Research Annick Gilles

Abstract

P - Tinnitus, the perception of a sound in the absence of an external sound source, causes a negative impact on the quality of life in 10% of patients leading to psychological burden. For chronic tinnitus patients, therefore, psychoeducation is of paramount importance often provided in the form of Cognitive Behavioral Therapy. Acute tinnitus (AT) is defined when the tinnitus is present for less than 3 months. Due to long waiting lists, tinnitus support is often postponed. As such, the known psychological tinnitus burden may occur over time due to the associated problems such as anxiety, depression, sleeping problems etc. caused by tinnitus over time. I - The current project suggests a preventive measure in the form of a psycho-educational program made available to AT patients through a web based e-learning care path. A comparative, blinded randomized-controlled trial will be performed. C - Patients presenting themselves with AT will be randomized into two groups. The active group receives the web based e-learning platform containing a 10-day psychoeducation tinnitus program. The control group does not receive any additional tinnitus guidance in the acute phase (= current standard of care). The Tinnitus Functional Index, a questionnaire reflecting the tinnitus burden, will serve as the primary outcome at second follow-up (12-16 weeks after baseline) in order to compare the difference in tinnitus evolution in this period of time and/or the occurrence of psychological tinnitus burden when the tinnitus remains over time and becomes chronic (follow-up measurements at 6 months). It is our hypothesis that the patients in the active group show lower tinnitus burden both in shorter as well as longer time frames. O – The cost-effectiveness of an web based platform for AT patients will be assessed and disseminated free of cotst to other caregivers at the end of the project.

Researcher(s)

• Promoter: Gilles Annick

Funding

• BOF

Project type(s)

• Research Project

Abstract

Transcranial direct current stimulation (tDCS) has been proposed as a non-invasive brain stimulation technique to alleviate tinnitus. Many trials target the right dorsolateral prefrontal cortex (rDLPFC), with the aim of strengthening deficient top-down mechanisms and interfering with the emotional response to tinnitus. This technique has a high theoretical potential, but the considerable number of trials investigating the effects of tDCS of the DLPFC on tinnitus are characterized by a high level of interindividual variability in treatment response, and attempts at replication often fail. A major reason for the variability observed in the literature is the known large interindividual variation in electric field strength and neurophysiological effects of tDCS. Moreover, there is a lack of insight into the underlying effects of the tDCS, as trials often only take clinical outcomes into account and not effects on cortical activity. The proposed research aims to optimise tDCS as a tinnitus treatment by delivering individualised paradigms and assessing its effects on evoked cortical activity alongside subjective tinnitus severity. We hypothesize that an individualised anodal tDCS paradigm, with the current optimum in the rDLPFC, will significantly decrease subjective tinnitus severity compared to a sham stimulation protocol. Moreover, we expect that tDCS effects on tinnitus severity will be mediated by its effects on evoked brain activity as measured via cortical auditory evoked potentials (CAEPs). Preliminary data from our centre have shown that active tDCS may elicit a measurable impact on CAEPs, and that these CAEPs may function as an objective neural marker of subjective tinnitus severity. Combining this prior knowledge in a prospective randomized controlled trial, we will elucidate the effects of optimised tDCS over the rDLPFC on tinnitus by taking the underlying effects on cortical activity into account. If successful, the results of this trial will have a tangible effect on the treatment of tinnitus.

Researcher(s)

• Promoter: Cardon Emilie
• Co-promoter: Gilles Annick
• Co-promoter: Van Rompaey Vincent

Research team(s)

• Translational Neurosciences (TNW)01/09/2025 - 01/09/2028

Funding

• PRIVE - non profit

Project type(s)

• Research Project

Abstract

Tinnitus is a highly prevalent disorder affecting 10 to 15% of adults. It has a high socioeconomic burden, because it affects patients' quality of life, is associated with depression, reduced productivity at work and sleeping difficulties. Many different risk factors for the development of tinnitus have been described, such as hearing loss. In about 25% of patients, tinnitus is influenced by neck or jaw related muscle tension or limitations in joint movement, then called somatic tinnitus (ST). Animal research has proposed that ST originates from brainstem connections between the areas that collect information from the neck and jaw and hearing related areas. One brain imaging study has shown that these connections also exist in humans. This, however, does not explain why some patients with tinnitus experience changes in their tinnitus when they are having neck pain while others don't. This is why we aim to use a unique multimodal medical imaging approach with the ultimate goal to identify how function, structure and neurochemistry of key nodes (somatosensory and auditory) in the brain are related to ST. By comparing the results of a group of patients with ST to patients with other types of tinnitus and patients with neck pain without tinnitus, we aim to better identify the mechanisms of ST. This will give us the tools to improve future assessment and treatment strategies for patients with tinnitus.

Researcher(s)

• Promoter: Gilles Annick
• Co-promoter: Jeurissen Ben

Funding

• FWO

Project type(s)

• Research Project