Shulman Abraham, Avitable Matthew J, Goldstein Barbara
Martha Entenmann Tinnitus Research Center, Forest Hills, New York, USA.
Int Tinnitus J. 2006;12(2):121-31.
We report a descriptive analysis-interpretation of quantitative electroencephalography (QEEG) data for the metric of power in patients with tinnitus of the severe disabling type (N = 61). The results are based on a statistical analysis of the data compared to a normative database as calculated in Z scores, controlling for the factors of age, gender, IQ, and the like.
We analyzed the QEEG data for the metric of power to measure (1) the number of significant recordings, normal and abnormal; (2) the significant recordings by electrode recording sites; (3) distribution of the electroencephalographic (EEG) frequency bands; and (4) occurrence of the EEG frequency bands correlated with the electrode recording sites. In the analysis of the occurrence of the EEG frequency bands by electrode recording area, we corrected for the number of recording sites.
We recorded normal power recordings in 20 of 61 patients (32.8%) and abnormal power recordings in 41 of 61 patients (67.2%); power distribution by frequency band in 41 of 61 patients,revealing the number of significant recordings of delta (119), alpha (69), beta (91), and theta (17); and the power distribution by location for all frequencies, which were revealed as recording site activity in the frontal greater than in the temporal sites, which in turn was greater than in the parietal site, and equal activity in parietal, occipital, and central sites. The analysis of the occurrence of the EEG frequency bands by electrode recording area as corrected for the number of recording sites reinforced our initial results.
Z-score analyses of QEEG recordings--based on a large normative database--for the metric of power for patients having tinnitus of the severe disabling type (N = 61) revealed statistically significant abnormalities in frontal greater than temporal electrode recording sites. We reported no difference between male and female tinnitus patients in the number of abnormal power QEEG recordings. However, we observed significant differences in the average Z scores between males and females in the alpha and theta bands. The results suggest multiple central electrophysiological correlates for different clinical types of tinnitus identifiable with QEEG, for the metric of power, by frequencies of brain activity of delta greater than beta greater than alpha greater than theta bands of activity, reflecting physiologically the individuality of brain function and clinically the heterogeneity of the symptom of tinnitus for tinnitus patients. Clinical interpretation of the QEEG data in terms of brain function in a tinnitus patient, with a focus on theories of a neuroanatomical homeostatic system that regulates baseline levels of local synchrony in multiple neuronal assemblies and on theories of consciousness, introduces a paradigm switch in our clinical understanding of the symptom of tinnitus and an application for tinnitus diagnosis and treatment.
我们报告了对重度致残型耳鸣患者（N = 61）定量脑电图（QEEG）数据功率指标的描述性分析和解读。结果基于与标准数据库相比的数据统计分析，以Z分数计算，并控制了年龄、性别、智商等因素。
我们分析了QEEG数据的功率指标，以测量（1）正常和异常的显著记录数量；（2）按电极记录部位的显著记录；（3）脑电图（EEG）频段分布；以及（4）与电极记录部位相关的EEG频段出现情况。在按电极记录区域分析EEG频段出现情况时，我们对记录部位数量进行了校正。
61例患者中20例（32.8%）记录到正常功率记录，41例（67.2%）记录到异常功率记录；61例患者中的41例按频段的功率分布，显示出δ波（119）、α波（69）、β波（91）和θ波（17）的显著记录数量；以及所有频率按位置的功率分布，显示为额叶记录部位的活动大于颞叶部位，颞叶部位又大于顶叶部位，顶叶、枕叶和中央部位活动相等。按电极记录区域并校正记录部位数量后对EEG频段出现情况的分析强化了我们的初始结果。
基于大型标准数据库对重度致残型耳鸣患者（N = 61）的QEEG记录进行Z分数分析，结果显示额叶电极记录部位的异常在统计学上显著大于颞叶部位。我们报告称，男性和女性耳鸣患者异常功率QEEG记录数量无差异。然而，我们观察到男性和女性在α波和θ波频段的平均Z分数存在显著差异。结果表明，对于不同临床类型的耳鸣，通过QEEG以功率指标、按脑活动频率δ波＞β波＞α波＞θ波频段可识别出多种中枢电生理相关性，从生理上反映了脑功能的个体性，从临床上反映了耳鸣患者耳鸣症状的异质性。根据耳鸣患者的脑功能对QEEG数据进行临床解读，重点关注调节多个神经元集合局部同步基线水平的神经解剖稳态系统理论和意识理论，为我们对耳鸣症状的临床理解以及耳鸣诊断和治疗的应用带来了范式转变。
