The tinnitus network: comorbidity, plasticity and response to treatment

耳鸣网络：合并症、可塑性和对治疗的反应

• 批准号: 317886062
• 负责人: Professor Dr. Christian Dobel
• 金额: --
• 依托单位: Klinik für Psychiatrie und Psychotherapie
• 依托单位国家: 德国
• 项目类别: Research Grants
• 资助国家: 德国
• 项目状态: 未结题
• 来源: https://gepris.dfg.de/gepris/projekt/317886062?language=en
• 关键词: tinnitus; network; comorbidity; plasticity; response

Tinnitus, the perception of a phantom sound, ranges from a mere nuisance to a debilitating disorder. As shown by our own research, it is characterized by high comorbidity including affective symptoms, but also attentional and speech comprehension difficulties. On a neuronal level, the disorder is associated with dysfunctions not only in purely auditory processing regions but also including limbic and particularly parietal and prefrontal areas both in spontaneous and evoked measures. Thus, tinnitus is rather a network disorder than a disorder marked by a circumscribed dysfunctional region. In the first funding period of our project, we have characterized pathological changes in the cortical tinnitus network by capitalizing on the excellent temporal and good spatial resolution of Magnetoencephalography (MEG). Here, we propose a project that builds on our earlier research and uses Magnetoencephalography (MEG) to investigate deeper functional connectivity and its changes due to therapeutic tinnitus intervention. Hypothesizing that the thalamus plays a pivotal role in the tinnitus network, we will measure the thalamo-cortical connectivity at rest, in response to musical stimuli and as an interplay of tinnitus with specific stimulated frequencies (study 1). To understand the mechanism for high comorbidity in chronic tinnitus and the impact on functional connectivity, we will further employ experimental paradigms that were used to understand affective disorders. Thus, study 2 will investigate increased fear and diminished safety learning and overgeneralization to conditioned stimuli associated with general threat stimuli in both, the tinnitus-related auditory and the tinnitus-unrelated visual domain. The paradigms of both studies in combination with resting state measures will be used to monitor function connectivity before and after interdisciplinary tinnitus treatment according to current guidelines (study 3). This approach allows us to study to what extent clinical intervention alleviates pathological connectivity changes in tinnitus patients. In addition to these neurophysiological measures, patients will undergo a standard clinical assessment, and will receive a smartphone app measuring depressive symptomatology, tinnitus and activity profiles so that a remote momentary assessment and longitudinal tracking of symptoms becomes possible. As shown by our own and others’ research, prediction of treatment response is still unsatisfactory and we hope to improve this situation by the proposed combination of measures and experimental approaches.Taken together, the proposal aims to further understand the neural correlates and mechanisms underlying tinnitus and its high comorbidity with affective disorders. Following this goal, we will establish novel methods and paradigms to understand the development and treatment of chronic tinnitus.

耳鸣是一种幻觉的感觉，其范围从单纯的滋扰到使人衰弱的疾病。正如我们自己的研究所示，它的特点是高度合并症，包括情感症状，但也存在注意力和言语理解困难。在神经元水平上，该疾病不仅与纯粹的听觉处理区域的功能障碍有关，而且还与自发和诱发测量中的边缘系统，特别是顶叶和前额叶区域的功能障碍有关。因此，耳鸣更像是一种网络疾病，而不是一种以局限性功能障碍区域为特征的疾病。在我们项目的第一个资助期，我们利用脑磁图（MEG）出色的时间和空间分辨率来表征皮质耳鸣网络的病理变化。在这里，我们提出了一个项目，该项目以我们早期的研究为基础，并使用脑磁图 (MEG) 来研究更深层的功能连接及其因耳鸣治疗干预而发生的变化。假设丘脑在耳鸣网络中起着关键作用，我们将测量静息时丘脑皮质的连接性、对音乐刺激的反应以及耳鸣与特定刺激频率的相互作用（研究 1）。为了了解慢性耳鸣高合并症的机制以及对功能连接的影响，我们将进一步采用用于理解情感障碍的实验范式。因此，研究 2 将调查与耳鸣相关的听觉区域和与耳鸣无关的视觉区域中的一般威胁刺激相关的条件刺激的增加的恐惧和减少的安全学习以及过度概括。这两项研究的范例与静息状态测量相结合，将用于根据当前指南（研究 3）在跨学科耳鸣治疗前后监测功能连接。这种方法使我们能够研究临床干预在多大程度上减轻耳鸣患者的病理连接变化。除了这些神经生理学测量之外，患者还将接受标准的临床评估，并将收到一个测量抑郁症状、耳鸣和活动概况的智能手机应用程序，以便对症状进行远程瞬时评估和纵向跟踪。正如我们自己和其他人的研究所示，治疗反应的预测仍然不能令人满意，我们希望通过所提出的措施和实验方法相结合来改善这种情况。总而言之，该提案旨在进一步了解耳鸣及其与情感障碍的高共病性的神经相关性和机制。遵循这一目标，我们将建立新的方法和范例来了解慢性耳鸣的发展和治疗。