Psychological Treatment Effects Unrelated to Hair-Cortisol and Hair-BDNF Levels in Chronic Tinnitus

Abstract

BackgroundCurrently, there are no objective markers to measure treatment efficacy in chronic (distressing) tinnitus. This study explores whether stress-related biomarkers cortisol and brain-derived neurotrophic factor (BDNF) measured in hair samples of chronic tinnitus patients change after compact multimodal tinnitus-specific cognitive behavioral therapy.MethodsIn this longitudinal study, hair-cortisol and hair-BDNF levels, self-reported tinnitus-related distress (Tinnitus Questionnaire; TQ), and perceived stress (Perceived Stress Questionnaire; PSQ-20) were assessed before and 3 months after 5 days of treatment in N = 80 chronic tinnitus patients. Linear mixed-effects models with backward elimination were used to assess treatment-induced changes, and a cross-lagged panel model (structural equation model) was used for additional exploratory analysis of the temporal associations between TQ and hair-BDNF.ResultsAt follow-up, a reduction in TQ (p < 0.001) and PSQ-20 scores (p = 0.045) was observed, which was not influenced by baseline hair-cortisol or hair-BDNF levels. No changes in biomarker levels were observed after treatment. The exploratory analysis tentatively suggests that a directional effect of baseline TQ scores on hair-BDNF levels at follow-up (trend; p = 0.070) was more likely than the opposite directional effect of baseline hair-BDNF levels on TQ scores at follow-up (n.s.).DiscussionWhile the treatment effectively reduced tinnitus-related distress and perceived stress in chronic tinnitus patients, this effect was not mirrored in biological changes. However, the lack of changes in hair-cortisol and hair-BDNF levels might have been influenced by the treatment duration, follow-up interval, or confounding medical factors, and therefore must be interpreted with caution. The relationship between tinnitus-related distress and hair-BDNF levels should be explored further to obtain a better understanding of stress-related effects in chronic tinnitus.

Tinnitus und beeinflussende Komorbiditäten

“…In future, the field can expect further improvements in assessment and therapy. Novel research frameworks focus on dimensional (not categorical) conceptualizations of psychological distress 124 125 126 , biomarkers of tinnitus-related distress 33 35 127 as well as refined psychotherapeutic treatment frameworks 128 . In addition, the importance of unified data collections 129 130 131 or methodological advances in big data analysis are of increasing importance 31 58 .…”

Negative Associations of Stress and Anxiety Levels With Cytotoxic and Regulatory Natural Killer Cell Frequency in Chronic Tinnitus

“…Regarding treatment effects, we expected treatment-induced changes in tinnitus-related distress and psychological symptoms based on previous studies with the same or similar treatment interventions ( Seydel et al, 2010 , 2015 ; Brueggemann et al, 2018 , 2019 ; Basso et al, 2022a ), but no significant effects were observed. Neither stress and anxiety levels nor NK cell frequencies showed significant treatment-related changes.…”

“…Participants were in-patients receiving treatment at the Tinnitus Center between July 2019 and March 2020, consisting of a short-term multimodal CBT-based treatment program specifically designed for chronic tinnitus lasting 4 to 5 days ( M = 4.59, SD = 0.5). The treatment included ENT and general medical examinations, education, counseling, individual and group CBT sessions, auditory attention training, relaxation, and physiotherapy ( Basso et al, 2022a ). The recruitment of new participants was stopped in spring 2020 due to the beginning of the COVID-19 pandemic; the completion of follow-up measurement sessions lasted until August 2020.…”

Differential effect of panic on the DNA methylation of the glucocorticoid receptor gene exon 1F in chronic subjective tinnitus with distress

“…Baseline cortisol concentrations were shown to be higher in participants with tinnitus and high tinnitus-related distress in one study (Hébert et al, 2004). More recently, higher perceived tinnitus loudness was also reported to be associated with higher hair-cortisol levels (Basso et al, 2022). In contrast, in individuals with chronic tinnitus (≥6 months) a blunted cortisol response to psychosocial stress was found (Hébert and Lupien, 2007), as well as a hypersuppression of cortisol after administration of a low dose (0.5 mg) of dexamethasone, pointing to HPA axis hypofunction and to enhanced negative feedback to the HPA axis (Simoens and Hébert, 2012).…”