Abstract
The diagnosis of tinnitus relies on self-report. Psychoacoustic measurements of tinnitus pitch and loudness are essential for assessing claims and discriminating true from false ones. For this reason, the quantification of tinnitus remains a challenging research goal. We aimed to: (1) assess the precision of a new tinnitus likeness rating procedure with a continuous-pitch presentation method, controlling for music training, and (2) test whether tinnitus psychoacoustic measurements have the sensitivity and specificity required to detect people faking tinnitus. Musicians and non-musicians with tinnitus, as well as simulated malingerers without tinnitus, were tested. Most were retested several weeks later. Tinnitus pitch matching was first assessed using the likeness rating method: pure tones from 0.25 to 16 kHz were presented randomly to participants, who had to rate the likeness of each tone to their tinnitus, and to adjust its level from 0 to 100 dB SPL. Tinnitus pitch matching was then assessed with a continuous-pitch method: participants had to match the pitch of their tinnitus to an external tone by moving their finger across a touch-sensitive strip, which generated a continuous pure tone from 0.5 to 20 kHz in 1-Hz steps. The predominant tinnitus pitch was consistent across both methods for both musicians and non-musicians, although musicians displayed better external tone pitch matching abilities. Simulated malingerers rated loudness much higher than did the other groups with a high degree of specificity (94.4%) and were unreliable in loudness (not pitch) matching from one session to the other. Retest data showed similar pitch matching responses for both methods for all participants. In conclusion, tinnitus pitch and loudness reliably correspond to the tinnitus percept, and psychoacoustic loudness matches are sensitive and specific to the presence of tinnitus.
Highlights
The diagnosis of tinnitus relies exclusively on patient selfreport and various subjective questionnaires [1,2,3], precluding objective assessment of the progression of the tinnitus percept and identification of physiological tinnitus at an acceptable level of specificity
Pitch matching Most conventional studies on tinnitus pitch matching designed to identify a single predominant frequency, using either a forced-choice paradigm or an adjustment method [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24], show that the perceived predominant pitch falls within the frequency band of the hearing loss [10,14,19,20,23]
The likeness rating method showed that tinnitus is composed of a wide frequency bandwidth mirroring the hearing loss region [26,28,29,30,31,33,35] even when no hearing loss is found at standard audiometric frequencies (0.25 to 8 kHz) [27,34]
Summary
The diagnosis of tinnitus relies exclusively on patient selfreport and various subjective questionnaires [1,2,3], precluding objective assessment of the progression of the tinnitus percept (with time or therapeutic intervention) and identification of physiological tinnitus at an acceptable level of specificity. The likeness rating method showed that tinnitus is composed of a wide frequency bandwidth mirroring the hearing loss region [26,28,29,30,31,33,35] even when no hearing loss is found at standard audiometric frequencies (0.25 to 8 kHz) [27,34] It remains unclear whether the likeness rating technique, which involves a discrete mode of presentation, can provide an accurate estimate of the predominant pitch compared to when only one pitch is matched, such as in the continuous-pitch paradigm proposed . We conducted test-retest trials to establish the method’s reproducibility
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