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Brain Sciences
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Tinnitus Subtyping
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Tinnitus Subtyping

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

Deadline for manuscript submissions: closed (31 October 2020) | Viewed by 29264

Special Issue Editors

Prof. Dr. Agnieszka Szczepek

E-Mail Website
Guest Editor
Department of Otorhinolaryngology, Head and Neck Surgery, Charité Universitätsmedizin, Berlin, Germany
Interests: hearing research; inner ear immunology; ototoxicity
Special Issues, Collections and Topics in MDPI journals
Dr. Haúla Haider

E-Mail Website
Co-Guest Editor
Department of Otorhinolaryngology,Hospital Cuf Infante Santo. Lisboa, Portugal
Interests: Tinnitus, Hearing loss, Inner ear diseases and treatments, ENT surgery (pediatrics’ and rhinology)

Special Issue Information

Dear Colleagues,

Tinnitus is a symptom and may accompany numerous diseases or be idiopathic. The classification of tinnitus used in the clinics or clinical research usually takes under account the tinnitus continuity (intermittent and constant); tinnitus duration or persistence (short term – acute; and long term - chronic); audiological characteristics (e.g., pitch and loudness); and psychological consequences (e.g. distressing and non-distressing). The comorbid conditions affecting the mental and the physical status of patients are additional classification factors. All of the above may contribute to the heterogeneity of tinnitus, making the therapeutic targeting of tinnitus difficult. Additionally, the methods for measuring therapeutic success or tinnitus-monitoring vary between clinical units, countries, and continents.

This special issue of Brain Sciences is an attempt to improve tinnitus classification and subtyping based on audiological characteristics, comorbid diseases, or the response to therapy. We especially encourage submissions concerning the biomarker discovery in tinnitus.

Dr. Agnieszka Szczepek

Guest Editor

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Keywords

  • Tinnitus Subtyping
  • Biomarkers of Tinnitus
  • Tinnitus-induced Psychological Burden
  • Comorbid Conditions of Tinnitus
  • Meniere’s Syndrome

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Published Papers (7 papers)

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Research

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15 pages, 327 KiB  
Article
Quality of Life and Psychological Distress in Portuguese Older Individuals with Tinnitus
by Haúla F. Haider, Sara F. Ribeiro, Derek J. Hoare, Graça Fialho, Deborah A. Hall, Marília Antunes, Helena Caria and João Paço
Brain Sci. 2021, 11(7), 953; https://doi.org/10.3390/brainsci11070953 - 20 Jul 2021
Cited by 6 | Viewed by 2862
Abstract
Tinnitus is the perception of a sound without an external source, often associated with adverse psychological and emotional effects leading to impaired quality of life (QoL). The present study investigated QoL and psychological distress in tinnitus patients and analysed the effects of associated [...] Read more.
Tinnitus is the perception of a sound without an external source, often associated with adverse psychological and emotional effects leading to impaired quality of life (QoL). The present study investigated QoL and psychological distress in tinnitus patients and analysed the effects of associated comorbidities. Tonal and speech audiometry, tinnitus assessment, and clinical interviews were obtained from 122 Portuguese individuals (aged from 55 to 75). Portuguese versions of the Brief Symptoms Inventory (BSI), the Medical Outcomes Study Short Form Health Survey (MOS SF-36) and Tinnitus Handicap Inventory (THI) were used to evaluate psychological distress, health-related QoL, social difficulties and tinnitus severity. The presence of tinnitus was significantly associated with hearing loss. The increases in tinnitus severity were associated with decreases in QoL, particularly regarding MOS SF-36 subscales “perception of health”, “social functioning”, and “mental health”. Regarding BSI, patients with greater tinnitus severity had more severe psychopathology symptoms, measured with scales “Obsessive–compulsive”, “Depression”, “Anxiety”, “Hostility” and “Phobic Anxiety”. Our study supports the notion of the negative impact of increased tinnitus severity on QoL and psychological distress in older adults. Presented data strengthen the importance of a multidisciplinary approach to tinnitus assessment and treatment. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
12 pages, 1152 KiB  
Article
Tinnitus and Metacognitive Beliefs—Results of a Cross-Sectional Observational Study
by Eleonora Natalini, Alessandra Fioretti, David Riedl, Roland Moschen and Alberto Eibenstein
Brain Sci. 2021, 11(1), 3; https://doi.org/10.3390/brainsci11010003 - 23 Dec 2020
Cited by 7 | Viewed by 2923
Abstract
Recent research has highlighted the role of metacognitions as a moderator for psychological distress in patients with chronic diseases. The present study investigates the role of metacognitions and worry in the association between tinnitus distress, anxiety, and depression. A cross-sectional study was carried [...] Read more.
Recent research has highlighted the role of metacognitions as a moderator for psychological distress in patients with chronic diseases. The present study investigates the role of metacognitions and worry in the association between tinnitus distress, anxiety, and depression. A cross-sectional study was carried out with a sample of tinnitus-outpatients who completed the Tinnitus-Handicap Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Metacognition Questionnaire-30, Penn-State-Worry-Questionnaire. Associations of metacognitions, worries, tinnitus distress, anxiety and depression were investigated using structural equation models (SEMs). A sample of n = 107 patients was included in the study. In the first SEM, tinnitus distress significantly predicted depression (β = 0.68, p < 0.001) and anxiety (β = 0.47, p < 0.001). In the second model, worries and meta-cognitions were added as moderators. The explained variance substantially increased for depression (46 to 53%) and anxiety (22 to 35%) and the association of tinnitus distress with depression (β = 0.57, p < 0.001) and anxiety was weakened (β = 0.32, p < 0.001). Negative beliefs significantly predicted worries (β = 0.51, p < 0.001) and explained 41% of its variance. A good model fit for the final model was found (comparative fit index (CFI) = 0.98; (Tucker Lewis index) TLI = 0.96; root mean square error of approximation (RMSEA) = 0.067). Anxiety and depression in tinnitus patients might be influenced by worries, which is mainly predicted by negative beliefs about uncontrollability and danger of worries. Thus, psychotherapeutic approaches focused on alterations of metacognitions in patients with tinnitus should be investigated in future studies.3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.) Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
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13 pages, 1078 KiB  
Article
The Effect of Non-Personalised Tips on the Continued Use of Self-Monitoring mHealth Applications
by Vishnu Unnikrishnan, Miro Schleicher, Yash Shah, Noor Jamaludeen, Ruediger Pryss, Johannes Schobel, Robin Kraft, Winfried Schlee and Myra Spiliopoulou
Brain Sci. 2020, 10(12), 924; https://doi.org/10.3390/brainsci10120924 - 30 Nov 2020
Cited by 9 | Viewed by 3036
Abstract
Chronic tinnitus, the perception of a phantom sound in the absence of corresponding stimulus, is a condition known to affect patients’ quality of life. Recent advances in mHealth have enabled patients to maintain a ‘disease journal’ of ecologically-valid momentary assessments, improving patients’ own [...] Read more.
Chronic tinnitus, the perception of a phantom sound in the absence of corresponding stimulus, is a condition known to affect patients’ quality of life. Recent advances in mHealth have enabled patients to maintain a ‘disease journal’ of ecologically-valid momentary assessments, improving patients’ own awareness of their disease while also providing clinicians valuable data for research. In this study, we investigate the effect of non-personalised tips on patients’ perception of tinnitus, and on their continued use of the application. The data collected from the study involved three groups of patients that used the app for 16 weeks. Groups A & Y were exposed to feedback from the start of the study, while group B only received tips for the second half of the study. Groups A and Y were run by different supervisors and also differed in the number of hospital visits during the study. Users of Group A and B underwent assessment at baseline, mid-study, post-study and follow-up, while users of group Y were only assessed at baseline and post-study. It is seen that the users in group B use the app for longer, and also more often during the day. The answers of the users to the Ecological Momentary Assessments are seen to form clusters where the degree to which the tinnitus distress depends on tinnitus loudness varies. Additionally, cluster-level models were able to predict new unseen data with better accuracy than a single global model. This strengthens the argument that the discovered clusters really do reflect underlying patterns in disease expression. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
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13 pages, 282 KiB  
Article
The Prevalence of Different Types of Headache in Patients with Subjective Tinnitus and Its Influence on Tinnitus Parameters: A Prospective Clinical Study
by Magdalena Nowaczewska, Michał Wiciński, Marcin Straburzyński and Wojciech Kaźmierczak
Brain Sci. 2020, 10(11), 776; https://doi.org/10.3390/brainsci10110776 - 24 Oct 2020
Cited by 14 | Viewed by 4896
Abstract
Both tinnitus and headache are very prevalent conditions in the general population, with bidirectional co-occurrence of them. A number of studies revealed a high prevalence of headache in tinnitus patients; however, most of them used self-reported symptoms, questionnaires, or health databases and were [...] Read more.
Both tinnitus and headache are very prevalent conditions in the general population, with bidirectional co-occurrence of them. A number of studies revealed a high prevalence of headache in tinnitus patients; however, most of them used self-reported symptoms, questionnaires, or health databases and were retrospective. The aim of this study was to evaluate the prevalence of different types of headache in a cohort of tinnitus patients and to assess the influence of headache on tinnitus parameters, focusing on appropriate headache and tinnitus diagnosis verified by clinical examination. This prospective study involved 286 patients diagnosed with subjective non-pulsating tinnitus. Patients’ clinical information was thoroughly assessed by the multidisciplinary team, including tinnitus characteristics and severity according to the Tinnitus Handicap Inventory (THI), loudness assessed by the Visual Analogue Scale (VAS), audiometry, type of headache diagnosed according to the third edition of the International Classification of Headache Disorders, severity of headache assessed by the Numeric Rating Scale (NRS), and impact of headache using the Headache Impact Test (HIT). In total, 141 (49.3%) tinnitus patients were diagnosed with headache, most of them with tension-type headache or migraine. They were significantly younger; mostly women; had bilateral tinnitus, vertigo, and depression more frequently; and had hearing loss less frequently as compared with the non-headache group. In total, 82 (58.16%) patients had the same localization of tinnitus and headache. Younger age, female gender, higher tinnitus burden measured by THI, and coexistence of hearing loss were independent variables connected with the occurrence of headache in the tinnitus group. According to our study, headaches impact tinnitus on many different levels and may be an important co-factor for tinnitus subtyping. We recommend screening for headache coexistence in all tinnitus patients. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)

Review

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21 pages, 2203 KiB  
Review
A Review and a Framework of Variables for Defining and Characterizing Tinnitus Subphenotypes
by Eleni Genitsaridi, Derek J. Hoare, Theodore Kypraios and Deborah A. Hall
Brain Sci. 2020, 10(12), 938; https://doi.org/10.3390/brainsci10120938 - 4 Dec 2020
Cited by 20 | Viewed by 3381
Abstract
Tinnitus patients can present with various characteristics, such as those related to the tinnitus perception, symptom severity, and pattern of comorbidities. It is speculated that this phenotypic heterogeneity is associated with differences in the underlying pathophysiology and personal reaction to the condition. However, [...] Read more.
Tinnitus patients can present with various characteristics, such as those related to the tinnitus perception, symptom severity, and pattern of comorbidities. It is speculated that this phenotypic heterogeneity is associated with differences in the underlying pathophysiology and personal reaction to the condition. However, there is as yet no established protocol for tinnitus profiling or subtyping, hindering progress in treatment development. This review summarizes data on variables that have been used in studies investigating phenotypic differences in subgroups of tinnitus, including variables used to both define and compare subgroups. A PubMed search led to the identification of 64 eligible articles. In most studies, variables for subgrouping were chosen by the researchers (hypothesis-driven approach). Other approaches included application of unsupervised machine-learning techniques for the definition of subgroups (data-driven), and subgroup definition based on the response to a tinnitus treatment (treatment response). A framework of 94 variable concepts was created to summarize variables used across all studies. Frequency statistics for the use of each variable concept are presented, demonstrating those most and least commonly assessed. This review highlights the high dimensionality of tinnitus heterogeneity. The framework of variables can contribute to the design of future studies, helping to decide on tinnitus assessment and subgrouping. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
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27 pages, 2320 KiB  
Review
Auditory Brainstem Responses (ABR) of Rats during Experimentally Induced Tinnitus: Literature Review
by Ewa Domarecka, Heidi Olze and Agnieszka J. Szczepek
Brain Sci. 2020, 10(12), 901; https://doi.org/10.3390/brainsci10120901 - 24 Nov 2020
Cited by 13 | Viewed by 5019
Abstract
Tinnitus is a subjective phantom sound perceived only by the affected person and a symptom of various auditory and non-auditory conditions. The majority of methods used in clinical and basic research for tinnitus diagnosis are subjective. To better understand tinnitus-associated changes in the [...] Read more.
Tinnitus is a subjective phantom sound perceived only by the affected person and a symptom of various auditory and non-auditory conditions. The majority of methods used in clinical and basic research for tinnitus diagnosis are subjective. To better understand tinnitus-associated changes in the auditory system, an objective technique measuring auditory sensitivity—the auditory brainstem responses (ABR)—has been suggested. Therefore, the present review aimed to summarize ABR’s features in a rat model during experimentally induced tinnitus. PubMed, Web of Science, Science Direct, and Scopus databanks were searched using Medical Subject Heading (MeSH) terms: auditory brainstem response, tinnitus, rat. The search identified 344 articles, and 36 of them were selected for the full-text analyses. The experimental protocols and results were evaluated, and the gained knowledge was synthesized. A high level of heterogeneity between the studies was found regarding all assessed areas. The most consistent finding of all studies was a reduction in the ABR wave I amplitude following exposure to noise and salicylate. Simultaneously, animals with salicylate-induced but not noise-induced tinnitus had an increased amplitude of wave IV. Furthermore, the present study identified a need to develop a consensus experimental ABR protocol applied in future tinnitus studies using the rat model. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
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16 pages, 1473 KiB  
Review
Contemporary Review of Smartphone Apps for Tinnitus Management and Treatment
by Muntazir Mehdi, Albi Dode, Rüdiger Pryss, Winfried Schlee, Manfred Reichert and Franz J. Hauck
Brain Sci. 2020, 10(11), 867; https://doi.org/10.3390/brainsci10110867 - 17 Nov 2020
Cited by 18 | Viewed by 5741
Abstract
Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for [...] Read more.
Tinnitus is a complex and heterogeneous psycho-physiological disorder responsible for causing a phantom ringing or buzzing sound albeit the absence of an external sound source. It has a direct influence on affecting the quality of life of its sufferers. Despite being around for a while, there has not been a cure for tinnitus, and the usual course of action for its treatment involves use of tinnitus retaining and sound therapy, or Cognitive Behavioral Therapy (CBT). One positive aspect about these therapies is that they can be administered face-to-face as well as delivered via internet or smartphone. Smartphones are especially helpful as they are highly personalized devices, and offer a well-established ecosystem of apps, accessible via respective marketplaces of differing mobile platforms. Note that current therapeutic treatments such as CBT have shown to be effective in suppressing the tinnitus symptoms when administered face-to-face, their effectiveness when being delivered using smartphones is not known so far. A quick search on the prominent market places of popular mobile platforms (Android and iOS) yielded roughly 250 smartphone apps offering tinnitus-related therapies and tinnitus management. As this number is expected to steadily increase due to high interest in smartphone app development, a contemporary review of such apps is crucial. In this paper, we aim to review scientific studies validating the smartphone apps, particularly to test their effectiveness in tinnitus management and treatment. We use the PRISMA guidelines for identification of studies on major scientific literature sources and delineate the outcomes of identified studies. Full article
(This article belongs to the Special Issue Tinnitus Subtyping)
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