BAA talk

http://isrc.ulster.ac.uk
From cochlea to cortex: How neural imaging
techniques can observe tinnitus
1
Richard Gault
PhD student within Intelligent Systems Research Centre,
Ulster University

Acknowledgements
 Lorraine Acheson and BAA
 Collaborators:
Dr Sarah Mitchell (Audiologist, Altnagelvin Area Hospital)
 Supervisors:
Professors Martin McGinnity and Sonya Coleman
2

Contents
- Tinnitus: What are we talking about?
3
Cochlear Nucleus
Inferior Colliculus
Auditory Cortex
Cochlea

Tinnitus: What are we talking about?
- Tinnitus is the conscious experience of sound
heard in or around the head in the absence of an
identifiable source.
4
Musical tinnitus
etc…

Tinnitus with hearing loss
 Approximately 80% of people with
tinnitus have some form of hearing
loss
 The frequency of tonal tinnitus often
falls in a region of hearing loss.
↑hearing threshold→↓auditory nerve
activity
5
(Sereda et al. 2015)

Tinnitus from
auditory
compensation
6
(Schaette and McAlpine 2011;
Schaette and Kempter 2006)

http://isrc.ulster.ac.uk 7
(Schaette and Kempter 2006)

Tinnitus without hearing loss
 Hidden hearing loss and tinnitus (Weisz et al. 2006; Schaette
and McAlpine 2011).
 Tinnitus in silence: 94% (Heller and Bergmann 1952) , 64-
68% (Tucker et al. 2005; Del Bo et al. 2008; Knobel and
Sanchez 2008).
8

Review: Tinnitus from cochlea to
cochlear nucleus
 Hearing impairment almost essential for tinnitus
(subjective only!),
 Compensating for the lack of input the auditory
system amplifies the little signal that it has.
 Consequently, there is an increase in the
spontaneous firing of the cochlear nucleus
(simulated on computer, observed in empirical
data).
Any questions?
9

Tinnitus and the brain
10
(Based upon Jastreboff 1990)
(McKenna et al. 2014)
default-mode network (blue),
limbic network (green),
auditory network (red),
visual network (orange),
attention networks (purple),
Stronger in tinnitus
Weaker in tinnitus
(Compared to controls)
(Husain and Schmidt 2014)
(DeRidder et al. 2014)

What imaging modalities are available?
11
2
4
6
10
8
1ms 0.1 s 1min 10mins 1hr1 s
EEG
MEG
fMRI
PET
MRI
SPECT
Temporal Resolution (not to scale)
SpatialResolution(mm)

PET and SPECT
 Schecklmann et al. 2013 studied 91 patients with chronic tinnitus
using PET.
- Tinnitus duration↑regions of emotional function
- Tinnitus distress ↑ regions of memory
- left-sided over activation of AC was found independently from
tinnitus laterality.
 Laureno et al. 2014 looked at 22 subjects with tinnitus and normal
hearing with 17 matched controls using SPECT.
- Tinnitus patients had increased activity in the left
parahippocampal gyrus->auditory memory.
- Abnormal activation sustains tinnitus preventing modification or
eliminating memory of the repeated sound thereby avoiding
habituation.
12

PET and SPECT: Pros and Cons
Pros:
 Can illuminate areas of
increased metabolic
activity,
 Both have been able to
confirm some of the
regions outlined by
Jastreboff and others.
Cons:
 Very poor temporal and
spatial resolution,
 Indirect measure of neural
activity,
 Expensive scanner required,
 Radioactive tracers required.
13

Functional magnetic resonance imaging (fMRI)
14
Blood oxygen level dependent (BOLD)

Tinnitus beyond the ear: Inferior Colliculus
15
(Melcher et al. 2000)

Functional connectivity with fMRI
Bothersome tinnitus
(Wineland et al. 2012)
 17 with moderate-severe
tinnitus (THI) and 17 age-match
controls.
 Resting state fMRI and looked
at regions of interest and
possible connections between
them.
 Bothersome tinnitus had a
dissociation between activity in
auditory cortex and visual,
attention and control networks.
Non-bothersome tinnitus
(Burton et al. 2012)
 18 with slight or mild tinnitus
(THI) and 23 age matched
controls.
 Same paradigm as before.
 No differences were found
between the control group and
the non-bothersome tinnitus
group.
16

Functional magnetic resonance imaging (fMRI)
17
Positives
+ Excellent spatial resolution,
+ Non-invasive,
+ Widely available imaging method,
+ Can show a wide range of neural
correlates from connectivity to
neuronal activity.
Negatives
- In direct measure of functional
activity,
- Poor temporal resolution
- Participant unfriendly,
- Noise of MRI scanner can
habituate tinnitus.

Neuronal activity
18

Magneto/Electro-encephalography (MEG/EEG)
19

Electro-magnetic activity and Neural
Oscillations
20
https://www.youtube.com/watch?v=OCpYdSN_kts

Tinnitus Intensity and neural oscillations
 Using EEG, Van der Loo et al (2009) found
correlation between tinnitus loudness (VAS) and high
frequency neural oscillations (30Hz+ Gamma)
↑loudness ∝ ↑Gamma activity
21

Tinnitus Perception and Distress
22
(Weisz et al. 2005)
 Results found enhanced slow activity (delta band activity) and
reduced alpha activity from 5minutes resting state MEG
recording.
 It is possible to augment the brain rhythms using neural feedback
methods, such as brain computer interfaces, which could be used
in the future to stabilise the abnormal activity.

MEG and EEG: Pros and Cons
Pros
 Both are a direct measure of
neural activity,
 High temporal resolution,
 Patient friendly recordings
(Particularly MEG),
 Non-invasive and passive
measuring techniques,
 Silent measuring
techniques,
 Can observe neural
oscillations ->consistently
seen across literature.
Cons
 Poor spatial resolution,
 MEG machines are very
expensive,
 EEG can struggle with the
impedance of the skull,
scalp and CSF,
 EEG and MEG are very
sensitive to external (extra
neural fields) sources of
electro-magnetic fields.
23

Review: Neural Imaging
 Where does the brain activate?
 How does the brain activate?
 How do different neural systems interact?
 Every imaging technique has its limitations and
vulnerability.
24

Future Goals
 Objective measure of tinnitus using neural
correlates of tinnitus.
 Understand how neural systems change in
response to treatment.
 Developing more consistent research methods.
 Identifying subgroups of tinnitus with less
diversity.
25

Thank you for listening!
Richard gault
PhD Research Student (ISRC)
Email: gault-r2@email.ulster.ac.uk
Slides can be found at:
Slideshare-> “tinnitus ulster”
27

Recommended Reading/Viewing
 David Baguley, Gerhard Andersson, Don McFerran, Laurence
McKenna (2013) Tinnitus: A Multidisciplinary Approach, : John Wiley &
Sons.
 Aage R. Møller (2011) Textbook of Tinnitus, New York, NY: Springer
Science+Business Media, LLC.
 Adjamian, P., Sereda, M. & Hall, D.A. (2009), "The mechanisms of
tinnitus: Perspectives from human functional neuroimaging", Hearing
research, vol. 253, no. 1–2, pp. 15-31.
 Elgoyhen, A.B., Langguth, B., De Ridder, D. & Vanneste, S. (2015),
"Tinnitus: perspectives from human neuroimaging", Nature
reviews.Neuroscience, vol. 16, no. 10, pp. 632-642.
 Roland Schaette Talk: https://www.youtube.com/watch?v=4jFscPfqxI0
 Susan Shore Talk: https://www.youtube.com/watch?v=AQoazdaZK14
28

 Textbook of tinnitus, 2011, Springer, New York ; London.
 Adjamian, P., Sereda, M. & Hall, D.A. 2009, "The mechanisms of tinnitus: perspectives from human
functional neuroimaging", Hearing research, vol. 253, no. 1-2, pp. 15-31.
 Burton, H., Wineland, A., Bhattacharya, M., Nicklaus, J., Garcia, K.S. & Piccirillo, J.F. 2012, "Altered
networks in bothersome tinnitus: a functional connectivity study", BMC neuroscience, vol. 13, pp. 3-2202-
13-3.
 De Ridder, D., Vanneste, S., Adriaenssens, I., Lee, A.P., Plazier, M., Menovsky, T., van der Loo, E., Van
de Heyning, P. & Moller, A. 2010, "Microvascular decompression for tinnitus: significant improvement for
tinnitus intensity without improvement for distress. A 4-year limit", Neurosurgery, vol. 66, no. 4, pp. 656-
660.
 Del Bo, L., Forti, S., Ambrosetti, U., Costanzo, S., Mauro, D., Ugazio, G., Langguth, B. & Mancuso, A.
2008, "Tinnitus aurium in persons with normal hearing: 55 years later",Otolaryngology--head and neck
surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, vol. 139, no. 3,
pp. 391-394.
 Eggermont, J.J. & Roberts, L.E. 2004, "The neuroscience of tinnitus", Trends in neurosciences, vol. 27, no.
11, pp. 676-682.
 Elgoyhen, A.B., Langguth, B., De Ridder, D. & Vanneste, S. 2015, "Tinnitus: perspectives from human
neuroimaging", Nature reviews.Neuroscience, vol. 16, no. 10, pp. 632-642.
 Gilles, A., De Ridder, D. & Van de Heyning, P. 2013, "No cochlear dead regions detected in non-pulsatile
tinnitus patients: an assessment with the threshold equalizing noise (sound pressure level) test", Noise &
health, vol. 15, no. 63, pp. 129-133.
 HELLER, M.F. & BERGMAN, M. 1953, "Tinnitus aurium in normally hearing persons", The Annals of
Otology, Rhinology, and Laryngology, vol. 62, no. 1, pp. 73-83.
29
References

 Husain, F.T. & Schmidt, S.A. 2014, "Using resting state functional connectivity to unravel networks of
tinnitus", Hearing research, vol. 307, pp. 153-162.
 Jastreboff, P.J. 1990, "Phantom auditory perception (tinnitus): mechanisms of generation and
perception", Neuroscience research, vol. 8, no. 4, pp. 221-254.
 Knobel, K.A. & Sanchez, T.G. 2008, "Influence of silence and attention on tinnitus
perception", Otolaryngology--head and neck surgery : official journal of American Academy of
Otolaryngology-Head and Neck Surgery, vol. 138, no. 1, pp. 18-22.
 Konig, O., Schaette, R., Kempter, R. & Gross, M. 2006, "Course of hearing loss and occurrence of
tinnitus", Hearing research, vol. 221, no. 1-2, pp. 59-64.
 Laureano, M.R., Onishi, E.T., Bressan, R.A., Castiglioni, M.L., Batista, I.R., Reis, M.A., Garcia, M.V., de
Andrade, A.N., de Almeida, R.R., Garrido, G.J. & Jackowski, A.P. 2014, "Memory networks in tinnitus: a
functional brain image study", PloS one, vol. 9, no. 2, pp. e87839.
 Maudoux, A., Lefebvre, P., Cabay, J.E., Demertzi, A., Vanhaudenhuyse, A., Laureys, S. & Soddu, A. 2012,
"Auditory resting-state network connectivity in tinnitus: a functional MRI study", PloS one, vol. 7, no. 5, pp.
e36222.
 McKenna, L., Handscomb, L., Hoare, D.J. & Hall, D.A. 2014, "A scientific cognitive-behavioral model of
tinnitus: novel conceptualizations of tinnitus distress", Frontiers in neurology, vol. 5, pp. 196.
 Melcher, J.R., Levine, R.A., Bergevin, C. & Norris, B. 2009, "The auditory midbrain of people with tinnitus:
abnormal sound-evoked activity revisited", Hearing research, vol. 257, no. 1-2, pp. 63-74.
 Melcher, J.R., Sigalovsky, I.S., Guinan, J.J.,Jr & Levine, R.A. 2000, "Lateralized tinnitus studied with
functional magnetic resonance imaging: abnormal inferior colliculus activation", Journal of
neurophysiology, vol. 83, no. 2, pp. 1058-1072.
30
References

References
 Schaette, R. & Kempter, R. 2006, "Development of tinnitus-related neuronal hyperactivity through
homeostatic plasticity after hearing loss: a computational model", The European journal of
neuroscience, vol. 23, no. 11, pp. 3124-3138.
 Schaette, R. & McAlpine, D. 2011, "Tinnitus with a normal audiogram: physiological evidence for hidden
hearing loss and computational model", The Journal of neuroscience : the official journal of the Society for
Neuroscience, vol. 31, no. 38, pp. 13452-13457.
 Schaette, R., Turtle, C. & Munro, K.J. 2012, "Reversible induction of phantom auditory sensations through
simulated unilateral hearing loss", PloS one, vol. 7, no. 6, pp. e35238.
 Schecklmann, M., Landgrebe, M., Poeppl, T.B., Kreuzer, P., Manner, P., Marienhagen, J., Wack, D.S.,
Kleinjung, T., Hajak, G. & Langguth, B. 2013, "Neural correlates of tinnitus duration and distress: a positron
emission tomography study", Human brain mapping, vol. 34, no. 1, pp. 233-240.
 Sereda, M., Edmondson-Jones, M. & Hall, D.A. 2015, "Relationship between tinnitus pitch and edge of
hearing loss in individuals with a narrow tinnitus bandwidth",International journal of audiology, vol. 54, no. 4,
pp. 249-256.
 Tucker, D.A., Phillips, S.L., Ruth, R.A., Clayton, W.A., Royster, E. & Todd, A.D. 2005, "The effect of silence
on tinnitus perception", Otolaryngology--head and neck surgery : official journal of American Academy of
 van der Loo, E., Gais, S., Congedo, M., Vanneste, S., Plazier, M., Menovsky, T., Van de Heyning, P. & De
Ridder, D. 2009, "Tinnitus intensity dependent gamma oscillations of the contralateral auditory cortex", PloS
one, vol. 4, no. 10, pp. e7396.
 Weisz, N., Hartmann, T., Dohrmann, K., Schlee, W. & Norena, A. 2006, "High-frequency tinnitus without
hearing loss does not mean absence of deafferentation", Hearing research, vol. 222, no. 1-2, pp. 108-114.
31

 Weisz, N., Moratti, S., Meinzer, M., Dohrmann, K. & Elbert, T. 2005, "Tinnitus perception and distress is
related to abnormal spontaneous brain activity as measured by magnetoencephalography", PLoS
medicine, vol. 2, no. 6, pp. e153.
 Wineland, A.M., Burton, H. & Piccirillo, J. 2012, "Functional connectivity networks in nonbothersome
tinnitus", Otolaryngology--head and neck surgery : official journal of American Academy of
 Xiong, H., Chen, L., Yang, H., Li, X., Qiu, Z., Huang, X. & Zheng, Y. 2013, "Hidden hearing loss in tinnitus
patients with normal audiograms: implications for the origin of tinnitus", Lin chuang er bi yan hou tou jing
wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery, vol. 27, no. 7, pp. 362-365.
 Zilany, M.S., Bruce, I.C. & Carney, L.H. 2014, "Updated parameters and expanded simulation options for
a model of the auditory periphery", The Journal of the Acoustical Society of America, vol. 135, no. 1, pp.
283-286.
32
References

BAA talk

Recommended

Recommended

More Related Content

What's hot

What's hot (12)

Similar to BAA talk

Similar to BAA talk (19)

Recently uploaded

Recently uploaded (20)

BAA talk

Editor's Notes