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This study retrospectively analyzed the first and second visit data of chronic subjective tinnitus patients who received music combined with cognitive behavioral therapy in our hospital in recent years. Behavioral tests and tinnitus questionnaires, as well as sleep and depression scores, were used to analyze the therapeutic effects of this approach. EEG results were analyzed as a potential neurobiological marker to explore the neural mechanism of tinnitus symptom improvement.
The subjects of this study were chronic subjective tinnitus patients and normal controls who were treated with music therapy combined with cognitive behavioral therapy (music-CBT) in the Department of Otolaryngology of Sun Yat-sen Memorial Hospital from December 2016 to March 2024 and who had completed re-examination. The pre- and post-music-CBT data of past patients who met our study conditions were collected for retrospective statistics. The complete sample data included medical history, pure tone audiometry, tinnitus matching, tinnitus questionnaires (Tinnitus Handicap Inventory, Visual Analog Scales, tinnitus Functional Index), sleep quality questionnaire (Pittsburgh Sleep Quality Index), and depression questionnaire (Hamilton Depression Scale -24 items). The resting state electroencephalogram (rs-EEG). Retrospective statistical analysis was conducted to determine the clinical efficacy and influencing factors of music-CBT for chronic subjective tinnitus at 3 months and long term. Finally, the neural mechanism of music-CBT for tinnitus treatment was analyzed based on rs-EEG results.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| pre-operative results | pre-operative period test results, baseline data. |
| |
| post-operative results | post-operative period test results, review data. | ||
| healthy control | Subjects with no tinnitus and matched baseline information |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| music-CBT | Behavioral | notched relaxation music combined with personalized CBT |
|
| Measure | Description | Time Frame |
|---|---|---|
| pure tone audiometry | The air conductivity threshold of pure tone audiometry across the frequency range of 500-4000Hz is referred to as the pure tone average (PTA) for the tested ear | the exact 1 day of the first visit |
| tinnitus loudness | Tinnitus loudness was calculated by the matched intensity subtracting the pure tone threshold at that frequency. | the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
| tinnitus handicap inventory (THI) | There were 25 items in the THI scale, divided into three subscales (functional, emotional, and catastrophic), and response choices consisted of "no" (0 points), "sometimes" (2 points), and "yes" (4 points). A higher score of THI indicateed more severe tinnitus. | the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
| tinnitus functional index (TFI) | The TFI scale assessed tinnitus-related distress and severity. It contained 8 subscales. They were denoted as TFI-I (Intrusiveness) and TFI-SC (Sense of) control), TFI-C (Cognition), TFI-S (Sleep), TFI-A (Auditory), TFI-R (Relaxation), TFI-Q (Quality of life), TFI-E (Emotional) distress); A total of 25 items are included. Each item worthes 100 points. The average score of all items was recorded as the total TFI score (0-100). A higher score of TFI indicateed more severe tinnitus. | the exact day of the first visit and review visit, within 3 - 4.5 months |
| EEG functional connectivity and brain network characteristics | EEG signals were used to explore the activation of brain regions and remodeling of poor connections in the postoperative outcomes of conductive hearing loss patients accompanied by with tinnitus. Power spectral density calculation, traceability analysis, functional connection, microstate, clustering coefficient, feature path length, feature path intermediation, and isocompatibility coefficient were collected and then analyzed. |
| Measure | Description | Time Frame |
|---|---|---|
| visual analogue scale (VAS) | VAS scaled from 0 to 10. A score of 0 means that tinnitus has no impact on daily life, and a score of 10 means that tinnitus has an intolerable, fatal level of impact on daily life. | the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
| Pittsburgh sleep quality index (PSQI) |
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Inclusion Criteria:
Exclusion Criteria:
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The participants involved in this study were patients admitted to Sun Yat-sen Memorial Hospital with chronic subjective tinnitus that had lasted for more than six months. They were all treated with Music-CBT for 3 months.
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| Name | Affiliation | Role |
|---|---|---|
| Haidi Yang, master | SunYatSunU2H | Study Director |
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| ID | Term |
|---|---|
| D014012 | Tinnitus |
| D012893 | Sleep Wake Disorders |
| ID | Term |
|---|---|
| D006311 | Hearing Disorders |
| D004427 | Ear Diseases |
| D010038 | Otorhinolaryngologic Diseases |
| D012678 | Sensation Disorders |
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| the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
PSQI scale was compiled by Buysse et al in 1989 to assess the sleep quality of individuals in the last 1 month. The total score ranges from 0 to 21. A higher score indicates worse sleep quality in the past month. |
| the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
| Hamilton Depression Scale -24 items (HAMD-24) | The HAMD-24 was used to assess the degree of depression and emotional state in patients with chronic subjective tinnitus. The assessment included the emotional state and symptoms of autonomic nervous system disorders in the past week, and each question was scored according to the presence and severity of symptoms. | the exact 1 day of the first visit and review visit, within 3 - 4.5 months |
| D009461 |
| Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001523 | Mental Disorders |