Special Issue "Novel Treatments and Diagnosis for Chronic Tinnitus"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Otolaryngology".

Deadline for manuscript submissions: 31 August 2021.

Special Issue Editors

Dr. Winfried Schlee
Website
Guest Editor
Clinic and Polyclinic for Psychiatry and Psychotherapy, 93053 Regensburg, Germany
Interests: tinnitus; chronic diseases; mobile health; ecological momentary assessment
Special Issues and Collections in MDPI journals
Prof. Dr. Jose A. Lopez-Escamez
Website
Guest Editor
Otology & Neurotology Group CTS495, Department of Genomic Medicine, GENYO—Centre for Genomics and Oncological Research—Pfizer/University of Granada/Junta de Andalucía, PTS, 18016 Granada, Spain
Interests: hearing loss; tinnitus; vertigo; Meniere disease; vestibular migraine; vestibular disorders; genomics; exome sequencing; sensorineural hearing loss; genetics of vestibular disorders

Special Issue Information

Dear Colleagues,

We would like to invite you to contribute to this Special Issue on "Novel Treatments and Diagnosis for Chronic Tinnitus".

Tinnitus is the perception of a phantom sound, including the patient’s reaction to it. It can occur at all ages, as well as in various frequencies and intensity and duration scales, whereas the annoyance experienced by the patients varies from totally absent to tinnitus-related suicidal tendency. To date, there is no standard treatment that reliably cures tinnitus. Among the most important reasons is the large variety among tinnitus patients, their temporal variation of symptoms and the heterogeneous responses to clinical interventions. Hearing loss seems to be one of the largest risk factors for tinnitus, but not all patients with hearing loss develop tinnitus, and not all patients with tinnitus exhibit measurable hearing loss. In recent years, genetic risk factors as well as the impact of somatosensory disorders have been revealed. In addition to this, some rare forms of tinnitus have a clearly identifiable neuroanatomical origin, such as arteriovenous malformation, aneurysm or acoustic neuroma.

The challenge is to improve the diagnostic procedures of tinnitus and assign the appropriate treatment or combination of treatments to the individual tinnitus patient. With this Special Issue, we want to concentrate on innovative diagnostic procedures and novel treatment strategies that aim to improve the patient journey from diagnosis to the best-suited therapeutic approach for the individual patient. In this respect, research papers on individualized treatment decisions and decision support systems are also strongly encouraged. Original research papers and systematic reviews of high quality are welcome.

Dr. Winfried Schlee
Dr. Jose A. Lopez-Escamez
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 papers will be 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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly 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

  • chronic tinnitus
  • novel treatment approaches
  • novel diagnostic measures
  • big data
  • personalized medicine
  • hearing loss

Published Papers (5 papers)

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Research

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Open AccessArticle
Comparison of Treatment Outcome between Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcutaneous Direct Current Stimulation (tDCS) in Intractable Tinnitus
J. Clin. Med. 2021, 10(4), 635; https://doi.org/10.3390/jcm10040635 - 07 Feb 2021
Viewed by 395
Abstract
Repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) are non-invasive treatments for chronic tinnitus based on neuromodulation of cortical activity. Both are considered effective, but with heterogeneous results due to lack of established protocols. Because the target groups for both [...] Read more.
Repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) are non-invasive treatments for chronic tinnitus based on neuromodulation of cortical activity. Both are considered effective, but with heterogeneous results due to lack of established protocols. Because the target groups for both modalities overlap, it is difficult to recommend one of them. We tried to unify the inclusion criteria and treatment schedules to compare the two modalities. The medical charts of 36 patients who underwent rTMS as part of clinical routine were reviewed and data for 34 patients who underwent tDCS about 7 years later were collected prospectively. Both groups had chronic unilateral tinnitus refractory to medication. Patients were treated for 5 consecutive days, and tinnitus symptoms were evaluated by survey both at the end of the treatment schedule and 1 month after the treatment. The ratio of responders who showed >20% reduction in tinnitus handicap inventory scores were compared. At the end of the treatment, the rTMS group showed a rapid response compared to the tDCS group (rTMS, 30.6%; tDCS, 12.1%; p = 0.054). However, both groups showed a significant and similar reduction in tinnitus symptoms 1 month after the treatment (rTMS, 47.2%; tDCS, 36.4%; p = 0.618). As both groups showed comparable results for tinnitus reduction, tDCS may be superior in terms of cost-effectiveness. Full article
(This article belongs to the Special Issue Novel Treatments and Diagnosis for Chronic Tinnitus)
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Open AccessArticle
Sex-Dependent Aggregation of Tinnitus in Swedish Families
J. Clin. Med. 2020, 9(12), 3812; https://doi.org/10.3390/jcm9123812 - 25 Nov 2020
Viewed by 888
Abstract
Twin and adoption studies point towards a genetic contribution to tinnitus; however, how the genetic risk applies to different forms of tinnitus is poorly understood. Here, we perform a familial aggregation study and determine the relative recurrence risk for tinnitus in siblings (λs). [...] Read more.
Twin and adoption studies point towards a genetic contribution to tinnitus; however, how the genetic risk applies to different forms of tinnitus is poorly understood. Here, we perform a familial aggregation study and determine the relative recurrence risk for tinnitus in siblings (λs). Four different Swedish studies (N = 186,598) were used to estimate the prevalence of self-reported bilateral, unilateral, constant, and severe tinnitus in the general population and we defined whether these 4 different forms of tinnitus segregate in families from the Swedish Tinnitus Outreach Project (STOP, N = 2305). We implemented a percentile bootstrap approach to provide accurate estimates and confidence intervals for λs. We reveal a significant λs for all types of tinnitus, the highest found being 7.27 (95% CI (5.56–9.07)) for severe tinnitus, with a higher susceptibility in women (10.25; 95% CI (7.14–13.61)) than in men (5.03; 95% CI (3.22–7.01)), suggesting that severity may be the most genetically influenced trait in tinnitus in a sex-dependent manner. Our findings strongly support the notion that genetic factors impact on the development of tinnitus, more so for severe tinnitus. These findings highlight the importance of considering tinnitus severity and sex in the design of large genetic studies to optimize diagnostic approaches and ultimately improve therapeutic interventions. Full article
(This article belongs to the Special Issue Novel Treatments and Diagnosis for Chronic Tinnitus)
Open AccessArticle
The Effect of Environmental Stressors on Tinnitus: A Prospective Longitudinal Study on the Impact of the COVID-19 Pandemic
J. Clin. Med. 2020, 9(9), 2756; https://doi.org/10.3390/jcm9092756 - 26 Aug 2020
Cited by 1 | Viewed by 1580
Abstract
Tinnitus, the perception of sound in the absence of a corresponding sound, and the distress caused by it, is rarely a static phenomenon. It rather fluctuates over time depending on endogenous and exogenous factors. The COVID-19 pandemic is a potential environmental stressor that [...] Read more.
Tinnitus, the perception of sound in the absence of a corresponding sound, and the distress caused by it, is rarely a static phenomenon. It rather fluctuates over time depending on endogenous and exogenous factors. The COVID-19 pandemic is a potential environmental stressor that might influence the individually perceived tinnitus distress. Since not all people are affected by the pandemic in the same way, the situation allows one to identify environmental factors and personality traits that impact tinnitus distress differently. In our study, 122 tinnitus patients were included at two time points: in the year 2018 and during the German lockdown in April 2020. We assessed tinnitus-related distress, depressive symptoms, personality characteristics and the individual perception of the pandemic situation. On average, there was only a small increase of tinnitus distress with heterogeneous changes during the lockdown. People perceiving the situation as generally stressful with increased grief, frustration, stress and nervousness reported the worsening of tinnitus distress. People with high values in neuroticism also reported the worsening of tinnitus distress, while the personality traits extraversion, conscientiousness and openness seemed to be a protection factor. The study identifies factors that influence tinnitus distress change during a pandemic and spots those patients that need specific help in the pandemic situation. Full article
(This article belongs to the Special Issue Novel Treatments and Diagnosis for Chronic Tinnitus)
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Open AccessArticle
Association between Hyperacusis and Tinnitus
J. Clin. Med. 2020, 9(8), 2412; https://doi.org/10.3390/jcm9082412 - 28 Jul 2020
Cited by 2 | Viewed by 1999
Abstract
Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) [...] Read more.
Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18–90 years, and provided information on socio-demographic characteristics, as well as presence of hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with (n = 1388) or without (n = 1044) hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99–4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06–10.9), and THI ≥ 58 (OR 12.1, 95% CI 7.06–20.6). The association with THI ≥ 58 was greater with increasing severity of hyperacusis, the ORs being 8.15 (95% CI 4.68–14.2) for moderate and 77.4 (95% CI 35.0–171.3) for severe hyperacusis. No difference between sexes was observed in the association between hyperacusis and tinnitus. The occurrence of hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between hyperacusis and tinnitus. Full article
(This article belongs to the Special Issue Novel Treatments and Diagnosis for Chronic Tinnitus)
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Review

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Open AccessReview
A Systematic Review on the Association of Acquired Human Cytomegalovirus Infection with Hearing Loss
J. Clin. Med. 2020, 9(12), 4011; https://doi.org/10.3390/jcm9124011 - 11 Dec 2020
Viewed by 528
Abstract
Congenital cytomegalovirus (CMV) infection induces a clinical syndrome usually associated with hearing loss. However, the effect of acquired CVM infection in adults and children has not been clearly defined. The objective of this review is to critically appraise scientific evidence regarding the association [...] Read more.
Congenital cytomegalovirus (CMV) infection induces a clinical syndrome usually associated with hearing loss. However, the effect of acquired CVM infection in adults and children has not been clearly defined. The objective of this review is to critically appraise scientific evidence regarding the association of acquired CMV infection with postnatal hearing loss or tinnitus. A systematic review of records reporting sensorineural hearing loss (SNHL) or tinnitus and acquired CMV infection including articles published in English was performed. Search strategy was limited to human studies with acquired CMV infection. After screening and quality assessment, nine studies involving 1528 individuals fulfilled the inclusion criteria. A total of 14% of patients with SNHL showed evidence of previous exposure to CMV, while in individuals without SNHL (controls) the percentage rose up to 19.3%. SNHL was reported as unilateral or bilateral in 15.3%, and not specified in 84.7% of cases. The degree of SNHL ranged from mild to profound for both children and adults. None of the records reported tinnitus. The prevalence of children or adults with acquired SNHL with a confirmed acquired CMV infection by Polymerase Chain Reaction (PCR) or IgM anti-CMV antibodies is low. Phenotyping of patients with acquired CMV infection was limited to hearing loss by pure tone audiometry and no additional audiological testing was performed in most of the studies. Additional symptoms deserve more attention, including episodic vertigo or tinnitus, since some patients with the clinical spectrum of Meniere Disease could result from a CMV latent infection. Full article
(This article belongs to the Special Issue Novel Treatments and Diagnosis for Chronic Tinnitus)
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