Short-Term Tinnitus Suppression With Electric-Field Guided rTMS for Individualizing rTMS Treatment: A Technical Feasibility Report

Background: Past research highlighted the benefits of personalized repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic subjective tinnitus. Objective/Hypothesis: The objective was to investigate the feasibility of rTMS personalization by identifying individually optimal stimulation parameters in test sessions. Particularly, effectiveness and retest-reliability of different stimulation parameters were examined. Methods: Via electric-field guided rTMS, five patients were stimulated with different frequencies on three positions of the left and right superior temporal gyrus on 2 separate days. After each stimulation, the patients had to evaluate tinnitus loudness and discomfort of the used protocol. Results: Individualization of rTMS was possible in all five patients. Significant lower tinnitus loudness was found for 1 Hz stimulation. Positive correlations between 2 days were observed for hemisphere (left, right), position (mSTG, pSTG), and frequency (1, 10, 20 Hz). High-frequency stimulation produced high discomfort. Conclusion: Personalization of rTMS is considered as feasible. Consistency of parameter-specific tinnitus suppression is demonstrated

Deep resequencing of the voltage-gated potassium channel subunit KCNE3 gene in chronic tinnitus

Membrane-stabilizing drugs have long been used for the treatment of chronic tinnitus, suggesting an underlying disturbance of sensory excitability due to changes in ion conductance. The present study addresses the potassium channel subunit gene KCNE3 as a potential candidate for tinnitus susceptibility. 288 Caucasian outpatients with a diagnosis of chronic tinnitus were systematically screened for mutations in the KCNE3 open reading frame and in the adjacent region by direct sequencing. Allele frequencies were determined for 11 known variants of which two (F66F and R83H) were polymorphic but were not associated with the disorder. No novel variants were identified and only three carriers of R83H were noted. However, owing to a lack of power, our study can neither rule out effects of KCNE3 on the risk for developing chronic tinnitus, nor can it exclude a role in predicting the severity of tinnitus. More extensive investigations are invited, including tests for possible effects of variation in this ion channel protein on the response to treatment

Curing tinnitus with a Cochlear Implant in a patient with unilateral sudden deafness: a case report

Cochlear implantation is a routine procedure for patients with bilateral profound sensorineural hearing loss. Some reports demonstrated a suppression of tinnitus as a side-effect after implantation. We describe the case of a 55-year-old man suffering from severe right-sided tinnitus in consequence of sudden right-sided deafness. Multiple therapeutic efforts including intravenous steroids and tympanoscopy with grafting of the round window remained unsuccessful. One year after onset of symptoms right-sided cochlear implantation was performed, which resulted in a complete abolishment of tinnitus after activating the implant. Severe unilateral tinnitus after sudden deafness might represent a new indication for cochlear implantation

Mobile Crowdsensing Services for Tinnitus Assessment and Patient Feedback

Assessment of chronic disorders requires new ways of data collection compared to the traditional pen & paper based approaches. For example, tinnitus, the phantom sensation of sound, is a highly prevalent disorder that is difficult to treat; i.e., available treatments are only effective for patient subgroups. In most individuals with tinnitus, loudness and annoyance of tinnitus varies over time. Currently, established assessment methods of tinnitus neither systematically assess this moment-to-moment variability nor environmental factors having an effect on tinnitus loudness and distress. However, information of individual fluctuations and the effect of envi-ronmental factors on the tinnitus might represent important information for tinnitus subtyping and for individualized treat-ment. In this context, a promising approach for collecting ecological valid longitudinal datasets at rather low costs is mobile crowdsensing. In the TrackYourTinnitus project, we developed an advanced mobile crowdsensing platform to reveal more detailed information about the course of tinnitus over time. In this paper, the patient mobile feedback service as a particular component of the platform is presented. It was developed to provide patients with aggregated information about the variation of their tinnitus over time. This mobile feedback service shall help a patient to demystify the tinnitus and to get better control of it, which should facilitate coping with this chronic health condition. As the basic principles and design of this mobile services are also applicable to other chronic disorders, promising perspectives for disorder management and clinical research arise

Mobile Crowd Sensing Services for Tinnitus Assessment, Therapy and Research

Tinnitus, the phantom sensation of sound, is a highly prevalent disorder that is difficult to treat; i.e., available treatments are only effective for patient subgroups. Sufficiently large and qualitative longitudinal data sets, which aggregate the individuals’ demographic and clinical characteristics, together with their response to specific therapeutic interventions, would therefore facilitate evidence-based treatment suggestions for individual patients. Currently, clinical trials are the standard instrument for realizing evidence-based medicine. However, the related information gathering is limited. For example, clinical trials try to reduce the complexity of the individual case by generating homogeneous groups to obtain significant results. From the latter, individual treatment decisions are inferred. A complementary approach would be to assess the effect of specific interventions in large samples considering the individual peculiarity of each subject. This allows providing individualized treatment decisions. Recently, mobile crowd sensing emerged as an approach for collecting large and ecological valid datasets at rather low costs. By providing mobile crowd sensing services to large numbers of patients, large datasets can be gathered cheaply on a daily basis. In the TrackYourTinnitus project, we implemented a mobile crowd sensing platform to reveal new medical aspects on tinnitus and its treatment. Additionally, we work on mobile services exploring approaches for understanding tinnitus and for improving its diagnostic and therapeutic management. We present the TrackYourTinnitus platform as well as its goals, architecture and preliminary results. Overall, the platform and its mobile services offer promising perspectives for tinnitus research and treatment

Tinnitus and Coxsackie B infections: A case series

Tinnitus is a frequent and often debilitating condition. There is consensus in the scientific community that there exist various forms of tinnitus, which differ in their pathogenesis. Here we report a series of five cases where the onset of tinnitus was associated with viral infections. In all five patients elevated antibodies against Coxsackie B have been detected. This observation suggests that Coxsackie B Virus infections might be involved in the development of some cases of tinnitus and indicate that further systematic investigations are warranted.Fil: Langguth, Berthold. Universitat Regensburg; AlemaniaFil: Stadtlaender, Hans. An der Zuckerfabrik 2; AlemaniaFil: Landgrebe, Michael. Universitat Regensburg; AlemaniaFil: Elgoyhen, Ana Belen. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Investigaciones en Ingeniería Genética y Biología Molecular "Dr. Héctor N. Torres"; ArgentinaFil: Coors, Hermann. Gaußstr 10; AlemaniaFil: Vielsmeier, Veronika. Universitat Regensburg; AlemaniaFil: Kleinjung, Tobias. Universitat Regensburg; Alemani

Tinnitus: Clinical Insights in Its Pathophysiology-A Perspective

Tinnitus, the perception of sound without a corresponding external sound source, and tinnitus disorder, which is tinnitus with associated suffering, present a multifaceted clinical challenge due to its heterogeneity and its incompletely understood pathophysiology and especially due to the limited therapeutic options. In this narrative review, we give an overview on various clinical aspects of tinnitus including its heterogeneity, contributing factors, comorbidities and therapeutic pathways with a specific emphasis on the implications for its pathophysiology and future research directions. Tinnitus exhibits high perceptual variability between affected individuals (heterogeneity) and within affected individuals (temporal variability). Hearing loss emerges as predominant risk factor and the perceived pitch corresponds to areas of hearing loss, supporting the compensatory response theory. Whereas most people who have tinnitus can live a normal life, in 10–20% tinnitus interferes severely with quality of life. These patients suffer frequently from comorbidities such as anxiety, depression or insomnia, acting as both risk factors and consequences. Accordingly, neuroimaging studies demonstrate shared brain networks between tinnitus and stress-related disorders shedding light on the intricate interplay of mental health and tinnitus. The challenge lies in deciphering causative relationships and shared pathophysiological mechanisms. Stress, external sounds, time of day, head movements, distraction, and sleep quality can impact tinnitus perception. Understanding these factors provides insights into the interplay with autonomic, sensory, motor, and cognitive processes. Counselling and cognitive-behavioural therapy demonstrate efficacy in reducing suffering, supporting the involvement of stress and anxiety-related networks. Hearing improvement, especially through cochlear implants, reduces tinnitus and thus indirectly validates the compensatory nature of tinnitus. Brain stimulation techniques can modulate the suffering of tinnitus, presumably by alteration of stress-related brain networks. Continued research is crucial for unravelling the complexities of tinnitus. Progress in management hinges on decoding diverse manifestations, identifying treatment-responsive subtypes, and advancing targeted therapeutic approaches

Метаболическая активность митохондрий корней гороха в условиях моделированной микрогравитации

Наведено дані досліджень впливу кліностатування на метаболічну активність мітохондрій, ізольованих із коренів 5-добових проростків гороху (Pisum sativum L). Встановлено збільшення швидкості окиснення в стані 3 малату+глутамату та екзогенного НАДН, а також значення коефіцієнта дихального контролю одночасно зі зниженням відношення АДФ/О порівняно з контролем. Висловлено припущення, що такі зміни характеру дихання є наслідком адаптації метаболічної системи мітохондрій до умов кліностатування.The effect of clinorotation on the respiration of mitochondria isolated from roots of pea 5-day-old seedlings has been examined. An increase in the rate of oxidation of malate and NADH in state 3 is detected. A respiratory control ratio is also increased simultaneously with a decrease in the efficiency of oxidative phosphorylation. Such character of mitochondrial respiration under simulated microgravity is supposed to be a consequence of the adaptation to these conditions

Minimal Clinically Important Difference of Tinnitus Outcome Measurement Instruments—A Scoping Review

Objective: Tinnitus assessment and outcome measurement are complex, as tinnitus is a purely subjective phenomenon. Instruments used for the outcome measurement of tinnitus in the context of clinical trials include self-report questionnaires, visual analogue or numeric rating scales and psychoacoustic measurements of tinnitus loudness. For the evaluation of therapeutic interventions, it is critical to know which changes in outcome measurement instruments can be considered as clinically relevant. For this purpose, the concept of the minimal clinically important difference (MCID) has been introduced. Study design: Here we performed a literature research in PubMed in order to identify for which tinnitus outcome measurements MCID criteria have been estimated and which of these estimates fulfil the current methodological standards and can thus be considered as established. Results: For most, but not all tinnitus outcome instruments, MCID calculations have been performed. The MCIDs for the Tinnitus Handicap Inventory (THI), the Tinnitus Questionnaire (TQ), the Tinnitus Functional Index (TFI) and visual analogue scales (VAS) vary considerably across studies. Psychoacoustic assessments of tinnitus such as loudness matching have not shown sufficient reliability and validity for the use as an outcome measurement. Conclusion: Future research should aim at the confirmation of the available estimates in large samples involving various therapeutic interventions and under the consideration of time intervals and baseline values. As a rule of thumb, an improvement of about 15% can be considered clinically meaningful, analogous to what has been seen in other entirely subjective pathologies like chronic pain

Differential impact of posterior lesions in the left and right hemisphere on visual category learning and generalization to contrast reversal

Hemispheric differences in the learning and generalization of pattern categories were explored in two experiments involving sixteen patients with unilateral posterior, cerebral lesions in the left (LH) or right (RH) hemisphere. In each experiment participants were first trained to criterion in a supervised learning paradigm to categorize a set of patterns that either consisted of simple geometric forms (Experiment 1) or unfamiliar grey-level images (Experiment 2). They were then tested for their ability to generalize acquired categorical knowledge to contrast-reversed versions of the learning patterns. The results showed that RH lesions impeded category learning of unfamiliar grey-level images more severely than LH lesions, whereas this relationship appeared reversed for categories defined by simple geometric forms. With regard to generalization to contrast reversal, categorization performance of LH and RH patients was unaffected in the case of simple geometric forms. However, generalization to of contrast-reversed grey-level images distinctly deteriorated for patients with LH lesions relative to those with RH lesions, with the latter (but not the former) being consistently unable to identify the pattern manipulation. These findings suggest a differential use of contrast information in the representation of pattern categories in the two hemispheres. Such specialization appears in line with previous distinctions between a predominantly lefthemispheric, abstract-analytical and a righthemispheric, specific-holistic representation of object categories, and their prediction of a mandatory representation of contrast polarity in the RH. Some implications for the well-established dissociation of visual disorders for the recognition of faces and letters are discussed