Ranking the global burden of tinnitus among the leading causes of disasters…: Neuroscience today

Written by Mark Moran

September 15, 2022

Article in brief

a Gamma Neurology The report estimates that 14.4 percent of the world’s population suffers from tinnitus. She noted that there is a dearth of effective treatments and called for more investment in research into treatments for the condition.

It is estimated that 14.4 percent of the world’s population — or more than 740 million people — have experienced symptoms of tinnitus, and about 115 million people are severely affected by tinnitus, according to a report in Gamma Neurology.

The prevalence of tinnitus did not differ by sex, but increased prevalence was associated with increased age, with any tinnitus present in 10 percent of young adults, 14 percent of middle-aged adults, and 24 percent of older adults.

Tinnitus is the perception of noise, usually a ringing, whistling, rustling or hissing sound, felt in the ears or head, in the absence of an external sound stimulus. To date, there are no approved medications to treat tinnitus, only some treatments that allow people to live with the symptoms. In its most severe form, it can affect people’s mental and emotional health, ability to sleep, and social well-being.

The Gamma Neurology The report is the first to estimate the global prevalence of tinnitus and confirms on a global scale the findings in a European study published in November 2021 in Lancet Regional Health – Europe by the same authors. The authors say estimates place tinnitus among the leading causes of disability, and that the lack of effective treatment options justifies a significant investment in research in this area.

“Major health organizations, including the World Health Organization and the Global Burden of Disease, should give appropriate weight to this disability, which appears to be present on a par with other disabilities such as migraines, back pain and hearing loss,” said the study’s senior author. Silvano Gallos, MD, head of the Lifestyle Epidemiology Laboratory at the Mario Negri Institute in Milan, Italy, said in a statement from the institute. “We hope that these findings will help raise awareness of the problem so that the search for effective treatments for tinnitus can be accelerated.”

The authors performed a meta-analysis deriving prevalence estimates from 83 articles and incidence estimates from 12 articles published between 1972 and 2021.

Among all studies, estimates of global prevalence for adults ranged from 4.1 percent to 37.2 percent with a pooled prevalence of 14.4 percent. The prevalence of any tinnitus did not differ according to the definitions that were used in the studies or the questions asked. The prevalence of acute tinnitus in adults ranged from 0.5% to 12.6% with a combined prevalence of 2.3%.

The severity of tinnitus varied among adults depending on how its severity was determined and the question asked (“Does tinnitus bother you,” “How does tinnitus bother you,” or “Does your tinnitus interfere with sleep and concentration?”).

The combined prevalence of any tinnitus among children and adolescents was 13.6 percent, with a range of 0.7 percent to 66.9 percent. The authors note that data on tinnitus among children or adolescents is more likely to have different interpretations of the question used to assess tinnitus.

“One possible reason may be that children are frequently asked about tinnitus without specifically mentioning the symptom’s name,” they wrote. Other researchers have suggested that children may report the presence of noise to please interlocutors. Despite the growing number of studies on this topic, tinnitus remains an underrecognized and inadequately evaluated problem in the pediatric population.”

Expert Comment

Experts who reviewed the report for Neuroscience Today He said it provides a global picture of common symptoms in practice, especially among older patients, for which there are few definitive treatments.

“This paper sheds light on an unknown cause of deterioration in quality of life that is very common but also often overlooked in our neurological patient community,” said Scott Grossman, MD, assistant professor of neuroscience at NYU Langone Health. This article highlights the fact that tinnitus is often “tolerated” by patients even if it causes a reduced quality of life. My experience is consistent with the authors’ conclusion that tinnitus becomes more common as we age.

“Few breakthroughs have been made beyond symptom management,” said Dr. Grossman. “Standard of care includes a comprehensive assessment to determine the causes of hearing loss or associated vestibular symptoms, as well as first-line approaches, such as white noise machines which can be highly productive especially at night when patients are sleeping and ambient noise providing less distraction. This is a prevalent condition It will only increase with age among the population of the United States and the world.”

The most common cause of tinnitus (and hearing loss) is exposure to loud sound, said James Henry, senior researcher specializing in Veterans Affairs Rehabilitation Research and Development, National Center for Rehabilitation Audio Research in Portland, Oregon.

“There are efforts to inform the public about this relationship, and hearing preservation efforts in schools and industrial settings, but I believe the impact of these efforts is limited and I am not aware of any evidence that the prevalence of tinnitus and hearing loss is declining,” said Dr. Henry, a research professor in the Department of Otolaryngology. and laryngology and head and neck surgery at Oregon Health & Science University in Portland, Oregon.

He added, “There is really no standard of care for tinnitus, although cognitive behavioral therapy (CBT) has the strongest research evidence according to published systematic reviews and clinical practice guidelines for tinnitus. We have developed the Progressive Management of Tinnitus (PTM) and completed two randomized trials Evidence-based evidence showing good results. To my knowledge, PTM has not yet been evaluated in a systematic review.”

Dr. Henry said CBT includes a combination of CBT and voice therapy. The approach is to teach people skills so that they can manage their reactions to tinnitus for as long as necessary.

The availability of physicians trained to manage tinnitus is variable, he said. Dr. Henry said: “CBT has the strongest research evidence for treating tinnitus, however health professionals with CBT experience – most of whom are psychologists – are generally not trained to provide CBT specifically for tinnitus.” Neuroscience Today. Audiologists, ear, and throat specialists are often the point of contact for people who complain of tinnitus. These professionals are fully trained to treat hearing problems. There is great variation in graduate training problems, however, in providing training in tinnitus management.”

“We need more systematic research to determine which types of sound therapy are most effective for reducing reactions to tinnitus and possibly even reducing or removing the sound itself,” he said. There is preliminary evidence that this may be possible, but the research has not been done. Meanwhile, treatments with evidence of efficacy include cognitive-behavioral therapy, PTM therapy, tinnitus retraining therapy (TRT), tinnitus activity therapy (TAT), and hearing aids, especially those with streaming capabilities (from smartphones). “

Dr. Henry explained that TRT seeks to retrain the brain to “get used” or stop caring about tinnitus. Treatment includes structured counseling focused on the “neurophysiological model” and “enrichment of a healthy environment 24/7.” The TAT determines, for each patient, which of the four categories presents a problem: emotional well-being, hearing, sleep, and concentration. “All relevant groups are treated with educational guidance about tinnitus and its associated problems, and appropriate coping strategies are taught,” he said. In most cases, ‘partial blocking sound therapy’ is used.

Disclosures

None of the sources quoted had disclosures.