The correlation between tinnitus-specific and quality of life questionnaires to assess the impact on the quality of life in tinnitus patients

IntroductionSubjective tinnitus is often associated with a reduction in health-related quality of life (HRQoL). The HRQoL represents the impact of tinnitus on an individual's life by addressing the physical, social, and psychological domains of 1. A limited amount of studies has investigated the association between tinnitus and HRQoL questionnaires. The aim of this study was to examine the correlation between tinnitus-specific and HRQoL questionnaires in order to shorten fulfilling questionnaires, as it is often time-consuming.Material and methodEighty-five patients with tinnitus as primary complaint completed five questionnaires, including one general, two tinnitus-specific, and two generic HRQoL questionnaires: Tinnitus Sample Case History Questionnaire (TSCHQ), Tinnitus Functional Index (TFI), Tinnitus Handicap Inventory (THI), short version of World Health Organization Quality of Life (WHOQOL-BREF), and the eight-item Short-Form (SF-8). Four simple linear regression models were used to analyze the relationship between the THI and TFI and the WHOQOL-BREF and SF-8.ResultsA negative and strong correlation was found between the tinnitus questionnaires and the SF-8. More than half of the variability in the SF-8 scores could be explained by the TFI and THI, respectively 50.6 and 54.4% (all p < 0.001). A strong negative regression was also found between the WHOQOL-BREF and the THI and TFI with a decrease in the determination coefficient of approximately 10% compared with the SF-8. The weakest correlation (regression coefficient of 0.628, p < 0.001) was observed between the WHOQOL-BREF and the TFI, indicating that the WHOQOL-BREF mean score explained 39.4% of the TFI. When looking at the subdomain scores, a strong correlation was observed between the QoL subdomain of the TFI and a combination of the physical and psychological subdomain of the WHOQOL-BREF (r = −0.627, p < 0.001).ConclusionThe QoL subdomain of the TFI gives good information about the physical and psychological health. Thus, the TFI is suitable to assess both tinnitus severity and the HRQoL. The coefficients of determination of the WHOQOL-BREF were significantly lower compared to the SF-8, suggesting that the WHOQOL-BREF provides more specific information about HRQoL. If more specific information on HRQoL, such as “environment” and “social relationships”, is required, it is recommended to use the WHOQOL-BREF

Dataset for "Random forest classification to predict response to high-definition transcranial direct current stimulation for tinnitus relief"

Abstract: This is the dataset necessary to reproduce the results described in the manuscript\ua0"Random forest classification to predict response to high-definition transcranial direct current stimulation for tinnitus relief"

Minimal dataset for "Systematic review and meta-analysis of late auditory evoked potentials as a candidate biomarker in the assessment of tinnitus"

This text file contains the minimal dataset necessary to reproduce the results and analyses in the paper: Cardon E et al., "Systematic review and meta-analysis of late auditory evoked potentials as a candidate biomarker in the assessment of tinnitus". Plos One;2020.This work was supported by an Applied Biomedical Research grant of the University of Antwerp (FWO T001618 N). The funder provided support in the form of salaries for authors, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript

JMS

While an increasing number of Informal CareGivers (ICGs) are assisting their dependent loved ones with the daily living tasks and medical care, they are rarely considered in the medical devices design process. The objective of this study is to identify the characteristics of ICGs impacting the use of the iHealth® Sense BP7 medical device, namely a connected wrist blood pressure monitor. For this purpose, user tests were conducted with 29 potential or actual ICGs. First, the participants filled out a socio-demographic questionnaire and then handled the blood pressure monitor. Finally, they completed the System Usability Scale questionnaire. The results revealed an impact of technophilia and age on usability dimensions. To conclude, the consideration of the ICG population in the design process of connected medical devices is discussed, particularly the age and level of technophilia.European Regional Development Fund (FEDER

Somatosensory tinnitus diagnosis : diagnostic value of existing criteria

Background: Tinnitus can be influenced by changes in somatosensory afference from the cervical spine or temporomandibular area, then called somatosensory or somatic tinnitus (ST). In 2018, a new set of diagnostic criteria for ST was agreed upon by a large group of ST experts. Currently, however, it still requires extensive and specific expertise to diagnose ST correctly. The next step in the development of easily applicable diagnostic criteria is to assess the diagnostic value of each individual criterion. Objectives: The aim of this study was, therefore, to further investigate the diagnostic value of these criteria, validate them empirically, and identify their sensitivity and specificity. Methods: An online survey, questioning the presence of 12 diagnostic criteria for ST in a convenience sample of participants with tinnitus, was launched on the online forum Tinnitus Talk, managed by Tinnitus Hub. Participants were divided into three groups: a group with no somatic influence, a group with some somatic influence and a group with large somatic influence on their tinnitus. Chi-square tests were used to calculate differences between these groups. Afterward, sensitivity, specificity, positive and negative likelihood ratios (LR), and pre- and posttest probabilities were calculated for each ST diagnostic criterion. For this analysis, all patients with some and large somatic influence were compared as one group to the group with no somatic influence. Results: In total, 8221 participants filled out the online survey. As expected, the diagnostic criteria for ST are more prevalent in the groups with somatic influence, but the criterium of tinnitus modulation also often occurs in the group with no somatic influence. The simultaneous onset or increase and decrease of both tinnitus and pain complaints have the highest positive LR (6.29 and 10.72, respectively), next to the influence of certain postures on the tinnitus (+LR: 6.04). To rule out ST, the absence of neck pain or tension in the neck extensor muscles are most suited, as they decrease the posttest probability to 18% and 19%, respectively. Conclusion: The simultaneous onset or increase and decrease of tinnitus and neck or jaw pain and the influence of certain postures are most suited to use as a single criterion for identifying patients with a somatic influence on their tinnitus. On the other hand, the absence of neck pain or tension in the neck extensor muscles is valid criterion to rule out a somatic influence. Additional analysis is needed to identify clusters of symptoms and criteria to further aid ST diagnosis

Health-related quality of life in subjective, chronic tinnitus patients : a scoping review

Abstract: Purpose This scoping review aims to assess whether the severity or distress of subjective tinnitus is negatively associated or correlated with the level of health-related quality of life (HRQoL). A second objective is to examine whether tinnitus patients score differently on HRQoL questionnaires in comparison to subjects without tinnitus and whether HRQoL differs between specific subgroups of tinnitus. Methods This scoping review adheres to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines (PRISMA guidelines): the statement and extension for scoping reviews (PRISMA-ScR). The following databases were consulted (on the 20th of October 2023): PubMed, Cochrane Library, Web of Science, and Scopus. The search string was composed of the terms tinnitus, HRQoL, and synonyms. A double-blinded screening for eligibility was performed, first on the title and abstract and subsequently on the full-text articles. Studies were considered eligible if they looked at HRQoL questionnaire results for adult patients (> 18 years) reporting chronic (> 3 months), subjective tinnitus as a primary complaint. Results In total, 37 studies with a total sample size of 33,900 participants were included in this scoping review, with some studies answering multiple study objectives. Seventeen studies demonstrated the presence of a significant negative correlation between tinnitus-related distress and HRQoL. Two studies indicated that HRQoL is mediated by tinnitus-related distress. Eighteen studies found that, in general, patients with tinnitus scored significantly lower on HRQoL questionnaires in comparison to subjects without tinnitus. Nineteen studies demonstrated that subgroups of patients with more severe tinnitus complaints or specific additional complaints scored worse on HRQoL questionnaires. Conclusion Based on the current literature, chronic subjective tinnitus-related distress has a significant impact on health-related quality of life. In addition, subjects without tinnitus generally score significantly higher on HRQoL questionnaires than patients with tinnitus. The heterogeneity in outcome measures between studies precludes meta-analysis. Increased homogeneity in the choice of HRQoL questionnaires would make a comparison between studies possible, which would give valuable information on both a clinical and an economic level, guiding future tinnitus treatment

The photosensitive phase acts as a sensitive window for seasonal multisensory neuroplasticity in male and female starlings

Traditionally, research unraveling seasonal neuroplasticity in songbirds has focused on the male song control system and testosterone. We longitudinally monitored the song and neuroplasticity in male and female starlings during multiple photoperiods using Diffusion Tensor and Fixel-Based techniques. These exploratory data-driven whole-brain methods resulted in a population-based tractogram uncovering microstructural sexual dimorphisms in the song control system and beyond. Male brains showed microstructural hemispheric asymmetries, whereas females had higher interhemispheric connectivity, which could not be attributed to brain size differences. Only females with large brains sing but differ from males in their song behavior by showing involvement of the hippocampus. Both sexes experienced multisensory neuroplasticity in the song control, auditory and visual system, and the cerebellum, mainly during the photosensitive period. This period with low gonadal hormones might represent a 'sensitive window' during which different sensory and motor systems in telencephalon and cerebellum can be seasonally re-shaped in both sexes.In each group, one scan failed due to excessive movement of the animal (subject ssw at SD12 and subject GoRR at LD4). In the male group, one animal died at the third time point (subject sblw). Of this animal we included MRI data of the first two time points. Funding provided by: Fonds Wetenschappelijk OnderzoekCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100003130Award Number: G0302123NFunding provided by: Fonds Wetenschappelijk OnderzoekCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100003130Award Number: 1115217NFunding provided by: Fonds Wetenschappelijk OnderzoekCrossref Funder Registry ID: http://dx.doi.org/10.13039/501100003130Award Number: 12R1917NFunding provided by: Interuniversity Attraction Poles*Crossref Funder Registry ID: Award Number: P7/17Funding provided by: Interuniversity Attraction PolesCrossref Funder Registry ID: Award Number: P7/171. MRI Data Processing Whole-brain volume was manually delineated on the T2-weighted 3D anatomical RARE scan, which covered the entire brain, including telencephalon, diencephalon, mesencephalon and metencephalon. These volumes were used as a measure of brain size, used in further statistical analysis. DW-images were prepared for voxel-based analysis using MRtrix3 version 3.0 (Tournier et al., 2012). We used an in-house algorithm to convert the Bruker 2dseq files to nifti files, which are compatible with other software programs such as SPM and MRtrix3. This step includes a signal scale correction, since the DWI data is acquired in three separate sequential scans. Furthermore, all DW-images were scaled by factor a 10 in 3 dimensions, to enable proper processing of small brains in software programs designed to process human data like SPM and MRtrix3. Voxel-based analysis requires that all images are spatially normalized to the same template, to enable voxel-wise comparisons. A simplified overview of the different MRI data processing steps is given in figure 1B-D. 1.1 DTI processing Preprocessing the diffusion data for voxel-based analysis was performed using MRtrix3 (Tournier et al., 2012). First, diffusion gradient orientations were checked and automatically corrected to match the coordinate frame of MRtrix3 and ensure the best global 'connectivity' (Jeurissen et al., 2014a). Since the DTI data is acquired in three separate sequential scans, we further corrected for intensity differences between scans by rescaling the diffusion scans based on their b0 images. Preprocessing of the individual DW-images included the following steps: denoising (Veraart et al., 2016), correction for Gibbs ringing (Kellner et al., 2016), motion and distortion correction using FSL (Andersson and Sotiropoulos, 2016; Jenkinson et al., 2012), bias field correction using ANTS (Advanced Normalization Tool; (Avants et al., 2010)), creating an automated whole-brain mask for whole-brain extraction that were manually checked, upsampling to isotropic voxels of 1.75 mm. These preprocessed diffusion-weighted images were used to calculate individual diffusion maps (FA, MD, AD, RD). The transformation parameters derived from building the FOD template (see 5.5.2) were applied to the diffusion maps to warp them into the template space to perform voxel-based analysis. Next, these images were smoothed to double voxel size (3.5 x 3.5 x 3.5 mm³). Finally, all normalized diffusion maps were averaged to create an FA template that is used as a background to display the statistical results. 1.2 Fixel based analysis For calculation of the fiber-based metrics, we followed the preprocessing steps as defined in (Raffelt et al., 2017). Fixel based analysis follows the same preprocessing steps as DTI processing up until the bias field correction. Apparent fiber density analysis differs from DTI analysis by the fact that it is related to the diffusion-weighted signal intensity within a given voxel. Therefore, global intensity normalization is performed to ensure robust voxel-wise comparison across subjects. Within this step, we used the default FA threshold of 0.4 to create an approximate WM mask, which is used to normalize the median white matter b=0 intensity across all subjects (Raffelt et al., 2012). For each image, a white matter response function was estimated for spherical deconvolution using the unsupervised Dhollander algorithm (Dhollander et al., 2019). Next, the average of all individual response functions was calculated and used for constrained spherical deconvolution to estimate FOD images (Jeurissen et al., 2014b). These FOD images were normalized to create an unbiased study-based FOD template, which involves linear and non-linear registration (Raffelt et al., 2011). Next, the fixels in the FOD template are thresholded at 0.15, identifying the template white matter fixels to be included in further analysis. This threshold is lower than the default threshold of 0.25 for the human brain, as this threshold is too high for the songbird brain and excludes many of the genuine white matter fibers. We are aware that choosing a lower threshold comes with the risk of introducing noisy fixels, especially within grey matter, and take this into account in the interpretation of the results. The estimated transformation parameters or warps of each subject to the template were used to transform the individual FOD maps into template space without FOD reorientation, so that the apparent FD can be estimated prior to reorienting the fixels. In the next step, we compare the fixels within a spatially matching voxel of the individual subject and the template white matter fixels, to identify which fixels correspond to each other and subsequently assign the corresponding FD value (Raffelt et al., 2017). Next to FD, we also computed a fixel-based metric related to the macroscopic morphology in fiber bundle cross-section (FC). Fiber bundle cross-section (FC) information relies solely on the transformation parameters or Jacobian determinants generated during the construction of the population template, similar to other morphometry analyses like voxel-based morphometry (Ashburner and Friston, 2000). Morphological differences in the plane perpendicular to the fixel orientation could reflect differences in the number of axons, myelination, or the spacing between axons. For group statistical analysis, the FC values were logarithmically transformed to log FC to ensure that the data are centered around zero and normally distributed. Positive values indicate then expansion, whereas negative values reflect shrinkage of a fiber bundle relative to the template (Raffelt et al., 2017)