Pinpointing a Highly Specific Pathological Functional Connection That Turns Phantom Sound into Distress

Vanneste, Sven; Congedo, Marco; Ridder, Dirk De

doi:10.1093/cercor/bht068

Cited by 51 publications

(56 citation statements)

References 75 publications

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“…46 These connectivity changes are confirmed on the pretreatment source-localized EEGs in this study, but there is a very striking difference between the 2 patients. Although the patient who responded to the dACC implant (Case 1) has the previously described increased alpha functional connectivity between the parahippocampal area and the sgACC, the nonresponder (Case 2) has decreased functional connectivity between these areas, even though both patients presented with very severe tinnitus.…”

Section: Discussionsupporting

confidence: 69%

“…This is reminiscent of what has been demonstrated in auditory cortex stimulation via implanted electrodes. The success of stimulation also depends on the presence of good functional connectivity between the auditory cortex (where the electrode was placed) and the parahippocampal gyrus, 9 which has been considered a critical hub in the tinnitus network, as it is involved in tinnitus in general 27,42,57 and in tinnitus lateralization more specifically, 47 as well as in tinnitus distress 37,46 and tinnitus-related depression. 21 Whereas these are only case reports, our results suggest that it is worthwhile to further explore this avenue of neuromodulation for tinnitus in severely distressed patients and that a biomarker consisting of EEG functional connectivity and/or rTMS might become important in selecting the right patient for this technique.…”

Section: Discussionmentioning

confidence: 99%

“…3 In tinnitus the amount of distress present is related to 10-and 11.5-Hz oscillations between the parahippocampal area and the subgenual (sg)ACC. 46 As such, the brain uses multiple nonspecific networks in parallel, each with their own oscillatory signature, that adapt to the context to construct a unified percept possibly by synchronized activation integrated at the hubs at discrete oscillatory frequencies. 17 Whether an external auditory stimulus is consciously perceived depends on activity in the dorsal (d)ACC and insula, 36 which is part of the salience network.…”

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confidence: 99%

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Anterior cingulate implants for tinnitus: report of 2 cases

Ridder

Joos

Vanneste

2016

JNS

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893case report J Neurosurg 124: [893][894][895][896][897][898][899][900][901] 2016 N oNpulsatile tinnitus is the perception of a sound in the absence of an external source and is therefore often considered a phantom sound. 30 It is related to abnormal activity in the auditory and nonauditory brain areas, 48 which can be altered by neuromodulation techniques. 24 As tinnitus is most commonly related to auditory deafferentation 20 with 30,31 or without 59 audiometric hearing loss, it has been regarded as maladaptive auditory memory traces 5 attempting to reduce the inherent auditory uncertainty associated with auditory deafferentation.11 Apart from abnormal activity, pathological functional connectivity is also associated with the presence of tinnitus as demonstrated by electroencephalography (EEG), 57 magnetoencephalography (MEG), 38,39 and functional MRI (fMRI). 26,27 Thus, it has been proposed that the phenomenologically unified percept of tinnitus can be considered an emergent property of multiple, parallel, dynamically changing, and partially overlapping subnetworks, each with a specific spontaneous oscillatory pattern and functional connectivity signature. 17 Functional imaging studies using source-localized EEG and MEG have shown that tinnitus distress is related to a network involving the anterior cingulate cortex (ACC), anterior insula, and parahippocampal area, 6,22,56 whereas the auditory cortex is involved in the perceived tinnitus intensity. 44 The distress subnetwork is predominantly lateralized to the right, in contrast to a similar network encoding depression that is lateralized to the left. 21 The loudness and distress networks are clearly separable even though they interact. Communication between these different subnetworks is proposed to occur at hubs, brain areas that are involved in multiple subnetworks simultaneously. These hubs can take part in each separable subnetwork at different frequencies. ComabbreviatioNs ACC = anterior cingulate cortex; BA = Brodmann area; BOLD = blood oxygen level-dependent; d = dorsal; DLPFC = dorsolateral prefrontal cortex; EEG = electroencephalography; fMRI = functional MRI; HADS = Hospital Anxiety Depression Scale; MEG = magnetoencephalography; NRS = numeric rating scale; r = repetitive; sg = subgenual; sLORETA = standardized low-resolution electromagnetic tomography; tDCS = transcranial direct current stimulation; TENS = transcutaneous electrical nerve stimulation; TMS = transcranial magnetic stimulation; TQ = tinnitus questionnaire. Tinnitus can be distressful, and tinnitus distress has been linked to increased beta oscillatory activity in the dorsal anterior cingulate cortex (dACC). The amount of distress is linked to alpha activity in the medial temporal lobe (amygdala and parahippocampal area), as well as the subgenual (sg)ACC and insula, and the functional connectivity between the parahippocampal area and the sgACC at 10 and 11.5 Hz. The authors describe 2 patients with very severely distressing intractable tinnitus who underwent transcranial magnetic st...

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Anterior cingulate implants for tinnitus: report of 2 cases

Ridder

Joos

Vanneste

2016

JNS

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“…It is conscious perception due to the multiple, parallel and overlapping brain networks 4 . Chronic tinnitus is maladaptive neuronal plasticity and subsequent hyperactivity in primary and secondary auditory pathways, higher-order association areas and parts of the limbic system 2,3,[5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Association of Chronic Subjective Tinnitus with Neuro-Cognitive Performance

Gudwani¹,

Munjal²,

Panda³

et al. 2017

The International Tinnitus Journal

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Introduction: Chronic subjective tinnitus is associated with cognitive disruptions affecting perception, thinking, language, reasoning, problem solving, memory, visual tasks (reading) and attention. Objective: To evaluate existence of any association between tinnitus parameters and neuropsychological performance to explain cognitive processing. Materials and Methods: Study design was prospective, consisting 25 patients with idiopathic chronic subjective tinnitus and gave informed consent before planning their treatment. Neuropsychological profile included (i) performance on verbal information, comprehension, arithmetic and digit span; (ii) non-verbal performance for visual pattern completion analogies; (iii) memory performance for long-term, recent, delayed-recall, immediate-recall, verbal-retention, visualretention, visual recognition; (iv) reception, interpretation and execution for visual motor gestalt. Correlation between tinnitus onset duration/ loudness perception with neuropsychological profile was assessed by calculating Spearman's coefficient. Results: Findings suggest that tinnitus may interfere with cognitive processing especially performance on digit span, verbal comprehension, mental balance, attention & concentration, immediate recall, visual recognition and visual-motor gestalt subtests. Negative correlation between neurocognitive tasks with tinnitus loudness and onset duration indicated their association. Positive correlation between tinnitus and visual-motor gestalt performance indicated the brain dysfunction. Conclusion: Tinnitus association with non-auditory processing of verbal, visual and visuo-spatial information suggested neuroplastic changes that need to be targeted in cognitive rehabilitation.

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“…These hubs can take part in each separable subnetwork at different frequencies [23]. Communication between the subnetworks is proposed to occur at discrete oscillatory frequencies [57]. As such, it has been proposed that the brain uses multiple nonspecific networks in parallel, each with their own oscillatory signature, that adapt to the context to construct a unified percept possibly by synchronized activation integrated at hubs at discrete oscillatory frequencies [23].…”

Section: Introductionmentioning

confidence: 99%