), and high-volume use (3+ pipes/joints per day). Multivariable regression models with interaction and mediation analyses were conducted. Sampling weights were incorporated to yield results generalizable to the US population. RESULTS Tinnitus prevalence was significantly higher among high-volume cannabis users (odds ratio [OR], 20.5%; 95% confidence interval [CI], 16.0-26.0%]) and low-volume users (OR, 17.0%; 95% CI, 14.3-20.0%) than nonusers (OR, 12.0%; 95% CI, 10.4-13.9%). High-volume cannabis use was significantly associated with tinnitus relative to nonusers in multivariable models adjusting for demographics, cardiovascular factors, hearing loss, noise exposure, and depression (OR, 2.05; 95% CI, 1.1-3.9). Tinnitus severity was comparable among high volume, low volume, and noncannabis users. There was no significant mediation or interaction of depression affecting the association between cannabis use and tinnitus. CONCLUSIONS Bothersome tinnitus prevalence was significantly higher among cannabis users relative to nonusers. High-volume cannabis use was independently associated with tinnitus in a multivariable model accounting for relevant factors including depression. Future study is warranted to elucidate the impact of various levels of cannabis use on tinnitus.
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Affiliation(s)
- Francis Reyes Orozco
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Matthew Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Bhavishya Clark
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | - Joni K Doherty
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | - John S Oghalai
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, California
| | | | - Janet S Choi
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota
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Lin D, Selleck AM. Tinnitus cases after COVID-19 vaccine administration, one institution's observations. Am J Otolaryngol 2023; 44:103863. [PMID: 36989754 PMCID: PMC10036149 DOI: 10.1016/j.amjoto.2023.103863] [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: 02/24/2023] [Accepted: 03/19/2023] [Indexed: 03/25/2023]
Abstract
OBJECTIVE After the role out of the COVID-19 vaccine in the United States, there has been increase in case reports of tinnitus attributed to the vaccine reported. We present our institution's experience over the initial 13 month period the vaccines were available. STUDY DESIGN Retrospective chart review. SETTING Tertiary academic otology and general otolaryngology practice. PATIENTS Patients who received a COVID-19 vaccine and a tinnitus diagnosis code. INTERVENTIONS Observation, steroids (oral and intratympanic), diagnostic imaging and audiometry. MAIN OUTCOME MEASURES Patients who received a COVID-19 vaccine in the time frame of 12/1/2020-12/31/21 with a diagnosis of tinnitus, an audiogram, and at least one visit with one of our Otolaryngologists were included in the study. Twenty-seven of the 1254 patients identified met these criteria. The patients ranged in age from 41 to 84 years old including seven male and twenty female patients. Sixteen received the Pfizer vaccine, seven received the Moderna vaccine and four patients received the Janssen vaccine. CONCLUSIONS No definite correlation could be established between COVID-19 vaccine and tinnitus. Any concurrent sudden hearing loss should be treated as usual with oral or intratympanic steroids. Health care providers should be aware of the tinnitus onset and if new or recent onset, to refer for prompt audiogram and Otolaryngology evaluation.
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Affiliation(s)
- Doris Lin
- University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599-7070, United States of America.
| | - Anne Morgan Selleck
- University of North Carolina at Chapel Hill, 170 Manning Drive, Campus Box 7070, Chapel Hill, NC 27599-7070, United States of America.
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Vaziri Z, Salmon CEG, Ghodratitoostani I, Santos ACD, Hyppolito MA, Delbem ACB, Leite JP. Down-Regulation of Tinnitus Negative Valence via Concurrent HD-tDCS and PEI Technique: A Pilot Study. Brain Sci 2023; 13:brainsci13050826. [PMID: 37239298 DOI: 10.3390/brainsci13050826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
Around 30% of the general population experience subjective tinnitus, characterized by conscious attended awareness perception of sound without an external source. Clinical distress tinnitus is more than just experiencing a phantom sound, as it can be highly disruptive and debilitating, leading those affected to seek clinical help. Effective tinnitus treatments are crucial for psychological well-being, but our limited understanding of the underlying neural mechanisms and a lack of a universal cure necessitate further treatment development. In light of the neurofunctional tinnitus model predictions and transcranial electrical stimulation, we conducted an open-label, single-arm, pilot study that utilized high-definition transcranial direct current stimulation (HD-tDCS) concurrent with positive emotion induction (PEI) techniques for ten consecutive sessions to down-regulate tinnitus negative valence in patients with clinical distress tinnitus. We acquired resting-state functional magnetic resonance imaging scans of 12 tinnitus patients (7 females, mean age = 51.25 ± 12.90 years) before and after the intervention to examine resting-state functional connectivity (rsFC) alterations in specific seed regions. The results showed reduced rsFC at post-intervention between the attention and emotion processing regions as follows: (1) bilateral amygdala and left superior parietal lobule (SPL), (2) left amygdala and right SPL, (3) bilateral dorsolateral prefrontal cortex (dlPFC) and bilateral pregenual anterior cingulate cortex (pgACC), and (4) left dlPFC and bilateral pgACC (FWE corrected p < 0.05). Furthermore, the post-intervention tinnitus handicap inventory scores were significantly lower than the pre-intervention scores (p < 0.05). We concluded that concurrent HD-tDCS and PEI might be effective in reducing tinnitus negative valence, thus alleviating tinnitus distress.
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Affiliation(s)
- Zahra Vaziri
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14048-900, Brazil
| | - Carlos E G Salmon
- InBrain Lab, Department of Physics, Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto 14040-901, Brazil
| | - Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos 13566-590, Brazil
| | - Antonio Carlos Dos Santos
- Department of Medical Imaging, Hematology and Clinical Oncology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Miguel A Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14049-900, Brazil
| | - Alexandre C B Delbem
- Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos 13566-590, Brazil
| | - João P Leite
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto 14048-900, Brazil
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Chen X, Ren L, Xue X, Yu N, Liu P, Shen W, Zhou H, Wang B, Zhou J, Yang S, Jiang Q. The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis. Brain Sci 2023; 13:brainsci13040583. [PMID: 37190548 DOI: 10.3390/brainsci13040583] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 03/24/2023] [Accepted: 03/28/2023] [Indexed: 05/17/2023] Open
Abstract
OBJECTIVE Sufferers of tinnitus, especially of the prolonged type, frequently suffer from comorbid depression and anxiety. From the perspective of the network model, this comorbidity is thought to be an interacting system of these two symptoms. In our study, we conducted a network analysis of depression and anxiety comorbidity in tinnitus sufferers, aiming to identify the central and bridge symptoms and make informed suggestions for clinical interventions and psychotherapy. METHOD A total of 566 tinnitus sufferers were enrolled in our study. The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder 7-Item Questionnaire (GAD-7) were selected to evaluate depression and anxiety symptoms, respectively, followed by network analysis to construct the interacting networks. RESULTS The findings identified six edges of strongest regularized partial correlations in this network. Of these, three were depression symptoms and three were anxiety symptoms. The anxiety symptoms "Unable to control worry" and "Relaxation difficulty" and the depression symptom "Feeling depressed or hopeless" had the highest expected influence centrality. The analysis results also revealed three bridge symptoms: "Afraid something awful might happen", "Feeling of worthlessness", and "Trouble concentrating". As for "Suicidal ideation", the direct relations between this symptom and "Afraid something awful might happen" and "Feeling depressed or hopeless" were the strongest. CONCLUSIONS The central and bridge symptoms of the interacting network of depression and anxiety symptoms in tinnitus sufferers can be considered a significant transdiagnostic intervention target for the management of this comorbidity. In particular, clinical prevention and psychotherapy should be implemented, targeting the symptoms that have the strongest associations with suicidal ideation.
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Affiliation(s)
- Xuemin Chen
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Lei Ren
- Department of Military Medical Psychology, Air Force Medical University, Xi'an 710032, China
| | - Xinmiao Xue
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Ning Yu
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Peng Liu
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Weidong Shen
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Hanwen Zhou
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Ben Wang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Jingcheng Zhou
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
- Medical School of Chinese PLA, Beijing 100853, China
| | - Shiming Yang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
| | - Qingqing Jiang
- Senior Department of Otolaryngology-Head & Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China
- National Clinical Research Center for Otolaryngologic Diseases, Beijing 100853, China
- State Key Lab of Hearing Science, Ministry of Education, Beijing 100853, China
- Beijing Key Lab of Hearing Impairment Prevention and Treatment, Beijing 100853, China
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Langguth B, Shiao AS, Lai JT, Chi TS, Weber F, Schecklmann M, Li LPH. Tinnitus and treatment-resistant depression. PROGRESS IN BRAIN RESEARCH 2023; 281:131-147. [PMID: 37806713 DOI: 10.1016/bs.pbr.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Tinnitus, a frequent disorder, is the conscious perception of a sound in the absence of a corresponding external acoustic sound source in the sense of a phantom sound. Although the majority of people who perceive a tinnitus sound can cope with it and are only minimaly impaired in their quality of lfe, 2-3% of the population perceive tinnitus as a major problem. Recently it has been proposed that the two groups should be differentiated by distict terms: "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. There is overwhelming evidence that a high tinnitus burden is associated with the increased occurrence of comorbidities, including depression. Since no causal therapeutic options are available for patients with tinnitus at the present time, the identification and adequate treatment of relevant comorbidities is of great importance for the reduction of tinnitus distress. This chapter deals with the relationship between tinnitus and depression. The neuronal mechanisms underlying tinnitus will first be discussed. There will also be an overview about depression and treatment resistant depression (TRD). A comprehensive review about the state-of-the-art evidences of the relationship between tinnitus and TRD will then be provided.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - An-Suey Shiao
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Jen-Tsung Lai
- Department of Otolaryngology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Tai-Shih Chi
- Department of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Franziska Weber
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Lieber Po-Hung Li
- Department of Otolaryngology, Cheng Hsin General Hospital, Taipei, Taiwan; Faculty of Medicine, and Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan; Integrated Brain Research Laboratory, Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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8
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Williams AP, Gourishetti SC, Flaherty MA, Eisenman DJ. Anxiety, Depression, and Symptom Severity in Patients with Pulsatile and Non-Pulsatile Tinnitus. Laryngoscope 2023; 133:683-688. [PMID: 35655445 DOI: 10.1002/lary.30238] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE(S) To compare the rates of anxiety and depression between patients with pulsatile (PT) and non-pulsatile tinnitus (NPT), and their correlation with tinnitus severity. METHODS A prospective cross-sectional study of consecutive patients presenting either to the otolaryngology clinic for pulsatile (PT) and NPT or to a tertiary care tinnitus habituation program (THP) were administered the tinnitus handicap inventory (THI), 7-item general anxiety disorder scale (GAD-7), and 9-item patient health questionnaire (PHQ-9). Median scores between groups and correlation of scores within groups were calculated and compared. RESULTS Median THI scores were significantly higher for THP and PT patients as compared with unselected NPT patients (58 and 44 vs. 20, p ≤ 0.001). Median GAD-7 (10 vs. 2.5 and 2, p ≤ 0.001) and PHQ-9 (7 vs. 4 and 4, p = 0.04) scores were highest in THP patients compared with PT and NPT. The strongest correlation between tinnitus handicap and psychiatric measures was seen in THP patients. CONCLUSION THP patients report higher levels of anxiety and depression compared with PT and other NPT patients. Tinnitus severity correlates more strongly with GAD-7 and PHQ-9 scores in THP patients compared with other patient groups. PT patients have a greater self-perceived tinnitus handicap than the general cohort of NPT patients, statistically comparable to THP patients. Despite this, anxiety and depression are not more severe in patients with PT as they are in THP patients. LEVEL OF EVIDENCE 2B Laryngoscope, 133:683-688, 2023.
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Affiliation(s)
- Allison P Williams
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Saikrishna C Gourishetti
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - Marissa A Flaherty
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
| | - David J Eisenman
- Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, U.S.A
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Mavedatnia D, Levin M, Lee JW, Hamour AF, Dizon K, Le T. Cannabis use amongst tinnitus patients: consumption patterns and attitudes. J Otolaryngol Head Neck Surg 2023; 52:19. [PMID: 36823672 PMCID: PMC9951523 DOI: 10.1186/s40463-022-00603-8] [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: 07/26/2022] [Accepted: 10/20/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Tinnitus has a significant impact on quality of life and causes considerable psychological distress. Cannabis is known to modulate neuron hyperexcitability, provide protection against auditory damage, and has been used for treatment for many diseases which have physiological similarities with tinnitus. The objective of this study was to survey patients presenting with tinnitus regarding their perspectives and usage patterns of cannabis. METHODS Patients with a primary presenting complaint of tinnitus in a tertiary neuro-otology clinic completed a 18-item questionnaire assessing perception, attitudes, and cannabis usage patterns. RESULTS Forty five patients completed the survey (mean age: 54.5 years, 31 females and 14 males). Overall, 96% of patients reported that they would consider cannabis as treatment for their tinnitus. Patients considered cannabis use for auditory symptoms (91%), and symptoms related to their tinnitus, such as emotional complaints (60%), sleep disturbances (64%), and functional disturbances (56%). 36% of patients had previously used cannabis and 22% of patients reported cannabis use at the time of the study. 80% of patients that were actively using cannabis reported that it helped with tinnitus-related symptoms, such as dizziness, anxiety, bodily pain, and sleep disturbances. Most patients would prefer to use edibles (62%), tablet (58%) and cream (47%) formulations of cannabis. Patients were concerned about the cost (29%), potential physical health implications (53%) and psychosocial side effects (60%) of cannabis. Over half of patients learned about cannabis from a friend or family member and only 22% of patients learned about cannabis from a physician or nurse. CONCLUSION Cannabis use is common amongst patients with tinnitus and current users of cannabis reported that it helped with their symptoms. Most patients would consider its use as a potential treatment to alleviate their tinnitus-related symptoms and are interested in learning more regarding its use. By understanding how cannabis is perceived by tinnitus patients, healthcare providers can provide appropriate patient education.
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Affiliation(s)
- Dorsa Mavedatnia
- grid.28046.380000 0001 2182 2255Faculty of Medicine, University of Ottawa, Ottawa, ON Canada
| | - Marc Levin
- grid.17063.330000 0001 2157 2938Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON Canada
| | - Jong Wook Lee
- grid.17063.330000 0001 2157 2938Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON Canada
| | - Amr F. Hamour
- grid.17063.330000 0001 2157 2938Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON Canada
| | - Kaye Dizon
- grid.413104.30000 0000 9743 1587Sunnybrook Health Sciences Center, Toronto, ON Canada
| | - Trung Le
- Department of Otolaryngology - Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
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10
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Odes R, Chin DL, Li J, Hong O. Association of Occupational Stress With Tinnitus Among Career Firefighters in the United States. J Occup Environ Med 2023; 65:e30-e35. [PMID: 36306205 DOI: 10.1097/jom.0000000000002742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study explores the relationship between occupational stress and tinnitus among firefighters, a group often exposed to two tinnitus risk factors: high stress and noise. METHODS This cross-sectional study includes 240 firefighters in the United States. Data describing demographic characteristics, occupational stress, noise exposure, and tinnitus were collected by survey. Occupational stress was measured using the short version of the Effort-Reward Imbalance Questionnaire. RESULTS Forty-three percent of participants reported experiencing tinnitus within the past month. For occupational stress, higher effort (odds ratio, 1.25; 95% confidence interval, 1.05 to 1.49) and higher effort-reward ratio (odds ratio, 12.28; 95% confidence interval, 3.08 to 48.86) were associated with increased odds of tinnitus, after adjustment for demographic characteristics and noise exposure. CONCLUSIONS Occupational stress may increase the likelihood of tinnitus for firefighters, an already at-risk group of workers. Health providers should incorporate stress assessment into tinnitus management programs.
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Affiliation(s)
- Rachel Odes
- From the Occupational and Environmental Health Nursing Graduate Program, School of Nursing, University of California San Francisco, San Francisco, California (Drs Odes, Chin, and Hong); National Clinician Scholars Program, Institute for Health Policy Studies, University of California San Francisco, San Francisco, California (Dr Odes); and Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, California (Dr Li)
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11
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Mazurek B, Rose M, Schulze H, Dobel C. Systems Medicine Approach for Tinnitus with Comorbid Disorders. Nutrients 2022; 14:nu14204320. [PMID: 36297004 PMCID: PMC9611054 DOI: 10.3390/nu14204320] [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: 07/28/2022] [Revised: 09/26/2022] [Accepted: 10/06/2022] [Indexed: 11/07/2022] Open
Abstract
Despite the fact that chronic diseases usually occur together with a spectrum of possible comorbidities that may differ strongly between patients, they are classically still viewed as distinct disease entities and, consequently, are often treated with uniform therapies. Unfortunately, such an approach does not take into account that different combinations of symptoms and comorbidities may result from different pathological (e.g., environmental, genetic, dietary, etc.) factors, which require specific and individualised therapeutic strategies. In this opinion paper, we aim to put forward a more differentiated, systems medicine approach to disease and patient treatment. To elaborate on this concept, we focus on the interplay of tinnitus, depression, and chronic pain. In our view, these conditions can be characterised by a variety of phenotypes composed of variable sets of symptoms and biomarkers, rather than distinct disease entities. The knowledge of the interplay of such symptoms and biomarkers will provide the key to a deeper, mechanistic understanding of disease pathologies. This paves the way for prediction and prevention of disease pathways, including more personalised and effective treatment strategies.
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Affiliation(s)
- Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
- Correspondence:
| | - Matthias Rose
- Medical Department, Division of Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, 10117 Berlin, Germany
| | - Holger Schulze
- Department of Otorhinolaryngology–Head and Neck Surgery, Universitätsklinikum Erlangen, 91054 Erlangen, Germany
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, 07743 Jena, Germany
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12
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Weber FC, Schlee W, Langguth B, Schecklmann M, Schoisswohl S, Wetter TC, Simões J. Low Sleep Satisfaction Is Related to High Disease Burden in Tinnitus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11005. [PMID: 36078720 PMCID: PMC9518088 DOI: 10.3390/ijerph191711005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 06/15/2023]
Abstract
Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However, no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life. This is a retrospective analysis of 2344 outpatients with tinnitus presenting at a tertiary German tinnitus clinic from 2010 to 2020. Patients who filled in five questionnaires (Tinnitus Handicap Inventory (THI), Tinnitus Questionnaire (TQ), Major Depression Inventory (MDI), Tinnitus Sample Case History Questionnaire (TSCHQ), and the World Health Organization Quality of Life Brief Version (WHOQOL-Bref)) were included. Based on the question about sleep satisfaction in the WHOQOL-Bref, group classification into (I) sleep-satisfied, (II) neither satisfied or dissatisfied, and (III) sleep-dissatisfied patients was performed. Associations between sleep satisfaction and quality of life, depression, tinnitus distress, and tinnitus characteristics were analyzed by group differences and a multinomial regression model with elastic net penalization. A total of 42.38% of patients were satisfied or very satisfied with sleep, whereas 40.91% of patients were dissatisfied or very dissatisfied with sleep. The remaining patients reported being neither satisfied nor dissatisfied with sleep. Sleep-dissatisfied patients were significantly more burdened in questionnaires on depressive symptoms (MDI), tinnitus distress (TQ, THI), and quality of life (WHOQOL-Bref). In addition, they suffered significantly more often from comorbidities such as headache, neck pain, or temporomandibular joint disorder (TMJ). The elastic net regression based on sum scores of THI, TQ, MDI, the four domains of WHOQOL-Bref, as well as all individual questions from the TSCHQ was able to classify patients satisfied with their sleep with an accuracy of 79%, 87.8% sensitivity, and 70.4% specificity. The model could not identify patients indifferent with the quality of their sleep (neither satisfied nor dissatisfied) (sensitivity: 0%; specificity: 100%). The accuracy of the model to predict patients dissatisfied with their sleep was 80.7%, with 83% sensitivity and 78.4% specificity. Poor physical and mental health (Domain I/II WHOQOL-Bref) as well as tinnitus distress were the strongest predictors of sleep dissatisfaction. Conversely, for sleep satisfaction, good physical and mental health as well as low tinnitus distress were the strongest predictors. The division into sleep-satisfied and sleep-dissatisfied tinnitus patients allows a very good discrimination regarding disease burden as indicated by depression, tinnitus distress, quality of life, and pain-related comorbidities. Physical and mental health as well as tinnitus distress seem to be strongly related to sleep satisfaction underscoring the concept of "tinnitus" versus "tinnitus disorder", but also the importance of sleep satisfaction as a global health indicator. Moreover, these data indicate the relevance of addressing sleep disorders in the therapeutic management of chronic tinnitus patients.
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Affiliation(s)
- Franziska C. Weber
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
| | - Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
- Department of Psychology, Bundeswehr University Munich, 85577 Neubiberg, Germany
| | - Thomas C. Wetter
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Center for Sleep Medicine, University of Regensburg, 93053 Regensburg, Germany
| | - Jorge Simões
- Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Centre, University of Regensburg, 93053 Regensburg, Germany
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13
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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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14
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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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15
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Degen CV, Mikuteit M, Niewolik J, Schröder D, Vahldiek K, Mücke U, Heinemann S, Müller F, Behrens GMN, Klawonn F, Dopfer-Jablonka A, Steffens S. Self-reported Tinnitus and Vertigo or Dizziness in a Cohort of Adult Long COVID Patients. Front Neurol 2022; 13:884002. [PMID: 35547372 PMCID: PMC9082801 DOI: 10.3389/fneur.2022.884002] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/30/2022] [Indexed: 11/13/2022] Open
Abstract
Tinnitus, vertigo and dizziness are symptoms commonly reported among Long and Post COVID patients, however the severity of these symptoms has not been assessed in large trials. Therefore, in this study a large cohort of Long COVID patients was surveyed about the presence and severity of tinnitus and vertigo or dizziness symptoms. The online survey was completed by a German cohort of 1,082 adult Long COVID patients after a mean period of 43.2 weeks ± 23.4 weeks after infection. Eighty percent were not fully vaccinated (at least two vaccinations) at the time of their first COVID symptoms and 9.8% were hospitalized in the course of their acute SARS-CoV-2 infection. At the time of the survey, 60% of patients reported the presence of vertigo or dizziness with a mean severity of 4.6 ± 2.7 on a scale of 1 (least severe) to 10 (most severe) and 30% complained of tinnitus with a mean severity of 4.8 ± 3.0. Approximately one fifth of the participants with tinnitus and vertigo or dizziness, rated their symptoms to be severe. The data shown in this study confirms that tinnitus and vertigo or dizziness are common symptoms in Long COVID patients and demonstrates, that a compelling number of patients rate their symptoms as severe. The self-reported severity highlights the need for Long COVID clinics to address these symptoms effectively. We suggest a multidisciplinary diagnostic and therapeutic approach to prevent further morbidity and socioeconomic burden for Long COVID patients suffering from severe vertigo, dizziness or tinnitus.
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Affiliation(s)
- Chantal Vanessa Degen
- Department of Otorhinolaryngology, Hannover Medical School, Hanover, Germany.,Dean's Office-Curriculum Development, Hannover Medical School, Hanover, Germany
| | - Marie Mikuteit
- Dean's Office-Curriculum Development, Hannover Medical School, Hanover, Germany.,Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Jacqueline Niewolik
- Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
| | - Dominik Schröder
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
| | - Kai Vahldiek
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany
| | - Urs Mücke
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hanover, Germany
| | - Stephanie Heinemann
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Frank Müller
- Department of General Practice, University Medical Center Göttingen, Göttingen, Germany
| | - Georg Martin Norbert Behrens
- Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research, Brunswick, Germany
| | - Frank Klawonn
- Department of Computer Science, Ostfalia University of Applied Sciences, Wolfenbüttel, Germany.,Biostatistics Research Group, Helmholtz Centre for Infection Research, Brunswick, Germany
| | - Alexandra Dopfer-Jablonka
- Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany.,German Center for Infection Research, Brunswick, Germany
| | - Sandra Steffens
- Dean's Office-Curriculum Development, Hannover Medical School, Hanover, Germany.,Department for Rheumatology and Immunology, Hannover Medical School, Hanover, Germany
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16
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Brueggemann P, Mebus W, Boecking B, Amarjargal N, Niemann U, Spiliopoulou M, Dobel C, Rose M, Mazurek B. Dimensions of Tinnitus-Related Distress. Brain Sci 2022; 12:brainsci12020275. [PMID: 35204037 PMCID: PMC8870247 DOI: 10.3390/brainsci12020275] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives: (1) To determine which psychosocial aspects predict tinnitus-related distress in a large self-reported dataset of patients with chronic tinnitus, and (2) to identify underlying constructs by means of factor analysis. Methods: A cohort of 1958 patients of the Charité Tinnitus Center, Berlin completed a large questionnaire battery that comprised sociodemographic data, tinnitus-related distress, general psychological stress experience, emotional symptoms, and somatic complaints. To identify a construct of “tinnitus-related distress”, significant predictive items were grouped using factor analysis. Results: For the prediction of tinnitus-related distress (linear regression model with R2 = 0.7), depressive fatigue symptoms (concentration, sleep, rumination, joy decreased), the experience of emotional strain, somatization tendencies (pain experience, doctor contacts), and age appeared to play a role. The factor analysis revealed five factors: “stress”, “pain experience”, “fatigue”, “autonomy”, and low “educational level”. Conclusions: Tinnitus-related distress is predicted by psychological and sociodemographic indices. Relevant factors seem to be depressive exhaustion with somatic expressions such as sleep and concentration problems, somatization, general psychological stress, and reduced activity, in addition to higher age.
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Affiliation(s)
- Petra Brueggemann
- Tinnitus Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (P.B.); (W.M.); (B.B.); (N.A.)
| | - Wilhelm Mebus
- Tinnitus Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (P.B.); (W.M.); (B.B.); (N.A.)
| | - Benjamin Boecking
- Tinnitus Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (P.B.); (W.M.); (B.B.); (N.A.)
| | - Nyamaa Amarjargal
- Tinnitus Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (P.B.); (W.M.); (B.B.); (N.A.)
| | - Uli Niemann
- Knowledge Management & Discovery Lab, Faculty of Computer Science, Otto von Guericke University, 39106 Magdeburg, Germany; (U.N.); (M.S.)
| | - Myra Spiliopoulou
- Knowledge Management & Discovery Lab, Faculty of Computer Science, Otto von Guericke University, 39106 Magdeburg, Germany; (U.N.); (M.S.)
| | - Christian Dobel
- Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany;
| | - Matthias Rose
- Medical Department, Section of Psychosomatic Medicine, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany;
| | - Birgit Mazurek
- Tinnitus Center, Charité—Universitätsmedizin Berlin, Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany; (P.B.); (W.M.); (B.B.); (N.A.)
- Knowledge Management & Discovery Lab, Faculty of Computer Science, Otto von Guericke University, 39106 Magdeburg, Germany; (U.N.); (M.S.)
- Correspondence: ; Tel.: +49-30-450-555-009
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17
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Seidl E, Schwerthöffer D, Seidl O. Psychodynamic factors in tinnitus aurium. PSYCHOANALYTIC PSYCHOTHERAPY 2021. [DOI: 10.1080/02668734.2021.1988683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Elias Seidl
- Department of Pediatrics, Dr. Von Hauner Children’s Hospital, University Hospital, LMU Munich, Munich, Germany
| | - Dirk Schwerthöffer
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Otmar Seidl
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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18
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Sleep disturbance and psychological distress in adult patients with tinnitus. J Formos Med Assoc 2021; 121:995-1002. [PMID: 34366185 DOI: 10.1016/j.jfma.2021.07.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 04/23/2021] [Accepted: 07/20/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/PURPOSE Sleep disturbance and psychological distress are among the most prevalent comorbidities of tinnitus. We aimed to clarify the dose-response effects of these phenomena with tinnitus severity. METHODS This study enrolled adult patients with subjective tinnitus for more than 6 months was conducted from January 2017 to December 2018 in one tertiary medical center and one local hospital. Data collected included demographic data and questionnaires, namely Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression Scale (HADS). RESULTS In total, 1610 patients with tinnitus (1105 male, 68.6%) with mean age of 48.3 ± 14.3 years completed all questionnaires. The average THI score was 9.2 ± 19.4, and 82.4% of patients reported to have slight tinnitus (THI ranged 0-16). The mean PSQI score was 8.4 ± 4.3, and 70.8% of participants had sleep difficulty (PSQI > 5). Compared with patients with slight tinnitus, those with catastrophic tinnitus were mostly old women with lower body mass index, and had higher scores in ESS, PSQI, and HADS (all P < 0.05). In 1140 patients with sleep difficulty, independent factors influencing THI were age, ESS, and HADS, and positive correlations were observed between age-adjusted THI and ESS, HADS-A, and HADS-D (all P < 0.001). CONCLUSION Old age, daytime sleepiness, and psychological distress are highly associated with tinnitus severity among patients with sleep difficulty. Management of sleep disturbance and psychological distress is necessary to control tinnitus.
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Genitsaridi E, Dode A, Qirjazi B, Mehdi M, Pryss R, Probst T, Reichert M, Hauck F, Hall DA. An Albanian translation of a questionnaire for self-reported tinnitus assessment. Int J Audiol 2021; 61:515-519. [PMID: 34182868 DOI: 10.1080/14992027.2021.1933221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To our knowledge, there is no published study investigating the characteristics of people experiencing tinnitus in Albania. Such a study would be important, providing the basis for further research in this region and contributing to a wider understanding of tinnitus heterogeneity across different geographic locations. The main objective of this study was to develop an Albanian translation of a standardised questionnaire for tinnitus research, namely the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire (ESIT-SQ). A secondary objective was to assess its applicability and usefulness by conducting an exploratory survey on a small sample of the Albanian tinnitus population. DESIGN AND STUDY SAMPLE Three translators were recruited to create the Albanian ESIT-SQ translation following good practice guidelines. Using this questionnaire, data from 107 patients attending otolaryngology clinics in Albania were collected. RESULTS Participants reporting various degrees of tinnitus symptom severity had distinct phenotypic characteristics. Application of a random forest approach on this preliminary dataset showed that self-reported hearing difficulty, and tinnitus duration, pitch and temporal manifestation were important variables for predicting tinnitus symptom severity. CONCLUSIONS Our study provided an Albanian translation of the ESIT-SQ and demonstrated that it is a useful tool for tinnitus profiling and subgrouping.
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Affiliation(s)
- Eleni Genitsaridi
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK
| | - Albi Dode
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Birkena Qirjazi
- Department of ENT, Faculty of Medicine, University of Tirana, Tirana, Albania
| | - Muntazir Mehdi
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Thomas Probst
- Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems, Austria
| | - Manfred Reichert
- Institute of Databases and Information Systems, Ulm University, Ulm, Germany
| | - Franz Hauck
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - Deborah Ann Hall
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.,National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham, UK.,Department of Psychology, School of Social Sciences, Heriot-Watt University Malaysia, Putrajaya, Malaysia
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20
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Abstract
In this chapter, I address the topic of tinnitus in the context of the patient's trajectory of care, with special attention to psychological comorbidities. Although most patients will cope with tinnitus and need no more than information and reassurance from professionals, a proportion of patients will need more supportive management. Assessment of psychological comorbidities is important to determine how urgent they should be seen in the clinic and their specific needs. The most frequent complaints are stress, depression, and anxiety. Although the direction of this relationship is still unclear (are comorbidities at the origin of tinnitus or are they a consequence of it), it is evident that the more serious comorbidities are at the onset of tinnitus, the worse the prognosis. Therefore, an assessment at the initial visit in the clinic is of utmost importance. There are valid and reliable psychometric tools to quickly draw a portrait of the psychological state of patients that can be used by audiologists, psychologists, or doctors. Therapeutic avenues can then be discussed with the patients to ensure them the best support possible.
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21
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Development of ebselen for the treatment of sensorineural hearing loss and tinnitus. Hear Res 2021; 413:108209. [PMID: 33678494 DOI: 10.1016/j.heares.2021.108209] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 12/29/2020] [Accepted: 02/13/2021] [Indexed: 02/08/2023]
Abstract
The global impact of hearing loss and related auditory dysfunction including tinnitus and hyperacusis on human health is significant and growing. A substantial body of literature has found that these hearing diseases and disorders result from significant number of genetic variations and molecular mechanisms. Investigational new drugs have been tested and several approved drugs have been repurposed in clinical trials, but no therapeutics for any auditory related indication have been FDA approved. A unique investigational new drug called ebselen (SPI-1005), that is anti-inflammatory and neuroprotective, has been shown to reduce noise-induced and aminoglycoside-induced hearing loss in animals. Multiple phase 2 clinical trials have demonstrated the safety and efficacy of SPI-1005 treatment in Meniere's disease and acute noise-induced hearing loss. SPI-1005 is currently being tested to prevent and treat tobramycin-induced ototoxicity in cystic fibrosis patients with acute lung infections. This review summarizes the published and presented data involving SPI-1005 and other drugs being tested to prevent or treat sensorineural hearing loss. Additionally, recent clinical data showing the relationship between pure tone audiometry and words-in-noise test results in a Meniere's disease are presented, which may have larger implications for the field of hearing research.
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Kleinstäuber M, Weise C. Psychosocial Variables That Predict Chronic and Disabling Tinnitus: A Systematic Review. Curr Top Behav Neurosci 2021; 51:361-380. [PMID: 33527333 DOI: 10.1007/7854_2020_213] [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] [Indexed: 03/06/2023]
Abstract
To improve tinnitus management we have to gain more knowledge of factors that explain how a persistent distressing tinnitus develops. The central aim of this systematic review was to identify longitudinal studies that investigated psychosocial variables predicting the transition from an acute to a chronic, disabling tinnitus (i.e. tinnitus decompensation) or tinnitus outcomes in chronic tinnitus sufferers. We conducted a systematic literature search of electronic databases and searched manually reference lists. We identified 16 eligible studies: Four longitudinal studies targeted predictors of the transition from acute to chronic tinnitus and 12 longitudinal studies investigated predictors of tinnitus distress (k = 9 observational, longitudinal studies; k = 3 ecological momentary assessment [EMA] and diary studies). The results of this systematic review showed that tinnitus distress, general psychological distress, tendencies to somatize, tinnitus-related delay of sleep onset, certain health behaviors, general illness coping, and certain personality traits (e.g. neuroticism) predicted the transition from acute to chronic, disabling tinnitus. General psychological, mental disorders, tinnitus distress, tinnitus disability (e.g. in different domains of physical, emotional, and social functioning; sleep disturbances), certain health behaviors (e.g. physical exercise), the level of physical and social functioning, and the report of other somatic problems such as pain were predictors of tinnitus outcomes in chronic tinnitus patients at a later follow-up. Studies that examined psychosocial variables as predictors of tinnitus distress are rare and had substantial methodological shortcomings. Future research should focus on core outcome domains and use standardized outcome measures to improve the comparability of results from different studies. Numerous psychosocial variables that have already been investigated as correlates of tinnitus sufferers' functioning in cross-sectional studies are worth investigating with longitudinal designs in future research. Identified predictors of the transition from acute to chronic, disabling tinnitus have to be addressed by health care practitioners who commonly function as the first contact person of individuals with acute tinnitus in the healthcare system.
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Affiliation(s)
- Maria Kleinstäuber
- Department of Psychological Medicine, Otago Medical School - Dunedin Campus, University of Otago, Dunedin, New Zealand.
| | - Cornelia Weise
- Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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Abstract
Emotional stress has accompanied humans since the dawn of time and has played an essential role not only in positive selection and adaptation to an ever-changing environment, but also in the acceleration or even initiation of many illnesses. The three main somatic mechanisms induced by stress are the hypothalamus-pituitary-adrenal axis (HPA axis), the sympathetic-adreno-medullar (SAM) axis, and the immune axis. In this chapter, the stress-induced mechanisms that can affect cochlear physiology are presented and discussed in the context of tinnitus generation and auditory neurobiology. It is concluded that all of the presented mechanisms need to be further investigated. It is advised that clinical practitioners ask patients about stressful events or chronic stress preceding the tinnitus onset and measure the vital signs. Finally, taking into account that tinnitus itself acts as a stressor, the implementation of anti-stress therapies for tinnitus treatment is recommended.
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Narwani V, Bourdillon A, Nalamada K, Manes RP, Hildrew DM. Does cannabis alleviate tinnitus? A review of the current literature. Laryngoscope Investig Otolaryngol 2020; 5:1147-1155. [PMID: 33364406 PMCID: PMC7752070 DOI: 10.1002/lio2.479] [Citation(s) in RCA: 2] [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: 08/24/2020] [Revised: 10/07/2020] [Accepted: 10/10/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES Endocannabinoid pathways have been proposed to affect the underlying pathophysiology of tinnitus. The aim of this study is to evaluate the scope and findings of existing literature on the relationship between cannabis and cannabinoid pathways and tinnitus. METHODS We conducted a review of animal, clinical and survey studies investigating the relationship between the use of cannabis-derived agents and tinnitus. Using pertinent keywords and MeSH terms on PubMed, relevant studies were identified, yielding four animal studies, two large cross-sectional survey studies, one clinical cross-over study, and one case report. RESULTS Animal studies revealed that cannabinoid receptor expression in the cochlear nucleus varied with tinnitus symptomatology and the use of cannabinoid agents either increased or had no effect on tinnitus-related behavior. Survey studies yielded conflicting results between cannabis use and tinnitus in the general population. Clinical data is largely lacking, although a small cohort study showed a dose-dependent relationship between tetrahydrocannabinol consumption and frequency of tinnitus episodes in patients receiving treatment for cancer. CONCLUSION While animal studies have revealed that cannabinoid receptors likely have a role in modulating auditory signaling, there is no compelling data either from animal or human studies for the use of cannabinoids to alleviate tinnitus. Further research is necessary to elucidate their precise role to guide development of therapeutic interventions. LEVEL OF EVIDENCE NA.
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Affiliation(s)
- Vishal Narwani
- Division of Otolaryngology – Head and Neck Surgery, Department of SurgeryYale University School of MedicineNew HavenConnecticutUSA
| | | | - Keerthana Nalamada
- Department of NeurologyUniversity of ConnecticutFarmingtonConnecticutUSA
| | - R. Peter Manes
- Division of Otolaryngology – Head and Neck Surgery, Department of SurgeryYale University School of MedicineNew HavenConnecticutUSA
| | - Douglas M. Hildrew
- Division of Otolaryngology – Head and Neck Surgery, Department of SurgeryYale University School of MedicineNew HavenConnecticutUSA
- Division of Otolaryngology – Head and Neck Surgery, Department of SurgeryVA Connecticut Healthcare SystemWest HavenConnecticutUSA
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Beukes EW, Manchaiah V, Allen PM, Andersson G, Baguley DM. Exploring tinnitus heterogeneity. PROGRESS IN BRAIN RESEARCH 2020; 260:79-99. [PMID: 33637233 DOI: 10.1016/bs.pbr.2020.05.022] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Tinnitus experiences differ widely. A greater understanding of the core processes underlying these variations is needed. Moreover, meaningful definitions for different subgroups are required to better manage this heterogeneous population. The objective of the present research was to contribute toward the understanding of tinnitus heterogeneity by identifying factors that can predict tinnitus severity and to ascertain if distinct subgroups of tinnitus presentation can be identified. METHODS This cross-sectional study consisted of 326 adults subdivided into subgroups of those with mild tinnitus (n=32; 10%), significant tinnitus (n=99; 30%) and severe tinnitus (n=195; 60%) according to their scores from the Tinnitus Functional Index. Multiple regression was used to identify factors associated with tinnitus severity. These factors included personal traits, tinnitus-related traits, treatment modalities and clinical comorbidities. RESULTS Insomnia, hearing distress, and anxiety were the best predictors of tinnitus severity (explaining 53% of the variability). These comorbidities were stronger predictors than any demographical factors (that explained 11% of the variability). Distinct subgroups based on tinnitus severity (mild, significant, and severe) and anxiety levels were evident. Those with severe tinnitus had significantly more severe comorbidities compared with the mild and significant groups. CONCLUSIONS This study highlights that people with tinnitus could initially be grouped according to tinnitus severity to direct further management. Those with higher tinnitus severity should receive more immediate and intensive care. Due to the strong associations between tinnitus severity and tinnitus-related comorbidities (e.g., insomnia, hearing disability, and anxiety), tinnitus assessment and interventions should focus on these comorbidities.
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Affiliation(s)
- Eldré W Beukes
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom.
| | - Vinaya Manchaiah
- Department of Speech and Hearing Sciences, Lamar University, Beaumont, TX, United States; Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal, Karnataka, India
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge, United Kingdom; Vision and Eye Research Unit, Anglia Ruskin University, Cambridge, United Kingdom
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institute, Stockholm, Sweden
| | - David M Baguley
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, Nottingham, United Kingdom; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom; Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, United Kingdom
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Cederroth CR, PirouziFard M, Trpchevska N, Idrizbegovic E, Canlon B, Sundquist J, Sundquist K, Zöller B. Association of Genetic vs Environmental Factors in Swedish Adoptees With Clinically Significant Tinnitus. JAMA Otolaryngol Head Neck Surg 2020; 145:222-229. [PMID: 30653224 PMCID: PMC6439751 DOI: 10.1001/jamaoto.2018.3852] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Question Is clinically significant tinnitus associated with genetic factors? Findings In this study of national registry data from 11 060 adoptees, 19 015 adoptive parents, and 17 025 biological parents, a heritability of 32% and no association of shared environment with the transmission of tinnitus were found. Meaning The present study suggests that genetic factors are associated with the familial clustering of severe tinnitus. Importance No effective treatments are currently available for severe tinnitus, which affects 1% of the population and lowers the quality of life. The factors that contribute to the transition from mild to severe tinnitus are poorly known. Before performing genetic analyses and determining the mechanisms involved in the development of severe tinnitus, its heritability needs to be determined. Objectives To examine whether clinically significant tinnitus is associated with genetic factors and to evaluate the genetic risk in the transmission of tinnitus using adoptees. Design, Setting, and Participants Data from adoptees and their biological and adoptive parents from Swedish nationwide registers were collected from January 1, 1964, to December 31, 2015, and used to separate genetic from environmental factors in familial clustering. In all, 11 060 adoptees, 19 015 adoptive parents, and 17 025 biological parents were investigated. The study used a cohort design and a case-control approach to study genetic and nongenetic factors in tinnitus among adoptees. Main Outcomes and Measures The primary outcome was odds ratio (OR) of tinnitus in adoptees with at least 1 affected biological parent compared with adoptees without any affected biological parent using logistic regression. The secondary outcome was OR in adoptees with at least 1 affected adoptive parent compared with adoptees without any affected adoptive parent. Results A total of 1029 patients (440 [42.8%] male; mean [SD] age, 62 [14] years) with tinnitus were identified. The prevalence of diagnosed tinnitus was 2.2%. The OR for tinnitus was 2.22 for adoptees (95% CI, 1.03-4.81) of biological parents diagnosed with tinnitus, whereas the OR was 1.00 (95% CI, 0.43-2.32) for adoptees from adoptive parents diagnosed with tinnitus. Mean (SE) heritability determined using tetrachoric correlations was 31% (14%). Conclusions and Relevance The findings suggest that genetic factors are associated with the familial clustering of clinically significant tinnitus with no shared-environment association, revealing that the transition from negligible to severe tinnitus may be associated with genetic factors. These findings may provide insight for future genetic analyses that focus on severe tinnitus.
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Affiliation(s)
| | - MirNabi PirouziFard
- Centre for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Natalia Trpchevska
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Esma Idrizbegovic
- Hörsel-och Balanskliniken, Karolinska Universitetssjukhuset, Stockholm, Sweden
| | - Barbara Canlon
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
| | - Jan Sundquist
- Centre for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Centre for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Bengt Zöller
- Centre for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
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Kunelskaya NL, Levina YV, Baibakova EV, Shurpo VI. [Tinnitus - current trends and prospects]. Vestn Otorinolaringol 2020; 84:54-60. [PMID: 32027324 DOI: 10.17116/otorino20198406154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Tinnitus is described as the perception of any sound or noise in the absence of real acoustic stimulation. Numerous investigations have been tried for this potentially debilitating, heterogeneous symptom. The authors overview the current concepts of the management of the suffering tinnitus patients. The review contains modern views on the mechanisms of generation, etiology and pathogenesis of tinnitus. Classifications for practical management of patients are presented. The review of medical and physical methods of therapy and rehabilitation of a tinnitus patients given. The review includes the most clinically reliable and common methods of treatment and rehabilitation.
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Affiliation(s)
- N L Kunelskaya
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152; Department of Otorhinolaryngology N.I.Pirogov Russian National Research Medical University, Moscow, Russia,117997
| | - Yu V Levina
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152; Department of Otorhinolaryngology N.I.Pirogov Russian National Research Medical University, Moscow, Russia,117997
| | - E V Baibakova
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
| | - V I Shurpo
- L.I. Sverzhevskiy Research Institute of Clinical Otorhinolaryngology, Moscow Health Department, Moscow, Russia, 117152
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Qian ZJ, Alyono JC. An association between marijuana use and tinnitus. Am J Otolaryngol 2020; 41:102314. [PMID: 31732310 DOI: 10.1016/j.amjoto.2019.102314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 10/01/2019] [Accepted: 10/03/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVE While some advocates have argued for marijuana as a treatment for tinnitus, the relationship between marijuana use and tinnitus is unknown. The objective of this study was to evaluate associations between marijuana use and the prevalence, severity, and rate of occurrence of tinnitus. STUDY DESIGN Cross-sectional analysis of nationally representative data. SETTING National Health and Nutrition Examination Survey 2011-2012. SUBJECTS AND METHODS Statistical analysis was performed on data collected from 2705 non-institutionalized adults aged 20-69 who underwent audiometric testing and were administered questionnaires about hearing, drug use, current health status, and medical history. RESULTS The use of marijuana at least once per month for the previous 12 months was significantly associated with experiencing tinnitus during that 12-month month (X2(1) = 19.41, p < 0.001). Subjects who used marijuana were more likely to experience tinnitus after accounting for covariables including age, gender, audiometric hearing loss, noise exposure history, depression, anxiety, smoking, salicylate use, cardiovascular disease, hypertension, and diabetes (OR = 1.75, 95% CI 1.02-3.01, p = 0.043). There were no associations between the severity or frequency of tinnitus occurrence and the quantity or frequency of marijuana use. Use of other substances such as alcohol, cocaine, methamphetamine, and heroin was not associated with tinnitus. CONCLUSION Regular marijuana use is associated with prevalent tinnitus. However, no dose response between marijuana use and tinnitus was observed. The relationship between marijuana use and tinnitus is complex and is likely modulated by psychosocial factors.
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Park E, Kim H, Choi IH, Han HM, Han K, Jung HH, Im GJ. Psychiatric Distress as a Common Risk Factor for Tinnitus and Joint Pain: A National Population-Based Survey. Clin Exp Otorhinolaryngol 2019; 13:234-240. [PMID: 31842535 PMCID: PMC7435435 DOI: 10.21053/ceo.2019.00563] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/30/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the relationship between tinnitus and joint pain from representative samples of Koreans. METHODS The demographics and the responses to a questionnaire about tinnitus and joint pain severity and mental health status of adults aged ≥50 years in the 2010-2012 Korean National Health and Nutrition Examination Survey were analyzed. RESULTS Among 9,032 individuals, 26.7% reported experiencing tinnitus within the past year. Participants with tinnitus were more frequently older, hearing loss, and had lower education levels, income, and body weight. Participants with regular exercise and sleep had a lower tinnitus prevalence. The incidences of stress, depressed mood, and suicidal ideation were significantly higher in the tinnitus group and participants with joint pain. The rates of participants with tinnitus according to the number of joint pain sites (zero, one, two, and three) was 22.1%, 31.4%, 33.3%, and 44.2%, and those of participants with severely annoying tinnitus according to the number of joint pain sites (zero, one, two, and three) were 3.3%, 6.8%, 7.9%, and 10.7%, respectively. CONCLUSION Tinnitus prevalence and severity were significantly related to joint pain, and both conditions were related to psychiatric distress. Thus, the authors suggest that psychiatric distress as a common risk factor for tinnitus and joint pain should be considered when deciding treatment strategies and in guiding public health policy.
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Affiliation(s)
- Euyhyun Park
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hyunjung Kim
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - In Hak Choi
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hye Min Han
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hak Hyun Jung
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
| | - Gi Jung Im
- Department of Otolaryngology-Head and Neck Surgery, Korea University College of Medicine, Seoul, Korea
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Zhang J. Blast-induced tinnitus: Animal models. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2019; 146:3811. [PMID: 31795642 DOI: 10.1121/1.5132551] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Blast-induced tinnitus is a prevalent problem among military personnel and veterans, as blast-related trauma damages the vulnerable microstructures within the cochlea, impacts auditory and non-auditory brain structures, and causes tinnitus and other disorders. Thus far, there is no effective treatment of blast-induced tinnitus due to an incomplete understanding of its underlying mechanisms, necessitating development of reliable animal models. This article focuses on recent animal studies using behavioral, electrophysiological, imaging, and pharmacological tools. The mechanisms underlying blast-induced tinnitus are largely similar to those underlying noise-induced tinnitus: increased spontaneous firing rates, bursting, and neurosynchrony, Mn++ accumulation, and elevated excitatory synaptic transmission. The differences mainly lie in the data variability and time course. Noise trauma-induced tinnitus mainly originates from direct peripheral deafferentation at the cochlea, and its etiology subsequently develops along the ascending auditory pathways. Blast trauma-induced tinnitus, on the other hand, results from simultaneous impact on both the peripheral and central auditory systems, and the resultant maladaptive neuroplasticity may also be related to the additional traumatic brain injury. Consequently, the neural correlates of blast-induced tinnitus have different time courses and less uniform manifestations of its neural correlates.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, 4201 Saint Antoine, Detroit, Michigan 48201, USA
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Aazh H, Landgrebe M, Danesh AA, Moore BC. Cognitive Behavioral Therapy For Alleviating The Distress Caused By Tinnitus, Hyperacusis And Misophonia: Current Perspectives. Psychol Res Behav Manag 2019; 12:991-1002. [PMID: 31749641 PMCID: PMC6817772 DOI: 10.2147/prbm.s179138] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 10/01/2019] [Indexed: 11/23/2022] Open
Abstract
This article reviews the evidence related to the efficacy of Cognitive Behavioral Therapy (CBT) for alleviating the distress caused by tinnitus, hyperacusis and misophonia. Where available, the review was focused on meta-analyses of randomized controlled trials (RCTs) using either passive control groups (typically waiting list or education only) or active control groups (receiving some other form of treatment). Where data from RCTs were not available, case studies and retrospective studies were reviewed. Analyses were conducted separately for studies of patients with tinnitus, hyperacusis and misophonia. RCTs show that CBT is effective in alleviating the distress caused by tinnitus in comparison to passive control groups and sometimes active control groups. CBT for tinnitus can be effective both in individual and in group settings, whether delivered by psychiatrists, clinical psychologists, or specially trained audiologists. CBT for tinnitus can also be effective when delivered via the internet, when combined with help from audiologists. Usually, CBT does not reduce the loudness of tinnitus but it can improve quality of life. Case studies and some limited RCTs suggest that CBT can also be effective in alleviating the distress caused by hyperacusis and misophonia. However, RCTs with active control groups are currently lacking. There is strong evidence supporting the effectiveness of CBT in alleviating the distress caused by tinnitus. However, it is not yet clear whether CBT is more effective than some other forms of treatment. RCTs with active control groups are needed to establish more clearly the extent to which CBT is effective in alleviating the distress caused by hyperacusis and misophonia.
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Affiliation(s)
- Hashir Aazh
- London Tinnitus and Hyperacusis Therapy Specialist Clinic, London, WC2N 5BW, UK.,Guildford Tinnitus and Hyperacusis Therapy Specialist Clinic, Guildford, Surrey, GU2 4RG, UK.,Audiology Department, Royal Surrey County Hospital, Guildford GU2 7XX, UK
| | - Michael Landgrebe
- Department of Psychiatry, Psychosomatics and Psychotherapy, Kbo Lech-Mangfall-Hospital Agatharied, Hausham 83734, Germany
| | - Ali A Danesh
- Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Brian Cj Moore
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK
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Abstract
Tinnitus is not traceable to a single disease or pathology, but merely a symptom, which is distressing to some but not all individuals able to perceive it. The experience of tinnitus does not equate to tinnitus distress. Tinnitus suffering might be understood as a function of tinnitus-related distress in that bothersome tinnitus is an illness rather than a disease. In bothersome (distressing) tinnitus, the perception of the characteristic sound is a very disturbing and bothersome experience because of maladaptive psychological responses. Several cognitive and behavioral theoretical frameworks attempting to explain the nature and cause of tinnitus suffering have been introduced in and will be summarized here. Current treatment approaches are generally based on models that aim to: alleviate the perceptional experience by focusing on the tinnitus perception for habituation or even soothing purposes; decrease awareness of the sound by attentional training and cognitive interventions; decrease the maladaptive responses and the resulting distress by behavioral methods (i. e., exposure). The cognitive behavioral fear-avoidance model may offer an integrative cognitive behavioral approach that can lead to a new set of paradigms for studying the underlying mechanisms explaining chronic tinnitus suffering as well for developing innovative strategies to treat bothersome tinnitus.
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Affiliation(s)
- R F F Cima
- Section Behavioural Medicine, Faculty of Psychology and Neuroscience, Maastricht University, 616, 6200 MD, Maastricht, The Netherlands.
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Standardised profiling for tinnitus research: The European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ). Hear Res 2019; 377:353-359. [DOI: 10.1016/j.heares.2019.02.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 01/25/2019] [Accepted: 02/27/2019] [Indexed: 12/25/2022]
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Theodoroff SM, Kaltenbach JA. The Role of the Brainstem in Generating and Modulating Tinnitus. Am J Audiol 2019; 28:225-238. [PMID: 31022358 DOI: 10.1044/2018_aja-ttr17-18-0035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Purpose The purpose of this work is to present a perspective article summarizing ideas pertaining to the brainstem's role in generating and modulating tinnitus. It is organized in 4 sections: Part 1, the role of the brainstem as a tinnitus generator; Part 2, the role of the brainstem in modulating tinnitus; Part 3, the role of the brainstem in nonauditory comorbid conditions associated with tinnitus; and Part 4, clinical implications. In Part 1, well-established neurophysiological models are discussed providing the framework of evidence that auditory brainstem nuclei play a role in generating tinnitus. In Part 2, ideas are presented explaining modulatory effects on tinnitus related to underlying pathways originating from or projecting to brainstem auditory and nonauditory nuclei. This section addresses multiple phenomena including somatic-related, attention-mediated, and emotion-mediated changes in the tinnitus percept. In Part 3, the role of the brainstem in common nonauditory comorbidities that occur in patients with tinnitus is discussed. Part 4 presents clinical implications of these new ideas related to the brainstem's involvement in generating and modulating tinnitus. Impact Knowledge of the brainstem's involvement in generating and modulating tinnitus provides a context for health care professionals to understand the temporal relationship between tinnitus and common nonauditory comorbid conditions.
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Affiliation(s)
- Sarah M. Theodoroff
- VA RR&D, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, Portland, OR
- Department of Otolaryngology, Head & Neck Surgery, Oregon Health & Science University, Portland
| | - James A. Kaltenbach
- Department of Neurosciences, Lerner Research Institute/Head and Neck Institute, Cleveland Clinic, OH
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Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in Patients with Tinnitus: A Systematic Review. Otolaryngol Head Neck Surg 2019; 161:28-35. [PMID: 30909841 DOI: 10.1177/0194599819835178] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Tinnitus is a condition that causes distress and impairment across cognitive, functional, and psychiatric spectra. In the psychiatric realm, tinnitus has long been associated with depression. To better characterize the co-occurrence of depression and tinnitus, we performed a systematic review of the prevalence of depression among patients with tinnitus. DATA SOURCES We comprehensively examined original studies reporting the prevalence of depression in adult populations with tinnitus, as indexed in the PubMed and Web of Science databases and published from January 2006 to August 2016. REVIEW METHODS All identified articles were reviewed independently by 2 researchers, with a third reviewer for adjudication. Included studies were evaluated for threats to validity across 3 domains-representativeness, response rate, and ascertainment of outcome-on a 4-point modified Newcastle-Ottawa Quality Assessment Scale. RESULTS Twenty-eight studies were included, representing 15 countries and 9979 patients with tinnitus. Among the included studies, the median prevalence of depression was 33%, with an interquartile range of 19% to 49% and an overall range of 6% to 84%. Studies were high quality overall, with a mean score of 3.3 (SD = 0.76), and 89% utilized a validated tool to ascertain depression. CONCLUSIONS We conducted one of the largest contemporary comprehensive reviews, which suggests a 33% prevalence of depression among patients with tinnitus. Our review reaffirms that a substantial proportion of patients with tinnitus have depression, and we recommend that all who treat tinnitus should screen and treat their patients for depression, if present.
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Affiliation(s)
- James W Salazar
- 1 Department of Medicine, University of California, San Francisco, California, USA
| | - Karl Meisel
- 2 Department of Neurology, University of California, San Francisco, California, USA
| | - Eric R Smith
- 3 Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Aaron Quiggle
- 4 Department of Psychiatry, University of California, San Francisco, California, USA
| | - David B McCoy
- 5 Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
| | - Matthew R Amans
- 5 Department of Radiology and Biomedical Imaging, University of California, San Francisco, California, USA
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Ferraro L, La Barbera D, Messina A, Galioto S, Marinaro AM, Caruso C, Rizzo R, La Cascia C. Metacognitive Therapy in Patients with Tinnitus: a Single Group Study. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2019. [DOI: 10.1007/s10879-018-09415-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Abstract
Tinnitus is the sensation of hearing a sound with no external auditory stimulus present. It is a public health issue correlated with multiple comorbidities and precipitating factors such as noise exposure, military service, and traumatic brain injury, migraine, insomnia, small vessel disease, smoking history, stress exposure, anxiety, depression, and socioeconomic status. Clinical experience and a recent literature review point at tinnitus as a neuropsychiatric condition involving both auditory and nonauditory cortical areas of the brain and affecting brain-auditory circuitry. In fact, brain-ear connections have been highlighted in different models. Forward management of this disorder should take this body of research into consideration as tinnitus remains a challenging condition to evaluate and treat with current management protocols still symptomatic at best. With a better understanding of the etiologic factors and comorbidities of tinnitus, additional research trials and new therapeutic approaches could see the light to tackle this public health disability bringing hope to patients and doctors.
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Affiliation(s)
- Zeina Chemali
- Departments of Neurology and Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
| | - R Nehmé
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Gregory Fricchione
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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Herr RM, Bosch JA, Theorell T, Loerbroks A. Bidirectional associations between psychological distress and hearing problems: an 18-year longitudinal analysis of the British Household Panel Survey. Int J Audiol 2018; 57:816-824. [PMID: 30052099 DOI: 10.1080/14992027.2018.1490034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Hearing problems are a significant public health concern. It has been suggested that psychological distress may represent both a cause and a consequence of hearing problems. Prospective data that allow testing such potential bi-directionality have thus far been lacking. The present study aimed to address this knowledge gap. Random (RE) and fixed effects (FE) panel regression models estimated the association of psychological distress (GHQ-12) and participant-reported hearing problems. Data from 18 annual waves of the British Household Panel Survey were used (n = 10,008). Psychological distress was prospectively associated with self-reported hearing problems in women (multivariable odds ratios (ORs) ≥1.44; one-year time lag ≥ 1.16) and men (ORs ≥ 1.15; time lag ≥ 1.17). Conversely, self-reported hearing problems were associated with increases in psychological distress in both sexes (OR ≥ 1.26; time lag ≥ 1.08). These associations were independent of the analytical strategy and of adjustment for sociodemographic variables, lifestyle factors, and measurement period. We present first evidence of a bidirectional association between psychological distress and self-reported hearing problems. These findings suggest that stress management interventions may contribute to the prevention of self-reported hearing problems, and, in turn, alleviating self-reported hearing problems may reduce psychological distress.
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Affiliation(s)
- Raphael M Herr
- a Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany.,b Department of Clinical Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Jos A Bosch
- a Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany.,b Department of Clinical Psychology , University of Amsterdam , Amsterdam , The Netherlands
| | - Töres Theorell
- c Stress Research Institute , Stockholm University , Stockholm , Sweden.,d Department of Neuroscience , Karolinska Institutet , Stockholm , Sweden
| | - Adrian Loerbroks
- a Mannheim Institute of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim , Heidelberg University , Mannheim , Germany.,e Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine , University of Düsseldorf , Düsseldorf , Germany
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41
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A systematic review and meta-analysis of psychological functioning in chronic tinnitus. Clin Psychol Rev 2018; 60:62-86. [DOI: 10.1016/j.cpr.2017.12.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 10/31/2017] [Accepted: 12/28/2017] [Indexed: 11/19/2022]
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Tinnitus, depression, and suicidal ideation in adults: A nationally representative general population sample. J Psychiatr Res 2018; 98:124-132. [PMID: 29406247 DOI: 10.1016/j.jpsychires.2018.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 01/09/2018] [Accepted: 01/09/2018] [Indexed: 11/24/2022]
Abstract
Tinnitus is strongly associated with psychiatric symptoms, including depression and suicidality. We aimed to further investigate the association of tinnitus with depressive mood and/or suicidal ideation, and explore the shared risk factors for these within a representative sample of the adult general population. We also investigated potential mediation pathways among tinnitus, suicidal ideation, depression, shared risk factors, and perceived stress levels. We analysed data from 28,930 adults (aged ≥19 years) from the fourth and fifth Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2008 to 2012 in South Korea. We investigated the presence and severity of tinnitus, depressive mood, suicidal ideation, perceived usual stress level, and socioeconomic and health-related variables. We conducted logistic regression and mediation analyses. Tinnitus and its severity were significantly associated with depressive mood and suicidal ideation. Tinnitus, depressive mood, and suicidal ideation shared common socioeconomic and health-related risk factors. Tinnitus significantly mediated the association of shared risk factors for depressive mood and suicidal ideation. Perceived usual stress level mediates the association of tinnitus with depressive mood and suicidal ideation. The correlation of perceived usual stress levels with depression and suicidal ideation was also mediated by tinnitus. Our findings implicate that tinnitus may contribute substantially to the development of depressive symptom and suicidal ideation in adults via apparent interactions with shared risk factors and stress levels.
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Aazh H, Moore BCJ. Factors Associated With Depression in Patients With Tinnitus and Hyperacusis. Am J Audiol 2017; 26:562-569. [PMID: 29209701 DOI: 10.1044/2017_aja-17-0008] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 08/03/2017] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to assess factors associated with depression for patients with tinnitus and hyperacusis. METHOD Data were gathered from the records of 620 consecutive patients who sought help concerning their tinnitus or hyperacusis from an audiology clinic in the United Kingdom. RESULTS One third of the patients had borderline abnormal or abnormal scores on the Depression subscale of the Hospital Anxiety and Depression Scale (HADS-D). Linear regression models showed that HADS-D scores were related to scores for tinnitus handicap, tinnitus loudness, and uncomfortable loudness levels. Mediation analyses showed that (a) the influence of tinnitus handicap scores on HADS-D scores was mainly mediated via the effects of insomnia, hyperacusis, and anxiety; (b) the influence of tinnitus loudness scores on HADS-D scores was fully mediated via the effects of tinnitus handicap, insomnia, hyperacusis handicap, and anxiety; (c) and the small influence of uncomfortable loudness levels on HADS-D scores was fully mediated by hyperacusis handicap and anxiety. CONCLUSION Those involved in the management of patients with tinnitus and/or hyperacusis should use a wide range of instruments to assess the full impact of tinnitus on a patient's life and should be prepared to refer a patient for treatment for depression, especially when the patient has anxiety, hyperacusis, and/or insomnia.
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Affiliation(s)
- Hashir Aazh
- Tinnitus & Hyperacusis Therapy Specialist Clinic, Audiology Department, Royal Surrey County Hospital NHS Foundation Trust, Egerton Road, Guildford, United Kingdom
| | - Brian C. J. Moore
- Department of Experimental Psychology, University of Cambridge, United Kingdom
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Hunter A. Attitudes, Risk Behavior, and Noise Exposure among Young Adults with Hearing Problems: Identifying a Typology. Semin Hear 2017; 38:332-347. [PMID: 29026265 PMCID: PMC5634807 DOI: 10.1055/s-0037-1606327] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
This study explored attitudes toward leisure noise, use of hearing protection, and perceived susceptibility to leisure-noise damage in young adults with hearing problems. Twelve participants aged between 18 and 35 years took part in a semistructured interview. Data were analyzed using framework analysis. The results showed that a positive attitude to noise, a passion for loud music, a lack of knowledge of the consequences of noise damage, and perceived low risk of hearing problems were associated with people not using earplugs. The aesthetics, comfort, perceived effects on music quality and attitude of others were all barriers to earplug use. Of those who had used earplugs, previous hearing-related symptoms and concern about future hearing damage were the main motivators for use. Four types of people were identified to describe the variation in attitudes and behaviors: those who had no change in behavior or concern about damage; those who were concerned and used earplugs; those who were concerned and avoided loud venues; and those who were concerned about communication difficulties only. Considering the wide variability, it may be more effective to shift attention from trying to change individual attitudes and behaviors to considering systemic changes to protect hearing, through ensuring the music industry and relevant authorities take greater responsibility.
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Affiliation(s)
- Abby Hunter
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Ropewalk House, Nottingham, United Kingdom
- Division of Epidemiology and Public Health, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, United Kingdom
- Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Zuo H, Lei D, Sivaramakrishnan S, Howie B, Mulvany J, Bao J. An operant-based detection method for inferring tinnitus in mice. J Neurosci Methods 2017; 291:227-237. [DOI: 10.1016/j.jneumeth.2017.08.029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 07/25/2017] [Accepted: 08/24/2017] [Indexed: 01/04/2023]
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Hesse G. [Diagnosis and therapy of tinnitus]. MMW Fortschr Med 2017; 159:45-55. [PMID: 29071593 DOI: 10.1007/s15006-017-9593-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Gerhard Hesse
- Ohr- und Hörinstitut, TInnitus-Klinik am KH Bad Arolsen, Große Allee 50, D-34454, Bad Arolsen, Deutschland.
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Gollnast D, Tziridis K, Krauss P, Schilling A, Hoppe U, Schulze H. Analysis of Audiometric Differences of Patients with and without Tinnitus in a Large Clinical Database. Front Neurol 2017; 8:31. [PMID: 28232817 PMCID: PMC5298966 DOI: 10.3389/fneur.2017.00031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/24/2017] [Indexed: 11/13/2022] Open
Abstract
Human hearing loss (HL) and comorbidities like tinnitus pose serious problems for people's daily life, which in most severe cases may lead to social isolation, depression, and suicide. Here, we investigate the relationship between hearing deficits and tinnitus. To this end, we conducted a retrospective study on anonymized pure tone and speech audiometric data from patients of the ENT hospital Erlangen in which we compare audiometric data between patients with and without tinnitus. Overall data from 37,661 patients with sensorineural (SHL) or conductive HL (CHL) with (T, 9.5%) or without (NT, 90.5%) a tinnitus percept in different age groups and with different tinnitus pitches were included in this study. The results of the pure tone audiometry comparisons showed significant differences in T patients compared to NT patients. In young patients, we generally found lower hearing thresholds in T compared to NT patients. In adult patients, differences were more heterogeneous: hearing thresholds in T patients were lower in low frequency ranges, while they were higher at high frequencies. Furthermore, lower thresholds were more often found in CHL patients and could rarely be detected in SHL patients. In speech audiometry, only CHL patients with high-pitched tinnitus showed lower thresholds compared to NT patients' thresholds. The results of this study may point to a biologically plausible functional benefit on hearing thresholds in HL tinnitus patients. We hypothesize that the physiological mechanism of stochastic resonance counteracts HL by adding neuronal noise to the system. This neuronal noise may induce changes in the auditory pathway and finally-as a side effect of threshold improvement-lead to the development of a tinnitus percept. We propose a general model of changed hearing thresholds in T patients, being either decreased or increased compared to NT patients.
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Affiliation(s)
- Dominik Gollnast
- Experimental Otolaryngology, Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich Alexander University Erlangen-Nürnberg (FAU) , Erlangen , Germany
| | - Konstantin Tziridis
- 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; Department of Physics, Center for Medical Physics and Technology, Biophysics Group, 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; Department of Physics, Center for Medical Physics and Technology, Biophysics Group, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Ulrich Hoppe
- Audiology, 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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Bhatt JM, Bhattacharyya N, Lin HW. Relationships between tinnitus and the prevalence of anxiety and depression. Laryngoscope 2017; 127:466-469. [PMID: 27301552 PMCID: PMC5812676 DOI: 10.1002/lary.26107] [Citation(s) in RCA: 198] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 04/27/2016] [Accepted: 05/01/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVES/HYPOTHESIS Quantify the relationships between tinnitus, and anxiety and depression among adults. STUDY DESIGN Cross-sectional analysis of a national health survey. METHODS Adult respondents in the 2007 Integrated Health Interview Series tinnitus module were analyzed. Data for tinnitus symptoms and severity and reported anxiety and depression symptoms were extracted. Associations between tinnitus problems and anxiety, depression, lost workdays, days of alcohol consumption, and mean hours of sleep were assessed. RESULTS Among 21.4 ± 0.69 million adult tinnitus sufferers, 26.1% reported problems with anxiety in the preceding 12 months, whereas only 9.2% of those without tinnitus reported an anxiety problem (P < .001). Similarly, 25.6% of respondents with tinnitus reported problems with depression, whereas only 9.1% of those without tinnitus reported depression symptoms (P < .001). Those reporting tinnitus symptoms as a "big" or "very big" problem were more likely to concurrently report anxiety (odds ratio [OR]: 5.7; 95% CI: 4.0-8.1; P < .001) and depression (OR: 4.8; 95% CI: 3.5-6.7; P < .001) symptoms. Tinnitus sufferers reported significantly fewer mean hours of sleep per night (7.00 vs. 7.21; P < .001) and greater mean days of work missed (6.94 vs. 3.79, P < .001) compared to those who did not report tinnitus. Mean days of alcohol consumption between the two groups were not significantly different. CONCLUSIONS Tinnitus symptoms are closely associated with anxiety, depression, shorter sleep duration, and greater workdays missed. These comorbidities and sequelae should be recognized and addressed to optimally manage patients with chronic and bothersome tinnitus. LEVEL OF EVIDENCE 4 Laryngoscope, 2016 127:466-469, 2017.
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Affiliation(s)
- Jay M Bhatt
- Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California
| | - Neil Bhattacharyya
- Department of Otology & Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Harrison W Lin
- Department of Otolaryngology-Head & Neck Surgery, University of California, Irvine, Irvine, California
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Lopez-Escamez JA, Bibas T, Cima RFF, Van de Heyning P, Knipper M, Mazurek B, Szczepek AJ, Cederroth CR. Genetics of Tinnitus: An Emerging Area for Molecular Diagnosis and Drug Development. Front Neurosci 2016; 10:377. [PMID: 27594824 PMCID: PMC4990555 DOI: 10.3389/fnins.2016.00377] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 08/03/2016] [Indexed: 12/13/2022] Open
Abstract
Subjective tinnitus is the perception of sound in the absence of external or bodily-generated sounds. Chronic tinnitus is a highly prevalent condition affecting over 70 million people in Europe. A wide variety of comorbidities, including hearing loss, psychiatric disorders, neurodegenerative disorders, and temporomandibular joint (TMJ) dysfunction, have been suggested to contribute to the onset or progression of tinnitus; however, the precise molecular mechanisms of tinnitus are not well understood and the contribution of genetic and epigenetic factors remains unknown. Human genetic studies could enable the identification of novel molecular therapeutic targets, possibly leading to the development of novel pharmaceutical therapeutics. In this article, we briefly discuss the available evidence for a role of genetics in tinnitus and consider potential hurdles in designing genetic studies for tinnitus. Since multiple diseases have tinnitus as a symptom and the supporting genetic evidence is sparse, we propose various strategies to investigate the genetic underpinnings of tinnitus, first by showing evidence of heritability using concordance studies in twins, and second by improving patient selection according to phenotype and/or etiology in order to control potential biases and optimize genetic data output. The increased knowledge resulting from this endeavor could ultimately improve the drug development process and lead to the preventive or curative treatment of tinnitus.
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Affiliation(s)
- Jose A Lopez-Escamez
- Otology and Neurotology Group, Department of Genomic Medicine, Pfizer - Universidad de Granada - Junta de Andalucía Centro de Genómica e Investigación Oncológica, PTSGranada, Spain; Department of Otolaryngology, Instituto de Investigación Biosanitaria ibs.GRANADA, Complejo Hospital Universitario GranadaGranada, Spain
| | - Thanos Bibas
- 1st Department of Otolaryngology, National and Kapodistrian University of Athens, Hippocrateion HospitalAthens, Greece; Ear Institute, UCLLondon, UK
| | - Rilana F F Cima
- Department of Clinical Psychological Science, Maastricht University Maastricht, Netherlands
| | - Paul Van de Heyning
- University Department ENT and Head and Neck Surgery, Antwerp University Hospital, University of Antwerp Antwerp, Belgium
| | - Marlies Knipper
- Hearing Research Centre Tübingen, Molecular Physiology of Hearing Tübingen, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité-Universitätsmedizin Berlin Berlin, Germany
| | | | - Christopher R Cederroth
- Experimental Audiology, Department of Physiology and Pharmacology, Karolinska Institutet Stockholm, Sweden
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