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Objective: To assess the secondary effect of hearing aids primarily fitted for presbyacusis and their impact on the quality of life of patients complaining of tinnitus. Design: Pilot case study Study sample: Adults with presbyacusis hearing loss were recruited in the Asker ENT clinic in Norway. Twenty consecutive patients were included in the pilot study. Methods: Twenty patients who were diagnosed with presbyacusis and additional tinnitus by the hearing tests (pure tone audiometry and speech audiometry) and medical interviews were recruited for the study. The level of their tinnitus distress was measured by the Tinnitus Handicap Inventory (THI) before and around 2 months after the hearing aid fitting. The results were afterwards statistically analyzed using paired sampled t-tests in Excel. Results: The data showed that hearing aids fitted primarily for presbyacusis can improve the quality of life in individuals suffering from tinnitus (p = 0.001504). In our sample, women showed higher levels of complaints about their tinnitus, compared to men. We found that age was an influencing factor on the outcomes of hearing aid usage for both presbyacusis and tinnitus, as people in this study before the age of 75 benefited less than patients above 75 (p = 0.005). All patients with moderate hearing loss in our sample showed significant improvement in their quality of life in regard to their tinnitus complaint, with a statistical value of p = 0.044. Also, patients with the lower levels of THI (slight and mild) were the groups who had the most clinically significant improvements in tinnitus distress. Finally, while analyzing the answers to all the THI questionnaire questions from the patients who did not show improvements in THI scores, a pattern of having trouble sleeping was detected as the most probable factor. Conclusions: The results showed that hearing aids fitted primarily for presbycusis can have a positive influence on the perception of tinnitus and their quality of life. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Methods: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. Results: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Conclusions: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis. Method: A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both accep- tance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70--80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hypera- cusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time. Results: In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during ther- apy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an SD of 7.9, p< .001), a decrease in sensitivity to daily sounds (mean [SD] change was -1.6 [2.1], p<.001),anda decrease in HQ (mean [SD] change was -9.8 [4.9], p< .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean (SD) change was 0.2 (4.3), p=.81. Conclusions: The evaluation of CSET indicated a decrease in short- and long- term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate whether Internet-based cognitive behavioural therapy intervention (ICBT) for individuals with tinnitus had an indirect effect on the third-party disability noticed by significant others (SOs). Methods: Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. Results: In total, 194 pairs of individuals with tinnitus and their SOs participated. The impact of third-party disability experienced by SOs was significantly reduced after individuals with tinnitus undertook the ICBT intervention (d = 0.41). This reduced SOs with severe difficulties from 52% to 35%. The remaining impact was mild for 30% and moderate for 35%. SOs with higher baseline difficulties and SOs who were partners (e.g., spouses) were less likely to notice indirect benefits from intervention undertaken by their family members. There was a moderate positive correlation between the post-intervention CTSOQs and the clinical variables of tinnitus severity and depression. Conclusions: Third-party disability may be reduced as an indirect effect of individuals with tinnitus undertaking ICBT. Including SOs of individuals with tinnitus within the rehabilitation process may add additional benefits, and such involvement should be encouraged.

Background: The term temporomandibular disorder (TMD) indicates a set of musculoskeletal conditions involving temporomandibular joint (TMJ), masticatory musculature, and related anatomical structures. Pain is the most common clinical manifestation of TMD, and the auditory system might be involved and affected, through tinnitus, dizziness, otalgia and ear fullness sensation. Objectives: The aim of this systematic review of randomised controlled trails (RCTs) was to evaluate the efficacy of rehabilitative approaches on otologic symptoms in patients with TMD. Methods: PubMed, Scopus and Web of Science were systematically searched from the inception until 8th October 2023 to identify RCTs presenting participants with a diagnosis of TMD associated with otologic signs and symptoms, rehabilitative approaches as interventions, and modification of the otological symptoms as outcome. Results: Out of 931 papers suitable for title/abstract screening, 627 articles were assessed for eligibility. Five studies were included reporting the efficacy of occlusal splint therapy, low‐level laser therapies, and physical therapy in patients diagnosed whit secondary otalgia or tinnitus associated with TMD. No RCTs evaluating other otologic symptoms, ear fullness, dizziness or vertigo were found. Conclusions: Results of this systematic review suggested that rehabilitative approaches might be effective in improving secondary otalgia and tinnitus in TMD patients. Thus, further RCTs with a higher level of evidence and more representative samples should be conducted to better understand the effects of TMD therapy on otologic complains. [ABSTRACT FROM AUTHOR]

Physicians will frequently encounter patients who report tinnitus. Tinnitus is a symptom whereby there is the perception of sound or sounds in the ear or head in the absence of an external source of sound. Most individuals experiencing tinnitus will have a neutral reaction to the percept, but in a small proportion of patients, tinnitus can be a debilitating symptom. When it causes burden, patients can be affected in multiple different facets of life, including impairment in sleep, hearing cognition and psychological and psychiatric well‐being, often resulting in high healthcare utilisation and societal costs. Hence, chronic, disabling tinnitus is a complex condition with multifactorial causes and multiple perpetuating biopsychosocial factors. Despite efforts to increase knowledge about its pathophysiology and research into treatments, little impact on real‐world clinical practice has been seen. There are no proven effective pharmacological treatments or complementary medicines specifically for chronic, disabling tinnitus. Despite this, there is a role for treating this condition through a multidisciplinary approach specifically targeting comorbid active psychiatric conditions, using hearing aids in appropriate clinical settings such as in those with a coassociated confirmed hearing loss, and specialised cognitive behavioural therapy for patients reporting bothersome tinnitus. Cognitive behavioural therapy remains the most valuable evidence‐based intervention in this regard. This narrative review attempts to summarise the current understanding in terms of pathophysiology, assessment and treatment of tinnitus for the internal physician who may encounter patients with disabling, chronic tinnitus. [ABSTRACT FROM AUTHOR]

Background and Aim: Tinnitus, characterized by the perception of sound without the presence of an external auditory stimulus, can profoundly affect the quality of life. This review study aims to assess the role of attention modulation in tinnitus management and investigate the neurophysiological mechanism of attention and its interaction with emotional processing in patients with tinnitus. Recent Findings: The studies revealed differences in the function of attentional networks among individuals with tinnitus. The studies showed the positive impact of various techniques for attention modulation through direct attention training or indirect mechanisms influencing attention. These techniques could modify attentional biases, enhance attention control, and alleviate tinnitus-related distress. Conclusion: The results of studies suggest the potential role of attention modulation in tinnitus management. By targeting attentional processes, researchers and clinicians can provide more effective interventions for individuals with tinnitus. However, there is a need for further investigation to optimize the intervention protocols by collaboration between researchers, clinicians, and individuals with tinnitus to achieve success in tinnitus management. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Hearing Science is the property of Institute of Sensory Organs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Tonic tensor tympani syndrome is found in a subset of tinnitus patients who experience intra-aural and peri-aural symptoms, in addition to their tinnitus, in the absence of clinically detectable pathology. As the syndrome has not been widely reported, this study aims to determine its prevalence and evaluate the effectiveness of current management. Methods: The tinnitus management clinic records of patients over the past six years were assessed to identify tonic tensor tympani syndrome patients and track their progress based on patient-reported Tinnitus Handicap Index scores. Patients with reversible ear pathology and temporomandibular joint disorder were excluded. Results: It was found that 13 per cent of the tinnitus management patients fulfilled the criteria for tonic tensor tympani syndrome and 94 per cent of those who returned for follow up showed an improvement in their Tinnitus Handicap Index grades. Conclusion: This study suggests that tonic tensor tympani syndrome is a significant problem among tinnitus patients and current tinnitus management strategies contribute effectively to helping such patients habituate to their symptoms. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive behavioral therapy (CBT) is a key intervention for management of misophonia, hyperacusis, and tinnitus. The aim of this study was to perform a preliminary analysis comparing the scores for self-report questionnaires before and after audiologist-delivered CBT via video calls for adults with misophonia, hyperacusis, or tinnitus or a combination of these. Method: This was a retrospective cross-sectional study. The data for 37 consecutive patients who received CBT for misophonia, hyperacusis, or tinnitus from a private institute in the United Kingdom were analyzed. Self-report questionnaires taken as part of routine care were as follows: 4C Questionnaires for tinnitus, hyperacusis, and misophonia (4C-T, 4C-H, and 4C-M, respectively), Tinnitus Impact Questionnaire (TIQ), Hyperacusis Impact Questionnaire (HIQ), Misophonia Impact Questionnaire (MIQ), Sound Sensitivity Symptoms Questionnaire (SSSQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T). Responses were also obtained to other questionnaires related to tinnitus, hyperacusis, insomnia, and anxiety and mood disorders. A linear mixed-model method was used to assess the changes in response to the questionnaires pretreatment and posttreatment. Results: Pretreatment--posttreatment comparisons showed that scores for the 4C-T, 4C-H, 4C-M, TIQ, HIQ, MIQ, SSSQ, and SAD-T improved, with effect sizes of 1.4, 1.2, 1.3, 2.6, 0.9, 0.7, 0.9, and 1.4, respectively (all p < .05). Conclusions: This preliminary analysis suggests that CBT via video calls may be effective in reducing the impact of misophonia, hyperacusis, and tinnitus. However, this study did not have a control group, so its results need to be interpreted with caution. [ABSTRACT FROM AUTHOR]

Purpose: So far, there have been no in-depth analyses of the connection between tinnitus sensation--level loudness and sleep quality. Accordingly, the present study was formulated as a mediation analysis focused on exploring this relationship. Method: Overall, 1,255 adults with consecutive subjective tinnitus who had sought outpatient treatment were enrolled in the present study. Results: Direct effects of tinnitus sensation--level loudness on sleep quality were not statistically significant (95% confidence intervals [CI] include zero), as measured by the point estimate, -0.016. However, the 95% CI for indirect effects did not include zero when assessing the Self-Rating Anxiety Scale (SAS) scores, the Self-Rating Depression Scale (SDS) scores, the visual analogue scale (VAS) scores, and self-reported tinnitus annoyance. Conclusions: These results suggest that tinnitus sensation--level loudness does not directly have an effect on sleep quality. However, it indirectly impacts sleep quality, mediated by SAS scores, SDS scores, the impact of tinnitus on life measured using the VAS, and self-reported tinnitus annoyance. As such, alleviating anxiety and depression in patients with tinnitus may result in reductions in their insomnia even if there is no reduction in tinnitus loudness. Importantly, otolaryngologists and other clinicians treating tinnitus should refer patients with tinnitus suffering from insomnia with comorbid depression or anxiety for appropriate psychological and/or psychiatric treatment. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore the potential for bimodal auditory and noninvasive electrical stimulation at the ears to alleviate tonal, somatic tinnitus that was investigated in a small preliminary trial (11 participants). Design: Auditory stimulation took the form of short "notched noise" bursts customized to each participant's tinnitus percept. Simultaneous pulsed electrical stimulation, intended to facilitate neuroplasticity, was delivered via hydrogel electrodes placed in opposite ears. Results: After a 6-week intervention period, average Tinnitus Functional Index (TFI) and Tinnitus Primary Function Questionnaire (TPFQ) scores were consistent with clinically meaningful improvements in the study population. Magnitudes and effect sizes of improvements in TFI and TPFQ are comparable to those reported in other recent bimodal therapy studies using different auditory and electrical stimulation parameters. Conclusions: Our results should be considered preliminary given the small sample size, lack of crossover data, and small subject pool. When considered alongside other recent bimodal therapy results, we do believe that there are therapeutic benefits of bimodal stimulation for tinnitus sufferers that have the potential to help some with tinnitus, with a variety of stimulation parameters and electrode placements. [ABSTRACT FROM AUTHOR]

The objective of this project was to establish cutoff scores on the tinnitus subscale of the Tinnitus and Hearing Survey (THS) using a large sample of United States service members (SM) with the end goal of guiding clinical referrals for tinnitus evaluation. A total of 4,589 SM undergoing annual audiometric surveillance were prospectively recruited to complete the THS tinnitus subscale (THS-T). A subset of 1,304 participants also completed the Tinnitus Functional Index (TFI). The original 5-point response scale of the THS (THS-T16) was modified to an 11-point scale (THS-T40) for some participants, to align with the response scale of the TFI. Age, sex, hearing loss, and self-reported tinnitus bother were also recorded. The THS-T was relatively insensitive to hearing, but self-reported bothersome tinnitus was significantly associated with the THS-T40 score. Receiver operating characteristic analysis was used to determine cutoff scores on the THS-T that aligned with recommended cutoff values for clinical intervention on the TFI. A cutoff of 9 on the THS-T40 aligns with a TFI cutoff of 25, indicating a patient may need intervention for tinnitus. A cutoff of 15 aligns with a TFI cutoff of 50, indicating that more aggressive intervention for tinnitus is warranted. The THS-T is a viable tool to identify patients with tinnitus complaints warranting clinical evaluation for use by hearing conservation programs and primary care clinics. The THS-T40 cutoff scores of 9 and 15 provide clinical reference points to guide referrals to audiology. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background and Aim: Evidence-Based Practice (EBP) is recommended by specialists for curing the patients more than other conventional treatments. In tinnitus management, Cognitive-Behavioral Therapy (CBT) is the only EBP-based method. Different factors, such as training, can affect the therapists' attitudes towards the use of these treatments. This study aimed to investigate the effect of a training program in CBT on Iranian audiologists' attitudes towards using CBT for tinnitus management. Methods: This descriptive-analytical study was conducted on 88 audiologists (including 65 females) with a mean age of 33±9.54 years, who were randomly divided into two groups of intervention (receiving CBT training) and control (no training). The data were collected by a researcher-made demographic/clinical questionnaire and the Persian version of the Evidence-Based Practice Attitude Scale-35 (EBPAS-P35), which was completed before and after training. Results: Comparison of the total score of EBPAS-P35 showed a significant difference in the intervention groups before and after training (p<0.001). In addition, all EBPAS-P35 subscales scores were significantly different before and after training in the intervention group (p<0.001). A positive significant correlation was observed between the total score of the EBPAS-P35 and two factors of age (r=0.38, p=0.009) and clinical experience (r=0.34, p=0.009). Conclusion: Training in CBT can improve the attitude of audiologists in Iran towards using CBT for tinnitus management in patients. The age and clinical experience can affect the attitude of audiologists toward using CBT. [ABSTRACT FROM AUTHOR]

The aim of this interventional non-randomised prospective controlled study was to assess the effectiveness of transcutaneous vagus nerve stimulation (tVNS) in human subjects with tinnitus. The ParasymTM tVNS device was paired with an auditory stimulation. Treatment and observations were conducted over 12 weeks. Audiological evaluation was performed. Responses from a set of questionnaires and quantitative electroencephalography (qEEG) before and after treatment were collected. Voice measurements were done to assess possible side-effects of tVNS. The study involved 29 adults who had chronic tinnitus (15 patients who underwent tVNS paired with sounds and a control group of 14 patients who did not). In general, subjective and objective measurements of tinnitus showed no improvement in the study group compared to the controls, although certain parameters as gauged by the questionnaires did statistically improve. The loudness and frequency of tinnitus remained the same in both groups. For the qEEG, activity in the theta band increased significantly in the study group compared to the control group. The tVNS was not effective in reducing tinnitus symptoms in our study group. However, changes in the theta band suggest there might be cortical effects that might, with sustained treatment, lead to improvements. [ABSTRACT FROM AUTHOR]

Objective: The objective of the present study was to compare the effectiveness of the selected tinnitus management protocols for the experimental groups, based on the scores obtained for psychosocial variables, quality of life and severity of tinnitus between the four experimental groups following the various treatment protocols. Method: Two-hundred adults ages ranged from 20 to 55 years (mean age 44.14, SD = 6.16) with mild-to-moderate sensorineural hearing loss without tinnitus were randomly selected for the control group, whereas the experimental group comprised 200 adults with mild-to-moderate sensorineural hearing loss with tinnitus without any other associated medical problems. Participants of both control and experimental groups underwent audiological tests and were administered the QoL questionnaire. The experimental group, in addition, was also administered the PSQ, TSI and THI questionnaire and psychoacoustic tests, i.e. measuring pitch, loudness and MML of tinnitus. Participants of experimental group were randomly assigned to 4 groups, each of 50 participants, and treatment was given as below: Group 1: only tinnitus masking sound was administered, Group 2: only counselling was given, Group 3: masking with counselling was given and Group 4: tinnitus masking combined with counselling and attention diversion task therapy was given. Result: The patients without tinnitus had significantly better quality of life in comparison to the patients with tinnitus. Pre-post comparisons of the treatment groups revealed that "masking + counselling + attention diversion task" group showed highly significant differences for psychosocial aspects, QoL and severity of tinnitus. Further, pairwise comparison based on differences in mean scores indicated significant impact of "masking + counselling + attention diversion task" as compared to both in combination like "masking + counselling" or independently, i.e. masking or counselling alone. Conclusion: It appears that an integrated package of intervention (masking + counselling + attention diversion task) might be preferable for providing immediate tinnitus relief by masking through reducing tinnitus loudness and pitch by altering neuroplasticity (tonotopicity); in the long term, it reduces tinnitus impact through positive thinking by counselling treatment and also diverts attention to daily activity through attention training. [ABSTRACT FROM AUTHOR]

Tinnitus acoustic therapy is defined as any use of sound where the intent is to alter the tinnitus perception and/or the reactions to tinnitus in a clinically beneficial way. The parameters of sound that may cause beneficial effects, however, are currently only theorized with limited data supporting their effectiveness. Residual inhibition is the temporary suppression or elimination of tinnitus that is usually observed following appropriate auditory stimulation. Our pilot study investigated the effects of a therapeutic acoustic stimulus that was individually customized to maximize residual inhibition of tinnitus and extend its duration to determine if there could be a sustained suppression of the tinnitus signal (i.e., reduced tinnitus loudness) and a reduction in the psychological and emotional reactions to tinnitus. This pilot study had two objectives: (1) to evaluate the feasibility of residual inhibition technique therapy through daily use of hearing aids and (2) to determine its effects by measuring reactionary changes in tinnitus with the Tinnitus Functional Index (TFI) and perceptual changes in tinnitus loudness. A total of 20 adults (14 males, 6 females; mean age: 58 years, SD = 12.88) with chronic tinnitus were enrolled in a four-visit study that consisted of the following: (1) baseline visit and initiation of the intervention period, (2) a 1-month postintervention visit, (3) 2-month postintervention visit and initiation of a wash-out period, and (4) a 3-month visit to assess the wash-out period and any lasting effects of the intervention. The intervention consisted of fitting bilateral hearing aids and creating an individualized residual inhibition stimulus that was streamed via Bluetooth from a smartphone application to the hearing aids. The participants were instructed to wear the hearing aids and stream the residual inhibition stimulus all waking hours for the 2-month intervention period. During the wash-out period, the participants were instructed to use the hearing aids for amplification, but the residual inhibition stimulus was discontinued. At all visits, the participants completed the TFI, study-specific self-report measures to document perceptions of tinnitus, a psychoacoustic test battery consisting of tinnitus loudness and pitch matching, and a residual inhibition test battery consisting of minimum masking and minimum residual inhibition levels. At the end of the trial, participants were interviewed about the study experience and acceptability of the residual inhibition treatment technique. Repeated measures analyses of variance (ANOVA) were conducted on the two main outcomes (TFI total score and tinnitus loudness) across all four visits. The results showed a significant main effect of visit on the TFI total score (p < 0.0001). Specifically, the results indicated a significant reduction in TFI total scores from baseline to the 1-month post-intervention period, which remained stable across the 2-month post-intervention period and the wash-out period. The ANOVA results did not show a significant change in tinnitus loudness as a function of visit (p = 0.480). The majority of the participants reported a positive experience with the study intervention at their exit interview. This pilot study demonstrated that residual inhibition as a sound therapy for tinnitus, specifically through the daily use of hearing aids, was feasible and acceptable to individuals suffering from chronic tinnitus. In addition, participants showed improvement in reactions to tinnitus as demonstrated by sustained reduction in TFI scores on average over the course of the treatment period. Achieving residual inhibition may also provide patients a feeling of control over their tinnitus, and this may have a synergistic effect in reducing the psychological and emotional distress associated with tinnitus. There was no significant reduction in long-term tinnitus loudness resulting from the residual inhibition treatment; however, the current pilot study may not have had sufficient power to detect such a change. The combination of tinnitus suppression and improved psychosocial/emotional reactions to tinnitus may result in a better quality of life in both the short and long term. A larger-scale study is needed to determine the validity of using residual inhibition as a clinical therapy option and to ascertain any effects on both perception and reactions to tinnitus. [ABSTRACT FROM AUTHOR]

To assess the psychometric properties of a new questionnaire evaluating patients' confidence in managing their tinnitus, the 4C tinnitus management questionnaire (4C), which was designed to be used in the process of cognitive behavioural therapy. Retrospective cross-sectional based on patient records. 99 consecutive patients who sought help for tinnitus (with or without hyperacusis) from an audiology clinic in the UK. Pure tone average (PTA) hearing thresholds, Uncomfortable Loudness Levels (ULLs), and responses to the 4C questionnaire, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T) questionnaire were gathered from the records of patients held at the audiology department. Cronbach's alpha for the 4C was 0.91, indicating high internal consistency. Exploratory factor analysis suggested a one-factor solution. Discriminant validity was supported by weak correlations between 4C scores and PTA across ears and ULLmin (the across-frequency average ULL for the ear with lower average ULL). Convergent validity was supported by moderate correlations between 4C scores and scores for the THI, HQ, and SAD-T. The 4C is an internally consistent questionnaire with high convergent and discriminant validity, which can be used to assess patients' confidence in managing their tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: Stimulation of the nonauditory nervous systems via the trigeminal nerve pathways can be a promising intervention for patients with tinnitus refractory to medical, conservative, and other treatment options. Therapy of the mandibular division of the trigeminal nerve through the auriculotemporal nerve has been reported as useful for patients with tinnitus. Objectives: The objective of our study was to study the long-term effects of pulsed radiofrequency of the auriculotemporal nerve in a large group of tinnitus sufferers and to find predictors for a prosperous result. Design: A monocenter backward-looking group study. Results: In a two-year period, 67 tinnitus patients had pulsed radiofrequency of the auriculotemporal nerve. Twenty- three (35%) reported reduced tinnitus loudness at the 7-week post-treatment follow-up. These patients valued the improvements as: 61% good, 22% moderate, and 17% slight. In 3% of patients, tinnitus magnified after the treatment. The odds of permanent tinnitus relief after successful pulsed radiofrequency of the auriculotemporal nerve are 68% at 1 year postoperative. In tinnitus patients without cervical pain 62% had an improvement following pulsed radiofrequency of the auriculotemporal nerve compared to 28% in those not fulfilling this criterion (p=0.024). Conclusions: Neuromodulation of the auriculotemporal nerve is an uncomplicated remedy for tinnitus. In a select group of tinnitus patients this treatment can a good relief of their tinnitus for a long period. Especially, tinnitus sufferers without cervical pain will benefit of this therapy [ABSTRACT FROM AUTHOR]

Background: Morningness-Eveningness Questionnaire (MEQ) has been used to assess working efficiency of an individual. The self-reporting MEQ is available in English language, and its applicability to Indian scenario is limited to educated/ English proficient individuals only. Since, majority in India still depend on the regional languages for communication, it is difficult to make live translation of the questionnaire while administration and results may also vary due to tester's language proficiency. The present study focused on adapting MEQ in Bengali language. Method: The English version of Morningness-Eveningness Questionnaire (MEQ) was a self-assessment questionnaire consisting of 19 questions to measure whether a person's peak alertness was in the morning, evening or in between. The translation of the questionnaire was done using forward-backward-translation method by six experts in Bengali language, and was content validated by thirty native Bengali speakers. The speakers were asked to rate the questions on a 5-point rating scale with 1 being very familiar and 5 being not at all familiar. All the questions rated as 1 or 2 were considered for the Bengali version of MEQ, while those rated as 3 or above were reframed and revalidated. Result: The Bengali version of the MEQ has good reliability (Cronbach's alpha 0.74). Item analysis revealed it as a good consistent scale for estimating the circadian type of the participants. Participants were classified into 5 Circadian types based on the cut-off scores. Majority of participants are intermediate type, followed by Morningness. Conclusion: The application of MEQ will help in management of tinnitus [ABSTRACT FROM AUTHOR]

Background: Chronic tinnitus during childhood/adolescence can be associated with impaired quality of life. Guidelines for managing paediatric tinnitus recommend assessment and interventions are often based upon the experiences and opinions of guideline committee members. Objective: To examine patient response tools used for the assessment and management of childhood tinnitus and how interventions had been evaluated. Design: A structured scoping review (i) identifying and critically appraising patient response measures (PRMs) assessing tinnitus in children/adolescents, and (ii) critically appraising evidence supporting reported interventions. Original papers written in English, involving paediatric participants ≤19 years, reporting (i) application of established PRMs to assess the experience of chronic tinnitus or (ii) application and evaluation of tinnitus interventions were included. Study sample: Papers written in English, identifying, or assessing the experience of chronic tinnitus (>3 months) as a primary complaint during childhood/adolescence in participants ≤19 years of age using a PRM and studies evaluating the application of non-pharmaceutical interventions for tinnitus in children/adolescents. Results: Six studies involving the assessment of tinnitus during childhood/adolescence using a PRM were identified and evaluated. Three established (previously named, described, and published) PRMs were applied of which none were developed specifically for children/adolescents. Three behavioural tinnitus interventions and three combination intervention strategies (coupling of psychological intervention with sound enrichment) had been applied to and evaluated within paediatric populations. Conclusions: Although clinicians are seeing children/adolescents with tinnitus, they are evaluating and managing children’s distress without appropriate PRMs, and little evidence exists to support clinical interventions. [ABSTRACT FROM AUTHOR]

Objective: Treatment for tinnitus focuses on supportive therapies. Long waiting times in the National Health Service encourage telemedicine options as an alternative. This study aimed to review the literature on telemedicine in the management of tinnitus and analyse its impact on the burden of tinnitus, long-term, anxiety, depression, insomnia and quality of life. Method: PubMed, Embase, Cochrane Library, Google Scholar, Scopus and Web of Science were searched. English randomised, controlled trials with adult participants suffering from tinnitus were included. A random effects model looking at standardised mean differences between intervention and control groups was utilised. Results: Eleven randomised, controlled trials were included. Nine studies looked at internet-based cognitive behavioural therapy. A z -value of 9.87 (p < 0.00001; I2 = 21 per cent) showed telemedicine approaches may be better at reducing tinnitus burden compared with passive controls. Conclusion: Telemedicine options have multiple benefits, but more research will be needed to conclusively say they are better than alternatives. [ABSTRACT FROM AUTHOR]

Background: Tinnitus is often difficult to treat because it is closely related to hearing loss, central nervous system disorders, and emotional problems. Although various drug treatments have been attempted for patients with tinnitus, there is no drug that has been clearly proven to be effective. On the other hand, there are some studies showing the effectiveness of various non-pharmacological treatments for tinnitus. Current Concepts: Tinnitus is classified into subjective and objective tinnitus. Representative non-pharmacological treatments for chronic subjective tinnitus include sound therapy, hearing aids or implantable hearing rehabilitation devices, tinnitus retraining therapy, neuropsychiatric therapy, and neuromodulatory treatment. When objective tinnitus does not improve with conservative treatment, surgical treatment can be selected depending on the cause. Acupuncture treatment for tinnitus is not recommended due to lack of evidence on its effectiveness and safety. Discussion and Conclusion: Despite many studies, the mechanisms of tinnitus remain unknown. Thus, it is difficult to cure the cause of tinnitus. Because subjective responses to tinnitus vary according to the patient's psychological state, a variety of approaches would be needed for the treatment of tinnitus. [ABSTRACT FROM AUTHOR]

Background and Aim: Tinnitus is a common disorder of the auditory system with a rich history dating back to ancient times. This review aims to provide a historical perspective on tinnitus in Traditional Persian Medicine (TPM) by summarizing the views of TPM scholars on its etiology and treatment. Methods: A qualitative research (summative content analysis) was conducted, utilizing TPM texts to identify the historical perspectives of TPM scholars on tinnitus. The analysis focused on their understanding of tinnitus, its causes, and recommended treatments. Results: In TPM, tinnitus was referred to as Tanin and Davi. The accumulation of phlegm and internal gases in the head or ears was considered as the main cause of tinnitus, with sudden movement or ripple of these vapors leading to auditory nerve stimulation and resulting in tinnitus. TPM scholars recommended addressing the sources of these vapors, such as gastrointestinal issues, and promoting humeral balance through temperament modification and the use of medicinal herbs for treatment. Conclusion: The TPM view on tinnitus was similar to the Greco-Roman understanding of the disease, with Persian scholars expanding on its details. TPM scholars believed in addressing the underlying causes of tinnitus and promoting humeral balance to alleviate symptoms. These historical perspectives provide insight into traditional medical systems and their approaches to the management of health conditions. [ABSTRACT FROM AUTHOR]

Objective: Current studies still find insufficient evidence to support the routine use of repetitive transcranial magnetic stimulation (rTMS) in tinnitus. This study aimed to assess response of tinnitus to treatment with rTMS and identify factors influencing the overall response. Methods: Between January 2016 and May 2017, 199 tinnitus patients were identified from a retrospective review of the electronic patient record at the Sun Yat-sen Memorial Hospital. All patients received rTMS treatment. Their clinicodemographic profile and outcomes, including the tinnitus handicap inventory (THI) and visual analog scale (VAS) scores, were extracted for analysis. Results: Regarding the THI results, 62.3% of all patients responded to rTMS. The analysis of the VAS score revealed an overall response rate of 66.3%. Both percentages were close to the patient's subjective assessment result, of 63.8%. Patients with tinnitus of less than 1-week duration had the highest response rate to rTMS in terms of either THI/VAS scores or the patient's subjective assessment of symptoms. Tinnitus duration was recognized as a factor influencing the overall response to the treatment. Conclusions: Repetitive transcranial magnetic stimulation treatment is effective for patients with tinnitus, but its efficacy is affected by tinnitus duration. Tinnitus patients are advised to attend for rTMS as soon as possible since therapy was more effective in those with a shorter duration of disease of less than 1 week. [ABSTRACT FROM AUTHOR]

Background Pulsatile tinnitus (PT) can cause significant detriment to quality of life and may herald a life- threatening condition. Endovascular evaluation is the gold standard for the definitive diagnosis of PT and facilitates treatment. However, no large study has determined the distribution of causes and treatment outcomes of PT evaluated endovascularly. Methods Consecutive patients evaluated at a multidisciplinary PT clinic from a single academic center were retrospectively reviewed. Patients with a suspected cerebrovascular etiology of PT based on clinical and/ or non- invasive imaging, who were evaluated by endovascular techniques (arteriography, venography, manometry, and/or balloon test occlusion), were included in analysis. Baseline clinical features and treatment results by final etiology of PT were compared. Results Of 552 patients referred for PT evaluation, 164 patients (29.7%) who underwent endovascular evaluation of PT were included. Mean (±SD) age at first clinical evaluation was 54.3±14.1 years (range 25--89 years); 111 patients (67.7%) were female. PT causes were 75.6% vascular and 24.4% non- vascular. Arteriovenous shunting lesions caused 20.7% of cases, venous etiologies 48.2%, and arterial etiologies 6.7%. Of patients with a shunting lesion treated with endovascular embolization, 96.9% had lasting significant improvement or resolution in PT. Endovascular stenting for venous sinus stenosis gave 84.6% of patients lasting improvement or resolution in PT. Arterial and nonvascular PT had fewer patients treated endovascularly and less improvement in PT symptoms. Conclusion PT with a suspected vascular cause is most often attributable to venous etiologies. PT caused by arteriovenous shunting or venous sinus stenosis may be effectively treated endovascularly. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Hearing Science is the property of Institute of Sensory Organs and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There has been a growing interest in the provision of smartphone- or internet-based tinnitus management. Studies have shown a positive impact of the smartphone applications on tinnitus symptoms. However, research into a relatively long-term effect of these applications on tinnitus relief as well as sound preferences has been sparse. This study explored the potential benefit of a tinnitus application in tinnitus relief over a period of six months. Methods: Twenty-two participants with subjective tinnitus were enrolled in the study. Puretone audiometry, tinnitus pitch and loudness matching, stress assessment, and questionnaires were completed at the initial visit and three and six months after the first visit. The participants used the tinnitus application for six months. Results: A significant reduction in subjective tinnitus loudness and annoyance and subjective stress level was observed. The Tinnitus Handicap Inventory scores were also significantly decreased after six months. The participants also reported high satisfaction with the application. Music and environmental sounds were the most preferred sound stimuli. Conclusions: The findings of this study demonstrate the potential benefit of the tinnitus application for tinnitus improvement. [ABSTRACT FROM AUTHOR]

Of the 21% of the US population with tinnitus, between 3% and 6% develop tinnitus distress, a sudden, traumatic, and severe emotional response to tinnitus. Cognitive behavioral therapy (CBT) is the most effective therapy for reducing the initial and secondary emotional stresses caused by tinnitus distress. The skills taught in CBT lead to habituation and desensitization, providing relief for the patient. This article describes tinnitus distress, CBT, and resources that clinicians can use immediately in their practices. [ABSTRACT FROM AUTHOR]

Purpose: Cognitive behavioral therapy (CBT) is a gold standard yet underutilized treatment for tinnitus, and tinnitus is especially highly prevalent among veterans. The aims of this study were twofold: to determine (a) if CBT for tinnitus is underutilized because participants find it less acceptable than other behavioral treatments for tinnitus and (b) if veterans and nonveterans rate behavioral treatments for tinnitus differently. Method: This cross-sectional study was conducted online with a sample of 277 adults in the United States who self-reported at least some level of bothersome tinnitus in the past week. The sample for this study consisted of 129 veterans and 148 nonveterans. Participants read descriptions of CBT, tinnitus retraining therapy (TRT), and mindfulness-based stress reduction (MBSR). For each treatment, presented to them in random order, they provided credibility, expectancy, and acceptability ratings. Results: Among 277 participants, 147 (53.07%) reporting gender were women, 216 (77.98%) reporting race/ethnicity were White, and 129 (46.57%) were veterans of any branch of the U.S. Armed Forces. Veteran ratings of credibility, expectancy, and acceptability were significantly lower than nonveteran ratings across treatments. There were differences in credibility, expectancy, and acceptability ratings across treatments, and post hoc testing revealed that TRT was consistently rated higher than CBT or MBSR. Conclusions: Despite strong research support, CBT was rated as less acceptable than a different, less widely empirically supported treatment. Veterans' ratings of acceptability were lower than those of nonveterans across all treatments. [ABSTRACT FROM AUTHOR]

There is currently increasing awareness of third-party disability, defined as the disability and functioning of a significant other (SO) due to a health condition of one of their family members. The effects of third-party disability on the SOs of individuals with tinnitus has received little attention. To address this knowledge gap, this study investigated third-party disability in the significant others (SOs) of individuals with tinnitus. A cross-sectional survey design included 194 pairs of individuals from the USA with tinnitus and their significant others. The SO sample completed the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. The CTSOQ showed that 34 (18%) of the SOs were mildly impacted, 59 (30%) were significantly impacted, and 101 (52%) were severely impact. The clinical variables of tinnitus severity, anxiety, and hyperacusis in individuals with tinnitus were the best predictors of the impact of tinnitus on SOs. These results show that the SOs of individuals with tinnitus may experience third-party disability. The effect of the individual’s tinnitus on their SO may be greater when the individual with tinnitus has a higher level of tinnitus severity, anxiety, and hyperacusis.

Introduction: The aim of this study was to evaluate the effectiveness of psychological and behavioural therapy in improving the quality of life of a person after tetraparesis with comorbidities: tinnitus, hypersensitivity. Case report: This case study concerns a 37-year-old patient with tinnitus, hypersensitivity to noise and chronic arm pain. The complaints occurred after a cervical spine reoperation. The reoperation was performed because of a C1 to TH 2 epi-dural haematoma and tetraplegia after the first surgery. The patient's quality of life and psychosocial functioning were perceived to be significantly impaired. A diagnostic audi-ological, psychological and neurophysiological assessment (QEEG study) was performed. The patient was qualified for HRV (heart rate variability) therapy and ACT (acceptance and commitment therapy). After the interactions, changes in brain bioelectrical activity in terms of Alpha-Beta1 and Beta2 waves and an improvement in psychosocial state were observed. Conclusions: The individualized, holistic approach applied to the patient's problems related to chronic complaints allowed an improvement in his quality of life. [ABSTRACT FROM AUTHOR]

Introduction: Audiological aliments like tinnitus and hyperacusis require multidisciplinary care. Therapy for these ailments should be available on a daily basis because of their troublesomeness in everyday functioning. To meet this challenge, specialists are looking for solutions in increasingly common access to the Internet and increasingly widespread use of mobile devices. Furthermore, smartphones have an application ecosystem that can be extended by new apps programmed for a particular health problem. Aim: Assessment of the scale and direction of creating and using mobile applications to diagnose and treat tinnitus and hyperacusis. Material and methods: Google Scholar and PubMed were searched for the 13 years 2010-2023. The search strategy used the following keywords: "tinnitus mobile applications", "hyperacusis mobile applications", "smartphone-based treatment tinnitus/hyperacusis", "smartphone-based diagnostic tinnitus/hyperacusis", "CBT apps", "sound and relaxation therapy apps", "tinnitus/hyperacusis therapy smart". The results of the review were catalogued and organized into themes. Results: Results were organized into the following themes: (1) ranking evaluation and analysis of applications supporting tinnitus/hyperacusis therapy existing in the Internet space, (2) applications supporting the diagnosis of tinnitus, with particular emphasis on the EMAs (Ecological Momentary Assesments), (3) applications supporting the therapy of tinnitus/hyperacusis (4) a look into the future - the use of sensors built-in or connected with mobile devices, the use of artificial intelligence (AI), bid data techonology. Conclusions: Smartphone-based applications with EMAs, sensors, possibility of using different wearable diagnostic devices can be helpful in better understanding the tinnitus variability and its causes. Combining the mobile applications with a mobile crowdsensing, central database and the support of AI techniques is a valuable source for developing scientific research. Clinically verified methods provided by mobile applications can become a part of the therapeutic process proposed by specialists and enable easy, cost-free and wide range of therapeutic support in dealing with tinnitus and hyperacusis. In tinnitus/hyperacusis therapy multifunctional smart devices managed by mobile applications such as: smart hearing aids, cochlear implants, hearables may be equally important. The development of mobile technologies and AI techniques will contribute to the creation of smart therapy platforms for tinnitus/hyperacusis in the future. [ABSTRACT FROM AUTHOR]

Vagus nerve stimulation (VNS) is a technology that provides electrical stimulation to the cervical vagus nerve and can be applied in the treatment of a wide variety of neuropsychiatric and systemic diseases. VNS exerts its effect by stimulating vagal afferent and efferent fibers, which project upward to the brainstem nuclei and the relayed circuits and downward to the internal organs to influence the autonomic, neuroendocrine, and neuroimmunology systems. The neuroimmunomodulation effect of VNS is mediated through the cholinergic anti-inflammatory pathway that regulates immune cells and decreases pro-inflammatory cytokines. Traditional and non-invasive VNS have Food and Drug Administration (FDA)-approved indications for patients with drug-refractory epilepsy, treatment-refractory major depressive disorders, and headaches. The number of clinical trials and translational studies that explore the therapeutic potentials and mechanisms of VNS is increasing. In this review, we first introduced the anatomical and physiological bases of the vagus nerve and the immunomodulating functions of VNS. We covered studies that investigated the mechanisms of VNS and its therapeutic implications for a spectrumof brain disorders and systemic diseases in the context of neuroimmunomodulation. [ABSTRACT FROM AUTHOR]

Purpose: The effect of hearing aids (HAs) and educational counseling (EC) or their combination on tinnitus is ambiguous. This study aimed to investigate whether the combined use of HAs and EC is more effective than EC alone on tinnitus relief. Method: A total of 72 adults with chronic, bothersome tinnitus and coexisting sensorineural hearing loss completed at least 1-month and 3-month follow-up. After receiving EC and HA prescriptions, 21 participants selected to purchase HAs (i.e., the HA + EC group), whereas the remaining 51 refused to use HAs despite recommendations (i.e., the EC group). Tinnitus severity was measured by Tinnitus Handicap Inventory (THI), Tinnitus Evaluation Questionnaire (TEQ), and Visual Analog Scale (VAS) for loudness. The primary outcome measure was THI, and tinnitus relief was defined as a 20-point or more reduction in THI. A generalized linear mixed model was used to confirm that the heterogeneity in baseline characteristics between groups did not interfere with the results. Results: The THI, TEQ, and VAS scores decreased significantly after treat- ments, and both groups yielded a similar trend of reduction. There were no sig- nificant differences in the incidence of tinnitus relief and time-to-event curves between the two groups. In addition, the length of follow-up did not affect treat- ment effectiveness. Conclusion: There was insufficient evidence to support the superiority of the combined use of HA and EC for tinnitus over EC with no device. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic led the British Tinnitus Association to offer more online support to people with tinnitus. The aim of this study was to understand how low-intensity group-based digital interventions could benefit people with tinnitus. Semi-structured interviews explored participants' experiences and views on receiving support via an online group. Sixteen people with tinnitus who had attended a recent online tinnitus group and/or workshop were recruited using convenience sampling Three overarching themes were extrapolated from the data: feeling part of a community, being reliably informed, and living better with tinnitus. Participants reported significant benefits from both types of online group. There was appreciation for the accessibility of help during lockdown, and participants felt that this type of support would continue to be valuable post-pandemic. As seen in research on face-to-face groups, benefits came from a supportive community of people with tinnitus and knowledgeable, skilled and trustworthy facilitation and information provision. Outcomes focussed on feeling less isolated, more informed and hopeful. Online groups could offer an accessible ongoing resource supporting people on their journey with tinnitus. [ABSTRACT FROM AUTHOR]

Introduction: Pulsed radiofrequency of the auricular branch of the vagal nerve has strongly reduced tinnitus in a person with violent tinnitus and severe cervical pain. Objectives: The objective of our study was to study the long-term effects of pulsed radiofrequency of the auricular branch of the vagal nerve in a large group of tinnitus sufferers and to find predictors for a prosperous result. Design: A monocenter backward-looking group study. Results: 48% of tinnitus sufferers who undertook pulsed radiofrequency of the auricular branch of the vagal nerve reported a reduced loudness of their tinnitus, which was qualified as being moderate to good in 87% of these patients. The reduction exceeded mostly 1 year. An angle smaller than 3 degrees between the 2nd and 3rd cervical vertebrae on lateral radiograph predicted a better outcome of this therapy. Conclusion: Neuromodulation of the auricular branch of the vagal nerve is an uncomplicated remedy for tinnitus, especially for tinnitus patients with a pathologically small C2-C3 angle. [ABSTRACT FROM AUTHOR]

Copyright of Acta Oto-Laryngologica is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There is currently increasing awareness of third-party disability, defined as the disability and functioning of a significant other (SO) due to a health condition of one of their family members. The effects of third-party disability on the SOs of individuals with tinnitus has received little attention. To address this knowledge gap, this study investigated third-party disability in the significant others (SOs) of individuals with tinnitus. A cross-sectional survey design included 194 pairs of individuals from the USA with tinnitus and their significant others. The SO sample completed the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing-related quality of life, tinnitus cognitions, hearing disability, and hyperacusis. The CTSOQ showed that 34 (18%) of the SOs were mildly impacted, 59 (30%) were significantly impacted, and 101 (52%) were severely impact. The clinical variables of tinnitus severity, anxiety, and hyperacusis in individuals with tinnitus were the best predictors of the impact of tinnitus on SOs. These results show that the SOs of individuals with tinnitus may experience third-party disability. The effect of the individual's tinnitus on their SO may be greater when the individual with tinnitus has a higher level of tinnitus severity, anxiety, and hyperacusis. [ABSTRACT FROM AUTHOR]

Purpose: Directed attention and habituation are key concepts pertaining to clinical intervention for bothersome tinnitus. Directed attention is the strategy of distracting attention away from the tinnitus. Habituation is the process of learning to stop paying attention to stimuli that are irrelevant or meaningless. Although tinnitus may be intrusive, it usually does not reflect some underlying condition requiring medical attention. Tinnitus in most instances is therefore considered an irrelevant, meaningless stimulus that is best treated by facilitating habituation to the phantom sound. This tutorial describes directed attention and habituation and how they relate to major behavioral methods of tinnitus intervention. Method: Arguably, the four major behavioral methods of tinnitus intervention with the strongest research evidence are cognitive behavioral therapy (CBT), tinnitus retraining therapy (TRT), tinnitus activities treatment (TAT), and progressive tinnitus management (PTM). Each of these four methods was evaluated to determine the role of directed attention as a treatment strategy and habituation as a treatment goal. Results: All four of the methods (CBT, TRT, TAT, and PTM) utilize some form of directed attention as a component of their counseling. Habituation is the explicit or implicit goal of each of these methods. Conclusions: Directed attention and habituation are essential concepts for all of the major methods of behavioral intervention for tinnitus that were studied. It would therefore seem appropriate to include directed attention as a universal treatment strategy for bothersome tinnitus. Likewise, the commonality of habituation as the objective of treatment would suggest that habituation should be the universal goal of any method that is intended to mitigate the emotional and functional effects of tinnitus. [ABSTRACT FROM AUTHOR]

Backgrounds: Tinnitus is a meaningless sound signal perceived by the patients in the absence of auditory stimuli. Due to the complex etiology and unclear mechanism, specific therapies for tinnitus are still in the exploratory stage. In recent years, personalized and customized music therapy has been proposed as an effective method for tinnitus treatment. The aim of this study was to explore the efficacy of customized therapy with a well-designed follow-up system in the treatment of tinnitus through a large sample one arm study and to identify the relevant factors affecting the treatment outcome. Methods: The study investigated a total of 615 patients with unilateral or bilateral chronic tinnitus who received personalized and customized music therapy for 3 months. A complete follow-up system was designed by the professionals. Questionnaires of Tinnitus Handicap Inventory (THI), Hospital Anxiety and Depression Scale (HADS) and Visual Analogue Scale (VAS) were used to evaluate the therapeutic effects and relevant factors affecting the efficacy of therapy. Results: The results showed a decreasing trend in THI and VAS scores after 3 months of therapy, with statistically significant differences between pre- and post-therapy time points (P < 0.001). All patients were divided into 5 groups according to THI scores, and the mean reduction score in catastrophic, severe, moderate, mild and slight group was 28, 19, 11, 5, 0 respectively. The proportion of tinnitus patients with anxiety was higher than that with depression (70.57% and 40.65%, respectively), and there were statistically significant differences between HADS-A/D scores pre- and post-therapy. Binary logistic regression showed that the baseline of THI, VAS scores, the duration of tinnitus and the state of anxiety prior to therapy were significant influencing factors of therapeutic efficacy. Conclusions: The magnitude of reduction in THI scores after music therapy depended on the severity of the patients' tinnitus, the higher the initial THI scores, the greater the potential for improvement in tinnitus disorders. Music therapy also reduced the anxiety and depression levels of tinnitus patients. Therefore, personalized and customized music therapy with a comprehensive follow-up system may be an effective treatment option for chronic tinnitus patients. [ABSTRACT FROM AUTHOR]

Background: Blood lipid levels have been reported as novel biomarkers for chronic subjective tinnitus (CST), with their levels being higher in patients with CST. Objectives: This trial aimed to determine the change in lipid profile and tinnitus-related quality of life (TR-QoL) responses to 8-week acupuncture treatment in patients with CST. Methods: Sixty obese patients with CST were randomly assigned to group A (treatment group; n = 30; mean age = 44.10 ± 3.69 years) or group B (sham group; n = 30; mean age = 45.53 ± 3.62 years). Patients in group A (n = 30) received manual stimulation at the TE3, TE5, TE17, TE18, TE19, TE20, TE21, TE22, GB2, GB8, GB20, LI4, LI11, KI3, SP6, ST36, CV4, CV9, and CV12 acupoints through in-site acupuncture needles thrice weekly. Furthermore, the bilateral abdominal ST25 and GB28 acupoints were electrically stimulated through in-site acupuncture needles. Group B (n = 30) received the same acupuncture protocol as group A but the insertion of needles was a sham insertion. Anthropometrics such as body mass index (BMI) and waist circumference (WC), TRQoL (assessed via tinnitus handicap inventory), blood lipid levels such as high-density lipoprotein (HDLs), low-density lipoprotein (LDLs), cholesterol (C), and triglycerides (TGs), and the visual analogue scale (VAS) score for tinnitus severity, were assessed prospectively. Results: Only group A showed significant within-group improvements. Except for HDLs, BMI, and WC, unpaired between-group comparisons showed significantly greater improvements in other outcome measures of all patients with tinnitus (TR-QoL, LDLs, TGs, C, and VAS) in group A than in group B. Conclusion: Safe acupuncture treatment not only improves anthropometrics and TRQoL, but also helps resolve hyperlipidemia and reduces the severity of tinnitus in obese patients with CST. [ABSTRACT FROM AUTHOR]

The article focuses on the development of clinical practice guidelines (CPGs) for the therapeutic use of repetitive transcranial magnetic stimulation (rTMS) in neuropsychiatric disorders. Topics include aim of the guidelines is to provide expert guidance based on the available evidence and bring consistency in the clinical application of rTMS; and used in developing the CPGs, which were informed by an umbrella review of studies assessing the role of rTMS in various psychiatric disorders.

Background and Aim: Prevalence of noise-induced tinnitus is approximately twice as high among military personnel and veterans as in the general population. So they appear to have poorer quality of life. Many forms of sound therapy have been applied to reduce the effects of subjective tinnitus. This study aimed to investigate the effect of binaural beat stimulation on the annoyance of tinnitus in military personnel with the experience of acoustic trauma-induced tinnitus. Methods: This study was conducted on 60 men with mean(SD) age 38.30(6.12) years individuals suffering from chronic tinnitus. They were randomly assigned to either the experimental group who were exposed to an audio file with an embedded binaural beat in the alpha frequency range or the control group who were supposed to merely listen to their favorite music without any included beat stimulation. Tinnitus Handicap Inventory (THI) and Tinnitus Handicap Questionnaire (THQ) were used as outcome measures to collect the data after a period of one month. Results: There were statistically significant differences (score decrease) between the two study groups after intervention in terms of THI (p<0.05) and THQ total score (p<0.05) and the subscales involving emotional effects of tinnitus. Conclusion: Binaural beat stimulation in the alpha frequency range has the potential of inducing some positive effects on subjective feelings of chronic tinnitus sufferers. [ABSTRACT FROM AUTHOR]