Heidelberg Neuro-Music Therapy Restores Attention-Related Activity in the Angular Gyrus in Chronic Tinnitus Patients

Abstract

Background: Tinnitus is the perception of a phantom sound without external acoustic stimulation. Recent tinnitus research suggests a relationship between attention processes and tinnitus-related distress. It has been found that too much focus on tinnitus comes at the expense of the visual domain. The angular gyrus (AG) seems to play a crucial role in switching attention to the most salient stimulus. This study aims to evaluate the involvement of the AG during visual attention tasks in tinnitus sufferers treated with Heidelberg Neuro-Music Therapy (HNMT), an intervention that has been shown to reduce tinnitus-related distress.Methods: Thirty-three patients with chronic tinnitus, 45 patients with recent-onset tinnitus, and 35 healthy controls were tested. A fraction of these (21/21/22) were treated with the “compact” version of the HNMT lasting 1 week with intense treatments, while non-treated participants were included as passive controls. Visual attention was evaluated during functional Magnet-Resonance Imaging (fMRI) by a visual Continous Performance Task (CPT) using letter-based alarm cues (“O” and “X”) appearing in a sequence of neutral letters, “A” through “H.” Participants were instructed to respond via button press only if the letter “O” was followed by the letter “X” (GO condition), but not to respond if a neutral letter appeared instead (NOGO condition). All participants underwent two fMRI sessions, before and after a 1-week study period.Results: The CPT results revealed a relationship between error rates and tinnitus duration at baseline whereby the occurrence of erroneous “GO omissions” and the reaction time increased with tinnitus duration. Patients with chronic tinnitus who were treated with HNMT had decreasing error rates (fewer GO omissions) compared to treated recent-onset patients. fMRI analyses confirmed greater activation of the AG during CPT in chronic patients after HNMT treatment compared to treated recent-onset patients.Conclusions: Our findings suggest that HNMT treatment helps shift the attention from the auditory phantom percept toward visual cues in chronic tinnitus patients and that this shift in attention may involve the AG.

Baseline Functional Connectivity Features of Neural Network Nodes Can Predict Improvement After Sound Therapy Through Adjusted Narrow Band Noise in Tinnitus Patients

“…Current therapeutic approaches include tinnitus retraining therapy (Scherer et al, 2014; Kim et al, 2016), counseling, cognitive behavior therapy (Conrad et al, 2015; Weise et al, 2016), transcranial magnetic stimulation (Kreuzer et al, 2017; Formanek et al, 2018), hearing aids (Searchfield et al, 2010), pharmacological treatments (von Boetticher, 2011), and several innovative sound-based treatments (e.g., Heidelberg Neuro-Music Therapy) (Krick et al, 2015, 2017a,b), Cochleural Alternating Acoustic Beam Therapy (CAABT) (Liu et al, 2018), and Tailor-Made Notched Music Training (TMNMT) (Okamoto et al, 2010; Kim et al, 2017; Lee et al, 2017). Sound therapy is considered as a cost-effective management for tinnitus (Tunkel et al, 2014; Walker et al, 2016; Makar et al, 2017) and is one of the most commonly used first-line therapy interventions for decades (Henry et al, 2002).…”

Acupuncture Treatment Decreased Temporal Variability of Dynamic Functional Connectivity in Chronic Tinnitus

“…The above results indicated that the neural mechanism of acupuncture treatment improving tinnitus might be decreasing the time variability of DFC between the left PCG and right AG. The previous studies also indicated that the PCG and the AG tightly associated with chronic tinnitus (Chen et al, 2014(Chen et al, , 2015bKrick et al, 2017). Impaired visual attention function was found in chronic tinnitus patients, and Heidelberg Neuro-Music Therapy treatment helped shift the attention from the auditory phantom percept toward visual cues in chronic tinnitus patients through the AG (Krick et al, 2017).…”

relação entre Música e Atenção

“…Os estudos em musicoterapia e atenção podem apresentar uma ampla variedade de objetivos, como: (a) identificação de elementos ou características da música relevantes para a captura da atenção em diferentes grupos de intervenção (Kalas 2012;Loureiro et.al. 2014;Sussman 2009); (b) investigação dos benefícios das experiências musicais como meio de distrair a atenção de sintomas incômodos (Krick et al 2017) ou de procedimentos dolorosos e invasivos (Waldon;Broadhurst 2014); (c) busca de evidências da eficácia de técnicas da musicoterapia no treinamento de diferentes dimensões da atenção (Särkämö et al 2008;Kim, Wigram;Gold 2008;Pasiali et al 2014).…”