Wei Xuan, Lv Han, Chen Qian, Wang Zhaodi, Zhao Pengfei, Liu Chunli, Gong Shusheng, Yang Zhenghan, 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. 2021 Nov 17;15:709482. doi: 10.3389/fnins.2021.709482. eCollection 2021.
This study aimed to investigate abnormal tinnitus activity by evaluating brain surface-based amplitude of low-frequency fluctuation (ALFF) changes detected by resting-state functional magnetic resonance imaging (RS-fMRI) in patients with idiopathic tinnitus before and after 24 weeks of sound therapy. We hypothesized that sound therapy could gradually return cortical local brain function to a relatively normal range. In this prospective observational study, we recruited thirty-three tinnitus patients who had undergone 24 weeks of sound therapy and 26 matched healthy controls (HCs). For the two groups of subjects, we analyzed the spontaneous neural activity of tinnitus patients by cortical ALFF and detected its correlation with clinical indicators of tinnitus. Patients' Tinnitus Handicap Inventory (THI) scores were assessed to determine the severity of their tinnitus before and after treatment. Two-way mixed model analysis of variance and Pearson's correlation analysis were used in the statistical analysis. Student-Newman-Keuls tests were used in the analysis. Interaction effects between the two groups and between the two scans revealing local neural activity as assessed by ALFF were observed in the bilateral dorsal stream visual cortex (DSVC), bilateral posterior cingulate cortex (PCC), bilateral anterior cingulate and medial prefrontal cortex (ACC and MPC), left temporo-parieto-occipital junction (TPOJ), left orbital and polar frontal cortex (OPFC), left paracentral lobular and mid cingulate cortex (PCL and MCC), right insular and frontal opercular cortex (IFOC), and left early visual cortex (EVC). Importantly, local functional activity in the left TPOJ and right PCC in the patient group was significantly lower than that in the HCs at baseline and was increased to relatively normal levels after treatment. The 24-week sound therapy tinnitus group demonstrated significantly higher ALFF in the left TPOJ and right PCC than in the tinnitus baseline group. Also, compared with the HC baseline group and the 24-week HC group, the 24-week sound therapy tinnitus group demonstrated slightly lower or higher ALFF in the left TPOJ and right PCC, and there were no differences between the 24-week sound therapy tinnitus and HC groups. Decreased THI scores and ALFF changes in the abovementioned brain regions were not correlated. Taken together, surface-based RS-fMRI can provide more subtle local functional activity to explain the mechanism of tinnitus treatment, and long-term sound therapy had a normalizing effect on tinnitus patients.
本研究旨在通过评估静息态功能磁共振成像（RS-fMRI）检测到的特发性耳鸣患者在声音治疗24周前后基于脑表面的低频波动幅度（ALFF）变化，来研究异常耳鸣活动。我们假设声音治疗可使皮质局部脑功能逐渐恢复到相对正常范围。在这项前瞻性观察性研究中，我们招募了33名接受了24周声音治疗的耳鸣患者和26名匹配的健康对照者（HCs）。对于两组受试者，我们通过皮质ALFF分析耳鸣患者的自发神经活动，并检测其与耳鸣临床指标的相关性。评估患者的耳鸣 handicap 量表（THI）得分，以确定治疗前后耳鸣的严重程度。统计分析采用双向混合模型方差分析和Pearson相关分析。分析中使用Student-Newman-Keuls检验。在双侧背侧视觉通路皮质（DSVC）、双侧后扣带回皮质（PCC）、双侧前扣带回和内侧前额叶皮质（ACC和MPC）、左侧颞顶枕交界区（TPOJ）、左侧眶额和极前额皮质（OPFC）、左侧中央旁小叶和中扣带回皮质（PCL和MCC）、右侧岛叶和额下回皮质（IFOC）以及左侧早期视觉皮质（EVC）中观察到两组之间以及两次扫描之间的交互作用，这些交互作用揭示了通过ALFF评估的局部神经活动。重要的是，患者组左侧TPOJ和右侧PCC的局部功能活动在基线时显著低于HCs，治疗后增加到相对正常水平。24周声音治疗耳鸣组在左侧TPOJ和右侧PCC的ALFF显著高于耳鸣基线组。此外，与HC基线组和24周HC组相比，24周声音治疗耳鸣组在左侧TPOJ和右侧PCC的ALFF略低或略高，24周声音治疗耳鸣组与HC组之间无差异。上述脑区THI得分的降低与ALFF变化无相关性。综上所述，基于脑表面的RS-fMRI可以提供更细微的局部功能活动来解释耳鸣治疗机制，长期声音治疗对耳鸣患者有归一化作用。
