Exposing Pathological Sensory Predictions in Tinnitus Using Auditory Intensity Deviant Evoked Responses

Sedley, William; Alter, Kai; Gander, Phillip E.; Berger, Joel I.; Griffiths, Timothy D.

doi:10.1523/jneurosci.1308-19.2019

Cited by 41 publications

(43 citation statements)

References 53 publications

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“…The assessment of both tinnitus and hyperacusis is essential in this population. However, some potential measurements for assessment may be off-limits due to their loud nature (e.g., (f)MRI, auditory brainstem responses, mismatch negativity or gap pre-pulse inhibition of startle response) [55][56][57]. The potential use of hearing aids to reduce the starkness of tinnitus may be restricted by the presence of hyperacusis.…”

Section: Implications For Diagnosis and Treatmentmentioning

confidence: 99%

Association between Hyperacusis and Tinnitus

Cederroth

Lugo

Edvall

et al. 2020

JCM

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Many individuals with tinnitus report experiencing hyperacusis (enhanced sensitivity to sounds). However, estimates of the association between hyperacusis and tinnitus is lacking. Here, we investigate this relationship in a Swedish study. A total of 3645 participants (1984 with tinnitus and 1661 without tinnitus) were enrolled via LifeGene, a study from the general Swedish population, aged 18–90 years, and provided information on socio-demographic characteristics, as well as presence of hyperacusis and its severity. Tinnitus presence and severity were self-reported or assessed using the Tinnitus Handicap Inventory (THI). Phenotypes of tinnitus with (n = 1388) or without (n = 1044) hyperacusis were also compared. Of 1661 participants without tinnitus, 1098 (66.1%) were women and 563 were men (33.9%), and the mean (SD) age was 45.1 (12.9). Of 1984 participants with tinnitus, 1034 (52.1%) were women and 950 (47.9%) were men, and the mean (SD) age was 47.7 (14.0) years. Hyperacusis was associated with any tinnitus [Odds ratio (OR) 3.51, 95% confidence interval (CI) 2.99–4.13], self-reported severe tinnitus (OR 7.43, 95% CI 5.06–10.9), and THI ≥ 58 (OR 12.1, 95% CI 7.06–20.6). The association with THI ≥ 58 was greater with increasing severity of hyperacusis, the ORs being 8.15 (95% CI 4.68–14.2) for moderate and 77.4 (95% CI 35.0–171.3) for severe hyperacusis. No difference between sexes was observed in the association between hyperacusis and tinnitus. The occurrence of hyperacusis in severe tinnitus is as high as 80%, showing a very tight relationship. Discriminating the pathophysiological mechanisms between the two conditions in cases of severe tinnitus will be challenging, and optimized study designs are necessary to better understand the mechanisms behind the strong relationship between hyperacusis and tinnitus.

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Section: Implications For Diagnosis and Treatmentmentioning

confidence: 99%

Association between Hyperacusis and Tinnitus

Cederroth

Lugo

Edvall

et al. 2020

JCM

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“…Emerging data suggest that tinnitus may be due to the breakdown of sensory gating circuitry between the auditory system and non-auditory limbic regions (Rauschecker et al, 2010;De Ridder et al, 2014), such that altered activity due to cochlear damage reaches the cortex and ultimately leads to a conscious percept (Rauschecker et al, 2010(Rauschecker et al, , 2015De Ridder et al, 2014). Specifically it has been suggested when the increased spontaneous activity in tinnitus patients fails to be ignored and is recognized as sound, this leads to a resetting of auditory predictions allowing the tinnitus to continue (Sedley et al, 2016(Sedley et al, , 2019. Debate does exist to the cause of the increased spontaneous activity as some suggest an increased neural gain (Sheppard et al, 2020) whereas others argue the increased neural gain is underlying hyperacusis but not tinnitus (Brotherton et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Excitatory Repetitive Transcranial Magnetic Stimulation Over Prefrontal Cortex in a Guinea Pig Model Ameliorates Tinnitus

et al. 2021

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Tinnitus, a phantom auditory perception that can seriously affect quality of life, is generally triggered by cochlear trauma and associated with aberrant activity throughout the auditory pathways, often referred to as hyperactivity. Studies suggest that non-auditory structures, such as prefrontal cortex (PFC), may be involved in tinnitus generation, by affecting sensory gating in auditory thalamus, allowing hyperactivity to reach the cortex and lead to perception. Indeed, human studies have shown that repetitive transcranial magnetic stimulation (rTMS) of PFC can alleviate tinnitus. The current study investigated whether this therapeutic effect is achieved through inhibition of thalamic hyperactivity, comparing effects of two common clinical rTMS protocols with sham treatment, in a guinea pig tinnitus model. Animals underwent acoustic trauma and once tinnitus developed were treated with either intermittent theta burst stimulation (iTBS), 20 Hz rTMS, or sham rTMS (10 days, 10 min/day; weekdays only). Tinnitus was reassessed and extracellular recordings of spontaneous tonic and burst firing rates in auditory thalamus made. To verify effects in PFC, densities of neurons positive for calcium-binding proteins, calbindin and parvalbumin, were investigated using immunohistochemistry. Both rTMS protocols significantly reduced tinnitus compared to sham. However, spontaneous tonic firing decreased following 20 Hz stimulation and increased following iTBS in auditory thalamus. Burst rate was significantly different between 20 Hz and iTBS stimulation, and burst duration was increased only after 20 Hz treatment. Density of calbindin, but not parvalbumin positive neurons, was significantly increased in the most dorsal region of PFC indicating that rTMS directly affected PFC. Our results support the involvement of PFC in tinnitus modulation, and the therapeutic benefit of rTMS on PFC in treating tinnitus, but indicate this is not achieved solely by suppression of thalamic hyperactivity.

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“…The reduced ABR amplitudes suggested a central pathology at the subcortical level. Sedley et al [2016Sedley et al [ , 2019 proposed an interesting theory of tinnitus causation. In this theory, those authors suggested that the origin of the tinnitus signal is spontaneous firing in the ascending auditory pathway that is usually successfully ignored as irrelevant noise.…”

Section: Discussionmentioning

confidence: 99%

Binaural Interaction in Tinnitus Patients

Gabr

Lasheen

2020

Audiol Neurotol

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The auditory brainstem response (ABR) is a commonly used objective clinical measure for hearing evaluation. It can be also used to draw conclusions about the functioning of distinct stages of the auditory pathway including the binaural processing stages using the binaural interaction component (BIC) of the ABR. Objective: To study binaural processing in normal hearing subjects complaining of tinnitus. Methods: Sixty cases with bilateral normal peripheral hearing were included in this work, divided into 2 groups, i.e., group 1 (comprised of 30 healthy subjects representing the control group) and group 2 (comprised of 30 subjects with tinnitus representing the study group). All of the subjects were submitted to a basic audiological evaluation (including pure tone audiometry, speech audiometry, and immittancemetry) and ABR audiometry recorded in monaural and then binaural conditions. Results: In monaural recording, the tinnitus group showed significantly delayed latencies of waves I, III, and V in addition to significantly reduced wave I and III amplitudes when compared with the controls. Similar significant findings were found when binaural ABR responses were compared between both groups. Comparing BIC between both groups showed significant earlier BIC for latencies of waves I and V in the control group, while the BIC for amplitudes showed similar results in both groups. Conclusions: These finding suggest the presence of binaural processing deficits in tinnitus patients at different levels along the ascending auditory pathway.

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Exposing Pathological Sensory Predictions in Tinnitus Using Auditory Intensity Deviant Evoked Responses

Cited by 41 publications

References 53 publications

Association between Hyperacusis and Tinnitus

Association between Hyperacusis and Tinnitus

Excitatory Repetitive Transcranial Magnetic Stimulation Over Prefrontal Cortex in a Guinea Pig Model Ameliorates Tinnitus

Binaural Interaction in Tinnitus Patients

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