The Distressed (Type D) Personality Is Independently Associated With Tinnitus:A Case-Control Study

Background: Tinnitus is a common and disturbing condition, reported by 10% to 20% of the general population. Objective: The authors sought to determine personality characteristics associated with tinnitus patients versus a control group of ear-nose-throat (ENT) patients without tinnitus. Method: Adult chronic tinnitus sufferers (N = 265) and ENT patients without tinnitus (N = 265) participated in a cross-sectional study. The authors evaluated personality characteristics with tests for distressed personality (Type D), neuroticism, extraversion, and emotional stability. Results: As compared with control subjects, tinnitus patients had statistically significant and clinically relevant higher levels of neuroticism, negative affectivity, and social inhibition, on one hand, and lower levels of extraversion and emotional stability on the other hand. Also, tinnitus patients were more likely to have a type D personality. Conclusions: Neuroticism, reduced extraversion, and reduced emotional stability were associated with tinnitus, but the level of prediction of the model improved with the addition of type D personality to the single traits. This might indicate that personality characteristics, and type D personality, in particular, are associated with having tinnitus and might contribute to its perceived severity. (Psychosomatics 2010; 51: 29-38)</p

Functional sex differences in human primary auditory cortex

Background We used PET to study cortical activation during auditory stimulation and found sex differences in the human primary auditory cortex (PAC). Regional cerebral blood flow (rCBF) was measured in 10 male and 10 female volunteers while listening to sounds (music or white noise) and during a baseline (no auditory stimulation). Results and discussion We found a sex difference in activation of the left and right PAC when comparing music to noise. The PAC was more activated by music than by noise in both men and women. But this difference between the two stimuli was significantly higher in men than in women. To investigate whether this difference could be attributed to either music or noise, we compared both stimuli with the baseline and revealed that noise gave a significantly higher activation in the female PAC than in the male PAC. Moreover, the male group showed a deactivation in the right prefrontal cortex when comparing noise to the baseline, which was not present in the female group. Interestingly, the auditory and prefrontal regions are anatomically and functionally linked and the prefrontal cortex is known to be engaged in auditory tasks that involve sustained or selective auditory attention. Thus we hypothesize that differences in attention result in a different deactivation of the right prefrontal cortex, which in turn modulates the activation of the PAC and thus explains the sex differences found in the activation of the PAC. Conclusion Our results suggest that sex is an important factor in auditory brain studies

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Tinnitus and neural plasticity of the brain

Objective: To describe the current ideas about the manifestations of neural plasticity in generating tinnitus. Data Sources: Recently published source articles were identified using MEDLINE, PubMed, and Cochrane Library according to the key words mentioned below. Study Selection: Review articles and controlled trials were particularly selected. Data Extraction: Data were selected systematically, scaled on validity and comparability. Conclusion: An altered afferent input to the auditory pathway may be the initiator of a complex sequence of events, finally resulting in the generation of tinnitus at the central level of the auditory nervous system. The effects of neural plasticity can generally be divided into early modifications and modifications with a later onset. The unmasking of dormant synapses, diminishing of (surround) inhibition and initiation of generation of new connections through axonal sprouting are early manifestations of neural plasticity, resulting in lateral spread of neural activity and development of hyperexcitability regions in the central nervous system. The remodeling process of tonotopic receptive fields within auditory pathway structures (dorsal cochlear nucleus, inferior colliculus, and the auditory cortex) are late manifestations of neural plasticity. The modulation of tinnitus by stimulating somatosensory or visual systems in some people with tinnitus might be explained via the generation of tinnitus following the nonclassical pathway. The similarities between the pathophysiological processes of phantom pain sensations and tinnitus have stimulated the theory that chronic tinnitus is an auditory phantom perception

Chemoprophylaxis of fungal deterioration of the Provox silicone tracheoesophageal prosthesis in postlaryngectomy patients

A double-blind randomized trial was conducted among 36 laryngectomees to assess the influence of a buccal bioadhesive slow-release tablet containing miconazole nitrate on the lifetime of the Provox voice prosthesis. All patients colonized with Candida spp and treated with miconazole showed a significant decrease of colonization at the end of the study. Intratracheal phonatory pressures were remarkably higher after 2 months of follow-up in the placebo group. No local or systemic adverse reactions to miconazole were observed during this study. Patient compliance was acceptable according to regular miconazole determination in saliva samples. The device lifetime was significantly higher in patients treated with miconazole even after 1 year of follow-up. The use of a buccal bioadhesive slow-release tablet containing an antimycotic agent proves to be an adequate method of preventing fungal colonization and deterioration of silicone voice prostheses

Hippocampal volume measurement in patients with Meniere's disease:a pilot study

Conclusion. No signs of chronic stress as in hippocampal atrophy were present in patients with Meniere's disease. Objective. To evaluate the effect of chronic stress (allostatic load) by measuring hippocampal volume in patients with Meniere's disease. Subjects and methods. Ten patients with Meniere's disease and 10 healthy controls were evaluated for absolute and relative hippocampal volumes measured on MRI scans, saliva cortisol levels and frequency of daily stressors. The study was performed in a prospective, controlled setting with two raters who were blinded as to subject identity. Results. Saliva cortisol levels and presence of daily stressor scores were similar in both groups. The first rater measured mean hippocampal volumes of 2.80 +/- 90.36 cm(3) vs 3.15 +/- 90.52 cm(3) ( right) and 2.49 +/- 90.32 cm(3) vs 3.06 +/- 90.46 cm(3) (left), for the Meniere's disease and control group, respectively. The second rater measured 3.44 +/- 0.35 cm(3) vs 3.60 +/- 0.52 cm(3) ( right) and 3.00 +/- 0.40 cm(3) vs 3.42 +/- 0.45 cm(3) ( left), respectively. The volume of the left hippocampus was significantly smaller in patients with Meniere's disease compared with the controls for both raters ( p <0.05) and the right hippocampal volume was not different between the two groups. With correction for variation in head size ( partial brain and partial intracranial volume) no significant differences in relative hippocampal volumes were observed between patients with Meniere's disease and the control group

Intratympanic gentamicin therapy for control of vertigo in unilateral Meniere's disease:a prospective, double-blind, randomized, placebo-controlled trial

Conclusions. Intratympanic application of gentamicin is a relatively safe and efficient treatment for the reduction of complaints of vertigo attacks associated with Meniere's disease. The treatment also reduces the severity of the perceived aural fullness. Objective. To investigate the effectiveness of intratympanic gentamicin treatment in patients with unilateral Meniere's disease. Subjects and methods. In a prospective, double-blind, randomized, placebo-controlled clinical trial subjects scored vertigo complaints, aural fullness and tinnitus, before, during and up to 1 year after treatment. Hearing loss was monitored with pure tone audiometry. Results. Gentamicin treatment resulted in a significant reduction of the score for vertigo complaints and the score for perceived aural fullness. A small increase in hearing loss (average 8 dB) was measured in the gentamicin group