An Adaptation Level Theory of Tinnitus Audibility

Up to Date on Tinnitus, 2011

Abstract Tinnitus may be linked to aberrant, attention-related processes.1 Reducing tinnitus annoyance may involve decreasing tinnitus’ attention-capturing properties. A broad overview is presented, to introduce the fields of attention and auditory attention toward understanding how they may contribute to tinnitus or be capitalized upon toward tinnitus remediation. A study based in the context of auditory attention and attention is presented, investigating the effect of performing attention tasks on tinnitus; toward linking attention theory with practical, tinnitus treatment.2 Results showed selective attention domain tests showed better control-group performance than the tinnitus-group for 2, focused attention tasks (p = 0.06 and p = 0.02). No significant difference was noted between tinnitus and control groups for divided attention tasks. Analysis of Comprehensive Attention Battery™ (CAB™) 3 and Tinnitus Handicap Questionnaire4 scores showed evidence (p = 0.06) for greater tinnitus handicap; hindering selective attention task execution. Findings support the hypothesis that bothersome tinnitus and underlying, aberrant central processes contribute to tinnitus perception and disrupt selective attention processes. Tinnitus questionnaire scores may be predicative, indicating less selective attention resources available to tinnitus sufferers, explaining poorer performance. Attention training for tinnitus sufferers may address such deficits. A follow-up study comparing tinnitus sufferers and controls to determine if repeat administration of an attention battery may confound results, showed practice effects are a concern.

Audiology and Neurotology, 2004

A current idea about the persistence of tinnitus is that fixation of this phantom auditory perception in the central auditory system may be influenced by attention to it. The present study investigated the mechanisms of involuntary attention and analysed performance in categorising sounds in tinnitus, simulated-tinnitus and control subjects. The sounds were presented in one ear and were preceded by presentation of frequent and deviant stimuli in the other ear. The results showed classical attention capture by deviant stimuli. In addition, the unilateral tinnitus subjects responded more accurately in the tinnitus ear than in the non-tinnitus ear. In contrast, the 'simulated-tinnitus' group showed no difference in the results between the ear where the tinnitus simulation was presented and the opposite ear. These findings suggest a difficulty in attention directing when the attention location coincides with the tinnitus ear and provides evidence for an attention focus on the tinnitus ear.

Frontiers in Aging Neuroscience

PLoS ONE, 2013

The diagnosis of tinnitus relies on self-report. Psychoacoustic measurements of tinnitus pitch and loudness are essential for assessing claims and discriminating true from false ones. For this reason, the quantification of tinnitus remains a challenging research goal. We aimed to: (1) assess the precision of a new tinnitus likeness rating procedure with a continuous-pitch presentation method, controlling for music training, and (2) test whether tinnitus psychoacoustic measurements have the sensitivity and specificity required to detect people faking tinnitus. Musicians and non-musicians with tinnitus, as well as simulated malingerers without tinnitus, were tested. Most were retested several weeks later. Tinnitus pitch matching was first assessed using the likeness rating method: pure tones from 0.25 to 16 kHz were presented randomly to participants, who had to rate the likeness of each tone to their tinnitus, and to adjust its level from 0 to 100 dB SPL. Tinnitus pitch matching was then assessed with a continuous-pitch method: participants had to match the pitch of their tinnitus to an external tone by moving their finger across a touchsensitive strip, which generated a continuous pure tone from 0.5 to 20 kHz in 1-Hz steps. The predominant tinnitus pitch was consistent across both methods for both musicians and non-musicians, although musicians displayed better external tone pitch matching abilities. Simulated malingerers rated loudness much higher than did the other groups with a high degree of specificity (94.4%) and were unreliable in loudness (not pitch) matching from one session to the other. Retest data showed similar pitch matching responses for both methods for all participants. In conclusion, tinnitus pitch and loudness reliably correspond to the tinnitus percept, and psychoacoustic loudness matches are sensitive and specific to the presence of tinnitus.

Diagnostic Pathology, 2013

Background: This study investigates the usefulness and effectiveness of a new way of tinnitus screening and diagnosing. The authors believe that in order to arrive at relevant diagnostic information, select the tinnitus treatment and quantitatively substantiate its effects, the measurement of the Tinnitus psychoacoustic parameters should be made an inherent part of the Tinnitus therapy. Methods: For this purpose the multimedia-based sound synthesizer has been proposed for testing tinnitus and the results obtained this way are compared with the outcome of the audiometer-based Wilcoxon test. The method has been verified with 14 patients suffering from tinnitus. Results: The experiments reveal capabilities, limitations, advantages and disadvantages of both methods. The synthesizer enables the patient to estimate his/her tinnitus more than twice as fast as the audiometer and makes the information on the tinnitus character perception more accurate. The analysis of the Wilcoxon test results shows that there are statistically important differences between the two tests. Conclusions: Patients using the synthesizer operate the software application themselves and thus get more involved in testing. Moreover, they do not concentrate on describing verbally their tinnitus, which could be difficult for some of them. As a result, the test outcome is closer to the perceived tinnitus. However, the more complex the description of the perceived tinnitus, the harder it is to determine the sound parameters of the patient's perception. It also takes more time regardless of the method.

The International Tinnitus Journal, 2014

Tinnitus is the perception of a sound without an external source. It can affect auditory perception abilities in individuals with normal hearing sensitivity. Purpose: The aim of the study was to determine the effect of tinnitus on psychoacoustic abilities in individuals with normal hearing sensitivity. Materials and Methods: The study was conducted on twenty subjects with tinnitus and twenty subjects without tinnitus. Tinnitus group was again divided into mild and moderate tinnitus based on the tinnitus handicap inventory. Data Collection and Analysis: Differential limen of intensity, differential limen of frequency, gap detection test, modulation detection thresholds were done through the mlp toolbox in Matlab and speech in noise test was done with the help of Quick SIN in Kannada. Results: Results of the study showed that the clinical group performed poorly in all the tests except for differential limen of intensity. Conclusions: Tinnitus affects aspects of auditory perception like temporal resolution, speech perception in noise and frequency discrimination in individuals with normal hearing. This could be due to subtle changes in the central auditory system which is not reflected in the pure tone audiogram.

European Archives of Oto-rhino-laryngology

We aim to assess the correlation between audiometric data, and psychotic and acoustic measures associated with subjective tinnitus (ST) and to clarify the importance of the psychological process in determining the degree of subjective annoyance and disability due to tinnitus. Fifty-four patients experiencing unilateral ST were allocated for the study. Acoustic assessment of patients including LDL (loudness discomfort levels), MML (minimum masking level) and RI (residual inhibition) was performed. Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI) and Visual Analog Scale (VAS) tests were performed for the psychological aspects of subjective annoyance. RI was positive in 23 patients with 13 frequency-matched stimuli at 8,000 Hz. Masking treatment response was successful in 16 RI-positive patients. Mean and standard deviation (SD) of THI scores were 38.77 ± 23.63. Ten patients (%18.51) with tinnitus had ≥17 points score, which was significant for BDI. Mean and SD were 5.01 ± 2.31 for VAS-1 scores (severity of tinnitus), 7.98 ± 2.79 for VAS-2 (frequency and duration of tinnitus), 5.77 ± 2.72 for VAS-3 (discomfort level), 3.56 ± 3.30 for VAS-4 (attention deficit) and 3.31 ± 3.31 for VAS-5 (sleep disorders). A significant correlation was found between the tinnitus duration time, age, gender and THI scores (P P > 0.05). RI might be largely frequency dependent and was found as an indicator for the masking treatment response. We did not notice statistically significant correlations between audiometric data and THI and BDI. There were correlations between with VAS and LDL and with MML and RI. VAS was simpler and easier for the assessment of ST. We should consider the psychological aspects of ST and assess it as a symptom separately with acoustic and psychotic tests.

Tinnitus is a conscious attended awareness perception of sourceless sound. Widespread theoretical and evidence-based neurofunctional and psychological models have tried to explain tinnitus-related distress considering the influence of psychological and cognitive factors. However, tinnitus models seem to be less focused on causality, thereby easily misleading interpretations. Also, they may be incapable of individualization. This study proposes a Conceptual Cognitive Framework (CCF) providing insight into cognitive mechanisms involved in the predisposition, precipitation, and perpetuation of tinnitus and consequent cognitive-emotional disturbances. The current CCF for tinnitus relies on evaluative conditional learning and appraisal, generating negative valence (emotional value) and arousal (cognitive value) to annoyance, distress, and distorted perception. The suggested methodology is well-defined, reproducible, and accessible, which can help foster future high-quality clinical datab...

Auris Nasus Larynx, 2011

Objectives: Tinnitus can be accompanied by depression, anxiety, insomnia, problems with auditory perception and poor general and mental health. This work was designed to evaluate the cognitive and psychological status in tinnitus patients using different subjective and objective measures. Methods: This work included 40 patients complaining of tinnitus without any vestibular complaints. Those patients were compared with 40 healthy age and sex matched controls. All subjects were evaluated through: basic audiologic evaluation, electrophysiological test (P300), oculomotor tests (smooth-pursuit, optokinetic, gaze and saccadic eye movements) and psychological evaluation (Hamilton depression and anxiety scales, Mini Mental Status Examination and Trail making tests). Results: Patients with tinnitus showed abnormalities at both electrophysiological and psychological levels when compared with normal subjects. Conclusion: This study provides evidences that different pathological mechanisms are involved in tinnitus generation which are more extensive than we thought.