Abstract
BACKGROUNDThe heterogeneity of tinnitus is thought to underlie the lack of objective diagnostic measures.METHODSLongitudinal data from 20,349 participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort from 2008 to 2018 were used to understand the dynamics of transition between occasional and constant tinnitus. The second part of the study included electrophysiological data from 405 participants of the Swedish Tinnitus Outreach Project (STOP) cohort.RESULTSWe determined that with increasing frequency of the occasional perception of self-reported tinnitus, the odds of reporting constant tinnitus after 2 years increases from 5.62 (95% CI, 4.83–6.55) for previous tinnitus (sometimes) to 29.74 (4.82–6.55) for previous tinnitus (often). When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603.02 (524.74–692.98), suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater. Auditory brain stem responses (ABRs) from subjects reporting nontinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared with occasional tinnitus or nontinnitus. The ABR from occasional tinnitus was indistinguishable from that of the nontinnitus controls.CONCLUSIONSOur results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.FUNDINGThis study was supported by the GENDER-Net Co-Plus Fund (GNP-182), the European Union’s Horizon 2020 grants no. 848261 (Unification of Treatments and Interventions for Tinnitus [UNITI]) and no. 722046 (European School for Interdisciplinary Tinnitus Research [ESIT]).
Highlights
Tinnitus is the perception of sounds in the absence of any external sound source
The generalized estimating equation (GEE) analysis confirmed that the risk of constant tinnitus is greater with the increasing frequency of occasional tinnitus [previous tinnitus: adjusted odds ratio and 95% confidence interval = 5.62 (4.83–6.55), p < .0001; previous tinnitus aOR: 29.74 (25.69–34.42), p < .0001; Supplemental Table 3]
Our findings confirm that constant tinnitus is associated with increased Auditory brainstem responses (ABRs) wave V latency when compared to either occasional tinnitus or non-tinnitus controls when controlling for biological variables such as age, sex, hearing loss, and hyperacusis
Summary
Tinnitus is the perception of sounds in the absence of any external sound source. It is a common condition that is experienced by nearly 15% of the population and has been shown to be influenced by environmental factors and genetics [1,2,3,4,5,6]. The auditory brainstem response (ABR) has been suggested as a tool to measure such alterations in response to sound stimuli in spite of tinnitus not being elicited by sounds. The aim of this study is to address these controversies using a large cohort of deeply phenotyped tinnitus and control subjects and provide additional insights on the dynamics of the transition between occasional and constant tinnitus. Auditory brainstem responses (ABRs) from subjects reporting non-tinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared to occasional tinnitus or non-tinnitus. CONCLUSIONS: Our results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is less likely to remit.
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