Neuroplastic Effect of Constraint-Induced Music Therapy on Hearing Recovery in Patients with Sudden Sensorineural Hearing Loss

Abstract

Objective: Constraint-induced music therapy (CIMT) has been shown to enhance hearing recovery in patients with sudden sensorineural hearing loss (SSNHL) by preventing maladaptive reorganization of the auditory cortex. Our objective in this study was to assess the effectiveness of CIMT in restoring hearing among patients with SSNHL. Methods: The study included prospective (CIMT group) and retrospective (non-CIMT group) study arms. CIMT is characterized by (1) plugging the healthy ear to induce temporary artificial hearing loss (i.e., constraint) and (2) simultaneous acoustic stimulation of the affected ear using relaxing music. The outcome variables used to evaluate hearing recovery included (1) hearing threshold, (2) interaural hearing gap, and (3) hearing recovery rate. We measured the P300 component of long-latency auditory evoked potential to analyze brain activity to determine the appearance of neuroplasticity in assessing a subgroup of six patients with CIMT. All of the patients in the study also received conventional steroid therapy. Results: The CIMT and non-CIMT groups were comparable in terms of pre-treatment hearing level (P = 0.710), age (P = 0.124), gender (P = 0.272), and side of hearing loss (P = 0.132). In both groups, we observed a significant improvement in hearing thresholds at two weeks and four weeks after treatment (all P <0.01). Nevertheless, we did not observe a statistically significant difference in hearing recovery when using hearing threshold, interaural hearing gap, or hearing recovering rate as outcome variables (P >0.05). This observation was verified using multivariate analysis (non-CIMT vs. CIMT, odds ratio 3.84, 95% confidence interval 0.18-81.65, P = 0.388 at two weeks after treatment; odds ratio 2.70, 95% confidence interval 0.15-47.60, P = 0.497 at four weeks after treatment). P300 measurements conducted on affected ears failed to identify significant signs of neuroplastic change in response to CIMT (P = 0.063 for the amplitude comparison; P = 0.094 for the latency comparison). Conclusion: CIMT is a safe, cost-effective addition to corticosteroid treatment for SSNHL patients. It is also possible that CIMT provides an enjoyable therapeutic adjunct for the relief of stress and anxiety associated with SSNHL. However, our results failed to identify the additive effect of CIMT on hearing recovery in patients with SSNHL. Our study was also unable to confirm the degree of neuroplasticity in patients with CIMT.

Musicoterapia y otorrinolaringología

“…Dentro de la evidencia científica que apoya el uso de musicoterapia en medicina, existen actualmente múltiples líneas de investigación activas que se han dedicado a estudiar las posibles aplicaciones de herramienta en el campo de la otorrinolaringología. Diversos protocolos de musicoterapia se han aplicado logrando resultados bastante prometedores en tinnitus [13][14][15][16] , rehabilitación auditiva 4,17 , manejo del dolor y ansiedad en procedimientos [18][19][20] , entre otros. A continuación, se exponen algunos de estos resultados.…”

“…Actualmente, la Federación Mundial de Musicoterapia (WFMT) define musicoterapia como "el uso profesional de la música y sus elementos como intervención en el ámbito médico, educativo y cotidiano con individuos, grupos, familias o comunidades, que buscan optimizar su calidad de vida y mejorar su salud y bienestar físico, social, comunicativo, emocional, intelectual y espiritual" 3 La musicoterapia es una intervención integral que actúa a nivel individual, interpersonal, social y comunitario, y usualmente en sus actividades se incluyen escuchar, cantar, bailar o interpretar música con instrumentos, componer canciones, realizar ejercicios de música, relajación y discusiones líricas grupales 3 Existen varios estudios que han evidenciado la ocurrencia de cambios neuroplásticos, psicológicos y cognitivos en respuesta a la música [4][5][6] , así como otros que han demostrado beneficios del uso de musicoterapia en la salud 7,8 .…”

Auditory Evoked Potential in Patients with Tinnitus

“…It is possible that the central auditory system also plays a significant role, which means that tinnitus may also be associated with cognitive processing abnormalities or attention deficit disorders. Auditory evoked potentials provide a non-invasive means by which to record the electrical signals of neural activities from the scalp, thus provide a useful tool for the evaluation of auditory disorder, such as tinnitus and hearing loss [10].…”