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Brain Sciences
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New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus
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New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Systems Neuroscience".

Deadline for manuscript submissions: closed (31 August 2022) | Viewed by 21814

Special Issue Editors

Dr. Pedro Cobo

E-Mail Website
Guest Editor
Institute for Physical and Information Technologies (ITEFI), Spanish National Research Council (CSIC), Madrid, Spain
Interests: tinnitus assessment; counselling of tinnitus; sound therapies of tinnitus
Special Issues, Collections and Topics in MDPI journals
Dr. Maria Cuesta

E-Mail Website
Guest Editor
Institute for Physical and Information Technologies (ITEFI), Spanish National Research Council (CSIC), Madrid, Spain
Interests: tinnitus; hearing loss; sound therapy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Tinnitus is a rather heterogeneous auditory disorder having a severe impact on the regular life of about 0.5–2% of people by annoying, irritating, disturbing sleep patterns, and producing panic, anxiety, and/or depression. Although many research works have been published on its pathophysiology, diagnosis, and treatment, the precise generation, measurement, and remedy of tinnitus remains to be completely elucidated.

This Special Issue of Brain Sciences aims to present a collection of research and clinical studies detailing the most recent advancements in the field of tinnitus. Authors are invited to submit innovative research and reviews that address a broad range of topics related to tinnitus, including the pathophysiology (where and how tinnitus is generated), diagnosis (tinnitus assessment, tinnitus outcomes, objective techniques), and treatments (sound therapies, TRT, CBT, neuromodulation, etc.) of tinnitus. In particular, we aim to present advances in tinnitus research that could contribute to alleviate the most severe effects in patients.

Dr. Pedro Cobo
Dr. Maria Cuesta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • tinnitus
  • auditory system
  • tinnitus pathophysiology
  • tinnitus generation
  • tinnitus mechanisms
  • tinnitus diagnosis
  • tinnitus treatment
  • tinnitus therapy

Published Papers (7 papers)

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Editorial

Jump to: Research, Review

4 pages, 222 KiB  
Editorial
Special Issue “New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus”
by Pedro Cobo and María Cuesta
Brain Sci. 2022, 12(10), 1330; https://doi.org/10.3390/brainsci12101330 - 30 Sep 2022
Cited by 1 | Viewed by 1200
Abstract
We are honoured to have been involved with Brain Sciences in the production of the Special Issue “New Insights into Pathophysiology; Diagnosis and Treatment of Tinnitus” aiming to address recent advances in the field of tinnitus [...] Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)

Research

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19 pages, 895 KiB  
Article
Integrating Distribution-Based and Anchor-Based Techniques to Identify Minimal Important Change for the Tinnitus Functional Index (TFI) Questionnaire
by Kathryn Fackrell, Deborah Ann Hall, Johanna Barry and Derek James Hoare
Brain Sci. 2022, 12(6), 726; https://doi.org/10.3390/brainsci12060726 - 31 May 2022
Cited by 5 | Viewed by 1940
Abstract
The Tinnitus Functional Index (TFI) was developed to be responsive to small treatment-related changes in the impact of tinnitus. Yet, no studies have integrated anchor-based and distribution-based techniques to produce a single Minimal Important Change (MIC) score. Here, we evaluated the responsiveness and [...] Read more.
The Tinnitus Functional Index (TFI) was developed to be responsive to small treatment-related changes in the impact of tinnitus. Yet, no studies have integrated anchor-based and distribution-based techniques to produce a single Minimal Important Change (MIC) score. Here, we evaluated the responsiveness and interpretability of the TFI, determining for the first time a robust MIC score in a UK clinical population. Two-hundred and fifty-five patients with tinnitus participated in this prospective longitudinal validation study. Distribution-based estimates (Standard Error of Measurement, Smallest Detectable Change and Effect size) and anchor-based estimates of important change (minimal clinically important difference and Receiver Operator Curve optimal value) were calculated and then integrated using a visual anchor-based MIC distribution plot. A reduction in score of −14 was determined as the MIC estimate that exceeds the measurement error, most of the variability and reliably identifies patients demonstrating true improvement. It is therefore recommended that a reduction of 14 points should be used as a minimum change required when calculating statistical power and sample size in tinnitus intervention studies and assessing patients in clinical practice. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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24 pages, 3878 KiB  
Article
The Quantum Tunneling of Ions Model Can Explain the Pathophysiology of Tinnitus
by Baeth M Al-Rawashdeh, Abdallah Barjas Qaswal, Aiman Suleiman, Fuad Mohammed Zayed, S. M. Al-Rawashdeh, Mohamed Tawalbeh, Lubna Khreesha, Ayham Alzubaidi, Enas Al-Zubidi, Zuhir Ghala, Ahmad Almasri, Mohammed Yasein, Khaled Ojjoh, Ahmad Alraiqib, Mohammad Iswaid, Murad Emar, Shahed Haimour, Ala’ Saifan and Zaid Mahameed
Brain Sci. 2022, 12(4), 426; https://doi.org/10.3390/brainsci12040426 - 23 Mar 2022
Cited by 5 | Viewed by 6710
Abstract
Tinnitus is a well-known pathological entity in clinical practice. However, the pathophysiological mechanisms behind tinnitus seem to be elusive and cannot provide a comprehensive understanding of its pathogenesis and clinical manifestations. Hence, in the present study, we explore the mathematical model of ions’ [...] Read more.
Tinnitus is a well-known pathological entity in clinical practice. However, the pathophysiological mechanisms behind tinnitus seem to be elusive and cannot provide a comprehensive understanding of its pathogenesis and clinical manifestations. Hence, in the present study, we explore the mathematical model of ions’ quantum tunneling to propose an original pathophysiological mechanism for the sensation of tinnitus. The present model focuses on two major aspects: The first aspect is the ability of ions, including sodium, potassium, and calcium, to depolarize the membrane potential of inner hair cells and the neurons of the auditory pathway. This membrane depolarization is induced via the quantum tunneling of ions through closed voltage-gated channels. The state of membrane depolarization can be a state of hyper-excitability or hypo-excitability, depending on the degree of depolarization. Both of these states aid in understanding the pathophysiology of tinnitus. The second aspect is the quantum tunneling signals between the demyelinated neurons of the auditory pathway. These signals are mediated via the quantum tunneling of potassium ions, which exit to the extracellular fluid during an action potential event. These quantum signals can be viewed as a “quantum synapse” between neurons. The formation of quantum synapses results in hyper-excitability among the demyelinated neurons of the auditory pathway. Both of these aspects augment and amplify the electrical signals in the auditory pathway and result in a loss of the spatiotemporal fidelity of sound signals going to the brain centers. The brain interprets this hyper-excitability and loss of spatiotemporal fidelity as tinnitus. Herein, we show mathematically that the quantum tunneling of ions can depolarize the membrane potential of the inner hair cells and neurons of the auditory pathway. Moreover, we calculate the probability of action potential induction in the neurons of the auditory pathway generated by the quantum tunneling signals of potassium ions. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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13 pages, 1269 KiB  
Article
Dimensions of Tinnitus-Related Distress
by Petra Brueggemann, Wilhelm Mebus, Benjamin Boecking, Nyamaa Amarjargal, Uli Niemann, Myra Spiliopoulou, Christian Dobel, Matthias Rose and Birgit Mazurek
Brain Sci. 2022, 12(2), 275; https://doi.org/10.3390/brainsci12020275 - 16 Feb 2022
Cited by 16 | Viewed by 2804
Abstract
Objectives: (1) To determine which psychosocial aspects predict tinnitus-related distress in a large self-reported dataset of patients with chronic tinnitus, and (2) to identify underlying constructs by means of factor analysis. Methods: A cohort of 1958 patients of the Charité Tinnitus Center, Berlin [...] Read more.
Objectives: (1) To determine which psychosocial aspects predict tinnitus-related distress in a large self-reported dataset of patients with chronic tinnitus, and (2) to identify underlying constructs by means of factor analysis. Methods: A cohort of 1958 patients of the Charité Tinnitus Center, Berlin completed a large questionnaire battery that comprised sociodemographic data, tinnitus-related distress, general psychological stress experience, emotional symptoms, and somatic complaints. To identify a construct of “tinnitus-related distress”, significant predictive items were grouped using factor analysis. Results: For the prediction of tinnitus-related distress (linear regression model with R2 = 0.7), depressive fatigue symptoms (concentration, sleep, rumination, joy decreased), the experience of emotional strain, somatization tendencies (pain experience, doctor contacts), and age appeared to play a role. The factor analysis revealed five factors: “stress”, “pain experience”, “fatigue”, “autonomy”, and low “educational level”. Conclusions: Tinnitus-related distress is predicted by psychological and sociodemographic indices. Relevant factors seem to be depressive exhaustion with somatic expressions such as sleep and concentration problems, somatization, general psychological stress, and reduced activity, in addition to higher age. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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7 pages, 623 KiB  
Article
Auditory Brainstem Response Wave I Amplitude Has Limited Clinical Utility in Diagnosing Tinnitus in Humans
by Katie Turner, Omid Moshtaghi, Neil Saez, Matthew Richardson, Hamid Djalilian, Fan-Gang Zeng and Harrison Lin
Brain Sci. 2022, 12(2), 142; https://doi.org/10.3390/brainsci12020142 - 21 Jan 2022
Cited by 7 | Viewed by 2782
Abstract
Animal studies have discovered that noise, even at levels that produce no permanent threshold shift, may cause cochlear damage and selective nerve degeneration. A hallmark of such damage, or synaptopathy, is recovered threshold but reduced suprathreshold amplitude for the auditory brainstem response (ABR) [...] Read more.
Animal studies have discovered that noise, even at levels that produce no permanent threshold shift, may cause cochlear damage and selective nerve degeneration. A hallmark of such damage, or synaptopathy, is recovered threshold but reduced suprathreshold amplitude for the auditory brainstem response (ABR) wave I. The objective of the present study is to evaluate whether the ABR wave I amplitude or slope can be used to diagnose tinnitus in humans. A total of 43 human subjects, consisting of 21 with tinnitus and 22 without tinnitus, participated in the study. The subjects were on average 44 ± 24 (standard deviation) years old and 16 were female; a subgroup of 19 were young adults with normal audiograms from 125 to 8000 Hz. The ABR was measured using ear canal recording tiptrodes for clicks, 1000, 4000 and 8000 Hz tone bursts at 30, 50, and 70 dB nHL. Compared with control subjects, tinnitus subjects did not show reduced ABR wave I amplitude or slope in either the entire group of 21 tinnitus subjects or a subset of tinnitus subjects with normal audiograms. Despite the small sample size and diverse tinnitus population, the present result suggests that low signal-to-noise ratios in non-invasive measurement of the ABR limit its clinical utility in diagnosing tinnitus in humans. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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13 pages, 3462 KiB  
Article
Efficacy of Sound Therapy for Tinnitus Using an Enriched Acoustic Environment with Hearing-Loss Matched Broadband Noise
by María Cuesta, Christiam Garzón and Pedro Cobo
Brain Sci. 2022, 12(1), 82; https://doi.org/10.3390/brainsci12010082 - 06 Jan 2022
Cited by 9 | Viewed by 2988
Abstract
Background: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort [...] Read more.
Background: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort of 83 tinnitus patients. Methods: 119 tinnitus subjects, recruited between January 2018 and June 2021, were subjected to a treatment consisting of a combination of an initial counselling session and four-month sound therapy. The sound stimulus was a personalized broadband noise colored by the audiometry of the subjects. These stimuli were given to the patients in mp3 format to be heard 1 h per day over 4 months. The tinnitus severity of the patients was evaluated monthly through the validated Spanish version of the Tinnitus Handicap Inventory. Results: Of the patients, 30% (36 of 119) withdrew from the treatment before finishing, and 96% (80 of 83) of the subjects completing the therapy attained some relief after 4 months. The overall average THI decrease of these 80 participants was 23. However, when the THI was analyzed by severity scales, it was found that patients with initial mild, moderate, severe and catastrophic handicap had an average THI decrease of 14, 20, 31 and 42 points, respectively. Thus, the average THI decrease depended on the baseline severity scale of patients. Conclusions: Consequently, the proposed treatment was demonstrated to be effective in providing clinically relevant relief in tinnitus distress patients in just 4 months. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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Review

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36 pages, 1125 KiB  
Review
Objective Detection of Tinnitus Based on Electrophysiology
by Shuwen Fan and Shufeng Li
Brain Sci. 2022, 12(8), 1086; https://doi.org/10.3390/brainsci12081086 - 16 Aug 2022
Cited by 4 | Viewed by 2326
Abstract
Tinnitus, a common disease in the clinic, is associated with persistent pain and high costs to society. Several aspects of tinnitus, such as the pathophysiology mechanism, effective treatment, objective detection, etc., have not been elucidated. Any change in the auditory pathway can lead [...] Read more.
Tinnitus, a common disease in the clinic, is associated with persistent pain and high costs to society. Several aspects of tinnitus, such as the pathophysiology mechanism, effective treatment, objective detection, etc., have not been elucidated. Any change in the auditory pathway can lead to tinnitus. At present, there is no clear and unified mechanism to explain tinnitus, and the hypotheses regarding its mechanism include auditory plasticity theory, cortical reorganization theory, dorsal cochlear nucleus hypothesis, etc. Current theories on the mechanism of tinnitus mainly focus on the abnormal activity of the central nervous system. Unfortunately, there is currently a lack of objective diagnostic methods for tinnitus. Developing a method that can detect tinnitus objectively is crucial, only in this way can we identify whether the patient really suffers from tinnitus in the case of cognitive impairment or medical disputes and the therapeutic effect of tinnitus. Electrophysiological investigations have prompted the development of an objective detection of tinnitus by potentials recorded in the auditory pathway. However, there is no objective indicator with sufficient sensitivity and specificity to diagnose tinnitus at present. Based on recent findings of studies with various methods, possible electrophysiological approaches to detect the presence of tinnitus have been summarized. We analyze the change of neural activity throughout the auditory pathway in tinnitus subjects and in patients with tinnitus of varying severity to find available parameters in these methods, which is helpful to further explore the feasibility of using electrophysiological methods for the objective detection of tinnitus. Full article
(This article belongs to the Special Issue New Insights into Pathophysiology, Diagnosis and Treatment of Tinnitus)
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