Krick Christoph M, Argstatter Heike, Grapp Miriam, Plinkert Peter K, Reith Wolfgang
Department for Neuroradiology, Saarland University HospitalHomburg, Germany.
German Research Centre for Music Therapy ResearchHeidelberg, Germany.
Front Neurosci. 2017 Jul 20;11:418. doi: 10.3389/fnins.2017.00418. eCollection 2017.
Tinnitus is the perception of a phantom sound without external acoustic stimulation. Recent tinnitus research suggests a relationship between attention processes and tinnitus-related distress. It has been found that too much focus on tinnitus comes at the expense of the visual domain. The angular gyrus (AG) seems to play a crucial role in switching attention to the most salient stimulus. This study aims to evaluate the involvement of the AG during visual attention tasks in tinnitus sufferers treated with Heidelberg Neuro-Music Therapy (HNMT), an intervention that has been shown to reduce tinnitus-related distress. Thirty-three patients with chronic tinnitus, 45 patients with recent-onset tinnitus, and 35 healthy controls were tested. A fraction of these (21/21/22) were treated with the "compact" version of the HNMT lasting 1 week with intense treatments, while non-treated participants were included as passive controls. Visual attention was evaluated during functional Magnet-Resonance Imaging (fMRI) by a visual Continous Performance Task (CPT) using letter-based alarm cues ("O" and "X") appearing in a sequence of neutral letters, "A" through "H." Participants were instructed to respond via button press only if the letter "O" was followed by the letter "X" (GO condition), but not to respond if a neutral letter appeared instead (NOGO condition). All participants underwent two fMRI sessions, before and after a 1-week study period. The CPT results revealed a relationship between error rates and tinnitus duration at baseline whereby the occurrence of erroneous "GO omissions" and the reaction time increased with tinnitus duration. Patients with chronic tinnitus who were treated with HNMT had decreasing error rates (fewer GO omissions) compared to treated recent-onset patients. fMRI analyses confirmed greater activation of the AG during CPT in chronic patients after HNMT treatment compared to treated recent-onset patients. Our findings suggest that HNMT treatment helps shift the attention from the auditory phantom percept toward visual cues in chronic tinnitus patients and that this shift in attention may involve the AG.
耳鸣是在没有外部声音刺激的情况下对虚幻声音的感知。近期的耳鸣研究表明，注意力过程与耳鸣相关的痛苦之间存在关联。研究发现，过度关注耳鸣是以牺牲视觉领域为代价的。角回（AG）似乎在将注意力转向最突出的刺激方面起着关键作用。本研究旨在评估接受海德堡神经音乐疗法（HNMT）治疗的耳鸣患者在视觉注意力任务期间AG的参与情况，该干预措施已被证明可减轻耳鸣相关的痛苦。对33名慢性耳鸣患者、45名新发耳鸣患者和35名健康对照者进行了测试。其中一部分（21/21/22）接受了为期1周的强化治疗的“紧凑型”HNMT治疗，而未接受治疗的参与者作为被动对照。在功能磁共振成像（fMRI）期间，通过视觉持续操作任务（CPT）评估视觉注意力，该任务使用基于字母的警报提示（“O”和“X”）出现在一系列中性字母“A”到“H”中。参与者被指示仅在字母“O”后面跟着字母“X”（执行条件）时通过按键做出反应，但如果出现中性字母则不做出反应（非执行条件）。所有参与者在为期1周的研究期之前和之后都进行了两次fMRI检查。CPT结果显示，基线时错误率与耳鸣持续时间之间存在关联，即错误的“执行遗漏”的发生率和反应时间随耳鸣持续时间增加。与接受治疗的新发耳鸣患者相比，接受HNMT治疗的慢性耳鸣患者的错误率降低（执行遗漏减少）。fMRI分析证实，与接受治疗的新发耳鸣患者相比，慢性患者在接受HNMT治疗后CPT期间AG的激活程度更高。我们的研究结果表明，HNMT治疗有助于将慢性耳鸣患者的注意力从听觉虚幻感知转移到视觉提示上，并且这种注意力的转移可能涉及AG。
