Prevalence and predictors of high-frequency hearing loss among mine workers in Gujarat, western India: a cross-sectional study on the need to implement a comprehensive hearing conservation program.

BACKGROUND: High-frequency hearing loss (HFHL) stands as a prevalent occupational morbidity globally, with numerous associated risk factors, some of which are modifiable. In the context of a comprehensive hearing conservation program, the initial steps involve early screening and identification of workers with these modifiable risk factors, aiming to reduce the prevalence of hearing loss. Our objective was to estimate the prevalence of HFHL and determine its predictors among mine workers. METHODS: We conducted a cross-sectional study among 226 mine workers in ten open-cast mines in Gujarat state, the western part of India, in November 2020. We collected data on socio-demography, addiction, occupation history and comorbidities, along with anthropometric, blood pressure, and blood sugar measurements. Audiometric evaluations using a portable diagnostic audiometer were employed to assess HFHL, defined as a hearing threshold exceeding 25 decibels (dB) at high frequencies (3000, 4000, 6000, and 8000 Hz). A generalized linear model (GLM) with a binomial family was performed to determine the predictors significantly predicting HFHL after adjusting for confounding variables. RESULTS: The prevalence of HFHL was 35% (95% CI: 29-42%) in our study setting. Office workers demonstrated a prevalence of 19%, whereas other job categories displayed a higher prevalence of 42%, resulting in a significant prevalence difference of 23% and a prevalence ratio of 2.2. The GLM analysis revealed that variables, such as noise exposure during work [adjusted prevalence ratio (aPR) 2.3 (95% CI: 1.2-4.7, p = 0.018)] and noise exposure duration [aPR 1.1 (95% CI: 1.0-1.1, p = 0.042)], were significant predictors of HFHL. CONCLUSIONS: In our study setting, mine workers exhibited a high prevalence of HFHL, with exposure to workplace noise and duration being modifiable predictors. Because HFHL advances slowly and is generally undetected by the individual, we recommend periodic testing using audiometry to identify it among mine workers and, if possible, shifting them from mining activities to office. Furthermore, we advocate for the implementation of a comprehensive hearing conservation program to the extent possible.

Association of weight change across adulthood with hearing loss: A retrospective cohort study.

OBJECTIVES: We aimed to investigate the relationship of weight change across adulthood with the risk of hearing loss. METHODS: The data from National Health and Nutrition Examination Surveys. Cox proportional hazards models were applied to explore the association between weight change and risk of hearing loss. Kaplan-Meier method was used to plot the survival curves associated with weight change patterns. RESULTS: Compared with participants who remained at normal weight, those with stable obese participants had increased risks of total hearing loss across adulthood, with hazard ratios of 1.24 (95% confidence intervals 1.11-1.38) from age 25 years to baseline, 1.09 (1.001-1.18) from 10 years before baseline to baseline, and 1.23 (1.10-1.37) from age 25 years to 10 years before baseline. Moving the obese to non-obese weight change pattern from middle to late adulthood was not significantly associated with an increased risk of total hearing loss (1.04, 0.91-1.19) and high-frequency hearing loss (1.02, 0.90-1.17), whereas changing from non-obese to obese body mass index over this period was associated with total hearing loss risk (1.20, 1.11-1.29), and speech- and high-frequency hearing loss (1.21, 1.07-1.36; 1.18, 1.09-1.28). Those moving from the non-obese to obese category between young and middle adulthood had a 16% (1.16, 1.02-1.33) higher risk of speech-frequency hearing loss. CONCLUSIONS: Stable obesity and weight gain across adulthood are both associated with increased risks of hearing loss. Our findings imply that maintaining normal weight across adulthood is of great importance for preventing hearing loss in later life.

Tinnitus Suppression Effect of Hearing Aids in Patients With High-frequency Hearing Loss: A Randomized Double-blind Controlled Trial.

INTRODUCTION: Hearing aids (HAs) with frequency lowering have been used for high-frequency hearing loss (HFHL), but their effects on tinnitus relief have not been studied extensively. This randomized double-blind trial was performed to investigate and compare tinnitus suppression effects of conventional type HAs and frequency-lowering HAs in patients with HFHL. METHODS: A total of 114 patients were randomized into three groups: conventional HA using wide dynamic range compression, HA with frequency translation, and HA with linear frequency transposition. Participants wore HAs for 3 months and then discontinued their use. The final evaluation was performed at 3 months after cessation of wearing HA (6 mo after the initial visit). The Tinnitus Handicap Inventory (THI) score and additional variables, such as matched tinnitus loudness and visual analog scale scores of subjectively perceived tinnitus loudness, daily awareness, and annoyance, were measured at the initial visit and at 3- and 6-month follow-ups. RESULTS: THI score and most of the additional outcomes were significantly improved at 3 and 6 months (3 mo after HA removal) compared with their initial values in all three groups. The incidence rates of patients with improvements in the THI score by 20% or more were 71.0, 72.7, and 74.3% at 3 months, and 54.8, 51.6, and 59.4% at 6 months for the three groups, respectively. There were no significant differences in primary or additional variables between hearing aid types at either 3 or 6 months. CONCLUSION: This is a consolidated standards of reporting trials-guided study providing direct evidence for tinnitus suppression effects of HA alone, without accompanying counseling or any other treatments, which lasted for at least 3 months after patients stopped using HAs. HAs effectively suppressed tinnitus in patients with HFHL regardless of the amplification strategy type.

Association of Obesity with Hearing Impairment in Adolescents.

Hearing loss (HL) is the third most common chronic physical condition in the United States. Obesity has become an increasingly important public health concern, as the prevalence in children, adolescents and adults has increased over the past few decades. The objectives of this study is to investigate whether obesity is associated with audiometric notches indicative of noise-induced hearing loss (NIHL), speech frequency hearing loss (SFHL), and high frequency hearing loss (HFHL) in adolescent participants of the National Health and Nutrition Examination Survey 2007-2010. The prevalence of overall audiometric notches in the adolescent population was 16.0% with higher prevalence in females than males. The prevalence of SFHL and HFHL were higher in males than females (SFHL, 7.3% vs. 5.4%, respectively; and HFHL 14.3% vs. 8.1%, respectively). Obese adolescents had a higher adjusted OR to have audiometric notches (OR = 1.93; 95% CI: 1.33-2.81) and HFHL (OR = 1.95; 95% CI: 1.19-3.21). Continued preventative efforts towards reducing obesity might also help to reduce the risk for HL and NIHL.

Association of Cardiovascular Comorbidities With Hearing Loss in the Older Old.

Importance: In the United States, the population of individuals older than 80 years is expected to double in the next 40 years. Cardiovascular comorbidities are prevalent in this older old population, and their relationship with hearing loss has not been well characterized. Objective: To investigate the association of cardiovascular disease (CVD)-related risk factors with auditory function among the older old (>80 years). Design, Setting, and Participants: Audiological data and medical records from 2001 through 2014 of 433 patients aged 80 to 106 years at an academic medical center were analyzed in 2017. Main Outcomes and Measures: The degree of low- and high-frequency hearing loss of participants with coronary artery disease, diabetes, hypertension, history of cerebrovascular accident, and smoking status was compared with that of disease-free individuals. Rate of hearing loss was also determined. Results: Among the 433 patients (67% female; mean [SD] age, 89 [5.8] years), the presence of at least 1 cardiovascular morbidity was associated with elevated mean (SD) low-frequency pure-tone average (LFPTA) of 42.4 (1.6) vs 36.9 (3.5) decibels hearing loss (dB HL), a difference of 5.47 (95% CI, 4.15-9.49) dB HL. Among the 96 patients with 2 audiograms performed at age 80 years or older from which the rate of hearing loss could be calculated, 32 patients had CVD or related risk factors and 64 were healthy controls. Those with at least 1 disease had accelerated hearing loss. Patients with cardiovascular morbidity experienced a faster mean (SD) decline in LFPTA of 1.90 (0.27) vs 1.18 (0.42) dB HL/y, a difference of 0.72 (95% CI, 0.08-1.36) dB HL/y. Of the conditions studied, coronary artery disease had the highest association with audiometric thresholds and was associated with hearing loss at all frequencies tested and with poor word recognition score. Hearing loss was more strongly associated with CVD risk factors in men than in women. Conclusions and Relevance: In this study of the older old, cardiovascular risk factors and disease were associated with worse hearing and a greater rate of hearing deterioration. Hearing loss in women was less associated with the presence of CVD, possibly owing to the cardioprotective effects of estrogen. The association of hearing with CVD severity and management remains to be determined.

Effects of Various Extents of High-Frequency Hearing Loss on Speech Recognition and Gap Detection at Low Frequencies in Patients with Sensorineural Hearing Loss.

This study explored whether the time-compressed speech perception varied with the degree of hearing loss in high-frequency sensorineural hearing loss (HF SNHL) individuals. 65 HF SNHL individuals with different cutoff frequencies were recruited and further divided into mildly, moderately, and/or severely affected subgroups in terms of the averaged thresholds of all frequencies exhibiting hearing loss. Time-compressed speech recognition scores under both quiet and noisy conditions and gap detection thresholds within low frequencies that had normal thresholds were obtained from all patients and compared with data from 11 age-matched individuals with normal hearing threshold at all frequencies. Correlations of the time-compressed speech recognition scores with the extents of HF SNHL and with the 1 kHz gap detection thresholds were studied across all participants. We found that the time-compressed speech recognition scores were significantly affected by and correlated with the extents of HF SNHL. The time-compressed speech recognition scores also correlated with the 1 kHz gap detection thresholds except when the compression ratio of speech was 0.8 under quiet condition. Above all, the extents of HF SNHL were significantly correlated with the 1 kHz gap thresholds.

The ototronix MAXUM middle ear implant for severe high-frequency sensorineural hearing loss: Preliminary results.

OBJECTIVES/HYPOTHESIS: To report the preliminary results of the Ototronix MAXUM middle ear implant for treatment of severe high-frequency sensorineural hearing loss. STUDY DESIGN: Case series with chart review. METHODS: Six consecutive ears with severe high-frequency sensorineural hearing loss (≥75 dB HL at 2, 3, and 4 kHz) and poor aided word recognition performance (≤60% single words) underwent implantation of the MAXUM system at a single, private otologic referral center. Primary outcome measures included frequency-specific functional gain and word recognition score improvement compared to optimally fitted hearing aids. RESULTS: Six ears, in four adult patients (two female; median age 67.5 years) were included. The median unaided preoperative high-frequency pure-tone average (HFPTA) (2, 3, and 4 kHz) was 80.0 dB (range, 75.0-85.0 dB), and the median best-aided word recognition score was 48.0% (range, 24%-60%). The median HFPTA functional gain with the MAXUM system was 47.2 dB, a 25.0 dB improvement (range, 16.7-33.3 dB) (P = .03) over optimally fit hearing aids, and the median word recognition score with MAXUM was 81.5%, a 42.0% improvement (range, 20%-48%) (P = .03) with the MAXUM middle ear implant over optimally fitted hearing aids. CONCLUSIONS: These preliminary data demonstrate that the MAXUM middle ear implant provides superior functional gain and word recognition scores in quiet for patients with severe high-frequency sensorineural hearing loss compared to optimally fitted hearing aids. Future studies with greater patient numbers and patient reported outcome measures are needed to confirm these promising but preliminary results. LEVEL OF EVIDENCE: 4 Laryngoscope, 126:2124-2127, 2016.

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

OBJECTIVE: To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. DESIGN: Retrospective analysis. STUDY SAMPLE: The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. RESULTS: Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. CONCLUSION: These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

Clinical and genetic features of hearing loss in facioscapulohumeral muscular dystrophy.

OBJECTIVE: To describe the hearing loss in facioscapulohumeral muscular dystrophy (FSHD) and examine the relationship to genotype. METHODS: Medical records of all individuals with FSHD seen at the University of Iowa neuromuscular clinic between July 2006 and July 2012 (n = 59) were reviewed. Eleven had significant hearing loss and no non-FSHD cause. All available audiology records for these individuals were analyzed. The relationship between the FSHD mutation (EcoRI/BlnI fragment size) and hearing loss was evaluated using a logistic regression analysis. RESULTS: In patients with hearing loss, recalled age at onset of facial weakness ranged from birth to 5 years and shoulder weakness was 3 to 15 years. The age at diagnosis of hearing loss ranged from birth to 7 years. Only 2 were identified by newborn hearing screen. Most audiograms demonstrated a bilateral, sloping, high-frequency sensorineural hearing loss. Of the 4 patients with more than 5 years of data, 3 had progression of hearing loss. Logistic regression showed statistically significant negative association between the presence of hearing loss and EcoRI/BlnI fragment size (p = 0.0207). CONCLUSIONS: FSHD with a small EcoRI/BlnI fragment is associated with a bilateral, progressive, sloping, high-frequency hearing loss with onset in childhood. Patients with FSHD and small EcoRI/BlnI fragment sizes should have hearing screened, even if the child passed newborn hearing screening.

The use of Nucleus CI422 in a ski-slope high-frequency hearing loss and chronic external ear pathology: a case study.

OBJECTIVE AND IMPORTANCE: This case report illustrates the ongoing extending criteria for cochlear implantation (CI). It reinforces the statement that patients who do not fulfill the standard criteria for CI should be carefully considered on an individual basis. CLINICAL PRESENTATION: The patient on this report presented with a ski-slope high-frequency hearing loss and chronic external ear canal infections. The latter precluded the consistent use of hearing aids with moulds. His speech discrimination in quiet and in noise was poor and his hearing loss was interfering with his ability to work. INTERVENTION: After years of frustration, this patient decided to risk losing his low-frequency residual hearing and was implanted with the new Nucleus CI422 (Cochlear Ltd). CONCLUSION: Hearing preservation was achieved and he gained a remarkable improvement in his hearing performance. It is thought that his outcomes are the result of the combination of hearing presentation surgery, electrode design, and intensive auditory training.

Does hyperandrogenism have an effect on hearing loss in patients with polycystic ovary syndrome?

OBJECTIVE: Polycystic ovary syndrome (PCOS) is an endocrinopathy characterized by chronic anovulation and hyperandrogenism. Hormonal changes can affect hearing loss and inner ear functions. We evaluated hearing loss with audiometric tests in young patients with PCOS. METHODS: Twenty-six women having PCOS and 25 normal individuals were enrolled in the study. Age ranges for PCOS and control groups were 20-35 years. Hormonal and biochemical values including LH, LH/FSH, E2, testosterone, fasting glucose and fasting insulin were calculated. Each subject was tested with low- (250-2000Hz) and high-frequency audiometry (4000-8000Hz). For each set of tests, mean values of air conduction at each frequency were measured for the PCOS and control groups and compared. RESULTS: No difference was observed in speech frequencies on audiologic tests between the groups, however high-frequency hearing loss were significantly higher (p<0.05) in PCOS patients than in control women. Also, hearing thresholds were normal range in all of frequencies in PCOS and control subjects. PCOS patients showed high levels of LH, LH/FSH, testosterone and fasting insulin. CONCLUSION: Our findings suggest that patients diagnosed with PCOS should be advised audiologic evaluation especially in the high frequency.

Prevalence and significance of high-frequency hearing loss in subjectively normal-hearing patients with tinnitus.

OBJECTIVES: We investigated the incidences of high-frequency hearing loss (HFHL; above 2 kHz) and extended high-frequency hearing loss (EHFHL; above 8 kHz) in patients with tinnitus and subjectively normal hearing, and evaluated their effects on the clinical and audiological features of the patients. METHODS: The sample included 85 patients with sensorineural tinnitus who had normal hearing sensitivity in the frequencies from 250 Hz to 2 kHz, and who had undergone extended high-frequency audiometry between July 2009 and February 2010. We investigated the incidences of HFHL and EHFHL in these patients and analyzed the significance of the hearing losses. RESULTS: The incidence of HFHL or EHFHL was 88%. The proportion of patients with EHFHL, among the patients who had normal hearing sensitivity up to 8 kHz, was about 74%. The patients with normal hearing sensitivity at all test frequencies were significantly younger, had larger otoacoustic emissions, and had tinnitus that was less loud as measured by tinnitus matching than did the subjects with HFHL and/or EHFHL. However, other comparisons of clinical factors in the three groups did not show any differences. CONCLUSIONS: Even if patients with tinnitus do not have any subjective hearing impairment, most of them have HFHL and/or EHFHL. The effects on the clinical features of the patients are still vague.

Amplitude modulation detection by listeners with unilateral dead regions.

BACKGROUND: A dead region is a region in the cochlea where the inner hair cells and/or neurons are functioning very poorly, if at all. We have shown that, for people with sensorineural hearing loss, thresholds for detecting sinusoidal amplitude modulation (AM) of a sinusoidal carrier were lower for ears with high-frequency dead regions, as diagnosed using the threshold-equalizing noise test, calibrated in hearing level, than for ears without dead regions when the carrier frequency was below the edge frequency, fe, of the dead region. PURPOSE: To measure AM-detection thresholds for subjects with unilateral dead regions, using carrier frequencies both below and above fe. RESEARCH DESIGN: Ten subjects with bilateral high-frequency hearing loss, but with unilateral high-frequency dead regions, were tested. The carriers were presented at sensation levels of 5, 10, or 15 dB. The values of fe were close to 1000, 1500, or 2000 Hz. RESULTS: For carrier frequencies below fe, AM-detection thresholds were lower for the ears with dead regions than forthe ears without dead regions, replicating earlier findings. In contrast, for carrier frequencies above fe, AM-detection thresholds tended to be higher for ears with dead regions than for ears without dead regions. CONCLUSIONS: The reason why AM detection was poorer in the ears with dead regions for carrier frequencies above fe is unclear. However, this finding is consistent with the generally poor discrimination of sounds that has been reported previously for sounds with frequency components falling within a dead region. The results have implications for the ability of people with dead regions to use information from frequency components falling inside the dead region.

High-frequency sensorineural hearing loss in patients with ankylosing spondylitis: is it an extrarticuler feature of disease?

OBJECTIVE: The aim of this study was to investigate the ear involvement, especially at extended higher frequencies than those previously studied, in patients with ankylosing spondylitis (AS). PATIENTS AND METHODS: We prospectively evaluated 45 consecutive patients with AS. All patients underwent a complete physical examination of the ear, nose, and throat and an audiologic evaluation that included pure-tone audiometry at conventional and extended high frequencies, the determination of a speech discrimination score and the uncomfortable loudness level, and impedance audiometry. Thirty healthy volunteers were included as controls. RESULTS: The mean age of the patients was 39.6 +/- 9.1 years (range 19-63 years) and that of the controls was 10.6 +/- 8.1 years (range 1-30 years). There was no statistically significant difference between the two groups with respect to conventional frequency air conduction threshold and bone conduction threshold. There was a statistically significant difference at 14,000-16,000 Hz at extended high frequencies in 32 patients with AS (71.1%) versus 12 controls (40%). At 14,000-16,000 Hz, eight patients demonstrated a sensorineural hearing loss caused by extraspinal involvement. There was a significant difference between the patients with or without extraspinal involvement, and a positive correlation was noted between the duration of disease and the hearing level at 10,000-16,000 Hz. CONCLUSION: Sensorineural hearing loss, especially at extended high frequencies, is common in patients with AS and may be an extra-articular feature of that disease. A long duration of disease and extraspinal involvement are important parameters for ear involvement in patients with AS.

Clinical investigation on hypotensive patients with vertigo.

The aim of this study was to investigate the characteristic of hypotensive patients with vertigo. Twenty hypotensive patients with rotatory vertigo, 15 hypotensive subjects without vertigo, and 15 mitral valve prolapse subjects without vertigo underwent a battery of tests including audiometry, electronystagmography (ENG), and vestibular evoked myogenic potential (VEMP) test. The abnormal rates in terms of audiometry, eye tracking, optokinetic nystagmus, visual suppression, and caloric tests were 15, 35, 35, 10, and 42% for the first group; 13, 20, 33, 0, and 0% for the second group; and 7, 13, 60, 0, and 3% for the third group, respectively. Comparison of the first group with the other two control groups revealed that significant difference existed only in the abnormality of caloric responses. Fifteen (75%) of 20 hypotensive patients with vertigo having abnormal ENG results, asymmetric caloric responses, or delayed VEMPs were attributed to vertigo of central origin, possibly from ischemic disorder. In contrast, five patients (25%) had neither central signs in ENG nor abnormal VEMPs, but showing bilateral normal or hyperactive caloric responses were classified as autonomic dysfunction. After 3 months of medication, all patients with autonomic dysfunction had their vertigo and autonomic symptoms subsided, whereas 27% of the patients with ischemic disorder had vertigo persisted, showing a significant difference. In conclusion, hypotensive patients with vertigo could be due to either direct autonomic dysfunction or ischemic disorder mediated by autonomic deficits.

The suffering of tinnitus in childhood and adolescence.

OBJECTIVES: Investigate the profile of young patients complaining of tinnitus and study the prevalence and the severity of tinnitus in schoolchildren. DESIGN: Ninety-five consecutive patients (55 boys), 8-20 years old, seeking help for tinnitus at our clinic were studied using audiometry, structural interviews, Tinnitus Severity Questionnaire (TSQ) and Hospital Anxiety and Depression Scale (HAD), together with Visual Analog Scales (VAS) on tinnitus loudness and annoyance. RESULTS: The onset of tinnitus was twice as often sudden than gradual. In 54% of the children, tinnitus had started after noise exposure, most commonly listening to music. Correlations were found between the pure-tone average (PTA) of 3, 4, and 6 kHz and TSQ scores; between TSQ and HAD subscales; and between TSQ and VAS. According to the Hospital Anxiety Depression Scale, 32% and 14.5%, respectively, were above the cut level for clinical anxiety and depressive disorders. The girls showed more signs of anxiety disorders than the boys. CONCLUSIONS: The majority of the help seekers had been exposed to noise, mostly music. Predisposing factors for tinnitus severity are high-frequency hearing loss and anxiety and depressive disorders.

Neuromagnetic indicators of auditory cortical reorganization of tinnitus.

Animal studies show that following damage to inner-ear receptors, central representations of intact lesion-edge (LE) frequencies become enlarged (map reorganization). One theory of tinnitus holds that this process could be related to the tinnitus sensation. To test this hypothesis, neuromagnetic evoked fields of tinnitus participants with high-frequency hearing loss and normal hearing controls were measured, while subjects listened to monaurally presented LE or control (CO; an octave below LE) tones. The predictions made based on the map reorganization hypothesis of tinnitus were that neuronal responses to LE frequencies would be enhanced, and that source localizations for LE would be distorted. N1m equivalent dipole moments for LE were not supranormal in the tinnitus group, whereas responses to CO of tinnitus patients compared to controls were enlarged in the right hemisphere. This effect was positively associated with tinnitus-related distress. Abnormal source locations were found for generators activated by LE tones in the right hemisphere of the tinnitus group. This right-hemispheric map distortion was not associated with subjective variables of tinnitus. A positive correlation with tinnitus distress was found for the left hemisphere with more anterior sources being associated with enhanced distress. However, this result was independent of the frequency of the stimulus. Overall, the present study suggests that mechanisms of map reorganization, although present in the data, cannot satisfactorily explain the emergence of tinnitus and that differential hemispheric involvement must be considered.

Tinnitus perception and distress is related to abnormal spontaneous brain activity as measured by magnetoencephalography.

BACKGROUND: The neurophysiological mechanisms underlying tinnitus perception are not well understood. Surprisingly, there have been no group studies comparing abnormalities in ongoing, spontaneous neuronal activity in individuals with and without tinnitus perception. METHODS AND FINDINGS: Here, we show that the spontaneous neuronal activity of a group of individuals with tinnitus (n = 17) is characterised by a marked reduction in alpha (8-12 Hz) power together with an enhancement in delta (1.5-4 Hz) as compared to a normal hearing control group (n = 16). This pattern was especially pronounced for temporal regions. Moreover, correlations with tinnitus-related distress revealed strong associations with this abnormal spontaneous activity pattern, particularly in right temporal and left frontal areas. Overall, effects were stronger for the alpha than for the delta frequency band. A data stream of 5 min, recorded with a whole-head neuromagnetometer under a resting condition, was sufficient to extract the marked differences. CONCLUSIONS: Despite some limitations, there are arguments that the regional pattern of abnormal spontaneous activity we found could reflect a tinnitus-related cortical network. This finding, which suggests that a neurofeedback approach could reduce the adverse effects of this disturbing condition, could have important implications for the treatment of tinnitus.