Tinnitus distress: a paradoxical attention to the sound?

Kandeepan, Sivayini; Maudoux, Audrey; Paula, Demetrius Ribeiro de; Zheng, Jing; Cabay, Jean-Evrard; Gómez, Francisco; Chronik, Blaine A.; Ridder, Dirk De; Vanneste, Sven; Soddu, Andrea

doi:10.1007/s00415-019-09390-1

Cited by 28 publications

(16 citation statements)

References 52 publications

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“…Theoretically, the premise of a dysfunctional top-down attention system provides a unifying framework for the interpretation of current results 9 , 34 . Non-auditory brain areas that have been consistently shown to be involved in tinnitus include the middle temporal and para-hippocampus, the precuneous and the dorsal attention network 7 , 35 . These brain regions, which are functionally connected to the auditory cortex, 36 are involved in regulating the focus of awareness and are important components of the top-down, executive control of attention 37 .…”

Section: Discussionmentioning

confidence: 99%

“…executive attention) and inhibit the voluntary division of attentional resources 37 . Moreover, a recent resting-state functional magnetic resonance imaging study reported that tinnitus distress is associated with modifications of functional connectivity within regions of the executive network as well as the salience and default mode networks, suggesting that tinnitus distress is inevitably linked to attention of the tinnitus sound 35 . Thus, these underlying mechanisms, if exploited clinically should focus on actively redirecting attention away from the tinnitus sound as well as the related distress.…”

Section: Discussionmentioning

confidence: 99%

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The potential interruptive effect of tinnitus-related distress on attention

Leong

Tchen

Robertson

et al. 2020

Sci Rep

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The mechanism through which tinnitus affects attention is unclear. This study examines whether distress mediates the relationship(s) between tinnitus and sustained, selective and executive attentions as well as response inhibition. Eighteen participants with tinnitus and fifteen controls completed the Counting Stroop, Vigilance and Stop Signal tasks. Tinnitus distress was assessed using the Tinnitus Questionnaire (TQ), severity of depressive mood states examined using the Beck Depression Inventory-II, and general distress assessed using the Hospital Anxiety and Depression Scale. Tinnitus participants had significantly slower reactions during the Vigilance task ( F = 4.86, p = .035), and incongruent trials of the Cognitive Counting task ( F = 3.45, p = .045) compared to controls. Tinnitus-related distress significantly mediated the effect of tinnitus in incongruent trials (TQ: Sobel test t = 1.73, p = .042) of the Cognitive Counting Task. Complaints of distress and concentration difficulties are common amongst tinnitus patients in clinical settings and these afflictions have been shown to negatively impact an individual’s quality of life. If confirmed in future studies, results suggest that distress may be an important factor in the causal mechanism between tinnitus and attention.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The potential interruptive effect of tinnitus-related distress on attention

Leong

Tchen

Robertson

et al. 2020

Sci Rep

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“…The majority of patients are able to get used to their tinnitus percept, however, in some patients the reaction to this novel sound (tinnitus) does not reduce over time. Low-distress and high-distress tinnitus have different neural representation, as can be observed in EEG and fMRI studies on resting brain activity [50][51][52][53][54][55][56][57][58][59][60], when, in the absence of any external stimuli, patients are asked to relax and not think of anything in particular [61,62]. Specifically, these studies show that troublesome tinnitus is associated with increased upper beta activity in the frontal area, whereas less bothersome tinnitus is associated with enhanced delta, alpha, and lower gamma (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) in the bilateral temporal area [58].…”

Section: Introductionmentioning

confidence: 90%

“…There is also evidence of a positive correlation between tinnitus-related distress and FC of the right superior temporal gyrus and the cerebellum, which might reflect a dysfunctional filtering of unpleasant sounds [ 55 ]. In a recent study on a large tinnitus patient group ( n = 135), highly bothersome tinnitus was associated with increased FC within the right executive control network encompassing the frontal and parietal regions, as well as greater connectivity between this network and the left executive control, default mode, auditory, and salience networks [ 57 ]. Since the executive control network is considered to be involved in various attentional processes (e.g.…”

Section: Introductionmentioning

confidence: 99%

Electrophysiological correlates of focused attention on low- and high-distressed tinnitus

et al. 2020

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Objectives The study aimed at determining the EEG correlates of concentration on either low or high-distressed tinnitus. Methods Sixty-seven patients (36 women, mean age = 50.34 ± 12.94 years) with chronic tinnitus were assigned to either a high (HD) or low (LD) tinnitus-related distress group based on THI results. All participants took part in the EEG study comprising two 3–4 min blocks of focusing on either tinnitus (Tinnitus Focus Condition, TFC) or the sensations from one’s own body (Body Focus Condition, BFC). The absolute power and current density of 8 frequency bands in 7 clusters were compared between conditions and groups. Results The most pronounced differences were found in the HD patients in the TFC, relative to the BFC, i.e. reduced power of frontally distributed low alpha (8–10 Hz) and posterior high alpha (10–12 Hz) as well as lower current density of 8–10 Hz rhythm over the right frontal/anterior cingulate cortex and higher middle beta (15–18 Hz) density in the precuneus. The HD, relative to LD patients, in both conditions, exhibited increased low beta (12–15 Hz) power over the left middle area and greater higher beta (15–25 Hz) power in the left posterior region. Conclusions The present study contrasted bioelectrical activity, acquired when concentrating on tinnitus with EEG data collected whilst patients focused on their body. Decreased alpha power and current density in the frontal/cingulate cortex when listening to bothersome tinnitus might reflect greater cortical arousal whereas increased beta power and density in the precuneus/posterior cingulate activity in this condition could be indicative for elevated tension or augmented cognitive/emotional processing of tinnitus sound. Enhanced beta rhythm in patients with high versus low tinnitus distress, observed independently of the study condition, may be due to greater self-focused attention or more active processing of sensations derived from the own body.

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“…In recent years, connectome analysis of the brain has gained increasing popularity, given its ability in unraveling the complex network organization, and various networkbased approaches such as graph-theoretical methods have been developed accordingly (Bullmore and Sporns, 2009;Lv et al, 2018). They have also been applied in tinnitus, which indeed helps find topological changes in their neural network properties (Mohan et al, 2016;Kandeepan et al, 2019). For instance, one study used a graph-theoretical approach to investigate the lagged phase functional connectivity in tinnitus using resting-state EEG and found that the topology of the patients' network had increased regularity in low-frequency carrier oscillations, whereas decreased regularity in the highfrequency oscillations, which suggested maladaptive top-down modulation in compensation for the auditory deafferentation (Mohan et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Altered Topological Patterns of Gray Matter Networks in Tinnitus: A Graph-Theoretical-Based Study

et al. 2020

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Objective: Tinnitus is a prevalent hearing disorder, which could have a devastating impact on a patient's life. Functional studies have revealed connectivity pattern changes in the tinnitus brains that suggested a change of network dynamics as well as topological organization. However, no studies have yet provided evidence for the topological network changes in the gray matter. In this research, we aim to use the graph-theoretical approach to investigate the changes of topology in the tinnitus brain using structural MRI data, which could provide insights into the underlying anatomical basis for the neural mechanism in generating phantom sounds. Methods:We collected 3D MRI images on 46 bilateral tinnitus patients and 46 age and gender-matched healthy controls. Brain networks were constructed with correlation matrices of the cortical thickness and subcortical volumes of 80 cortical/subcortical regions of interests. Global network properties were analyzed using local and global efficiency, clustering coefficient, and small-world coefficient, and regional network properties were evaluated using the betweenness coefficient for hub connectivity, and interregional correlations for edge properties. Between-group differences in cortical thickness and subcortical volumes were assessed using independent sample t-tests, and local efficiency, global efficiency, clustering coefficient, sigma, and interregional correlation were compared using non-parametric permutation tests.Results: Tinnitus was found to have increased global efficiency, local efficiency, and cluster coefficient, indicating generally heightened connectivity of the network. The small-world coefficient remained normal for tinnitus, indicating intact smallworldness. Betweenness centrality analysis showed that hubs in the amygdala and parahippocampus were only found for tinnitus but not controls. In contrast, hubs in the auditory cortex, insula, and thalamus were only found for controls but not tinnitus. Interregional correlation analysis further found in tinnitus enhanced connectivity between the auditory cortex and prefrontal lobe, and decreased connectivity of the insula with anterior cingulate gyrus and parahippocampus.

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Tinnitus distress: a paradoxical attention to the sound?

Cited by 28 publications

References 52 publications

The potential interruptive effect of tinnitus-related distress on attention

The potential interruptive effect of tinnitus-related distress on attention

Electrophysiological correlates of focused attention on low- and high-distressed tinnitus

Altered Topological Patterns of Gray Matter Networks in Tinnitus: A Graph-Theoretical-Based Study

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