A review of auditory gain, low-level noise and sound therapy for tinnitus and hyperacusis

Sheppard, Adam; Stocking, Christina; Ralli, Massimo; Salvi, Richard

doi:10.1080/14992027.2019.1660812

Cited by 28 publications

(25 citation statements)

References 161 publications

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“…This suggests that objective markers for either tinnitus or hyperacusis may have indeed been identified. Keeping this in mind, numerous previously controversial findings of either reduced or enhanced central auditory responses in tinnitus (27,47,67) may find a rational explanation. Also, previous studies that included tinnitus patients with unilateral and bilateral tinnitus and only found tinnitus characteristics in the sub-chronical group (28) may reconsider the findings in the context of the present study.…”

Section: Differences In Neural Correlates Behind T-group and Th-groupmentioning

confidence: 99%

Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care

et al. 2021

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Although tinnitus represents a major global burden, no causal therapy has yet been established. Ongoing controversies about the neuronal pathophysiology of tinnitus hamper efforts in developing advanced therapies. Hypothesizing that the unnoticed co-occurrence of hyperacusis and differences in the duration of tinnitus may possibly differentially influence the neural correlate of tinnitus, we analyzed 33 tinnitus patients without (T-group) and 20 tinnitus patients with hyperacusis (TH-group). We found crucial differences between the T-group and the TH-group in the increase of annoyance, complaints, tinnitus loudness, and central neural gain as a function of tinnitus duration. Hearing thresholds did not differ between T-group and TH-group. In the TH-group, the tinnitus complaints (total tinnitus score) were significantly greater from early on and the tinnitus intensity distinctly increased over time from ca. 12 to 17 dB when tinnitus persisted more than 5 years, while annoyance responses to normal sound remained nearly constant. In contrast, in the T-group tinnitus complaints remained constant, although the tinnitus intensity declined over time from ca. 27 down to 15 dB beyond 5 years of tinnitus persistence. This was explained through a gradually increased annoyance to normal sound over time, shown by a hyperacusis questionnaire. Parallel a shift from a mainly unilateral (only 17% bilateral) to a completely bilateral (100%) tinnitus percept occurred in the T-group, while bilateral tinnitus dominated in the TH-group from the start (75%). Over time in the T-group, ABR wave V amplitudes (and V/I ratios) remained reduced and delayed. By contrast, in the TH-group especially the ABR wave III and V (and III/I ratio) continued to be enhanced and shortened in response to high-level sound stimuli. Interestingly, in line with signs of an increased co-occurrence of hyperacusis in the T-group over time, ABR wave III also slightly increased in the T-group. The findings disclose an undiagnosed co-occurrence of hyperacusis in tinnitus patients as a main cause of distress and the cause of complaints about tinnitus over time. To achieve urgently needed and personalized therapies, possibly using the objective tools offered here, a systematic sub-classification of tinnitus and the co-occurrence of hyperacusis is recommended.

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Section: Differences In Neural Correlates Behind T-group and Th-groupmentioning

confidence: 99%

Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care

et al. 2021

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“…The heterogeneity of tinnitus may explain why there is no one effective treatment for all patients and the outcomes of a given therapeutic intervention are highly variable. Patients might use various non-specific methods to cope with tinnitus including sound or music therapies [9][10][11], cochlear implantation [12], psychological therapies [13][14][15][16][17][18][19], brain stimulation [20][21][22], or neurofeedback training [23,24]. No effective pharmacological treatment for this condition is yet available.…”

Section: Introductionmentioning

confidence: 99%

“…A possible theory accounting for reduced slow-wave activity together with increased gamma over the temporal areas in tinnitus patients is the thalamo-cortical dysrhythmia model [29,45] in which tinnitus relates to persistent gamma activity in the auditory cortex due to auditory deafferentation. In the deafferented state the dominant resting-state alpha rhythm (8)(9)(10)(11)(12) decreases to a theta rhythm (4)(5)(6)(7). As a result, GABA-mediated lateral inhibition is reduced, inducing gamma band activity in regions adjacent to the deafferented theta (called PLOS ONE an edge effect, 40).…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological correlates of focused attention on low- and high-distressed tinnitus

et al. 2020

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Objectives The study aimed at determining the EEG correlates of concentration on either low or high-distressed tinnitus. Methods Sixty-seven patients (36 women, mean age = 50.34 ± 12.94 years) with chronic tinnitus were assigned to either a high (HD) or low (LD) tinnitus-related distress group based on THI results. All participants took part in the EEG study comprising two 3–4 min blocks of focusing on either tinnitus (Tinnitus Focus Condition, TFC) or the sensations from one’s own body (Body Focus Condition, BFC). The absolute power and current density of 8 frequency bands in 7 clusters were compared between conditions and groups. Results The most pronounced differences were found in the HD patients in the TFC, relative to the BFC, i.e. reduced power of frontally distributed low alpha (8–10 Hz) and posterior high alpha (10–12 Hz) as well as lower current density of 8–10 Hz rhythm over the right frontal/anterior cingulate cortex and higher middle beta (15–18 Hz) density in the precuneus. The HD, relative to LD patients, in both conditions, exhibited increased low beta (12–15 Hz) power over the left middle area and greater higher beta (15–25 Hz) power in the left posterior region. Conclusions The present study contrasted bioelectrical activity, acquired when concentrating on tinnitus with EEG data collected whilst patients focused on their body. Decreased alpha power and current density in the frontal/cingulate cortex when listening to bothersome tinnitus might reflect greater cortical arousal whereas increased beta power and density in the precuneus/posterior cingulate activity in this condition could be indicative for elevated tension or augmented cognitive/emotional processing of tinnitus sound. Enhanced beta rhythm in patients with high versus low tinnitus distress, observed independently of the study condition, may be due to greater self-focused attention or more active processing of sensations derived from the own body.

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“…The exact pathophysiological mechanism(s) responsible for tinnitus and hyperacusis remains enigmatic. However, many researchers believe tinnitus emerges from excessive spontaneous neural activity [87][88][89][90] and hyperacusis results from enhanced sound-evoked neural activity [90] triggered by excessive/aberrant central gain control mechanisms [91][92][93]. Central gain functions in a homeostatic manner, attempting to centrally compensate for a reduced neural output peripherally (i.e., cochlea afferent fibers).…”

Section: Tinnitus and Hyperacusismentioning

confidence: 99%

Occupational Noise: Auditory and Non-Auditory Consequences

Sheppard¹,

Ralli

Gilardi

et al. 2020

IJERPH

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Occupational noise exposure accounts for approximately 16% of all disabling hearing losses, but the true value and societal costs may be grossly underestimated because current regulations only identify hearing impairments in the workplace if exposures result in audiometric threshold shifts within a limited frequency region. Research over the past several decades indicates that occupational noise exposures can cause other serious auditory deficits such as tinnitus, hyperacusis, extended high-frequency hearing loss, and poor speech perception in noise. Beyond the audiogram, there is growing awareness that hearing loss is a significant risk factor for other debilitating and potentially life-threatening disorders such as cardiovascular disease and dementia. This review discusses some of the shortcomings and limitations of current noise regulations in the United States and Europe.

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A review of auditory gain, low-level noise and sound therapy for tinnitus and hyperacusis

Cited by 28 publications

References 161 publications

Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care

Co-occurrence of Hyperacusis Accelerates With Tinnitus Burden Over Time and Requires Medical Care

Electrophysiological correlates of focused attention on low- and high-distressed tinnitus

Occupational Noise: Auditory and Non-Auditory Consequences

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