Qualitative Analysis of Newborn Hearing Screening Program in Iran.

Background: Early diagnosis of hearing loss and timely interventions are important to minimize the consequences of this condition, especially for children. This research was conducted to analyze the newborn hearing loss screening program in Iran. Methods: This qualitative study was conducted using the content analysis method and based on the CIPP model in 2023. The snowball method was used to recruit a sample with maximum diversity. The criteria for selecting people for interviews included having at least three years of experience in the newborn hearing loss screening program and sufficient knowledge in the field. To ensure the reliability of the results, four criteria proposed by Lincoln and Guba were used. Data analysis was conducted by MAXQDA2022 software. Results: In the current research, using content analysis in the form of the CIPP model, based on the viewpoints of the interviewees (40 people), the management requirements of the newborn hearing loss screening program were categorized into the four main categories of context (texture), input, process, and output. Eight subcategories were identified in the context dimension, four subcategories in the input dimension, seven subcategories in the process dimension, and four subcategories in the output dimension. Conclusion: According to the findings of this research, in order to properly implement the newborn hearing loss screening program, there is a need to conduct pilot studies, need assessments, evidence-based programs, and epidemiological studies and to prioritize services and resources. Also, communication between service delivery levels needs to be improved, and attention should be paid to personnel motivation and screening programs.

Photobiomodulation therapy in mood disorders: a systematic review.

Mood disorders are common, debilitating and impose a high-cost burden on society. Side effects and resistance to psychiatric drugs justify finding new treatment methods. Photobiomodulation therapy (PBMT) uses photons of light to repair, modulate and improve the function of target tissue. The purpose of this study is to systematically review the use of PBMT for the treatment of mood disorders and to identify the useful parameters of PBMT, the level of evidence of its effectiveness, and the degree of its practical recommendation. "Google scholar," "Pub Med," "Scopus," and "Science direct" online databases were searched based on Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA) guidelines. The human or animal studies written in English and published from January 2009 to August 2021 were included. Sixteen studies, which included four randomized controlled trials (RCTs), met the inclusion criteria. Infrared wavelength ranges from 800 to 830 nm, power density of 250 mW/cm2 and energy density of 60 to 120 J/ cm2 were the most used PBMT parameters. Bias risk assessment was performed to evaluate the quality of RCTs in which 2 out of 4 RCTs were evaluated as high quality. Based on grade practice recommendations, PBMT can be classified as strongly recommended for moderate grade of major depressive disorder (MDD) and recommended for anxiety disorder. In bipolar disorder, further studies are needed to recommend this therapeutic method.

Situation Analysis of Ear and Hearing Care Program in Islamic Republic of Iran: System's Challenges and Proper Interventions.

Background: More than 6.8% of the world's population suffer from disabling hearing impairment. Hearing impairment can cause lifelong or even life-threatening problems and has a significant impact on the health and quality of life. This study aimed to analyze the current situation of the ear and hearing care (EHC) in the frame of Iran health system. Methods: This situation analysis was performed over a 5-year period (2013-2017) using the Strengths, Weaknesses, Opportunities, and Threats analysis method. First, after formation of the steering committee, all relevant published and unpublished articles and reports were reviewed and analyzed. In the next step, focused group discussion sessions (FGDs) were held with the participation of the experts, stakeholders, and Steering Committee members. Through the scissor-and-sort technique, the relevant data were highlighted and main categories evolved. Results: The main challenges included inadequate health literacy, weak intrasectoral and intersectoral cooperation, the inadequacy of policy responses, nonintegration of the EHC in the primary health care system, poor standard processes, and resources of EHC, and lack of EHC surveillance system. The 6 major interventions and strategies extracted as identifying the capacities of both the public and private sectors, reinforcement of intersectoral cooperation and intersectoral collaboration, standardizing the processes and integrating of EHC services in the PHC, reorganizing the referral system, promoting hearing health literacy, and minimizing hearing loss risk factors. Conclusion: Implementing the proposed interventions and strategies is essential to improve the situation of Iran EHC management system during the next 5 years.

The relationship between ultra-high frequency thresholds and transient evoked otoacoustic emissions in adults with tinnitus.

Background: The possible role of cochlear function in tinnitus generation is still a matter of debate. To assess the role of outer hair cell dysfunction in tinnitus and its possible relationship with ultra-high frequency (UHF) hearing sensitivity, transient evoked otoacoustic emissions (TEOAE) and UHF hearing thresholds were investigated in normal hearing individuals with and without tinnitus. Methods: Eighteen individuals with tinnitus and 22 without tinnitus participated in this study. TEOAE was recorded with click stimulus at 80 dBpeSPL. UHF pure tone audiometry was performed at 10, 12.5, 16, and 18 kHz. Results: TEOAE was significantly abnormal in 72.2% of the tinnitus, and 18.2% of the control groups (p=0.001). The individuals with tinnitus had significantly poorer UHF hearing sensitivity compared to the control group at 12.5 and 18 kHz (p≤0.048). There was a stronger correlation between increasing UHFs hearing threshold and decreasing SNRs of TEOAEs in the tinnitus group compared to the controls. Conclusion: Our study revealed poorer UHF hearing thresholds and more TEOAE abnormalities in normal hearing individuals with tinnitus compared to the controls. Perhaps the alterations in the basal cochlea, following a decrease in UHF hearing sensitivity, affect OAEs that are originated from more apical cochlear parts in tinnitus ears more than non-tinnitus ears.

Photobiomodulation therapy in improvement of harmful neural plasticity in sodium salicylate-induced tinnitus.

Tinnitus is a common annoying symptom without effective and accepted treatment. In this controlled experimental study, photobiomodulation therapy (PBMT), which uses light to modulate and repair target tissue, was used to treat sodium salicylate (SS)-induced tinnitus in a rat animal model. Here, PBMT was performed simultaneously on the peripheral and central regions involved in tinnitus. The results were evaluated using objective tests including gap pre-pulse inhibition of acoustic startle (GPIAS), auditory brainstem response (ABR) and immunohistochemistry (IHC). Harmful neural plasticity induced by tinnitus was detected by doublecortin (DCX) protein expression, a known marker of neural plasticity. PBMT parameters were 808 nm wavelength, 165 mW/cm2 power density, and 99 J/cm2 energy density. In the tinnitus group, the mean gap in noise (GIN) value of GPIAS test was significantly decreased indicated the occurrence of an additional perceived sound like tinnitus and also the mean ABR threshold and brainstem transmission time (BTT) were significantly increased. In addition, a significant increase in DCX expression in the dorsal cochlear nucleus (DCN), dentate gyrus (DG) and the parafloccular lobe (PFL) of cerebellum was observed in the tinnitus group. In PBMT group, a significant increase in the GIN value, a significant decrease in the ABR threshold and BTT, and also significant reduction of DCX expression in the DG were observed. Based on our findings, PBMT has the potential to be used in the management of SS-induced tinnitus.

Correlation between brain cortex metabolic and perfusion functions in subjective idiopathic tinnitus.

OBJECTIVES: Subjective tinnitus has associated with abnormal brain metabolism and perfusion found in functional imaging studies by fluorodeoxyglucose (FDG) and technetium99m (TC99m). But there is no study evaluating the association of brain metabolism and perfusion abnormalities in a group of these subjects. The aim of this study was to investigate if there is any significant correlation between the brain perfusion and metabolism abnormalities in subjects with tinnitus. MATERIALS AND METHODS: In this cross-sectional study, 52 patients were undergone TC99m-ECD single photon emission computerized tomography (SPECT) scan and F18-FDG positron emission tomography (PET). The results of PET and SPECT scanning were fused with MRI to accurate anatomical localization of abnormalities. The analysis was performed using Kendal's correlation, t-test and chi square. RESULTS: Assessing these 52 tinnitus subjects (containing 42 males [76.4%]) showed that a significant correlation was found between the brain metabolic function and perfusion (p value 0.001).

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation.

INTRODUCTION: Residual inhibition (RI) is the temporary inhibition of tinnitus by use of masking stimuli when the device is turned off. OBJECTIVE: The main aim of this study was to evaluate the effects of RI induced by auditory electrical stimulation (AES) in the primary auditory pathways using early auditory-evoked potentials (AEPs) in subjective idiopathic tinnitus (SIT) subjects. MATERIALS AND METHODS: A randomized placebo-controlled study was conducted on forty-four tinnitus subjects. All enrolled subjects based on the responses to AES, were divided into two groups of RI and Non-RI (NRI). The results of the electrocochleography (ECochG), auditory brain stem response (ABR) and brain stem transmission time (BTT) were determined and compared pre- and post-AES in the studied groups. RESULTS: The mean differences in the compound action potential (CAP) amplitudes and III/V and I/V amplitude ratios were significantly different between the RI, NRI and PES controls. BTT was significantly decreased associated with RI. CONCLUSION: The observed changes in AEP associated with RI suggested some peripheral and central auditory alterations. Synchronized discharges of the auditory nerve fibers and inhibition of the abnormal activity of the cochlear nerve by AES may play important roles associated with RI. Further comprehensive studies are required to determine the mechanisms of RI more precisely.

Acoustic and optoacoustic stimulations in auditory brainstem response test in salicylate induced tinnitus.

As a common debilitating disorder worldwide, tinnitus requires objective assessment. In the auditory brainstem response (ABR) test, auditory potentials can be evoked by acoustic or optoacoustic (induced by laser light) stimulations. In order to use the ABR test in the objective assessment of tinnitus, in this study, acoustic ABR (aABR) and optoacoustic ABR (oABR) were compared in the control and tinnitus groups to determine the changes caused by sodium salicylate (SS)-induced tinnitus in rat. In both aABR and oABR, wave II was the most prominent waveform, and the amplitude of wave II evoked by oABR was significantly higher than that of aABR. Brainstem transmission time (BTT), which represents the time required for a neural stimulation to progress from the auditory nerve ending to the inferior colliculus, was significantly shorter in oABR. In the tinnitus group, there was a significant increase in the threshold of both ABRs and a significant decrease in the amplitude of wave II only in the oABR. Based on our findings, the ABR test has the potential to be used in the assessment of SS-induced tinnitus, but oABR has the advantages of producing more prominent waveforms and significantly reducing the amplitude of wave II in tinnitus.

Electrophysiological and molecular changes following neuroprotective placental protein administration on tinnitus-induced rats.

Objective: Despite 6%-20% of the adult population suffering from tinnitus, there is no standard treatment for it. Placenta extract has been used for various therapeutic purposes, including hearing loss. Here, we evaluate the effect of a novel neuroprotective protein composition (NPPC) extract on electrophysiological and molecular changes in the medial geniculate body (MGB) of tinnitus-induced rats. Methods: To evaluate the protein analysis by western blot, the rats were divided into three groups: (1) saline group (intraperitoneal injection of 200 mg/kg saline twice a day for 28 consecutive days, (2) chronic Na-Sal group received sodium salicylate as in the first group, and (3) chronic treatment group (received salicylate 200 mg/kg twice daily for 2 weeks, followed by 0.4 mg NPPC daily from day 14 to day 28). Single-unit recordings were performed on a separate group that was treated as in group 4. Gap-prepulse inhibition of the acoustic startle (GPIAS) and pre-pulse inhibition (PPI) was performed to confirm tinnitus in all groups at the baseline, 14th and 28th days. Results: Western blot analysis showed that the expression of γ-Aminobutyric acid Aα1 subunit (GABA Aα1), N-methyl-d-aspartate receptor subtype 2B (NR2B or NMDAR2B), α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors subunit GluR1 (GluR1), and α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors subunit GluR2 (GluR2) decreased after Na-Sal injection, while NPPC upregulated their expression. MGB units in rats with tinnitus showed decreased spontaneous firing rate, burst per minute, and a spike in a burst. After NPPC administration, neural activity patterns showed a significant positive effect of NPPC on tinnitus. Conclusion: NPPC can play an effective role in the treatment of tinnitus in salicylate-induced rats, and MGB is one of the brain areas involved in these processes. Level of Evidence: NA.

The human neuroprotective placental protein composition suppressing tinnitus and restoring auditory brainstem response in a rodent model of sodium salicylate-induced ototoxicity.

The effect of neuroprotective placental protein composition (NPPC) on the suppression of tinnitus and the restoration of the auditory brainstem response (ABR) characteristics was explored in tinnitus-induced rats. The animals were placed into two groups: (1) the study group, rats received sodium salicylate (SS) at the dose of 200 mg/kg twice a day for two weeks, and then 0.4 mg of the NPPC per day, between the 14th and 28th days, (2) the placebo group, rats received saline for two weeks, and then the NPPC alone between the 14th and 28th days. The gap pre-pulse inhibition of the acoustic startle (GPIAS), the pre-pulse inhibition (PPI), and the ABR assessments were performed on animals in both groups three times (baseline, day 14, and 28). The GPIAS value declined after 14 consecutive days of the SS injection, while NPPC treatment augmented the GPIAS score in the study group on the 28th day. The PPI outcomes revealed no significant changes, indicating hearing preservation after the SS and NPPC administrations. Moreover, some changes in ABR characteristics were observed following SS injection, including (1) higher ABR thresholds, (2) lowered waves I and II amplitudes at the frequencies of 6, 12, and 24 kHz and wave III at the 12 kHz, (3) elevated amplitude ratios, and (4) prolongation in brainstem transmission time (BTT). All the mentioned variables returned to their normal values after applying the NPPC. The NPPC use could exert positive therapeutic effects on the tinnitus-induced rats and improve their ABR parameters.

The relationship between treatment of mental disorder and chronic tinnitus.

INTRODUCTION: Comorbidity of chronic tinnitus and mental disorders may result in more disability. OBJECTIVES: This research provides an evaluation about the effects of medically treated comorbid mental disorder on chronic tinnitus. MATERIALS AND METHODS: Fifty-five patients diagnosed with chronic tinnitus and mental disorders were randomly requited by producing a before-after design. They underwent three months of drug therapy for comorbid mental disorders by psychiatrists. Study instruments are Tinnitus Handicap Inventory, Tinnitus Questionnaire, Loudness Match Tinnitus, Hamilton Depression Rating Scale, Beck Anxiety Inventory, The Structured Clinical Interview and Symptom Check List -90. RESULTS: Three months medical treatment puts forward the argument that among mental disorders, anxiety and major depressive disorder demonstrate a significant reduction. Pearson Correlation coefficient ostensibly reveals that there is no significant relationship between mental disorders and tinnitus severity. The statistics lend support to profound effect of major depressive disorder as a key factor on tinnitus disability exacerbation. Medical treatment also touches on issue such as tinnitus severity, its disabling effects and TQ subscales that statistics shows significant trends in their reduction. CONCLUSION: Findings lay emphasis on tinnitus severity reduction and connection might be established between alleviated mental disorders comorbidity and the improvement of quality of life.

Pattern of brain blood perfusion in tinnitus patients using technetium-99m SPECT imaging.

BACKGROUND AND PURPOSE: Tinnitus is associated with an increased activity in central auditory system as demonstrated by neuroimaging studies. Brain perfusion scanning using single photon emission computed tomography (SPECT) was done to understand the pattern of brain blood perfusion of tinnitus subjects and find the areas which are mostly abnormal in these patients. MATERIALS AND METHODS: A number of 122 patients with tinnitus were enrolled to this cross-sectional study. They underwent SPECT and magnetic resonance imaging (MRI) of brain, and the images were fused to find the regions with abnormal perfusion. RESULTS: SPECT scan results were abnormal in 101 patients (83%). Most patients had bilateral abnormal perfusion (N = 65, 53.3%), and most subjects had abnormality in middle-temporal gyrus (N = 83, 68%) and temporoparietal cortex (N = 46, 37.7%). Patients with multifocal involvement had the least mean age than other 2 groups (patients with no abnormality and unifocal abnormality) (P value = 0.045). CONCLUSIONS: Brain blood perfusion pattern differs in patient with tinnitus than others. These patients have brain perfusion abnormality, mostly in auditory gyrus (middle temporal) and associative cortex (temporoparietal cortex). Multifocal abnormalities might be due to more cognitive and emotional brain centers involvement due to tinnitus or more stress and anxiety of tinnitus in the young patients.

Persian language version of the "Tinnitus Handicap Inventory": translation, standardization, validity and reliability.

UNLABELLED: Tinnitus is a debilitating condition that is widespread yet difficult to successfully diagnose and treat. This symptom can seriously affect the individual's life quality. OBJECTIVES: The aim of current study was to compose and validate a Persian version of the Tinnitus Handicap Inventory (THI-P). MATERIALS AND METHODS: The linguistic validation of the original version of THI into Persian version (THI-P) included translation, back translation and data gathering. The THI-P was administered to 112 tinnitus subjects. Age, gender, medical history and tinnitus characteristics were recorded as baseline information. All participants complained of chronic unilateral or bilateral subjective idiopathic tinnitus lasting for at least 6 months before consulting about their tinnitus. RESULTS: There was no significant difference between gender, age, hearing impairment and total score and subscales of THI-P. Pearson product-moment correlations revealed adequate test-retest reliability for the THI-P (r = 0.96). Cronbach's-alpha coefficient indicated adequate internal stability of the THI-P (r= 0.943), with a total item correction varying between r=0.939 and r=0.944, indicating its reproducibility. CONCLUSION: The present study proved the internal consistency/ coherency of the Persian version of THI (THI-P). This provides satisfactory application in clinical/research environments.

Transcranial photobiomodulation in the management of brain disorders.

Transcranial photobiomodulation (tPBM) is the process of delivering light photons through the skull to benefit from its modifying effect. Brain disorders are important health problems. The aim of this review was to determine the existing evidence of effectiveness, useful parameters, and safety of tPBM in the management of traumatic brain injury, stroke, Parkinson, and Alzheimer's disease as the common brain disorders. Four online databases, including Cochrane, Pub Med, Embase, and Google scholar were searched according to the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA) guidelines. 4728 articles were obtained in the initial search. Only those articles that were published until September 2020 and designed as randomized clinical trials (RCTs) or animal-controlled studies were included. 6 RCTs, 2 related supplementary articles, and 38 controlled animal studies met the inclusion criteria of this study. No RCTs were performed in the fields of Alzheimer's and Parkinson's diseases. The human RCTs and animal studies reported no adverse events resulted from the use of tPBM. Useful parameters of tPBM were identified according to the controlled animal studies. Since the investigated RCTs had no homogenous results, making an evidence-based decision for definite therapeutic application of tPBM is still unattainable. Altogether, these data support the need for large confirmatory well-designed RCTs for using tPBM as a novel, safe, and easy-to-administer treatment of brain disorders. EVIDENCE BEFORE THIS STUDY: High prevalence and complications of brain disorders and also side effects of neuropsychiatric medications have encouraged researchers to find alternative therapeutic techniques which tPBM can be one of them. In present review we tried to determine the existing evidence of effectiveness, useful parameters, and safety of tPBM in the management of traumatic brain injury, stroke, Alzheimer, and Parkinson's disease as common brain disorders. Four online databases, including "Cochrane", "Pub Med", "Embase", and "Google scholar" were searched. Only those articles that were published until September 2020 and designed as RCTs or animal-controlled studies were included. Search keywords were the followings: transcranial photobiomodulation" OR "transcranial low-level laser therapy" AND "stroke" OR "traumatic brain injury" OR "Alzheimer" OR "Parkinson". Several studies have confirmed effectiveness of tPBM in treatment of different brain disorders but the level of evidence of its effectiveness remain to be determined. ADDED VALUE OF THIS STUDY: In this study we systematically reviewed human RCTs to determine the existing evidence of tPBM effectiveness in management of four mentioned brain disorders. Since the outcomes of the reviewed RCTs were not homogeneous, further well-designed RCTs are required to decide more definitively on the evidence of this noninvasive and probably safe therapeutic intervention. We hypothesized that non-homogeneous outcomes could be due to inefficiency of PBM parameters. Controlled animal studies have the advantage of using objective tests to evaluate the results and compare them with the control group. We determined useful tPBM parameters based on these studies. IMPLICATIONS OF ALL THE AVAILABLE EVIDENCE: This research is part of our main project of tinnitus treatment using photobiomodulation (PBM). Evidence of central nervous system involvement in tinnitus led us to believe that treatment protocol of tinnitus should also include transcranial PBM. The determined useful parameters can be helpful in designing more efficient tPBM protocols in the management of brain disorders and tinnitus as a common debilitating symptom that can be associated with these disorders.

Development and application of a tool to measure hearing health literacy of young people in the Islamic Republic of Iran.

BACKGROUND: A reliable and valid tool to assess hearing health literacy in Iranian young people is lacking. AIMS: This study aimed to develop a tool to assess the hearing health literacy of young people in the Islamic Republic of Iran and to use the tool to determine the hearing health literacy of a sample of Iranians aged 12-25 years. METHODS: A questionnaire was designed with three skill sections: obtaining health information, evaluating this information and applying it to benefit health. The validity and reliability of the tool were determined. Cluster sampling was used to select 50 urban clusters across the country from which 5000 Iranians aged between 12-25 years old were selected to complete the questionnaire. RESULTS: The final questionnaire had 22 items with scores ranging from 22 to 44. The Cronbach alpha was 0.65, and content validity ratio and index were 0.92 and 0.82, respectively. Of the 5000 questionnaires completed, 4890 were included in the analysis. The mean (standard deviation (SD)) age of the participants was 17 (SD 3) years and 45.9% were males. The mean score on the tool was 30.81 (SD 3.75), indicating inadequate health literacy (score 22-36). Only 137 (2.8%) participants had adequate health literacy (score 37-44). Statistically significant differences in mean hearing health literacy were seen for sex, age, years of education, occupation, marital status and income (P < 0.05). CONCLUSIONS: Given the low level of hearing health literacy in Iranian young people, programmes to improve the ear and hearing health literacy are urgently needed.

Aberrant Frequency Related Change-Detection Activity in Chronic Tinnitus.

Tinnitus is the perception of sound without the occurrence of an acoustic event. The deficit in auditory sensory or echoic memory may be the cause of the perception of tinnitus. This study considered the mismatch negativity (MMN) to investigate the potential difference between and within groups of persons with normal hearing (NH) and tinnitus. Using an auditory multi-feature paradigm to elicit the MMN, this study considered the MMN peak amplitude at two central frequencies for two MMN subcomponents. These central frequencies were 1 and 5 kHz, which the latter was closer to the perceived tinnitus frequency in the group with tinnitus. The deviants were higher frequency, lower frequency, higher intensity, lower intensity, duration, location (left), location (right), and gap. The pure tone audiometry (PTA) test and distortion product otoacoustic emissions (DPOAE) test showed no meaningful difference between the two groups. For the frontal subcomponent, the mean amplitudes of the MMN peak for the two groups illustrated less negative meaningful MMN peak amplitudes in the group of persons with tinnitus. For the supratemporal component at 5 kHz central frequency, amplitudes were lower for the group of persons with tinnitus, whereas for the central frequency of 1 kHz, most deviants exhibited meaningful differences. Additionally, within-group comparisons indicated that mean amplitudes for both groups were more negative at the central frequency of 1 kHz for the frontal MMN subcomponent. In comparison, the supratemporal component illustrated a lower peak amplitude at 5 kHz central frequency in the group of persons with tinnitus and no difference in the NH group, which is a unique observation of this study. Results of the between-groups are in accordance with previous studies and within-group comparisons consider the probability of decreasing the change detection capability of the brain. The results of this study indicate that increasing the frequency of the stimuli close to the tinnitus perceived frequencies decreases the prediction error, including the prediction error of the silence. Such a decrease may cause the prediction error of the spontaneous neural activity in the auditory pathway to exceed the silence prediction error, and as a result, increases the probability of occurrence of tinnitus in higher frequencies according to the predictive coding model.

The investigation of semantic memory deficit in chronic tinnitus: a behavioral report.

INTRODUCTION: Tinnitus is a central auditory disorder in which different processing systems are involved as a network. One of these networks is memory. Previous studies have demonstrated some deficits in various types of memory in chronic tinnitus. OBJECTIVES: The main purpose of the present study was to investigate the semantic memory, which is not yet investigated in the tinnitus population. METHODS: In this case-control study, 15 subjects with chronic tinnitus and 16 matched healthy controls were included. 40 semantically related and 40 semantically unrelated word pairs were presented to the participants in a counter-balanced fashion. They were asked to make decision about their semantic relatedness. Then the participants' reaction times and the accuracy of responses were calculated. RESULTS: Mean of reaction times were significantly longer in the tinnitus group (M=1034ms, SD=0.31) compared to the control group (Mean=1016ms, SD=0.13), p<0.05. However, no significant difference was found for the mean percentage of correct responses between the two groups. CONCLUSION: The current study provided behavioral evidence that chronic tinnitus can affect the semantic memory. Such behavioral outcomes may provide new insights into more research activities in the field of electrophysiology and neuroimaging in the tinnitus population.

Impact of Acamprosate on Chronic Tinnitus: A Randomized-Controlled Trial.

OBJECTIVES: Tinnitus is a common and distressing otologic symptom, with various probable pathophysiologic mechanisms, such as an imbalance between excitatory and inhibitory mechanisms. Acamprosate, generally used to treat alcoholism, is a glutaminergic antagonist and GABA agonist suggested for treating tinnitus. Thus, we aimed to evaluate the efficacy and safety of acamprosate in the treatment of tinnitus. METHODS: The current randomized-controlled trial study included 20 subjects with chronic tinnitus. After performing psycho-acoustic, psychometric and electrophysiological evaluations, all studied tinnitus subjects were randomly divided into two groups of acamprosate and placebo. The first group received oral acamprosate (two tablets of 333 mg/d, three times a day), whereas the second group was given placebo treatment (two tablets, three times a day). After the first 30 days, all evaluations were repeated for the studied groups just in the same manner before the study. Subsequently, the final results of each evaluation were compared together with the baseline values. RESULTS: Nine studied subjects randomly received acamprosate, whereas eleven others received a placebo. There was no significant improvement in the psycho-acoustic tests, except a decrease was observed in the pitch match of tinnitus (P = .039). For those subjects who were receiving acamprosate, a significant reduction was observed in tinnitus handicap inventory (P = .006), tinnitus questionnaire scores (P = .007), and the visual analog scores (P = .007) compared to the placebo group. There was a significant reduction in Action Potential latency (P = .048) as well as an increase in the amplitude of distortion product otoacoustic emissions at 4 kHz (P = .048). CONCLUSIONS: The study results indicated a subjective relief of tinnitus as well as some degree of the electrophysiological improvement at the level of the cochlear and the distal portion of the auditory nerve among the subjects who received the acamprosate. CLINICAL TRIAL REGISTRATION CODE: IRCT2013121115751N1.

Toward An Exploration of Habituating to Tinnitus: Perspectives on Sensory Gating.

BACKGROUND: Some tinnitus participants habituate to their tinnitus, but some others do not and complain of its annoyance so much. It has been suggested that tinnitus is a habituation deficit. Habituation and the ability to ignore a sensory input depend on the normal function of filtering mechanism of sensory gating. PURPOSE: The purpose of this study was to compare behavioral aspects of sensory gating in normal and tinnitus participants to search for the reason why some tinnitus participants habituate to their tinnitus but some others do not. RESEARCH DESIGN: This investigation was an observational case-control study. STUDY SAMPLE: There were 60 tinnitus participants who were categorized into two tinnitus groups (30 compensated tinnitus participants and 30 decompensated tinnitus participants) based on the complaint of tinnitus annoyance, visual analog scale (VAS) for tinnitus loudness, annoyance, and awareness, scores on Tinnitus Questionnaire (TQ), and Tinnitus Handicap Inventory (THI). Also, there were 30 normal hearing participants without tinnitus as the normal control group. DATA COLLECTION AND ANALYSIS: Sensory Gating Inventory (SGI), TQ, THI, and VAS was obtained from all participants. THI, TQ, VAS, and SGI total scores and their factors were compared among the groups. Correlations between SGI scores with THI, TQ, and VAS score were calculated. RESULTS: The results showed that SGI total score and the scores of its four factors were significantly higher in decompensated tinnitus participants compared with compensated tinnitus participants and normal controls. Also, there was a positive correlation between SGI perceptual modulation factor and TQ emotional distress factor and with the VAS for loudness in decompensated tinnitus group. CONCLUSIONS: These results suggested that tinnitus associated with behavioral aspects of sensory gating and decompensated tinnitus may be a result of deficient sensory gating.

Correlation Analysis of the Tinnitus Handicap Inventory and Distress Network in Chronic Tinnitus: An EEG Study.

INTRODUCTION: Tinnitus is a common disorder with a considerable amount of distress that affects the patient's daily life. No objective tools were approved for measuring tinnitus distress. It can be estimated only by subjective scales and questionnaires, albeit, the Electroencephalography (EEG) studies have reported some alterations regarding tinnitus distress network. This study aimed to investigate the correlation between Tinnitus Handicap Inventory (THI) and the recorded EEG data. METHODS: A total of 33 chronic tinnitus cases (9 females) with the mean age of 42.67 years were recruited. Their THI scores were collected, and a 3-minute EEG recorded with eye closed at resting-state. The correlation analysis was performed on THI scores and the current density in the selected Region of Interests (ROIs) concerning the distress network for the eight frequency bands. The patients grouped depending on the THI cutoff point of 56 into low and high THI groups, and then the groups were compared for source analysis and functional connectivity between ROIs using standardized low-resolution brain electromagnetic tomography. RESULTS: A significant positive correlation was seen between THI scores and the electrical activity in the Anterior Cingulate Cortex (ACC), the prefrontal cortex, and the parahippocampus for an alpha band (P<0.05) and in the ACC for beta (P<0.01). Source analysis showed significant differences with increased activity in the high THI group for alpha, beta and gamma bands. Functional connectivity was also elevated in the high THI group between the ROIs in alpha and beta bands. CONCLUSION: THI can be a useful tool for measuring tinnitus distress, and it has a high correlation with EEG data.