Theoretical Tinnitus Multimodality Framework: A Neurofunctional Model

Ghodratitoostani, Iman; Delbem, Alexandre C. B.; Torabi-Nami, Mohammad; Makkiabadi, Bahador; Jalilvand, Hamid; Sánchez, Tanit Ganz

doi:10.18869/nrip.jamsat.2.1.181

Cited by 8 publications

(20 citation statements)

References 135 publications

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“…By considering previous functional and structural neuroimaging techniques, quantitative electroencephalography (qEEG), magnetoencephalography (MEG), and animal lesion studies, distinct brain areas have been implicated in tinnitus. These areas are as follows: the peripheral auditory system, the thalamus (reticular, medial geniculate and dorsal nuclei), auditory cortex, the limbic system (anterior cingulate cortex, amygdala), brainstem (raphe nucleus), subcallosal and paralimbic areas, which include basal ganglia (ventral palladium), striatum (nucleus accumbens), and vmPFC (Ghodratitoostani et al, 2016 ). Figure 3 provides a schematic tinnitus network overview of different brain areas as composed by integrating data from SPECT, PET, fMRI and MEG studies research in tinnitus.…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…This includes external-middle ears organs and cochlea, which receive acoustical pressure and sound as input and propagate electrical signals from auditory nerves (Ghodratitoostani et al, 2016 ).…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…Cochlear nucleus sends projection to SOC and inferior colliculus and receives input from, auditory nerve which encompasses cochlea (Kraus and Canlon, 2012 ; Ghodratitoostani et al, 2016 ). The SOC receives inputs from the cochlear nucleus and relays the signal to inferior colliculus (Kraus and Canlon, 2012 ; Ghodratitoostani et al, 2016 ). We have ignored the internal parts of the auditory midbrain/brainstem compartment to decrease the complexity of the model.…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…The serotonin originates in the raphe nucleus of the cerebellum. Its non-equilibrium can disturb normal sleep (Ghodratitoostani et al, 2016 ).…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…TRN receives excitatory inputs from MGN, auditory cortex, MDN, vmPFC and amygdale. It sends inhibitory projections to thalamus MGN and MDN (Ghodratitoostani et al, 2016 ).…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

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Theoretical Tinnitus Framework: A Neurofunctional Model

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Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the “sourceless” sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general personality biases toward evaluative conditioning combined with a cognitive-emotional negative appraisal of stimuli such as the case of people with present hypochondria. We acknowledge that the projected Neurofunctional Tinnitus Model does not cover all tinnitus variations and patients. To support our model, we present evidence from several studies using neuroimaging, electrophysiology, brain lesion, and behavioral techniques.

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Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…The serotonin originates in the raphe nucleus of the cerebellum. Its non-equilibrium can disturb normal sleep (Ghodratitoostani et al, 2016 ).…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

“…TRN receives excitatory inputs from MGN, auditory cortex, MDN, vmPFC and amygdale. It sends inhibitory projections to thalamus MGN and MDN (Ghodratitoostani et al, 2016 ).…”

Section: Fundamental Ideas and Postulations Of Neurofunctional Tinnitmentioning

confidence: 99%

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Theoretical Tinnitus Framework: A Neurofunctional Model

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Conceptual framework for tinnitus: a cognitive model in practice

Ghodratitoostani,

Vaziri,

Miranda Neto

et al. 2024

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Tinnitus is a conscious attended awareness perception of sourceless sound. Widespread theoretical and evidence-based neurofunctional and psychological models have tried to explain tinnitus-related distress considering the influence of psychological and cognitive factors. However, tinnitus models seem to be less focused on causality, thereby easily misleading interpretations. Also, they may be incapable of individualization. This study proposes a Conceptual Cognitive Framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of tinnitus and consequent cognitive-emotional disturbances. The current CCF for tinnitus relies on evaluative conditional learning and appraisal, generating negative valence (emotional value) and arousal (cognitive value) to annoyance, distress, and distorted perception. The suggested methodology is well-defined, reproducible, and accessible, which can help foster future high-quality clinical databases. Perceived tinnitus through the perpetual-learning process can always lead to annoyance, but only in the clinical stage directly cause annoyance. In the clinical stage, tinnitus perception can lead indirectly to distress only with experiencing annoyance either with (“$${\underset{{\mathcal {C}}}{{{\varvec{Ind-1}}}}}$$ I n d - 1 C ” = 1.87; 95% CI 1.18–2.72)[“1st indirect path in the Clinical stage model”: Tinnitus Loudness $$\rightarrow$$ → Attention Bias $$\rightarrow$$ → Cognitive-Emotional Value $$\rightarrow$$ → Annoyance $$\rightarrow$$ → Clinical Distress]or without (“$${\underset{{\mathcal {C}}}{{{\varvec{Ind-2}}}}}$$ I n d - 2 C ”= 2.03; 95% CI 1.02–3.32)[ “2nd indirect path in the Clinical stage model”: Tinnitus Loudness $$\rightarrow$$ → Annoyance $$\rightarrow$$ → Clinical Distress] the perpetual-learning process. Further real-life testing of the CCF is expected to express a meticulous, decision-supporting platform for cognitive rehabilitation and clinical interventions. Furthermore, the suggested methodology offers a reliable platform for CCF development in other cognitive impairments and supports the causal clinical data models. It may also enhance our knowledge of psychological disorders and complicated comorbidities by supporting the design of different rehabilitation interventions and comprehensive frameworks in line with the “preventive medicine” policy.

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Down-regulation of tinnitus negative valence through concurrent HD-tDCS and positive emotion induction: effects on neural and behavioral correlates

Vazirikangolya¹

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Regulação para baixo da valência negativa do zumbido através de HD-tDCS concomitante e indução de emoções positivas: efeitos sobre correlatos neurais e comportamentaisA percepção consciente do zumbido subjetivo, experimentado como uma sensação de toque ou zumbido na ausência de uma fonte externa, influencia cerca de 30% da população geral.Pacientes com transtorno clínico do zumbido experimentam uma situação altamente perturbadora e debilitante, tornando-a mais complicada do que simplesmente experimentar um som fantasma que os incita a procurar ajuda médica. Com sua alta prevalência e impacto potencialmente devastador no bem-estar psicológico de uma pessoa, a demanda por um tratamento clínico eficaz do zumbido é altamente priorizada. No entanto, atualmente não há cura universal especificamente adaptada para aliviar o sofrimento do zumbido. Nosso conhecimento do transtorno do zumbido ainda é limitado em termos de seus mecanismos neurais subjacentes e causas que exigem a necessidade de desenvolvimento de tratamentos, aliviando o sofrimento do zumbido. À luz das previsões acerca do modelo neurofuncional do zumbido e da aplicação da estimulação elétrica transcraniana, realizamos um estudo utilizando simultaneamente técnicas de estimulação transcraniana por corrente contínua de alta definição (HD-tDCS) e técnicas de indução de emoção positiva (PEI) por dez sessões consecutivas para regular a valência negativa do zumbido em pacientes com zumbido de angústia clínica. Recrutamos exames de ressonância magnética funcional em estado de repouso de doze pacientes antes e após a intervenção para examinar alterações de conectividade funcional em estado de repouso (rsFC) em regiões específicas de sementes. Os resultados mostraram rsFC reduzido no pós entre as regiões de atenção e processamento de emoção como se segue: 1) amígdala bilateral e lóbulo parietal superior esquerdo (SPL), 2) amígdala esquerda e SPL direito, 3) córtex pré-frontal dorsolateral bilateral (dlPFC) e pré-genual anterior bilateral córtex cingulado (pgACC), 4) dlPFC esquerdo e pgACC bilateral. Além disso, os escores do tinnitus handicap inventory foram significativamente menores no pós-intervenção em comparação com o pré-intervenção. Conclusão: HD-tDCS concomitante com PEI podem ser eficazes na redução da valência negativa do zumbido, aliviando assim o desconforto do zumbido.

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Theoretical Tinnitus Multimodality Framework: A Neurofunctional Model

Cited by 8 publications

References 135 publications

Theoretical Tinnitus Framework: A Neurofunctional Model

Theoretical Tinnitus Framework: A Neurofunctional Model

Conceptual framework for tinnitus: a cognitive model in practice

Down-regulation of tinnitus negative valence through concurrent HD-tDCS and positive emotion induction: effects on neural and behavioral correlates

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