Gap-induced pre-pulse inhibition of the acoustic startle (GPIAS) is a behavioural test for tinnitus in animals. It relies on a short gap in a continuous background noise which provides a cue to the loud startling stimulus which follows. As a result, gap conditions demonstrate an inhibition of the response to the startling stimulus compared to no-gap conditions. The disrupting effect of tinnitus on the normal GPIAS has been shown in a number of species, including in humans. Such disruption was originally thought to be caused by tinnitus ‘filling in’ the gap, but recent studies have challenged this explanation. Preliminary work in humans measuring the eye blink reflex showed gap detection deficits in tinnitus subjects, but the underlying mechanisms of this effect are unclear. The eye blink response has a relatively long latency (>40ms) and therefore is not a simple primary reflex, nor is it specifically related to the auditory system. In small rodents the acoustic startle is measured by the whole body response involving axial muscles but in larger animals like the guinea pig this response habituates very quickly. Thus here a variation of the GPIAS method is used in which the acoustic startle is measured in guinea pigs using the simple pinna reflex. This reflex has been used to provide evidence of tinnitus in guinea pigs and postulated that it might be possible to use a similar method to obtain objective evidence of tinnitus in humans. The post-auricular muscle reflex (PAMR) is the human analogue of the pinna reflex and may represent a metric for an objective tinnitus test. The PAMR is a short-latency (15-18ms) response that involves only two or three synapses in the brainstem and provides a much tighter link between auditory input and motor output than the eye blink reflex. However, gap-induced pre-pulse inhibition (PPI) of the PAMR has not previously been demonstrated. This question is one of the main objectives examined in this thesis, using measures taken in guinea pigs and in humans, with and without tinnitus. The work reports two feasibility experiments and two-hypothesis testing studies in which I have sought to optimise the stimulus parameters for maximising the magnitude of the PAMR, and reflects on the challenges of working at the first translational gap developing adequate animal models of human hearing-related problems.

Submitted by Viviane Lima da Cunha (viviane@biblioteca.ufpb.br) on 2016-01-26T14:21:45Z No. of bitstreams: 1 arquivototal.pdf: 1043037 bytes, checksum: 92788ad999f4b08f8e2b154fa22c70b0 (MD5) / Made available in DSpace on 2016-01-26T14:21:45Z (GMT). No. of bitstreams: 1 arquivototal.pdf: 1043037 bytes, checksum: 92788ad999f4b08f8e2b154fa22c70b0 (MD5) Previous issue date: 2015-04-28 / Tinnitus is the perception of sound in the absence of a sound source. Occurring between 10-15% of the world population still needs better understanding of its pathophysiology, clinical comorbidities and more effective treatments. To this end, a better standardization of the use of evaluation methods in researches is required. This study aims the choice of most appropriate and easier use and interpretation methods. Initially an article in the form of a systematic review was performed in order to establish which evaluation methods of tinnitus are currently being used by scientific works. The aim of their uses was also identified. The THI, the EVA and the acuphenometry were the most used methods in 24 articles reviewed. The evaluation of therapy for tinnitus was the most frequent verified goal. A second article was performed to carry out a comparative analysis of these three methods. It was the THI, EVA (bother) and acuphenometry (loudness and pitch) in 44 patients with chronic tinnitus. A positive correlation of moderate intensity between them was found, being stronger between THI and VAS. It is concluded that the three evaluated tests keep moderate relation to each other. this should be taken into account when comparing with each other the results of different studies. The results of THI and EVA are be more strongly compared. Other future studies with more patients and more homogeneous sample can bring more contribution to the topic. / O zumbido é a percepção de um som na ausência de uma fonte sonora. Ocorre entre 10-15% da população mundial. Há a necessidade de melhor padronização do uso dos métodos avaliativos nas pesquisas, permitindo assim melhores comparações dos seus resultados. Este estudo visa contribuir na escolha dos métodos mais adequados e de mais fácil uso e interpretação. Inicialmente realizou-se um artigo de revisão sistemática, a fim de observar os métodos avaliativos do zumbido mais utilizados e o objetivo dos mesmos. Nos 24 artigos de revista analisados, o THI, a EVA e a acufenometria foram os métodos mais utilizados. A avaliação de terapia para o zumbido foi o mais frequente objetivo verificado. Um segundo artigo foi elaborado para analisar comparativamente estes 3 métodos. Aplicou-se o THI, EVA (incômodo) e acufenometria (loudness e pitch), em 44 pacientes com zumbido crônico. Encontrou-se uma correlação positiva de moderada intensidade entre eles, sendo mais forte entre o THI e a EVA. Concluiu-se que os 3 métodos avaliados guardam relação moderada entre si, devendo isso ser levado em consideração quando se comparam seus resultados entre si. Os escores do THI e da EVA podem mais fortemente serem comparados.

The diploma thesis is dealing with the issue of tinnitus which is defined as the perception of sound within the human ear in the absence of corresponding external sound. The thesis describes classification, etiology, symptomatology, diagnosis and therapy of tinnitus. The focus lies particularly in the description of various therapeutic approaches. Empirical part of the thesis presents the case studies of 12 respondents with tinnitus. Using qualitative research methods, the answers received from German respondents from Hesse region are compared to the answers of respondents living in the Czech Republic. The research focuses on the tinnitus diagnose, cooperation with experts, possibilities of therapy and their results, ways of funding, satisfaction of respondents with the therapy and contribution of self-help group for people with tinnitus.

In research on tinnitus, it is recognised that various psychological factors play a role in whether an individual is negatively impacted by the symptoms of tinnitus. In this exploratory study, through the use of descriptive statistical analysis of the data obtained from the MCMI-III and 16PF5 of tinnitus sufferers, possible psychological constructs can be identified as being present in subjective tinnitus sufferers. Scarce research on tinnitus stemming from or being exacerbated by various psychological constructs is found in South Africa. Many studies exist outside of South Africa; however, the results of these studies need to be verified in terms of the South African population. The study used previously administered protocols of the MCMI-III and the 16PF5 of subjective tinnitus sufferers in order to explore the psychological constructs in the form of test scales using descriptive statistical analysis on the protocol data. By investigating possible psychological constructs present in a sample of individuals with subjective tinnitus, the aim is to be able to make recommendations on possible focus areas for future research. The results of the study suggest the most significant finding related to the global factors of the 16PF5 is that 84.6% of the participants can be classified as accommodating. None of the participants can be described as independent, extraverted or abstract. More than half of the participants can be described as deferential and shy. None of the participants measured as self-assured. On the MCMI-III very few significant elevations were present. On the Anxiety scale 38.5% of participants fell into the insignificant and significant categories respectively. This is the only result for the MCMI-III where the insignificant score is not the highest, and thus is a noteworthy finding. Keywords: Cognitive behavioural therapy; Millon Clinical Multiaxial Inventory-III; Psychological constructs; Sixteen Personality Factor Questionnaire; Tinnitus. / Mini Dissertation (MA)--University of Pretoria, 2017. / Psychology / MA / Unrestricted

BACKGROUND: The aim of this study was to evaluate distortion product otoacoustic emissions (DPOAEs) and extended high-frequency (EHF) thresholds in a control group and in patients with normal hearing sensitivity in the conventional frequency range and reporting unilateral tinnitus. MATERIAL/METHODS: Seventy patients were enrolled in the study: 47 patients with tinnitus in the left ear (Group 1) and 23 patients with tinnitus in the right ear (Group 2). The control group included 60 otologically normal subjects with no history of pathological tinnitus. Pure-tone thresholds were measured at all standard frequencies from 0.25 to 8 kHz, and at 10, 12.5, 14, and 16 kHz. The DPOAEs were measured in the frequency range from approximately 0.5 to 9 kHz using the primary tones presented at 65/55 dB SPL. RESULTS: The left ears of patients in Group 1 had higher median hearing thresholds than those in the control subjects at all 4 EHFs, and lower mean DPOAE levels than those in the controls for almost all primary frequencies, but significantly lower only in the 2-kHz region. Median hearing thresholds in the right ears of patients in Group 2 were higher than those in the right ears of the control subjects in the EHF range at 12.5, 14, and 16 kHz. The mean DPOAE levels in the right ears were lower in patients from Group 2 than those in the controls for the majority of primary frequencies, but only reached statistical significance in the 8-kHz region. CONCLUSIONS: Hearing thresholds in tinnitus ears with normal hearing sensitivity in the conventional range were higher in the EHF region than those in non-tinnitus control subjects, implying that cochlear damage in the basal region may result in the perception of tinnitus. In general, DPOAE levels in tinnitus ears were lower than those in ears of non-tinnitus subjects, suggesting that subclinical cochlear impairment in limited areas, which can be revealed by DPOAEs but not by conventional audiometry, may exist in tinnitus ears. For patients with tinnitus, DPOAE measures combined with behavioral EHF hearing thresholds may provide additional clinical information about the status of the peripheral hearing.

Aim of the study: To evaluate the influence of high frequency hearing loss (>8000 Hz) on distortion product otoacoustic emissions registered in the frequency range from 0,5 to 8 kHz. Material and methods: 280 ears with tinnitus and normal hearing (0.25–8 kHz) divided into 3 groups depending on the degree of high frequency hearing loss: group A – hearing threshold up to 20 dB for 10, 12.5, 14 and 16 kHz (68 ears); group B – hearing threshold 25–40 dB HLfor at least one of four EHfs (93 ears); group C – hearing threshold above 40 dB HL for at least one of four EHFs (119 ears). For each group mean audiogram and DP-gram were obtained and statistical analysis was used for comparison across these groups. Results: Mean DPOAE values in group C were significantly lower in comparison with group A for the frequency range 2–8 kHz, and in comparison with group B were significantly lower for the frequency range 4–8 kHz. Conclusions: High frequency hearing loss (above 8 kHz) has a relevant influence on distortion product otoacoustic emissions registered at frequencies below 8 kHz in tinnitus patients. The greater is hearing loss above 8 kHz, the lower is DPOAE value below 8 kHz.

Background: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. Aims: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. Methods: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer's only analysis were undertaken. Results: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. Conclusion: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention's effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this.

Objective: The primary aim of the study was to examine the automated linguistic analysis of the open-ended problem (PQ) and life-effects (LEQ) questionnaires to understand the psychological effects of tinnitus. Design: The study used a cross-sectional design. Participants completed online questionnaires which included demographic questions, several standardised patient-reported outcome measures (PROMs), and two open-ended questions focussing on PQ and LEQ related to tinnitus. The response to open-ended questions was analysed using the Linguistic Inquiry Word Count (LIWC) software to identify the frequency of text on various linguistic dimensions relevant to tinnitus. Study sample: 336 individuals with tinnitus. Results: The study results point to two broad findings. First, although PQ and LEQ have some similarities with PROMs (e.g. the linguistic dimension negative emotions having a weak positive correlation with anxiety and depression), no correlation with the number of dimensions suggests that the open-ended questions identify additional elements that are not captured in PROMs. Second, more linguistic dimensions from the PQ correlate with PROMs compared to LEQ suggesting that the current PROMs are problem-oriented. Conclusions: The study results support the idea that the use of open-ended questions in addition to PROMs may help optimise the efforts in examining the effects of chronic conditions such as tinnitus.

No description available.

FFifteen to thirty-five percent of the population in the United States experience tinnitus, a subjective "ringing in the ears". Up to 10% of tinnitus patients report their symptoms are severe and disabling. Tinnitus was induced in FBN rats using 116 dB (SPL) unilateral octave-band sound exposures centered at 16 kHz for one hour in an anesthetized preparation. Rats were assessed behaviorally by an operant conditioning paradigm as well as a gap detection method to verify the development of tinnitus. Both young (7 mos.) and aged (30 mos.) sound exposed rats showed significant elevated auditory brainstem-evoked response (ABR) thresholds for clix and all tested frequencies immediately after the sound exposure. Eighty days post-exposure, ABR thresholds for the young exposed rats were significantly close to the initial young control values while aged exposed rats showed residual thresholds shifts relative to aged controls. Sixteen weeks following sound exposure, young exposed rats showed significantly reduced gap detection at 24 and 32 kHz, suggestive of high frequency tinnitus. Aged exposed animals showed significant tinnitus-related behavioral changes near 10 kHz by both behavior methods. Message and protein levels of &alpha1-3 glycine receptor subunits (GlyRs), gephyrin, BDNF and its receptor TrkB were assessed in dorsal cochlear nucleus (DCN) fusiform cells 4 months post exposure utilizing quantitative in situ hybridization and immunocytochemistry. Young exposed rats showed significant decreases of GlyR &alpha1 protein at middle and high frequency regions in DCN unlike the contrasting increase of their message levels. Aged exposed rats showed higher &alpha1 subunit protein levels in the same high and middle DCN frequency regions. The GlyR anchoring protein, gephyrin, was significantly increased in both young and aged exposed rats, suggesting an intracellular receptor trafficking change following acoustic trauma. BDNF and TrkB were also increased over fusiform cells in both young and aged exposed rats. [3H] strychnine binding was used to evaluate DCN GlyR pharmacology and function following sound exposure. The age-related decrease in GlyR α1 protein was reflected in the significant age-related down-regulation of GlyR (Bmax). Tinnitus-related changes in GlyR &alpha1 protein level was reflected in the decline of the GlyR (Bmax) in young exposed rats and up-regulated GlyRs in aged exposed animals. The GlyRs in DCN of young exposed animals also demonstrated an increase in affinity, further suggesting a post-exposure receptor composition change. These findings suggest that both aging and/or sound exposure/tinnitus are associated with GlyR changes capable of altering alter the output of the DCN. Detailed characterization of these GlyR modifications could advance the development of novel selective drugs for tinnitus and age-related hearing loss.