Alterations in auditory brain stem response distinguish occasional and constant tinnitus

Abstract

BACKGROUND.The heterogeneity of tinnitus is thought to underlie the lack of objective diagnostic measures. METHODS:Longitudinal data from 20,349 participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort from 2008 to 2018 was used to understand the dynamics of transition between occasional and constant tinnitus. The second part of the study included electrophysiological data from 405 participants of the Swedish Tinnitus Outreach Project (STOP) cohort. RESULTS:We determined that with increasing frequency of the occasional perception of selfreported tinnitus, the odds of reporting constant tinnitus after 2 years increases from 5 for previous tinnitus (sometimes) to 30 for previous tinnitus (often). When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603, suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater.Auditory brainstem responses (ABRs) from subjects reporting non-tinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared to occasional tinnitus or non-tinnitus. The ABR from occasional tinnitus was indistinguishable from that of the non-tinnitus controls. CONCLUSIONS:Our results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.

Using coding and non-coding rare variants to target candidate genes in patients with severe tinnitus

“…As tinnitus is a subjective percept, it has traditionally been assessed by means of questionnaires 44 . Such findings, together with emerging evidence of additional electrophysiological 45 and neuroimaging signatures for tinnitus 46 – 48 suggest that objective diagnostic methods for the assessment of tinnitus are underway and may improve patient selection. Third, despite the known impact of sex on tinnitus severity 49 , 50 and the increased genetic liability in women with severe tinnitus 5 , our study was insufficiently powered to perform a sex-stratified analysis.…”

Development of a Prognostic Nomogram for Modified Tinnitus Relieving Sound Therapy for Subjective Tinnitus

“…5 It may be constant or intermittent and can be accompanied by other symptoms such as HL, dizziness, and hyperacusis. 6,7 Tinnitus can have a significant impact on quality of life (QoL), leading to sleep disturbances, difficulty concentrating, anxiety, and depression. 8 In some cases, tinnitus may be a sign of more severe underlying conditions such as acoustic neuroma or Meniere's disease.…”

“…Tinnitus is characterized by a ringing, buzzing, humming, or hissing sound in the ears or head, which can vary in pitch and loudness 5 . It may be constant or intermittent and can be accompanied by other symptoms such as HL, dizziness, and hyperacusis 6,7 . Tinnitus can have a significant impact on quality of life (QoL), leading to sleep disturbances, difficulty concentrating, anxiety, and depression 8 .…”

Low Evidence for Tinnitus Risk Factors: A Systematic Review and Meta-analysis

“…Whereas in medically assessed tinnitus, there is an increased likelihood of tinnitus being more severe than in self-reported tinnitus; there is a large degree of uncertainty in both cases whether tinnitus was perceived occasionally or constant. Indeed, Edvall et al [ 66 ] recently reported using longitudinal data that the more often occasional tinnitus is perceived, the more likely it will become constant and that constant tinnitus increases the odds of tinnitus becoming permanent. In this study, given the highly dynamic transitions of tinnitus states in individuals with occasional tinnitus, a decision was taken not to use a Cox regression model, and instead rely on generalized estimating equation (GEE) to circumvent these issues (Cederroth, personal communication).…”