정상청력 역치를 가지는 일측성 이명환자의 불쾌역치에 대한 개체내 비교 연구
A Study of Uncomfortable Loudness Level in Unilateral Tinnitus Subjects with Normal Audiogram : Within-Subject Comparisons
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background and Objectives:Several studies have demonstrated that tinnitus subjects show significantly re- duced sound level tolerance compared with control subjects, but they did not separate into groups with unilat- eral and bilateral tinnitus in the analyses. To investigate the influence of tinnitus on sound level tolerance, we compared uncomfortable loudness level (UCL) among tinnitus ears (TEs) and non-tinnitus ears (NTEs) of unilateral tinnitus subjects and control ears of normal subjects. Moreover, we compared UCL between tinnitus subjects who complained hyperacusis and those who did not. Materials and Methods:Human subjects in- cluded 50 unilateral tinnitus subjects (12 males and 38 females) with normal and symmetric hearing thresh- olds and 64 control subjects. We conducted psychoacoustic measurements of UCLs with 500 Hz and 3,000 Hz pure tones in each ear separately. Results:The There were no significant differences of UCLs at 500Hz and 3,000 Hz of between TEs and NTEs, but the UCLs at 500 Hz and 3,000 Hz of both TEs and NTEs were lower than those of the control ears. No significant differences of UCLs at 500 Hz and 3,000 Hz were found between tinnitus subjects with hyperacusis and without hyperacusis. The UCL of 500 Hz had significantly negative correlation with the duration of tinnitus and subjective tinnitus loudness. Conclusions:These results support the existing hypothesis that tinnitus and hyperacusis are commonly caused by an increase of central gain. Re- duced sound level tolerance in not only TEs but also NTEs might imply that the increased central gain affects bilaterally in consequence of loudness balance mechanism by lateral olivocochlear efferents.
Abstract
Background and Objectives:Several studies have demonstrated that tinnitus subjects show significantly re- duced sound level tolerance compared with control subjects, but they did not separate into groups with unilat- eral and bilateral tinnitus in the analyses. To investigate the influence of tinnitus on sound level tolerance, we compared uncomfortable loudness level (UCL) among tinnitus ears (TEs) and non-tinnitus ears (NTEs) of unilateral tinnitus subjects and control ears of normal subjects. Moreover, we compared UCL between tinnitus subjects who complained hyperacusis and those who did not. Materials and Methods:Human subjects in- cluded 50 unilateral tinnitus subjects (12 males and 38 females) with normal and symmetric hearing thresh- olds and 64 control subjects. We conducted psychoacoustic measurements of UCLs with 500 Hz and 3,000 Hz pure tones in each ear separately. Results:The There were no significant differences of UCLs at 500Hz and 3,000 Hz of between TEs and NTEs, but the UCLs at 500 Hz and 3,000 Hz of both TEs and NTEs were lower than those of the control ears. No significant differences of UCLs at 500 Hz and 3,000 Hz were found between tinnitus subjects with hyperacusis and without hyperacusis. The UCL of 500 Hz had significantly negative correlation with the duration of tinnitus and subjective tinnitus loudness. Conclusions:These results support the existing hypothesis that tinnitus and hyperacusis are commonly caused by an increase of central gain. Re- duced sound level tolerance in not only TEs but also NTEs might imply that the increased central gain affects bilaterally in consequence of loudness balance mechanism by lateral olivocochlear efferents.
참고문헌 (27)
- Nondahl DM, "Prevalence and 5-year incidence of tinnitus among older adults: the epidemiology of hearing loss study", J Am Acad Audiol, 13(6), pp.323~331 (2002)
- Baguley DM, "Hyperacusis", J R Soc Med, 96(12), pp.582~585 (2003)
- Andersson G, "Hypersensitivity to sound (hyperacusis): a prevalence study conducted via the internet and post", Int J Audiol, 41(8), pp.545~554 (2002)
- Paulin J, "Characteristics of hyperacusis in the general population", Noise Health, 18(83), pp.178~184 (2016)
- Hiller W, "Factors inflencing tinnitus loudness an annoyance", Arch Otolaryngol Head Neck Surg, 132(10), pp.1323~1330 (2006)
- Guimarães AC, "Study of the relationship between the degree of tinnitus annoyance and the presence of hyperacusis", Braz J Otorhinolaryngol, 80(1), pp.24~28 (2014)
- Hébert S, "Emotional Exhaustion as a Predictor of Tinnitus", Psychother Psycosom, 81(5), pp.324~326 (2012)
- Dauman R, "Assessment and amelioration of hyperacusis in tinnitus patients", Acta Otolaryngol, 125(5), pp.503~509 (2005)
- Hebert S, "The auditory sensitivity is increased in tinnitus ears", J Neurosci, 33(6), pp.2356~2364 (2013)
- Zeng FG, "An active loudness model suggesting tinnitus as increased central noise and hyperacusis as increased nonlinear gain", Hear Res, 295, pp.172~179 (2013)
- Norena AJ, "An integrative model of tinnitus based on a central gain controlling neural sensitivity", Neurosci Biobehav Rev, 35(5), pp.1089~1109 (2011)
- Sanchez TG, "Tinnitus is associated with reduced sound level tolerance in adolescents with normal audiograms and otoacoustic emissions", Sci Rep, 6, pp.27109~ (2016)
- Munro KJ, "Plasticity and modified loudness following short-term unilateral deprivation: evidence of multiple gain mechanisms within the quditory system", J Acoust Soc Am, 135(1), pp.315~322 (2014)
- Darrow KN, "Cochlear efferent feedback balances interaural sesitivity", Nat Neurosci, 9(12), pp.1474~1476 (2006)
- Sanchez TG, "Tinnitus in normally hearing patients: clinical aspects and repercussions", Braz J Otorhinolaryngol, 71(4), pp.427~431 (2005)
- Barnea G, "Tinnitus with normal hearing sensitivity: extended high-frequency audiometry and auditory-nerve brain-stem-evoked responses", Audiology, 29(1), pp.36~45 (1990)
- Jastreboff PJ, "Tinnitus retraining therapy for patients with tinnitus and decreased sound tolerance", Otolaryngol Clin North Am, 36(2), pp.321~336 (2003)
- 심현준, "Hearing Abilities at Ultra-High Frequency in Patients with Tinnitus", Clinical and Experimental Otorhinolaryngology, 2(4), pp.169~174 (2009), 대한이비인후과학회
- Kim DK, "Prevalence and significance of high-frequency hearing loss in subjectively normal-hearing patients with tinnitus", Ann Otol Rhinol Laryngol, 120(8), pp.523~528 (2011)
- Fabijańska A, "The relationship between distortion product otoacoustic emissions and extended high-frequency audiometry in tinnitus patients. Part 1:normally hearing patients with unilateral tinnitus", Med Sci Monit, 18(12), pp.CR765~CR770 (2012)
- Shiomi Y, "Characteristics of DPOAE audiogram in tinnitus patients", Hear Res, 108(1-2), pp.83~88 (1997)
- Onishi ET, "Distortion product otoacoustic emissions in tinnitus patients", Int Tinnitus J, 10(1), pp.13~16 (2004)
- Gouveris H, "DPOAEgrams in patients with acute tonal tinnitus", Otolaryngol Head Neck Surg, 132(4), pp.550~553 (2005)
- Job A, "Susceptibility to tinnitus revealed at 2 kHz range by bilateral lower DPOAEs in normal hearing subjects with noise exposure", Audiol Neurootol, 12(3), pp.137~144 (2007)
- Ami M, "Relation of distortion product otoacoustic emission with tinnitus", Laryngoscope, 118(4), pp.712~717 (2008)
- Kujawa SG, "Adding Insult to Injury: cochlear nerve degeneration after “Temporary” noise-induced hearing Loss", J Neurosci, 29(45), pp.14077~14085 (2009)
- Schaette R, "Tinnitus with a normal audiogram:physiological evidence for hidden hearing loss and computational model", J. Neurosci, 31(38), pp.13452~13457 (2011)