Marc Fagelson discusses how not just hearing loss, but tinnitus and hyperacusisand impairments to an individual’s ability to process music can adversely affect one’s quality of life, as well as their overall interactions from a societal and personal perspective. He explains the processes and anatomy underlying our music perception so that as clinicians we can be better advocates for our patients, thus enhancing their participation in music-related activities and preventing avoidance behaviours.

Subjective tinnitus is the perception of sound despite the absence of an external stimulus. This challenging sensory event affects millions of people per year. There currently is no cure for tinnitus, but there have been many different options researched to help patients manage its effects, albeit with varying efficacy. In a viral internet video, the Beating the Heavenly Drum maneuver, found in the Eastern practice of Qigong, was said to eliminate the perception of tinnitus for the participants. In this current study, the Beating the Heavenly Drum maneuver was compared to a sham maneuver and evaluated for effectiveness in relieving tinnitus. To be included in this study, participants had experienced tinnitus for at least 6 months and were not currently receiving other tinnitus care. Exclusionary criteria included a diagnosis of Post-Traumatic Stress Disorder, Traumatic Brain Injury, any neurological condition, whiplash, neck injury, or severe anxiety or depression, as determined by the Hospital Anxiety and Depression Scale. Participants completed a tinnitus case history form, Tinnitus Functional Index (TFI), Tinnitus Handicap Index (THI), and Visual Analog Scale (VAS) ranking the annoyance of their tinnitus. Participants were assigned to groups in an alternating fashion, with odd identifiers in Group 1 and even identifiers in Group 2. In Group 2, participants received the experimental maneuver (Beating the Heavenly Drum) during the first session and the sham maneuver (circles rubbed at the base of the skull) during the second. In Group 1, participants received a sham maneuver during the first session and the experimental maneuver during the second session. Within 48 hours after each session, participants completed the TFI, THI, and rated the annoyance of their tinnitus on a scale of 0 to 10 (keeping the same parameters from the VAS) via phone call. Of the twelve participants, two reported that the experimental maneuver, Qigong, was effective for tinnitus relief; while five reported the sham condition relieved their tinnitus. The remaining five participants stated that neither maneuver altered their tinnitus sensation. Across all participants, there were no significant difference scores on the THI, and only one significant difference score on the TFI. While participants reported some change in their tinnitus with either maneuver, none of the questionnaire measures corroborated their subjective report. Additionally, the sham maneuver was perceived as more effective than the experimental maneuver. The Qigong maneuver was not effective for tinnitus relief in this study. It should be noted that a limitation to this study is the small sample size. While this Qigong maneuver did not relieve tinnitus, there are other Internet tinnitus “cures” that should be investigated for their effectiveness in tinnitus relief. With the rise of the Internet and more patients searching for “quick fixes” to tinnitus, it is vital that clinicians provide appropriate education and research to best help patients manage their tinnitus.

Les acouphènes subjectifs chroniques concernent entre 10 et 15% de la population des pays industrialisés. Ils peuvent entraîner des modifications visibles du comportement, une détérioration très nette de la qualité de vie et dans des cas extrêmes des troubles nerveux post-traumatiques ou un état dépressif clinique (Berrios & Rose, 1992; Berrios et al, 1988) pouvant mener à des pensées suicidaires (Dobie, 2003). Les acouphènes peuvent provenir de différents relais des voies auditives périphériques ou centrales, cependant la grande majorité des acouphènes chroniques est liée à une perte auditive, presbyacousie, ou exposition au bruit. En effet, approximativement 90% des acouphènes chroniques sont liés à une perte auditive (Nicolas-Puel et al. 2006).Les acouphènes peuvent entraîner des changements importants dans le fonctionnement de certains réseaux cérébraux. Même en cas de lésion périphérique, l’anomalie perceptive qui en résulte peut à terme entraîner une modification de l’activité des structures cérébrales, par des phénomènes de plasticité. Malheureusement aujourd’hui compte tenu des divergences constatées aux niveaux des résultats obtenus par les différentes études effectuées chez les sujets acouphéniques, aucun consensus n’a pu être établi quant à l’établissement d’un modèle de la physiopathologie des acouphènes liés à une perte auditive.L’objectif général de ce travail est donc de mettre en place un protocole multimodal robuste afin de détecter des d’anomalies d’activation cérébrales chez des sujets souffrants d’acouphènes unilatéraux liés à une perte auditive par rapport à des sujets normo-entendants. Ce protocole comprend :- un paradigme permettant de réaliser des acquisitions fonctionnelles avec et sans acouphènes perçus, grâce à l’inhibition résiduelle des acouphènes,- un paradigme d’IRM fonctionnelle de repos,- un paradigme d’IRM fonctionnelle avec stimulation sonores,- une mesure du débit sanguin cérébral régional.Notre étude a permis de mettre en évidence l’implication du réseau du mode par défaut et notamment du précunéus dans la perception d’acouphènes. En effet, les résultats de notre étude montrent selon plusieurs modalités que ce réseau est hypo-activé chez les sujets présentant des acouphènes liés à une perte auditive. L’hypoactivité de ces régions pourrait être réduite de façon temporaire par le masquage des acouphènes par une stimulation sonore. De plus, l’inhibition résiduelle des acouphènes conduit à l’hyper-activations des régions du réseau du mode par défaut et notamment du précunéus. / Chronic subjective tinnitus concern 10 to 15% of the population in industrialized countries. They can cause visible changes in behavior, a sharp deterioration in the quality of life and in extreme cases of post-traumatic stress disorder or clinical depression (Berrios & Rose, 1992; Berrios et al, 1988) that could lead to suicidal thoughts (Dobie, 2003). Tinnitus may originate from different peripherical nodes or central auditory pathways, however the majority of chronic tinnitus is associated with hearing loss, presbycusis, or exposure to noise. Indeed, approximately 90% of chronic tinnitus is associated with hearing loss (Nicolas-Puel et al. 2006).Tinnitus can cause significant changes in the activity of brain networks. Even in case of peripherical lesions, the perceptual abnormality that results can ultimately lead to a change in the activity of brain structures, by plasticity phenomena. Unfortunately today given the discrepancies in the levels of results obtained by different studies in the affected persons, no consensus has been established regarding the establishment of a model of the pathophysiology of tinnitus associated with a loss hearing.The general objective of this work is to develop a robust multimodal protocol to detect cerebral activation abnormalities in subjects suffering from unilateral tinnitus associated with hearing loss compared to normal-hearing subjects. This protocol includes:- An acquisition paradigm with and without perceived tinnitus through the residual inhibition,- A resting state fMRI paradigm,- A sound evoked fMRI paradigm (with sound stimulation),- A measure of the regional cerebral blood flow.Our study has permitted to highlight the involvement of the default mode network including the precuneus in the perception of tinnitus. Indeed, the results of our study show as many terms as the network is hypo-activated in subjects with tinnitus associated with hearing loss. Hypoactivity of these areas could be reduced temporarily by masking the tinnitus by sound stimulation. In addition, residual inhibition of tinnitus leads to hyper-activation regions of the default mode of the network and in particular precuneus.

Untersucht wurden an 110 Patienten der Zusammenhang von Beschwerden im Mund-Kiefer-Gesichtsbereich und einem Tinnitus nach einem HWS-Schleudertrauma. Von den 110 gutachterlich untersuchen Patienten litten 82 an einem Tinnitus und 23 an Beschwerden im Mund-Kiefer-Gesichtsbereich. Die Daten ergaben eine mögliche Notwendigkeit der Untersuchung im Mund-Kiefer-Gesichtsbereich von Patienten nach einem HWS-Schleudertrauma und Tinnitus.

Universiẗat, Diss., 2006--Saarbrücken.

Heidelberg, University, Diss., 2008.

Hannover, Med. Hochsch., Diss., 2008.

Tübingen, Univ., Diss., 2008

Annotation: Master thesis "Psychosocial effects of tinnitus" is based on a general approach to this phenomenon as a disease of civilization. The symptom that tinnitus represents is underestimated in Czech Republic as well as treatment possibilities and the impact of tinnitus itself on person's life and his/hers surroundings. It can have devastating consequences. Coping with tinnitus can be very difficult if not impossible and in the end it can lead to suicidal attempt. Similar negative effects as on affected person can tinnitus have on his/hers closest surroundings which could not understand him/her.

No description available.