• 文章类型: Journal Article
    经颅直流电刺激(tDCS)正在成为一种有希望的非侵入性耳鸣干预措施,旨在调节异常的大脑活动。这项研究调查了双会话tDCS对缓解感知的功效,苦恼,严重慢性主观性耳鸣患者的响度和响度,并在2个月的随访中评估了与单次治疗组和对照组相比的耳鸣抑制效果的持续时间。在一个潜在的,随机化,单盲,安慰剂对照试验,30名患有严重慢性主观性耳鸣的参与者接受了双额tDCS。对照组(n=9),单会话组(n=10),双会话组(n=11)接受2mA刺激,每次20分钟,一周两次,一个月。每周使用视觉模拟量表(VAS)监测治疗反应,在第四和第八周使用耳鸣障碍量表(THI)和贝克抑郁量表(BDI)进行额外评估。单疗程组和双疗程组在VAS方面显示出统计学上的显着改善,THI,和BDI评分与对照组比较。THI和BDI评分在单疗程组和双疗程组之间显示出显着差异。双会话组比单会话组表现出更持久的耳鸣抑制作用。TDCS已被验证为抑制耳鸣的有效干预措施,双会话协议显示出更长期的好处。这些发现支持tDCS作为治疗耳鸣的潜力,特别是在双会话应用程序。
    Transcranial direct current stimulation (tDCS) is emerging as a promising non-invasive intervention for tinnitus by aiming to modulate abnormal brain activity. This study investigated the efficacy of dual-session tDCS for the relief of perception, distress, and loudness in patients with severe chronic subjective tinnitus and assessed the duration of tinnitus suppression effects compared to single-session and control groups over a 2-month follow-up. In a prospective, randomized, single-blind, placebo-controlled trial, 30 participants with severe chronic subjective tinnitus underwent bifrontal tDCS. The control group (n = 9), single-session group (n = 10), and dual-session group (n = 11) received 2 mA stimulation for 20 min per session, twice a week for one month. The treatment response was monitored weekly using the Visual Analogue Scale (VAS), with additional assessments using the Tinnitus Handicap Inventory (THI) and Beck Depression Inventory (BDI) at the fourth and eighth weeks. The single- and dual-session groups showed statistically significant improvements in VAS, THI, and BDI scores compared to the control group. THI and BDI scores showed a significant difference between the single- and dual-session groups. The dual-session group demonstrated a more sustained tinnitus suppression effect than the single-session group. tDCS has been validated as an effective intervention for the suppression of tinnitus, with the dual-session protocol showing longer-term benefits. These findings support the potential of tDCS as a treatment for tinnitus, particularly in dual-session applications.
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  • 文章类型: Journal Article
    背景:尽管在研究其心理物理复杂性方面取得了实质性进展,耳鸣仍然是科学和临床之谜。本研究,通过生态和多学科的方法,目的是确定脑电图(EEG)和心理听力学变量之间的关联。
    方法:脑电图β活性,通常与压力和焦虑有关,在音频认知任务和休息时,从12名耳鸣患者(TIN组)和7名对照(CONT组)获得。我们还使用非参数统计量调查了心理变量(SCL-90-R;STAI-Y;BFI-10)和听力学变量(THI;TQ12-I;Hyperacusis),以评估组间和组间的差异和关系。
    结果:在TIN组中,额叶β活性与运动过度呈正相关,顶叶活动,和特质焦虑;后者也与CONT中的抑郁有关。两组之间的偏执观念和开放性存在显着差异。
    结论:焦虑特征之间的联系,额-顶叶皮质和高音的β活性提供了对耳鸣患者大脑功能的见解,为临床医生提供定量描述和新的多学科治疗假设。
    BACKGROUND: Despite substantial progress in investigating its psychophysical complexity, tinnitus remains a scientific and clinical enigma. The present study, through an ecological and multidisciplinary approach, aims to identify associations between electroencephalographic (EEG) and psycho-audiological variables.
    METHODS: EEG beta activity, often related to stress and anxiety, was acquired from 12 tinnitus patients (TIN group) and 7 controls (CONT group) during an audio cognitive task and at rest. We also investigated psychological (SCL-90-R; STAI-Y; BFI-10) and audiological (THI; TQ12-I; Hyperacusis) variables using non-parametric statistics to assess differences and relationships between and within groups.
    RESULTS: In the TIN group, frontal beta activity positively correlated with hyperacusis, parietal activity, and trait anxiety; the latter is also associated with depression in CONT. Significant differences in paranoid ideation and openness were found between groups.
    CONCLUSIONS: The connection between anxiety trait, beta activity in the fronto-parietal cortices and hyperacusis provides insights into brain functioning in tinnitus patients, offering quantitative descriptions for clinicians and new multidisciplinary treatment hypotheses.
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  • 文章类型: Journal Article
    耳鸣是一种常见的幻影听觉感知,被认为与听力损失引起的大脑可塑性变化有关。然而,在没有任何临床听力损失的情况下也可能发生耳鸣。在这种情况下,因为没有听力损失,推动塑料变化的机制在很大程度上仍然是神秘的。先前的研究表明,在耳鸣和其他正常听力的受试者中,与耳鸣相关的声音诱发的大脑活动存在细微差异,但研究结果并不一致.这里,我们的目的是使用单耳而不是双耳刺激来研究这些差异。使用功能磁共振成像(MRI)测量有和没有耳鸣的参与者的声音诱发反应。所有参与者都有临床正常的听力图。刺激是纯音,频率在353到8000赫兹之间,单耳呈现。对听觉皮层反应的主成分分析(PCA)显示,音调组织没有差异,这证实了早期的研究。GLM分析显示,双侧听觉皮层外侧区域活动过度。与地形图一致,这种过度活动主要发生在低刺激频率下。这可能与运动过度有关。此外,刺激侧和海马旁的耳鸣之间存在相互作用。这可能反映了耳鸣和空间取向之间的干扰。
    Tinnitus is a common phantom auditory percept believed to be related to plastic changes in the brain due to hearing loss. However, tinnitus can also occur in the absence of any clinical hearing loss. In this case, since there is no hearing loss, the mechanisms that drive plastic changes remain largely enigmatic. Previous studies showed subtle differences in sound-evoked brain activity associated with tinnitus in subjects with tinnitus and otherwise normal hearing, but the results are not consistent across studies. Here, we aimed to investigate these differences using monaural rather than binaural stimuli. Sound-evoked responses were measured using functional magnetic resonance imaging (MRI) in participants with and without tinnitus. All participants had clinically normal audiograms. The stimuli were pure tones with frequencies between 353 and 8000 Hz, presented monaurally. A Principal Component Analysis (PCA) of the response in the auditory cortex revealed no difference in tonotopic organization, which confirmed earlier studies. A GLM analysis showed hyperactivity in the lateral areas of the bilateral auditory cortex. Consistent with the tonotopic map, this hyperactivity mainly occurred in response to low stimulus frequencies. This may be related to hyperacusis. Furthermore, there was an interaction between stimulation side and tinnitus in the parahippocampus. This may reflect an interference between tinnitus and spatial orientation.
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  • 文章类型: Journal Article
    介绍咽鼓管调节中耳功能,如通气和压力正常化。咽鼓管功能障碍(ETD)定义为咽鼓管无法维持其一种或多种功能。这是与其他中耳疾病相关的常见病,如胆脂瘤,鼓膜肺不张,和渗出性中耳炎(OME)。本研究旨在评估Qassim地区的ETD患病率和危险因素。方法这项横断面研究是在2023年9月20日至10月10日期间在沙特阿拉伯的Qassim地区进行的。数据是通过经过验证的,自我管理的电子问卷,包括社会人口统计信息,ETD的患病率,以及其各种症状的普遍性,通过咽鼓管功能障碍问卷(ETDQ-7)评估。结果我们在Qassim的研究,沙特阿拉伯,467名参与者显示ETD的高患病率为12.2%.18-25岁年龄组占主导地位(50.1%),女性占多数(66.2%)。使用ETDQ-7问卷的症状分析显示不同的患病率,伴有严重疼痛(7%)和听力低沉(29.8%)。Logistic回归确定了重要的预测因子,包括听力损失史(比值比=28.2)和吸烟(比值比=3.70)。具体症状,例如感觉被阻塞或在水下,与更严重的ETD症状显着相关(比值比=1.73)。结论我们的研究突出了ETD的显著患病率。重要的预测因素,包括听力损失史和吸烟,已确定。具体症状,例如感觉被阻塞或在水下,与更严重的ETD症状相关。
    Introduction The Eustachian tube regulates middle ear functions such as ventilation and pressure normalization. Eustachian tube dysfunction (ETD) is defined as the failure of the Eustachian tube to maintain one or more of its functions. It is a common condition that is associated with other middle ear disorders such as cholesteatoma, tympanic membrane atelectasis, and otitis media with effusion (OME). This study aims to assess ETD prevalence and risk factors in the Qassim region. Methodology This cross-sectional study was conducted in the Qassim region of Saudi Arabia during the period from September 20 to October 10, 2023. Data were gathered via a validated, self-administered electronic questionnaire that encompasses socio-demographic information, the prevalence of ETD, and the prevalence of its various symptoms, as assessed by the Eustachian Tube Dysfunction Questionnaire (ETDQ-7). Results Our study in Qassim, Saudi Arabia, with 467 participants reveals a high prevalence of ETD at 12.2%. The 18-25 age group dominates (50.1%), with a majority of females (66.2%). Symptom analysis using the ETDQ-7 questionnaire shows varied prevalence, with severe pain (7%) and muffled hearing (29.8%) notable. Logistic regression identifies significant predictors, including hearing loss history (odds ratio = 28.2) and smoking (odds ratio = 3.70). Specific symptoms, such as feeling blocked or underwater, significantly correlate with more severe ETD symptoms (odds ratio = 1.73). Conclusion Our study highlights a notable prevalence of ETD. Significant predictors, including hearing loss history and smoking, were identified. Specific symptoms, such as feeling blocked or underwater, were associated with more severe ETD symptoms.
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  • 文章类型: Journal Article
    背景:在这项研究中,我们调查了人工耳蜗植入对舌后双侧深度听力损失患者耳鸣的影响。
    方法:在这项回顾性研究中,包括66名18岁以上的舌后聋人患者,他们转诊人工耳蜗植入并抱怨耳鸣。将患者分为有残余听力(频率为250-500Hz)和没有残余听力的两组。所有数据包括年龄,性别,植入物的类型,手术类型,疾病的原因,以及人工耳蜗植入前THI评分的信息,记录并分析人工耳蜗植入后1个月和人工耳蜗植入后1年。
    结果:9例患者有残余听力,而57名患者没有。一个月和一年后,在这两组中,平均THI评分显著下降(p值=0.001),但术前和术后1个月和1年的平均THI评分在有和无残余听力的两组之间没有显著差异.根据THI等级,两组之间的耳鸣严重程度没有显着差异。此外,THI评分和听力损失的原因也没有显着差异,植入的类型和插入方法,两组术后1个月和1年。
    结论:根据我们的结果,残余听力与术前耳鸣评分无显著相关性,手术后一个月一年.
    BACKGROUND: In this study we investigated the effect of cochlear implantation on tinnitus in patients with post lingual bilateral profound hearing loss.
    METHODS: In this retrospective study, 66 post-lingual deaf patients over 18 years old who referred for cochlear implantation and complained of tinnitus were included. Patients were divided into two groups with residual hearing (in frequency 250-500 Hz) and without residual hearing. All data including age, gender, type of implants, type of surgery, cause of the disease, and information on the THI score before cochlear implantation, one month after cochlear implantation and one year after cochlear implantation was recorded and analyzed.
    RESULTS: Nine patients had residual hearing, while 57 patients did not. After one month and one year, in both groups, the mean THI score has decreased significantly (p-value = 0.001), but there was no significant difference in the mean THI score before surgery and one month and one year after surgery between two groups with and without residual hearing. There was no significant difference in tinnitus severity according to THI-grade between two groups. Also there was no significant difference in THI score and the cause of the hearing loss, type and insertion method of implantation, one month and one year after the surgery between two groups.
    CONCLUSIONS: According to our results, the was no significant correlation between residual hearing and tinnitus score before surgery, one month and one year after the surgery.
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  • 文章类型: Journal Article
    听力损失和耳鸣与轻度认知障碍(MCI)有关;然而,证据受到伦理和时间限制的约束,很少有前瞻性研究确定因果关系。本研究旨在利用孟德尔随机化(MR)和横断面研究来验证和分析这种关联。
    本研究采用两步法。最初,本研究利用全基因组关联研究(GWAS)数据库中欧洲人群的遗传数据,通过孟德尔随机化,采用方差逆加权(IVW)方法,建立听力损失和认知障碍之间的因果关系.这是通过鉴定强相关的单核苷酸多态性(SNP)来实现的,消除连锁不平衡,并排除弱工具变量。第二步,来自青岛市10个社区的363名老年人,使用问卷调查和纯音听力学(PTA)的方法对中国进行评估和检查。采用Logistic回归和多元线性回归分析老年MCI的危险因素并计算临界值。
    孟德尔随机化研究表明,听力损失是欧洲人群中MCI的危险因素,听力损失与MCI损失的风险比为1。23.这项横断面研究的结果表明,年龄,耳鸣,在单因素logistic回归分析中,听力损失是MCI的重要危险因素.此外,多因素logistic回归分析确定听力损失和耳鸣是MCI的潜在危险因素。在多元线性回归分析中观察到一致的结果,揭示听力损失和年龄显著影响MCI的发展。此外,一个值得注意的发现是,当听力阈值超过20分贝时,MCI发生的可能性增加了9%.
    这项研究提供了来自基因组和流行病学调查的证据,表明听力损失可能是认知障碍的危险因素。虽然我们的流行病学研究发现听力损失和耳鸣是认知能力下降的潜在危险因素,需要额外的研究来建立因果关系,特别是考虑到耳鸣可以表现为各种潜在疾病的症状。
    UNASSIGNED: Hearing loss and tinnitus have been linked to mild cognitive impairment (MCI); however, the evidence is constrained by ethical and temporal constraints, and few prospective studies have definitively established causation. This study aims to utilize Mendelian randomization (MR) and cross-sectional studies to validate and analyze this association.
    UNASSIGNED: This study employs a two-step approach. Initially, the genetic data of the European population from the Genome-wide association studies (GWAS) database is utilized to establish the causal relationship between hearing loss and cognitive impairment through Mendelian randomization using the inverse variance weighted (IVW) method. This is achieved by identifying strongly correlated single nucleotide polymorphisms (SNPs), eliminating linkage disequilibrium, and excluding weak instrumental variables. In the second step, 363 elderly individuals from 10 communities in Qingdao, China are assessed and examined using methods questionnaire survey and pure tone audiology (PTA). Logistic regression and multiple linear regression were used to analyze the risk factors of MCI in the elderly and to calculate the cutoff values.
    UNASSIGNED: Mendelian randomization studies have shown that hearing loss is a risk factor for MCI in European populations, with a risk ratio of hearing loss to MCI loss of 1. 23. The findings of this cross-sectional study indicate that age, tinnitus, and hearing loss emerged as significant risk factors for MCI in univariate logistic regression analysis. Furthermore, multivariate logistic regression analysis identified hearing loss and tinnitus as potential risk factors for MCI. Consistent results were observed in multiple linear regression analysis, revealing that hearing loss and age significantly influenced the development of MCI. Additionally, a notable finding was that the likelihood of MCI occurrence increased by 9% when the hearing threshold exceeded 20 decibels.
    UNASSIGNED: This study provides evidence from genomic and epidemiological investigations indicating that hearing loss may serve as a risk factor for cognitive impairment. While our epidemiological study has found both hearing loss and tinnitus as potential risk factors for cognitive decline, additional research is required to establish a causal relationship, particularly given that tinnitus can manifest as a symptom of various underlying medical conditions.
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  • 文章类型: Journal Article
    目的:过度的噪音是令人不快的,会引起一些生理和心理影响。噪声污染是对人类的潜在威胁,特别是那些连续长时间暴露在一天中多年的人。这篇综述旨在研究与长期暴露于噪声污染相关的各种听觉和非听觉结果。
    方法:本综述利用相关关键词的组合来搜索电子数据库。在根据所应用的标题选择标准进行筛选后,abstract,和全文,最终选择了44篇文章进行批判性审查。
    结果:我们确定并分析了与噪声引起的听力损失有关的研究结果,耳鸣,和睡眠障碍以及烦恼等非听觉问题,认知障碍,和与心血管疾病相关的精神压力。此外,对现有研究进行了比较和整理,以强调噪声污染作为一种独特的环境问题的独特挑战和意义,并探索其研究和预防方面的持续努力,包括噪声引起的听力损失的早期检测和潜在逆转。
    结论:噪声污染的基本健康后果强调了需要进行广泛的研究,包括新兴的噪声源和技术,以建立专门的健康管理系统,以解决与噪声相关的健康问题并降低人群中的噪声暴露风险。最后,有必要进行进一步的研究,以确保改善噪声暴露和相关健康结果的测量,尤其是在职业噪声的背景下。
    OBJECTIVE: Excessive noise is unpleasant and induces several physiological and psychological effects. Noise pollution is a potential threat to humans, particularly those continuously exposed for extended periods throughout the day over many years. This review aims to examine the various auditory and non-auditory outcomes associated with prolonged exposure to noise pollution.
    METHODS: The review utilized a combination of relevant keywords to search the electronic databases. After screening based on the applied selection criteria for title, abstract, and full text, 44 articles were finally selected for critical review.
    RESULTS: We identified and analyzed research findings related to noise-induced hearing loss, tinnitus, and sleep disturbances along with non-auditory issues such as annoyance, cognitive impairments, and mental stress associated with cardiovascular disorders. Furthermore, the existing studies were compared and collated to highlight the unique challenges and significance of noise pollution as a distinctive environmental concern and to explore the ongoing efforts in its research and prevention, including the early detection and potential reversal of noise-induced hearing loss.
    CONCLUSIONS: The fundamental health consequences of noise pollution underscore the need for extensive research encompassing emerging noise sources and technologies to establish a health management system tailored to address noise-related health concerns and reduce noise exposure risk among populations. Finally, further research is warranted to ensure improved measurement of noise exposure and related health outcomes, especially in the context of occupational noise.
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  • 文章类型: Journal Article
    背景:人类工作和生活中严重大流行的主观征兆是数学上的神经耳鸣。fNIRS(功能近红外光谱)是一种新的非侵入性脑成像技术,用于研究人类大脑皮层的神经活动。它基于神经耦合效应。这项研究使用fNIRS方法来检测声音刺激任务中脑皮肤神经活动的差异,以便更好地区分感觉性神经性耳鸣。
    方法:在fNIRS脑成像方法中,14名感觉神经性耳鸣患者和14名健康对照者听了各种噪声和安静的fNIRS数据收集。在MATLAB中采用线性拟合来消除预处理和事件相关设计分析过程中的缓慢漂移。在IBMSPSSStatistics26.0中应用了错误发现率(FDR)程序,以控制多个比较分析中的假阳性率。
    结果:当疾病组和健康对照组受到粉红噪声刺激时,血氧浓度差异有统计学意义(P<0.05),健康对照组表现出高度激活,根据fNIRS测量数据。在相同的刺激任务设置下,患者组的血氧浓度水平在针灸治疗一个月后显著提高,它与THI和TEQ量表的水平密切相关。
    结论:以感觉神经性耳鸣疾病为例,fNIRS技术有可能在整个时间内揭示未来对主观疾病的病理研究。还可以检查涉及颞叶和邻近大脑区域的其他临床疾病。除了与耳鸣有关的大脑改变.
    BACKGROUND: The subjective sign of a serious pandemic in human work and life is mathematical neural tinnitus. fNIRS (functional near-infrared spectroscopy) is a new non-invasive brain imaging technology for studying the neurological activity of the human cerebral cortex. It is based on neural coupling effects. This research uses the fNIRS approach to detect differences in the neurological activity of the cerebral skin in the sound stimulation mission in order to better discriminate between the sensational neurological tinnitus.
    METHODS: In the fNIRS brain imaging method, 14 sensorineural tinnitus sufferers and 14 healthy controls listened to varied noise and quiet for fNIRS data collection. Linear fitting was employed in MATLAB to eliminate slow drifts during preprocessing and event-related design analysis. The false discovery rate (FDR) procedure was applied in IBM SPSS Statistics 26.0 to control the false positive rate in multiple comparison analyses.
    RESULTS: When the ill group and the healthy control group were stimulated by pink noise, there was a significant difference in blood oxygen concentration (P < 0.05), and the healthy control group exhibited a high activation, according to the fNIRS measurement data. The blood oxygen concentration level in the patient group was dramatically enhanced after one month of acupuncture therapy under the identical stimulation task settings, and it was favorably connected with the levels of THI and TEQ scales.
    CONCLUSIONS: Using sensorineural tinnitus illness as an example, fNIRS technology has the potential to disclose future pathological study on subjective diseases throughout time. Other clinical disorders involving the temporal lobe and adjacent brain areas may also be examined, in addition to tinnitus-related brain alterations.
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  • 文章类型: Journal Article
    背景:耳鸣影响全球约7.4亿成年人,涉及听力,情感,和睡眠系统。然而,使用多导睡眠图和纯音测听(PTA)的研究有限。我们的目的是评估耳鸣和听力之间的相关性,睡眠质量,特点,和抑郁症使用多导睡眠图和PTA。
    方法:在这项横断面研究中,我们将参与者分为耳鸣和非耳鸣组。我们纳入了100名门诊患者(65名耳鸣患者,35没有)来自台湾的医疗中心,接受多导睡眠监测并完成包括患者健康问卷-9(PHQ-9)在内的评定量表,匹兹堡睡眠质量指数(PSQI)中文版和中文版耳鸣障碍量表(THI-CM)。我们分析了相关性,进行了分组比较,与THI-CM得分相关的评估因素,构建ROC曲线来预测耳鸣组的抑郁,并进行多项和逻辑回归以探索关联。
    结果:描述性统计确定了一个平均年龄为53.9±12.80岁的队列,63%的患者PHQ-9评分≥10,66%的患者呼吸暂停低通气指数(AHI)>5。快速眼动和深度睡眠与1+2阶段睡眠的比率相对较低且不显着。同样,耳鸣组的腿部运动较高,但无统计学意义.在耳鸣组中,63.08%有抑郁症,81.54%的AHI>5。单因素logistic回归分析将耳鸣与AHI>5(赔率比(OR)2.67,p=0.026)和男性(OR2.49,p=0.034)相关联。THI-CM评分与PHQ-9评分呈中度正相关(rs=0.50,p<0.001)。对阻塞性睡眠呼吸暂停的进一步调整显示PHQ-9(总分)或抑郁症与THI-CM3-5级之间存在关联(OR=1.28;OR=8.68)。单因素和多因素回归分析强调了PSQI评分>13(OR7.06,p=0.018)和THI-CM评分>47(OR7.43,p=0.002)与抑郁的显著关联。
    结论:我们的研究招募了有轻微或轻度听力损失和轻度耳鸣障碍的耳鸣参与者。抑郁症被认为是耳鸣相关障碍的主要因素。耳鸣参与者的轻度耳鸣障碍可以解释抑郁症缺乏显着差异,睡眠质量,耳鸣和非耳鸣组之间的多导睡眠图睡眠特征。需要进一步广泛和前瞻性的研究来阐明抑郁症之间的复杂联系,睡眠,还有耳鸣.
    BACKGROUND: Tinnitus affects approximately 740 million adults globally, involving hearing, emotion, and sleep systems. However, studies using polysomnography and pure-tone audiometry (PTA) are limited. We aimed to assess the correlation between tinnitus and hearing, sleep quality, characteristics, and depression using polysomnography and PTA.
    METHODS: In this cross-sectional study, we divided participants into tinnitus and non-tinnitus groups. We included 100 outpatients (65 with tinnitus, 35 without) from a medical center in Taiwan, who underwent polysomnography and completed rating scales including the Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM). We analyzed correlations, conducted group comparisons, assessed factors related to THI-CM scores, constructed ROC curves to predict depression in the tinnitus group, and performed multinomial and logistic regression to explore associations.
    RESULTS: Descriptive statistics identified a cohort with mean age 53.9 ± 12.80 years, 63% exhibited PHQ-9 scores ≥ 10, and 66% had Apnea-Hypopnea Index (AHI) > 5. The ratio of rapid eye movement and deep sleep to stage 1 + 2 sleep was relatively low and non-significant. Likewise, leg movements was higher in the tinnitus group but not statistically significant. In the tinnitus group, 63.08% had depression, and 81.54% had AHI > 5. Univariate logistic regression linked tinnitus to AHI > 5 (Odds ratio (OR) 2.67, p = 0.026) and male sex (OR 2.49, p = 0.034). A moderate positive correlation was found between the THI-CM score and PHQ-9 score (rs = 0.50, p < 0.001). Further adjustment for obstructive sleep apnea showed associations between PHQ-9 (total score) or depression and THI-CM Grade 3-5 (OR = 1.28; OR = 8.68). Single- and multifactor regression analyses highlighted significant associations of PSQI scores > 13 (OR 7.06, p = 0.018) and THI-CM scores > 47 (OR 7.43, p = 0.002) with depression.
    CONCLUSIONS: Our study recruited tinnitus participants with slight or mild hearing loss and mild tinnitus handicap. Depression was identified as a predominant factor in tinnitus-related handicap. The mild tinnitus handicap in tinnitus participants may explain the lack of significant differences in depression, sleep quality, and polysomnographic sleep characteristics between tinnitus and non-tinnitus groups. Further extensive and prospective studies are needed to elucidate the complex links among depression, sleep, and tinnitus.
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  • 文章类型: Journal Article
    OBJECTIVE: To observe the clinical efficacy of acupuncture intervention at different time for patients with sudden hearing loss.
    METHODS: According to the timing of acupuncture intervention, 86 patients were divided into early exposure group (n=43) and late exposure group (n=43) . The early exposure group was given acupuncture treatment within 14 days of onset, and the late exposure group was given acupuncture treatment after 14 days of onset. After propensity score matching (PSM, a statistical matching technique for observational data) processing by using SPSS26.0 software, outcomes of 30 cases in the early exposure group and 30 cases in the late exposure group were analyzed. In addition to receiving basic treatment with drugs for vascular dilatation, thrombolysis, nourishing nerve, etc., all patients of the two groups were treated with neck acupuncture (\"Neck Seven Meridian Lines\" acupuncture), once every other day except Sundays, for a total of 12 time. Before, after the treatment and 3 months after the treatment, the total score of the Tinnitus Handicap Inventory (THI, 0, 2 and 4 points for each of the 25 items, total scores = 100 points) scale was used to evaluate the improvement of tinnitus symptoms caused by hearing loss. The clinical therapeutic effect was evaluated according to the efficacy grading criteria in the Guidelines for Diagnosis and Treatment of Sudden Deafness (2015) and the changes of pure tone audiometry curve. Multivariate Logistic regression was used to analyze the effect of factors that might influence efficacy before propensity score matching.
    RESULTS: The THI scores of patients in both groups decreased strikingly after the treatment and 3 months\' follow-up (P<0.05). Compared with the same time-points of the late exposure group, the total THI scores of post-treatment and 3 months\' follow-up were evidently lower in the early exposure group (P<0.05). The effective rate of the early exposure group (22/30, 80.00%) was significantly higher (P<0.05) than that of the late exposure group (16/30, 53.33%). The classification of sudden deafness and the application of traditional Chinese medicine in this study were not independent factors affecting the total effective rate.
    CONCLUSIONS: The time point of acupuncture intervention is an important factor affecting the effect on hearing and tinnitus disability of patients with sudden deafness. The earlier acupuncture treatment is accepted, the better the therapeutic effect is.
    目的: 研究不同针刺介入时机治疗突发性聋患者的临床疗效差异。方法: 纳入突发性聋患者(87例,脱落1例),根据针刺介入时机分为早暴露组和晚暴露组,早暴露组为发病14 d内介入针刺治疗,晚暴露组为发病14 d后介入针刺治疗。应用倾向性评分匹配法均衡组间基线,最终成功匹配30对患者,每组各30例。两组患者均在西医基础治疗同时给予“颈部七线法”针刺治疗,每周针刺3次,隔日1次,共12次。治疗前、治疗后及治疗3个月后观察患者耳鸣残疾评估量表(THI)评分;治疗前后分别对患者进行纯音测听,评价临床疗效;采用多因素Logistic回归分析倾向性评分匹配前可能影响疗效的因素对临床疗效的影响。结果: 与本组治疗前比较,两组患者治疗后及随访时THI评分均下降(P<0.05);与同时点晚暴露组比较,早暴露组治疗后及随访时THI评分均降低(P<0.05)。早暴露组总有效率为80.00%(24/30),晚暴露组为53.33%(16/30),早暴露组总有效率高于晚暴露组(P<0.05)。多因素Logistic回归分析结果显示,本研究中突发性聋的分型及中药使用情况并非影响总有效率的独立因素。结论: 介入时机是影响针刺治疗突发性聋患者听力疗效及耳鸣残疾程度的重要因素,早期针刺介入的疗效优于晚介入。.
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