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Langguth B, de Ridder D, Schlee W, Kleinjung T. Tinnitus: Clinical Insights in Its Pathophysiology-A Perspective. J Assoc Res Otolaryngol 2024:10.1007/s10162-024-00939-0. [PMID: 38532055 DOI: 10.1007/s10162-024-00939-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 02/26/2024] [Indexed: 03/28/2024] Open
Abstract
Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a multifaceted clinical challenge due to its heterogeneity and its incompletely understood pathophysiology and especially due to the limited therapeutic options. In this narrative review, we give an overview on various clinical aspects of tinnitus including its heterogeneity, contributing factors, comorbidities and therapeutic pathways with a specific emphasis on the implications for its pathophysiology and future research directions. Tinnitus exhibits high perceptual variability between affected individuals (heterogeneity) and within affected individuals (temporal variability). Hearing loss emerges as predominant risk factor and the perceived pitch corresponds to areas of hearing loss, supporting the compensatory response theory. Whereas most people who have tinnitus can live a normal life, in 10-20% tinnitus interferes severely with quality of life. These patients suffer frequently from comorbidities such as anxiety, depression or insomnia, acting as both risk factors and consequences. Accordingly, neuroimaging studies demonstrate shared brain networks between tinnitus and stress-related disorders shedding light on the intricate interplay of mental health and tinnitus. The challenge lies in deciphering causative relationships and shared pathophysiological mechanisms. Stress, external sounds, time of day, head movements, distraction, and sleep quality can impact tinnitus perception. Understanding these factors provides insights into the interplay with autonomic, sensory, motor, and cognitive processes. Counselling and cognitive-behavioural therapy demonstrate efficacy in reducing suffering, supporting the involvement of stress and anxiety-related networks. Hearing improvement, especially through cochlear implants, reduces tinnitus and thus indirectly validates the compensatory nature of tinnitus. Brain stimulation techniques can modulate the suffering of tinnitus, presumably by alteration of stress-related brain networks. Continued research is crucial for unravelling the complexities of tinnitus. Progress in management hinges on decoding diverse manifestations, identifying treatment-responsive subtypes, and advancing targeted therapeutic approaches.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
- Interdisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany.
| | - Dirk de Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Clinic, University of Regensburg, Regensburg, Germany
- Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Liu M, Zhang J, Wang Y, Zhou Y, Xie F, Guo Q, Shi F, Zhang H, Wang Q, Shen D. A common spectrum underlying brain disorders across lifespan revealed by deep learning on brain networks. iScience 2023; 26:108244. [PMID: 38026184 PMCID: PMC10651682 DOI: 10.1016/j.isci.2023.108244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/26/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Brain disorders in the early and late life of humans potentially share pathological alterations in brain functions. However, the key neuroimaging evidence remains unrevealed for elucidating such commonness and the relationships among these disorders. To explore this puzzle, we build a restricted single-branch deep learning model, using multi-site functional magnetic resonance imaging data (N = 4,410, 6 sites), for classifying 5 different early- and late-life brain disorders from healthy controls (cognitively unimpaired). Our model achieves 62.6 ± 1.9% overall classification accuracy and thus supports us in detecting a set of commonly affected functional subnetworks, including default mode, executive control, visual, and limbic networks. In the deep-layer representation of data, we observe young and aging patients with disorders are continuously distributed, which is in line with the clinical concept of the "spectrum of disorders." The relationships among brain disorders from the revealed spectrum promote the understanding of disorder comorbidities and time associations in the lifespan.
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Affiliation(s)
- Mianxin Liu
- School of Biomedical Engineering, State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai 201210, China
- Shanghai Artificial Intelligence Laboratory, Shanghai 200232, China
| | - Jingyang Zhang
- School of Biomedical Engineering, State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai 201210, China
| | - Yao Wang
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Yan Zhou
- Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200001, China
| | - Fang Xie
- PET Center, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai 200233, China
| | - Feng Shi
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai 200232, China
| | - Han Zhang
- School of Biomedical Engineering, State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai 201210, China
| | - Qian Wang
- School of Biomedical Engineering, State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai 201210, China
| | - Dinggang Shen
- School of Biomedical Engineering, State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai 201210, China
- Department of Research and Development, Shanghai United Imaging Intelligence Co., Ltd, Shanghai 200232, China
- Shanghai Clinical Research and Trial Center, Shanghai 201210, China
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Elgoyhen AB. The α9α10 acetylcholine receptor: a non-neuronal nicotinic receptor. Pharmacol Res 2023; 190:106735. [PMID: 36931539 DOI: 10.1016/j.phrs.2023.106735] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/17/2023]
Abstract
Within the superfamily of pentameric ligand-gated ion channels, cholinergic nicotinic receptors (nAChRs) were classically identified to mediate synaptic transmission in the nervous system and the neuromuscular junction. The α9 and α10 nAChR subunits were the last ones to be identified. Surprisingly, they do not fall into the dichotomic neuronal/muscle classification of nAChRs. They assemble into heteropentamers with a well-established function as canonical ion channels in inner ear hair cells, where they mediate central nervous system control of auditory and vestibular sensory processing. The present review includes expression, pharmacological, structure-function, molecular evolution and pathophysiological studies, that define receptors composed from α9 and α10 subunits as distant and distinct members within the nAChR family. Thus, although α9 and α10 were initially included within the neuronal subdivision of nAChR subunits, they form a distinct clade within the phylogeny of nAChRs. Following the classification of nAChR subunits based on their main synaptic site of action, α9 and α10 should receive a name in their own right.
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Affiliation(s)
- Ana Belén Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres" (INGEBI), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Vuelta de Obligado 2490, Buenos Aires 1428, Argentina.
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Hyperacusis: Loudness Intolerance, Fear, Annoyance and Pain. Hear Res 2022; 426:108648. [DOI: 10.1016/j.heares.2022.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
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De Ridder D, Vanneste S, Song JJ, Adhia D. Tinnitus and the triple network model: a perspective. Clin Exp Otorhinolaryngol 2022; 15:205-212. [PMID: 35835548 PMCID: PMC9441510 DOI: 10.21053/ceo.2022.00815] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Tinnitus is defined as the conscious awareness of a sound without an identifiable external sound source, and tinnitus disorder as tinnitus with associated suffering. Chronic tinnitus has been anatomically and phenomenologically separated into three pathways: a lateral “sound” pathway, a medial “suffering” pathway, and a descending noise-canceling pathway. Here, the triple network model is proposed as a unifying framework common to neuropsychiatric disorders. It proposes that abnormal interactions among three cardinal networks—the self-representational default mode network, the behavioral relevance-encoding salience network and the goal-oriented central executive network—underlie brain disorders. Tinnitus commonly leads to negative cognitive, emotional, and autonomic responses, phenomenologically expressed as tinnitus-related suffering, processed by the medial pathway. This anatomically overlaps with the salience network, encoding the behavioral relevance of the sound stimulus. Chronic tinnitus can also become associated with the self-representing default mode network and becomes an intrinsic part of the self-percept. This is likely an energy-saving evolutionary adaptation, by detaching tinnitus from sympathetic energy-consuming activity. Eventually, this can lead to functional disability by interfering with the central executive network. In conclusion, these three pathways can be extended to a triple network model explaining all tinnitus-associated comorbidities. This model paves the way for the development of individualized treatment modalities.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jae-Jin Song
- Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Divya Adhia
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
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Kumar G, Kumar R, Pal MK, Pramanik N, Lahiri T, Gupta A, Pandey S. APT: An Automated Probe Tracker From Gene Expression Data. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2021; 18:1864-1874. [PMID: 31825870 DOI: 10.1109/tcbb.2019.2958345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Out of currently available semi-automatic tools for detecting diagnostic probes relevant to a pathophysiological condition, ArrayMining and GEO2R of NCBI are most popular. The shortcomings of ArrayMining and GEO2R are that both tools list the probes ordering them on the basis of their individual statistical level of significances with only difference of statistical methods used by them. While the latest tool GEO2R outputs either top 250 or all genes following its own ranking mechanism, ArrayMining requires number of probes to be inputted by the user. This study provided a way for automatic selection of probe-set that can be obtained from the voting of outputs resulted from statistical methods, t-Test, Mann-Whitney Test and Empirical Bayes Moderated t-test. It was also intriguing to find that the parameters of these statistical methods can be represented as a mathematical function of group fisher's discriminant ratio of a disease-control expression data-pair. Result of this fully automatic method, APT shows 88.97 percent success in comparison to 80.40 and 87.60 percent successes of ArrayMining and GEO2R respectively to include reported probes. Furthermore, out of 10 fold cross validation and 5 new test cases, APT shows a better performance than both ArrayMining and GEO2R in regards to sensitivity and specificity.
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Zhou XF, Zhou WE, Liu WJ, Luo MJ, Wu XQ, Wang Y, Liu P, Wen YM, Li JL, Zhao TT, Zhang HJ, Zhao HL, Li P. A Network Pharmacology Approach to Explore the Mechanism of HuangZhi YiShen Capsule for Treatment of Diabetic Kidney Disease. J Transl Int Med 2021; 9:98-113. [PMID: 34497749 PMCID: PMC8386324 DOI: 10.2478/jtim-2021-0020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE HuangZhi YiShen Capsule (HZYS) is a Chinese patent herbal drug that protects kidney function in diabetic kidney disease (DKD) patients. However, the pharmacologic mechanisms of HZYS remain unclear. This study would use network pharmacology to explore the pharmacologic mechanisms of HZYS. METHODS Chemical constituents of HZYS were obtained through the Traditional Chinese Medicine Systems Pharmacology Database (TCMSP) and literature search. Potential targets of HZYS were identified by using the TCMSP and the SwissTarget Prediction databases. DKD-related target genes were collected by using the Online Mendelian Inheritance in Man, Therapeutic Target Database, GeneCards, DisGeNET, and Drugbank databases. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were carried out to further explore the mechanisms of HZYS in treating DKD. Molecular docking was conducted to verify the potential interactions between the prime compounds and the hub genes. RESULTS 179 active compounds and 620 target genes were obtained, and 571 common targets were considered potential therapeutic targets. The top 10 main active compounds of HZYS were heparin, quercetin, kaempferol, luteolin, methyl14-methylpentadecanoate, methyl (Z)-11-hexadecenoate, 17-hydroxycorticosterone, 4-pregnene-17α, 20β, 21-triol-3, 11-dione, wogonin, and hydroxyecdysone. Hub signaling pathways by which HZYS treating DKD were PI3K-Akt, MAPK, AGE-RAGE in diabetic complications, TNF, and apoptosis. The top 10 target genes associated with these pathways were IL6, MAPK1, AKT1, RELA, BCL2, JUN, MAPK3, MAP2K1, CASP3, and TNF. Quercetin and Luteolin were verified to have good binding capability with the hub potential targets IL6, MAPK1, AKT1 through molecular docking. CONCLUSION HZYS appeared to treat DKD by regulating the inflammatory, oxidative stress, apoptotic, and fibrosis signaling pathways. This study provided a novel perspective for further research of HZYS.
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Affiliation(s)
- Xue-Feng Zhou
- Beijing University of Chinese Medicine, Beijing100029, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Wei-E Zhou
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing100730, China
| | - Wen-Jing Liu
- Beijing University of Chinese Medicine, Beijing100029, China
| | - Min-Jing Luo
- Beijing University of Chinese Medicine, Beijing100029, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Xia-Qing Wu
- Faculty of Life Science and Medicine, Northwest University, No. 229 Taibai North Road, Xi'an, Shaanxi710069, China
| | - Ying Wang
- Beijing University of Chinese Medicine, Beijing100029, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Peng Liu
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Yu-Min Wen
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Jia-Lin Li
- Beijing University of Chinese Medicine, Beijing100029, China
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Ting-Ting Zhao
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Hao-Jun Zhang
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Hai-Ling Zhao
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
| | - Ping Li
- Beijing Key Laboratory for Immune-Mediated Inflammatory Diseases, Institute of Clinical Medical Sciences, China-Japan Friendship Hospital, Beijing100029, China
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Tracking white-matter brain modifications in chronic non-bothersome acoustic trauma tinnitus. NEUROIMAGE-CLINICAL 2021; 31:102696. [PMID: 34029920 PMCID: PMC8163994 DOI: 10.1016/j.nicl.2021.102696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 11/30/2022]
Abstract
Tractography was compared between two groups of tinnitus and control participants. Diffusion was modeled with ss3t-CSD allowing apparent fiber density (AFD) calculation. 27 bundles of interest were chosen for their link to the auditory and limbic systems. AFD was significantly increased in the tinnitus group in the right frontal isthmus. AFD in the acoustic radiations was not significantly different between the groups.
Subjective tinnitus is a symptom characterized by the perception of sound with no external acoustic source, most often accompanied by co-morbidities. To date, the specific role of white matter abnormalities related to tinnitus reaches no consensus in the literature. The goal of this study was to explore the structural connectivity related to tinnitus percept per se, thus focusing on a specific population presenting chronic non-bothersome tinnitus of similar etiology (noise induced) without co-morbidities. We acquired diffusion-weighted images with high angular resolution in a homogeneous group of mildly impacted tinnitus participants (n = 19) and their matched controls (n = 19). We focused the study on two subsets of fiber bundles of interest: on one hand, we extracted the acoustic radiation and further included any intersecting fiber bundles; on the other hand, we explored the tracts related to the limbic system. We modeled the diffusion signal using constrained spherical deconvolution. We conducted a deep-learning based tractography segmentation and mapped Apparent Fiber Density (AFD) on the bundles of interest. C, as well as Fractional Anisotropy (FA) and FOD peak amplitude for comparison. Between group statistical comparison was performed along the 27 tracts of interest controlling for confounding hearing loss, tinnitus severity, and duration since onset. We tested a potential correlation with hearing loss, tinnitus duration and tinnitus handicap score along these tracts. In the tinnitus group, we observed increased AFD related to chronic tinnitus percept after acoustic trauma in two main white matter regions. First, in the right hemisphere, in the isthmus between inferior temporal and inferior frontal cortices, in the uncinate fasciculus (UF), and in the inferior fronto-occipital bundle (IFO). Second, in the left hemisphere, underneath the superior parietal region in the thalamo parietal tract and parieto-occipital pontine tract. Between-group differences in the acoustic radiations were not significant with AFD but were with FA. Furthermore, significant correlations with hearing loss were found in the left hemisphere in the inferior longitudinal fasciculus and in the fronto-pontine tract. No additional correlation was found with tinnitus duration nor with tinnitus handicap, as reflected by THI scores. The regions that displayed tinnitus related increased AFD also displayed increased FA. The isthmus of the UF and IFO in the right hemisphere appear to be involved with a number of neuropsychiatric and traumatic disorders confirming the involvement of the limbic system even in chronic non-bothersome tinnitus subjects, potentially suggesting a common pathway between these pathologies. White matter changes underneath the superior parietal cortex found here in tinnitus participants supports the implication of an auditory-somatosensory pathway in tinnitus perception.
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Mohagheghian F, Khajehpour H, Samadzadehaghdam N, Eqlimi E, Jalilvand H, Makkiabadi B, Deevband MR. Altered effective brain network topology in tinnitus: An EEG source connectivity analysis. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Job A, Jaroszynski C, Kavounoudias A, Jaillard A, Delon-Martin C. Functional Connectivity in Chronic Nonbothersome Tinnitus Following Acoustic Trauma: A Seed-Based Resting-State Functional Magnetic Resonance Imaging Study. Brain Connect 2020; 10:279-291. [DOI: 10.1089/brain.2019.0712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Agnès Job
- Institut de Recherche Biomédicale des Armées (IRBA), Brétigny s/Orge, France
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, Grenoble, France
| | - Chloé Jaroszynski
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, Grenoble, France
| | | | | | - Chantal Delon-Martin
- Univ. Grenoble Alpes, Inserm, U1216, Grenoble Institut Neurosciences, Grenoble, France
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Mohagheghian F, Makkiabadi B, Jalilvand H, Khajehpoor H, Samadzadehaghdam N, Eqlimi E, Deevband MR. Computer-Aided Tinnitus Detection based on Brain Network Analysis of EEG Functional Connectivity. J Biomed Phys Eng 2020; 9:687-698. [PMID: 32039100 PMCID: PMC6943854 DOI: 10.31661/jbpe.v0i0.937] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 06/30/2018] [Indexed: 01/04/2023]
Abstract
Background Tinnitus known as a central nervous system disorder is correlated with specific oscillatory activities within auditory and non-auditory brain areas. Several studies in the past few years have revealed that in the most tinnitus cases, the response pattern of neurons in auditory system is changed due to auditory deafferentation, which leads to variation and disruption of the brain networks. Objective In this paper, we introduce an approach to automatically distinguish tinnitus individuals from healthy controls based on whole-brain functional connectivity and network analysis. Material and Methods The functional connectivity analysis was applied to the resting state electroencephalographic (EEG) data of both groups using Weighted Phase Lag Index (WPLI) for various frequency bands in 2-44 Hz frequency range. In this case- control study, the classification was performed on graph theoretical measures using support vector machine (SVM) as a robust classification method. Results Experimental results showed promising classification performance with a high accuracy, sensitivity, and specificity in all frequency bands, specifically in the beta2 frequency band. Conclusion The current study provides substantial evidence that tinnitus network can be successfully detected by consistent measures of the brain networks based on EEG functional connectivity.
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Affiliation(s)
- F Mohagheghian
- PhD, Department of Medical Physics and Biomedical engineering, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - B Makkiabadi
- PhD, Department of Medical Physics and Biomedical engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- PhD, Research Center for Biomedical Technology and Robotics (RCBTR), Institute of Advanced Medical Technologies (IAMT), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - H Jalilvand
- PhD, Department of Audiology, School of Rehabilitation, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
| | - H Khajehpoor
- MSc, Department of Medical Physics and Biomedical engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- MSc, Research Center for Biomedical Technology and Robotics (RCBTR), Institute of Advanced Medical Technologies (IAMT), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - N Samadzadehaghdam
- MSc, Department of Medical Physics and Biomedical engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- MSc, Research Center for Biomedical Technology and Robotics (RCBTR), Institute of Advanced Medical Technologies (IAMT), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - E Eqlimi
- MSc, Department of Medical Physics and Biomedical engineering, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- MSc, Research Center for Biomedical Technology and Robotics (RCBTR), Institute of Advanced Medical Technologies (IAMT), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - M R Deevband
- PhD, Department of Medical Physics and Biomedical engineering, School of Medicine, Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran
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Berlot E, Arts R, Smit J, George E, Gulban OF, Moerel M, Stokroos R, Formisano E, De Martino F. A 7 Tesla fMRI investigation of human tinnitus percept in cortical and subcortical auditory areas. NEUROIMAGE-CLINICAL 2020; 25:102166. [PMID: 31958686 PMCID: PMC6970183 DOI: 10.1016/j.nicl.2020.102166] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/12/2019] [Accepted: 01/09/2020] [Indexed: 01/13/2023]
Abstract
Tinnitus is a clinical condition defined by hearing a sound in the absence of an objective source. Early experiments in animal models have suggested that tinnitus stems from an alteration of processing in the auditory system. However, translating these results to humans has proven challenging. One limiting factor has been the insufficient spatial resolution of non-invasive measurement techniques to investigate responses in subcortical auditory nuclei, like the inferior colliculus and the medial geniculate body (MGB). Here we employed ultra-high field functional magnetic resonance imaging (UHF-fMRI) at 7 Tesla to investigate the frequency-specific processing in sub-cortical and cortical regions in a cohort of six tinnitus patients and six hearing loss matched controls. We used task-based fMRI to perform tonotopic mapping and compared the magnitude and tuning of frequency-specific responses between the two groups. Additionally, we used resting-state fMRI to investigate the functional connectivity. Our results indicate frequency-unspecific reductions in the selectivity of frequency tuning that start at the level of the MGB and continue in the auditory cortex, as well as reduced thalamocortical and cortico-cortical connectivity with tinnitus. These findings suggest that tinnitus may be associated with reduced inhibition in the auditory pathway, potentially leading to increased neural noise and reduced functional connectivity. Moreover, these results indicate the relevance of high spatial resolution UHF-fMRI for the investigation of the role of sub-cortical auditory regions in tinnitus.
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Affiliation(s)
- Eva Berlot
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands; The Brain and Mind Institute, University of Western Ontario, 1151 Richmond St. N., London, ON N6A 5B7, Canada
| | - Remo Arts
- Cochlear Benelux NV, Mechelen Campus - Industrie Noord, Schaliënhoevedreef 20, Building I, Mechelen B-2800, Belgium
| | - Jasper Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, the Netherlands; Department of Ear Nose and Throat/Head and Neck Surgery, Zuyderland Medical Center, Sittard/Heerlen, the Netherlands
| | - Erwin George
- Department of Ear Nose and Throat /Audiology, School for Mental Health and Neuroscience (MHENS), Maastricht University Medical Center, Maastricht, the Netherlands
| | - Omer Faruk Gulban
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Michelle Moerel
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands; Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | - Robert Stokroos
- UMC Utrecht, department of Otolaryngology- Head and Neck Surgery, UMC Utrecht Brain Center, Utrecht, the Netherlands
| | - Elia Formisano
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands; Maastricht Centre for Systems Biology, Maastricht University, Maastricht, the Netherlands
| | - Federico De Martino
- Department of Cognitive Neuroscience, Maastricht University, Maastricht, the Netherlands; Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, MN, United States.
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Abstract
Tinnitus is a common symptom for which there is in most cases no causal therapy. The search for an improvement of tinnitus through pharmacological interventions has a long tradition. The observation that tinnitus can be transiently suppressed by the use of lidocaine has shown that the symptom is susceptible to pharmacotherapy. So far, however, no medication has been found for either acute or chronic subjective tinnitus that reliably leads to a long-term reduction or even complete disappearance of the symptom for the majority of tinnitus sufferers. Nevertheless, in everyday clinical life, drugs are frequently used, usually off-label, to relieve tinnitus or tinnitus-associated symptoms (e.g. sleep disturbance, depression, anxiety disorder or hearing loss). This chapter shows the different approaches to acute and chronic subjective tinnitus by means of pharmacotherapeutic interventions. Furthermore, this review reports on the scientific studies carried out in this area in recent years and explains the difficulties in finding a suitable medication for most forms of tinnitus. In addition, it reports on the pharmacotherapeutic options for objective tinnitus and describes the development of tinnitus as a side effect of certain drugs. Finally, possible target structures are mentioned, which should possibly be addressed in pharmacological studies in the near future.
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Affiliation(s)
- Tobias Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany
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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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Langguth B, Elgoyhen AB, Cederroth CR. Therapeutic Approaches to the Treatment of Tinnitus. Annu Rev Pharmacol Toxicol 2019; 59:291-313. [DOI: 10.1146/annurev-pharmtox-010818-021556] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Tinnitus is a highly prevalent condition that is associated with hearing loss in most cases. In the absence of external stimuli, phantom perceptions of sounds emerge from alterations in neuronal activity within central auditory and nonauditory structures. Pioneering studies using lidocaine revealed that tinnitus is susceptible to pharmacological interventions. However, lidocaine is not effective in all patients, and no other drug has been identified with clear efficacy for the long-term treatment of tinnitus. In this review, we present recent advances in tinnitus research, including more detailed knowledge of its pathophysiology and involved neurotransmitter systems. Moreover, we summarize results from animal and clinical treatment studies as well as from studies that identified tinnitus as a side effect of pharmacological treatments. Finally, we focus on challenges in the development of pharmacological compounds for the treatment of tinnitus, namely the limitations of available animal models and of standardized clinical research methodologies.
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Affiliation(s)
- Berthold Langguth
- Department of Psychiatry and Psychotherapy, and Interdisciplinary Tinnitus Clinic, University of Regensburg, 93053 Regensburg, Germany
| | - Ana Belen Elgoyhen
- Instituto de Investigaciones en Ingeniería Genética y Biología Molecular “Dr. Héctor N. Torres,” Consejo Nacional de Investigaciones Científicas y Técnicas, 1428 Buenos Aires, Argentina
- Instituto de Farmacología, Facultad de Medicina, Universidad de Buenos Aires, 1121 Buenos Aires, Argentina
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Assessment of the State of the Natural Antioxidant Barrier of a Body in Patients Complaining about the Presence of Tinnitus. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2018; 2018:1439575. [PMID: 30510615 PMCID: PMC6230382 DOI: 10.1155/2018/1439575] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 09/24/2018] [Accepted: 10/08/2018] [Indexed: 12/19/2022]
Abstract
Background Tinnitus is defined as a phantom auditory perception, i.e., sound experience despite the lack of acoustic stimuli in the environment. The aim of this study was to assess the state of the natural antioxidant barrier of a body in patients complaining about the presence of tinnitus. Material and Methods The study included a total of 51 patients aged from 20 to 62 years with diagnosed idiopathic tinnitus and 19 healthy subjects as a control group. All patients underwent the audiometric tone test, speech audiometry, distortion otoacoustic emission product testing, study of evoked auditory potentials of short latency, and biochemical analysis of venous blood concerning values of activity or concentration of glutathione, glutathione peroxidase, S-transferase, glutathione reductase superoxide dismutase, malondialdehyde, and ceruloplasmin as the selected parameters of oxidative stress. Results Disorders of the auditory pathway were not only limited to the cochlea but also covered its further episodes. Mean values of activity or concentration of the selected parameters of oxidative stress in the study and control groups showed reduced effectiveness of the body's natural antioxidant barrier. Discussion Patients complaining about the presence of tinnitus showed reduced effectiveness of the body's natural antioxidant barrier compared to the control group. Conclusions The main indication to undertake further research on the functioning of the antioxidant barrier in people suffering from ailments in the form of tinnitus is to determine a suitable therapy aimed at improving the quality of life of these patients, which might be the administration of antioxidant medications.
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Lv H, Zhao P, Liu Z, Liu X, Ding H, Liu L, Wang G, Xie J, Zeng R, Chen Y, Yang Z, Gong S, Wang Z. Lateralization effects on functional connectivity of the auditory network in patients with unilateral pulsatile tinnitus as detected by functional MRI. Prog Neuropsychopharmacol Biol Psychiatry 2018; 81:228-235. [PMID: 28941768 DOI: 10.1016/j.pnpbp.2017.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 09/15/2017] [Accepted: 09/19/2017] [Indexed: 02/06/2023]
Abstract
Unilateral pulsatile tinnitus (PT) was proved to be a kind of disease with brain functional abnormalities within and beyond the auditory network (AN). However, changes in patterns of the lateralization effects of PT are yet to be established. Relationship between the AN and other brain networks in PT patients is also a scientific question need to be answered. In this study, we recruited 23 left-sided, 23 right-sided PT (LSPT, RSPT) patients and 23 normal controls (NC). We combined applied independent component analysis and seed-based functional connectivity (FC) analysis to investigate alteration feature of the FC of the AN by using resting-state functional magnetic resonance imaging (rs-fMRI). Compared with NC, LSPT patients demonstrated disconnected FC within the AN on both sides. Disrupted network integrity between AN and several brain functional networks, including executive control network, self-perceptual network and the limbic network, was also demonstrated in LSPT patient group bilaterally. In contrast, compared with NC, RSPT demonstrated decreased FC within the AN on the left side, but significant increased FC within the AN on the right side (symptomatic side). Enhanced FC between AN and executive control network, self-perceptual network and limbic network was also found mainly on the right side in patients with RSPT. Positive FC between the auditory network and the limbic network may be a reason to explain why RSPT patients are willing to be in the clinic. Briefly, LSPT exhibit disrupted network integrity in brain functional networks. But RSPT is featured by enhanced FC within AN and between networks, especially on the right (symptomatic) side. Corroboration of featured FC helps to reveal the pathophysiological changing process of the brain in patients with PT, providing imaging-based biomarker to distinguish PT from other kind of tinnitus.
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Affiliation(s)
- Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhaohui Liu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China
| | - Xuehuan Liu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Heyu Ding
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Liheng Liu
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Guopeng Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Jing Xie
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Rong Zeng
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Yuchen Chen
- Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Shusheng Gong
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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Yoon YS, Hwang B, Coltisor A. Commentary: Comparison of the Long-Term Effect of Positioning the Cathode in tDCS in Tinnitus Patients. Front Aging Neurosci 2018; 9:443. [PMID: 29375367 PMCID: PMC5768642 DOI: 10.3389/fnagi.2017.00443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 12/21/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Yang-soo Yoon
- Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, United States
- *Correspondence: Yang-soo Yoon
| | - Byungkwan Hwang
- Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, United States
| | - Allison Coltisor
- Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, United States
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19
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How Can Synergism of Traditional Medicines Benefit from Network Pharmacology? Molecules 2017; 22:molecules22071135. [PMID: 28686181 PMCID: PMC6152294 DOI: 10.3390/molecules22071135] [Citation(s) in RCA: 254] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 07/04/2017] [Accepted: 07/05/2017] [Indexed: 12/14/2022] Open
Abstract
Many prescriptions of traditional medicines (TMs), whose efficacy has been tested in clinical practice, have great therapeutic value and represent an excellent resource for drug discovery. Research into single compounds of TMs, such as artemisinin from Artemisia annua L., has achieved great success; however, it has become evident that a TM prescription (which frequently contains various herbs or other components) has a synergistic effect in effecting a cure or reducing toxicity. Network pharmacology targets biological networks and analyzes the links among drugs, targets, and diseases in those networks. Comprehensive, systematic research into network pharmacology is consistent with the perspective of holisticity, which is a main characteristic of many TMs. By means of network pharmacology, research has demonstrated that many a TM show a synergistic effect by acting at different levels on multiple targets and pathways. This approach effectively bridges the gap between modern medicine and TM, and it greatly facilitates studies into the synergistic actions of TMs. There are different kinds of synergistic effects with TMs, such as synergy among herbs, effective parts, and pure compounds; however, for various reasons, new drug discovery should at present focus on synergy among pure compounds.
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Santangelo A, Passani MB, Casarrubea M. Brain histamine and behavioral neuroscience. Oncotarget 2017; 8:16107-16108. [PMID: 28209924 PMCID: PMC5369950 DOI: 10.18632/oncotarget.15365] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 02/13/2017] [Indexed: 01/15/2023] Open
Affiliation(s)
- Andrea Santangelo
- Department of Neuroscience, Psychology, Drug Research and Child Health, Psychiatric Unit, University of Florence, Florence, Italy
| | - Maria Beatrice Passani
- Department of Neuroscience, Psychology, Drug Research and Child Health, Psychiatric Unit, University of Florence, Florence, Italy
| | - Maurizio Casarrubea
- Department of Neuroscience, Psychology, Drug Research and Child Health, Psychiatric Unit, University of Florence, Florence, Italy
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21
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Differential tinnitus-related neuroplastic alterations of cortical thickness and surface area. Hear Res 2016; 342:1-12. [DOI: 10.1016/j.heares.2016.08.016] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 08/26/2016] [Accepted: 08/31/2016] [Indexed: 12/27/2022]
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Alterations of Regional Cerebral Blood Flow in Tinnitus Patients as Assessed Using Single-Photon Emission Computed Tomography. PLoS One 2015; 10:e0137291. [PMID: 26332128 PMCID: PMC4557829 DOI: 10.1371/journal.pone.0137291] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 08/14/2015] [Indexed: 12/12/2022] Open
Abstract
Tinnitus is the perception of phantom sound without an external auditory stimulus. Using neuroimaging techniques, such as positron emission tomography, electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI), many studies have demonstrated that abnormal functions of the central nervous system are closely associated with tinnitus. In our previous research, we reported using resting-state fMRI that several brain regions, including the rectus gyrus, cingulate gyrus, thalamus, hippocampus, caudate, inferior temporal gyrus, cerebellar hemisphere, and medial superior frontal gyrus, were associated with tinnitus distress and loudness. To reconfirm these results and probe target regions for repetitive transcranial magnetic stimulation (rTMS), we investigated the regional cerebral blood flow (rCBF) between younger tinnitus patients (<60 years old) and the age-matched controls using single-photon emission computed tomography and easy Z-score imaging system. Compared with that of controls, the rCBF of tinnitus patients was significantly lower in the bilateral medial superior frontal gyri, left middle occipital gyrus and significantly higher in the bilateral cerebellar hemispheres and vermis, bilateral middle temporal gyri, right fusiform gyrus. No clear differences were observed between tinnitus patients with normal and impaired hearing. Regardless of the assessment modality, similar brain regions were identified as characteristic in tinnitus patients. These regions are potentially involved in the pathophysiology of chronic subjective tinnitus.
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23
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Simonetti P, Oiticica J. Tinnitus Neural Mechanisms and Structural Changes in the Brain: The Contribution of Neuroimaging Research. Int Arch Otorhinolaryngol 2015; 19:259-65. [PMID: 26157502 PMCID: PMC4490922 DOI: 10.1055/s-0035-1548671] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/09/2015] [Indexed: 12/26/2022] Open
Abstract
Introduction Tinnitus is an abnormal perception of sound in the absence of an external stimulus. Chronic tinnitus usually has a high impact in many aspects of patients' lives, such as emotional stress, sleep disturbance, concentration difficulties, and so on. These strong reactions are usually attributed to central nervous system involvement. Neuroimaging has revealed the implication of brain structures in the auditory system. Objective This systematic review points out neuroimaging studies that contribute to identifying the structures involved in the pathophysiological mechanism of generation and persistence of various forms of tinnitus. Data Synthesis Functional imaging research reveals that tinnitus perception is associated with the involvement of the nonauditory brain areas, including the front parietal area; the limbic system, which consists of the anterior cingulate cortex, anterior insula, and amygdala; and the hippocampal and parahippocampal area. Conclusion The neuroimaging research confirms the involvement of the mechanisms of memory and cognition in the persistence of perception, anxiety, distress, and suffering associated with tinnitus.
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Affiliation(s)
- Patricia Simonetti
- Department of Otolaryngology, School of Medicine, University of São Paulo, Brazil
| | - Jeanne Oiticica
- Department of Otolaryngology, School of Medicine, University of São Paulo, Brazil
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Miroddi M, Bruno R, Galletti F, Calapai F, Navarra M, Gangemi S, Calapai G. Clinical pharmacology of melatonin in the treatment of tinnitus: a review. Eur J Clin Pharmacol 2015; 71:263-70. [DOI: 10.1007/s00228-015-1805-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 01/07/2015] [Indexed: 11/30/2022]
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Auditory cortex tACS and tRNS for tinnitus: single versus multiple sessions. Neural Plast 2014; 2014:436713. [PMID: 25587455 PMCID: PMC4283418 DOI: 10.1155/2014/436713] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/14/2014] [Indexed: 11/20/2022] Open
Abstract
Tinnitus is the perception of a sound in the absence of an external acoustic source, which often exerts a significant impact on the quality of life. Currently there is evidence that neuroplastic changes in both neural pathways are involved in the generation and maintaining of tinnitus. Neuromodulation has been suggested to interfere with these neuroplastic alterations. In this study we aimed to compare the effect of two upcoming forms of transcranial electrical neuromodulation: alternating current stimulation (tACS) and random noise stimulation (tRNS), both applied on the auditory cortex. A database with 228 patients with chronic tinnitus who underwent noninvasive neuromodulation was retrospectively analyzed. The results of this study show that a single session of tRNS induces a significant suppressive effect on tinnitus loudness and distress, in contrast to tACS. Multiple sessions of tRNS augment the suppressive effect on tinnitus loudness but have no effect on tinnitus distress. In conclusion this preliminary study shows a possibly beneficial effect of tRNS on tinnitus and can be a motivation for future randomized placebo-controlled clinical studies with auditory tRNS for tinnitus. Auditory alpha-modulated tACS does not seem to be contributing to the treatment of tinnitus.
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26
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Searchfield GD. Tinnitus what and where: an ecological framework. Front Neurol 2014; 5:271. [PMID: 25566177 PMCID: PMC4266022 DOI: 10.3389/fneur.2014.00271] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 12/01/2014] [Indexed: 01/04/2023] Open
Abstract
Tinnitus is an interaction of the environment, cognition, and plasticity. The connection between the individual with tinnitus and their world seldom receives attention in neurophysiological research. As well as changes in cell excitability, an individual's culture and beliefs, and work and social environs may all influence how tinnitus is perceived. In this review, an ecological framework for current neurophysiological evidence is considered. The model defines tinnitus as the perception of an auditory object in the absence of an acoustic event. It is hypothesized that following deafferentation: adaptive feature extraction, schema, and semantic object formation processes lead to tinnitus in a manner predicted by Adaptation Level Theory (1, 2). Evidence from physiological studies is compared to the tenants of the proposed ecological model. The consideration of diverse events within an ecological context may unite seemingly disparate neurophysiological models.
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Affiliation(s)
- Grant D. Searchfield
- Section of Audiology, School of Population Health, Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
- Tinnitus Research Initiative, Regensburg, Germany
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Hoare DJ, Van Labeke N, McCormack A, Sereda M, Smith S, Taher HA, Kowalkowski VL, Sharples M, Hall DA. Gameplay as a source of intrinsic motivation in a randomized controlled trial of auditory training for tinnitus. PLoS One 2014; 9:e107430. [PMID: 25215617 PMCID: PMC4162598 DOI: 10.1371/journal.pone.0107430] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Accepted: 06/19/2014] [Indexed: 11/18/2022] Open
Abstract
Background Previous studies of frequency discrimination training (FDT) for tinnitus used repetitive task-based training programmes relying on extrinsic factors to motivate participation. Studies reported limited improvement in tinnitus symptoms. Purpose To evaluate FDT exploiting intrinsic motivations by integrating training with computer-gameplay. Methods Sixty participants were randomly assigned to train on either a conventional task-based training, or one of two interactive game-based training platforms over six weeks. Outcomes included assessment of motivation, tinnitus handicap, and performance on tests of attention. Results Participants reported greater intrinsic motivation to train on the interactive game-based platforms, yet compliance of all three groups was similar (∼70%) and changes in self-reported tinnitus severity were not significant. There was no difference between groups in terms of change in tinnitus severity or performance on measures of attention. Conclusion FDT can be integrated within an intrinsically motivating game. Whilst this may improve participant experience, in this instance it did not translate to additional compliance or therapeutic benefit. Trial Registration ClinicalTrials.gov NCT02095262
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Affiliation(s)
- Derek J. Hoare
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- * E-mail:
| | - Nicolas Van Labeke
- Institute of Educational Technology, The Open University, Milton Keynes, United Kingdom
| | - Abby McCormack
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Magdalena Sereda
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sandra Smith
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Hala Al Taher
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
| | | | - Mike Sharples
- Institute of Educational Technology, The Open University, Milton Keynes, United Kingdom
| | - Deborah A. Hall
- National Institute for Health Research Nottingham Hearing Biomedical Research Unit, Nottingham, United Kingdom
- Otology and Hearing group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Meyer M, Luethi MS, Neff P, Langer N, Büchi S. Disentangling tinnitus distress and tinnitus presence by means of EEG power analysis. Neural Plast 2014; 2014:468546. [PMID: 25276437 PMCID: PMC4168245 DOI: 10.1155/2014/468546] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 07/03/2014] [Accepted: 07/16/2014] [Indexed: 01/16/2023] Open
Abstract
The present study investigated 24 individuals suffering from chronic tinnitus (TI) and 24 nonaffected controls (CO). We recorded resting-state EEG and collected psychometric data to obtain information about how chronic tinnitus experience affects the cognitive and emotional state of TI. The study was meant to disentangle TI with high distress from those who suffer less from persistent tinnitus based on both neurophysiological and behavioral data. A principal component analysis of psychometric data uncovers two distinct independent dimensions characterizing the individual tinnitus experience. These independent states are distress and presence, the latter is described as the perceived intensity of sound experience that increases with tinnitus duration devoid of any considerable emotional burden. Neuroplastic changes correlate with the two independent components. TI with high distress display increased EEG activity in the oscillatory range around 25 Hz (upper β-band) that agglomerates over frontal recording sites. TI with high presence show enhanced EEG signal strength in the δ-, α-, and lower γ-bands (30-40 Hz) over bilateral temporal and left perisylvian electrodes. Based on these differential patterns we suggest that the two dimensions, namely, distress and presence, should be considered as independent dimensions of chronic subjective tinnitus.
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Affiliation(s)
- Martin Meyer
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Institute of Psychology, University of Zurich, Andreasstrasse 15/2, 8050 Zurich, Switzerland
- International Normal Aging and Plasticity Imaging Center, University of Zurich, Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Cognitive Psychology Unit (CPU), University of Klagenfurt, Klagenfurt am Wörthersee, Austria
| | - Matthias S. Luethi
- Biological Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland
| | - Patrick Neff
- Neuroplasticity and Learning in the Healthy Aging Brain (HAB LAB), Institute of Psychology, University of Zurich, Andreasstrasse 15/2, 8050 Zurich, Switzerland
- University Research Priority Program “Dynamics of Healthy Aging”, University of Zurich, Zurich, Switzerland
- Institute for Computer Music and Sound Technology (ICST), University of the Arts (ZHdK), Zurich, Switzerland
| | - Nicolas Langer
- Laboratories of Cognitive Neuroscience, Division of Developmental Medicine, Department of Medicine, Children's Hospital Boston, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- City College New York, New York, NY, USA
- Child Mind Institute, New York, NY, USA
| | - Stefan Büchi
- Child Mind Institute, New York, NY, USA
- Clinic for Psychotherapy and Psychosomatics “Hohenegg”, Meilen, Switzerland
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De Ridder D, Vanneste S, Weisz N, Londero A, Schlee W, Elgoyhen AB, Langguth B. An integrative model of auditory phantom perception: Tinnitus as a unified percept of interacting separable subnetworks. Neurosci Biobehav Rev 2014; 44:16-32. [PMID: 23597755 DOI: 10.1016/j.neubiorev.2013.03.021] [Citation(s) in RCA: 253] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 03/19/2013] [Accepted: 03/27/2013] [Indexed: 01/30/2023]
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Identifying tinnitus-related genes based on a side-effect network analysis. CPT-PHARMACOMETRICS & SYSTEMS PHARMACOLOGY 2014; 3:e97. [PMID: 24477090 PMCID: PMC3910011 DOI: 10.1038/psp.2013.75] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Accepted: 11/24/2013] [Indexed: 12/13/2022]
Abstract
Tinnitus, phantom sound perception, is a worldwide highly prevalent disorder for which no clear underlying pathology has been established and for which no approved drug is on the market. Thus, there is an urgent need for new approaches to understand this condition. We used a network pharmacology side-effect analysis to search for genes that are involved in tinnitus generation. We analyzed a network of 1,313 drug–target pairs, based on 275 compounds that elicit tinnitus as side effect and their targets reported in databases, and used a quantitative score to identify emergent significant targets that were more common than expected at random. Cyclooxigenase 1 and 2 were significant, which validates our approach, since salicylate is a known tinnitus generator. More importantly, we predict previously unknown tinnitus-related targets. The present results have important implications toward understanding tinnitus pathophysiology and might pave the way toward the design of novel pharmacotherapies.
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De Ridder D, Vanneste S, Engineer ND, Kilgard MP. Safety and Efficacy of Vagus Nerve Stimulation Paired With Tones for the Treatment of Tinnitus: A Case Series. Neuromodulation 2013; 17:170-9. [DOI: 10.1111/ner.12127] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 08/15/2013] [Accepted: 09/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Dirk De Ridder
- Brai n, Tinnitus Research Initiative Clinic Antwerp & Department of Neurosurgery; University Hospital Antwerp; Belgium
- Department of Surgical Sciences, Dunedin School of Medicine; University of Otago; New Zealand
| | - Sven Vanneste
- Brai n, Tinnitus Research Initiative Clinic Antwerp & Department of Neurosurgery; University Hospital Antwerp; Belgium
- Department of Translational Neuroscience, Faculty of Medicine; University of Antwerp; Belgium
| | | | - Michael P. Kilgard
- School of Behavioral and Brain Sciences; University of Texas at Dallas; Richardson TX USA
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Role of attention in the generation and modulation of tinnitus. Neurosci Biobehav Rev 2013; 37:1754-73. [DOI: 10.1016/j.neubiorev.2013.07.007] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2013] [Revised: 06/24/2013] [Accepted: 07/11/2013] [Indexed: 01/23/2023]
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Ueyama T, Donishi T, Ukai S, Ikeda Y, Hotomi M, Yamanaka N, Shinosaki K, Terada M, Kaneoke Y. Brain regions responsible for tinnitus distress and loudness: a resting-state FMRI study. PLoS One 2013; 8:e67778. [PMID: 23825684 PMCID: PMC3692468 DOI: 10.1371/journal.pone.0067778] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 05/27/2013] [Indexed: 12/31/2022] Open
Abstract
Subjective tinnitus is characterized by the perception of phantom sound without an external auditory stimulus. We hypothesized that abnormal functionally connected regions in the central nervous system might underlie the pathophysiology of chronic subjective tinnitus. Statistical significance of functional connectivity (FC) strength is affected by the regional autocorrelation coefficient (AC). In this study, we used resting-state functional MRI (fMRI) and measured regional mean FC strength (mean cross-correlation coefficient between a region and all other regions without taking into account the effect of AC (rGC) and with taking into account the effect of AC (rGCa) to elucidate brain regions related to tinnitus symptoms such as distress, depression and loudness. Consistent with previous studies, tinnitus loudness was not related to tinnitus-related distress and depressive state. Although both rGC and rGCa revealed similar brain regions where the values showed a statistically significant relationship with tinnitus-related symptoms, the regions for rGCa were more localized and more clearly delineated the regions related specifically to each symptom. The rGCa values in the bilateral rectus gyri were positively correlated and those in the bilateral anterior and middle cingulate gyri were negatively correlated with distress and depressive state. The rGCa values in the bilateral thalamus, the bilateral hippocampus, and the left caudate were positively correlated and those in the left medial superior frontal gyrus and the left posterior cingulate gyrus were negatively correlated with tinnitus loudness. These results suggest that distinct brain regions are responsible for tinnitus symptoms. The regions for distress and depressive state are known to be related to depression, while the regions for tinnitus loudness are known to be related to the default mode network and integration of multi-sensory information.
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Affiliation(s)
- Takashi Ueyama
- Department of Anatomy and Cell Biology, Graduate School of Wakayama Medical University, Wakayama, Japan.
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Lang A, Vernet M, Yang Q, Orssaud C, Londero A, Kapoula Z. Differential auditory-oculomotor interactions in patients with right vs. left sided subjective tinnitus: a saccade study. Front Hum Neurosci 2013; 7:47. [PMID: 23550269 PMCID: PMC3581810 DOI: 10.3389/fnhum.2013.00047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Accepted: 02/05/2013] [Indexed: 12/31/2022] Open
Abstract
Subjective tinnitus (ST) is a frequent but poorly understood medical condition. Recent studies demonstrated abnormalities in several types of eye movements (smooth pursuit, optokinetic nystagmus, fixation, and vergence) in ST patients. The present study investigates horizontal and vertical saccades in patients with tinnitus lateralized predominantly to the left or to the right side. Compared to left sided ST, tinnitus perceived on the right side impaired almost all the parameters of saccades (latency, amplitude, velocity, etc.) and noticeably the upward saccades. Relative to controls, saccades from both groups were more dysmetric and were characterized by increased saccade disconjugacy (i.e., poor binocular coordination). Although the precise mechanisms linking ST and saccadic control remain unexplained, these data suggest that ST can lead to detrimental auditory, visuomotor, and perhaps vestibular interactions.
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Affiliation(s)
- Alexandre Lang
- CNRS CESEM - UMR 8194, Université Paris Descartes Paris, France
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Analysis of inner ear potassium recycling genes as potential factors associated with tinnitus. Int J Occup Med Environ Health 2012; 25:356-64. [PMID: 23224734 DOI: 10.2478/s13382-012-0061-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2012] [Accepted: 10/25/2012] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Tinnitus is defined as a perception of sound in the absence of an external acoustic stimulus. Several factors are known to influence tinnitus, e.g. hearing loss, noise exposure, age, and hypertension. As only certain individuals develop tinnitus in the presence of the above risks and in approximately 50% of cases tinnitus is not attributed to any particular cause, the question arose whether this inter-individual susceptibility to tinnitus could be explained by the influence of genetic factors. OBJECTIVES To test the hypothesis that genetic variability in genes of the potassium recycling pathway is associated with increased susceptibility to tinnitus. MATERIALS AND METHODS The study group consisted of 626 subjects exposed to occupational noise (128 with tinnitus and 498 without tinnitus). 99 single nucleotide polymorphisms were investigated in 10 genes involved in the potassium recycling pathway in the inner ear, previously selected as putative noise-induced hearing loss (NIHL) candidate genes. RESULTS Nominally significant associations were obtained for 2 variants in KCNE1 (potassium voltage-gated channel, Isk-related family, member 1) and SLC12A2 (solute carrier family 12, member 2) genes. The first gene contributed to tinnitus that developed independently of hearing loss, while the second one was associated with increased susceptibility to noise-induced hearing loss. CONCLUSIONS Present findings lend support to the notion of potassium recycling pathway genes as possible risk modifiers of tinnitus in individuals with and without hearing loss. Due to the lack of replication in other independent populations these results should be seen as suggestive.
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Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother 2012; 13:2495-509. [DOI: 10.1517/14656566.2012.739608] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Song JJ, Vanneste S, Van de Heyning P, De Ridder D. Transcranial direct current stimulation in tinnitus patients: a systemic review and meta-analysis. ScientificWorldJournal 2012; 2012:427941. [PMID: 23133339 PMCID: PMC3483673 DOI: 10.1100/2012/427941] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 09/24/2012] [Indexed: 02/01/2023] Open
Abstract
Although transcranial direct current stimulation (tDCS) has already been used to manage tinnitus patients, paucity of reports and variations in protocols preclude a comprehensive understanding. Hence, we conducted a meta-analysis based on systemic review to assess effectiveness of tDCS in tinnitus management and to compare stimulation parameters. PubMed was searched for tDCS studies in tinnitus. For randomized controlled trials (RCTs), a meta-analysis was performed. A total of 17 studies were identified and 6 of them were included in the systemic review and 2 RCTs were included in the meta-analysis. Overall 39.5% responded to active tDCS with a mean tinnitus intensity reduction of 13.5%. Additionally, left temporal area (LTA) and bifrontal tDCS indicated comparable results. Active tDCS was found to be more effective than sham tDCS for tinnitus intensity reduction (Hedges' g = .77, 95% confidence interval 0.23-1.31). The efficacy of tDCS in tinnitus could not be fully confirmed by the current study because of the limited number of studies, but all studies included in the current systemic review and meta-analysis demonstrated significant tinnitus intensity improvement. Therefore, tDCS may be a promising tool for tinnitus management. Future RCTs in a large series regarding the efficacy as well as the comparison between LTA- and bifrontal tDCS are recommended.
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Affiliation(s)
- Jae-Jin Song
- Brain, TRI & Department of Neurosurgery, University Hospital Antwerp, Wilrijkstraat 10, Edegem, Belgium.
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Abstract
BACKGROUND This is an update of a Cochrane review first published in The Cochrane Library in Issue 4, 2006 and previously updated in 2009.Tinnitus is described as the perception of sound or noise in the absence of real acoustic stimulation. It has been compared with chronic pain, and may be associated with depression or depressive symptoms which can affect quality of life and the ability to work. Antidepressant drugs have been used to treat tinnitus in patients with and without depressive symptoms. OBJECTIVES To assess the effectiveness of antidepressants in the treatment of tinnitus and to ascertain whether any benefit is due to a direct tinnitus effect or a secondary effect due to treatment of concomitant depressive states. SEARCH METHODS We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; PsycINFO; CINAHL; Web of Science; BIOSIS; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 5 January 2012. SELECTION CRITERIA Randomised controlled clinical studies of antidepressant drugs versus placebo in patients with tinnitus. DATA COLLECTION AND ANALYSIS Two authors critically appraised the retrieved studies and extracted data independently. Where necessary we contacted study authors for further information. MAIN RESULTS Six trials involving 610 patients were included. Trial quality was generally low. Four of the trials looked at the effect of tricyclic antidepressants on tinnitus, investigating 405 patients. One trial investigated the effect of a selective serotonin reuptake inhibitor (SSRI) in a group of 120 patients. One study investigated trazodone, an atypical antidepressant, versus placebo. Only the trial using the SSRI drug reached the highest quality standard. None of the other included trials met the highest quality standard, due to use of inadequate outcome measures, large drop-out rates or failure to separate the effects on tinnitus from the effects on symptoms of anxiety and depression. All the trials assessing tricyclic antidepressants suggested that there was a slight improvement in tinnitus but these effects may have been attributable to methodological bias. The trial that investigated the SSRI drug found no overall improvement in any of the validated outcome measures that were used in the study although there was possible benefit for a subgroup that received higher doses of the drug. This observation merits further investigation. In the trial investigating trazodone, the results showed an improvement in tinnitus intensity and in quality of life after treatment, but in neither case reached statistical significance. Reports of side effects including sedation, sexual dysfunction and dry mouth were common. AUTHORS' CONCLUSIONS There is as yet insufficient evidence to say that antidepressant drug therapy improves tinnitus.
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Affiliation(s)
- Paolo Baldo
- Pharmacy Unit, Drug Information Centre, CRO Aviano - Centro di RiferimentoOncologico IRCCS, Aviano (PN), Italy. .
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Giessing C, Thiel CM. Pro-cognitive drug effects modulate functional brain network organization. Front Behav Neurosci 2012; 6:53. [PMID: 22973209 PMCID: PMC3428580 DOI: 10.3389/fnbeh.2012.00053] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2012] [Accepted: 07/25/2012] [Indexed: 12/14/2022] Open
Abstract
Previous studies document that cholinergic and noradrenergic drugs improve attention, memory and cognitive control in healthy subjects and patients with neuropsychiatric disorders. In humans neural mechanisms of cholinergic and noradrenergic modulation have mainly been analyzed by investigating drug-induced changes of task-related neural activity measured with functional magnetic resonance imaging (fMRI). Endogenous neural activity has often been neglected. Further, although drugs affect the coupling between neurons, only a few human studies have explicitly addressed how drugs modulate the functional connectome, i.e., the functional neural interactions within the brain. These studies have mainly focused on synchronization or correlation of brain activations. Recently, there are some drug studies using graph theory and other new mathematical approaches to model the brain as a complex network of interconnected processing nodes. Using such measures it is possible to detect not only focal, but also subtle, widely distributed drug effects on functional network topology. Most important, graph theoretical measures also quantify whether drug-induced changes in topology or network organization facilitate or hinder information processing. Several studies could show that functional brain integration is highly correlated with behavioral performance suggesting that cholinergic and noradrenergic drugs which improve measures of cognitive performance should increase functional network integration. The purpose of this paper is to show that graph theory provides a mathematical tool to develop theory-driven biomarkers of pro-cognitive drug effects, and also to discuss how these approaches can contribute to the understanding of the role of cholinergic and noradrenergic modulation in the human brain. Finally we discuss the "global workspace" theory as a theoretical framework of pro-cognitive drug effects and argue that pro-cognitive effects of cholinergic and noradrenergic drugs might be related to higher network integration.
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Affiliation(s)
- Carsten Giessing
- Biological Psychology Lab, Institute of Psychology, University of OldenburgOldenburg, Germany
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Landgrebe M, Azevedo A, Baguley D, Bauer C, Cacace A, Coelho C, Dornhoffer J, Figueiredo R, Flor H, Hajak G, van de Heyning P, Hiller W, Khedr E, Kleinjung T, Koller M, Lainez JM, Londero A, Martin WH, Mennemeier M, Piccirillo J, De Ridder D, Rupprecht R, Searchfield G, Vanneste S, Zeman F, Langguth B. Methodological aspects of clinical trials in tinnitus: a proposal for an international standard. J Psychosom Res 2012; 73:112-21. [PMID: 22789414 PMCID: PMC3897200 DOI: 10.1016/j.jpsychores.2012.05.002] [Citation(s) in RCA: 128] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 05/05/2012] [Accepted: 05/09/2012] [Indexed: 11/15/2022]
Abstract
Chronic tinnitus is a common condition with a high burden of disease. While many different treatments are used in clinical practice, the evidence for the efficacy of these treatments is low and the variance of treatment response between individuals is high. This is most likely due to the great heterogeneity of tinnitus with respect to clinical features as well as underlying pathophysiological mechanisms. There is a clear need to find effective treatment options in tinnitus, however, clinical trials differ substantially with respect to methodological quality and design. Consequently, the conclusions that can be derived from these studies are limited and jeopardize comparison between studies. Here, we discuss our view of the most important aspects of trial design in clinical studies in tinnitus and make suggestions for an international methodological standard in tinnitus trials. We hope that the proposed methodological standard will stimulate scientific discussion and will help to improve the quality of trials in tinnitus.
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Affiliation(s)
- Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany.
| | - Andréia Azevedo
- Department of Otolaryngology, Otosul-Otorrinolaringologia Sul-Fluminense, Volta Redonda, Brasil
| | - David Baguley
- Audiology Department, Cambridge University Hospitals, Cambridge, UK
| | - Carol Bauer
- Division of Otolaryngology Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Anthony Cacace
- Department of Communications Sciences & Disorders, Wayne State University, Detroit, Michigan, USA
| | - Claudia Coelho
- Instituto de Avaliação de Tecnologia em Saúde and Grupo de Pesquisa em Neurotologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - John Dornhoffer
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Ricardo Figueiredo
- Department of Otolaryngology, Otosul-Otorrinolaringologia Sul-Fluminense, Volta Redonda, Brasil
| | - Herta Flor
- Institute of Neuropsychology, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Goeran Hajak
- Department of Psychiatry, Psychosomatics and Psychotherapy, Sozialstiftung Bamberg, Germany
| | - Paul van de Heyning
- Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Belgium
| | - Wolfgang Hiller
- Clinical Psychology and Psychotherapy, Psychological Institute, University of Mainz, Germany
| | - Eman Khedr
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Tobias Kleinjung
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Zurich, Switzerland
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Germany
| | | | - Alain Londero
- Service ORL et CCF, Hôpital Européen G. Pompidou, Paris, France
| | - William H. Martin
- Department of Otolaryngology, Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Mark Mennemeier
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, USA
| | - Jay Piccirillo
- Department of Otolaryngology-Head and Neck and Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Dirk De Ridder
- TRI Tinnitus Clinic Antwerp, University Hospital Antwerp, Belgium
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany
| | - Grant Searchfield
- Section of Audiology, School of Population Health, The University of Auckland, New Zealand
| | - Sven Vanneste
- TRI Tinnitus Clinic Antwerp, University Hospital Antwerp, Belgium
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Germany,Interdisciplinary Tinnitus Clinic, University of Regensburg, Germany
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Eggermont JJ, Roberts LE. The neuroscience of tinnitus: understanding abnormal and normal auditory perception. Front Syst Neurosci 2012; 6:53. [PMID: 22798948 PMCID: PMC3394370 DOI: 10.3389/fnsys.2012.00053] [Citation(s) in RCA: 89] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 06/20/2012] [Indexed: 11/13/2022] Open
Affiliation(s)
- Jos J Eggermont
- Department of Physiology and the Hotchkiss Brain Institute, University of Calgary Calgary, AB, Canada
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