Efficacy of Sound Therapy for Tinnitus Using an Enriched Acoustic Environment with Hearing-Loss Matched Broadband Noise

Background: Tinnitus is a rather heterogeneous chronic condition/disorder which is difficult to treat. Some tinnitus treatments combine sound therapy with counselling. The main goal of this study is to report the efficacy of a customized sound therapy combined with counselling on a cohort of 83 tinnitus patients. Methods: 119 tinnitus subjects, recruited between January 2018 and June 2021, were subjected to a treatment consisting of a combination of an initial counselling session and four-month sound therapy. The sound stimulus was a personalized broadband noise colored by the audiometry of the subjects. These stimuli were given to the patients in mp3 format to be heard 1 h per day over 4 months. The tinnitus severity of the patients was evaluated monthly through the validated Spanish version of the Tinnitus Handicap Inventory. Results: Of the patients, 30% (36 of 119) withdrew from the treatment before finishing, and 96% (80 of 83) of the subjects completing the therapy attained some relief after 4 months. The overall average THI decrease of these 80 participants was 23. However, when the THI was analyzed by severity scales, it was found that patients with initial mild, moderate, severe and catastrophic handicap had an average THI decrease of 14, 20, 31 and 42 points, respectively. Thus, the average THI decrease depended on the baseline severity scale of patients. Conclusions: Consequently, the proposed treatment was demonstrated to be effective in providing clinically relevant relief in tinnitus distress patients in just 4 months.

Differential diagnosis of tinnitus

Tinnitus is a common clinical symptomthat can be debilitating. Risk factors forits development are hearing loss, use of ototoxic drugs, head injury and depression. At the onset of the disease, the likelihood of ear pathology, the presence of anxiety and depression should be considered. There are no effective drug treatments for tinnitus, although a number of scientific studies are ongoing to determine the mechanisms of the development of this condition and to search for possible options for its treatment. When ear pathology is detected, surgical interventions can be effective, but tinnitus associated with this disease persists. Available treatment approaches include hearing aids for diagnosed hearing loss (even mild or unilateral), broadband sound therapy, and counseling. Cognitive-behavioral therapy is indicated for some patients, but availability remains inadequate. The evidence base is most significant for the combination of sound therapy and CBT-based counseling, although clinical trials are complicated by the heterogeneity of the tinnitus patient population.

Surface-Based Amplitude of Low-Frequency Fluctuation Alterations in Patients With Tinnitus Before and After Sound Therapy: A Resting-State Functional Magnetic Resonance Imaging Study

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 post hoc 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.

Assessment and Management of Misophonia in a Female Adolescent: A Case Study

Purpose Misophonia is a condition in which individuals experience negative reactions, including anger and disgust, to specific sounds in their environment. Individuals with misophonia often report feelings of anxiety and a reduced quality of life. While there is no cure for misophonia, there are management protocols supported by case studies in the literature, including tinnitus retraining therapy (TRT) and Misophonia Management Protocol (MMP), along with coping strategies. The purpose of this case study is to contribute to the field of clinical research on patients with misophonia. Method Case studies involving misophonia are limited, and further research in this area is needed to provide evidence-based treatment. This case details misophonia questionnaires and assessment, case formulation, and management of misophonia in an 11-year-old girl, using a variation of both the TRT and MMP, including ear-level sound generators and coping strategies. Conclusions This case serves as a contribution to the evidence base for the use of sound therapy and coping strategies in the treatment and management of misophonia, as well as tools that are available in diagnosing misophonia. Clinical implications reveal sound therapy and coping strategies as a means to manage misophonia symptoms. Further research is needed for large-scale data to be available.

Mobile applications for anxiety and stress reduction: potential for preventing noncommunicable diseases

The article discusses using mobile applications for smartphones as tools to reduce anxiety and stress. The modern views on pathogenesis of the relationship between stress, anxiety disorders and cardiovascular disease are considered. Based on a review of some representative studies, a methodology for evaluating the characteristics and functions of mobile applications for managing anxiety and stress symptoms is proposed. The applications selected for analysis were tested according to this methodology. There are following key features of the Russianlanguage field of mobile applications for anxiety and stress reduction: a small number of applications, high prevalence of using breathing exercises, meditations and sound therapy, an extremely low disease specificity and focus mainly on helping with general symptoms of anxiety.

Indicators of the Spectrum of Lipids of the Water-Lipid Mantle of the Skin Before and after Pathogenetically Sound Therapy of Patients with Psoriasis

Aim: The aim of the study is to analyze the features of the spectrum of lipids of the water-lipid mantle of the skin before and after pathogenetically sound therapy of patients with psoriasis. Methods: Comparative evaluation of the therapeutic efficacy of monotherapy with the immunobiological drug Humir (adalimumab), as well as its combination with a non-hormonal drug based on natural components Psori Active (cream) in the examined patients with psoriasis vulgaris was performed according to the dynamics of regression of dermatoses clinical manifestations erythema, infiltration, peeling of the skin psoriatic rash, changes in the index PASI, PGA, BSA. Results: The study involved 137 patients. Changes in the level of other components of the lipid spectrum of the water-lipid mantle of the skin, in particular phospholipids, cholesterol and cholesterol esters in patients of the first observation group changed insignificantly compared to their values before treatment. When comparing the normalization of the level of the studied spectrum of lipids of the water-lipid mantle of the skin in patients of the second group with different seasonal types (autumn-winter, spring-summer, off-season) and previously diagnosed with varying severity treatment, no statistically significant differences were found between seasonal types of dermatosis. Conclusion: Analysis of the results of clinical follow-up of the examined patients with psoriasis of the first and second groups after completion of treatment and achieving clinical clinical remission indicates significant benefits of systemic immunobiological therapy in combination with topical therapy with Psori Active.