Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0917801 (insomnia)
 10,606 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Tinnitus is one of the most common hearing disorders, with wide-ranging risk factors including age, hearing loss, noise exposure, inflammatory diseases or tumors of the ear, ototoxic drugs, head or cervical vertebra trauma, and psychological disorders (e.g., anxiety and depression). Tinnitus can be a lifelong disorder and will bring about annoyance, anxiety, depression, insomnia, hyperacusis, concentration difficulty, and, in some extreme cases, suicide. Not every tinnitus patient will require medical attention, and the majority often get accustomed to the phantom sound; however, about 20% of the sufferers will seek clinical intervention. As a matter of fact, evidence was rare for successful tinnitus treatment with a randomized clinical trial. With recent advances in neuroimaging approaches and development of novel tinnitus animal models, scientists have gained new insights into the neural basis of tinnitus. Current theories regarding mechanisms underlying tinnitus focus on abnormal activities in the central nervous system, such as elevated spontaneous neuronal firing rate and increased neuronal synchronization caused by the auditory deprivation, changes in the tonotopic map, auditory cortical reorganization, dysregulation of the limbic system, and the central auditory cortex. At the present, there is a lack of objective indicator of tinnitus, and the diagnosis battery for tinnitus mainly relies on subjective assessments and self-reports, such as case history, audiometric tests, detailed tinnitus inquiry, tinnitus matching, and neuropsychological assessment. While there is currently no golden standard treatment for tinnitus, counseling, psychotherapy, pharmacological approaches, masking devices, individualized sound stimulation, and cognitive behavioral therapy (CBT) are the most widely used strategies, and among these only CBT treatment has been shown to have a definite improvement effect on tinnitus in a large randomized controlled trial. In summary, this article reviews recent advances in understanding, diagnosis, and treatment of tinnitus.
 ...
PMID:Advances in Understanding, Diagnosis, and Treatment of Tinnitus. 3091 4

Objective The aim of this study was to evaluate the views of patients who completed audiologist-delivered cognitive behavioral therapy (CBT) about (a) the effectiveness of the treatment, (b) the acceptability of receiving CBT from audiologists, and (c) the most effective treatment components. Design This was a service evaluation survey with a cross-sectional design. Study Sample The study population comprised 40 consecutive adult patients who received a full course of audiologist-delivered CBT for tinnitus and/or hyperacusis management at a Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom over a 1-year period. Thirty-one of 40 patients who attended their final session as planned completed the survey questionnaire. Data Collection and Analysis As a part of their routine care, all patients completed a wide range of questionnaires before and after receiving audiologist-delivered CBT. These comprised Tinnitus Handicap Inventory (Newman, Sandridge, & Bolek, 2008); Hyperacusis Questionnaire (Khalfa et al., 2002); Insomnia Severity Index (Bastien, Vallieres, & Morin, 2001); Visual Analogue Scale (Maxwell, 1978) for tinnitus loudness, tinnitus annoyance, and effect of tinnitus on life; Generalized Anxiety Disorder (Spitzer, Kroenke, Williams, & Lowe, 2006) questionnaire; and Patient Health Questionnaire (Kroenke, Spitzer, & Williams, 2001). In addition, patients were asked to complete the survey questionnaire at their final session to provide feedback with regard to their therapy. Results The majority of patients reported that it was very acceptable to them to receive CBT focused on tinnitus and hyperacusis from a specialist audiologist; the median response was 10/10. The majority of patients felt that the CBT was very effective (median response 8/10) and that they were able to manage their tinnitus and/or hyperacusis well (median response 9/10). The effect sizes of treatment based on pre- and postintervention comparison of scores for the Tinnitus Handicap Inventory, Visual Analogue Scale of tinnitus annoyance and effect on life, Hyperacusis Questionnaire, Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire were large. Conclusions Audiologist-delivered CBT is acceptable to patients and is effective in the management of tinnitus and/or hyperacusis from the patients' perspectives.
 ...
PMID:Patients' Perspectives About the Acceptability and Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and/or Hyperacusis Rehabilitation. 3177 10