Chen Qian, Wang Zhaodi, Lv Han, Zhao Pengfei, Yang Zhenghan, Gong Shusheng, Wang Zhenchang
Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Neurosci. 2020 Jun 16;14:591. doi: 10.3389/fnins.2020.00591. eCollection 2020.
It remains unknown whether tinnitus or tinnitus-related hearing loss (HL) could indirectly impair or reshape the white matter (WM) of the human brain. We aim to explore the possible brain WM change in tinnitus patients without HL and further to investigate their associations with clinical variables. Structural and diffusion tensor imaging (DTI) of 20 idiopathic tinnitus patients without HL and 22 healthy controls (HCs) were obtained. Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis were conducted to investigate the differences in WM volume and integrity between patients and HCs, separately. We extracted WM parameters to determine a sensitive imaging index to differentiate the idiopathic tinnitus patients from the HCs in the early stage. Correlations between the clinical variables and WM indices were also performed in patients. Compared with the controls, the tinnitus patients without HL exhibited significant decreased fractional anisotropy (FA) in the body and genu of corpus callosum (CC), left cingulum (LC) and right cingulum (RC), and right superior longitudinal fasciculus (RSLF) and increase in mean diffusivity (MD) in the body of CC in WM. Moreover, the patients also showed decreases in WM axial diffusivity (AD) in LC, left superior longitudinal fasciculus (LSLF), and right interior cerebellar peduncle (ICP) and increases in radial diffusivity (RD) in the body and genu of CC and RSLF ( < 0.05, voxel-level FWE corrected). Furthermore, the increased RD value of the genu of CC is closely associated with the tinnitus handicap inventory (THI) subscale scores. No WMV changes were detected in tinnitus patients. We combined the altered WM integrity index of body and genu of CC and LC and RSLF as an index to differentiate the two groups and reached a sensitivity of 100% and a specificity of 77.3%. Our findings suggest that tinnitus without HL is associated with significant alterations of WM integrity. These changes may be irrespective of the duration and other clinical performance. The combination of diffusion indices of body and genu of CC and LC and RSLF might be used as the potential useful imaging index for the diagnosis of persistent idiopathic tinnitus without HL in the early stage.
耳鸣或与耳鸣相关的听力损失（HL）是否会间接损害或重塑人脑的白质（WM）仍不清楚。我们旨在探索无HL的耳鸣患者脑WM可能的变化，并进一步研究其与临床变量的关联。获取了20例无HL的特发性耳鸣患者和22名健康对照者（HCs）的结构和扩散张量成像（DTI）。分别进行基于体素的形态学测量（VBM）和基于纤维束的空间统计学（TBSS）分析，以研究患者与HCs之间WM体积和完整性的差异。我们提取WM参数以确定一个敏感的成像指标，用于在早期区分特发性耳鸣患者与HCs。还对患者的临床变量与WM指标之间进行了相关性分析。与对照组相比，无HL的耳鸣患者在胼胝体（CC）的体部和膝部、左侧扣带（LC）和右侧扣带（RC）以及右侧上纵束（RSLF）中表现出显著降低的各向异性分数（FA），在WM中CC体部的平均扩散率（MD）增加。此外，患者在LC、左侧上纵束（LSLF）和右侧小脑内脚（ICP）中的WM轴向扩散率（AD）降低，在CC体部和膝部以及RSLF中的径向扩散率（RD）增加（<0.05，体素水平FWE校正）。此外，CC膝部增加的RD值与耳鸣障碍量表（THI）子量表得分密切相关。在耳鸣患者中未检测到WM体积（WMV）变化。我们将CC体部和膝部以及LC和RSLF改变的WM完整性指数组合作为区分两组的指标，灵敏度达到100%，特异性为77.3%。我们的研究结果表明，无HL的耳鸣与WM完整性的显著改变有关。这些变化可能与病程和其他临床表现无关。CC体部和膝部以及LC和RSLF的扩散指数组合可能用作早期诊断无HL的持续性特发性耳鸣的潜在有用成像指标。
