Abstract
BackgroundTinnitus, the perception of a sound without an external sound source, can lead to variable amounts of distress.MethodologyIn a group of tinnitus patients with variable amounts of tinnitus related distress, as measured by the Tinnitus Questionnaire (TQ), an electroencephalography (EEG) is performed, evaluating the patients' resting state electrical brain activity. This resting state electrical activity is compared with a control group and between patients with low (N = 30) and high distress (N = 25). The groups are homogeneous for tinnitus type, tinnitus duration or tinnitus laterality. A group blind source separation (BSS) analysis is performed using a large normative sample (N = 84), generating seven normative components to which high and low tinnitus patients are compared. A correlation analysis of the obtained normative components' relative power and distress is performed. Furthermore, the functional connectivity as reflected by lagged phase synchronization is analyzed between the brain areas defined by the components. Finally, a group BSS analysis on the Tinnitus group as a whole is performed.ConclusionsTinnitus can be characterized by at least four BSS components, two of which are posterior cingulate based, one based on the subgenual anterior cingulate and one based on the parahippocampus. Only the subgenual component correlates with distress. When performed on a normative sample, group BSS reveals that distress is characterized by two anterior cingulate based components. Spectral analysis of these components demonstrates that distress in tinnitus is related to alpha and beta changes in a network consisting of the subgenual anterior cingulate cortex extending to the pregenual and dorsal anterior cingulate cortex as well as the ventromedial prefrontal cortex/orbitofrontal cortex, insula, and parahippocampus. This network overlaps partially with brain areas implicated in distress in patients suffering from pain, functional somatic syndromes and posttraumatic stress disorder, and might therefore represent a specific distress network.
Highlights
At some point in life most people experience a sound in their ears or head no external sound is present [1]
When performed on a normative sample, group blind source separation (BSS) reveals that distress is characterized by two anterior cingulate based components
Spectral analysis of these components demonstrates that distress in tinnitus is related to alpha and beta changes in a network consisting of the subgenual anterior cingulate cortex extending to the pregenual and dorsal anterior cingulate cortex as well as the ventromedial prefrontal cortex/orbitofrontal cortex, insula, and parahippocampus
Summary
At some point in life most people experience a sound in their ears or head no external sound is present [1] This has been related to listening to loud music[2], sudden sensorineural hearing loss[3], use of medication[4], trauma[5] or other causes. The early explorers of Africa titrated the dose of quinine to the reversible presence of a phantom sound, as was done for aspirin in the treatment for rheumathoid arthritis and gout[6]. The perception of a sound without an external sound source, can lead to variable amounts of distress
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