Effect of tinnitus on the performance of central auditory system: a review

Background and Aim: Tinnitus is one of the most difficult challenges in audiology and oto­logy. Previous studies have been shown that tinn­itus may interfere with the function of central auditory system (CAS). Involvement of CAS abilities including speech perception and audi­tory processing has led to serious problems in people with tinnitus. Due to the lack of enough information about the impact of tinnitus on CAS and its function, and given that there is no standardized protocol for assessment and mana­gement of tinnitus, this study aimed to review the studies on the effect of tinnitus on the CAS function. Recent Findings: Sixteen eligible articles were reviewed. Temporal and spectral resolution, fre­quency differentiation and speech perception deficits were reported in patients with tinnitus, especially in background noise. This was repor­ted even in tinnitus patients with normal hearing. Conclusion: Assessment of central auditory pro­cessing and speech perception in noise seems to be useful for proper management of tinnitus in clinical practice. Keywords: Tinnitus; auditory system; central auditory processing; speech in noise performance

Auditory evoked potential P300 characteristics in adults with and without idiopathic bilateral tinnitus

Background and Aim: Based on neurophysio­logical measurements, auditory and non-audi­tory pathways are involved in tinnitus. People who experience tinnitus may suffer from several problems such as attention disorder. The audi­tory evoked potential P300 is an endogenous response and depends on cognitive processes like attention. The purpose of this study was to compare the auditory P300 characteristics (amp­litude and latency) in adults with and without tinnitus. Methods: Participants were 20 adults with idio­pathic bilateral tinnitus with mean duration of 8.4 ± 4.73 months, and 20 healthy adults. The P300 was recorded using oddball paradigm con­sisted of two standard (1000 Hz) and target sti­muli (2000 Hz). To reduce eye blink during recording, all participants was instructed to look at and fixate on a dot sign located in front of them. The tinnitus handicap inventory (THI) was completed and pitch matching (PM) and loudness matching (LM) were measured in tinn­itus group. Results: P300 amplitude was lower at both Fz and Cz electrode placements in tinnitus patients compared to the normal group, but it was not statistically significant (p = 0.57). Tinnitus pati­ents had delayed latency at Fz and Cz, but this difference was not significant either psychomet­ric and psychoacoustic assessment had no statis­tically significant correlation with P300 ampli­tude and latency. Conclusion: It seems that P300 characteristics are not different between adults with and with­out idiopathic bilateral tinnitus, may be due to using low sample size. Keywords: Tinnitus; auditory evoked potential P300; attention

A Systematic Review and Meta-analysis of Randomized Controlled Trials on the Effect of Transcranial Magnetic Stimulation on Tinnitus Management

Introduction: Tinnitus occurs in 10-15% of the world’s population. It may lead to hearing loss, depression, and suicidal tendencies, as well as reduced quality of life. The aim of this study was to assess whether Transcranial Magnetic Stimulation (TMS) effectively reduces tinnitus handicapping after six months or more of follow-up.Methods: A systematic review of randomized controlled trials with follow-up of six months was undertaken. The review took place through searching Medline, Science Direct, and Google Scholar databases using the keywords “tinnitus” and “Transcranial Magnetic Stimulation” and limiting the search results to randomized controlled trials (RCTs) conducted on adults (19 years and older) published between 2005-2015. Meta-analysis was performed on the similarly designed studies.Results: Five RCTs with six month follow-up were found conforming to the inclusion criteria. In total, there were 119 patients in the TMS arms and 115 in the placebo arms. However, designs were different between the studies and were therefore not all comparable. Different parameters were used to measure the severity of tinnitus and depression scores. Tinnitus handicapped inventory (THI) was the common measured outcome parameter used in all studies. THI score decreased after the TMS in four studies. Meta-analysis was performed on three similarly designed RCTs with the overall effect being insignificant.Conclusion: TMS reduced the THI score and decreased the severity of tinnitus in 45% of patients and lead to a complete recovery in 32% of cases in one study. However, the meta-analysis demonstrated lack of significant effect of TMS on tinnitus management.

A preliminary study on the reliability of the Persian version of the tinnitus functional index in a military population

Background and Aim: Tinnitus functional index (TFI) has been introduced as a standard self-assessment questionnaire for the evaluation of tinnitus severity and its negative consequences with enough sensitivity to detect the outcomes of treatment. The purpose of this study was to translate the original tinnitus functional index into Persian and to evaluate its reliability in a military population. Methods: The translation was performed in accordance with the Principles of Good Practice for the Translation and Cultural Adaptation Pro­cess for Patient-Reported Outcomes Measures. 32 military and veteran men with tinnitus aged 22−74 years participated in the current study. The participants completed the Persian version of the TFI and the second re-evaluation session was conducted over the telephone 10−14 days later. Both relative and absolute reliability indices were computed. Results: Intraclass correlation coefficient(2,1) with consistency definition for the TFI subscales varied from good to excellent. The agreement between the TFI total scores in the evaluation and re-evaluation using Bland-Altman analysis was acceptable and only one case was not located within the limits of agreement. Conclusion: Initial evaluation of the Persian version of TFI shows acceptable results in terms of reliability. The evaluation of the Persian TFI in different populations of patients with tinnitus and its validity would facilitate its clinical appli­cation. Keywords: Tinnitus; questionnaire; Persian

INFLUÊNCIA DO ZUMBIDO NO BEM-ESTAR DE IDOSOS

O objetivo deste estudo foi verificar a opinião de idosos sobre a influência do zumbido no bem-estar. Foram entrevistados 11 idosos, sendo 7 institucionalizados e 4, não institucionalizados. As idades variaram entre 60 e 95 anos. Eles responderam a uma entrevista semiestruturada elaborada para este estudo. A avaliação qualitativa dos dados foi feita de acordo com os pressupostos de Giorgi (1978). Verificou-se que os idosos institucionalizados e não institucionalizados consideraram que o zumbido interfere no bem-estar. palavras-chave Zumbido. Idosos. Qualidade de Vida. abstract The aim of this study was to assess the opinion of the elderly on the influence of tinnitus in the welfare. Eleven elderly were interviewed, 7 were institutionalized and 4 were not. Their ages ranged from 60 to 95 years old. The elderly answered to a semistrutured interview. Qualitative evaluation of the data was done according to the assumptions of Giorgi (1978). It was found that the majority of the elderly considered that tinnitus has a negative influence on welfare. Keywords Tinnitus. Aging. Quality of Life.