Tinnitus classification based on resting-state functional connectivity using a convolutional neural network architecture.

OBJECTIVES: Many studies have investigated aberrant functional connectivity (FC) using resting-state functional MRI (rs-fMRI) in subjective tinnitus patients. However, no studies have verified the efficacy of resting-state FC as a diagnostic imaging marker. We established a convolutional neural network (CNN) model based on rs-fMRI FC to distinguish tinnitus patients from healthy controls, providing guidance and fast diagnostic tools for the clinical diagnosis of subjective tinnitus. METHODS: A CNN architecture was trained on rs-fMRI data from 100 tinnitus patients and 100 healthy controls using an asymmetric convolutional layer. Additionally, a traditional machine learning model and a transfer learning model were included for comparison with the CNN, and each of the three models was tested on three different brain atlases. RESULTS: Of the three models, the CNN model outperformed the other two models with the highest area under the curve, especially on the Dos_160 atlas (AUC = 0.944). Meanwhile, the model with the best classification performance highlights the crucial role of the default mode network, salience network, and sensorimotor network in distinguishing between normal controls and patients with subjective tinnitus. CONCLUSION: Our CNN model could appropriately tackle the diagnosis of tinnitus patients using rs-fMRI and confirmed the diagnostic value of FC as measured by rs-fMRI.

Reorganization of the cortical connectome functional gradient in age-related hearing loss.

Age-related hearing loss (ARHL), one of the most common sensory deficits in elderly individuals, is a risk factor for dementia; however, it is unclear how ARHL affects the decline in cognitive function. To address this issue, a connectome gradient framework was used to identify critical features of information integration between sensory and cognitive processing centers using resting-state functional magnetic resonance imaging (rs-fMRI) data from 40 individuals with ARHL and 36 healthy controls (HCs). The first three functional gradient alterations associated with ARHL were investigated at the global, network and regional levels. Using a support vector machine (SVM) model, our analysis distinguished individuals with ARHL with normal cognitive function from those with cognitive decline. Compared to HCs, individuals with ARHL had a contracted principal primary-to-transmodal gradient axis, especially in the visual and default mode networks, with an altered gradient explained ratio and variance. Among individuals with ARHL, cognitive decline was detected in the visual network in the principal gradient as well as in the limbic, salience and default mode networks in the third gradient (salience to frontoparietal/default mode). These results suggest that ARHL is associated with disrupted information processing from the primary sensory networks to higher-order cognitive networks and highlight the key nodes closely associated with cognitive decline during cognitive processing in ARHL, providing new insights into the mechanism of cognitive impairment and suggesting potential treatments related to ARHL.

Efficacy of Tailor-Made Notched Music Training Versus Tinnitus Retraining Therapy in Adults With Chronic Subjective Tinnitus: A Randomized Controlled Clinical Trial.

OBJECTIVES: Chronic subjective tinnitus can have a serious effect on daily life, even causing serious psychological disorders. Currently there are no specific effective solutions or cures. Tailor-made notched music training (TMNMT) is a recently proposed sound therapy that has simpler processes and a higher compliance rate than tinnitus retraining therapy (TRT), a widely used treatment for chronic subjective tinnitus. This study explores the therapeutic effect of TMNMT in comparison to TRT to highlight its clinical value. DESIGN: The study was a randomized controlled, single-blinded clinical trial. One hundred twenty eligible participants were randomly assigned to receive TMNMT (n = 60) or TRT (n = 60) for 3 mo with concurrent follow-up. It should be noted that the duration of sound treatment in TRT was modified to 2 hr per day for better feasibility in practice. The primary outcome was mean change in tinnitus handicap inventory (THI) measured at baseline ( T0 ), 1 mo ( T1 ) and 3 mo ( T2 ) after intervention. Change in visual analog scale (VAS) was measured as a secondary outcome. A comparison of therapeutic effectiveness between TMNMT and TRT was evaluated by repeated measure analysis of variance. RESULTS: One hundred and twelve (93%) of participants took part in the study, of which 64 were men and 48 women. Mean (SD) age was 42.80 (12.91) years. Fifty-eight were allocated to receive TMNMT and 54 to receive TRT. The between-group difference in primary outcome was -6.90 points (95% confidence interval [CI], -13.53 to -0.27) at T1 and -6.17 points (95% CI, -13.04 to 0.71) at T2 . These results closely reached to clinical significance of tinnitus-related effective relief. For the secondary outcome, the mean value in the TMNMT group was 0.83 points (95% CI, 0.12 to 1.54), significantly lower than the mean value of the TRT group. The differences in THI and VAS between the two groups were statistically significant after intervention. Further analysis showed that age and baseline THI and VAS scores were associated with change in THI and VAS scores after interventions. CONCLUSIONS: Both TMNMT and TRT were able to alleviate chronic subjective tinnitus effectively after a 3 month intervention. When the two forms of therapy were compared TMNMT appeared to be more effective and consequently potentially superior to TRT for reducing tinnitus loudness and functional and emotional disturbance associated with chronic subjective tinnitus.

A deep learning approach to the diagnosis of atelectasis and attic retraction pocket in otitis media with effusion using otoscopic images.

BACKGROUND: This study aimed to develop and validate a deep learning (DL) model to identify atelectasis and attic retraction pocket in cases of otitis media with effusion (OME) using multi-center otoscopic images. METHOD: A total of 6393 OME otoscopic images from three centers were used to develop and validate a DL model for detecting atelectasis and attic retraction pocket. A threefold random cross-validation procedure was adopted to divide the dataset into training validation sets on a patient level. A team of otologists was assigned to diagnose and characterize atelectasis and attic retraction pocket in otoscopic images. Receiver operating characteristic (ROC) curves, including area under the ROC curve (AUC), accuracy, sensitivity, and specificity were used to assess the performance of the DL model. Class Activation Mapping (CAM) illustrated the discriminative regions in the otoscopic images. RESULTS: Among all OME otoscopic images, 3564 (55.74%) were identified with attic retraction pocket, and 2460 (38.48%) with atelectasis. The diagnostic DL model of attic retraction pocket and atelectasis achieved a threefold cross-validation accuracy of 89% and 79%, AUC of 0.89 and 0.87, a sensitivity of 0.93 and 0.71, and a specificity of 0.62 and 0.84, respectively. Larger and deeper cases of atelectasis and attic retraction pocket showed greater weight, based on the red color depicted in the heat map of CAM. CONCLUSION: The DL algorithm could be employed to identify atelectasis and attic retraction pocket in otoscopic images of OME, and as a tool to assist in the accurate diagnosis of OME.

Comparison between 3D-FLAIR and 3D-real IR MRI sequences with visual classification method in the imaging of endolymphatic hydrops in Meniere's disease.

BACKGROUND: Clinically, the evidence of endolymphatic hydrops (EH) in Meniere's disease (MD) primarily relies on audiological examinations, such as glycerol tests and electrocochleography, to suggest the presence of EH indirectly. However, these techniques lack sensitivity and specificity, and they do not sufficiently assess the degree of EH. This study aims to explore the application of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) and three-dimensional real inversion recovery (3D-real IR) sequence imaging of EH in MD and to assess the image quality and grading of EH. METHODS: The study included 50 patients with definite MD. The 3D-FLAIR and 3D-real IR sequence images were performed 24 h after bilateral intratympanic injection of gadolinium. The image quality of both sequences was reviewed by two experienced radiologists. The vestibular and cochlear EH grades of both sequences were reviewed by two experienced otologists using a visual grading method. The Cohen's kappa and Pearson tests were used to analyze the data. RESULTS: The reliability of image quality between the two radiologists was excellent (0.7 < kappa < 0.9). There were significant statistical differences in the image quality between the 3D-real IR and 3D-FLAIR sequences (p = 0.023 and p = 0.035, respectively). The reliability for the grading of vestibular and cochlear EH between the two otologists was excellent (0.7 < kappa < 0.9). The 3D-real IR sequence detected more severe hydrops than did the 3D-FLAIR sequence (p < 05). CONCLUSION: The image quality of the 3D-real IR sequence is better than that of the 3D-FLAIR sequence, and there are differences in the vestibular and cochlear EH grades of both sequences. The sensitivity of the 3D-real IR sequence in the cochlea is higher. The method of visual grading can be applied to both technologies when combined with 3D-real IR.

Alterations of brain activity and functional connectivity in transition from acute to chronic tinnitus.

The objective of this study was to investigate alterations to brain activity and functional connectivity in patients with tinnitus, exploring neural features in the transition from acute to chronic phantom perception. Twenty-four patients with acute tinnitus, 23 patients with chronic tinnitus, and 32 healthy controls were recruited. High-density electroencephalography (EEG) was used to explore changes in brain areas and functional connectivity in different groups. When compared with healthy subjects, acute tinnitus patients had a significant reduction in superior frontal cortex activity across all frequency bands, whereas chronic tinnitus patients had a significant reduction in the superior frontal cortex at beta 3 and gamma frequency bands as well as a significant increase in the inferior frontal cortex at delta-band and superior temporal cortex at alpha 1 frequency band. When compared to the chronic tinnitus group, the acute tinnitus group activity was significantly increased in the middle frontal and parietal gyrus at the gamma-band. Functional connectivity analysis showed that the chronic tinnitus group had increased connections between the parahippocampus gyrus, posterior cingulate cortex, and precuneus when compared with the healthy group. Alterations of local brain activity and connections between the parahippocampus gyrus and other nonauditory areas appeared in the transition from acute to chronic tinnitus. This indicates that the appearance and development of tinnitus is a dynamic process involving aberrant local neural activity and abnormal connectivity in multifunctional brain networks.

[An electroencephalogram-based study of resting-state spectrogram and attention in tinnitus patients].

The incidence of tinnitus is very high, which can affect the patient's attention, emotion and sleep, and even cause serious psychological distress and suicidal tendency. Currently, there is no uniform and objective method for tinnitus detection and therapy, and the mechanism of tinnitus is still unclear. In this study, we first collected the resting state electroencephalogram (EEG) data of tinnitus patients and healthy subjects. Then the power spectrum topology diagrams were compared of in the band of δ (0.5-3 Hz), θ (4-7 Hz), α (8-13 Hz), ß (14-30 Hz) and γ (31-50 Hz) to explore the central mechanism of tinnitus. A total of 16 tinnitus patients and 16 healthy subjects were recruited to participate in the experiment. The results of resting state EEG experiments found that the spectrum power value of tinnitus patients was higher than that of healthy subjects in all concerned frequency bands. The t-test results showed that the significant difference areas were mainly concentrated in the right temporal lobe of the θ and α band, and the temporal lobe, parietal lobe and forehead area of the ß and γ band. In addition, we designed an attention-related task experiment to further study the relationship between tinnitus and attention. The results showed that the classification accuracy of tinnitus patients was significantly lower than that of healthy subjects, and the highest classification accuracies were 80.21% and 88.75%, respectively. The experimental results indicate that tinnitus may cause the decrease of patients' attention.

Event-Related Potential Evidence of Enhanced Visual Processing in Auditory-Associated Cortex in Adults with Hearing Loss.

OBJECTIVE: The present study investigated the characteristics of visual processing in the auditory-associated cortex in adults with hearing loss using event-related potentials. METHODS: Ten subjects with bilateral postlingual hearing loss were recruited. Ten age- and sex-matched normal-hearing subjects were included as controls. Visual ("sound" and "non-sound" photos)-evoked potentials were performed. The P170 response in the occipital area as well as N1 and N2 responses in FC3 and FC4 were analyzed. RESULTS: Adults with hearing loss had higher P170 amplitudes, significantly higher N2 amplitudes, and shorter N2 latency in response to "sound" and "non-sound" photo stimuli at both FC3 and FC4, with the exception of the N2 amplitude which responded to "sound" photo stimuli at FC3. Further topographic mapping analysis revealed that patients had a large difference in response to "sound" and "non-sound" photos in the right frontotemporal area, starting from approximately 200 to 400 ms. Localization of source showed the difference to be located in the middle frontal gyrus region (BA10) at around 266 ms. CONCLUSIONS: The significantly stronger responses to visual stimuli indicate enhanced visual processing in the auditory-associated cortex in adults with hearing loss, which may be attributed to cortical visual reorganization involving the right frontotemporal cortex.

Prevalence and factors associated with tinnitus: data from adult residents in Guangdong province, South of China.

There is a lack of national studies on tinnitus in China and data based on a large sample size from multiple areas of the country. A cross-sectional study was carried out in Guangdong province from October 2015 to February 2016. In the study, tinnitus was defined as the presence of ringing, buzzing or other sounds in the ears in the past one year. Fourteen districts in Guangdong Province were selected as the first-level cluster by using the sampling method of probability proportional to size (PPS). Two sub-districts in each first-level cluster were randomly selected as the second-level cluster by PPS method. The sample consisted of 3705 eligible people aged over 18 years old, which were also selected by the PPS methods. The prevalence of tinnitus was 10.4% in Guangdong Province. Age, region, educational background, hearing impairment, ear trauma, otitis media and self-health report were the main risk factors for tinnitus. Tinnitus is a common condition and a large population suffers from tinnitus in Guangdong province, south of China. Greater public awareness and understanding of the associated factors are required for further interventions of prevention and management of tinnitus in China.

Effect of the combination of balloon Eustachian tuboplasty and tympanic paracentesis on intractable chronic otitis media with effusion.

OBJECTIVE: To evaluate the effect of the combination of balloon Eustachian tuboplasty (BET) and tympanic paracentesis (TP) on intractable chronic otitis media with effusion (COME). METHODS: Ninety patients with intractable COME were included and randomly assigned to three groups: BET only (30 patients), BET+paracentesis (30 patients), and paracentesis only (30 patients). Otic endoscopic findings and tympanograms were recorded before the surgery and at the month 1, month 3, and month 6 follow-up evaluations. RESULTS: Both the BET only and BET+paracentesis groups achieved better outcomes than the paracentesis group. The BET+paracentesis group exhibited better otic endoscopic scores than the BET only group (p<0.05) at 1month post-operation. However, no significant difference was found at month 3 or month 6 post-operation. No significant difference in the tympanograms was observed between these two groups at month 1, month 3, or month 6 post-operation. The otic endoscopic sign scores improved from month 1 to month 6 in the BET only group and from month 1 to month 3 in the BET+paracentesis group. The conversion of type B tympanograms improved from month 1 to month 6 in the BET and BET+paracentesis groups but not in the paracentesis only group. CONCLUSIONS: Our results suggested that the combination of BET and TP was effective for intractable COME and can help shorten the recovery period for middle ear effusion.

The effect of symmetrical and asymmetrical hearing impairment on music quality perception.

The purpose of this study was to investigate the effect of symmetrical, asymmetrical and unilateral hearing impairment on music quality perception. Six validated music pieces in the categories of classical music, folk music and pop music were used to assess music quality in terms of its 'pleasantness', 'naturalness', 'fullness', 'roughness' and 'sharpness'. 58 participants with sensorineural hearing loss [20 with unilateral hearing loss (UHL), 20 with bilateral symmetrical hearing loss (BSHL) and 18 with bilateral asymmetrical hearing loss (BAHL)] and 29 normal hearing (NH) subjects participated in the present study. Hearing impaired (HI) participants had greater difficulty in overall music quality perception than NH participants. Participants with BSHL rated music pleasantness and naturalness to be higher than participants with BAHL. Moreover, the hearing thresholds of the better ears from BSHL and BAHL participants as well as the hearing thresholds of the worse ears from BSHL participants were negatively correlated to the pleasantness and naturalness perception. HI participants rated the familiar music pieces higher than unfamiliar music pieces in the three music categories. Music quality perception in participants with hearing impairment appeared to be affected by symmetry of hearing loss, degree of hearing loss and music familiarity when they were assessed using the music quality rating test (MQRT). This indicates that binaural symmetrical hearing is important to achieve a high level of music quality perception in HI listeners. This emphasizes the importance of provision of bilateral hearing assistive devices for people with asymmetrical hearing impairment.

Development and validation of a Chinese music quality rating test.

OBJECTIVE: The present study aims to develop and validate a Chinese music quality rating test (MQRT). DESIGN: In Experiment 1, 22 music pieces were initially selected and paired as a 'familiar music piece' and 'unfamiliar music piece' based on familiarities amongst the general public in the categories of classical music (6), Chinese folk music (8), and pop music (8). Following the selection criteria, one pair of music pieces from each music category was selected and used for the MQRT in Experiment 2. In Experiment 2, the MQRT was validated using these music pieces in the categories 'Pleasantness', 'Naturalness', 'Fullness', 'Roughness', and 'Sharpness'. STUDY SAMPLE: Seventy-two adult participants and 30 normal-hearing listeners were recruited in Experiments 1 and 2, respectively. RESULTS: Significant differences between the familiar and unfamiliar music pieces were found in respect of pleasantness rating for folk and pop music pieces as well as in sharpness rating for pop music pieces. The comparison of music category effect on MQRT found significant differences in pleasantness, fullness, and sharpness ratings. CONCLUSION: The Chinese MQRT developed in the present study is an effective tool for assessing music quality.

Machine Learning in Diagnosing Middle Ear Disorders Using Tympanic Membrane Images: A Meta-Analysis.

OBJECTIVE: To systematically evaluate the development of Machine Learning (ML) models and compare their diagnostic accuracy for the classification of Middle Ear Disorders (MED) using Tympanic Membrane (TM) images. METHODS: PubMed, EMBASE, CINAHL, and CENTRAL were searched up until November 30, 2021. Studies on the development of ML approaches for diagnosing MED using TM images were selected according to the inclusion criteria. PRISMA guidelines were followed with study design, analysis method, and outcomes extracted. Sensitivity, specificity, and area under the curve (AUC) were used to summarize the performance metrics of the meta-analysis. Risk of Bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool in combination with the Prediction Model Risk of Bias Assessment Tool. RESULTS: Sixteen studies were included, encompassing 20254 TM images (7025 normal TM and 13229 MED). The sample size ranged from 45 to 6066 per study. The accuracy of the 25 included ML approaches ranged from 76.00% to 98.26%. Eleven studies (68.8%) were rated as having a low risk of bias, with the reference standard as the major domain of high risk of bias (37.5%). Sensitivity and specificity were 93% (95% CI, 90%-95%) and 85% (95% CI, 82%-88%), respectively. The AUC of total TM images was 94% (95% CI, 91%-96%). The greater AUC was found using otoendoscopic images than otoscopic images. CONCLUSIONS: ML approaches perform robustly in distinguishing between normal ears and MED, however, it is proposed that a standardized TM image acquisition and annotation protocol should be developed. LEVEL OF EVIDENCE: NA Laryngoscope, 133:732-741, 2023.

Abnormal Functional Connectivity Within Default Mode Network and Salience Network Related to Tinnitus Severity.

BACKGROUND: Previous studies have demonstrated that tinnitus is associated with neural changes in the cerebral cortex. This study is aimed at investigating the central nervous characteristics of tinnitus patients with different severity by using a rs-EEG. PARTICIPANTS AND METHODS: rs-EEG was recorded in fifty-seven patients with chronic tinnitus and twenty-seven healthy controls. Tinnitus patients were divided into moderate-to-severe tinnitus group and slight-to-mild tinnitus group based on their Tinnitus Handicap Inventory (THI) scores. Source localization and functional connectivity analyses were used to measure the changes in central levels and examine the altered network patterns. The correlation between functional connectivity and tinnitus severity was analyzed. RESULT: Compared to the healthy controls, all tinnitus patients showed significant activation in the auditory cortex (middle temporal lobe, BA 21), while moderate-to-severe tinnitus group showed enhanced connectivity between the parahippocampus and posterior cingulate gyrus. Moreover, the moderate-to-severe tinnitus group had enhanced functional connectivity between auditory cortex and insula compared to the slight-to-mild tinnitus group. The connections between the insula and the parahippocampal and posterior cingulate gyrus were positively correlated with THI scores. CONCLUSION: The current study reveals that patients with moderate-to-severe tinnitus demonstrate greater changes in the central brain areas, including the auditory cortex, insula, parahippocampus and posterior cingulate gyrus. In addition, enhanced connections were found between the insula and the auditory cortex, as well as the posterior cingulate gyrus and the parahippocampus, which suggests abnormality in the auditory network, salience network, and default mode network. Specifically, the insula is the core region of the neural pathway that is composed of the auditory cortex, insula, and parahippocampus/posterior cingulate gyrus. This suggests that the severity of tinnitus is affected by multiple brain regions.

Cross-Subject Tinnitus Diagnosis Based on Multi-Band EEG Contrastive Representation Learning.

Electroencephalogram (EEG) is an important technology to explore the central nervous mechanism of tinnitus. However, it is hard to obtain consistent results in many previous studies for the high heterogeneity of tinnitus. In order to identify tinnitus and provide theoretical guidance for the diagnosis and treatment, we propose a robust, data-efficient multi-task learning framework called Multi-band EEG Contrastive Representation Learning (MECRL). In this study, we collect resting-state EEG data from 187 tinnitus patients and 80 healthy subjects to generate a high-quality large-scale EEG dataset on tinnitus diagnosis, and then apply the MECRL framework on the generated dataset to obtain a deep neural network model which can distinguish tinnitus patients from the healthy controls accurately. Subject-independent tinnitus diagnosis experiments are conducted and the result shows that the proposed MECRL method is significantly superior to other state-of-the-art baselines and can be well generalized to unseen topics. Meanwhile, visual experiments on key parameters of the model indicate that the high-classification weight electrodes of tinnitus' EEG signals are mainly distributed in the frontal, parietal and temporal regions. In conclusion, this study facilitates our understanding of the relationship between electrophysiology and pathophysiology changes of tinnitus and provides a new deep learning method (MECRL) to identify the neuronal biomarkers in tinnitus.

Age-related hearing loss accelerates the decline in fast speech comprehension and the decompensation of cortical network connections.

Patients with age-related hearing loss face hearing difficulties in daily life. The causes of age-related hearing loss are complex and include changes in peripheral hearing, central processing, and cognitive-related abilities. Furthermore, the factors by which aging relates to hearing loss via changes in auditory processing ability are still unclear. In this cross-sectional study, we evaluated 27 older adults (over 60 years old) with age-related hearing loss, 21 older adults (over 60 years old) with normal hearing, and 30 younger subjects (18-30 years old) with normal hearing. We used the outcome of the upper-threshold test, including the time-compressed threshold and the speech recognition threshold in noisy conditions, as a behavioral indicator of auditory processing ability. We also used electroencephalography to identify presbycusis-related abnormalities in the brain while the participants were in a spontaneous resting state. The time-compressed threshold and speech recognition threshold data indicated significant differences among the groups. In patients with age-related hearing loss, information masking (babble noise) had a greater effect than energy masking (speech-shaped noise) on processing difficulties. In terms of resting-state electroencephalography signals, we observed enhanced frontal lobe (Brodmann's area, BA11) activation in the older adults with normal hearing compared with the younger participants with normal hearing, and greater activation in the parietal (BA7) and occipital (BA19) lobes in the individuals with age-related hearing loss compared with the younger adults. Our functional connection analysis suggested that compared with younger people, the older adults with normal hearing exhibited enhanced connections among networks, including the default mode network, sensorimotor network, cingulo-opercular network, occipital network, and frontoparietal network. These results suggest that both normal aging and the development of age-related hearing loss have a negative effect on advanced auditory processing capabilities and that hearing loss accelerates the decline in speech comprehension, especially in speech competition situations. Older adults with normal hearing may have increased compensatory attentional resource recruitment represented by the top-down active listening mechanism, while those with age-related hearing loss exhibit decompensation of network connections involving multisensory integration.

Prognostic Factors Influencing the Tinnitus Improvement After Idiopathic Sudden Sensorineural Hearing Loss Treatment.

PURPOSE: Logistic regression analysis was used to explore the factors that influence tinnitus improvement after idiopathic sudden sensorineural hearing loss (ISSNHL) treatment. MATERIALS AND METHODS: In this retrospective study, 137 ISSNHL patients with tinnitus were recruited at the Sun Yatsen Memorial Hospital of Sun Yat-sen University, China. They underwent audiological examinations, vestibular assessments, tinnitus examinations, a Tinnitus Handicap Inventory (THI) assessment and ISSNHL treatments. Logistic regression analysis was performed to investigate factors that affected tinnitus improvement. RESULTS: Participants were divided into an effective group (73 patients) and noneffective group (64 patients) according to THI scores before and after treatment. The effective group had better averaged hearing threshold than the noneffective group (effective group vs. noneffective group: 74.47 vs. 87.66 dB HL; t = 3.03, p < 0.05). Additionally, before intervention there were significant difference in profound audiogram configuration (effective group vs. noneffective group: 17.81% vs. 46.88%, x2 = 23.63; p < 0.001), mid tinnitus pitch (effective group vs. noneffective group: 19.18% vs. 35.94%, x2 = 6.58; p = 0.037) and mean THI scores (effective group vs. noneffective group: 57.07 ± 22.27 vs. 36.78 ± 24.41, t = -5.09, p < 0.001) between the effective and noneffective tinnitus groups. Logistic regression analysis showed that audiogram configurations (profound audiogram: OR = 0.10, 95% CI 0.01-0.72, p = 0.022), tinnitus pitch (mid tinnitus pitch: OR = 0.16, 95% CI 0.05-0.57, p = 0.004) and THI scores (OR = 1.05, 95% CI 1.03-1.07, p < 0.001) were independent factors associated with tinnitus improvement. CONCLUSION: Audiogram configuration, tinnitus pitch, and THI scores before intervention appear to be predictive of the effectiveness of acute tinnitus improvement following ISSNHL treatment.

Aberrant Modulations of Neurocognitive Network Dynamics in Migraine Comorbid With Tinnitus.

Purpose: The possible relationship between migraine and tinnitus still remains elusive although migraine is often accompanied by chronic tinnitus. Several neuroimaging studies have reinforced the cognitive network abnormality in migraine and probably as well as tinnitus. The present work aims to investigate the dynamic neurocognitive network alterations of migraine comorbid with tinnitus. Materials and Methods: Participants included migraine patients (n = 32), tinnitus patients (n = 20), migraine with tinnitus (n = 27), and healthy controls (n = 47), matched for age and gender. Resting-state functional magnetic resonance imaging (rs-fMRI) with independent component analysis (ICA), sliding window cross-correlation, and clustering state analysis was used to detect the dynamic functional network connectivity (dFNC) of each group. Correlation analyses illustrated the association between clinical symptoms and abnormal dFNC in migraine as well as tinnitus. Results: Compared with healthy controls, migraine patients exhibited decreased cerebellar network and visual network (CN-VN) connectivity in State 2; migraine with tinnitus patients showed not only decreased CN-VN connectivity in State 2 but also decreased cerebellar network and executive control network (CN-ECN) connectivity in State 2 and increased cerebellar network and somatomotor network (SMN-VN) connectivity in State 1. The abnormal cerebellum dFNC with the executive control network (CN-ECN) was negatively correlated with headache frequency of migraine (rho = -0.776, p = 0.005). Conclusion: Brain network characteristics of migraine with tinnitus patients may indicate different mechanisms for migraine and tinnitus. Our results demonstrated a transient pathologic state with atypical cerebellar-cortical connectivity in migraine with tinnitus patients, which might be used to identify the neuro-pathophysiological mechanisms in migraine accompanied by tinnitus.

Tinnitus Affects Endogenous But Not Exogenous Auditory Attention Orienting.

PURPOSE: Previous studies have demonstrated that people with tinnitus show attention dysfunctions. In this study, we investigated the influence of tinnitus on attention orienting, especially whether the ability of attention orienting could be modulated by the degree of tinnitus. METHOD: Fifty-nine and 54 unilateral tinnitus participants were included in Experiment 1 and Experiment 2, respectively. All participants reported subjective tinnitus for at least 3 months and were divided into a mild tinnitus group (Tinnitus Handicap Inventory [THI] < 37) or a moderate to severe tinnitus group (THI ≥ 37) according to the THI score. An auditory exogenous attention task and an auditory endogenous attention task were adopted. In the exogenous task, a target sound following a cue sound was presented on either the left or right side. Participants were required to discriminate whether the target was pure tone or white noise. In the endogenous task, participants were required to pay attention to the stimuli on one side and judge the pitch of a target sound. Mixed-design analyses of variance were conducted for the mean reaction times and accuracy across the experimental conditions. RESULTS: Our results showed that in the endogenous attention task, compared with the mild tinnitus group, moderate to severe tinnitus participants had better performance for stimuli presented on the tinnitus side but not on the nontinnitus side. In contrast, in the exogenous attention task, no differences were found between mild and moderate to severe tinnitus groups. CONCLUSION: The results suggest that the degree of tinnitus influences the performance of auditory endogenous attention but not auditory exogenous attention orienting.

Topological features of limbic dysfunction in chronicity of tinnitus with intact hearing: New hypothesis for 'noise-cancellation' mechanism.

PURPOSE: The reorganization of the limbic regions extend to general cognitive network is believed to exist in the chronicity of tinnitus with particular 'hubs' contributing to a 'noise-cancellation' mechanism. To test this hypothesis, we investigated the topological brain network of tinnitus in different periods. METHODS: Resting-state functional magnetic resonance imaging were obtained from 32 patients with acute tinnitus, 41 patients with chronic tinnitus and 60 age- and gender- matched healthy controls (HC). The topological features of their brain networks were explored using graph theory analysis. RESULTS: Common small-world attributes were compared between the three groups, all showed a significantly increased values in Cp, Lp, λ (all p < 0.05). Significantly increased nodal centralities in the left superior frontal gyrus and the right precuneus, significantly decreased nodal centralities in the right inferior temporal gyrus were observed for acute tinnitus patients compared to HC. While for chronic tinnitus patients, there were significant increased nodal centralities in the left hippocampus, amygdala, and temporal pole, but decreased nodal centralities in the right inferior temporal gyrus. Additionally, significant higher nodal centralities were found in bilateral medial superior frontal gyrus for acute tinnitus patients compared to chronic tinnitus patients. Besides, alterations in rich-club organization were found in acute tinnitus patients and chronic tinnitus patients compared with HC, with increased functional connections among rich-club nodes and peripheral nodes in patients with tinnitus. CONCLUSIONS: Brain network topological properties altered across prefrontal-limbic-subcortical regions in tinnitus. The existed hubs in tinnitus might indicate an emotional and cognitive burden in 'noise-cancellation' mechanism.