Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006

doi:10.1016/S0079-6123(07)66050-6

Progress in Brain Research

Volume 166, 2007, Pages 525-536

https://doi.org/10.1016/S0079-6123(07)66050-6 Get rights and content

Abstract

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. At the first Tinnitus Research Initiative meeting held in Regensburg in July 2006 an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements. It is hoped that this will contribute towards better cooperation between research centres in finding and evaluating treatments for tinnitus by allowing better comparability between studies.

Introduction

Chronic tinnitus, the phantom perception of sound, can be a debilitating and life-altering experience. It affects millions of people in western countries. Despite the enormous social and economic burden tinnitus causes, no well-established specific treatment for this disorder is available. Among the reasons for this unsatisfactory situation are the difficulties in assessing tinnitus as it is a purely self-report subjective phenomenon.

There is widespread recognition that consistency between research centres in the ways that patients with tinnitus are assessed and outcomes following interventions are measured would facilitate more effective co-operation and more meaningful evaluations and comparisons of outcomes. On the other hand most research centres already have long established systems for collecting and assessing data and hence are unable or unwilling to completely change to a different system because so much would be lost.

At the recent (July, 2006) Tinnitus Research Initiative meeting in Regensburg, Germany an attempt was made through workshops to gain a consensus both for patient assessments and for outcome measurements.

It is hoped that this consensus will facilitate cooperation between tinnitus research centres in finding and evaluating treatments for tinnitus and will help achieve more meaningful comparisons between studies.

Section snippets

There is a need for consensus on assessment and outcome measurement

There is an urgent need for a set of assessment methods to be agreed and utilised by the international tinnitus research community. This includes assessment of patients with tinnitus and subsequent measurement of outcomes following intervention.

Consistency in assessment of patients with tinnitus will advance the characterisation of their tinnitus into subtypes. As results for most known therapeutic interventions are very inconsistent, the identification of predictors for the effectiveness of

Acknowledgements

The authors wish to thank Ulli Soltani for organisational assistance.

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Many individuals with chronic subjective tinnitus report significant problems in comprehending speech in adverse listening situations. A large body of studies has provided evidence to support the notion that deficits in speech-in-noise (SIN) are prevalent in the tinnitus population, while some studies have challenged these findings. Elemental auditory perception is usually only minimally or not impaired. In addition, deficits in cognitive functions, particularly executive functions, have also been observed in individuals with tinnitus. Given these previous findings, we theorize that deficient central mechanisms may be responsible for the reported speech comprehension problems in tinnitus.
25 participants suffering from chronic subjective tinnitus and 25 control participants, between 23 and 58 years of age, were examined in a cross-sectional design. The groups were case-matched for age, sex, education, and hearing loss. A large audiometric battery was used ranging from threshold and supra-threshold tasks to spoken sentence level speech tasks. Additionally, four cognitive tests were performed, primarily covering the area of executive functions. Tinnitometry and tinnitus-related questionnaires were applied to complement sample description and allow for secondary analyses. We hypothesized that tinnitus participants score lower in complex speech comprehension tasks and executive function tasks compared to healthy controls, while no group differences in elementary audiometric tasks were expected.
As expected, individuals with chronic subjective tinnitus scored lower in the SIN and gated speech task, while there were no differences in the basic speech recognition threshold task and the other elementary auditory perception tasks. The cognitive tests revealed clear deficits in interference control in the Stroop task, but not in the Flanker task, in the tinnitus group. There were no differences in inhibition or working memory tasks.
Our results clearly delineate differences between tinnitus individuals and control participants in two tests on speech intelligibility under adverse listening conditions. Further, the poorer performance in a task of interference control in individuals with tinnitus points towards an impaired central executive control in individuals with tinnitus. Taken together, our (partly) exploratory study provides novel evidence to the view that deficient central executive system in individuals with tinnitus probably account for impaired speech comprehension.
Validated French translation of the ESIT-SQ standardized tinnitus screening questionnaire
2023, Annales Francaises d'Oto-Rhino-Laryngologie et de Pathologie Cervico-Faciale
L’hétérogénéité de l’acouphène, tant par ses étiologies multiples, sa présentation protéiforme et ses conséquences fonctionnelles parfois sévères, constituait un frein à la thérapeutique et à la recherche clinique. Le questionnaire standardisé d’anamnèse (ESIT-SQ) développé par l’école européenne pour la recherche interdisciplinaire sur les acouphènes (ESIT) visait à recueillir les caractéristiques de l’acouphène de manière normalisée pour aider au sous-typage des patients. Une traduction française validée de l’ESIT-SQ a été ici proposée.
Sous l’impulsion de l’Association Francophone des Équipes Pluridisciplinaires en Acouphénologie (AFREPA), trois traducteurs (traducteur professionnel, clinicien et chercheur) ont été recrutés pour traduire en français la version anglaise de l’ESIT-SQ en suivant les recommandations des bonnes pratiques en la matière. Puis neuf patients recrutés avec l’aide de l’association de patients France-Acouphènes ont testé et validé cette traduction de l’ESIT-SQ. Enfin une enquête exploratoire des réponses a été réalisée en ligne via l’application mobile Siopi (n = 105),
La traduction française de l’ESIT-SQ a été validée avec succès. Au total, 105 complétions du questionnaire ont pu être collectées dans le cadre de l’enquête exploratoire. Les caractéristiques de ces réponses ont été exposées.
Une traduction française validée de l’ESIT-SQ a été réalisée pour permettre de recueillir des données épidémiologiques et cliniques francophones et les agréger et de les comparer à celles disponibles dans les différentes autres langues déjà disponibles pour ce questionnaire.
Prediction meets time series with gaps: User clusters with specific usage behavior patterns
2023, Artificial Intelligence in Medicine
With mHealth apps, data can be recorded in real life, which makes them useful, for example, as an accompanying tool in treatments. However, such datasets, especially those based on apps with usage on a voluntary basis, are often affected by fluctuating engagement and by high user dropout rates. This makes it difficult to exploit the data using machine learning techniques and raises the question of whether users have stopped using the app. In this extended paper, we present a method to identify phases with varying dropout rates in a dataset and predict for each. We also present an approach to predict what period of inactivity can be expected for a user in the current state. We use change point detection to identify the phases, show how to deal with uneven misaligned time series and predict the user’s phase using time series classification. In addition, we examine how the evolution of adherence develops in individual clusters of individuals. We evaluated our method on the data of an mHealth app for tinnitus, and show that our approach is appropriate for the study of adherence in datasets with uneven, unaligned time series of different lengths and with missing values.
Validated French translation of the ESIT-SQ standardized tinnitus screening questionnaire
2023, European Annals of Otorhinolaryngology, Head and Neck Diseases
The heterogeneity of tinnitus in terms of etiology, presentation and sometimes severe impact on quality of life hinders treatment and clinical research. The European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ) collects standardized tinnitus characteristics for patient subtyping. A validated French translation of the ESIT-SQ is presented here.
On the initiative of the French Interdisciplinary Tinnitus Association (AFREPA), 3 translators (1 professional translator, 1 clinician and 1 researcher) were missioned to translate the English version of the ESIT-SQ into French, adhering to good practice guidelines. Nine patients were recruited with the help of the France-Acouphènes patient association, to test and validate the translation. Lastly, an exploratory survey of responses to the French questionnaire was conducted online via the Siopi mobile phone application.
The French translation of the ESIT-SQ was successfully validated. 105 patients responded to the exploratory survey, and their characteristics are presented here.
This new validated French translation of the ESIT-SQ will enable epidemiological and clinical data to be collected in French-speaking populations, and thus compiled and compared with data collected with other versions of this questionnaire already published in other languages.
Hearing aid effectiveness on patients with chronic tinnitus and associated hearing loss
2022, Brazilian Journal of Otorhinolaryngology
Citation Excerpt :
Loudness and MML are valid measures of sound perception as they estimate tinnitus magnitude and can be used after intervention to evaluate their immediate effect, for example, after sound therapies strategies or magnetic transcranial stimulation techniques. Those measures are still recommended as a parameter for evaluating the results of tinnitus long-term interventions.17,40 Changes in tinnitus pitch, on the other hand, may point out a sign of central nervous system tonotopy reorganization and neural plasticity.41
Our study aimed to measure the effectiveness of using HA in reducing the disturbance caused by tinnitus.
Study was designed as a within-subjects clinical trial. Nineteen patients with chronic tinnitus and untreated sensorineural hearing loss were under counseling, HA fitting and 6 months follow-up. Tinnitus assessment was performed with Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), pitch and loudness matching, and Minimum Masking Level measurements (MML).
following 6 months of HA use, a reduction in reported tinnitus and hearing handicap scales scores was observed both statistically and clinically. The pitch and loudness matching, as well as MML at the baseline and final evaluation were compared. MML’s thresholds reduced significantly after 6 months of HA use.
Our study has provided evidence that HA fitting is a valuable treatment strategy for chronic tinnitus relief and associated hearing loss subtype of patient.
3.
Neuroanatomical alterations in middle frontal gyrus and the precuneus related to tinnitus and tinnitus distress
2022, Hearing Research
Tinnitus is the phantom perception of sound when there is no external auditory input. This sound is mostly perceived as a ringing, whistling or buzzing in the ear. There is evidence of neural changes in both central auditory regions as well as other brain areas like the prefrontal cortex and the limbic system. However, brain morphological studies assessing gray matter volume and cortical thickness have shown inconsistent results. We here investigated neuroanatomical alterations in tinnitus related to the tinnitus perception along with tinnitus distress and cognitive abilities. Twenty tinnitus patients and 20 control participants matched in age, sex and hearing loss participated in the study. They underwent magnetic resonance imaging and audiometric as well as cognitive assessments. Our results demonstrate increased gray matter volume in the middle frontal gyrus and frontal pole in tinnitus compared to control participants. Moreover, we found increased cortical thickness in the precuneus associated with tinnitus distress as well as an interaction between group and cognitive assessment scores in cortical thickness of the middle frontal gyrus, indicating higher cortical thickness with better scores in controls and lower scores in tinnitus patients. These findings indicate that increased tinnitus awareness and annoyance is reflected in increased brain structural changes in the precuneus, frontal pole and middle frontal gyrus that may also have implications on general cognitive abilities.

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Consensus for tinnitus patient assessment and treatment outcome measurement: Tinnitus Research Initiative meeting, Regensburg, July 2006

Abstract

Introduction

Section snippets

There is a need for consensus on assessment and outcome measurement

Acknowledgements

Psychiatry Res.

Acta Otorrinolaringol. Esp.

Otolaryngol. Head Neck Surg.

Internal consistencies of the original and revised beck depression inventory

J. Clin. Psychol.

Cognitive variables in tinnitus annoyance

Br. J. Clin. Psychol.

Psychoacoustic measures of tinnitus

J. Am. Acad. Audiol.

Validation of the German-version tinnitus handicap inventory (THI)

Psychiatr. Prax.