Univ. Grenoble Alpes, Inserm U1216, Grenoble Institut Neurosciences, 38000 Grenoble, France.
Univ. Grenoble Alpes, CHU Grenoble Alpes, 38000 Grenoble, France.
Neuroimage Clin. 2021;31:102696. doi: 10.1016/j.nicl.2021.102696. Epub 2021 May 8.
Subjective tinnitus is a symptom characterized by the perception of sound with no external acoustic source, most often accompanied by co-morbidities. To date, the specific role of white matter abnormalities related to tinnitus reaches no consensus in the literature. The goal of this study was to explore the structural connectivity related to tinnitus percept per se, thus focusing on a specific population presenting chronic non-bothersome tinnitus of similar etiology (noise induced) without co-morbidities. We acquired diffusion-weighted images with high angular resolution in a homogeneous group of mildly impacted tinnitus participants (n = 19) and their matched controls (n = 19). We focused the study on two subsets of fiber bundles of interest: on one hand, we extracted the acoustic radiation and further included any intersecting fiber bundles; on the other hand, we explored the tracts related to the limbic system. We modeled the diffusion signal using constrained spherical deconvolution. We conducted a deep-learning based tractography segmentation and mapped Apparent Fiber Density (AFD) on the bundles of interest. C, as well as Fractional Anisotropy (FA) and FOD peak amplitude for comparison. Between group statistical comparison was performed along the 27 tracts of interest controlling for confounding hearing loss, tinnitus severity, and duration since onset. We tested a potential correlation with hearing loss, tinnitus duration and tinnitus handicap score along these tracts. In the tinnitus group, we observed increased AFD related to chronic tinnitus percept after acoustic trauma in two main white matter regions. First, in the right hemisphere, in the isthmus between inferior temporal and inferior frontal cortices, in the uncinate fasciculus (UF), and in the inferior fronto-occipital bundle (IFO). Second, in the left hemisphere, underneath the superior parietal region in the thalamo parietal tract and parieto-occipital pontine tract. Between-group differences in the acoustic radiations were not significant with AFD but were with FA. Furthermore, significant correlations with hearing loss were found in the left hemisphere in the inferior longitudinal fasciculus and in the fronto-pontine tract. No additional correlation was found with tinnitus duration nor with tinnitus handicap, as reflected by THI scores. The regions that displayed tinnitus related increased AFD also displayed increased FA. The isthmus of the UF and IFO in the right hemisphere appear to be involved with a number of neuropsychiatric and traumatic disorders confirming the involvement of the limbic system even in chronic non-bothersome tinnitus subjects, potentially suggesting a common pathway between these pathologies. White matter changes underneath the superior parietal cortex found here in tinnitus participants supports the implication of an auditory-somatosensory pathway in tinnitus perception.
主观耳鸣是一种症状,其特征是感知到没有外部声源的声音,通常伴有共病。迄今为止,文献中关于与耳鸣相关的白质异常的具体作用尚未达成共识。本研究的目的是探索与耳鸣感知本身相关的结构连接,因此专注于具有相似病因(噪声诱导)且无共病的慢性无困扰耳鸣的特定人群。我们在一组轻度受影响的耳鸣参与者(n=19)及其匹配的对照组(n=19)中获得了具有高角分辨率的弥散加权图像。我们将研究集中在两个感兴趣的纤维束子集上:一方面,我们提取了声辐射,并进一步包括任何相交的纤维束;另一方面,我们探索了与边缘系统相关的束。我们使用约束球分解模型对扩散信号进行建模。我们进行了基于深度学习的束追踪分割,并将表观纤维密度(AFD)映射到感兴趣的束上。为了进行比较,我们还测量了 C、分数各向异性(FA)和 FOD 峰值幅度。对 27 条感兴趣的束进行了组间统计比较,以控制混杂性听力损失、耳鸣严重程度和发病后时间。我们沿着这些束测试了与听力损失、耳鸣持续时间和耳鸣残疾评分的潜在相关性。在耳鸣组中,我们在两个主要的白质区域观察到与慢性耳鸣感知相关的 AFD 在听觉创伤后增加。首先,在右侧半球,在下颞叶和下额叶皮质之间的峡部,在钩束(UF)和下额枕束(IFO)中。其次,在左侧半球,在上顶叶下方,在丘脑-顶叶束和顶枕桥束中。在 AFD 方面,两组之间的辐射差异不显著,但 FA 差异显著。此外,在左侧半球的下纵束和额桥束中发现与听力损失相关的显著相关性。与耳鸣持续时间或耳鸣残疾评分(THI 评分)均无其他相关性。显示与耳鸣相关的 AFD 增加的区域也显示出 FA 增加。右侧半球 UF 和 IFO 的峡部似乎与多种神经精神和创伤性疾病有关,这证实了边缘系统的参与,即使在慢性无困扰的耳鸣患者中也是如此,这可能表明这些病理学之间存在共同途径。在这里在耳鸣参与者中发现的上顶叶皮层下方的白质变化支持听觉-躯体感觉通路在耳鸣感知中的作用。