Tinnitus Overview

Abstract

Tinnitus affects more than 10% of the population and can be a severe condition in ∼0.5% of people. Although it is related to diseases of the auditory system in the majority of cases, involvement of nonauditory structures in the brain is an important pathophysiological mechanism in patients with severe tinnitus, who often also present with sleep difficulties, mood disturbances, and cognitive dysfunction. Comprehensive evaluation of a patient with tinnitus often requires application of evaluation tools beyond audiological tests. When managing patients with chronic tinnitus and no obvious treatable underlying conditions, employment of a combination of sound treatments, habituation therapies, psychological intervention, and pharmacological agents is often needed to minimize the impact of tinnitus on patients and to improve their functionality and quality of life. Future research on tinnitus, with appropriate designs and improved measurement tools, may help us better understand tinnitus and facilitate development of novel and effective treatments.

Keywords

Tinnitus - epidemiology - pathophysiology - neurophysiology - evaluation - research

• References

• 1 Heller AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am 2003; 36 (2) 239-248
• 2 Galazyuk AV, Wenstrup JJ, Hamid MA. Tinnitus and underlying brain mechanisms. Curr Opin Otolaryngol Head Neck Surg 2012; 20 (5) 409-415
• 3 Chan Y. Tinnitus: etiology, classification, characteristics, and treatment. Discov Med 2009; 8 (42) 133-136
• 4 Brunger K. Managing tinnitus. J Fam Health Care 2008; 18 (2) 47-48
• 5 McFerran DJ, Phillips JS. Tinnitus. J Laryngol Otol 2007; 121 (3) 201-208
• 6 Ahmad N, Seidman M. Tinnitus in the older adult: epidemiology, pathophysiology and treatment options. Drugs Aging 2004; 21 (5) 297-305
• 7 Ursick J, Staecker H. An overview of animal models of tinnitus. B-ENT 2007; 3 (Suppl. 07) 23-25
• 8 Tranter RM, Graham JR. A review of the otological aspects of whiplash injury. J Forensic Leg Med 2009; 16 (2) 53-55
• 9 Meikle MB, Creedon TA, Griest SE. 2004. ) Tinnitus Archive, 2nd ed. Available at: http://www.tinnitusarchive.org/dataSets/1/ . Accessed on August 31, 2013
• 10 Langguth B. A review of tinnitus symptoms beyond “ringing in the ears”: a call to action. Curr Med Res Opin 2011; 27 (8) 1635-1643
• 11 Savastano M, Marioni G, de Filippis C. Tinnitus in children without hearing impairment. Int J Pediatr Otorhinolaryngol 2009; 73 (Suppl. 01) S13-S15
• 12 Wallhäusser-Franke E, Schredl M, Delb W. Tinnitus and insomnia: is hyperarousal the common denominator?. Sleep Med Rev 2013; 17 (1) 65-74
• 13 Lanting CP, de Kleine E, van Dijk P. Neural activity underlying tinnitus generation: results from PET and fMRI. Hear Res 2009; 255 (1–2) 1-13
• 14 Kaltenbach JA. Tinnitus: models and mechanisms. Hear Res 2011; 276 (1–2) 52-60
• 15 Wang H, Brozoski TJ, Caspary DM. Inhibitory neurotransmission in animal models of tinnitus: maladaptive plasticity. Hear Res 2011; 279 (1–2) 111-117
• 16 Eggermont JJ. Role of auditory cortex in noise- and drug-induced tinnitus. Am J Audiol 2008; 17 (2) S162-S169
• 17 Zenner HP, Pfister M, Birbaumer N. Tinnitus sensitization: sensory and psychophysiological aspects of a new pathway of acquired centralization of chronic tinnitus. Otol Neurotol 2006; 27 (8) 1054-1063
• 18 Shore SE. Plasticity of somatosensory inputs to the cochlear nucleus—implications for tinnitus. Hear Res 2011; 281 (1–2) 38-46
• 19 Baizer JS, Manohar S, Paolone NA, Weinstock N, Salvi RJ. Understanding tinnitus: the dorsal cochlear nucleus, organization and plasticity. Brain Res 2012; 1485: 40-53
• 20 Tzounopoulos T. Mechanisms of synaptic plasticity in the dorsal cochlear nucleus: plasticity-induced changes that could underlie tinnitus. Am J Audiol 2008; 17 (2) S170-S175
• 21 Dehmel S, Cui YL, Shore SE. Cross-modal interactions of auditory and somatic inputs in the brainstem and midbrain and their imbalance in tinnitus and deafness. Am J Audiol 2008; 17 (2) S193-S209
• 22 Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. Tinnitus and depression. World J Biol Psychiatry 2011; 12 (7) 489-500
• 23 Gerken GM. Central tinnitus and lateral inhibition: an auditory brainstem model. Hear Res 1996; 97 (1–2) 75-83
• 24 Cacace AT. Expanding the biological basis of tinnitus: crossmodal origins and the role of neuroplasticity. Hear Res 2003; 175 (1–2) 112-132
• 25 Møller AR. Pathophysiology of tinnitus. Otolaryngol Clin North Am 2003; 36 (2) 249-266 , v–vi
• 26 Kraus KS, Canlon B. Neuronal connectivity and interactions between the auditory and limbic systems. Effects of noise and tinnitus. Hear Res 2012; 288 (1–2) 34-46
• 27 Hallam RS. Manual of the Tinnitus Questionnaire. The Psychological Corporation. London, UK: Brace & Co.; 1996
• 28 Newman CW, Jacobson GP, Spitzer JB. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg 1996; 122 (2) 143-148
• 29 Newman CW, Sandridge SA, Jacobson GP. Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome. J Am Acad Audiol 1998; 9 (2) 153-160
• 30 Wilson PH, Henry J, Bowen M, Haralambous G. Tinnitus reaction questionnaire: psychometric properties of a measure of distress associated with tinnitus. J Speech Hear Res 1991; 34 (1) 197-201
• 31 Kuk FK, Tyler RS, Russell D, Jordan H. The psychometric properties of a tinnitus handicap questionnaire. Ear Hear 1990; 11 (6) 434-445
• 32 Meikle MB. Methods for evaluation of tinnitus relief procedures. In: Aran JM, , ed. Tinnitus 91. Proc. IV Internat Tinnitus Seminar. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam, The Netherlands: Kugler; 1992: 555-562
• 33 Meikle MB, Griest SE, Stewart BJ, Press LS. Measuring the negative impact of tinnitus: a brief severity index. In: Ryan A, , ed. Midwinter Meeting: Association for Research in Otolaryngology. Des Moines, IA: Association for Research in Otolaryngology; 1995. 167.
• 34 Meikle MB, Henry JA, Griest SE , et al. The tinnitus functional index: development of a new clinical measure for chronic, intrusive tinnitus. Ear Hear 2012; 33 (2) 153-176
• 35 Folmer RL, Griest SE, Martin WH. Chronic tinnitus as phantom auditory pain. Otolaryngol Head Neck Surg 2001; 124 (4) 394-400
• 36 Langenbach M, Olderog M, Michel O, Albus C, Köhle K. Psychosocial and personality predictors of tinnitus-related distress. Gen Hosp Psychiatry 2005; 27 (1) 73-77
• 37 Kaldo-Sandström V, Larsen HC, Andersson G. Internet-based cognitive-behavioral self-help treatment of tinnitus: clinical effectiveness and predictors of outcome. Am J Audiol 2004; 13 (2) 185-192
• 38 Zöger S, Svedlund J, Holgers KM. The Hospital Anxiety and Depression Scale (HAD) as a screening instrument in tinnitus evaluation. Int J Audiol 2004; 43 (8) 458-464
• 39 Lee SY, Kim JH, Hong SH, Lee DS. Roles of cognitive characteristics in tinnitus patients. J Korean Med Sci 2004; 19 (6) 864-869
• 40 Robinson SK, McQuaid JR, Viirre ES , et al. Relationship of tinnitus questionnaires to depressive symptoms, quality of well-being, and internal focus. Int Tinnitus J 2003; 9 (2) 97-103
• 41 Andersson G, Eriksson J, Lundh LG, Lyttkens L. Tinnitus and cognitive interference: a stroop paradigm study. J Speech Lang Hear Res 2000; 43 (5) 1168-1173
• 42 Andersson G, Kaldo-Sandström V, Ström L, Strömgren T. Internet administration of the Hospital Anxiety and Depression Scale in a sample of tinnitus patients. J Psychosom Res 2003; 55 (3) 259-262
• 43 Hiller W, Goebel G, Rief W. Reliability of self-rated tinnitus distress and association with psychological symptom patterns. Br J Clin Psychol 1994; 33 (Pt 2): 231-239
• 44 Sullivan MD, Katon W, Dobie R, Sakai C, Russo J, Harrop-Griffiths J. Disabling tinnitus. Association with affective disorder. Gen Hosp Psychiatry 1988; 10 (4) 285-291
• 45 Harrop-Griffiths J, Katon W, Dobie R, Sakai C, Russo J. Chronic tinnitus: association with psychiatric diagnoses. J Psychosom Res 1987; 31 (5) 613-621
• 46 Vernon J, Schleuning A. Tinnitus: a new management. Laryngoscope 1978; 88 (3) 413-419
• 47 Henry JA, Schechter MA, Nagler SM, Fausti SA. Comparison of tinnitus masking and tinnitus retraining therapy. J Am Acad Audiol 2002; 13 (10) 559-581
• 48 Jastreboff PJ, Hazell JW. A neurophysiological approach to tinnitus: clinical implications. Br J Audiol 1993; 27 (1) 7-17
• 49 Henry JA, Jastreboff MM, Jastreboff PJ, Schechter MA, Fausti SA. Assessment of patients for treatment with tinnitus retraining therapy. J Am Acad Audiol 2002; 13 (10) 523-544
• 50 Sweetow RW. Cognitive aspects of tinnitus patient management. Ear Hear 1986; 7 (6) 390-396
• 51 Henry JL, Wilson PH. The Psychological Management of Chronic Tinnitus. A Cognitive-Behavioral Approach. Boston, MA: Allyn & Bacon; 2001
• 52 Dobie RA. Depression and tinnitus. Otolaryngol Clin North Am 2003; 36 (2) 383-388
• 53 Johnson RM, Brummett R, Schleuning A. Use of alprazolam for relief of tinnitus. A double-blind study. Arch Otolaryngol Head Neck Surg 1993; 119 (8) 842-845
• 54 Drew S, Davies E. Effectiveness of Ginkgo biloba in treating tinnitus: double blind, placebo controlled trial. BMJ 2001; 322 (7278) 73
• 55 Husain FT. Neural network models of tinnitus. Prog Brain Res 2007; 166: 125-140
• 56 Dohrmann K, Weisz N, Schlee W, Hartmann T, Elbert T. Neurofeedback for treating tinnitus. Prog Brain Res 2007; 166: 473-485
• 57 Viirre ES. Quantitative electroencephalography for tinnitus—a means for data collection, analysis, and translation. Int Tinnitus J 2009; 15 (2) 149-153
• 58 Pall ML, Bedient SA. The NO/ONOO- cycle as the etiological mechanism of tinnitus. Int Tinnitus J 2007; 13 (2) 99-104
• 59 Puel JL, Guitton MJ. Salicylate-induced tinnitus: molecular mechanisms and modulation by anxiety. Prog Brain Res 2007; 166: 141-146
• 60 Puel JL. Cochlear NMDA receptor blockade prevents salicylate-induced tinnitus. B-ENT 2007; 3 (7) (Suppl. 07) 19-22
• 61 Seidman MD, Standring RT, Dornhoffer JL. Tinnitus: current understanding and contemporary management. Curr Opin Otolaryngol Head Neck Surg 2010; 18 (5) 363-368
• 62 Martin DM, Raphael Y. Gene-based diagnostic and treatment methods for tinnitus. Int Tinnitus J 2003; 9 (1) 3-10
• 63 Tyler R, Coelho C, Tao P , et al. Identifying tinnitus subgroups with cluster analysis. Am J Audiol 2008; 17 (2) S176-S184
• 64 Cacace AT, Silver SM. Applications of magnetic resonance spectroscopy to tinnitus research: initial data, current issues, and future perspectives. Prog Brain Res 2007; 166: 71-81
• 65 U.S. National Institutes of Health. Search for Clinical Trials—Tinnitus. http://clinicaltrials.gov/ct2/results?term=tinnitus . Accessed January 11, 2014
• 66 Langguth B, Salvi R, Elgoyhen AB. Emerging pharmacotherapy of tinnitus. Expert Opin Emerg Drugs 2009; 14 (4) 687-702
• 67 Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother 2012; 13 (17) 2495-2509
• 68 Baldo P, Doree C, Molin P, McFerran D, Cecco S. Antidepressants for patients with tinnitus. Cochrane Database Syst Rev 2012; 9: CD003853
• 69 Plewnia C. Brain stimulation: new vistas for the exploration and treatment of tinnitus. CNS Neurosci Ther 2011; 17 (5) 449-461
• 70 Roberts LE. Residual inhibition. Prog Brain Res 2007; 166: 487-495
• 71 Kleinjung T, Vielsmeier V, Landgrebe M, Hajak G, Langguth B. Transcranial magnetic stimulation: a new diagnostic and therapeutic tool for tinnitus patients. Int Tinnitus J 2008; 14 (2) 112-118
• 72 Vanneste S, DeRidder D. Noninvasive and invasive neuromodulation for the treatment of tinnitus: an overview. Neuromodulation 2012; 15 (4) 350-360