Gopal Kamakshi V, Thomas Binu P, Nandy Rajesh, Mao Deng, Lu Hanzhang
Department of Audiology and Speech-Language Pathology, University of North Texas, Denton, TX.
Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.
J Am Acad Audiol. 2017 Sep;28(8):742-757. doi: 10.3766/jaaa.16106.
Subjective tinnitus, or ringing sensation in the ear, is a common disorder with no accepted objective diagnostic markers.
The purpose of this study was to identify possible objective markers of tinnitus by combining audiological and imaging-based techniques.
Case-control studies.
Twenty adults drawn from our audiology clinic served as participants. The tinnitus group consisted of ten participants with chronic bilateral constant tinnitus, and the control group consisted of ten participants with no history of tinnitus. Each participant with tinnitus was closely matched with a control participant on the basis of age, gender, and hearing thresholds.
Data acquisition focused on systematic administration and evaluation of various audiological tests, including auditory-evoked potentials (AEP) and otoacoustic emissions, and magnetic resonance imaging (MRI) tests. A total of 14 objective test measures (predictors) obtained from audiological and MRI tests were subjected to statistical analyses to identify the best predictors of tinnitus group membership. The least absolute shrinkage and selection operator technique for feature extraction, supplemented by the leave-one-out cross-validation technique, were used to extract the best predictors. This approach provided a conservative model that was highly regularized with its error within 1 standard error of the minimum.
The model selected increased frontal cortex (FC) functional MRI activity to pure tones matching their respective tinnitus pitch, and augmented AEP wave N₁ amplitude growth in the tinnitus group as the top two predictors of tinnitus group membership. These findings suggest that the amplified responses to acoustic signals and hyperactivity in attention regions of the brain may be a result of overattention among individuals that experience chronic tinnitus.
These results suggest that increased functional MRI activity in the FC to sounds and augmented N₁ amplitude growth may potentially be the objective diagnostic indicators of tinnitus. However, due to the small sample size and lack of subgroups within the tinnitus population in this study, more research is needed before generalizing these findings.
主观性耳鸣,即耳内的耳鸣感,是一种常见疾病,尚无公认的客观诊断标志物。
本研究的目的是通过结合听力学和基于成像的技术来确定耳鸣可能的客观标志物。
病例对照研究。
从我们的听力诊所招募了20名成年人作为参与者。耳鸣组由10名患有慢性双侧持续性耳鸣的参与者组成,对照组由10名无耳鸣病史的参与者组成。每名耳鸣参与者在年龄、性别和听力阈值方面与一名对照参与者进行了密切匹配。
数据采集重点在于对各种听力学测试进行系统管理和评估,包括听觉诱发电位(AEP)和耳声发射,以及磁共振成像(MRI)测试。从听力学和MRI测试中获得的总共14项客观测试指标(预测因子)进行了统计分析,以确定耳鸣组成员的最佳预测因子。使用最小绝对收缩和选择算子技术进行特征提取,并辅以留一法交叉验证技术,以提取最佳预测因子。这种方法提供了一个保守的模型,该模型高度正则化,其误差在最小值的1个标准误差范围内。
该模型选择了额叶皮质(FC)对与各自耳鸣音调匹配的纯音的功能磁共振成像活动增加,以及耳鸣组中AEP波N₁振幅增长增强,作为耳鸣组成员的前两个预测因子。这些发现表明,对声音的放大反应和大脑注意力区域的活动亢进可能是患有慢性耳鸣的个体过度关注的结果。
这些结果表明,FC对声音的功能磁共振成像活动增加和N₁振幅增长增强可能潜在地是耳鸣的客观诊断指标。然而,由于本研究中样本量小且耳鸣人群中缺乏亚组,在推广这些发现之前还需要更多的研究。