Sex Differences in the Response to Different Tinnitus Treatment

Annemarie Van der Wal

Tine Luyten

Emilie Cardon

Laure Jacquemin

Nancy Van Looveren+3 authors

^{Department of Otorhinolaryngology – Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium}

^{Department of Rehabilitation Sciences and Physiotherapy, Antwerp University, Antwerp, Belgium}

^{Department of Translational Neurosciences, Antwerp University, Antwerp, Belgium}

^{Hoorzorg Van Looveren BVBA, Borsbeek, Belgium}

^{Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium}

Edited by: Christopher R. Cederroth, Karolinska Institutet (KI), Sweden

Reviewed by: Eleftheria Vellidou, Institute of Communication and Computer Systems, Greece; Myra Spiliopoulou, Otto von Guericke University Magdeburg, Germany

*Correspondence: Sarah Michiels, eb.neprewtnau@sleihcim.haras

Annick Gilles, eb.azu@sellig.kcinna

^{These authors have contributed equally to this work}

This article was submitted to Auditory Cognitive Neuroscience, a section of the journal Frontiers in Neuroscience

Edited by: Christopher R. Cederroth, Karolinska Institutet (KI), Sweden

Reviewed by: Eleftheria Vellidou, Institute of Communication and Computer Systems, Greece; Myra Spiliopoulou, Otto von Guericke University Magdeburg, Germany

Received 2020 Jan 14; Accepted 2020 Apr 7.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

Introduction

Tinnitus is a complex symptom requiring a thorough multidisciplinary assessment to construct an individual’s tinnitus profile. The Antwerp University Hospital hosts a tertiary tinnitus clinic providing intensive, multidisciplinary tinnitus care in the form of combinational psychological treatment with either Tinnitus Retraining Therapy (TRT)/Cognitive Behavioral Therapy (CBT) or TRT/eye movement desensitization and reprocessing therapy (EMDR), high-definition transcranial direct current stimulation (HD-tDCS), and physical therapy treatment (in cases of somatic influence of the neck or the temporomandibular area). Several factors may contribute to therapy effect of which the role of gender has recently gained more interest. As such, the current manuscript explores gender differences in the outcome of different tinnitus treatments.

Methods

Data on treatment outcome of four distinct tinnitus treatments (1. HD-tDCS; 2. orofacial physical therapy; 3. combination TRT + CBT; and 4. combination TRT + EMDR) were pooled and compared. Treatment outcome was assessed via the Tinnitus Functional Index (TFI). Participants completed the TFI at baseline, immediately after treatment and after 9 weeks (±3 weeks) follow-up. To explore the effect of gender on different treatment outcomes, a linear mixed model was designed including Time point, Gender, and Therapy Group as fixed factors as well as all interactions between these factors.

Results

TFI scores improved significantly over time regardless of therapy group (p < 0.0001). A mean TFI decrease of at least 13 points was obtained by all participants except by those in the HD-tDCS. Significant interactions between Gender and Time point were identified in all groups except for the TRT +EMDR group. Female subjects improved more extensively than males in the HD-tDCS (p = 0.0009) and orofacial therapy group (p = 0.0299). Contrarily, in the TRT +CBT group, male participants showed a significant improvement whereas the mean TFI scores of female subjects remained on baseline levels (p = 0.0138).

Conclusion

Our data suggest that male and female tinnitus patients seem to react differently to different therapy options. We strongly encourage further prospective studies to discern the relevance of gender in therapy outcome.

Keywords: gender, tinnitus, gender-related outcome, TRT, CBT, neuromodulation, HDtDCS, tDCS

Abstract