Neuroanatomical Alterations in Patients With Tinnitus Before and After Sound Therapy: A Voxel-Based Morphometry Study

Xuan Wei, Han Lv, Zhaodi Wang, Chunli Liu, Pengling Ren, Peng Zhang, Qian Chen, Yawen Liu, Pengfei Zhao, Shusheng Gong, Zhenghan Yang, Zhenchang Wang, Xuan Wei, Han Lv, Zhaodi Wang, Chunli Liu, Pengling Ren, Peng Zhang, Qian Chen, Yawen Liu, Pengfei Zhao, Shusheng Gong, Zhenghan Yang, Zhenchang Wang

Abstract

According to previous studies, many neuroanatomical alterations have been detected in patients with tinnitus. However, few studies have reported on the morphological changes observed following sound therapy. To explore the brain anatomical alterations in patients with idiopathic tinnitus using voxel-based morphometry (VBM) analysis before and after effective 12 weeks sound therapy. The protocol was registered on ClinicalTrials.gov, ID: NCT02774122. In this study, we collected data from 27 matched healthy control (HC) individuals and 27 idiopathic tinnitus patients before and after 12 weeks of sound therapy by using adjusted narrow band sound. 3.0T MRI system and high-resolution 3D structural images were acquired with a 3D-BRAVO pulse sequence. Structural image data preprocessing was performed using the VBM8 toolbox. The Tinnitus Handicap Inventory (THI) score was acquired in the tinnitus group to assess the severity of tinnitus and tinnitus-related distress. Mann-Whitney U Test, Wilcoxon Signed-Ranks test, and Pearson's correlation analysis were used in the statistical analysis. We found significantly decreased gray matter (GM) volume in the left thalami, right thalami, and cochlear nucleus among the tinnitus patients before sound therapy (baseline) compared to the HC group. However, we did not find significant differences in brain regions between the 12-week treatment and HC groups. According to the results of Wilcoxon Signed-Ranks test, the 12-week sound therapy group demonstrated significant greater brain volume compared with the baseline group among these brain regions. Decreased THI score and changed GM volume were not correlated. This is a useful study for observing the characteristics of neuroanatomical changes in patients with idiopathic tinnitus before and after sound treatment. The study characterized the effect of sound therapy on brain volume. It found that sound therapy had a normalizing effect on the bilateral thalami and cochlear nucleus. Clinical Trial Registration: www.ClinicalTrials.gov, NCT02774122.

Keywords: functional magnetic resonance imaging; sound therapy; thalamus; tinnitus; voxel-based morphometry.

Copyright © 2020 Wei, Lv, Wang, Liu, Ren, Zhang, Chen, Liu, Zhao, Gong, Yang and Wang.

Figures

FIGURE 1
FIGURE 1
The differences in GM volume among the baseline, after 12 weeks of sound treatment and the healthy control groups (Nonparametric tests; P < 0.05, corrected for false discovery rate simulations; L left, R right). (A) The bilateral thalamus and cochlear nucleus were the brain regions with statistical differences. Panels (B–D) represent the GM volume changes of each brain region in tinnitus baseline after 12 weeks of sound treatment and HC group. Wilcoxon Signed-Ranks test was used to compare tinnitus baseline with after 12 weeks treatment; Mann–Whitney U test was used to compare after treatment with normal people, baseline with normal people. *P < 0.05. The results showed differences in GM volume in the left thalamus, right thalamus, and cochlear nucleus, which are shown in red. L, left; R, right; the labeled number corresponds to the number in Table 2. The threshold was set as P < 0.05 (corrected). It can be seen that the volume of gray matter increased after 12 weeks treatment compared to baseline and there was no statistically significant difference between the 12 weeks treatment and HC group.

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