Chronic tinnitus and the limbic system: Reappraising brain structural effects of distress and affective symptoms
Chronic tinnitus and the limbic system: Reappraising brain structural effects of distress and affective symptoms
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DOI：
10.1016/j.nicl.2019.101976
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发表时间：
2019-01-01
影响因子：
4.2
通讯作者：
Nenadic, Igor
中科院分区：
文献类型：
--
作者：
Besteher, Bianca;Gaser, Christian;Nenadic, Igor
慢性耳鸣与听觉系统和边缘系统的大脑结构变化有关。虽然大脑结构发现存在相当大的不一致，但越来越多的证据表明，痛苦和其他非听觉症状会调节影响。在这项研究中，我们解决了这个问题，检验了耳鸣边缘系统变化与疾病相关的痛苦以及共病精神病理学相关的假设。我们获得了总共 125 名受试者的高分辨率结构磁共振成像 (MRI) 扫描：59 名双侧慢性耳鸣患者（29 名患有共病精神疾病，30 名没有），40 名健康对照者和 26 名患有抑郁/焦虑症（无耳鸣）的精神对照者。使用基于体素的形态测定法和 CAT12 软件包来分析数据。首先，我们基于 2 x 2 因子设计（耳鸣；精神共病）分析数据，显示前扣带皮层和上/横颞回的 ROI 分析中耳鸣的趋势水平影响，以及左侧海马旁皮层基于体素的分析。多元回归分析表明，海马旁发现主要是通过耳鸣而不是（维度）精神病理学评级来预测的。仅将低痛苦耳鸣患者（独立于合并症）与健康对照进行比较也显示左侧海马旁灰质减少。我们的研究结果表明，抑郁和焦虑（不仅仅是主观困扰）是耳鸣大脑结构影响的主要调节因素，呼吁在未来的耳鸣神经生物学和临床研究中更深入地考虑精神病理学。
Chronic tinnitus has been associated with brain structural changes in both the auditory system as well as limbic system. While there is considerable inconsistency across brain structural findings, growing evidence suggests that distress and other non-auditory symptoms modulate effects. In this study we addressed this issue, testing the hypothesis that limbic changes in tinnitus relate to both disease-related distress as well as co-morbid psychopathology. We obtained high-resolution structural magnetic resonance imaging (MRI) scans from a total of 125 subjects: 59 patients with bilateral chronic tinnitus (29 with a co-morbid psychiatric condition, 30 without), 40 healthy controls and 26 psychiatric controls with depression/anxiety disorders (without tinnitus). Voxel-based morphometry with the CAT12 software package was used to analyse data. First, we analysed data based on a 2 x 2 factorial design (tinnitus; psychiatric co-morbidity), showing trend-level effects for tinnitus in ROI analyses of the anterior cingulate cortex and superior/transverse temporal gyri, and for voxel-based analysis in the left parahippocampal cortex. Multiple regression analyses showed that the parahippocampal finding was mostly predicted by tinnitus rather than (dimensional) psychopathology ratings. Comparing only low-distress tinnitus patients (independent of co-morbid conditions) with healthy controls also showed reduced left parahippocampal grey matter. Our findings demonstrate that depression and anxiety (not only subjective distress) are major modulators of brain structural effects in tinnitus, calling for a stronger consideration of psychopathology in future neurobiological and clinical studies of tinnitus.