Publication: Revealing the effects of different auditory stimulations on tinnitus suppression: an auditory brainstem response (ABR) study
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Date
2025-08
Authors
Yusri, Shamhana Anisya
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Abstract
Tinnitus, the perception of ringing in the ear affects approximately 10-30% of the global population, making it a prevalent health concern. However, the exact tinnitus pathophysiology and most effective treatment remain debatable. Sound therapy employing broadband noise (BBN) is commonly employed for tinnitus management, based on the principle of tinnitus suppression. Yet, not all patients respond positively to BBN therapy. In view of this, it is of interest to investigate the physiological mechanism of tinnitus suppression when stimulated with different auditory stimuli using an auditory brainstem response (ABR) test. In the initial stage, a pilot study involving 5 healthy adults (10 ears) and 10 tinnitus patients (10 ears) was conducted to determine the optimal stimulus intensity for tinnitus suppression when using different auditory stimulations. The optimal stimulus from the pilot studies was used to compare with click, BBN and narrowband noise (NBN) in the subsequent case control experiment. For main study, 28 participants (56 ears) from control group (mean age: 37.39 ± 11.21 years) and 31 participants (45 ears) from tinnitus group (mean age: 40.74 ± 13.24) participated. The pilot study revealed that stimulus intensity at 50dBSL produced higher amplitudes and shorter latencies of wave I and V compared to 30dBSL intensity. The 50dBSL was chosen to be used in the subsequent study. Results for the main findings revealed that the latency of wave I and V and interpeak latency of wave I-V were shorter when stimulated using click stimulus compared to the BBN and NBN stimuli in the control group. Additionally, the amplitude of wave I and V and amplitude ratio of wave V/I were higher with click stimulus compared to the BBN and NBN stimuli in control group. These results were similar to those observed in the tinnitus group. For the comparison between groups, the latency of wave I and V was shorter in the tinnitus group compared to the control group when stimulated using click and BBN stimuli, but longer with NBN stimulus at 50dBSL. Notably, only click stimulus showed a significant difference in the latency of wave I and V between groups. Regarding the amplitude of waves I and V, the tinnitus group showed higher amplitudes compared to the control group when stimulated using click, BBN and NBN stimuli. However, a significant difference in the amplitude of wave I was found only with BBN stimuli, while the amplitude of wave V showed a significant difference only with click stimuli. The findings suggest that tinnitus leads to the changes in the auditory pathway. BBN stimulus showed the greatest tinnitus suppression likely starting at the level of the inferior colliculus, which generates wave V of the ABR. This study provides valuable insights into the mechanisms of tinnitus suppression and highlights the potential of different auditory stimuli for targeted tinnitus interventions
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