Tziridis Konstantin, Brunner Sarah, Schilling Achim, Krauss Patrick, Schulze Holger
Experimental Otolaryngology, University of Erlangen-Nuremberg, Erlangen, Germany.
Front Neurosci. 2022 Mar 30;16:831581. doi: 10.3389/fnins.2022.831581. eCollection 2022.
Recently, we proposed a model of tinnitus development based on a physiological mechanism of permanent optimization of information transfer from the auditory periphery to the central nervous system by means of neuronal stochastic resonance utilizing neuronal noise to be added to the cochlear input, thereby improving hearing thresholds. In this view, tinnitus is a byproduct of this added neuronal activity. Interestingly, in healthy subjects auditory thresholds can also be improved by adding external, near-threshold acoustic noise. Based on these two findings and a pilot study we hypostatized that tinnitus loudness (TL) might be reduced, if the internally generated neuronal noise is substituted by externally provided individually adapted acoustic noise. In the present study, we extended the data base of the first pilot and further optimized our approach using a more fine-grained adaptation of the presented noise to the patients' audiometric data. We presented different spectrally filtered near-threshold noises (-2 dB to +6 dB HL, 2 dB steps) for 40 s each to 24 patients with tonal tinnitus and a hearing deficit not exceeding 40 dB. After each presentation, the effect of the noise on the perceived TL was obtained by patient's response to a 5-scale question. In 21 out of 24 patients (13 women) TL was successfully subjectively attenuated during acoustic near-threshold stimulation using noise spectrally centered half an octave below the individual's tinnitus pitch (TP). Six patients reported complete subjective silencing of their tinnitus percept during stimulation. Acoustic noise is able to reduce TL, but the TP has to be taken into account. Based on our findings, we speculate about a possible future treatment of tinnitus by near-threshold bandpass filtered acoustic noise stimulation, which could be implemented in hearing aids with noise generators.
最近，我们提出了一种耳鸣发展模型，该模型基于一种生理机制，即通过利用神经元噪声添加到耳蜗输入中来永久优化从听觉外周到中枢神经系统的信息传递，从而改善听力阈值。从这个角度来看，耳鸣是这种额外神经元活动的副产品。有趣的是，在健康受试者中，通过添加外部近阈值声学噪声也可以提高听觉阈值。基于这两个发现和一项初步研究，我们假设，如果内部产生的神经元噪声被外部提供的个体适应性声学噪声所替代，耳鸣响度（TL）可能会降低。在本研究中，我们扩展了首个初步研究的数据库，并通过对所呈现的噪声进行更精细的调整以适应患者的听力测定数据，进一步优化了我们的方法。我们向24名患有音调性耳鸣且听力损失不超过40 dB的患者分别呈现不同频谱滤波的近阈值噪声（-2 dB至+6 dB HL，步长为2 dB），每次持续40秒。每次呈现后，通过患者对一个5级问题的回答来获得噪声对感知到的TL的影响。在24名患者中的21名（13名女性）中，使用频谱中心位于个体耳鸣音调（TP）下方半个八度的噪声进行声学近阈值刺激时，TL成功地在主观上得到了减弱。6名患者报告在刺激过程中耳鸣感知完全主观消失。声学噪声能够降低TL，但必须考虑TP。基于我们的发现，我们推测未来可能通过近阈值带通滤波声学噪声刺激来治疗耳鸣，这可以在带有噪声发生器的助听器中实现。
