Tinnitus, the perception of sounds not present externally, can significantly impair quality of life. Currently there are no clinically available objective measures to enable monitoring of tinnitus-related changes in brain activity. Our previous work demonstrated sensitivity of a non-invasive imaging technique called functional near-infrared spectroscopy (fNIRS) to changes in brain activity associated with tinnitus presence and severity. In this study we aimed to assess whether fNIRS features could quantify tinnitus severity on a continuous scale, a requirement for effective monitoring of treatments. We collected fNIRS data at rest and in response to auditory and visual stimuli from a group of 103 individuals with tinnitus and 50 controls. We identified fNIRS-derived measures of connectivity which showed significant group differences and used these features in a linear regression model to predict tinnitus-related distress as rated using the Tinnitus Handicap Inventory (THI), and tinnitus loudness and annoyance scores. We assessed correlations between predicted and actual severity in the large tinnitus dataset as well as in two cohorts with shared clinical features- those with severe tinnitus (THI≥58), and cochlear implant users who experienced tinnitus. Findings showed predicted THI ratings correlated significantly with actual THI scores in our large group of individuals with tinnitus although predictive precision was limited, likely due to heterogeneity within this group. Predictions improved when considering both the severe cohort and cochlear implant users with tinnitus. A biomarker of tinnitus severity could provide a tool to monitor treatment effectiveness, particularly within tinnitus subtypes with shared clinical and neural characteristics.

This study aimed to analyse the effects of educational levels, sex, and residence on tinnitus-related distress, as well as the severity of depression and anxiety. A total of 235 patients with primary subjective tinnitus participated in the study. These patients underwent thorough evaluations in otorhinolaryngology and audiology. Additionally, all patients completed the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), and the Generalised Anxiety Disorder-7 (GAD-7) questionnaires. Patients with a primary school education scored significantly higher on the functional () subscale of the THI. When examining depression and anxiety levels, it was observed that patients with a primary school education exhibited the highest levels of anxiety, whereas those with a university education displayed the highest levels of depression. When analysing the effects of residency, slightly lower total THI scores were observed in individuals living in metropolitan areas. When comparing the subscale results of the THI, patients residing in metropolitan areas exhibited significantly lower scores on the subscale. In terms of the total BDI and GAD-7 scores, there were no statistically significant differences observed. Women had slightly higher scores on the BDI and GAD-7, without statistical differences. However, women had significantly higher total THI scores. Additionally, women exhibited statistically significantly higher scores on the catastrophic ( subscale. However, the results for the and emotional () subscales did not show any statistically significant differences. There was no correlation between age and the THI, BDI, or GAD-7 scores. The results of this study reveal significant differences in tinnitus distress based on sex, educational levels, and residence locations, along with the presence of psychiatric symptoms, which should also be considered in tinnitus management.

Tinnitus and reactions to the tinnitus are different dimensions that can be explored in research and in clinical settings. Notably, these dimensions can elucidate priorities and the most problematic areas for patient-centered approaches. The aim of this study is to determine how tinnitus is perceived and impacts people who have experienced tinnitus for different durations. People with tinnitus were invited to participate in a survey at the University of Iowa Tinnitus Website. 709 people responded and documented their perceived sound, problems experienced, and duration of tinnitus. We assessed correlations between the duration of tinnitus and the pitch rating, the loudness rating, and the Tinnitus Primary Function Questionnaire scores. Additionally, we performed a multiple linear regression analysis, considering the dependent variable 'duration of tinnitus', to explore associations between duration of tinnitus and the aforementioned factors. This was a cross-sectional study based on comparisons of responses from patients with different tinnitus durations, rather than examining the same patients longitudinally. The analysis demonstrated that respondents with a longer duration of tinnitus reported higher loudness ratings ( = 0.010). However, their reactions to tinnitus (Tinnitus Primary Function Questionnaire) were associated with a decrease compared with a shorter duration of tinnitus ( = 0.048). There was no association between pitch rating and duration of tinnitus. Our findings indicated louder tinnitus was associated with a longer duration of tinnitus. However, in general, the functional impact of the tinnitus was associated with a decrease. Notably, there was considerable variability among individuals, suggesting that additional factors contribute to these relationships. These findings can be considered in treatment decisions and counseling strategies.

Pharmacological approaches to tinnitus have remained peripheral within research, despite persistent patient demand and advances in auditory neuroscience. There is increasing consideration of whether these developments now justify renewed focus on pharmacological research in tinnitus and hyperacusis. This paper presents a narrative synthesis of perspectives arising from an international scientific meeting, based on invited contributions from speakers who expanded on themes related to their presentations, integrating insights from systems neuroscience, cellular and molecular mechanisms, animal and human models of auditory hypersensitivity, and patient-reported experience. Rather than summarising individual presentations, the analysis focuses on converging mechanistic explanations, biological heterogeneity, emerging therapeutic targets, and advances in objective measurement. Particular attention is given to how evolving mechanistic frameworks can support patient education and clinical communication, even in the absence of disease-modifying treatments. Taken together, these discussions reflect renewed examination of pharmacological approaches to tinnitus and hyperacusis, with attention to both emerging mechanistic rationales and the substantial challenges that remain. Integrating mechanistic insights, phenotype-informed care, and responsible communication may help clarify research priorities and support informed clinical and patient-facing discussions.

BACKGROUND: Subjective tinnitus (ST) often causes significant psychological and sleep disturbances, and limited treatment options are available. Neuroimaging suggests that acupuncture modulates brain activity. This study aimed to evaluate electroacupuncture (EA) for ST treatment using resting-state functional magnetic resonance imaging (rs-fMRI) to explore its central mechanisms. METHODS: This single-center, randomized, double-blind trial enrolled 90 patients with ST (aged 18-65 years), who were randomized at a 2:1 ratio to EA (n = 60) or sham acupuncture (SA, n = 30). Participants received 20 sessions over 7 weeks. EA applied electrical stimulation at seven fixed acupoints, while SA used non-penetrating needles. Primary outcome was change in Tinnitus Handicap Inventory (THI) score. Secondary outcomes included Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale (HADS), and audiometry. rs-fMRI assessed brain functional changes. RESULTS: The EA group showed significantly greater reduction in THI scores compared to the SA group at the end of the second treatment course (mean change: -30.38 to -21.76, P < 0.001). This improvement was maintained during the 3-month follow-up period (mean change: -29.13 to -19.53, P < 0.001). Resting-state functional magnetic resonance imaging analysis revealed that EA decreased the insula Regional Homogeneity (ReHo) value, and the change in insula ReHo values was positively correlated with improvements in HADS scores. Additionally, EA significantly improved sleep quality and emotional status compared to SA. CONCLUSION: EA effectively reduces ST severity, improving hearing, sleep, and mood and providing superior effects to SA. Its mechanism might involve modulating insular function and enhancing emotion-related brain regions.

Chronic tinnitus is often accompanied by considerable psychological burden, including anxiety, depression, and impaired quality of life. Mindfulness-based therapy has attracted growing attention as a potential psychological intervention for tinnitus management. This narrative review examines the current literature on the rationale, clinical application, reported efficacy, limitations, and future directions of mindfulness-based therapy in chronic tinnitus. Current evidence suggests that mindfulness-based interventions may help reduce tinnitus-related distress, improve emotional regulation, and enhance quality of life, while evidence for direct effects on tinnitus loudness remains limited. Although findings from existing studies are encouraging, the literature is heterogeneous with respect to intervention types, comparator conditions, and outcome measures. Mindfulness-based therapy may therefore represent a useful adjunctive option for some patients with chronic tinnitus, but further rigorous research is required to better define its clinical role.

Pulsatile tinnitus is a specific type of sound caused by vascular anomalies, usually associated with turbulent blood flow, secondary to high-output stenosis or arterial tortuosity. These alterations can produce rhythmic sounds that compromise patients' quality of life. This report describes the case of a 51-year-old woman with pulsating tinnitus in her right ear for 18 months. No significant changes were identified on arterial computed tomography angiography or cranial magnetic resonance angiography due to the non-completion of the joint venous phase. Carotid Doppler ultrasound showed abnormal flow in the right external carotid artery, with a decreased resistance index, suggesting an arteriovenous fistula. Cerebral angiography confirmed the diagnosis, showing communication between external carotid artery branches and intracranial veins. The patient underwent endovascular treatment with embolization, resulting in complete resolution of symptoms and normalization of Doppler parameters at 24-month follow-up.

[This corrects the article DOI: 10.3389/fphar.2024.1252343.].

OBJECTIVES: Sensory gating (SG) is the ability to differentiate novel or salient sensory input from known or irrelevant information. In tinnitus, SG is considered dysfunctional, as the brain fails to inhibit internal auditory neural activity before it reaches conscious perception. As a result, the brain continuously processes the tinnitus signal as if it was a new and relevant stimulus. SG can be assessed with a self-report tool, the Sensory Gating Inventory (SGI). DESIGN: A prospective questionnaire study was performed in persons with tinnitus (n = 358) and a control group without tinnitus (n = 436). Tinnitus severity was assessed with the tinnitus questionnaire (TQ) and used to split the tinnitus group into subgroups of persons with compensated and decompensated tinnitus. The decompensated tinnitus subgroup consisted of persons suffering from severe tinnitus, while the compensated subgroup consisted of persons with less severe tinnitus. Systematic covariation measures were applied to assess the association between the TQ and the SGI results. RESULTS: SG was impaired in the domains of Perceptual Modulation, Distractibility, and Vulnerability to Fatigue and Stress as well as in the auditory modality in persons with tinnitus when compared with persons without tinnitus. When the tinnitus group was divided into the subgroups, higher SGI scores on all subscales were prevalent in the decompensated tinnitus subgroup. The results in the compensated tinnitus subgroup were more similar to the control group, except for the auditory modality. CONCLUSIONS: The decompensated tinnitus subgroup showed higher scores on all SGI subscales, which might indicate a more substantial SG impairment. The relation between TQ and the SGI results and the subgrouping of persons with tinnitus can consequently inform and improve future research about the transitional period and the processes that dysregulate when compensated tinnitus turns into decompensated tinnitus.

INTRODUCTION: A ringing sensation in the ear is referred to as tinnitus. It is one of the common symptoms associated with hearing loss. It can be associated even with loudness-related conditions, such as hyperacusis. OBJECTIVE: To investigate the relationship between tinnitus and hyperacusis in individuals with normal hearing and up-to-mild hearing loss, focusing on the manifestation of loudness intolerance. METHODS: The Tinnitus Handicap Inventory (THI) was administered among 35 adults having primary complaints of tinnitus with normal hearing and up-to-mild hearing loss. Further, the Modified Khalfa Hyperacusis Questionnaire (M-HQ) was used to evaluate the hyperacusis severity among the same individuals. Spearman's correlation coefficient was used to check the correlation between tinnitus and hyperacusis severity. RESULTS: Of the 35 adults who reported tinnitus, 18 (51.4%) of them reported having hyperacusis. The outcome of Spearman's correlation indicated a moderate positive correlation between the THI and M-HQ scores r = 0.401(  = 0.017). CONCLUSION: The results obtained suggest that tinnitus is associated with hyperacusis. With the subjective evaluation, it is clear that the change in the severity of tinnitus perception is interconnected with the perception of hyperacusis severity. But this relationship is not a completely overlapping one. Future research on the comorbid interplay of tinnitus severity and hyperacusis severity may shed further light on this link.