Abstract
BackgroundTinnitus refers to auditory phantom sensation. It is estimated that for 2% of the population this auditory phantom percept severely affects the quality of life, due to tinnitus related distress. Although the overall distress levels do not differ between sexes in tinnitus, females are more influenced by distress than males. Typically, pain, sleep, and depression are perceived as significantly more severe by female tinnitus patients. Studies on gender differences in emotional regulation indicate that females with high depressive symptoms show greater attention to emotion, and use less anti-rumination emotional repair strategies than males.MethodologyThe objective of this study was to verify whether the activity and connectivity of the resting brain is different for male and female tinnitus patients using resting-state EEG.ConclusionsFemales had a higher mean score than male tinnitus patients on the BDI–II. Female tinnitus patients differ from male tinnitus patients in the orbitofrontal cortex (OFC) extending to the frontopolar cortex in beta1 and beta2. The OFC is important for emotional processing of sounds. Increased functional alpha connectivity is found between the OFC, insula, subgenual anterior cingulate (sgACC), parahippocampal (PHC) areas and the auditory cortex in females. Our data suggest increased functional connectivity that binds tinnitus-related auditory cortex activity to auditory emotion-related areas via the PHC-sgACC connections resulting in a more depressive state even though the tinnitus intensity and tinnitus-related distress are not different from men. Comparing male tinnitus patients to a control group of males significant differences could be found for beta3 in the posterior cingulate cortex (PCC). The PCC might be related to cognitive and memory-related aspects of the tinnitus percept. Our results propose that sex influences in tinnitus research cannot be ignored and should be taken into account in functional imaging studies related to tinnitus.
Highlights
Subjective tinnitus is a condition in which a patient perceives an auditory phantom sound that can take the form of ringing, buzzing, roaring or hissing in the absence of an external sound [1]
Female tinnitus patients differ from male tinnitus patients in the orbitofrontal cortex (OFC) extending to the frontopolar cortex in beta1 and beta2
Increased functional alpha connectivity is found between the OFC, insula, subgenual anterior cingulate, parahippocampal (PHC) areas and the auditory cortex in females
Summary
Subjective tinnitus is a condition in which a patient perceives an auditory phantom sound that can take the form of ringing, buzzing, roaring or hissing in the absence of an external sound [1]. In 5 to 15% of the population, this tinnitus sensation is unremitting and it is estimated that for 2–3 in 100 this auditory phantom percept severely affects the quality of life as tinnitus causes a considerable amount of distress [2]. Pain, sleep, and energy, are perceived to be significantly more severe by female tinnitus patients [5] These symptoms can have an influence on tinnitus perception. Further studies on gender differences in emotional regulation indicate that females with high depressive symptoms show greater attention to emotion, with less anti-rumination emotional repair strategies than males [8]. Studies on gender differences in emotional regulation indicate that females with high depressive symptoms show greater attention to emotion, and use less anti-rumination emotional repair strategies than males
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