评估助听器治疗耳鸣的疗效 - 正电子发射断层扫描研究。

Evaluating the efficacy of hearing aids for tinnitus therapy - A Positron emission tomography study.

机构信息

ENT Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR.

Nuclear Medicine Center and Division, Department of Radiology and Oncology, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, BR.

出版信息

Brain Res. 2022 Jan 15;1775:147728. doi: 10.1016/j.brainres.2021.147728. Epub 2021 Nov 15.

Abstract

Brain imaging studies have revealed neural changes in chronic tinnitus patients that are not restricted to auditory brain areas; rather, the engagement of limbic system structures, attention and memory networks are has been noted. Hearing aids (HA) provide compensation for comorbid hearing loss and may decrease tinnitus-related perception and annoyance. Using resting state positron emission tomography our goal was to analyze metabolic and functional brain changes after six months of effective HA use by patients with chronic tinnitus and associated sensorineural hearing loss. 33 age and hearing loss matched participants with mild/moderate hearing loss were enrolled in this study: 19 with tinnitus, and 14 without tinnitus. Participants with tinnitus of more than 6 months with moderate/severe Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) scores composed the tinnitus group. A full factorial 2X2 ANOVA was conducted for imaging analysis, with group (tinnitus and controls) and time point (pre-intervention and post-intervention) as factors. Six months after HA fitting, tinnitus scores reduced statistically and clinically. Analysis revealed increased glycolytic metabolism in the left orbitofrontal cortex, right temporal lobe and right hippocampus, and reduced glycolytic metabolism in the left cerebellum and inferior parietal lobe within the tinnitus group. The hearing loss control group showed no significant metabolic changes in the analysis. Parsing out the contribution of tinnitus independent of hearing loss, allowed us to identify areas implicated in declines in tinnitus handicap as a result of the intervention. Brain regions implicated in the present study may be part of chronic tinnitus-specific network.

摘要

脑影像学研究揭示了慢性耳鸣患者的神经变化,这些变化不仅局限于听觉脑区;相反,边缘系统结构、注意力和记忆网络的参与已经被注意到。助听器 (HA) 为合并的听力损失提供补偿,并可能降低耳鸣相关的感知和烦恼。使用静息状态正电子发射断层扫描,我们的目标是分析慢性耳鸣和相关感音神经性听力损失患者在接受有效的 HA 使用六个月后的代谢和功能大脑变化。33 名年龄和听力损失匹配的参与者患有轻度/中度听力损失,包括 19 名耳鸣患者和 14 名无耳鸣患者。耳鸣时间超过 6 个月、中度/重度耳鸣残疾量表 (THI) 和视觉模拟量表 (VAS) 评分较高的患者组成了耳鸣组。对影像学分析进行了全因子 2X2 ANOVA,以组(耳鸣和对照组)和时间点(干预前和干预后)为因素。在 HA 适配六个月后,耳鸣评分在统计学和临床上都有所降低。分析显示,耳鸣组的左眶额皮质、右颞叶和右海马的糖酵解代谢增加,左小脑和下顶叶的糖酵解代谢减少。听力损失对照组在分析中没有显示出明显的代谢变化。将耳鸣与听力损失分开,可以确定与干预后耳鸣残疾下降相关的区域。本研究中涉及的脑区可能是慢性耳鸣特异性网络的一部分。

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