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Sankey plot of main results of the 3 regression models. Predictors are plotted on the left and represent the source of the ribbons. Dependent variables of the 3 models are plotted on the right and serve as the targets of the ribbons. Relative influence of standardized predictors is coded by the width of the ribbon and the source as well as target boxes on the y axis. Polarity of coefficients is visualized by their position above or below the x axis at 0. Coefficient values can be retrieved from Table 2.
Source publication
Tinnitus is the chronic perception of a phantom sound with different levels of related distress. Past research has elucidated interactions of tinnitus distress with audiological, affective and further clinical variables. The influence of tinnitus distress on cognition is underinvestigated. Our study aims at investigating specific influences of tinn...
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Purpose
To check the degree of reliability of the Speech, Spatial and Qualities of Hearing Scale (SSQ), in the assessment of the benefit in hearing aid users.
Methods
Thirty hearing impaired adults, candidates for use (novice users) or users whose hearing aids (experienced users) were being replaced, participated in the study. All participants und...
Background POU3F4 is the causative gene for X-linked deafness-2 (DFNX2), characterized by incomplete partition type III (IP-III) malformation of the inner ear. The aim of this study was to investigate the clinical characteristics and molecular findings by Sanger or Nanopore single-molecule sequencing in IP-III patients. Methods
Diagnosis of IP-III...
Citations
... Globally, approximately 14% (95% CI 0.8%-1.6%) of adults are affected by tinnitus [1,2], which can cause stress, anxiety, and depression [3]. Distress and hearing impairment brought on by the disease can affect cognitive abilities and lead to suicidal tendencies in severe cases, greatly affecting the work and daily lives of patients [4]. ...
Background
Tinnitus diagnosis poses a challenge in otolaryngology owing to an extremely complex pathogenesis, lack of effective objectification methods, and factor-affected diagnosis. There is currently a lack of explainable auxiliary diagnostic tools for tinnitus in clinical practice.
Objective
This study aims to develop a diagnostic model using an explainable artificial intelligence (AI) method to address the issue of low accuracy in tinnitus diagnosis.
Methods
In this study, a knowledge graph–based tinnitus diagnostic method was developed by combining clinical medical knowledge with electronic medical records. Electronic medical record data from 1267 patients were integrated with traditional Chinese clinical medical knowledge to construct a tinnitus knowledge graph. Subsequently, weights were introduced, which measured patient similarity in the knowledge graph based on mutual information values. Finally, a collaborative neighbor algorithm was proposed, which scored patient similarity to obtain the recommended diagnosis. We conducted 2 group experiments and 1 case derivation to explore the effectiveness of our models and compared the models with state-of-the-art graph algorithms and other explainable machine learning models.
Results
The experimental results indicate that the method achieved 99.4% accuracy, 98.5% sensitivity, 99.6% specificity, 98.7% precision, 98.6% F1-score, and 99% area under the receiver operating characteristic curve for the inference of 5 tinnitus subtypes among 253 test patients. Additionally, it demonstrated good interpretability. The topological structure of knowledge graphs provides transparency that can explain the reasons for the similarity between patients.
Conclusions
This method provides doctors with a reliable and explainable diagnostic tool that is expected to improve tinnitus diagnosis accuracy.
... However, objective evidence of working memory and attentional (alerting sustained, selective) impairment is equivocal (119). Some domains of executive function appear to be consistently affected, particularly the executive control of attention (120). More research is required to understand the interactive relationship between tinnitus and cognition, establishing which cognitive domains are affected and why. ...
... Preliminary findings indicate that poorer signal in noise recognition might underlie cognitive difficulties when processing speech in noise (121). Research should also delineate the additional impact of co-existing psychological distress and hearing loss, as well as aging since these factors can impede cognition independently (120,122). Future studies could also compare the cognitive profiles of vestibular patients who present with tinnitus related to those who do not (123,124). ...
Vestibular disorders are prevalent and debilitating conditions of the inner ear and brain which affect balance, coordination, and the integration of multisensory inputs. A growing body of research has linked vestibular disorders to cognitive problems, most notably attention, visuospatial perception, spatial memory, and executive function. However, the mechanistic bases of these cognitive sequelae remain poorly defined, and there is a gap between our theoretical understanding of vestibular cognitive dysfunction, and how best to identify and manage this within clinical practice. This article takes stock of these shortcomings and provides recommendations and priorities for healthcare professionals who assess and treat vestibular disorders, and for researchers developing cognitive models and rehabilitation interventions. We highlight the importance of multidisciplinary collaboration for developing and evaluating clinically relevant theoretical models of vestibular cognition, to advance research and treatment.
... A similar effect was found for processing speed, although the authors noted this could be an artefact of the correlation between tinnitus and executive functions, as tasks that measure processing speed usually also require cognitive control. These findings were confirmed by Neff et al. [15], who found a small negative effect of tinnitus distress on general and crystalized intelligence and executive functions, but not on processing speed. Finally, Wang et al. [16] found that patients with severe tinnitus performed worse on most of the Cognitive Abilities Screening Instrument (CASI) subdomains and on total CASI score than patients with mild tinnitus, suggesting that tinnitus severity plays an important role in its effect on cognition. ...
... Previous literature has shown a negative effect of tinnitus on executive functions [11,12,15]. As there is no separate scale for executive functioning in the RBANS-H (only indirectly through the verbal fluency task), the specific effect of tinnitus on executive functions was not measured in the current study. ...
Purpose
Recent literature suggests that tinnitus can impact cognition, but results were varied due to a diversity in investigated aspects of cognition and utilized tests, as well as the possible influence of confounding factors. The purpose of this study was to assess the impact of tinnitus loudness on cognition by use of a within-subjects design in patients with a cochlear implant (CI). In this population, tinnitus loudness can be modulated by switching the CI on or off as CI is known to highly suppress tinnitus.
Methods
A total of 18 CI users completed two versions of the Repeatable Battery for Assessment of Neuropsychological Status for Hearing Impaired individuals (RBANS-H), once in unaided condition and once in best aided condition. Tinnitus suppression was defined as a difference in score on a visual-analogue scale (VAS) of at least one point out of ten between these two conditions.
Results
No significant differences in RBANS-H scores were found between the suppression and no suppression group, nor for the suppression group alone. No significant correlations between tinnitus loudness and RBANS-H were found, neither for the suppression group alone, nor for the group as a whole.
Conclusion
The current study shows no significant effect of tinnitus loudness on cognition, which contradicts previous literature. This discrepancy could be explained by the use of a within-subjects design, which controls for confounding factors. Future research should include a larger and more diverse study sample to draw definitive conclusions on this topic.
... Hair cells and neuronal structures in the inner ear can degenerate, and in some people, the central processing of information in the brain becomes slower, leading to cognitive losses [41]. Moreover, the ability to discriminate speech also decreases with age, as higher frequencies and voices are no longer recognized or differentiated so well [42]. ...
Background: Tinnitus severity is generally assessed by psychometric and audiological instruments. However, no objective measure exists to evaluate the subjective discomfort and suffering caused by this hearing phenomenon. The objective of this work was to determine the possible blood parameters for diagnostics and therapy. Methods: We measured tinnitus distress by using the Tinnitus Questionnaire (TQ) and collected tinnitus-related audiological measures, namely the hearing threshold (HT), tinnitus loudness (TL), and sensation level (SL, i.e., the tinnitus loudness/hearing threshold at a tinnitus frequency). Blood samples were taken from 200 outpatients of the Tinnitus Centre of the Charité, and 46 routine blood count parameters were examined. The possible interactions were determined by (robust) linear models. Results: Tinnitus distress and audiological measurements were largely uncorrelated but could partly be predicted by selected blood parameters. First, the erythrocyte counts predicted tinnitus distress to a small extent. Second, the levels of vitamin D3 explained about 6% of tinnitus loudness and, age-dependently, the hearing threshold variability. Last, the levels of uric acid explained about 5% of the sensation level variability. Conclusions: Tinnitus is a multidimensional phenomenon. The marginal influences of blood markers suggest the possible roles of inflammation and oxidative stress produced by psychological or somatic burdens. Clinically, a vitamin D substitution (in older patients) might have a hearing-protective effect.
... Die Rolle kognitiver Faktoren für Hörverlust, Tinnitus oder Tinnitusbelastung wird intensiv untersucht [81][82][83]. Kognition be-schreibt die Summe aller Denk-und Wahrnehmungsprozesse. Kognitive Prozesse können bewusst oder unbewusst ablaufen [84], und die Mehrzahl kognitiver Fähigkeiten nimmt im Alter ab [85]. Klinisch fällt auf, dass Personen mit chronischem Tinnitus oftmals Einschränkungen berichten, die zumindest teilweise kognitive Einflussfaktoren vermuten lassen -wie z. ...
... B. das Arbeitsgedächtnis sind ebenfalls gut belegt [102]. Neff et al. [83] beobachteten einen Zusammenhang zwischen Tinnitusbelastung und verminderter kristalliner Intelligenz sowie Reizverarbeitungsgeschwindigkeit. In Zusammenschau betonen diese Ergebnisse erneut, dass für die Anamneseerhebung und Behandlungsplanung neben sorgfältiger Abklärung otologischer, audiologischer und internistischer Einflüsse immer auch psychische -inklusiver kognitive -Faktoren mitberücksichtigt werden sollten. ...
Zusammenfassung
Zahlreiche Studien zeigen, dass Beeinträchtigungen bei chronischem Tinnitus eng mit psychosomatischen und anderen Begleiterscheinungen verwoben sind. In dieser Übersicht werden einige Arbeiten zu diesem Thema zusammengefasst und eingeordnet. Neben einer möglichen Hörminderung sind individuelle Wechselwirkungen aus medizinischen und psychosozialen Belastungsfaktoren sowie Ressourcen von zentraler Bedeutung. Tinnitusbelastung spiegelt eine große Anzahl interkorrelierter, psychosomatischer Einflussfaktoren wider – wie z. B. Persönlichkeitseigenschaften, Stressreaktivität sowie Depressions-, oder Angsterleben, die mit kognitiven Einschränkungen einhergehen können und im Rahmen eines Vulnerabilität-Stress-Reaktion Modells konzeptualisiert werden sollten. Des Weiteren können übergeordnete Faktoren wie Alter, Geschlecht oder Bildungsstand die Vulnerabilität für Belastungserleben erhöhen. Diagnostik und Therapie des chronischen Tinnitus müssen somit individualisiert, multidimensional und interdisziplinär erfolgen. Multimodale psychosomatische Therapieansätze zielen darauf ab, individuell konstellierte medizinische und audiologische Einflussfaktoren sowie psychologische Erlebensaspekte zu adressieren und die Lebensqualität Betroffener nachhaltig zu erhöhen. Ein Counselling im Erstkontakt ist für Diagnostik und Therapie ebenfalls unabdingbar.
... Figure 2 shows the seven regression models schematized as the Sankey diagram. To create a Sankey plot showing a regression model, we referred to the study of Neff et al. [88]. Appendix A includes a table of regression models. ...
The sudden adoption of working from home (WFH) during the COVID-19 pandemic has required the reconfiguration of home spaces to fit space for remote work into existing spaces already filled with other domestic functions. This resulted in blurring of home and work boundaries, the potential lack of space for telecommuting from home, and telecommuters' feelings of crowding. Numerous studies have shown the negative effects of crowding feelings on workers' responses. This study focused on the issue of crowding in the residential workspace. An online survey was conducted to investigate how features of the home workspace correlate with telecommuters' feelings of crowding and how these feelings affect satisfaction, health, and productivity. As a result, we found that various environmental features of home workspaces (e.g., house size, purpose of workspace, accessible balcony, lighting, noise, etc.), as well as psychological aspects (e.g., individual control over space use), had significant effects on telecommuters' feelings of crowdedness. It was also found that feelings of crowding in the WFH environment can directly and indirectly affect teleworkers' satisfaction with work environments, well-being, and work performance. Based on the results, we offered various potential ways to alleviate overcrowding issues in the WFH context.
... Expanding on the above-reported results [26][27][28], we use data from the original randomized controlled crossover study that investigated the effects of a hearing therapy protocol on TRD and SC. The present study examines pooled data from the crossover study's two intervention arms and includes N = 177 patients with chronic tinnitus and mild-to-moderate HL (age mean = 59.61 years; SD = 7.46) who were examined at a screening (t 0 ), pre-and post-treatment (t 1 − t 2 ), and at a 70-day follow up timepoint (t 3 ) (see also [27]). ...
... The hearing therapy combined binaural DSL child algorithm-based HA fittings and a 14-day auditory self-study program (terzo © Hearing Therapy). For detailed information on sample characteristics at screening [28] as well as study design, sample characteristics at baseline, the examined hearing therapy, and the obtained self-report measures, readers are referred to the current study's predecessor papers [26,27]. ...
Background:
Hearing aids (HAs) can improve tinnitus-related distress (TRD) and speech-comprehension (SC) in silence or at 55 dB noise-interference (SC_55 dB) in patients with chronic tinnitus and mild-to-moderate hearing loss. However, the role of HA use time in relation to psychological, audiological, or self-reported tinnitus characteristics is under-investigated.
Methods:
We examine 177 gender-stratified patients before (t1) and after an intervention comprising binaural DSLchild algorithm-based HA fitting and auditory training (t2) and at a 70-day follow up [t3]. HA use time was retrospectively retrieved (at t2) for the pre-post- and (at t3) post-follow up periods. General linear models investigated HA use time in relation to (1) general audiological, (2) tinnitus-related audiological, (3) tinnitus-related self-report, and (4) distress-related self-report indices before and after treatment, where applicable. Receiver operator characteristic analyses identified optimal HA use time for hereby-mediated treatment changes.
Results:
At t1 and t2, psychological, but not audiological indices causally influenced prospective HA use time-except for SC_55 dB at t1, which, however, correlated with patients' anxiety, depressivity, and psychological distress levels. Correlations did not differ between patient subgroups defined by categorical tinnitus-related audiological or self-report indices. HA use time partly mediated treatment-related improvement in TRD, but not SC. Optimal use amounted to 9.5-10.5 h/day.
Conclusions:
An awareness of psychological influences may help clinicians facilitate HA use and, thereby, TRD improvement with hearing amplification.
... Upon inclusion, all participants completed a set of screening measures (timepoint t 0 ), the results of which are reported elsewhere [30]. Applying a cross-over design, participants were then randomised to an immediate (IIG) or delayed intervention group (DIG). ...
Background:
Patients with chronic tinnitus and mild-to-moderate hearing loss (HL) can experience difficulties with speech comprehension (SC). The present study investigated SC benefits of a two-component hearing therapy.
Methods:
One-hundred-seventy-seven gender-stratified patients underwent binaural DSLchild-algorithm-based hearing aid (HA) fitting and conducted auditory training exercises. SC was measured at four timepoints under three noise interference conditions each (0, 55, and 65 dB): after screening (t0; without HAs), HA- fitting (t1), additional auditory training (t2), and at 70-day follow-up (t3). Repeated-measure analyses of covariance investigated the effects of HAs (t0-t1), auditory training (t1-t2), and the stability of the combined effect (t2-t3) on SC per noise interference level and HL subgroup. Correlational analyses examined associations between SC, age, and psychological indices.
Results:
Patients showed mildly elevated tinnitus-related distress, which was negatively associated with SC in patients with mild but not moderate HL. At 0 dB, the intervention lastingly improved SC for patients with mild and moderate HL; at 55 dB, for patients with mild HL only. These effects were mainly driven by HAs.
Conclusions:
The here-investigated treatment demonstrates some SC-benefit under conditions of no or little noise interference. The auditory training component warrants further investigation regarding non-audiological treatment outcomes.
... A recent study of a patient with clinical tinnitus in Germany showed that tinnitus was found to be associated with significantly decreased odds of dysfunction of processing speed/ attention/executive function. 35 In a recent meta-analysis, tinnitus correlated with not only poorer executive function and processing speed but also general short-term memory. 14 Tinnitus is also associated with working memory, 13 nonauditory processing of verbal, visual, and visuospatial information. ...
Aim:
To examine how the severity of age-related hearing loss (ARHL) and tinnitus or the presentation of ARHL with tinnitus is associated with overall cognition, in terms of specific cognitive domains in older community-dwelling Chinese adults.
Methods:
The study recruited 429 participants aged ≥58 years (mean age, 72.91 ± 7.014 years; female proportion, 57.30%), excluding those with dementia, disability, and severe mental illness. Patients were classified into normal cognition, pre-mild cognitive impairment (pre-MCI), and MCI according to the normative z-scores of neuropsychological test battery. The severity of ARHL and tinnitus was measured by pure-tone audiometry and the Tinnitus Handicap Inventory. Cognitive impairment and low functions in specific cognitive domains were used as dependent variables in multiple regression analyses adjusted for covariates.
Results:
ARHL severity was positively associated with MCI and low executive function, delayed memory, and language function. Only individuals with mild (odds ratio (OR) 1.791; CI, 0.952-3.373; P = 0.071), and moderate and the disaster tinnitus (OR, 2.493; CI, 0.982-6.328; P = 0.055) were marginally associated with increased odds of MCI in model 1. Individuals with ARHL and tinnitus (OR, 3.888, CI = 1.481-10.205; OR, 4.471, CI = 1.636-12.219) were independently associated with high risk for MCI in models 1 and 2.
Conclusions:
ARHL severity and the presentation of ARHL or ARHL with tinnitus were associated with overall cognition. ARHL severity was independently associated with executive function, delayed memory, and language function. The association between tinnitus severity and cognition is not clear. But the group with ARHL and tinnitus is a high-risk group with cognitive impairment.
Clinicaltrials:
gov identifier: NCT2017K020.
... Interestingly, we also observed that emotional arousal, mood and concentration had ambivalent associations with both loudness and distress (see Figures 4C,F). Such associations could explain why tinnitus is uniquely experienced, and future research could further investigate factors associated with tinnitus distress and loudness, such as behavior, emotional and cognitive dynamics samples from EMA. Tinnitus is known to have potential negative consequences on cognition (Andersson and McKenna, 2009;Mohamad et al., 2016;Neff et al., 2021), but this is the first time a positive association between concentration and tinnitus distress/loudness has been shown. Future studies should further investigate this seemingly paradoxical relationship, especially considering that concentration problems are one of the core domains that tinnitus patients would like to have as outcome measures from clinical interventions (Hall et al., 2018. ...
Background
Tinnitus is a heterogeneous condition which may be associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by capturing the fluctuations of tinnitus symptoms, such as distress and loudness, and psychological processes, such as emotional arousal, overall stress, mood, and concentration and how these variables interact over time. Whether any of those variables have an influence over the next day, that is, whether any of these variables are auto- or cross-correlated, is still unanswered.
Objectives
Assess whether behavioral and symptom-related data from tinnitus users from the TrackYourTinnitus (TYT) mobile app have an impact on tinnitus loudness and distress on subsequent days.
Methods
Anonymized data was collected from 278 users of the iOS or Android TYT apps between 2014 and 2020. Tinnitus-related distress, tinnitus loudness, concentration level, mood, emotional arousal, and overall stress level were assessed using either a slider or the Wong-Baker Pain FACES scale via a daily survey. Three modeling strategies were used to investigate whether tinnitus loudness and distress are affected by previous days symptoms or psychological processes: auto- and cross correlations, regressions with elastic net regularization, and subgrouping within group iterative multiple model estimation (S-GIMME).
Results
No autocorrelation or cross-correlation was observed at the group level between the variables assessed. However, application of the regression models with elastic net regularization identified individualized predictors of tinnitus loudness and distress for most participants, with the models including contemporaneous and lagged information from the previous day. S-GIMME corroborated these findings by identifying individualized predictors of tinnitus loudness and distress from the previous day.
Discussion
We showed that tinnitus loudness and tinnitus distress are affected by the contemporaneous and lagged dynamics of behavioral and emotional processes measured through EMA. These effects were seen at the group, and individual levels. The relevance EMA and the implications of the insights derived from it for tinnitus care are discussed, especially considering current trends toward the individualization of tinnitus care.
