The Analogy between Tinnitus and Chronic Pain: A Phenomenological Approach

Round 1

Reviewer 1 Report

Dear Author,

I have reviewed the manuscript. My response is given in a point-by-point manner below.

Sincerely,

Analogy between tinnitus and pain: a phenomenological approach

Title:

·         The title is so good and concise, but based on my search I found the article with the this title

“The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus (PMID: 2820913)”. For this, I suggest you to change little the title to attract more the audience.

Abstract:

·         In 3^rd line, for better of expression, It’s better to remove the “with which it may be associated”.

·         In 5^th and 7^th lined, it is better to use “paper” instead of “article”.

·         In 4^th line, I suggest you to add the “psychological factors” in the text, to direct better the attention of the audience.

·         I think for this valuable review article, add the “keyword section” to the text.

Main Text:

1. Introduction

·         In 4^th paragraph, the “timbre” is not suitable. I suggest to remove it.

·         In 5^th paragraph, it is better to use “paper” instead of “article”.

2. Critique of behavioural and cognitive psychology

2.1 The behaviourist model:

·         I think is better to use “behaviorism” instead of “behaviourist”.

2.2. The cognitivist model

·         I suggest you to apply “cognitive model” instead of “cognitivist model”.

·         In 12th line, I suggest to use “Sound therapy techniques” or “Masker devices” instead of “using acoustic devices”.

·         In 2^nd paragraph, what’s the means of “(…)”?

2.3. Some reflections on the behaviourist and cognitivist models

·         This part is comprehensive, I just suggest you to write it briefly.

3. What is phenomenology, 'the science of phenomena'?:

·         The topic "phenomenology" was very good for audience like me who may not be very familiar with its concept.

4. Sketching out a phenomenology of tinnitus?

·         Based on my opinion, it is comprehensive and flawless.

5. What is perceiving?

·         This section is excellent, but I suggest you to present it more briefly. For example, some explanation of 2^nd, 3^rd and 5^th paragraph is redundant.

6. Body, affectivity, emotion

·         This section seems complete.

·         I suggest you to blend 5^th and 6^th section with together.

7. What is pain?

·         I strongly suggest blending 7th and 8th sections and writing it briefly.

8. The affective part of pain

·         I strongly suggest blending 7th and 8th sections.

9. From pain to suffering (distress)

·         It may be better to apply “distress” in the title of this section, instead of “suffering”.

·         I think other parts of this section are flawless.

10. From pain to 'impressions of pain'

·         In 2^nd paragraph, applying “hearing” instead of “audition” is better.

11. What is hearing?

11.1. Hearing is the channel of vigilance

·         At the end of 1st paragraph, the “localization” may be better than “localizing” and “localize”.

·         Other parts are comprehensive.

11.2. Controlling the auditory system

·         It was so comprehensive, especially the examples, which directing the attention of readers to the tinnitus.

12. What is tinnitus?

12.1. Tinnitus is of the order of 'feeling'

·         In 1st paragraph, I suggest you to remove the “timbre”.

12.2. The implications of chronic tinnitus

·         In 1st paragraph, it may be better to use “somatic” or “physical” instead of “corporeal”. 

12.3. Tinnitus and event

·         This section is very long, I recommend making it more concise.

12.4. Tinnitus and plans

·         In 1st line, it’s better to write “Human beings are unique” instead of “Humans are unique animals”.

12.5. Tinnitus, temporality and suffering.

·         In 1st paragraph, I think “tinnitus subject” is better than “tinnitus sufferer”.

·         From a writing point of view, at the end of paragraph, the type of font seems incorrect.

12.6. Tinnitus, individuals and society

·         This section is comprehensive, but its length can make the audience tired. Therefore, I recommend removing its redundant sentences.

13. Discussion

·         At the end of 2^nd paragraph, the type of font seems difference.

·         In 3rd paragraph, I suggest you to write “The score of psychometric assessments, like questionnaires and VAS tool” instead of “The scores of the questionnaires”.

13.1. Acute vs. chronic tinnitus

·         Based on previous papers, “Chronic tinnitus” has duration at least 3 and or 6 months. I think one month is incorrect. Please revise it at 2^nd paragraph.

13.2. Estimation of the impact of tinnitus

·         In 3rd paragraph, the bullets have a different style and size. Editing it may be suitable.

13.3. Psychopathology and the DSM

·         In 1st paragraph, it’s better to apply “Tinnitus patients” instead of “Pathologising suffering‘.

13.4. Towards treatment

·         I recommend that other treatment options for tinnitus such as sound therapy or neuromodulation techniques (such as tDCS and rTMS) are added, so not to create a bias for the audiences that CBT is the only effective treatment option for tinnitus.

Minor editing of English language required.

Author Response

Reviewer 1

I would like to thank this reviewer for his thorough review of the article and his comments.

Title:

• The title is so good and concise, but based on my search I found the article with the this title

“The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus (PMID: 2820913)”. For this, I suggest you to change little the title to attract more the audience.

I changed the title to:

“The analogy between tinnitus and chronic pain: A phenomenological approach”

Abstract:

• In 3rd line, for better of expression, It’s better to remove the “with which it may be associated”.

Corrected as suggested.

• In 5th and 7th lined, it is better to use “paper” instead of “article”.

The manuscript has been corrected by a professional (English) translator who chose to use “article”. I'll stick to “article” throughout.

• In 4th line, I suggest you to add the “psychological factors” in the text, to direct better the attention of the audience.

Corrected as suggested.

• I think for this valuable review article, add the “keyword section” to the text.

Keywords have been added

Main Text:

1. Introduction

• In 4th paragraph, the “timbre” is not suitable. I suggest to remove it.

Timbre can be defined as what is not loudness or pitch so I decided to leave it.

• In 5th paragraph, it is better to use “paper” instead of “article”.

See above

2. Critique of behavioural and cognitive psychology

2.1 The behaviourist model:

• I think is better to use “behaviorism” instead of “behaviourist”.

Corrected.

2.2. The cognitivist model

• I suggest you to apply “cognitive model” instead of “cognitivist model”.

Corrected.

• In 12th line, I suggest to use “Sound therapy techniques” or “Masker devices” instead of “using acoustic devices”.

Corrected.

• In 2nd paragraph, what’s the means of “(…)”?

Part of McKenna’s paper is quoted.

2.3. Some reflections on the behaviourist and cognitivist models

• This part is comprehensive, I just suggest you to write it briefly.

This section has been shortened.

3. What is phenomenology, 'the science of phenomena'?:

• The topic "phenomenology" was very good for audience like me who may not be very familiar with its concept.

Thanks.

4. Sketching out a phenomenology of tinnitus?

• Based on my opinion, it is comprehensive and flawless.

Thanks.

5. What is perceiving?

• This section is excellent, but I suggest you to present it more briefly. For example, some explanation of 2nd, 3rd and 5th paragraph is redundant.

This section has been shortened.

6. Body, affectivity, emotion

• This section seems complete.
• I suggest you to blend 5th and 6th section with together.

Ok

7. What is pain?

• I strongly suggest blending 7th and 8th sections and writing it briefly.

This section has been reorganized.

8. The affective part of pain

• I strongly suggest blending 7th and 8th sections.

Ok

9. From pain to suffering (distress)

• It may be better to apply “distress” in the title of this section, instead of “suffering”.
• I think other parts of this section are flawless.

Ok

10. From pain to 'impressions of pain'

• In 2nd paragraph, applying “hearing” instead of “audition” is better.

Ok

11. What is hearing?

11.1. Hearing is the channel of vigilance

• At the end of 1st paragraph, the “localization” may be better than “localizing” and “localize”.
• Other parts are comprehensive.

Ok

11.2. Controlling the auditory system

• It was so comprehensive, especially the examples, which directing the attention of readers to the tinnitus.

Ok

12. What is tinnitus?

Ok

12.1. Tinnitus is of the order of 'feeling'

• In 1st paragraph, I suggest you to remove the “timbre”.

We decided to leave “timbre”. See above.

12.2. The implications of chronic tinnitus

• In 1st paragraph, it may be better to use “somatic” or “physical” instead of “corporeal”.

Ok

12.3. Tinnitus and event

• This section is very long, I recommend making it more concise.

This section has been shortened.

12.4. Tinnitus and plans

• In 1st line, it’s better to write “Human beings are unique” instead of “Humans are unique animals”.

Ok

12.5. Tinnitus, temporality and suffering.

• In 1st paragraph, I think “tinnitus subject” is better than “tinnitus sufferer”.
• From a writing point of view, at the end of paragraph, the type of font seems incorrect.

Ok

The font is ok.

12.6. Tinnitus, individuals and society

• This section is comprehensive, but its length can make the audience tired. Therefore, I recommend removing its redundant sentences.

This section has been reorganized (divided into sections) and shortened.

13. Discussion

• At the end of 2nd paragraph, the type of font seems difference.

No it is not.

• In 3rd paragraph, I suggest you to write “The score of psychometric assessments, like questionnaires and VAS tool” instead of “The scores of the questionnaires”.

Ok

13.1. Acute vs. chronic tinnitus

• Based on previous papers, “Chronic tinnitus” has duration at least 3 and or 6 months. I think one month is incorrect. Please revise it at 2nd paragraph.

Ok

13.2. Estimation of the impact of tinnitus

• In 3rd paragraph, the bullets have a different style and size. Editing it may be suitable.

No they haven’t.

13.3. Psychopathology and the DSM

• In 1st paragraph, it’s better to apply “Tinnitus patients” instead of “Pathologising suffering‘.

“Pathologizing suffering” has been replaced by “Pathologizing tinnitus distress”.

13.4. Towards treatment

• I recommend that other treatment options for tinnitus such as sound therapy or neuromodulation techniques (such as tDCS and rTMS) are added, so not to create a bias for the audiences that CBT is the only effective treatment option for tinnitus.

The point here is not to list the various treatments: the point is that tinnitus must be integrated by tinnitus patients at the cost of an existential metamorphosis. We changed the section’s title to:

“Tinnitus management: towards an existential metamorphosis”.

And a sentence has been slightly changed:

“CBT is useful to reduce the brazier of suffering, but it is on the other hand inoperative to address the meaning of life and profoundly transform the being.”

Author Response File: Author Response.docx

Reviewer 2 Report

The analogy between tinnitus and pain is well reported in the literature. The author proposes in this article a innovative phenomenological approach to tinnitus also towards effective treatments. The author carries out a complete and correct study not only on tinnitus but on all phenomena of perception.

Why  the author speaks of "Analogy between tinnitus and pain: a phenomenological approach" in the title and in the text (correctly) of chronic pain?

Pain is a symptom, chronic pain is a disease. Moreover the similarities between tinnitus and chronic pain involve the  frontolimbic striatal pathways that I don't find mentioned.

I have also some minor suggestions.

Introduction:

- the reference of the work by the AFREPA is not reported.

-the definition of tinnitus disorder (De Ridder et al. 2021) and auditory allucinosis (Messina et al. 2022) could be added.

Pag.26: the temporal definition of acute and chronic tinnitus (> 3 months for some authors, > 6 months for other authors) should be added with references and discussed.

The manuscript is written in fine English and requires a minor text editing.

Author Response

Reviewer 2

The analogy between tinnitus and pain is well reported in the literature. The author proposes in this article a innovative phenomenological approach to tinnitus also towards effective treatments. The author carries out a complete and correct study not only on tinnitus but on all phenomena of perception.

I would like to thank this reviewer for his valuable comments.

Why  the author speaks of "Analogy between tinnitus and pain: a phenomenological approach" in the title and in the text (correctly) of chronic pain?

Pain is a symptom, chronic pain is a disease. Moreover the similarities between tinnitus and chronic pain involve the  frontolimbic striatal pathways that I don't find mentioned.

The title has been changed to :

“The analogy between tinnitus and chronic pain: A phenomenological approach”

Regarding the reviewer’s comment about the “frontolimbic striatal pathways”: the article does not deal with the mechanisms of tinnitus or pain but with the way they are experienced.

I have also some minor suggestions.

Introduction:

- the reference of the work by the AFREPA is not reported.

Yes indeed, I forgot to add the reference. The reference has been added.

-the definition of tinnitus disorder (De Ridder et al. 2021) and auditory allucinosis (Messina et al. 2022) could be added.

The refence has been added:

(other definitions has been proposed: De Ridder et al., 2021; Messina et al., 2022)

Pag.26: the temporal definition of acute and chronic tinnitus (> 3 months for some authors, > 6 months for other authors) should be added with references and discussed.

References and additional text have been added.

Author Response File: Author Response.docx