Lan Tianxiang, Cao Zuwei, Zhao Fei, Perham Nick
Centre for Speech and Language Therapy and Hearing Sciences, Cardiff School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, United Kingdom.
Center for Rehabilitative Auditory Research, Guizhou Provincial People's Hospital, Guiyang, China.
Front Psychol. 2021 Jan 6;11:553449. doi: 10.3389/fpsyg.2020.553449. eCollection 2020.
Tinnitus refers to the perception of sound in the absence of an external stimulus. This can be problematic and can lead to health problems in some sufferers, including effects on cognitive functions such as attention and memory. Although several studies have examined the effectiveness of tinnitus interventions, e.g., cognitive behavioral therapy and sound therapy, it is still unclear as to the overall quality and limitations of these studies and whether their results could be generalized. Clarification is also needed as to whether poor cognitive function will lead to a less favorable intervention outcome in tinnitus patients. The present systematic review was therefore designed to critically appraise and synthesize findings from randomized controlled trials (RCTs) of tinnitus intervention and its effects on cognition. The methodology followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Medline (PubMed), Embase, and PsycINFO were searched. Only RCTs that compared the effectiveness of a tinnitus intervention and a measure of cognitive function in adult participants with tinnitus were included. A total of 8 studies involving 610 participants tested using 11 cognitive function assessment tools (e.g., Stroop Color and Word Test and Visual Continuous Performance Task) and 5 tinnitus intervention outcome measurements (e.g., Tinnitus Handicap Inventory and Tinnitus Questionnaire) were included and analyzed. The outcomes of the review suggest that tinnitus intervention not only facilitates tinnitus management but also improves cognitive functions. It is likely that cognition and emotion play an important role in a patient's adjustment to tinnitus. Whether cognition can predict treatment outcomes is unclear due to insufficient evidence. Future research is needed using a standardized assessment protocol focusing on the effect of sound-based interventions on tinnitus severity and cognitive functions. Studies on whether cognitive function measurement can be used as a predictor for the effectiveness of tinnitus therapy are also needed.
耳鸣是指在没有外部刺激的情况下感知到声音。这可能会带来问题，并在一些患者中导致健康问题，包括对注意力和记忆等认知功能的影响。尽管有几项研究检验了耳鸣干预措施（如认知行为疗法和声音疗法）的有效性，但这些研究的整体质量和局限性以及其结果是否能够推广仍不明确。对于认知功能较差是否会导致耳鸣患者的干预结果较差也需要加以澄清。因此，本系统评价旨在严格评估和综合耳鸣干预及其对认知影响的随机对照试验（RCT）的研究结果。该方法遵循系统评价和Meta分析的首选报告项目（PRISMA）。检索了Medline（PubMed）、Embase和PsycINFO。仅纳入了比较耳鸣干预措施与耳鸣成年参与者认知功能测量有效性的RCT。总共纳入并分析了8项研究，涉及610名参与者，使用了11种认知功能评估工具（如斯特鲁普颜色和文字测验以及视觉持续操作任务）和5种耳鸣干预结果测量指标（如耳鸣致残量表和耳鸣问卷）。评价结果表明，耳鸣干预不仅有助于耳鸣管理，还能改善认知功能。认知和情绪可能在患者对耳鸣的适应中起重要作用。由于证据不足，认知是否能预测治疗结果尚不清楚。未来需要采用标准化评估方案进行研究，重点关注基于声音的干预对耳鸣严重程度和认知功能的影响。还需要研究认知功能测量是否可作为耳鸣治疗有效性的预测指标。
