Modulating Mechanisms in Patients With Chronic Subjective Tinnitus and/or Chronic Pain

NCT ID: NCT05186259

Last Updated: 2024-01-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

135 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-12-21

Study Completion Date

2022-04-01

Brief Summary

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This is a cross-sectional investigation into modulating mechanisms in patients with chronic subjective tinnitus, which will compare 4 patient groups namely chronic tinnitus with chronic pain, chronic tinnitus without chronic pain, chronic pain without tinnitus and healthy controls.

Detailed Description

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The first aim is to investigate differences in pain-related factors, psychological factors, lifestyle factors and tinnitus-related factors in patients with chronic subjective tinnitus and the comparison with patients suffering from both chronic subjective tinnitus and chronic musculoskeletal pain, chronic musculoskeletal pain only and healthy controls. The primary outcome measures will be pain-related factors and correlations will also be calculated between pain-related factors on the one hand and psychological factors, lifestyle factors and tinnitus-related factors on the other hand.

A second aim is to assess contributing factors to tinnitus severity (measured by the Tinnitus Functional Index) in patients with tinnitus with or without chronic pain. Contributing factors will include pain-related factors, psychological factors, lifestyle factors, and tinnitus-related factors, audiological factors, cognitive factors.

* Pain-related factors include:

1. Self-perceived symptoms of central sensitization by means of the Central Sensitization Inventory: The Central Sensitization Inventory is a self-report questionnaire that assesses clinical symptoms indicative for central sensitization.
2. Experimental measures of central sensitization: Quantitative Sensory Testing Quantitative Sensory Testing (QST) is a psychophysiological assessment of sensory pathways including mechanicaldetection and pain thresholds, cutaneous heat detection and pain thresholds, and endogenous pain facilitation and inhibition.
3. Self-reported pain processing by means of the Pain Catastrophizing Scale
4. Self-reported neck pain related disability by means of the Neck Disability Index
* Psychological factors include:

Self-reported stress, anxiety and depression (Depression, Anxiety and Stress Scale\_21 and Beck Depression Inventory), resilience (Connor Davidson Resilience Scale), personality (Big Five Index)

\*Lifestyle factors include:

Self-reported physical activity (Baecke Questionnaire), self-reported sleep quality (Pittsburgh Sleep Quality Index) and self-reported insomnia severity (Insomnia Severity Index), self-reported quality of life (SF-36)

\*Tinnitus-related factors include:

Self-reported tinnitus severity and impact (Tinnitus Functional Index), self-reported hyperacusis (Hyperacusis Questionnare), self-reported tinnitus characteristics (Tinnitus Sample Case History Questionnaire)

* Cognitive factors include:

1. Verbal working memory capacity and processing speed (Letter-number sequencing task)
2. Attention span (detecting letters-task (COTESS))
3. Cognitive flexibility and inhibition (Auditory Stroop task)
4. Listening effort (Modified version of the behavioral listening effort test based on a dual-task paradigm by Degeest, Keppler \& Corthals (2018))
* Audiological factors include:

1. Hearing thresholds (Pure tone audiometry)
2. Psychoacoustic features of tinnitus (tinnitus pitch, loudness, masking ability, and residual inhibition using same devices as for pure tone audiometry)
3. Uncomfortable Loudness (using same devices as for pure tone audiometry)

Conditions

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Tinnitus Pain

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SCREENING

Blinding Strategy

NONE

Study Groups

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Patients with chronic tinnitus

Patients with chronic subjective tinnitus (\> 3 months)

Group Type ACTIVE_COMPARATOR

Self-reported signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Self-reported signs of central sensitization by means of the Central Sensitization Inventory (questionnaire)

Objective signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Objective signs of central sensitization by means of Quantitative Sensory Testing (mechanical and heat detection and pain thresholds, endogenous pain facilitation and inhibition)

Audiological outcome measures (audiometry, tinnitus analysis, uncomfortable loudness) in tinnitus patients with and without pain

Intervention Type DIAGNOSTIC_TEST

* Audiometry Performance of pure tone audiometry according to the modified Hughson-Westlake method
* Tinnitus analysis Measurement of psychoacoustic features of tinnitus, including (1) tinnitus pitch, (2) loudness, (3) masking ability, and (4) residual inhibition.
* Uncomfortable Loudness measures Performance of Uncomfortable Loudness measurements to evaluate the presence of hyperacusis. .

Cognitive functioning

Intervention Type DIAGNOSTIC_TEST

Evaluation of cognitive functioning by means of:

* Auditory Stroop test
* Detecting letters task
* Letter-number sequencing task

Listening effort

Intervention Type DIAGNOSTIC_TEST

Evaluation of listening effort by means of the modified version of the behavioral listening effort test based on a dual-task paradigm by Degeest, Keppler \& Corthals (2018) .

Self-reported psychological factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of psychological factors by means of:

* Depression, Anxiety and Stress Scale (DASS-21)
* Beck Depression Inventory (BDI)
* Big Five Inventory (BFI)
* Connor-Davidson Resilience Scale

Self-reported lifestyle factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of lifestyle factors by means of:

Baecke Questionnaire Pittsburg Sleep Quality Index Insomnia Severity Index Stress subscale of the DASS 21

Self-reported quality of life

Intervention Type DIAGNOSTIC_TEST

Self-reported quality of life by means of the SF-36 questionnaire

Self-reported tinnitus severity and impact on daily life

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported tinnitus severity and impact on daily life by means of the Tinnitus Functional Index

Self-reported hyperacusis

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported characteristics of hyperacusis by means of the Hyperacusis Questionnaire

Self-reported tinnitus characteristics

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported tinnitus characteristics by means of the Tinnitus Sample Case History Questionnaire

Patients with chronic idiopathic neck pain

Patients with chronic idiopathic neck pain (\> 3 months)

Group Type ACTIVE_COMPARATOR

Self-reported signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Self-reported signs of central sensitization by means of the Central Sensitization Inventory (questionnaire)

Objective signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Objective signs of central sensitization by means of Quantitative Sensory Testing (mechanical and heat detection and pain thresholds, endogenous pain facilitation and inhibition)

Self-reported psychological factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of psychological factors by means of:

* Depression, Anxiety and Stress Scale (DASS-21)
* Beck Depression Inventory (BDI)
* Big Five Inventory (BFI)
* Connor-Davidson Resilience Scale

Self-reported lifestyle factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of lifestyle factors by means of:

Baecke Questionnaire Pittsburg Sleep Quality Index Insomnia Severity Index Stress subscale of the DASS 21

Self-reported measure of pain processing

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported pain processing by means of the Pain Catastrophizing Scale

Self-reported quality of life

Intervention Type DIAGNOSTIC_TEST

Self-reported quality of life by means of the SF-36 questionnaire

Self reported neck pain related disability

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported neck pain related disability using the Neck Disability Index

Patients with chronic tinnitus and chronic musculoskeletal pain

Patients with chronic tinnitus and chronic musculoskeletal pain (\> 3 months)

Group Type ACTIVE_COMPARATOR

Self-reported signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Self-reported signs of central sensitization by means of the Central Sensitization Inventory (questionnaire)

Objective signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Objective signs of central sensitization by means of Quantitative Sensory Testing (mechanical and heat detection and pain thresholds, endogenous pain facilitation and inhibition)

Audiological outcome measures (audiometry, tinnitus analysis, uncomfortable loudness) in tinnitus patients with and without pain

Intervention Type DIAGNOSTIC_TEST

* Audiometry Performance of pure tone audiometry according to the modified Hughson-Westlake method
* Tinnitus analysis Measurement of psychoacoustic features of tinnitus, including (1) tinnitus pitch, (2) loudness, (3) masking ability, and (4) residual inhibition.
* Uncomfortable Loudness measures Performance of Uncomfortable Loudness measurements to evaluate the presence of hyperacusis. .

Cognitive functioning

Intervention Type DIAGNOSTIC_TEST

Evaluation of cognitive functioning by means of:

* Auditory Stroop test
* Detecting letters task
* Letter-number sequencing task

Listening effort

Intervention Type DIAGNOSTIC_TEST

Evaluation of listening effort by means of the modified version of the behavioral listening effort test based on a dual-task paradigm by Degeest, Keppler \& Corthals (2018) .

Self-reported psychological factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of psychological factors by means of:

* Depression, Anxiety and Stress Scale (DASS-21)
* Beck Depression Inventory (BDI)
* Big Five Inventory (BFI)
* Connor-Davidson Resilience Scale

Self-reported lifestyle factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of lifestyle factors by means of:

Baecke Questionnaire Pittsburg Sleep Quality Index Insomnia Severity Index Stress subscale of the DASS 21

Self-reported measure of pain processing

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported pain processing by means of the Pain Catastrophizing Scale

Self-reported quality of life

Intervention Type DIAGNOSTIC_TEST

Self-reported quality of life by means of the SF-36 questionnaire

Self-reported tinnitus severity and impact on daily life

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported tinnitus severity and impact on daily life by means of the Tinnitus Functional Index

Self-reported hyperacusis

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported characteristics of hyperacusis by means of the Hyperacusis Questionnaire

Self-reported tinnitus characteristics

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported tinnitus characteristics by means of the Tinnitus Sample Case History Questionnaire

Self reported neck pain related disability

Intervention Type DIAGNOSTIC_TEST

Evaluation of self-reported neck pain related disability using the Neck Disability Index

Healthy controls

Healthy controls without tinnitus or pain complaints

Group Type ACTIVE_COMPARATOR

Self-reported signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Self-reported signs of central sensitization by means of the Central Sensitization Inventory (questionnaire)

Objective signs of central sensitization

Intervention Type DIAGNOSTIC_TEST

Objective signs of central sensitization by means of Quantitative Sensory Testing (mechanical and heat detection and pain thresholds, endogenous pain facilitation and inhibition)

Self-reported psychological factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of psychological factors by means of:

* Depression, Anxiety and Stress Scale (DASS-21)
* Beck Depression Inventory (BDI)
* Big Five Inventory (BFI)
* Connor-Davidson Resilience Scale

Self-reported lifestyle factors

Intervention Type DIAGNOSTIC_TEST

Evaluation of lifestyle factors by means of:

Baecke Questionnaire Pittsburg Sleep Quality Index Insomnia Severity Index Stress subscale of the DASS 21

Self-reported quality of life

Intervention Type DIAGNOSTIC_TEST

Self-reported quality of life by means of the SF-36 questionnaire

Interventions

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Self-reported signs of central sensitization

Self-reported signs of central sensitization by means of the Central Sensitization Inventory (questionnaire)

Intervention Type DIAGNOSTIC_TEST

Objective signs of central sensitization

Objective signs of central sensitization by means of Quantitative Sensory Testing (mechanical and heat detection and pain thresholds, endogenous pain facilitation and inhibition)

Intervention Type DIAGNOSTIC_TEST

Audiological outcome measures (audiometry, tinnitus analysis, uncomfortable loudness) in tinnitus patients with and without pain

* Audiometry Performance of pure tone audiometry according to the modified Hughson-Westlake method
* Tinnitus analysis Measurement of psychoacoustic features of tinnitus, including (1) tinnitus pitch, (2) loudness, (3) masking ability, and (4) residual inhibition.
* Uncomfortable Loudness measures Performance of Uncomfortable Loudness measurements to evaluate the presence of hyperacusis. .

Intervention Type DIAGNOSTIC_TEST

Cognitive functioning

Evaluation of cognitive functioning by means of:

* Auditory Stroop test
* Detecting letters task
* Letter-number sequencing task

Intervention Type DIAGNOSTIC_TEST

Listening effort

Evaluation of listening effort by means of the modified version of the behavioral listening effort test based on a dual-task paradigm by Degeest, Keppler \& Corthals (2018) .

Intervention Type DIAGNOSTIC_TEST

Self-reported psychological factors

Evaluation of psychological factors by means of:

* Depression, Anxiety and Stress Scale (DASS-21)
* Beck Depression Inventory (BDI)
* Big Five Inventory (BFI)
* Connor-Davidson Resilience Scale

Intervention Type DIAGNOSTIC_TEST

Self-reported lifestyle factors

Evaluation of lifestyle factors by means of:

Baecke Questionnaire Pittsburg Sleep Quality Index Insomnia Severity Index Stress subscale of the DASS 21

Intervention Type DIAGNOSTIC_TEST

Self-reported measure of pain processing

Evaluation of self-reported pain processing by means of the Pain Catastrophizing Scale

Intervention Type DIAGNOSTIC_TEST

Self-reported quality of life

Self-reported quality of life by means of the SF-36 questionnaire

Intervention Type DIAGNOSTIC_TEST

Self-reported tinnitus severity and impact on daily life

Evaluation of self-reported tinnitus severity and impact on daily life by means of the Tinnitus Functional Index

Intervention Type DIAGNOSTIC_TEST

Self-reported hyperacusis

Evaluation of self-reported characteristics of hyperacusis by means of the Hyperacusis Questionnaire

Intervention Type DIAGNOSTIC_TEST

Self-reported tinnitus characteristics

Evaluation of self-reported tinnitus characteristics by means of the Tinnitus Sample Case History Questionnaire

Intervention Type DIAGNOSTIC_TEST

Self reported neck pain related disability

Evaluation of self-reported neck pain related disability using the Neck Disability Index

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Chronic subjective tinnitus patients without chronic pain:

* Aged between 18-65 years
* Chronic subjective tinnitus (\> 3 months during most of the days (4 or more)and for more than 5 minutes/day)
* Speaking and understanding Dutch fluently
* Chronic subjective tinnitus patients with chronic pain:

* Aged between 18-65 years
* Chronic subjective tinnitus (\> 3 months during most of the days (4 or more)and for more than 5 minutes/day)
* Speaking and understanding Dutch fluently
* Persistent musculoskeletal pain lasting more than 3 months
* Mean pain intensity of more than 3 of 10 on a numeric pain rating scale during the preceding month (the cutoff for clinically relevant pain)
* Chronic ideopathic neck pain:

* Aged between 18-65 years
* Persistent neck pain lasting more than 3 months
* Mean pain intensity of more than 3 of 10 on a numeric pain rating scale during the preceding month (the cutoff for clinically relevant pain)
* Healthy controls:

* Aged between 18-65 years

Exclusion Criteria

* Chronic subjective tinnitus with/without chronic pain:

* Objective tinnitus
* Subjective tinnitus caused by clear causes such as tumor, trauma, vascular dysfunction, neurological disorder, pulsatile tinnitus
* Vertigo (Menière's disease, BPPV,…)
* Deafness
* Progressive middle ear pathology
* Intracranial pathologies
* Subjects with prior otologic surgery (for example stapedotomy), active outer or middle ear pathology
* History of head, neck or shoulder trauma or surgery (\< 5 years, or remaining complaints)
* A history of whiplash trauma
* Major depression or psychiatric illness (diagnosed by a psychiatrist and being in medicamental or psychiatric treatment)
* Life threatening, metabolic, cardiovascular, neurologic, systemic diseases
* Diagnosis of fibromyalgia/chronic fatigue syndrome
* Pregnancy or given birth in the preceding year
* Dyslexia, dyscalculia, AD(H)D, language/communication disorder

* No history of chronic pain
* No pain condition in the last 6 months for which treatment was sought
* No pain in any region \> 2/10 on the testing day
* Chronic ideopathic neck pain:

* Ever experienced whiplash trauma or other form of trauma to the head, neck, or upper quadrant
* Specific causes of neck pain, such as cervical hernias with clinical symptoms
* Major depression or psychiatric illness (diagnosed by a psychiatrist and being in medicamental or psychiatric treatment)
* Life threatening, metabolic, cardiovascular, neurologic, systemic diseases
* Diagnosis of fibromyalgia/chronic fatigue syndrome
* A history of neck, head or shoulder girdle surgery
* A history of whiplash trauma
* Pregnancy or given birth in the preceding year
* Diagnosis of any TMD, according to the Research Diagnostic Criteria for TMD (RDC/TMD); or concomitant diagnosis of primary headache
* Healthy controls:

* Any form of tinnitus and/or hyperacusis
* Experiencing any type of pain during at least 8 consecutive days with an NRS higher than 2/10 in the preceding year
* Reported pain on the day of testing (VAS higher than 2/10)
* Vertigo (Menière's disease, BPPV,…)
* Deafness
* History of head, neck or shoulder trauma or surgery (\< 5 years, or remaining complaints)
* Wearing a hearing aid device, implant, noise generators or receiving neuromodulation therapy
* Intracranial pathologies
* History of head, neck or shoulder trauma or surgery (\< 5 years, currently no complaints)
* Major depression or psychiatric illness (diagnosed by a psychiatrist and being in medicamental or psychiatric treatment)
* Life threatening, metabolic, cardiovascular, neurologic, systemic diseases
* A history of whiplash trauma
* Diagnosis of fibromyalgia/chronic fatigue syndrome
* Pregnancy or given birth in the preceding year
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Bijzonder onderzoeksfonds (BOF)

UNKNOWN

Sponsor Role collaborator

University Ghent

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Ghent University

Ghent, Oost-Vlaanderen, Belgium

Site Status

Countries

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Belgium

References

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De Meulemeester K, Meeus M, De Pauw R, Cagnie B, Keppler H, Lenoir D. Suffering from chronic tinnitus, chronic neck pain, or both: Does it impact the presence of signs and symptoms of central sensitization? PLoS One. 2023 Aug 24;18(8):e0290116. doi: 10.1371/journal.pone.0290116. eCollection 2023.

Reference Type DERIVED
PMID: 37616265 (View on PubMed)

Other Identifiers

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BC-07036

Identifier Type: -

Identifier Source: org_study_id

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