Auditory hallucinations in tinnitus patients: Emotional relationships and depression

Electrophysiological correlates of focused attention on low- and high-distressed tinnitus

OBJECTIVES

The study aimed at determining the EEG correlates of concentration on either low or high-distressed tinnitus.

METHODS

Sixty-seven patients (36 women, mean age = 50.34 ± 12.94 years) with chronic tinnitus were assigned to either a high (HD) or low (LD) tinnitus-related distress group based on THI results. All participants took part in the EEG study comprising two 3-4 min blocks of focusing on either tinnitus (Tinnitus Focus Condition, TFC) or the sensations from one's own body (Body Focus Condition, BFC). The absolute power and current density of 8 frequency bands in 7 clusters were compared between conditions and groups.

RESULTS

The most pronounced differences were found in the HD patients in the TFC, relative to the BFC, i.e. reduced power of frontally distributed low alpha (8-10 Hz) and posterior high alpha (10-12 Hz) as well as lower current density of 8-10 Hz rhythm over the right frontal/anterior cingulate cortex and higher middle beta (15-18 Hz) density in the precuneus. The HD, relative to LD patients, in both conditions, exhibited increased low beta (12-15 Hz) power over the left middle area and greater higher beta (15-25 Hz) power in the left posterior region.

CONCLUSIONS

The present study contrasted bioelectrical activity, acquired when concentrating on tinnitus with EEG data collected whilst patients focused on their body. Decreased alpha power and current density in the frontal/cingulate cortex when listening to bothersome tinnitus might reflect greater cortical arousal whereas increased beta power and density in the precuneus/posterior cingulate activity in this condition could be indicative for elevated tension or augmented cognitive/emotional processing of tinnitus sound. Enhanced beta rhythm in patients with high versus low tinnitus distress, observed independently of the study condition, may be due to greater self-focused attention or more active processing of sensations derived from the own body.

The use of tDCS as a therapeutic option for tinnitus: a systematic review

INTRODUCTION

Due to the subjectivity of the tinnitus diagnosis and its diverse etiologies, establishing an effective treatment is complex. In this context, transcranial direct current stimulation, a noninvasive option, is available for most patients and has shown good results in the treatment of other symptoms such as chronic pain.

OBJECTIVE

To evaluate the therapeutic response of tinnitus to transcranial direct current stimulation.

METHODS

A systematic review of the literature was performed using the following descriptors: tinnitus, transcranial direct current stimulation and randomized clinical trial. The research was carried out in the MEDLINE/PUBMED, Lilacs, and Scielo databases. The inclusion criteria were: patients over 18 years of age with no associated comorbidities, who had a diagnosis established by a specialist or through the application of previously validated scales and criteria applied by a non-specialist physician.

RESULTS

A total of 4165 studies were found, and a total of six were selected after the inclusion criteria were applied, obtaining a sample of 602 patients. Based on the defined criteria, there was a positive response to transcranial direct current stimulation in 14.86% of the participants.

CONCLUSION

Based on literature studied, there is no therapeutic response of tinnitus to transcranial direct current stimulation.

The Influence of Tinnitus on the Audiometric Threshold of Sufferers

Introduction Tinnitus is a worldwide problem.

Objective The objective of this study is to evaluate the audiometric hearing thresholds of adult patients with ongoing tinnitus as their only otological symptom.

Methods We evaluated the hearing thresholds of 43 adult patients with ongoing tinnitus and no history of hearing loss from the otolaryngology department of a tertiary health institution at speech and high frequencies. A total of 56 tinnitus ears were compared against 30 contralateral normal ears as well as with the 100 ears of 50 healthy volunteers.

Results The study group consisted of 11 (25.6%) males and 32 (74.4%) females with a mean age of 40.9 ± 11.7. The mean Pure Tone Average of the 56 tinnitus ears was 14.8 ± 9, while that of the 100 control ears was 11.2 ± 6 (U = 2078, p = 0.008). The mean pure tone average of the control was also significantly lower than that of the 30 contralateral normal ears of the tinnitus sufferers (U = 1136, p = 0.02). We observed mild to moderate hearing loss in 10 (23%) of the participants. We observed no hearing loss among the control group.

Conclusion A proportion of tinnitus sufferers with self-professed normal hearing are likely to have mildly elevated pure tone audiometric thresholds. In patients with unilateral tinnitus, such elevated pure tone hearing thresholds are likely to be in the tinnitus ear and the contralateral non-tinnitus ear.