Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

Langguth, Berthold; Hund, Verena; Landgrebe, Michael; Schecklmann, Martin

doi:10.3389/fneur.2017.00440

Cited by 48 publications

(52 citation statements)

References 42 publications

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“…Assuming the severe tinnitus group is the most relevant group to focus tinnitus research on, we may use it to identify co-morbidities shared or distinct between individuals with hyperacusis, headache or TMJ problems. Unlike the previous studies using data from the TRI, where tinnitus with hyperacusis was found comorbid with vertigo, neck pain and TMJ [31], similar to tinnitus with headaches [53], our data indicates that this is not the case (Figure 1). Our results instead suggest that the general assumption that hyperacusis and headaches share similar somatosensory components is wrong.…”

Section: Discussioncontrasting

confidence: 94%

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: Discussioncontrasting

confidence: 94%

Association between Hyperacusis and Tinnitus

Cederroth

Lugo

Edvall

et al. 2020

JCM

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“…Patients with migraine have also an increased risk to develop cochlear disorders and in particular tinnitus (Hwang et al, 2018). Langguth et al (2017) described that the laterality and severity of primary headache and tinnitus are significantly related. The co-occurrence of tinnitus and other comorbidities like vertigo, hyperacusis, headache and depression could suggest the presence of a somatoform disorder.…”

Section: Discussionmentioning

confidence: 99%

Gender Comparison of Psychological Comorbidities in Tinnitus Patients – Results of a Cross-Sectional Study

et al. 2020

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Background: In the last decades, research focused on gender-related features in patients with tinnitus has often led to controversial results. The complex clinical picture of tinnitus patients often consists of an interdependent relationship between audiological symptoms and co-occurrent psychological disorders, which can complicate the diagnostic evaluation. Methods: Therefore, we studied 107 patients with tinnitus, investigating their psychological comorbidities in the light of gender differences. All patients were evaluated with ENT/audiological and psychological examination to consider presence/absence, type and gender distribution of psychopathological comorbidities. Patients completed questionnaires on tinnitus distress (Tinnitus Handicap Inventory, THI), anxiety (Beck Anxiety Inventory, BAI), depression (Beck Depression Inventory, BDI), metacognition (Metacognition Questionnaire-30, MCQ-30) and worry (Penn State Worry Questionnaire). The influence of gender on the relationship between tinnitus distress and psychological comorbidities was investigated with simple moderation analyses using the SPSS PROCESS macro. Results: The total sample included 65 male and 42 female patients (60.7 vs. 39.3%), matched for age and duration of tinnitus. We found no significant differences for tinnitus distress (THI total score, THI subscales) and MCQ-30 subscales, except for the control over thoughts, where men showed significantly higher scores than women (p = 0.045). Also, in our sample women showed significantly higher values for depression (BDI total score, p = 0.019), anxiety (BAI total score, p = 0.010) and worries (PSQW total score, p = 0.015). Moderation analyses revealed a significant influence of gender on the relationship of tinnitus distress with depression: higher scores of tinnitus distress were associated with significantly elevated levels of depression amongst men. No further gender influences could be observed in our sample. Discussion: In conclusion, our results indicate general gender differences for psychological comorbidities in tinnitus patients, with women reporting more depression, anxiety and worries. Men, on the other hand, showed a higher need to control their

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“…This may affect the composition of the endolymph (i.e., increase of the K + concentration) secreted by the stria vascularis and the dark cells, which may then lead to tinnitus and other disorders (hearing disorders and vertigo; Vass et al., 2001 ). Furthermore, this mechanism may also account for hearing and vestibular disorders that can accompany migraine ( Langguth, Hund, Landgrebe, & Schecklmann, 2017 ; Vass et al., 2001 ).…”

Section: A Pathophysiological Model Of Tttsmentioning

confidence: 99%

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

et al. 2018

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Acoustic shocks and traumas sometimes result in a cluster of debilitating symptoms, including tinnitus, hyperacusis, ear fullness and tension, dizziness, and pain in and outside the ear. The mechanisms underlying this large variety of symptoms remain elusive. In this article, we elaborate on the hypothesis that the tensor tympani muscle (TTM), the trigeminal nerve (TGN), and the trigeminal cervical complex (TCC) play a central role in generating these symptoms. We argue that TTM overuse (due to the acoustic shock), TTM overload (due to muscle tension), and ultimately, TTM injury (due to hypoxia and “energy crisis”) lead to inflammation, thereby activating the TGN, TCC, and cortex. The TCC is a crossroad structure integrating sensory inputs coming from the head–neck complex (including the middle ear) and projecting back to it. The multimodal integration of the TCC may then account for referred pain outside the ear when the middle ear is inflamed and activates the TGN. We believe that our model proposes a synthetic and explanatory framework to explain the phenomena occurring postacoustic shock and potentially also after other nonauditory causes. Indeed, due to the bidirectional properties of the TCC, musculoskeletal disorders in the region of the head–neck complex, including neck injury due to whiplash or temporomandibular disorders, may impact the middle ear, thereby leading to otic symptoms. This previously unavailable model type is experimentally testable and must be taken as a starting point for identifying the mechanisms responsible for this particular subtype of tinnitus and its associated symptoms.

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Tinnitus Patients with Comorbid Headaches: The Influence of Headache Type and Laterality on Tinnitus Characteristics

Cited by 48 publications

References 42 publications

Association between Hyperacusis and Tinnitus

Association between Hyperacusis and Tinnitus

Gender Comparison of Psychological Comorbidities in Tinnitus Patients – Results of a Cross-Sectional Study

An Integrative Model Accounting for the Symptom Cluster Triggered After an Acoustic Shock

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