Idiopathic Tinnitus Research Articles

Antioxidant Therapy in Tinnitus

Oxidative stress and reactive oxygen species (ROS) have been working in the pathophysiology of various chronic diseases. Under normal circumstances, the human cochlea has some antioxidant molecules which can scavenge the oxidant substances and ROS to avoid the possible damage into the inner ear. In tinnitus therapy, several forms of complementary and alternative medicine (CAM) are increasingly popular but they are generally selected with or without professional guidance. Although several antioxidant agents like vitamin A, C, E and glutathione can be used in the treatment of tinnitus as CAM, melatonin, N-acetyl cysteine (NAC) and coenzyme Q10 (CoQ10) were especially used as alternative for classic antioxidants. According to the literature, it seems antioxidant therapy in patients with idiopathic tinnitus may reduce oxidative stress and damage to the inner ear. And also it can reduce the intensity and discomfort of tinnitus. Further clinical studies are necessary to determine antioxidants’ protective role and to choose the appropriate therapeutic protocol.

The Impact of Sound on Electroencephalographic Waves during Sleep in Patients Suffering from Tinnitus

Based on the knowledge that sensory processing continues during sleep and that a relationship exists between sleep and learning, a new strategy for treatment of idiopathic subjective tinnitus, consisted of customized sound stimulation presented during sleep, was tested. It has been previously shown that this treatment induces a sustained decrease in tinnitus intensity; however, its effect on brain activity has not yet been studied. In this work, we compared the impact of sound stimulation in tinnitus patients in the different sleep stages.Ten patients with idiopathic tinnitus were treated with sound stimulation mimicking tinnitus during sleep. Power spectra and intra- and inter-hemispheric coherence of electroencephalographic waves from frontal and temporal electrodes were measured with and without sound stimulation for each sleep stage (stages N2 with sleep spindles; N3 with slow wave sleep and REM sleep with Rapid Eye Movements).The main results found were that the largest number of changes, considering both the power spectrum and wave׳s coherence, occurred in stages N2 and N3. The delta and theta bands were the most changed, with important changes also in coherence of spindles during N2. All changes were more frequent in temporal areas. The differences between the two hemispheres do not depend, at least exclusively, on the side where the tinnitus is perceived and, hence, of the stimulated side. These results demonstrate that sound stimulation during sleep in tinnitus patients׳ influences brain activity and open an avenue for investigating the mechanism underlying tinnitus and its treatment.

Influence of Tinnitus on Auditory Spectral, Temporal Resolution, and Speech Perception Ability in Tinnitus Patients

Objectives: (1) Evaluate the influence of tinnitus upon the auditory spectral and temporal resolution. (2) Evaluate the effect of tinnitus on speech perception ability in noise. Methods: To exclude the effect of decreased hearing threshold, unilateral idiopathic tinnitus patients with symmetric hearing threshold were enrolled. The subjects were 13 patients with symmetric hearing loss >20 dB HL and binaural difference <10 dB at 0.25, 0.5, 1, 2, 3, 4, and 8 kHz, or who have normal hearing threshold and binaural difference <10 dB at 0.25, 0.5, 1, 2, 3, 4, and 8 kHz, and threshold discrepancies <15 dB at 9, 11.2, 12.5, 14, 16, 18, and 20 kHz. A total of 13 volunteers with normal hearing were enrolled as a control group. Four different psychoacoustic measurements were performed: (1) spectral-ripple discrimination, (2) temporal modulation detection, (3) Schroeder-phase discrimination, and (4) word recognition in noise. Results: There were no significant differences in spectral-ripple threshold, temporal modulation detection threshold, and Schroeder-phase discrimination between affected sides and non-affected sides of unilateral tinnitus patients. For the word in noise test, affected sides showed worse signal-to-noise ratio compared to non-affected side. Conclusions: We could not find any evidence that the tinnitus-affected ears show worse spectral and temporal processing compared with nontinnitus ears in unilateral tinnitus patients. The spectral ripple discrimination data suggests that the tinnitus-affected ear does not have more damage in its cochlea (especially the outer hair cell) causing the auditory filters to broaden compared with the nonaffected ear with the same hearing threshold.

Intratympanic dexamethasone plus melatonin versus melatonin only in the treatment of unilateral acute idiopathic tinnitus

PurposeThe aim of our study was to determine whether the combination of intratympanic (IT) corticosteroid with melatonin could be associated with decreased tinnitus in patients with unilateral acute idiopathic tinnitus developed within 3months. Materials and methodsWe evaluated this hypothesis through a prospective, randomized, controlled, double-blinded trial. Patients included in the study were randomly allocated into two groups: Group A – comprising 30 patients, received melatonin and IT dexamethazone, and Group B – including 30 patients receiving melatonin alone. After 3months, improvement in tinnitus was assessed using different outcome measures: tinnitus loudness score, tinnitus awareness score, Tinnitus Handicap Inventory (THI), Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Inventory (BDI). ResultsWe have demonstrated significant improvements in each of the above mentioned outcomes subsequent to treatment in both groups. However, patients in the IT dexamathazone and melatonin group attained statistically significant better outcomes. Besides, the differences in improvement rate and cure rate were highly significant between the two groups, favoring the IT dexamethazone and melatonin group. ConclusionsOur preliminary study demonstrated that IT dexamethazone plus melatonin is efficient in improvement of idiopathic unilateral tinnitus developed within 3months.

RTMS Bimodal Treatment for Patients With Subjective Idiopathic Tinnitus: A Pilot Study of High-dose Stimulation

rTMS Bimodal Treatment for Patients With Subjective Idiopathic Tinnitus: A Pilot Study of High-dose Stimulation

Effect of different sounds on the treatment outcome of tinnitus retraining therapy.

ObjectivesThe purpose of this study was to evaluate the therapeutic effect of three different types of sounds on tinnitus patients undergoing tinnitus retraining therapy (TRT).MethodsThis is a single-institution retrospective study, performed in one tertiary otological referral center. Thirty-eight adults with subjective idiopathic tinnitus who were followed for at least 9 weeks were enrolled. Sound therapy was delivered in 3 different ways: narrowband noise TRT (nTRT); mixed band noise TRT (mTRT); broadband noise TRT (bTRT). Treatment response was measured through validated psychometric questionnaires: Tinnitus Handicap Inventory (THI), visual analog scale (VAS) on annoyance, and numerical description of hours of tinnitus perception (awareness hours).ResultsA total of 38 patients were followed for at least 9 weeks. In nTRT group, all outcome measures including THI, VAS, and the awareness hours, decreased over 9 weeks with no statistical significance. In mTRT group, all outcome measures except for awareness hours significantly improved 9 weeks after the beginning of the treatment. In bTRT group, all outcome measures decreased significantly in 9 weeks. When therapeutic success is defined as improvement in THI 7 or more, bTRT group (77.8%) showed a higher success rate than other groups for 38 patients with the minimum follow-up of 9 weeks.ConclusionAll three sounds can provide relief in patients with annoying tinnitus after TRT. However, there is difference in the therapeutic effect according to sound types. Broadband sound seems to be better than narrowband sound or mixed sound in relieving the patients from tinnitus. Therefore, sound therapy with broadband noise may be more appropriate during TRT, but further evidence is needed for precise conclusion.

Electrophysiology quantitative electroencephalography/low resolution brain electromagnetic tomography functional brain imaging (QEEG LORETA): Case report: Subjective idiopathic tinnitus - predominantly central type severe disabling tinnitus

The clinical significance of QEEG LORETA data analysis performed sequentially within 6 months is presented in a case report of a predominantly central type severe disabling subjective idiopathic tinnitus (SIT) before and following treatment. The QEEG LORETA data is reported as Z-scores of z = ± 2.54, p < 0.013. The focus is on demonstration of patterns of brain wave oscillations reflecting multiple brain functions in multiple ROIs in the presence of the tinnitus signal (SIT). The patterns of brain activity both high, middle and low frequencies are hypothesized to reflect connectivities within and between multiple neuronal networks in brain. The Loreta source localization non auditory ROI Images at the maximal abnormality in the very narrow band frequency spectra (24.21 Hz), showed the mathematically most probable underlying sources of the scalp recorded data to be greatest in the mid-cingulate, bilateral precuneus, cingulate and the bilateral caudate nucleus. Clinical correlation of the data with the history and course of the SIT is considered an objective demonstration of the affect, behavioral, and emotional component of the SIT. The correlation of the caudate activity, SIT as the traumatic event with the clinical course of PTSD, and the clinical diagnosis of PTSD is discussed. The clinical translation for patient care is highlighted in a SIT patient with multiple comorbidities by translation of QEEG/LORETA electrophysiologic data, as an adjunct to: provide an objectivity of patterns of brain wave activity in multiple regions of interest (ROIs) reflecting multiple brain functions, in response to and in the presence of the tinnitus signal, recorded from the scalp and analyzed with the metrics of absolute power, relative power, asymmetry, and coherence, for the subjective tinnitus complaint (SIT); 2) provide an increase in the accuracy of the tinnitus diagnosis; 3) assess/monitor treatment efficacy; 4) provide a rationale for selection of a combined tinnitus targeted therapy of behavioral, pharmacologic, sound therapy modalities of treatment attempting tinnitus relief; 5) provide insight into the medical significance of the SIT; 6) attempt discriminant function analysis for identification of a particular diagnostic clinical category of CNS neuropsychiatric disease; and 7) attempt to translate what is known of the neuroscience of sensation, brain function, QEEG/LORETA source localization, for the etiology and prognosis of the individual SIT patient.

MANAGEMENT OF KARNANADA (TINNITUS AURA) WITH BILWA TAILA KARNAPOORANAM AND ASWAGANDHA GHRUTHA INTERNALLY

Nowadays karnanada ( Tinnitus Aura ) is a commonest problem due to sound pollution, usage of ear phones, excessive talking o n mobile phones and modern pub culture etc. Karnanada is a vata predominant disease. Several regimens described about Karnanada in ancient samhitas and o ther literatures. The effective and more abundant available drugs are Bilva tailam contains Bilwa majja, Tila taila, aja ksheera and gomutra; and Aswagandha ghrutham contains Aswagandha, goksheer a and goghrutha . These drugs are having vatahara property , best nervine tonic and anti - o totoxic property. And Karnapooranam is a simple and safe specific therapy described in Karnarogas. The aim of this study is to evaluate the efficacy of Bilwataila in ka rnanada and evaluate the effi cacy of Karnapurana procedure, to evaluate the efficacy of R asayana property of Aswagandha ghritam in ternally in Karna nada and t he objective is to treat karnanada with simple and cost effective medicine. Totally 30 patients we re selected from O.P.D. of Shalakya Unit, Government Ayurvedic Hospital, Erragadda, Hyderabad , India. Pat ients suffering from karnanada are selected at random in the age group of 20 - 70 years, irrespective of sex, diet, religion, economic status and occupat ion. The results are very good. In this study short duration of symptoms, karnanada in younger and middle age group patients, affected in unilateral are responded well. Concluding the study, the Bilva taila karna poorana and Aswagandha ghrutham intern al me dicine in karnanada (idiopathic tinnitus) are most effective.

The Martha Entenmann Tinnitus Research Center, Inc.: Abraham Shulman, MD; and Barbara Goldstein, PhD; International Tinnitus Miniseminar: New Concepts in Electrophysiology and Tinnitus

Program Description: A neurobiology for all clinical types of tinnitus is emerging, reflecting advances in the neuroscience of brain function and the cochleovestibular system. The electrophysiologic identification of brain functions activated in the presence of the tinnitus signal can provide a basis for translation to optimize tinnitus diagnosis and treatment. This miniseminar will focus on electrophysiology and tinnitus. Electrophysiologic markers of ear and brain function have been identified in subjective idiopathic tinnitus patients of all clinical types. This clinical experience has been reflective predominantly of site of lesion testing of cochleovestibular function. Tinnitus is an aberrant auditory percept. Advances in the neuroscience of brain imaging, sensory physiology, auditory physiology, brain function, and tinnitus have provided the otolaryngologist and all tinnitus professionals methods for objectification of the subjective tinnitus complaint. This miniseminar will initially review the past and present experience with electrophysiologic markers for tinnitus of cochleovestibular function. Second, the focus will be on presentation of two methods of objectification for the identification of electrophysiologic markers of tinnitus in brain as follows: 1) Quantitative electroencephalography (QEEG) and 2) low resolution electromagnetic tomography (Loreta). In this miniseminar, the fourth in a series examining tinnitus, each speaker will examine an electrophysiologic technique and then provide case discussions to examine the use of this technique in treatment selection. Educational Objectives: 1) Understand the neurobiology of tinnitus. 2) Understand the availability of the use of electrophysiologic outcomes to provide objectivity for the subjective tinnitus complaint. 3) Recognize how established methodologies of recording electrophysiology of the ear and brain can be applied to the tinnitus patient.

Pulsatile Tinnitus

Pulsatile tinnitus, unlike idiopathic tinnitus, usually has a specific, identifiable cause. Nonetheless, uncertainty often arises in clinical practice about the findings to be sought and the strategy for work-up. Selective literature review and evaluation of our own series of patients. Pulsatile tinnitus can have many causes. No prospective studies on this subject are available to date. Pulsatile tinnitus requires both a functional organ of hearing and a genuine, physical source of sound, which can, under certain conditions, even be objectified by an examiner. Pulsatile tinnitus can be classified by its site of generation as arterial, arteriovenous, or venous. Typical arterial causes are arteriosclerosis, dissection, and fibromuscular dysplasia. Common causes at the arteriovenous junction include arteriovenous fistulae and highly vascularized skull base tumors. Common venous causes are intracranial hypertension and, as predisposing factors, anomalies and normal variants of the basal veins and sinuses. In our own series of patients, pulsatile tinnitus was most often due to highly vascularized tumors of the temporal bone (16%), followed by venous normal variants and anomalies (14%) and vascular stenoses (9%). Dural arteriovenous fistulae, inflammatory hyperemia, and intracranial hypertension were tied for fourth place (8% each). The clinical findings and imaging studies must always be evaluated together. Thorough history-taking and clinical examination are the basis for the efficient use of imaging studies to reveal the cause of pulsatile tinnitus.

Central auditory processing during chronic tinnitus as indexed by topographical maps of the mismatch negativity obtained with the multi-feature paradigm

This study aimed to compare the neural correlates of acoustic stimulus representation in the auditory sensory memory on an automatic basis between tinnitus subjects and normal hearing (NH) controls, using topographical maps of the MMNs obtained with the multi-feature paradigm. A new and faster paradigm was adopted to look for differences between 2 groups of subjects. Twenty-eight subjects with chronic subjective idiopathic tinnitus and 33 matched healthy controls were included in the study. Brain electrical activity mapping of multi-feature MMN paradigm was recorded from 32 surface scalp electrodes. Three MMN parameters for five deviants consisting frequency, intensity, duration, location and silent gap were compared between the two groups. The MMN amplitude, latency and area under the curve over a region of interest comprising: F3, F4, Fz, FC3, FC4, FCz, and Cz were computed to provide better signal to noise ratio. These three measures could differentiate the cognitive processing disturbances in tinnitus sufferers. The MMN topographic maps revealed significant differences in amplitude and area under the curve for frequency, duration and silent gap deviants in tinnitus subjects compared to NH controls. The current study provides electrophysiological evidence supporting the theory that the pre-attentive and automatic central auditory processing is impaired in individuals with chronic tinnitus. Considering the advantages offered by the MMN paradigm used here, these data might be a useful reference point for the assessment of sensory memory in tinnitus patients and it can be applied with reliability and success in treatment monitoring.

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation.

Residual inhibition (RI) is the temporary inhibition of tinnitus by use of masking stimuli when the device is turned off. The main aim of this study was to evaluate the effects of RI induced by auditory electrical stimulation (AES) in the primary auditory pathways using early auditory-evoked potentials (AEPs) in subjective idiopathic tinnitus (SIT) subjects. A randomized placebo-controlled study was conducted on forty-four tinnitus subjects. All enrolled subjects based on the responses to AES, were divided into two groups of RI and Non-RI (NRI). The results of the electrocochleography (ECochG), auditory brain stem response (ABR) and brain stem transmission time (BTT) were determined and compared pre- and post-AES in the studied groups. The mean differences in the compound action potential (CAP) amplitudes and III/V and I/V amplitude ratios were significantly different between the RI, NRI and PES controls. BTT was significantly decreased associated with RI. The observed changes in AEP associated with RI suggested some peripheral and central auditory alterations. Synchronized discharges of the auditory nerve fibers and inhibition of the abnormal activity of the cochlear nerve by AES may play important roles associated with RI. Further comprehensive studies are required to determine the mechanisms of RI more precisely.

Influence of visual and auditory masking on the brain glucose metabolism in an idiopathic tinnitus patient

To study the influence of the audio-visual block (AB) on the brain glucose metabolism of idiopathic tinnitus patients. The brain positron emission tomography (PET) test was performed on one chronic idiopathic tinnitus patient under audio-visual block and non-block (NB) conditions respectively. The visual analysis and statistical parameter mapping (SPM) analysis were both used to detect the brain glucose metabolism difference under AB and NB conditions. Under NB conditions, significant hyperactivity was detected at auditory and visual cortex on both sides of the brain. However, this phenomenon was not shown under AB conditions. Instead, a hyperactivity of brain was presented in the left Wernicke's area. The generation of chronic idiopathic tinnitus probably has no relationship with the auditory cortex abnormity. Wernicke's area might be involved in the central perception of tinnitus.

The impact of co-morbid factors on the psychological outcome of tinnitus patients

The study was carried out to determine the impact of some co-morbid otological symptoms and demographic factors on the emotional distress and cognitive functioning in patients with tinnitus. One hundred consecutive patients, complaining of constant idiopathic tinnitus, were enrolled into the study. Four tests were administered: Beck Depression Inventory, Hospital Anxiety Depression Scale (HADS, A--anxiety, D--depression), Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). A multivariate stepwise linear regression analysis was performed to estimate the relationship between the results of each of the tests and following co-morbid factors: age, sex, tinnitus duration, tinnitus laterality, hearing status (normal hearing, unilateral hearing loss and bilateral hearing loss) and vertigo/dizziness. It was found that the scores of MMSE and TMT were negatively correlated with age and with hearing status and the scores of HADS-A were slightly correlated with sex. In regression analysis, in HADS-A, sex and to a lesser extent tinnitus duration, in MMSE and TMT age and to a lesser extent tinnitus laterality were the variables that were comprised in the final model. Demographic factors had contributed more than overlapping otological symptoms to the psychological outcome in tinnitus patients.

Idiopathic Tinnitus Concomitant With Eye Closure

To describe 2 patients presenting with idiopathic tinnitus concomitant with eye closure. Clinical capsule report. University hospital. Two patients presented with intermittent tinnitus synchronous with eye closing or blinking. Otoscopic examination revealed inward movement of tympanic membranes concomitantly with eye blinking or eye closure in 1 patient. Neither patient had facial nerve disease or myoclonus. Compliance in impedance audiometry was recorded. Compliance in impedance audiometry was reduced during eye blinking and eye closure in both cases. The tinnitus was attributed to muscular tinnitus via stapedial muscle contraction during eye closure. These are the rare 2 reported patients presenting with idiopathic muscular tinnitus concomitant with eye closure. The reductive change of compliance in impedance audiometry during tinnitus coincident with eye closure is a feature of this form of tinnitus. We suggest evaluation of compliance change in impedance audiometry to be a key examination in patients with stapedial muscular tinnitus concomitant with eye closure.

Comparison of various treatment modalities for acute tinnitus

Because in most cases the development of tinnitus is triggered by cochlear damage, there exists the opportunity to eliminate tinnitus while the cochlear lesion is still reversible. Therefore, we evaluated the therapeutic effects of various treatment modalities on acute subjective idiopathic tinnitus (SIT) and investigated prognostic factors affecting the treatment outcome. Prospective, controlled, double-blind trial. A total 107 patients who underwent treatment for unilateral SIT that had developed within the previous 3 months completed the study. The patients were randomly assigned into three groups according to the treatment modality: group I (n = 32), alprazolam orally for 3 months; group II (n = 35), as for group I plus four intratympanic dexamethasone (ITD) injections; and group III (n = 40), as for group II plus four intravenous injections of lipo-prostaglandin E(1) . The improvement rate of group II (75.8%) was significantly higher than that of group I (40.3%; P < .05), and there was no significant difference in the improvement rate of group III (50.0%) compared with groups I and II (P > .05). The cure rates of group II (25.8%) and group III (20.0%) were significantly higher than that of group I (9.8%; P < .05). There was a significant correlation between the cure rate and duration of symptoms. The results of the present study indicate that ITD injection plus alprazolam medication is the best treatment choice for acute SIT within 3 months of development.

Comparison of efficacy of different treatment methods in the treatment of idiopathic tinnitus

This study aims to detect whether any differences were present between betahistine dihydrochloride, transcutaneal electrical nerve stimulation and pure tone masking-tinnitus retraining therapy (TRT) methods in the effects on quality of life and treatment of the symptoms of the patients. A total of 91 patients (42 females, 49 males; mean age 49.3±8.3 years; range 30 to 70 years) who admitted to the Otorhinolaryngology Clinic of the Ufuk University between June 2009 and June 2010 with a complaint of subjective tinnitus and who had no hearing loss were included in the study. In this study, the effects of these three treatment methods on healing and quality of life in patients suffering from bilateral subjective tinnitus were comparatively evaluated using Tinnitus Handicap Inventory Score (THIS), visual analog scale (VAS) and audiological parameters. The evaluations were made immediately before the treatment, immediately after the treatment and three weeks after the treatment. Kolmogorov-Smirnov analysis was used to test the normal distribution of the data and Wilcoxon signed rank test was used to show the differences between the different treatment methods before the treatment, immediately after the treatment and three weeks after the treatment. Mann-Whitney U and Kruskal-Wallis H tests were used to show the inter-group differences. In the inter-group analyzes, success rate of the pure tone masking-TRT was much higher when compared to the other treatment methods. In the evaluations performed at the end of the three-month period, it was seen that the efficacy of the treatment was continuing. According to these results, pure tone masking-TRT was found to be the best treatment method when compared to other methods and it was concluded that this treatment may be considered as the first choice in patients with idiopathic tinnitus.

Tinnitus Loudness in Quiet and Noise After Resection of Vestibular Schwannoma

(1) To use a loudness model to assess the influence of loudness recruitment on estimates of the loudness of tinnitus obtained by loudness matching; (2) To compare the effect of background noise on the loudness of tinnitus for individuals who are unilaterally deaf after resection of vestibular schwannoma (VS) and those with idiopathic tinnitus. After translabyrinthine resection of VS, patients experience unilateral deafness and tinnitus in the operated ear. Most complain that their tinnitus is more bothersome in noisy environments, unlike those with idiopathic tinnitus. Unilaterally deaf individuals experiencing tinnitus as a consequence of VS surgery and a comparison group with idiopathic tinnitus. Participants adjusted the level of a probe tone at the frequency where their hearing was best to match the loudness of their tinnitus in quiet; for VS participants, matches were made using a probe in the unaffected ear. Matches were then obtained in the presence of threshold-equalizing noise. For those with idiopathic tinnitus, the probe loudness level, calculated using a loudness model, was almost invariant with hearing loss at the probe frequency and was usually between 20 and 50 phons. For the VS group, the probe loudness level ranged from 6 to 51 phons. With increasing threshold-equalizing-noise level, the loudness match decreased slightly for the comparison group but increased significantly for the VS group. The tinnitus in quiet had a moderate loudness for both groups. Background noise slightly decreased tinnitus loudness for most participants with idiopathic tinnitus but increased tinnitus loudness for VS participants. We propose 2 possible mechanisms for the effect of noise in the VS group.

Efficacy of Gabapentin on Subjective Idiopathic Tinnitus: A Randomized, Double-Blind, Placebo-Controlled Trial

Tinnitus can cause extreme morbidity. Despite many attempts to find a treatment for idiopathic cases, they remain difficult to manage. Because nerve injury is one of the suspected etiologies of tinnitus and because gabapentin has been found to be effective in treating nerve injuries, some authors have attempted to determine if gabapentin has a role in treating tinnitus. Although gabapentin was found to be ineffective for tinnitus in these previous studies, to the best of our knowledge no studies have been performed that took into consideration the presence of various accompanying factors and concomitant diseases that might influence its effect. We conducted a prospective, randomized, double-blind, placebo-controlled clinical trial of gabapentin for idiopathic tinnitus. We treated 40 patients with gabapentin and measured its effectiveness by comparing differences between pre- and post-treatment Tinnitus Severity Index (TSI) values and tinnitus loudness scores. We also compared these outcomes with those of a group of 40 matched placebo controls. At study's end, we found no significant differences between the gabapentin and control groups in mean decreases in TSI value and loudness score (p=0.85 and p=0.12, respectively). However, we did find that patients with hypertension, diabetes, and/or dyslipidemia showed a better response to gabapentin than did those with tinnitus alone (p=0.01). We conclude that although there was no statistically significant difference between gabapentin and placebo in treating isolated tinnitus or tinnitus overall, patients with concomitant hypertension, diabetes, and/or dyslipidemia may benefit from gabapentin.

Functional brain abnormalities localized in 55 chronic tinnitus patients: fusion of SPECT coincidence imaging and MRI.

Tinnitus is often defined as the perception of sounds or noise in the absence of any external auditory stimuli. The pathophysiology of subjective idiopathic tinnitus remains unclear. The aim of this study was to investigate the functional brain activities and possible involved cerebral areas in subjective idiopathic tinnitus patients by means of single photon emission computerized tomography (SPECT) coincidence imaging, which was fused with magnetic resonance imaging (MRI). In this cross-sectional study, 56 patients (1 subject excluded) with subjective tinnitus and 8 healthy controls were enrolled. After intravenous injection of 5 mCi F18-FDG (fluorodeoxyglucose), all subjects underwent a brain SPECT coincidence scan, which was then superimposed on their MRIs. In the eight regions of interest (middle temporal, inferotemporal, medial temporal, lateral temporal, temporoparietal, frontal, frontoparietal, and parietal areas), the more pronounced values were represented in medial temporal, inferotemporal, and temporoparietal areas, which showed more important proportion of associative auditory cortices in functional attributions of tinnitus than primary auditory cortex. Brain coincidence SPECT scan, when fused on MRI is a valuable technique in the assessment of patients with tinnitus and could show the significant role of different regions of central nervous system in functional attributions of tinnitus.