Neurofeedback for subjective tinnitus patients.

OBJECTIVE: Previous studies report that enhanced power in the delta range (1.5-4Hz) and reduced power in the alpha frequency band (8-12Hz) were most pronounced in the temporal regions. These studies referred to the 8-12Hz activity as tau activity, and they created a new neurofeedback protocol to treat tinnitus using a temporally generated tau rhythm (8-12Hz) and slow waves in the delta range (3-4Hz) for feedback. This study aims to repeat this protocol and to evaluate its effect on tinnitus. METHODS: Fifteen normal-hearing patients with tinnitus were treated with the neurofeedback protocol. The Tinnitus Handicap Inventory and Visual Analogue Scales were administered before and after treatment and at 1, 3 and 6 months post-treatment. RESULTS: After therapy, all questionnaires scores were significant improved, and the improvements persisted throughout the followup period. Moreover, an increasing trend in the tau/delta ratio was observed; specifically, the trend was more stable respect of the pre-recording measure. However, only in some subjects may the signal alone be enough to develop the correct behaviors. CONCLUSION: Further studies are necessary to characterize the tinnitus subjects who recovered from and adapted to this psychophysical condition and, therefore, responded to neurofeedback therapy.

Tinnitus patients lost to follow-up.

Tinnitus patients without hearing loss or hyperacusis often start tinnitus retraining therapy but do not return to the tinnitus clinic for follow-up visits. The aim of this study was to evaluate how these 'missing patients' feel and whether they still use their sound generators after they discontinue retraining therapy. We interviewed 269 tinnitus patients by phone who never returned to the clinic after receiving initial counseling and a generator for sound enrichment. Twenty-six percent did not have tinnitus anymore, 30.5% still used the sound generator to treat their tinnitus, and 43.5% did not use their sound generator but still suffered from tinnitus. This study suggests that therapists need to contact missing patients periodically to follow their improvement, encourage them, and decide on new therapeutic approaches as necessary.

Questionnaires to evaluate anxiety and depressive levels in tinnitus patients.

OBJECTIVE: The aim of this study was to evaluate the correlation between the most common instruments used to quantify tinnitus and the level of anxiety and depression experienced by patients in order to provide a guideline for otolaryngologists. STUDY DESIGN: Cross-sectional survey. SUBJECTS AND METHODS: A total of 108 tinnitus patients were submitted to a series of instruments, including Visual Analogue Scales (VAS), Tinnitus Handicap Inventory (THI), State Trait Anxiety Inventory Form Y (STAI-T), and Beck Depression Inventory (BDI). These instruments were chosen based on their psychometric properties, time of administration, and validity in many countries. RESULTS: Of the patients studied, 24 percent had severe tinnitus, 35 percent had anxiety disorders, and 13 percent had a depressive pathosis. Significant correlations between STAI-T and THI scores (P < 0.001), and between BDI and THI scores were shown (P < 0.001). The same results were found with VAS. CONCLUSION: If a patient reports a THI greater than 38, the otolaryngologist should supplement diagnostic studies with a psychological consultation.

Results of TRT after eighteen months: our experience.

The aim of this study was to evaluate the efficacy of TRT in patients suffering from tinnitus. The tinnitus disorder affects about 10-15% of the population and, in one person out of a hundred, it is a disabling disorder. TRT treatment is based on Jastreboff's neurophysiological model. TRT consists of two parts: counselling, and sound therapy by means of dedicated hearing aids and sound generators. It proved to be useful to reduce the symptoms related to tinnitus. Jastreboff's structured interviews were proposed to a sample of 51 patients with tinnitus belonging to the I-II-III-IV classes according to Jastreboff. These patients were treated for 18 months. Sixty-eight percent of patients reported a reduction in the symptoms related to tinnitus, such as sleep disturbance, problems in concentration, and inability to relax. A percentage (64.7%) of patients thought that their quality of life was improved. Patients who had suffered from tinnitus for less than one year achieved significantly better results than patients who had suffered for a longer period of time. TRT is an effective tool in the treatment of tinnitus.