RESUMEN
OBJECTIVES: It was aimed at assessing the connection between tinnitus and central auditory dysfunction using both central auditory tests (CATs) and diffusion tensor imaging (DTI) for brain regions that are crucial for central auditory processing. METHODS: This prospective case-control study included 15 patients with persistent tinnitus and 20 healthy volunteers as controls. They underwent CATs for memory, attention, and DTI. The Tinnitus Handicap Inventory (THI) Questionnaire was applied as well. From several brain regions, the values of mean diffusivity (MD) and fractional anisotropy (FA) were determined. RESULTS: Comparing both groups, the tinnitus group showed statistically worse values as regards the CATs (memory for content, sequence memory, speech perception in noise (SPIN) at different signal-to-noise ratios, "SNRs") compared with the control group. As regards DTI, the tinnitus group showed decreased FA in several brain areas, including the cingulum, prefrontal-cortex (PFC), insula, and hippocampus. Furthermore, the tinnitus group showed significantly higher MD in the cingulum, BA-46, and amygdala compared with the control group. FA values of BA-46 were positively correlated with the SPIN-SNR-10 scores. Also, FA values of the middle cingulum were positively correlated with SPIN-SNRzero scores. MD values at BA-46 were negatively correlated with SPIN-SNR-10. THI scores were negatively correlated with FA at BA-46; however, they were positively correlated with MD at the amygdala. CONCLUSIONS: Central auditory dysfunction may be linked to the underlying neurophysiological changes in chronic tinnitus. LEVEL OF EVIDENCE: Level 2 Laryngoscope, 2024.
RESUMEN
BACKGROUND: Visual vertigo (VV) is a condition at which there is worsening or triggering of vestibular symptoms in certain visual environments with large size (full field) repetitive or moving visual patterns as shopping malls. PURPOSE: This work was designed to study effect of virtual reality and optokinetic stimulation on rehabilitation of VV. METHOD: A total of 60 subjects divided into 2 groups that were simply randomized by the concealed envelope method: Group I consisted of 30 VV patients underwent vestibular rehabilitation using virtual reality. Group II consisted of 30 VV patients underwent vestibular rehabilitation using optokinetic stimulation. RESULTS: Significant improvement in performance in the two groups after rehabilitation with no statistically significant difference when comparing both groups. CONCLUSIONS: A combined intense rehabilitation program including OPK stimulation or VR rehabilitation combined with home-based exercises appeared to be equally effective for management of patients with VV and improving their quality of life.