First assessment of sophrology for the treatment of subjective tinnitus.

OBJECTIVES: To assess (without comparison versus controls) the efficacy of a sophrology protocol adapted to disabling subjective tinnitus, in diminishing the handicap induced by perception of tinnitus. MATERIALS AND METHODS: One hundred and forty consecutive patients, aged 18-83 years, underwent a protocol comprising 6-8 sessions of sophrology over a 2-4 month period. Impact was assessed on pre- to post-treatment progression on the Tinnitus Handicap Inventory (THI), a validated questionnaire measuring handicap induced by tinnitus. RESULTS: Mean THI scores improved, by >20 points in 59.2% of cases (i.e., clinically significant decrease). Improvement was independent of tinnitus duration (>versus<6 months) and origin (acoustic trauma versus emotional shock), and concerned all 3 THI subscales (functional, catastrophic and emotional). CONCLUSION: The present sophrology protocol, dedicated to subjective tinnitus, reduced intrusiveness. Further studies with a control group are needed to confirm efficacy as compared to waiting list or other validated treatments such as cognitive behavioral therapies.

Effect of broiler breeders fed with corn or sorghum diet and canthaxanthin supplementation on production and reproductive performance.

This study was designed to evaluate the effect of corn or sorghum diet and canthaxanthin (CX) supplementation on performance in broiler breeders. A total of 440 females with similar body weight (BW) (3.71 ± 0.14 kg) and 60 roosters were placed in an open-sided house with 20 pens, randomly distributed in a factorial arrangement (2 × 2). There were 4 diets of 2 ingredients; corn (CO) or sorghum (SO) and 2 levels of CX; 6 mg/kg (CX) and 0 mg/kg (NCX) totaling 5 replicate pens of 22 females and 3 males each, from 42 to 65 wk, divided in 2 periods (from wk 42 to 53 and wk 54 to 65). Birds' BW was measured every 28 d and mortality rate was calculated at the end of trial. Egg production (%), egg specific gravity (g/cm3), egg weight (g), yolk weight (%), albumen weight (%), eggshell weight (%) and yolk colorimetric score were measured weekly. Incubation parameters were recorded in 12 incubations to evaluate hatching eggs, hatching (%), hatchability (%), fertility (%), weight of the chicks born and their quality. The BW, mortality, percentage of yolk and albumen weight, fertility and some incubation parameters were not affected (P > 0.05) by diets used. An increase in the egg production, hatching eggs, chicks born and first quality chick by hen at the second period were observed in CX breeder's diets (P = 0.0066; P = 0.0060; P = 0.0368; P = 0.0326). Egg specific gravity and eggshell weight were improved at the first period by SO+CX diet (P = 0.0138; P = 0.0209) and the same effect to egg weight, but at the second period (P = 0.0251). The CX was well absorbed from the diet and effectively transferred to the egg yolk, thereby increasing egg yolk pigmentation in the both periods (P < 0.0001). The CX supplementation in broiler breeder diets improved the productive and reproductive performance (laying% and hatchable eggs) at the second period, also to the both periods improved the egg yolk pigmentation.

Effect of broiler breeders fed with corn or sorghum and canthaxanthin on lipid peroxidation, fatty acid profile of hatching eggs, and offspring performance.

The aim of study was to evaluate the effect on broiler breeders fed with corn or sorghum diets and canthaxanthin on lipid peroxidation, fatty acid, and offspring's performance. A total of 440 females with similar body weight (BW) (3.77 ± 0.11 kg) and 60 roosters were placed in an open-sided house with 20 pens, randomly distributed in a factorial arrangement (2 × 2). There were 4 diets of 2 ingredients; corn (CO) or sorghum (SO) and 2 levels of canthaxanthin; 6 mg/kg (CX) and 0 mg/kg (NCX) totaling five replicate pens of 22 females and 3 males each, from 45 to 65 wk old. The BW was measured every 28 days, carotenoid concentration, thiobarbituric acid reactive substances (TBARS), fatty acid profile (%) in egg yolks, and the performance from two incubations and their offspring were evaluated. The study had the same statistical design as broiler breeders, making a total of 4 groups with 10 replicate pens of 8 chicks each. The BW and mortality were not affected (P > 0.05) by diets. Egg yolks coming from the CO diet had the highest (P < 0.05) lutein (3.8 vs. 0.49 mg/kg) and zeaxanthin (4.25 vs. 0.22 mg/kg) concentration compared to SO diet. The SO+CX diet had the highest CX concentration (P < 0.0001). The SO+CX diet showed the lowest TBARS (P = 0.0002) in the egg yolk compared to the CO+CX diet. Egg yolks coming from breeders fed with CO showed a higher concentration of saturated fatty acids (23.36 vs. 21.44%) and monounsaturated fatty acids (27.17 vs. 24.96%). Egg yolks arising from broiler breeders fed with SO diets showed a higher concentration of polyunsaturated fatty acids compared (15.29 vs. 12.88%). The CX reduced the offspring CO diets mortality and improved their viability at 64 wk-old for the broiler breeders (P < 0.05). CX was well absorbed from the diet and effectively transferred to the egg yolk, thereby increasing its concentration in the yolk. This conferred resistance to oxidative stress to the yolk and also later to the developing embryo and its ultimate performance.

Navigated rTMS for the treatment of tinnitus: a pilot study with assessment by fMRI and AEPs.

OBJECTIVE: Repeated transcranial magnetic stimulation (rTMS) of auditory cortex has been proposed to treat refractory chronic tinnitus, but the involved mechanisms of action remain largely unknown. The purpose of this pilot study was to evaluate the impact of rTMS on auditory cortex activity in a series of tinnitus patients, using for the first time both functional magnetic resonance imaging (fMRI) of the brain and auditory evoked potentials (AEPs). METHOD: In six patients with chronic, lateralized refractory tinnitus, we performed five sessions of neuronavigated rTMS delivered at 1Hz over the secondary auditory cortex (defined on morphological MRI), contralateral to tinnitus side. The effects of rTMS were assessed on clinical scales, fMRI, and AEPs (N1 and P2 components). RESULTS: The clinical impact of rTMS on tinnitus was good for three patients (25-50% improvement of tinnitus severity compared to baseline), moderate for two patients (15% improvement), and null for one patient who had the most severe tinnitus at baseline. The changes induced by rTMS on fMRI data varied with the baseline level of auditory cortex activation before rTMS. This baseline level of activation was itself related to the severity of tinnitus. Thus, cortical stimulation increased auditory cortex activation in patients who had less severe tinnitus and low level of activation before rTMS, whereas it decreased auditory cortex activation in patients who had more severe tinnitus and higher level of activation before rTMS. Regarding AEPs, rTMS decreased N1 amplitude in all patients, except in the patient who had the most severe tinnitus at baseline and showed no improvement after rTMS. Conversely, P2 amplitude decreased after rTMS only in patients with severe tinnitus, at least for auditory stimulation contralateral to tinnitus, but increased in patients with less severe tinnitus. CONCLUSIONS: The changes produced by rTMS in auditory cortex activity, as assessed by fMRI and AEPs, appeared to depend on a process of disease-related homeostatic cortical plasticity, regardless of the therapeutic impact of rTMS on tinnitus.

[Tinnitus treatment: neurosurgical management]. / Traitement des acouphènes: aspects neurochirurgicaux.

Tinnitus is a very frequent symptom affecting 10% of the general population. It corresponds to the perception of an internal noise that can severely impair the quality of life. Tinnitus management requires a multidisciplinary approach in which neuromodulation and neurosurgery tend to play major roles. Classification of tinnitus separates objective tinnitus (i.e., tinnitus that can be heard or recorded) from the more frequent subjective tinnitus (i.e., tinnitus only perceived by the patient). Objective tinnitus is either pulsatile synchronous with heartbeat or asynchronous. In the former, appropriate radiological testing should search for a vascular abnormality as well as other neurological diseases (intracranial hypertension, Arnold-Chiari malformation, vascular loops, etc.). Asynchronous objective tinnitus generally corresponds to muscular contractions that require specific management. The pathophysiology of subjective tinnitus is more complex, showing strong analogies with postamputation pain syndromes. After peripheral middle ear or inner ear damage, auditory deafferentation could result in hyperactivity and/or functional reorganization within central auditory and nonauditory structures. This could explain the persistence of tinnitus after total hearing amputation (e.g., translabyrinthine approach for vestibular schwannoma) and associated symptoms such as hyperacusis or anxiety and depression. This central model finds strong support in animal experiments and in functional neuroimagery (PET, fMRI, MEG). Since no etiologically based therapies are currently available, severe subjective tinnitus management only targets tinnitus tolerance with sound enrichment or cognitive behavior therapy. However, in the near future better knowledge of tinnitus pathophysiology and innovative therapeutic tools could emerge from neuromodulation techniques such as repeated transcranial magnetic or epidural electric stimulation.

Objective low-frequency audiometry by distortion-product acoustic emissions.

The aim of this study was to measure distortion-product otoacoustic emissions (DPOEs) in a clinical setting. First, DPOE input-output functions were automatically realized to determine the ratio of the pure tones (primaries) f2 and f1 that would elicit the most significant DPOE input-output function. The DPOE input-output functions presented two separate portions for the f2/f1 ratio, ranging from 1.18 to 1.26: (1) below 60-dB sound pressure level (SPL), a saturating portion with a DPOE detection threshold at 36-dB SPL; and (2) above 66-dB SPL, a linear portion. For other f2/f1 ratios, DPOE input-output functions had a more linear behavior. The DPOEs generated by primary intensities below 60-dB SPL, which show saturating behavior, probably have their origin in the properties of outer hair cells. This indicates that DPOE measurements in a clinical setting must be realized with precise stimulus values: (1) f2/f1 ratio near 1.22, and (2) primary intensities below 60-dB SPL. Second, DPOE input-output functions were realized for DPOEs varying from 707.5 to 342 Hz. No more saturating plateau could be observed with DPOEs below 512.5 Hz, suggesting that active mechanisms are absent below 725 Hz within the human cochlea. These data permit us to establish the bases of an objective low-frequency audiometric test.