Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)

Ridder, Dirk De; Schlee, Winfried; Vanneste, Sven; Londero, Alain; Weisz, Nathan; Kleinjung, Tobias; Shekhawat, Giriraj Singh; Elgoyhen, Ana Belén; Song, Jae J.; Andersson, Gerhard; Adhia, Divya Bharatkumar; Azevedo, Andréia Aparecida de; Baguley, David; Biesinger, E.; Binetti, Ana Carolina; Bo, Luca Del; Cederroth, Christopher R.; Cima, Rilana; Eggermont, Jos J.; Figueiredo, Ricardo Rodrigues; Fuller, Thomas; Gallus, Silvano; Gilles, Annick; Hall, Deborah A.; Heyning, Paul Van de; Hoare, Derek J.; Khedr, Eman M.; Kikidis, Dimitris; Kleinstaeuber, Maria; Kreuzer, Peter; Lai, Jen Tsung; Laínez, José Miguel; Landgrebe, Michael; Li, Lieber Po Hung; Lim, Hubert H.; Li, Chia Wei; Lopez-Escamez, José A.; Mazurek, Birgit; Møller, Aage R.; Neff, Patrick; Pantev, Christo; Park, Shi Nae; Piccirillo, Jay F.; Poeppl, Timm B.; Rauschecker, Josef P.; Salvi, Richard; Sánchez, Tanit Ganz; Schecklmann, Martin; Schiller, Axel; Searchfield, Grant D.; Tyler, Richard S.; Vielsmeier, Veronika; Vlaeyen, Johan W. S.; Zhang, Jinsheng; Zheng, Yiwen; Nora, Matteo de; Langguth, Berthold

doi:10.1016/bs.pbr.2020.12.002

Cited by 161 publications

(102 citation statements)

References 109 publications

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“…Furthermore, a major concern is that the definition of tinnitus could be ambiguous in addressing phantom sound perception related to hearing dysfunction alone, and the other symptoms may be underestimated. Considering the higher presence of comorbidities, as recently suggested, the associated symptoms including emotional distress and cognitive dysfunction can be more correctly expressed by the definition of “tinnitus disorder” [ 41 ]. We believe that this may explain the poor evidence found between cognitive dysfunction and tinnitus as a limitation of this systematic review; thus, further studies are desirable in focusing disorders related to tinnitus.…”

Section: Discussionmentioning

confidence: 99%

Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links

Malesci

Brigato

Cesare

et al. 2021

JCM

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Introduction: Tinnitus is a common and disabling symptom often associated with hearing loss. While clinical practice frequently shows that a certain degree of psychological discomfort often characterizes tinnitus suffers, it has been recently suggested in adults as a determining factor for cognitive decline affecting attention and memory domains. The aim of our systematic review was to provide evidence for a link between tinnitus, psychological distress, and cognitive dysfunction in older patients and to focus on putative mechanisms of this relationship. Methods: We performed a systematic review, finally including 192 articles that were screened. This resulted in 12 manuscripts of which the full texts were included in a qualitative analysis. Results: The association between tinnitus and psychological distress, mainly depression, has been demonstrated in older patients, although only few studies addressed the aged population. Limited studies on cognitive dysfunction in aged patients affected by chronic tinnitus are hardly comparable, as they use different methods to validate cognitive impairment. Actual evidence does not allow us with certainty to establish if tinnitus matters as an independent risk factor for cognitive impairment or evolution to dementia. Conclusion: Tinnitus, which is usually associated with age-related hearing loss, might negatively affect emotional wellbeing and cognitive capacities in older people, but further studies are required to improve the evidence.

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Section: Discussionmentioning

confidence: 99%

Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links

Malesci

Brigato

Cesare

et al. 2021

JCM

View full text Add to dashboard Cite

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“…These discrepancies demonstrate the difficulties in the concept of tinnitus. Even though the description of the phenomenon tinnitus is straightforward, the concept of what it means for patients varies greatly ( 30 , 31 ). Loudness alone does not fully explain the experienced distress and therefore, a decrease in subjective loudness does not necessarily correlate with a similar amount of decrease in tinnitus distress.…”

Section: Discussionmentioning

confidence: 99%

What Tinnitus Therapy Outcome Measures Are Important for Patients?– A Discrete Choice Experiment

et al. 2021

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Introduction: The therapeutic rationale varies among tinnitus therapies. A recent study identified which outcome measures should be used for different types of interventions. What patients consider the most important outcome measure in tinnitus therapy is unclear.Objectives: To study the preference of the tinnitus patient for different outcome measures in tinnitus therapy.Methods: A discrete choice experiment was conducted. Participants were provided with two alternatives per choice set (nine choice sets total). Each choice-set consisted of four attributes (tinnitus loudness, tinnitus acceptance, quality of sleep and concentration). With a difference in one of three levels (increased, similar or decreased after treatment) between the alternatives. Results were analyzed with a mixed logit model. Preference heterogeneity was explored with covariates, correlating attributes and a latent class analysis.Results: One hundred and twenty-seven participants took part. In the mixed logit models we found that the choice for a tinnitus therapy was significantly affected by all levels of the outcomes, except for a similar level in concentration and tinnitus acceptance. Tinnitus loudness was considered the most important outcome measure relative to the other attributes. Preference heterogeneity was not explained by correlating attributes. The latent class analysis identified two classes. The first class was similar to the mixed logit analysis, except for a non-significance of similar quality of sleep and tinnitus acceptance. The second class showed a statistical significant preference only for increased tinnitus acceptance and similar quality of sleep.Conclusion: Based on this study, tinnitus patients consider loudness the most important outcome measure. However, there is a variance in preference as indicated by the latent class analysis. This study underlines the importance of research into tinnitus heterogeneity. Next, this study highlights the need for research into tinnitus therapies that focus on diminishing tinnitus loudness.

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“…The lack of a clear definition and subsequently the lack of prevalence numbers in general populations around the world are two important obstacles that hinder the search for a curative treatment ( 6 , 16 ). The difficulties of defining tinnitus with and without suffering have recently been addressed by the Tinnitus Research Initiative (TRI) in a conceptual book chapter ( 17 , 18 ). The authors propose a different definition for tinnitus and tinnitus disorder.…”

Section: Recommendationsmentioning

confidence: 99%

Using Different Cutoffs to Define Tinnitus and Assess Its Prevalence—A Survey in the Dutch General Population

et al. 2021

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Introduction: Tinnitus prevalence numbers in the literature range between 5 and 43%, depending on the studied population and definition. It is unclear when tinnitus becomes pathologic.Objectives: To assess the tinnitus prevalence in the Dutch general population with different cutoffs for definition.Methods: In this cross-sectional study, a questionnaire was sent to a sample (n = 2,251) of the Nivel (Netherlands Institute for Health Services Research) Dutch Health Care Consumer Panel. Three questions were asked to assess the presence of tinnitus, duration, and frequency of the complaint. We classified people as having pathologic tinnitus when participants experienced it for 5–60 min (daily or almost daily or weekly), or tinnitus for >60 min or continuously (daily or almost daily or weekly or monthly), so tinnitus impact on daily life was measured with the Tinnitus Functional Index (TFI) and a single-item question. Answers were stratified to mid-decade years of age. Prevalence numbers were weighted by gender and age to match the Dutch population.Results: Nine hundred thirty-two of 2,251 participants (41%) filled out the questionnaire. The median age was 67.0 (IQR 17) years. Three hundred thirty-eight of 932 (36%) experienced tinnitus for an undefined amount of time during the last year. Two hundred sixteen of 932 (23%) met our definition of having pathologic tinnitus (21% when weighted for age and gender). The median TFI score for all pathologic tinnitus participants was 16.6 (IQR 21.8). A percentage of 50.4% of the pathologic tinnitus participants had a TFI in the range 0–17, which can be interpreted as not a problem.Conclusion: Twenty-three percent (unweighted) or 21% (weighted) of our sample met our definition of pathologic tinnitus, which was based on a combination of duration and frequency over the last year. The TFI score of 47.7% of the pathologic tinnitus participants is ≥18. This indicates that they consider the tinnitus to be at least “a small problem” [11.1% (unweighted) or 8.9% (weighted) of the total study group]. This study illustrates the difficulties with defining pathologic tinnitus. In addition, it demonstrates that tinnitus prevalence numbers vary with different definitions and, consequently, stresses the importance of using a uniform definition of tinnitus.

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Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)

Cited by 161 publications

References 109 publications

Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links

Tinnitus and Neuropsychological Dysfunction in the Elderly: A Systematic Review on Possible Links

What Tinnitus Therapy Outcome Measures Are Important for Patients?– A Discrete Choice Experiment

Using Different Cutoffs to Define Tinnitus and Assess Its Prevalence—A Survey in the Dutch General Population

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