Abstract
Tinnitus is associated with increased social costs and reduced quality of life through sleep disorders or psychological distress. The pathophysiology of chronic subjective tinnitus, which accounts for most tinnitus, has not been clearly elucidated. This is because chronic subjective tinnitus is difficult to evaluate objectively, and there are no objective markers that represent the diagnosis or therapeutic effect of tinnitus. Based on the results of studies on patients with chronic subjective tinnitus, objective and measurable biomarkers that help to identify the pathophysiology of tinnitus have been summarized. A total of 271 studies in PubMed, 303 in EMBASE, and 45 in Cochrane Library were found on biomarkers related to chronic subjective tinnitus published until April 2021. Duplicate articles, articles not written in English, review articles, case reports, and articles that did not match our topic were excluded. A total of 49 studies were included. Three specimens, including blood, saliva, and urine, and a total of 58 biomarkers were used as indicators for diagnosis, evaluation, prognosis, and therapeutic effectiveness of tinnitus. Biomarkers were classified into eight categories comprising metabolic, hemostatic, inflammatory, endocrine, immunological, neurologic, and oxidative parameters. Biomarkers can help in the diagnosis, measure the severity, predict prognosis, and treatment outcome of tinnitus.
Highlights
Depending on the initial trigger, it can be classified as primary tinnitus, which is associated with sensorineural hearing loss, or idiopathic and secondary tinnitus, which is related to organic causes [7]
In this study, we categorized objective biomarkers related to diagnosis, prognosis, and the pathophysiology of tinnitus based on the results of published studies on chronic subjective tinnitus
In a study comparing patients with chronic subjective tinnitus, aged 18 to 70 years, with a control group to rule out the effects of aging, there was no difference in High-density lipoprotein (HDL) levels between the two groups, but Total cholesterol (TC), TG, and low-density lipoprotein (LDL) levels were high in the tinnitus group [29]
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Depending on the initial trigger, it can be classified as primary tinnitus, which is associated with sensorineural hearing loss, or idiopathic and secondary tinnitus, which is related to organic causes [7]. It can be classified into central and peripheral types according to the problematic site in the auditory pathway [8]. The well-known neurophysiological theory was proposed by Jastreboff, who suggested that the auditory system and neurophysiology was associated with the occurrence of tinnitus [16] According to this theory, because the acoustic information passes through the autonomic nervous and limbic systems, negative emotional reactions or discomfort are triggered, which leads to a vicious cycle of recognizing tinnitus even if there is no sound stimulus. As per a survey conducted in Sweden, about 46.5% of patients with tinnitus were not satisfied with the treatment or were not receiving treatment [19]
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