Neuroanatomical Alterations in Patients With Tinnitus Before and After Sound Therapy: A Voxel-Based Morphometry Study

Abstract

According to previous studies, many neuroanatomical alterations have been detected in patients with tinnitus. However, few studies have reported on the morphological changes observed following sound therapy. To explore the brain anatomical alterations in patients with idiopathic tinnitus using voxel-based morphometry (VBM) analysis before and after effective 12 weeks sound therapy. The protocol was registered on ClinicalTrials.gov, ID: NCT02774122. In this study, we collected data from 27 matched healthy control (HC) individuals and 27 idiopathic tinnitus patients before and after 12 weeks of sound therapy by using adjusted narrow band sound. 3.0T MRI system and high-resolution 3D structural images were acquired with a 3D-BRAVO pulse sequence. Structural image data preprocessing was performed using the VBM8 toolbox. The Tinnitus Handicap Inventory (THI) score was acquired in the tinnitus group to assess the severity of tinnitus and tinnitus-related distress. Mann-Whitney U Test, Wilcoxon Signed-Ranks test, and Pearson's correlation analysis were used in the statistical analysis. We found significantly decreased gray matter (GM) volume in the left thalami, right thalami, and cochlear nucleus among the tinnitus patients before sound therapy (baseline) compared to the HC group. However, we did not find significant differences in brain regions between the 12-week treatment and HC groups. According to the results of Wilcoxon Signed-Ranks test, the 12-week sound therapy group demonstrated significant greater brain volume compared with the baseline group among these brain regions. Decreased THI score and changed GM volume were not correlated. This is a useful study for observing the characteristics of neuroanatomical changes in patients with idiopathic tinnitus before and after sound treatment. The study characterized the effect of sound therapy on brain volume. It found that sound therapy had a normalizing effect on the bilateral thalami and cochlear nucleus.

Surface-Based Amplitude of Low-Frequency Fluctuation Alterations in Patients With Tinnitus Before and After Sound Therapy: A Resting-State Functional Magnetic Resonance Imaging Study

“…In addition, we used 24 weeks of sound therapy to evaluate patients after a relatively long period of time in this study. Compared with the shorter treatment period of 12 weeks used in previous studies ( Wei et al, 2020 ; Lv et al, 2021 ), 24 weeks of treatment was more effective. With the extended treatment time, we obtained more detailed cortical information.…”

“…Some studies have reported microstructural changes in the brains of tinnitus patients with voxel-based morphometry (VBM) ( Husain et al, 2011 ). Our previous study also used VBM to evaluate tinnitus patients and found that the thalamus, as a deep gray matter (GM) nucleus, was significantly different in these patients after sound therapy ( Wei et al, 2020 ). Some studies have investigated microstructural changes such as GM and white matter (WM) volume and thickness of tinnitus patients with surface-based morphometry (SBM) ( Allan et al, 2016 ; Meyer et al, 2016 ).…”

Pretreatment intranetwork connectivity can predict the outcomes in idiopathic tinnitus patients treated with sound therapy

“…To date, there have been relatively few noninvasive studies on the effect of sound therapy in the treatment of idiopathic tinnitus, and these studies have had divergent results (Han et al, 2020; Han, Yawen, et al, 2019; Han, Na, et al, 2019; Lv et al, 2020; Moffat et al, 2009; Oishi et al, 2013; Parazzini, Del Bo, Jastreboff, Tognola, & Ravazzani, 2011; Wei et al, 2020). For example, using neuroimaging methods, some studies have indicated that sound therapy (narrowband sound stimulation) may modulate or even have a normalizing effect on abnormal brain activity or functional connectivity (FC) in some tinnitus‐related regions, which may reflect less involvement of the noise‐canceling system (Han et al, 2020; Han, Yawen, et al, 2019; Han, Na, et al, 2019; Lv et al, 2020).…”

“…Currently, many therapeutic approaches have been applied in the process of idiopathic tinnitus treatment, such as counseling and psychoeducation, pharmacological treatments, sound therapy, hearing aids, tinnitus retraining therapy, cochlear implants, brain stimulation, hyperbaric oxygen, and acupuncture (Langguth et al, 2013;Zenner et al, 2017). Among these therapeutic measures, sound therapy, such as frequency unmodulated noise generators involving the use of recorded noise, special tinnitus noisers, or tinnitus masker devices (Jastreboff, 1999;Oishi et al, 2013;Zenner et al, 2017), has been widely used in the treatment of idiopathic tinnitus in many studies (Han et al, 2020;Jastreboff, 1999;Lv et al, 2020;Oishi et al, 2013;Wei et al, 2020). Furthermore, it has been listed as an option in clinical practice guidelines (Henry, Schechter, Nagler, & Fausti, 2002;Tunkel et al, 2014) and even used as a first-line means for treating tinnitus patients when combined with other measures, such as hearing aids and information and counseling (Hoare, Edmondson-Jones, Sereda, Akeroyd, & Hall, 2014;Hobson, Chisholm, & El, 2012;Sereda, Hoare, Nicholson, Smith, & Hall, 2015;Tutaj, Hoare, & Sereda, 2018).…”

Cortical Thickness Alterations in Patients With Tinnitus Before and After Sound Therapy: A Surface-Based Morphometry Study

“…Some studies have reported microstructural changes in the brains of tinnitus patients with VBM ( Husain et al, 2011 ), which can quantitatively detect the volume of brain tissue at the voxel level ( Ashburner and Friston, 2000 ). Our previous study also applied VBM and found significantly decreased gray matter (GM) volume in the left thalamus, right thalamus, and cochlear nucleus in tinnitus patients before sound therapy (baseline) compared to the healthy control (HC) group ( Wei et al, 2020b ). By contrast, SBM focuses on cortical structural characteristics.…”