Search Results (27)

Objectives: This study aimed to analyse blood glucose and lipid levels in subjective tinnitus compared to healthy controls. Method: A total of 414 patients with subjective tinnitus and 274 healthy participants were enrolled. All participants underwent comprehensive laboratory testing, which included measurements of fasting blood glucose, HbA1c, and blood lipids. Results: The tinnitus group had significantly higher glucose levels than the control group (p = 0.024). Additionally, the HbA1c levels were higher in the tinnitus group (p = 0.006). Tinnitus patients exhibited elevated levels of total cholesterol (p < 0.001), triglycerides (p < 0.001), and LDL (p < 0.001). However, HDL levels showed no significant difference (p = 0.984). Although the triglyceride–glucose index tends to show higher values in the tinnitus group, this difference is statistically insignificant (p = 0.688). ROC indicated that LDL had the highest sensitivity for predicting tinnitus (AUC = 0.620; p < 0.001, 95% CI: 0.573–0.668). Other parameters showed significant results, excluding the triglyceride–glucose index (AUC = 0.514; p = 0.688, 95% CI: 0.443–0.585), which was not a significant predictor. Glucose levels significantly correlate with age (rho = 0.338, p < 0.001) and tinnitus onset (rho = 0.107, p = 0.034). Additionally, age showed a significant correlation with total cholesterol levels (rho = 0.156, p = 0.002) and triglycerides (rho = 0.121, p = 0.020) and tinnitus onset (rho = 0.344, p < 0.001). Logistic regression analysis revealed that the presence of tinnitus was significantly associated with elevated HbA1c levels (p = 0.007) and TG levels (p = 0.001). Furthermore, the occurrence of chronic tinnitus was significantly influenced by elevated glucose levels (p = 0.026). Conclusions: The results showed increased glucose and blood lipid levels in tinnitus. LDL levels exhibited the highest sensitivity in predicting tinnitus. However, the TyG index was not a significant predictor. Given the cross-sectional design of the study, which may limit the results, further longitudinal studies are necessary. Full article

Objectives: This study aimed to analyse the potential influence of abnormalities detected through carotid–vertebral ultrasonography and brain MRI on pure-tone averages (PTAs) and the frequency and intensity of tinnitus. Methods: 423 participants with subjective tinnitus were enrolled in this investigation. All patients underwent carotid– vertebral ultrasonography, brain MRI, and pure-tone audiometry, including tinnitus matching. Results: The median values for tinnitus onset indicated chronic tinnitus in most cases. Regarding tinnitus location, left-sided symptoms (32%) and bilateral symptoms (44%) were the most prevalent. In analysing the effects of abnormalities detected by carotid–vertebral ultrasonography on PTAs, a statistically significant difference was found between the groups (p = 0.0037). Specifically, individuals with intimal hyperplasia had significantly higher PTAs (p = 0.02), as did those with carotid artery plaques (p = 0.005). However, no significant differences in PTAs were noted in relation to carotid artery stenosis (p = 0.07). Similar trends emerged regarding tinnitus intensity (p = 0.013), with significantly higher values observed in the presence of any carotid–vertebral ultrasonography abnormalities. In contrast, tinnitus frequencies were not significantly affected (p = 0.401). Regarding brain MRI findings, Fazekas scores of 2 (p = 0.02) and 3 (p = 0.0052) significantly influenced PTAs. For tinnitus intensity, Fazekas scores of 2 (p = 0.0027) and 3 (p = 0.0005), and the presence of acoustic neuromas (p = 0.019), significantly impacted the intensity values. However, tinnitus frequencies were not significantly (p = 0.36) influenced by brain MRI abnormalities. Conclusions: The findings of this study show that carotid–vertebral ultrasonography and brain MRI abnormalities significantly influence PTAs and tinnitus intensities. Full article

Background: This study investigates electrophysiological distinctions in auditory evoked potentials (AEPs) among individuals with chronic subjective tinnitus, with a specific focus on the impact of treatment response and tinnitus localisation. Methods: Early AEPs, known as Auditory Brainstem Responses (ABR), and middle AEPs, termed Auditory Middle Latency Responses (AMLR), were analysed in tinnitus patients across four clinical centers in an attempt to verify increased neuronal activity, in accordance with the current tinnitus models. Our statistical analyses primarily focused on discrepancies in time–domain core features of ABR and AMLR signals, including amplitudes and latencies, concerning both treatment response and tinnitus laterality. Results: Statistically significant differences were observed in ABR wave III and V latencies, ABR wave III peak amplitude, and AMLR wave Na and Nb amplitudes when comparing groups based on their response to treatment, accompanied by varying effect sizes. Conversely, when examining groups categorised by tinnitus laterality, no statistically significant differences emerged. Conclusions: These results provide valuable insights into the potential influence of treatment responses on AEPs. However, further research is imperative to attain a comprehensive understanding of the underlying mechanisms at play. Full article

Background: Tinnitus is a frequent symptom, and is present in 10–15% of people who suffer from chronic tinnitus, defined as heard every day for at least 6 months. Among these, 1–2% develop a strong emotive reaction, anxiety, and depression, leading to poor quality of life. Objectives: to evaluate the comorbidities in tinnitus sufferers. Methods: In our retrospective study, we collected data on 1156 subjects with tinnitus present for at least 3 months, including age, audiometric exam, THI questionnaire, vascular disorders, fluctuations, causal factors, lifetime psychiatric disorders, and the presence of migraine. A linear regression model was used to assess the independent role of these variables on the THI total score representing tinnitus annoyance. A lifetime history of psychiatric disorders and migraine were predictive for the development of a disabling tinnitus. Results: Among comorbidities a history of previous psychiatric disorders was predictive for developing tinnitus. Moreover, no correlation has been found between hearing level and THI total score. Conclusions: Our data are not inconsistent with the hypothesis that psychological disorders and a particular personality trait may be the main causal factors for tinnitus annoyance. Full article

Background/Objectives: Over the past few decades, many studies have been conducted to explore the link between tinnitus and lipid metabolism, yielding inconsistent results. In our current study, we compared the prevalence of various lipid metabolism abnormalities in patients with chronic subjective idiopathic tinnitus (CSIT) to the official prevalence data of dyslipidaemia in the general adult Hungarian population. To counteract the distorting effect of the co-increase in both conditions with age, we also examined this relationship by age groups. Methods: A total of 231 adult patients, suffering from CSIT, who underwent rheological treatment at the Department of Otorhinolaryngology and Head and Neck Surgery of the Clinical Center (University of Debrecen, Debrecen, Hungary), were involved in a retrospective study. Total cholesterol, serum triglycerides, LDL-C, ApoB, HDL-C, ApoA, and Lp(a) were utilized. Results: For the aggregated data, we found that the occurrence of dyslipidaemia among our patients (78.35%) significantly exceeded the corresponding official data about the occurrence of dyslipidaemia in the whole adult Hungarian population (16.51%). This finding was supported by our age-specific approach and the results imply an association between CSIT and dyslipidaemia. This finding suggests an association between CSIT and dyslipidaemia. Conclusions: Considering the relationship between CSIT and dyslipidaemia suggested by our results, tinnitus could be an indicator of dyslipidaemia, even at a young age. Therefore, careful investigation of each tinnitus patient, along with a lipidological evaluation for those with CSIT, may be recommended. This approach could lower mortality from lipid-related diseases, particularly atherosclerosis and its complications, by serving as the first line of defence against a harmful and life-threatening lipid-related conditions. Full article

Objectives: The aim of this study was to investigate the relationships between tinnitus pitch and loudness, the frequency of hearing loss, hearing level, and the Tinnitus Handicap Inventory (THI) scores reported by patients. Methods: In total, 139 patients (50 men and 89 women; mean age ± SD, 60.19 ± 11.47 years) who suffered from chronic primary tinnitus associated with sensorineural hearing loss were included in the study. Participants underwent pure-tone audiometry and tinnitus pitch matching assessments. Additionally, all participants completed the Hungarian version of the THI questionnaire. Correlations were assessed using simple linear, Spearman’s, and Pearson’s correlation tests, and a linear regression model was applied. The Mann–Whitney U test was also used. Results: This study identified a significant correlation between the pitch of tinnitus and the frequency of hearing loss (p = 0.000 *; rho = 0.549). There was also a significant correlation between tinnitus noise and hearing levels (p = 0.000 *; rho = 0.375). Age was shown to significantly affect tinnitus loudness (p = 0.016 *) and hearing levels (p = 0.000 *) as determined by a linear regression model. Tinnitus duration only significantly influenced tinnitus loudness (p = 0.022). There was no significant effect of sex on tinnitus or audiometry parameters. Total THI scores were influenced solely by tinnitus loudness (p = 0.021 *). Furthermore, sex did have an effect on total THI scores, with women reporting higher scores (p = 0.000 *). Conclusions: This study concluded that there is a significant correlation between the pitch and loudness of tinnitus and hearing levels, suggesting a connection in their underlying mechanisms. The intensity of tinnitus and hearing level are primarily affected by ageing processes. Furthermore, the severity of self-perceived tinnitus is mainly related to the loudness of tinnitus. Full article

This research aimed to investigate the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) method on chronic subjective tinnitus. The research was planned as an observational study. The study group comprises individuals who applied to the training and research hospital in Ankara between 2019 and 2020 and were aged between 15 and 60 years old. They were identified as having tinnitus. The study samples were determined as 36 participants selected through purposeful sampling. The samples of the 36 participants included in the study. 12 were assigned to the 1st Group EMDR and Masking Group, 12 to the 2nd Group Masking and EMDR Group, and 12 to the 3rd Control Group. The study’s dependent variable was the tinnitus levels of the participants, and the independent variable was EMDR and the Masking method. The dependent variable data of the study was collected with the Visual Analog Scale and Tinnitus Handicap Inventory (THI). EMDR and Masking methods used as independent variables in the study were conducted in eight sessions for two months. As a result of the Wilcoxon Sign test used to determine whether the EMDR Method is effective on tinnitus severity level, the difference between tinnitus severity level pretest and post-test median scores of tinnitus patients was found to be statistically significant. Our research findings show that the EMDR method reduces and improves chronic subjective tinnitus, and further studies with a larger sample size could confirm our results. Full article

Background and Objectives: We hypothesized that an individual’s personality traits would have an impact on the distress of subjective tinnitus. To investigate this, 32 participants were recruited; we followed up with this cohort. This study is a cross-sectional analysis of a part of this cohort, identifying how their personality traits make a difference in the severity of tinnitus distress. Materials and Methods: Thirty-two participants completed a personality test based on the Big Five theory, consisting of 160 items. Additionally, the severity of tinnitus was assessed using the Tinnitus Handicap Inventory (THI), and the accompanying level of depression was measured using the Beck Depression Inventory (BDI). Audiometry tests, including pure-tone audiometry, were also conducted. Participants were categorized into the ‘mild group’ if their total THI score was 36 or below, and into the ‘severe group’ if their score was 38 or above. Results: In the traditional five domains of the Big Five Inventory (Openness, Conscientiousness, Extraversion, Agreeableness, Neuroticism), only the ‘Neuroticism’ domain showed a difference between the two groups (25.1 ± 21.0 in the mild group and 43.1 ± 18.2 in the severe group, p = 0.014). Among ego-related factors, the ‘Helplessness’ domain (26.3 ± 22.9 in the mild group and 62.3 ± 27.9 in the severe group, p < 0.001) and the communication-related factor of ‘Listening’ (58.7 ± 18.8 in the mild group and 37.8 ± 27.9 in the severe group, p = 0.020) showed differences between the two groups. In the multivariate analysis, ‘Helplessness’ (estimate 0.419, 95% confidence interval 0.249–0.589, p < 0.001), ‘Emotional Trauma’ (0.213, 0.020–0.406, p = 0.032), and ‘Pure-tone threshold at 2000 Hz’ (0.944, 0.477–1.411, p < 0.001) were identified as factors influencing the severity of tinnitus distress. Conclusions: Ego-related factors, particularly Helplessness and Emotional Trauma, can influence tinnitus distress and should be considered in the management of tinnitus. Full article

Transcranial direct current stimulation (tDCS) is emerging as a promising non-invasive intervention for tinnitus by aiming to modulate abnormal brain activity. This study investigated the efficacy of dual-session tDCS for the relief of perception, distress, and loudness in patients with severe chronic subjective tinnitus and assessed the duration of tinnitus suppression effects compared to single-session and control groups over a 2-month follow-up. In a prospective, randomized, single-blind, placebo-controlled trial, 30 participants with severe chronic subjective tinnitus underwent bifrontal tDCS. The control group (n = 9), single-session group (n = 10), and dual-session group (n = 11) received 2 mA stimulation for 20 min per session, twice a week for one month. The treatment response was monitored weekly using the Visual Analogue Scale (VAS), with additional assessments using the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory (BDI) at the fourth and eighth weeks. The single- and dual-session groups showed statistically significant improvements in VAS, THI, and BDI scores compared to the control group. THI and BDI scores showed a significant difference between the single- and dual-session groups. The dual-session group demonstrated a more sustained tinnitus suppression effect than the single-session group. tDCS has been validated as an effective intervention for the suppression of tinnitus, with the dual-session protocol showing longer-term benefits. These findings support the potential of tDCS as a treatment for tinnitus, particularly in dual-session applications. Full article

This study looked at the possible effect of the COVID-19 pandemic on individuals who came to our clinic seeking relief from tinnitus. The performance of the subjects during the COVID-19 pandemic was compared with similar individuals who came to our clinic before the pandemic began. The study involved 50 adults with chronic tinnitus, made up of a study group (24 subjects tested during the COVID-19 pandemic of 2020–2021) and a control group before the pandemic began (26 subjects tested from 2013 to 2017). None of the 24 reported having contracted COVID-19. Data collection involved the Tinnitus Handicap Inventory (THI) questionnaire, audiological tests, and quantitative electroencephalography (qEEG). In terms of THI scores, there were no statistically significant differences between the two groups. However, with regard to qEEG, some changes were observed, with significant decreases in alpha and beta band activity in the study group compared to the control group, particularly over the auditory cortex. We conclude that COVID-19 did not have a discernible impact on the general well-being of individuals with tinnitus. However, it did appear to alter brain activity, specifically in the alpha and beta bands over the auditory cortex, and these reults warrant further investigation. Full article

Objective: Tinnitus assessment and outcome measurement are complex, as tinnitus is a purely subjective phenomenon. Instruments used for the outcome measurement of tinnitus in the context of clinical trials include self-report questionnaires, visual analogue or numeric rating scales and psychoacoustic measurements of tinnitus loudness. For the evaluation of therapeutic interventions, it is critical to know which changes in outcome measurement instruments can be considered as clinically relevant. For this purpose, the concept of the minimal clinically important difference (MCID) has been introduced. Study design: Here we performed a literature research in PubMed in order to identify for which tinnitus outcome measurements MCID criteria have been estimated and which of these estimates fulfil the current methodological standards and can thus be considered as established. Results: For most, but not all tinnitus outcome instruments, MCID calculations have been performed. The MCIDs for the Tinnitus Handicap Inventory (THI), the Tinnitus Questionnaire (TQ), the Tinnitus Functional Index (TFI) and visual analogue scales (VAS) vary considerably across studies. Psychoacoustic assessments of tinnitus such as loudness matching have not shown sufficient reliability and validity for the use as an outcome measurement. Conclusion: Future research should aim at the confirmation of the available estimates in large samples involving various therapeutic interventions and under the consideration of time intervals and baseline values. As a rule of thumb, an improvement of about 15% can be considered clinically meaningful, analogous to what has been seen in other entirely subjective pathologies like chronic pain. Full article

Importance: Chronic subjective tinnitus, the perception of sound without an external source for longer than six months, may be a greatly debilitating condition for some people, and is associated with psychiatric comorbidities and high healthcare costs. Current treatments are not beneficial for all patients and there is a large need for new therapies for tinnitus. Observations: Unlike rarer cases of objective tinnitus, chronic subjective tinnitus often has no obvious etiology and a diverse pathophysiology. In the absence of objective testing, diagnosis is heavily based on clinical assessment. Management strategies include hearing aids, sound masking, tinnitus retraining therapy, cognitive behavioral therapy, and emerging therapies including transcranial magnetic stimulation and electrical stimulation. Conclusions and relevance: Although current treatments are limited, emerging diagnostics and treatments provide promising avenues for the management of tinnitus symptoms. Full article

Tinnitus is an auditory sensation without external acoustic stimulation or significance, which may be lived as an unpleasant experience and impact the subject’s quality of life. Tinnitus loudness, which is generally low, bears no relation to distress. Factors other than psychoacoustic (such as psychological factors) are therefore implicated in the way tinnitus is experienced. The aim of this article is to attempt to understand how tinnitus can, like chronic pain, generate a ‘crisis’ in the process of existence, which may go as far as the collapse of the subject. The main idea put forward in the present article is that tinnitus may be compared to the phenomenon of pain from the point of view of the way it is experienced. Although the analogy between tinnitus and pain has often been made in the literature, it has been limited to a parallel concerning putative physiopathological mechanisms and has never really been explored in depth from the phenomenological point of view. Tinnitus is comparable to pain inasmuch as it is felt, not perceived: it springs up (without intention or exploration), abolishes the distance between the subject and the sensation (there is only a subject and no object), and has nothing to say about the world. Like pain, tinnitus is formless and abnormal and can alter the normal order of the world with maximum intensity. Finally, tinnitus and pain enclose the subject within the limits of the body, which then becomes in excess. Tinnitus may be a source of suffering, which affects not only the body but a person’s very existence and, in particular, its deployment in time. Plans are thus abolished, so time is no longer ‘secreted’, it is enclosed in an eternal present. If the crisis triggered by tinnitus is not resolved, the subject may buckle and collapse (depression) when their resources for resisting are depleted. The path may be long and winding from the moment when tinnitus emerges to when it assaults existence and its eventual integration into a new existential norm where tinnitus is no longer a source of disturbance. Full article

Background and Objectives: Tinnitus affects millions of adults. Many therapies, including complementary and alternative medicine and tinnitus retraining therapies, have been trialed, but an effective option, particularly for chronic subjective tinnitus (CTS), is still lacking. Materials and Methods: This study investigated the effects of alpha-lipoic acid (600 mg. per day for two months) on two groups of patients using a questionnaire. One group (A) was affected by tinnitus associated with likely cochlear dysfunction and metabolic syndrome, and the other (B) was composed of subjects with acoustic nerve lesions. All the patients were asked to complete the Italian version of the tinnitus handicap inventory (THI) to determine the overall degree of perceived annoyance at the beginning and end of therapy. Pure tone averages for speech frequencies and for high frequencies were computed, and psychoacoustic pitch and loudness matches were determined for each subject before and after treatment. Results: The pure tone audiometry, pitch, loudness, and THI scores of both groups were reported. In group A, statistically significant differences were observed for the “functional” and “emotional” subscales. The total score of THI and the loudness of tinnitus were also significantly reduced. No statistically significant differences were observed in group B. Conclusions: These findings suggest a possible contribution of the antioxidant effect to the organ of Corti in subjects with metabolic syndrome and CST. Full article

(1) Background: Poor sleep and fragmented sleep are associated with several chronic conditions. Tinnitus is an auditory symptom that often negatively combines with poor sleep and has been associated with sleep impairment and sleep apnea. The relationship between tinnitus psychoacoustic characteristics and sleep is still poorly explored, notably for a particular subgroup of patients, for whom the perceived loudness of their tinnitus is highly modulated by sleep. (2) Methods: For this observational prospective study, 30 subjects with tinnitus were recruited, including 15 “sleep intermittent tinnitus” subjects, who had reported significant modulations of tinnitus loudness related to night sleep and naps, and a control group of 15 subjects displaying constant non-sleep-modulated tinnitus. The control group had matching age, gender, self-reported hearing loss grade and tinnitus impact on quality of life with the study group. All patients underwent a polysomnography (PSG) assessment for one complete night and then were asked to fill in a case report form, as well as a report of tinnitus loudness before and after the PSG. (3) Results: “Sleep Intermittent tinnitus” subjects had less Stage 3 sleep (p < 0.01), less Rapid-Eye Movement (REM) Sleep (p < 0.05) and more Stage 2 sleep (p < 0.05) in proportion and duration than subjects from the control group. In addition, in the “sleep Intermittent tinnitus” sample, a correlation was found between REM sleep duration and tinnitus overnight modulation (p < 0.05), as well as tinnitus impact on quality of life (p < 0.05). These correlations were not present in the control group. (4) Conclusions: This study suggests that among the tinnitus population, patients displaying sleep-modulated tinnitus have deteriorated sleep quality. Furthermore, REM sleep characteristics may play a role in overnight tinnitus modulation. Potential pathophysiological explanations accounting for this observation are hypothesized and discussed. Full article