Cassiers Laura Lucia Maria, Van Den Eede Filip, Schruers Koen, Gilles Annick, Van Rompaey Vincent, Sabbe Bernard G C
Department of Psychiatry, Antwerp University Hospital, Antwerp, Belgium.
Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Neuropsychobiology. 2025;84(1):15-25. doi: 10.1159/000542066. Epub 2024 Nov 21.
There is some evidence for hypothalamic-pituitary-adrenal (HPA) axis hypofunction in chronic tinnitus, but findings are contradicting possibly due to clinical heterogeneity. This study aimed to assess differential effects of childhood trauma and anxiety on HPA-axis functioning in adults suffering from chronic subjective tinnitus with distress.
Salivary cortisol data were collected in 22 chronic subjective tinnitus sufferers (without major depression) and 29 healthy controls after awakening, at baseline, and after a low-dose (0.5 mg) dexamethasone challenge. A factorial ANCOVA was conducted to compare the main effects of group (tinnitus versus. controls), trauma, and their interaction effect on the cortisol awakening response (CAR). Linear mixed models were fitted for baseline and post-dexamethasone cortisol levels with group, sampling time, trauma, and their interactions as fixed factors and subject as the random effect. The Beck Anxiety Index, Anxiety Sensitivity Index, and Panic Disorder Severity Scale were included to investigate effects of anxiety.
A significant interaction between group and trauma (F [1, 47] = 6.9755, p = 0.0112) was found, with the tinnitus group showing lower CARs (M = 5.1808, SD = 0.5821) than the comparison group (M = 5.9974, SD = 0.5251) in traumatized individuals only. No effects were found for baseline or post-dexamethasone cortisol. Anxiety scores had no effects on any of the outcome variables.
A differential effect of childhood trauma, but not anxiety, on the HPA-axis function in chronic subjective tinnitus was partly confirmed by the finding of a blunted CAR in tinnitus sufferers reporting early-life adversity.
有证据表明慢性耳鸣患者存在下丘脑 - 垂体 - 肾上腺（HPA）轴功能减退，但由于临床异质性，研究结果相互矛盾。本研究旨在评估童年创伤和焦虑对患有慢性主观性耳鸣并伴有痛苦的成年人HPA轴功能的不同影响。
收集了22名慢性主观性耳鸣患者（无重度抑郁症）和29名健康对照者在觉醒后、基线时以及低剂量（0.5毫克）地塞米松激发试验后的唾液皮质醇数据。进行了析因协方差分析以比较组（耳鸣组与对照组）、创伤及其对皮质醇觉醒反应（CAR）的交互作用的主要影响。以组、采样时间、创伤及其交互作用作为固定因素，个体作为随机效应，对基线和地塞米松激发试验后的皮质醇水平拟合线性混合模型。纳入贝克焦虑指数、焦虑敏感性指数和惊恐障碍严重程度量表以研究焦虑的影响。
发现组与创伤之间存在显著交互作用（F [1, 47] = 6.9755，p = 0.0112），仅在受过创伤的个体中，耳鸣组的CAR低于对照组（M = 5.1808，SD = 0.5821），而对照组为（M = 5.9974，SD = 0.5251）。未发现基线或地塞米松激发试验后皮质醇有影响。焦虑评分对任何结果变量均无影响。
报告早年逆境的耳鸣患者CAR减弱这一发现部分证实了童年创伤而非焦虑对慢性主观性耳鸣患者HPA轴功能有不同影响。
