Impact of Multiple Factors on the Degree of Tinnitus Distress

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Abstract

Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors.

Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history.

Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model.

Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.

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Tuning out the noise: limbic-auditory interactions in tinnitus.

Josef P. Rauschecker, Amber M. Leaver, Mark Mühlau (2010)

Tinnitus, the most common auditory disorder, affects about 40 million people in the United States alone, and its incidence is rising due to an aging population and increasing noise exposure. Although several approaches for the alleviation of tinnitus exist, there is as of yet no cure. The present article proposes a testable model for tinnitus that is grounded in recent findings from human imaging and focuses on brain areas in cortex, thalamus, and ventral striatum. Limbic and auditory brain areas are thought to interact at the thalamic level. While a tinnitus signal originates from lesion-induced plasticity of the auditory pathways, it can be tuned out by feedback connections from limbic regions, which block the tinnitus signal from reaching auditory cortex. If the limbic regions are compromised, this "noise-cancellation" mechanism breaks down, and chronic tinnitus results. Hopefully, this model will ultimately enable the development of effective treatment.

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Dysregulation of limbic and auditory networks in tinnitus.

Mark Chevillet, Amber M. Leaver, Josef P. Rauschecker … (2011)

Tinnitus is a common disorder characterized by ringing in the ear in the absence of sound. Converging evidence suggests that tinnitus pathophysiology involves damage to peripheral and/or central auditory pathways. However, whether auditory system dysfunction is sufficient to explain chronic tinnitus is unclear, especially in light of evidence implicating other networks, including the limbic system. Using functional magnetic resonance imaging and voxel-based morphometry, we assessed tinnitus-related functional and anatomical anomalies in auditory and limbic networks. Moderate hyperactivity was present in the primary and posterior auditory cortices of tinnitus patients. However, the nucleus accumbens exhibited the greatest degree of hyperactivity, specifically to sounds frequency-matched to patients' tinnitus. Complementary structural differences were identified in ventromedial prefrontal cortex, another limbic structure heavily connected to the nucleus accumbens. Furthermore, tinnitus-related anomalies were intercorrelated in the two limbic regions and between limbic and primary auditory areas, indicating the importance of auditory-limbic interactions in tinnitus. Copyright Â© 2011 Elsevier Inc. All rights reserved.

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The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples.

Herbert Fliege, Matthias Rose, Petra Arck … (2015)

The aim was to translate, revise, and standardize the Perceived Stress Questionnaire (PSQ) by Levenstein et al. (1993) in German. The instrument assesses subjectively experienced stress independent of a specific and objective occasion. Exploratory factor analyses and a revision of the scale content were carried out on a sample of 650 subjects (Psychosomatic Medicine patients, women after delivery, women after miscarriage, and students). Confirmatory analyses and examination of structural stability across subgroups were carried out on a second sample of 1,808 subjects (psychosomatic, tinnitus, inflammatory bowel disease patients, pregnant women, healthy adults) using linear structural equation modeling and multisample analyses. External validation included immunological measures in women who had suffered a miscarriage. Four factors (worries, tension, joy, demands) emerged, with 5 items each, as compared with the 30 items of the original PSQ. The factor structure was confirmed on the second sample. Multisample analyses yielded a fair structural stability across groups. Reliability values were satisfactory. Findings suggest that three scales represent internal stress reactions, whereas the scale "demands" relates to perceived external stressors. Significant and meaningful differences between groups indicate differential validity. A higher degree of certain immunological imbalances after miscarriage (presumably linked to pregnancy loss) was found in those women who had a higher stress score. Sensitivity to change was demonstrated in two different treatment samples. We propose the revised PSQ as a valid and economic tool for stress research. The overall score permits comparison with results from earlier studies using the original instrument.

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Author and article information

Contributors

Petra Brüggemann: URI : http://loop.frontiersin.org/people/307145/overview

Agnieszka J. Szczepek: URI : http://loop.frontiersin.org/people/34732/overview

Laurence McKenna: URI : http://loop.frontiersin.org/people/171244/overview

Heidi Olze: URI : http://loop.frontiersin.org/people/326376/overview

Birgit Mazurek: URI : http://loop.frontiersin.org/people/34723/overview

Journal

Journal ID (nlm-ta): Front Hum Neurosci

Journal ID (iso-abbrev): Front Hum Neurosci

Journal ID (publisher-id): Front. Hum. Neurosci.

Title: Frontiers in Human Neuroscience

Publisher: Frontiers Media S.A.

ISSN (Electronic): 1662-5161

Publication date (Electronic): 29 June 2016

Publication date Collection: 2016

Volume: 10

Electronic Location Identifier: 341

Affiliations

[1] ¹Tinnitus Center, Universitätsmedizin Berlin Berlin, Germany

[2] ²Department of Otorhinolaryngology, Universitätsmedizin Berlin Berlin, Germany

[3] ³Department of Internal Medicine and Psychosomatics, Universitätsmedizin Berlin Berlin, Germany

[4] ⁴Royal National Throat Nose and Ear Hospital, University College Hospitals London, UK

Author notes

Edited by: Srikantan S. Nagarajan, University of California, San Francisco, USA

Reviewed by: Dong-Hoon Lee, Johns Hopkins University School of Medicine, USA; Dawei Li, Duke University, USA

*Correspondence: Agnieszka J. Szczepek agnes.szczepek@ 123456charite.de ;

Birgit Mazurek birgit.mazurek@ 123456charite.de

†These authors have contributed equally to this work.

Article

DOI: 10.3389/fnhum.2016.00341

PMC ID: 4925660

PubMed ID: 27445776

SO-VID: 0378705d-25a1-4102-864c-284760696f0b

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 06 January 2016

Date accepted : 20 June 2016

Page count

Figures: 2, Tables: 3, Equations: 0, References: 72, Pages: 11, Words: 7736

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Impact of Multiple Factors on the Degree of Tinnitus Distress

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Most cited references 57

Tuning out the noise: limbic-auditory interactions in tinnitus.

Dysregulation of limbic and auditory networks in tinnitus.

The Perceived Stress Questionnaire (PSQ) reconsidered: validation and reference values from different clinical and healthy adult samples.

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Cited by 32

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