Evaluation of Eye Movement Desensitization and Reprocessing in the management of tinnitus. An observational study

ObjectivesTinnitus can induce disabling psychological suffering, requiring an integrative multimodal approach, combining neuromodulation and psychotherapeutic methods. We sought to evaluate the therapeutic efficacy and acceptability of Eye Movement Desensitization and Reprocessing (EMDR) in tinnitus.Materials and methodsThis was a single-center prospective non-comparative study. Inclusion criteria comprised: adult patient, with chronic tinnitus, Tinnitus Handicap Inventory (THI) score > 17, causing psychological distress motivating active treatment after ineffective “classic” treatment (combining advice, sound therapy and first-line drug treatment), and agreement to EMDR therapy. Therapeutic efficacy was defined by a decrease in THI or Visual Analog Scale (VAS) scores. Treatment acceptability was defined by the rate of included patients who completed therapy.ResultsThirty-eight patients were included. There was a significant reduction of 53.5% in THI score in 78.9% of patients (P < 0.0001; 64.8 ± 20.8 before versus 31.8 ± 24.7 after treatment), and of 51% in VAS score in 76.3% of patients (P < 0.0001; 7.24 ± 2.12 before versus 3.58 ± 2.03 after treatment). The treatment acceptability was 86.8%.ConclusionEMDR appeared to be an effective alternative that was acceptable to the majority of patients, after failure of “classic” first-line treatment, improving quality of life in tinnitus patients and thus relieving disability.     

Fos-like immunoreactivity in auditory and nonauditory brain structures of hamsters previously exposed to intense sound

Fos-like immunoreactivity (FLI) was evaluated in auditory and nonauditory brain structures in hamsters that had been exposed previously to intense sound and tested behaviorally for tinnitus. The immunocytochemical results demonstrated a significant increase in exposed animals of FLI in auditory brain structures such as the lateral lemniscus, central nucleus of inferior colliculus, and auditory cortex, as well as in some nonauditory brain structures such as the locus coeruleus, lateral parabrachial nucleus, certain subregions of the hypothalamus, and amygdala. The behavioral scores suggest that animals that had been exposed to intense sound developed tinnitus. This is consistent with the hypothesis that FLI induced by intense sound exposure might represent a neural correlate of tinnitus or of plasticity associated with tinnitus. The possibility and the mechanisms underlying the increased FLI are discussed.     

听宫穴针刺及注射利多卡因治疗神经性耳鸣

目的：探讨针刺听宫穴注射昨多卡因治疗神经性耳鸣的效果。方法：对神经性耳鸣80例采用针刺听宫穴得气后注射2％利多卡因1ml。结果：80例中治愈58例、66耳,显效10例、12耳、有效6例、6耳,无效6例、8耳。结论：突聋伴耳鸣及噪声性耳鸣且病程短短者疗效好,外伤性耳鸣及原因不明耳鸣者疗效较差。此法简便易行、安全,无毒副作用。     

联带运动性耳鸣

目的：探讨联带运动性鸣的发生机制,临床表现及治疗。     

耳鸣相关脑区的正电子发射断层成像

目的　探讨与耳鸣相关的脑区并观察听力损失、耳鸣侧别、优势半球等因素的影响。方法　用正电子发射断层成像 (positronemissiontomograph ,PET)研究 17例耳鸣患者的脑葡萄糖代谢活动 ,并与 15例无耳鸣者作对照。示踪剂为18F标记的去葡萄糖。按有无听力损失将所有受试者分为 4组 ,第 1组耳鸣伴听力损失 ,13例 ;第 2组耳呜但听力正常 ,4例 ;第 3组无耳呜有听力损失 ,2例 ;第 4组无耳呜且听力正常 ,13例。用专门统计分析软件Statisticalparametersmapping(SPM)进行统计分析 ,按照Talairach坐标确定与耳呜相关脑区的解剖部位 (brodmannarea ,BA)。结果　耳呜相关脑区位于左侧颞横回 (BA41)、左侧颞上回 (BA42、2 2 )、左侧颞中回前部 (BA38)和左侧海马 ,这一结果不依赖于耳呜的侧别 ,而且与优势关球无关。听力损失相关的脑区主要是双侧颞上回后部 (BA42、2 2 )、颞中回中部 (BA2 1)、联合听区 (BA39)、左侧额中回 (BA8、9)、左侧额下回 (BA45 )等。结论　PET为主观耳呜提供了客观证据 ,有望成为耳呜的客观检测方法。     

耳鸣的心理学问题

目的：分析耳鸣的心理原因和结果，以期引起临床医生的重视和研究。方法：对225例以耳鸣为第一主诉的主观耳鸣患者，采用唔谈，耳鸣分类调查表，耳鸣问卷，Zuang抑郁量表等进行心理问题评定，结果：全部患者均存在明显的心理问题，心理因素引起的耳鸣占21.0%，耳鸣引起的心理反应占67.7%，分不清先后（混合性）占11.3%。结论：耳鸣与心理因素密切相关，耳鸣问卷和耳鸣习服疗法能较好地测量和治疗患者的心理问题。     

天眩清治疗眩晕、耳鸣的临床观察

目的 观察天眩清注射液对周围性眩晕、神经性耳鸣的治疗效果。方法 眩晕患者120例，耳鸣患者80例，各随机分为实验组及对照组，按观察项目、评定标准进行系列临床观察。结果 两实验组病例中，眩晕者总有效率93．3％，耳鸣者总有效率77．5％。结论 天眩清注射液对周围性眩晕、神经性耳鸣有显著疗效，为一种安全有效的制剂。     

Acupuncture in the Management of Tinnitus: A Placebo-Controlled Study

The present study was performed on 20 patients randomly selected from a large group with noise-induced tinnitus in order to investigate the effect of acupuncture on their tinnitus. The patients were divided into two groups. One group first received classical Chinese needle acupuncture for 5 weeks, and the other was given a placebo procedure; after a 2-week interval, the procedures were reversed. A single-blind crossover design was used. Acupuncture was given by a Chinese otolaryngologist around the ear as well as at distal points on the extremities. Placebo consisted of mock electrical stimulation via surface electrodes connected to a Chinese electro-acupuncture stimulator which delivered a weak sound and a light flash at a frequency of 2 Hz but no current to the surface electrodes. The effect was evaluated by the use of visual analogue scales. No significant difference between acupuncture and placebo was found in annoyance, awareness or loudness of the tinnitus. Many patients indicated a preference for acupuncture due to unspecific effects such as improved sleep, decreased muscle tension and improved blood circulation. It is concluded that acupuncture has no specific alleviating effect on noise-induced tinnitus.