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New Insights into Tinnitus Heterogeneity
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New Insights into Tinnitus Heterogeneity

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

Deadline for manuscript submissions: closed (15 November 2023) | Viewed by 8087

Special Issue Editors

Dr. Petra Brüggemann

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Guest Editor
Tinnitus Centre, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
Interests: affecctive disorders; tinnitus; cognition; psychotherapy; prsychosomatic; stress
Prof. Dr. Birgit Mazurek

E-Mail Website
Guest Editor
Tinnitus Center, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117 Berlin, Germany
Interests: tinnitus; stress; comorbidities; psychometrics; psychology; phenotyping; audiology; hearing aids
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Christian Dobel

E-Mail Website
Guest Editor
Experimental ENT, ENT-Clinic University Hospital Jena, 07743 Jena, Germany
Interests: cognitive psychology; neuroscience; applied psychology; semantics; cognitive neuroscience; brain; event-related potentials; memory; language; language learning
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Holger Schulze

E-Mail Website
Guest Editor
ENT-Clinic, University Hospital Erlangen, 91054 Erlangen, Germany
Interests: neuroscience; neurophysiology; learning; neurobiology; physiology; neurobiology and brain physiology; audiology; hearing disorders; ear; brain
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Tinnitus is a multimodal phenomenon. It includes pathophysiological processes in the area of peripheral and central hearing, associative processing in central networks of the brain, and cognitive processes. In addition, subjective noise also interferes with affective or evaluative processes. Questions about the appropriate form of therapy, biological markers or the genetics of tinnitus distress are the focus of current research, and numerous studies have already proved that impairments in chronic tinnitus are often accompanied by a variety of psychosomatic causes and comorbidities. This Special Issue aims to summarize and classify important work on this subject. Original publications focusing on individual aspects of the phenomenon are welcome, whereby the findings should always be classified in an overall model.

A large number of highly correlated biopsychosocial factors can be identified for the impairment caused by tinnitus and the severity of tinnitus distress, e.g., general hearing ability, stress level, depression, anxiety, etc. In addition, personality traits have been described as predictive, and tinnitus problems can be associated with cognitive impairments. Furthermore, psychosocial factors such as age, gender or education seem to influence tinnitus suffering through their interactions with emotional and cognitive stress. Multimodal psychosomatic therapy with a focus on cognitive behavioral therapy can achieve lasting improvements in the experience of impairment caused by tinnitus, and in extensive emotional stress. Hearing therapies aim to improve speech understanding impaired by tinnitus and to help with audiological comorbidities such as hyperacusis.

The initial causes of tinnitus arise primarily in the peripheral auditory pathway, but the percept subsequently becomes chronic via neuronal plasticity mechanisms along the auditory pathway. Above all, suffering arises from the personal experience of those affected—and thus centrally in the brain as a result of individual processing paths of the neuronal information in acoustic, somatosensory, limbic or frontal neuronal networks. Diagnosis and therapy of chronic tinnitus must therefore be multidimensional and interdisciplinary as well as individually coordinated.

We are looking forward to your contributions on tinnitus heterogeneity as expressed in individual pathophysiology, medical and audiological influencing factors as well as psychological aspects of experiencing chronic tinnitus, diagnostic aspects and therapy in order to use these results to sustainably increase the quality of life of those affected.

Dr. Petra Brüggemann
Prof. Dr. Birgit Mazurek
Prof. Dr. Christian Dobel
Prof. Dr. Holger Schulze
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. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

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Keywords

  • tinnitus
  • severity of tinnitus
  • biopsychosocial factors
  • comorbidities
  • basic research aspects
  • tinnitus treatment

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Published Papers (4 papers)

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Research

13 pages, 570 KiB  
Article
Should Tinnitus Patients with Subclinical Hearing Impairment Be Offered Hearing Aids? A Comparison of Tinnitus Mitigation Following 3 Months Hearing Aid Use in Individuals with and without Clinical Hearing Impairment
by Sebastian Waechter, Maria Olovsson and Petter Pettersson
J. Clin. Med. 2023, 12(24), 7660; https://doi.org/10.3390/jcm12247660 - 13 Dec 2023
Viewed by 1172
Abstract
There is a consensus among tinnitus experts to not recommend hearing aids for tinnitus patients with subclinical hearing impairment. However, this notion is arbitrary, as no previous study has compared the treatment effect of hearing aids on tinnitus distress in patients with and [...] Read more.
There is a consensus among tinnitus experts to not recommend hearing aids for tinnitus patients with subclinical hearing impairment. However, this notion is arbitrary, as no previous study has compared the treatment effect of hearing aids on tinnitus distress in patients with and without clinical hearing impairment. In this article, we investigate whether tinnitus patients with clinical and subclinical hearing impairment differ in terms of tinnitus mitigation after hearing aid fitting. Twenty-seven tinnitus patients with either clinical (n = 13) or subclinical (n = 14) hearing impairment were fitted with hearing aids. All participants filled out the tinnitus functional index (TFI) before hearing aid fitting and after 3 months of hearing aid use. Clinically meaningful reductions in tinnitus distress (−13 TFI points or more) were seen in both groups, and the difference in tinnitus mitigation between tinnitus patients with clinical (mean TFI reduction = 17.0 points) and subclinical hearing impairment (mean TFI reduction = 16.9 points) was not statistically significant (p = 0.991). Group differences on the suspected confounding factors of age, sex, time since tinnitus debut, tinnitus distress (TFI score) at baseline, and treatment adherence were statistically insignificant. In light of this, we argue that clinical hearing impairment is not required to achieve meaningful tinnitus mitigation with hearing aids, and that hearing aids could be recommended for tinnitus patients with subclinical hearing impairment. Full article
(This article belongs to the Special Issue New Insights into Tinnitus Heterogeneity)
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13 pages, 1789 KiB  
Article
Personalized Neuromodulation: A Novel Strategy for Improving Tinnitus Treatment
by Seung Yeon Jeon, Jung Ho Choi, Sun Seong Kang, Yong-Hwi An and Hyun Joon Shim
J. Clin. Med. 2023, 12(22), 6987; https://doi.org/10.3390/jcm12226987 - 8 Nov 2023
Cited by 1 | Viewed by 1801
Abstract
This study evaluated the efficacy of personalized neuromodulation, where treatment modalities are chosen based on the patient’s responses in a pilot trial. A total of 71 patients with tinnitus were divided into two groups: a personalized group and a randomized neuromodulation group. In [...] Read more.
This study evaluated the efficacy of personalized neuromodulation, where treatment modalities are chosen based on the patient’s responses in a pilot trial. A total of 71 patients with tinnitus were divided into two groups: a personalized group and a randomized neuromodulation group. In the personalized group (n = 35), repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS) were assessed in a pilot trial, and responsive modalities were administered to 16 patients, while the non-responders (n = 19) were randomly assigned to rTMS, tDCS, or combined modalities. Patients in the randomized group (n = 36) were randomly allocated to rTMS, tDCS, or combined modalities. The Tinnitus Handicap Inventory (THI) score improvement after 10 sessions of each neuromodulation was significantly greater in the personalized group than in the randomized group (p = 0.043), with no significant differences in tinnitus loudness, distress, or awareness. The treatment success rate was highest in the personalized responder subgroup (92.3%), and significantly greater than that in the non-responder subgroup (53.0%; p = 0.042) and the randomized group (56.7%; p = 0.033). Personalized neuromodulation, where the treatment modality is chosen based on the patient’s responses in a pilot trial, is an advantageous strategy for treating tinnitus. Full article
(This article belongs to the Special Issue New Insights into Tinnitus Heterogeneity)
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14 pages, 1156 KiB  
Article
Mental Fatigue in Patients with Hearing Loss and/or Tinnitus Undergoing Audiological Rehabilitation—A Pilot Study
by Satu Turunen-Taheri, Per-Inge Carlsson, Elisabeth Ternevall and Sten Hellström
J. Clin. Med. 2023, 12(21), 6756; https://doi.org/10.3390/jcm12216756 - 25 Oct 2023
Viewed by 1784
Abstract
Background: Both tinnitus and hearing loss are multidimensional. The purpose of this study was to identify and determine the degree of mental fatigue in patients with hearing loss and/or tinnitus participating in audiological rehabilitation, and to examine the self-reported mental fatigue scale (MFS) [...] Read more.
Background: Both tinnitus and hearing loss are multidimensional. The purpose of this study was to identify and determine the degree of mental fatigue in patients with hearing loss and/or tinnitus participating in audiological rehabilitation, and to examine the self-reported mental fatigue scale (MFS) in this patient group. Methods: Patients undergoing audiological rehabilitation at the Department of Audiology and Neurotology, Karolinska University Hospital, Sweden, between 2011 and 2017 who completed a self-reported MFS questionnaire were investigated. Data on 76 patients were analysed in this pilot study. Patients were also assessed using the Tinnitus Handicap Inventory (THI). Results: The study population had an age range of 38–65 years, and most had normal hearing (37%) or mild to moderate hearing loss (46%). Only 17% had severe to profound hearing loss. A total of 56.5% had tinnitus, of whom 39.5% scored ≥57 on the THI, indicating severe tinnitus, whereas 43.5% reported no tinnitus. The MFS scores, ranging from 13 to 42.5 points, were divided into three severity levels for analysis: 10.5–15, 15.5–20, and ≥20.5. In total, 67% of the patients had MFS scores ≥ 20.5. Importantly, most of the participants (90%) with a THI score ≥ 57 belonged to that group. A significant positive correlation between a high MFS score and severe tinnitus was found. Conclusions: The study reveals that severe mental fatigue is more common in patients with severe tinnitus than sole hearing loss. Full article
(This article belongs to the Special Issue New Insights into Tinnitus Heterogeneity)
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17 pages, 1648 KiB  
Article
Limited Link of Common Blood Parameters with Tinnitus
by Jan Bulla, Petra Brueggemann, Małgorzata Wrzosek, Sven Klasing, Benjamin Boecking, Laura Basso, Amarjargal Nyamaa, Stamatina Psatha, Matthias Rose and Birgit Mazurek
J. Clin. Med. 2023, 12(11), 3814; https://doi.org/10.3390/jcm12113814 - 1 Jun 2023
Cited by 1 | Viewed by 2782
Abstract
Background: Tinnitus severity is generally assessed by psychometric and audiological instruments. However, no objective measure exists to evaluate the subjective discomfort and suffering caused by this hearing phenomenon. The objective of this work was to determine the possible blood parameters for diagnostics [...] Read more.
Background: Tinnitus severity is generally assessed by psychometric and audiological instruments. However, no objective measure exists to evaluate the subjective discomfort and suffering caused by this hearing phenomenon. The objective of this work was to determine the possible blood parameters for diagnostics and therapy. Methods: We measured tinnitus distress by using the Tinnitus Questionnaire (TQ) and collected tinnitus-related audiological measures, namely the hearing threshold (HT), tinnitus loudness (TL), and sensation level (SL, i.e., the tinnitus loudness/hearing threshold at a tinnitus frequency). Blood samples were taken from 200 outpatients of the Tinnitus Centre of the Charité, and 46 routine blood count parameters were examined. The possible interactions were determined by (robust) linear models. Results: Tinnitus distress and audiological measurements were largely uncorrelated but could partly be predicted by selected blood parameters. First, the erythrocyte counts predicted tinnitus distress to a small extent. Second, the levels of vitamin D3 explained about 6% of tinnitus loudness and, age-dependently, the hearing threshold variability. Last, the levels of uric acid explained about 5% of the sensation level variability. Conclusions: Tinnitus is a multidimensional phenomenon. The marginal influences of blood markers suggest the possible roles of inflammation and oxidative stress produced by psychological or somatic burdens. Clinically, a vitamin D substitution (in older patients) might have a hearing-protective effect. Full article
(This article belongs to the Special Issue New Insights into Tinnitus Heterogeneity)
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