Tinnitus: A Tingling Mystery to be Decrypted

Tinnitus-the perception of sound in the absence of an actual external sound-represents a symptom of an underlying condition rather than a single disease. Several theories have been proposed to explain the mechanisms underlying tinnitus. Tinnitus generators are theoretically located in the auditory pathway, and such generators and various mechanisms occurring in the peripheral auditory system have been explained in terms of spontaneous otoacoustic emissions, edge theory, and discordant theory. Those present in the central auditory system have been explained in terms of the dorsal cochlear nucleus, the auditory plasticity theory, the crosstalk theory, the somatosensory system, and the limbic and autonomic nervous systems. Treatments for tinnitus include pharmacotherapy, cognitive and behavioral therapy, sound therapy, music therapy, tinnitus retraining therapy, massage and stretching, and electrical suppression. This paper reviews the characteristics, causes, mechanisms, and treatments of tinnitus.

European Geriatric Medicine, 2015

The Lancet Neurology, 2013

Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus. With prevalence ranging from 10% to 15%, tinnitus is a common disorder. Many people habituate to the phantom sound, but tinnitus severely impairs quality of life of about 1-2% of all people. Tinnitus has traditionally been regarded as an otological disorder, but advances in neuroimaging methods and development of animal models have increasingly shifted the perspective towards its neuronal correlates. Increased neuronal fi ring rate, enhanced neuronal synchrony, and changes in the tonotopic organisation are recorded in central auditory pathways in reaction to deprived auditory input and represent-together with changes in non-auditory brain areas-the neuronal correlate of tinnitus. Assessment of patients includes a detailed case history, measurement of hearing function, quantifi cation of tinnitus severity, and identifi cation of causal factors, associated symptoms, and comorbidities. Most widely used treatments for tinnitus involve counselling, and best evidence is available for cognitive behavioural therapy. New pathophysiological insights have prompted the development of innovative brain-based treatment approaches to directly target the neuronal correlates of tinnitus. Lancet Neurol 2013; 12: 920-30 Department of Psychiatry and Psychotherapy (B Langguth MD, P M Kreuzer MD) and Interdisciplinary Tinnitus Center (B Langguth, P M Kreuzer, References 1 Krog NH, Engdahl B, Tambs K. The association between tinnitus and mental health in a general population sample: results from the HUNT Study. J Psychosom Res 2010; 69: 289-98. 2 Axelsson A, Ringdahl A. Tinnitus-a study of its prevalence and characteristics. Br J Audiol 1989; 23: 53-62. 3 Pilgram R. Tinnitus in der BRD. HNO aktuell 1999; 7: 261-65. 4 Shargorodsky J, Curhan GC, Farwell WR. Prevalence and characteristics of tinnitus among US adults. Am J Med 2010;

IIP, 2024

Understanding and Functioning of Tinnitus: Insights into Categorization, Reasons, and Evaluation** Tinnitus, the perception of noise in the absence of external stimuli, has intrigued both medical experts and scholars. This article delves into the etymology of tinnitus, exploring technical terms such as "Tinnitus aurium," "Acousma," and "Leudet tinnitus." Pioneers in this field, integrated Jack Vernon and Pawel J. The dispute extends to the neural mechanisms behind tinnitus, emphasizing the intricate relationship between the auditory, somatosensory, limbic and independent systems. The article details conditions similar to personal tinnitus, shedding light on otological, cardiovascular, metabolic, neurological and pharmacological components. An in-depth investigation of evaluation protocols, including comparison of pitch and loudness, provides insight into the clinical evaluation of tinnitus. The article then navigates through the intricate reasons for tinnitus, visually represented in a tree diagram. Psychological effects are catalogued in tables that describe the signs of emotional, interpersonal, and somatic distress associated with tinnitus. The multifaceted reasons for tinnitus are summarized in a comprehensive figure that shows a holistic perspective of the intricate network that contributes to this phenomenon. Moreover, this chapter discusses about the Tinnitus management employs diverse strategies, including advice, hearing aids, and innovative approaches like Neuromonics. Pharmacological options, noninvasive methods like Transcutaneous Vagus Nerve Stimulation, and alternative therapies contribute to a multifaceted approach.

2020

Bartels, H. (2008a). General conclusions, discussion and future perspectives. In H. Bartels (Ed.), Tinnitus: new insights into pathophysiology, diagnosis and treatment. (pp. 159-171). Groningen: Ponsen & Looijen b.v. Bartels, H. (2008b). General introduction and outline of the thesis. In H. Bartels (Ed.), Tinnitus: new insights into pathophysiology, diagnosis and treatment. (pp. 11-17). Groningen: Ponsen & Looijen b.v.

Progress in Brain Research, 2021

People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal. If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User Agreement:

2009

Seminars in Hearing, 2014

Tinnitus continues to challenge patients from all walks of life and clinicians from a variety of disciplines. The lack of an evidence base to support a specific treatment confounds efforts to provide consistent benefit to patients and in many instances creates in the patient the impression that nothing can be done to improve their situation. Part of the problem is that although patients rarely experience complete elimination of a tinnitus signal, they often experience relief when receiving effective counseling, specific coping strategies, and sound therapy. Although in most clinical activities the tinnitus remains (i.e., it is not cured), its influence may wane as the patient learns to manage their environment, activities, and ultimately their response to tinnitus. At the same time, several medical interventions target reduction of the tinnitus sound, an approach more consistent with what patients expect as a cure. Therefore, the majority of clinical activity directed at care for patients with tinnitus typically targets either elimination of the tinnitus sound (tinnitus treatment) or modification of the patient's response to the sound (tinnitus management). This review distinguishes and offers examples of both treatment and management programs employed clinically for patients with tinnitus.

Acta …, 2012

Tinnitus represents one of the most frequent symptoms observed in the general population in association with different pathologies, although often its etiology remains unclear. Objective of this work is to evidence the main aspects concerning epidemiology, causes, audiological characteristics and psychological consequences of tinnitus.

Journal of the Formosan Medical Association, 2016

Tinnitus is a phantom auditory perception that occurs in humans. Tinnitus, which is a distressing problem affecting many people around the world, is commonly referred to as ringing in the ears. No effective drug therapy is available for this elusive disease, although much research work into mechanism and possible treatment is underway. As yet, there are no Food and Drug Administration approved drugs available and the quest for a new treatment option for tinnitus focus on important challenges in tinnitus management. A number of options have been used to treat patients with tinnitus, but outcomes have been limited. A new, curative modality will provide a turning point in the management of tinnitus. The purpose of this review article is to discuss the pathophysiology, global burden, current treatment, and prevention of tinnitus, with future prospective studies in new drug therapy for this elusive condition.