Hébert Sylvie, Fournier Philippe
Faculty of Medicine, School of Speech Pathology and Audiology, Université de Montréal, Montréal, QC, Canada; BRAMS - International Laboratory for Research on Brain, Music, and Sound, Université de Montréal, Montréal, QC, Canada.
Front Neurol. 2017 Feb 21;8:38. doi: 10.3389/fneur.2017.00038. eCollection 2017.
Current clinical assessment of tinnitus relies mainly on self-report. Psychoacoustic assessment of tinnitus pitch and loudness are recommended but methods yield variable results. Herein, we investigated the proposition that a previously validated fixed laboratory-based method (Touchscreen) and a newly developed clinically relevant portable prototype (Stand-alone) yield comparable results in the assessment of psychoacoustic tinnitus pitch and loudness. Participants with tinnitus [ = 15, 7 with normal hearing and 8 with hearing loss (HL)] and participants simulating tinnitus (simulators, = 15) were instructed to rate the likeness of pure tones (250-16 kHz) to their tinnitus pitch and match their loudness using both methods presented in a counterbalanced order. Results indicate that simulators rated their "tinnitus" at lower frequencies and at louder levels (~10 dB) compared to tinnitus participants. Tinnitus subgroups (with vs. without HL) differed in their predominant tinnitus pitch (i.e., lower in the tinnitus with HL subgroups), but not in their loudness matching in decibel SL. Loudness at the predominant pitch was identified as a factor yielding significant sensitivity and specificity in discriminating between the two groups of participants. Importantly, despite differences in the devices' physical presentations, likeness and loudness ratings were globally consistent between the two methods and, moreover, highly reproducible from one method to the other in both groups. All in all, both methods yielded robust tinnitus data in less than 12 min, with the Stand-alone having the advantage of not being dependent of learning effects, being user-friendly, and being adapted to the audiogram of each patient to further reduce testing time.
目前对耳鸣的临床评估主要依赖于自我报告。虽然推荐对耳鸣的音高和响度进行心理声学评估，但这些方法得出的结果存在差异。在此，我们研究了这样一个观点：一种先前经过验证的基于实验室的固定方法（触摸屏法）和一种新开发的具有临床相关性的便携式原型方法（独立式）在评估心理声学耳鸣音高和响度方面能产生可比的结果。患有耳鸣的参与者（n = 15，7 名听力正常，8 名有听力损失 [HL]）和模拟耳鸣的参与者（模拟器，n = 15）被要求使用以平衡顺序呈现的两种方法，对纯音（250 - 16 kHz）与他们耳鸣音高的相似程度进行评分，并匹配其响度。结果表明，与耳鸣参与者相比，模拟器将他们的“耳鸣”评定为较低频率和较高响度（约 10 dB）。耳鸣亚组（有 HL 与无 HL）在其主要耳鸣音高上存在差异（即有 HL 的耳鸣亚组中较低），但在以分贝 SL 为单位的响度匹配方面没有差异。主要音高的响度被确定为在区分两组参与者时产生显著敏感性和特异性的一个因素。重要的是，尽管两种设备的物理呈现方式不同，但两种方法在相似性和响度评分方面总体上是一致的，而且在两组中从一种方法到另一种方法都具有高度可重复性。总而言之，两种方法都能在不到 12 分钟的时间内产生可靠的耳鸣数据，独立式方法具有不依赖学习效应、用户友好以及能根据每个患者的听力图进行调整以进一步缩短测试时间的优势。
