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TAYADE, AMITKUMAR GULABRAO, Ph.D. Role of Medial Olivocochlear Neural Efferent Pathway in Perception of Tinnitus in Presence of Silence

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TAYADE, AMITKUMAR GULABRAO, Ph.D. Role of Medial Olivocochlear Neural Efferent Pathway in Perception of Tinnitus in Presence of Silence TAYADE, AMITKUMAR GULABRAO, Ph.D. Role of Medial Olivocochlear Neural Efferent Pathway in Perception of Tinnitus in Presence of Silence. (2018) Directed by Dr. Denise Tucker. 116 pp. Over 20 million Americans struggle with troublesome effects of tinnitus. Tinnitus has a negative impact on a patient’s overall health and social well-being. Tinnitus can be a disabling condition. People with tinnitus regularly experience distress, depression, anxiety, sleep disturbances, frustration, poor concentration and in some cases pain. Currently, there are no scientifically validated cures available for most types of tinnitus. In fact, there is a deficiency in neurophysiological knowledge related to tinnitus. There is an informational gap between silence, which exacerbate or trigger tinnitus and Medial Oliovocochlear (MOC) efferent neural pathway connection. The primary aim of this study is to investigate the MOC efferent neural pathway and neural connections responsible for tinnitus generation in silence/sensory deprivation. The primary hypothesis of this study is that silence/sensory deprivation makes MOC efferent neural pathway hyperactive which participate in tinnitus perception. Method: fifty-eight normal hearing individuals between age 18-35 years were recruited as participants in this study. By placing normal hearing participants in a sound booth for 10 minutes, silence/sensory deprivation was created. This offered assessment of MOC neural pathway in normal hearing participants in silence. Hyperactivity of MOC neural pathway was assessed by its more suppressive effect on stimulated otoacoustic emissions (TEOAEs) in silence. The required auditory measurements were recorded in the sound booth using recommended diagnostic protocols to ensure the effect of “only silence” on auditory structures. Results: 41.4% of the participants perceived some type of tinnitus during/after 10 minutes of silence. Overall, Ringing was the most common type of tinnitus sound perception most participants who perceive tinnitus followed by “Cricket” and “Buzzing” sound. “Pulsating” or “Clear tone” sounds were less frequent followed by “Hissing,” “Ocean Roar,” and “Transformer.” No statistically significant difference was found in the total TEOAE and TEOAE suppression amplitude before and after 10 minutes of silence. Post silence total TEOAE suppression between tinnitus perceiving and non-perceiving tinnitus was not statistically significantly different. Conclusion: TEOAE generation is a peripheral phenomenon. Because tinnitus perception did not significantly change total TEOAE amplitude, the results may indicate higher central auditory structures as a source of tinnitus generation. Therefore, the results of the study support the notion that tinnitus is the central auditory processing phenomenon. The study may have failed to detect the changes in the medial olivocochlear efferent pathway because TEOAE tests might not be sensitive enough to detect the post silence changes in the pathway or top-down influence of the corticofugal pathway on lower auditory brainstem structures. This does not mean that medial olivocochlear efferent pathway does not participate in tinnitus perception. Results of the present study also seem to indicate that race may place a function in the perception of silence induced temporary tinnitus. Further investigation is needed to evaluate the functional contribution of the medial olivocochlear efferent pathway in tinnitus perception. ROLE OF MEDIAL OLIVOCOCHLEAR NEURAL EFFERENT PATHWAY IN PERCEPTION OF TINNITUS IN PRESENCE OF SILENCE by Amitkumar Gulabrao Tayade A Dissertation Submitted to the Faculty of The Graduate School at The University of North Carolina at Greensboro in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy Greensboro 2018 Approved by Committee Chair APPROVAL PAGE This dissertation, written by Amitkumar Gulabrao Tayade, has been approved by following committee of the Faculty of The Graduate School at The University of North Carolina at Greensboro. Committee Chair Committee Members Date of Acceptance by Committee Date of Final Oral Examination ii ACKNOWLEDGMENTS I would like to express the deep gratitude to Denise Tucker for her valuable guidance and support. I would like to extend my gratitude to my committee members, Lisa Fox-Thomas, George Michel, and Kristine Lundgren for their excellent support throughout my graduate program. I would like to thank my guide and mentor Kalyani Mandke for her valuable guidance. My special thanks go to all my friends Ishan, Carrie, Nilesh, Mohsin, Holly, Fadi, Cathrine, Ronda, and my entire cricket buddies for making my Ph.D. Journey memorable and enjoyable. I acknowledge with the deep feeling of respect, my gratitude towards my mother and family members, who have always been an immense source of encouragement and confidence throughout my life. iii TABLE OF CONTENTS Page LIST OF TABLES ........................................................................................................... viii LIST OF FIGURES ........................................................................................................... ix CHAPTER I. INTRODUCTION ................................................................................................1 II. REVIEW OF THE LITERATURE ......................................................................5 Tinnitus ........................................................................................................6 Definition of Tinnitus ......................................................................6 Prevalence of Tinnitus ....................................................................6 Tinnitus and Gender .........................................................................7 Tinnitus and Race ............................................................................7 Tinnitus and Location of Perception ................................................7 Physiological Aspects of Tinnitus (Possible Generators) ................8 Models of Tinnitus ...........................................................................9 The Salicylate Model ...........................................................9 The Sensorineural Model ...................................................11 The Somatic Tinnitus Model .............................................11 The Neural Synchrony Model ............................................12 Neurophysiological (Limbic System/Autonomic Nervous System) Model of Tinnitus Disturbance .........13 Tinnitus and Hearing Loss (Sensory Deprivation) ....................................16 Structural and Physiological Changes in the Peripheral and Central Auditory Nervous System (CANS) Due to Noise Exposure ................. 17 Changes in Cochlear Hair Cells and Auditory Nerve ....................17 Changes in the Dorsal Cochlear Nucleus (DCN) ..........................19 Changes in the Ventral Cochlear Nucleus (VCN) .........................20 Changes in the Inferior Colliculus (IC) .........................................21 Changes in the Auditory Cortex ....................................................22 Changes Due to Ossicular Removal (Conductive Hearing Loss) and Cochlear Ablation (Deafness) ........................................................24 Causes for Tinnitus Emergence .................................................................26 Excitatory-Inhibitory Imbalance and Neural Reorganization ........26 Excitatory-Inhibitory Imbalance of Neurotransmitters ..................26 Neural Reorganization in Auditory Cortex ....................................31 iv Tinnitus and Silence: Short-term Sensory Deprivation and Tinnitus Perception ...............................................................................................33 Brief Functional Anatomy of Efferent Auditory Pathway .........................37 Suppression of Otoacoustic Emissions (OAEs) in Population with Normal Hearing Sensitivity ...................................................................38 Otoacoustic Emissions (OAEs) ..................................................................39 Classification of Otoacoustic Emissions ........................................40 Spontaneous otoacoustic emissions ...................................40 Transient evoked otoacoustic emissions (TEOAEs)..........42 Effect of gender on TEOAE ..................................43 Characteristic of a TEOAE response waveform ..........................................................43 Distortion product otoacoustic emissions (DPOAEs) ........46 Stimulation of OAEs ..................................................................................47 Ipsilateral Acoustic Stimulation .....................................................48 Contralateral Acoustic Stimulation ................................................48 Suppression of Transient Evoked OAEs (TEOAEs) .................................48 Tinnitus and Suppression of Otoacoustic Emissions .................................50 Summary of Literature and Research Hypotheses .....................................52 Research Hypotheses .................................................................................55 III. METHODS .........................................................................................................57 Subjects ......................................................................................................57 Recruitment Method ......................................................................58 Data Collection Procedure
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