Applications of the Stroop Paradigm in Tinnitus: a Scoping Review Anna Carolina Marques Perrella de Barros, Daniela Gil, Flávia Alencar de Barros Suzuki, Andreia Cristina Feitosa do Carmo, Ektor Tsuneo Onishi, et al. Brain and Behavior, 2025 Introduction The Stroop paradigm is important for assessing top‐down attentional control. Considering that tinnitus has been linked to cognitive dysfunctions, the present study intends to investigate Stroop's application in the tinnitus population. Methods This is a scoping review, following PRISMA‐ScR guidelines, performed until December 2024. Searches were conducted in the MEDLINE (PubMed), Embase (Elsevier), PsycINFO (APA), SCOPUS (Elsevier), and Web of Science (Clarivate Analytics) databases. Studies were selected based on the following criteria: Types of participants: subjects with tinnitus (with no age limit); types of intervention: the Stroop paradigm applied to tinnitus population, isolated or combined with other evaluations or interventions for the tinnitus; types of study: original articles of different designs, with no language and publication date limits. Studies that used evaluations or intervention forms other than the Stroop paradigm, papers exclusively on other health conditions, congress or conferences’ material, and studies not available in the database and/or as a full text were excluded. Results were presented and qualitatively assessed based on the Critically Appraised Topics (CAT). Results 369 records were identified in the searching stage, and 22 studies were selected for data extraction. Author/date, Stroop paradigm application, Stroop methodology adopted, outcomes measures for Stroop, and level of evidence were extracted. The most common application for Stroop in tinnitus subjects was cognitive function assessment, followed by neuronal connectivity assessment during the task, development of auditory training strategies, and measurement before and after surgical treatment. The main methodology adopted for Stroop was based on conventional Stroop tasks. Conclusion Stroop applications to the tinnitus population were diverse, considering methodologies and finalities. Results showed that Stroop can highlight top‐down cognitive control in the tinnitus population. However, the current body of evidence is limited in quality and consistency, highlighting the need for more rigorous and standardized research to better inform its clinical applicability.
Auditory training for tinnitus treatment: a scoping review Anna Carolina Marques Perrella de Barros, Rhayane Vitória Lopes, Daniela Gil, Andreia Cristina Feitosa do Carmo, Ektor Tsuneo Onishi, et al. Brazilian Journal of Otorhinolaryngology, 2024
Perception of Tinnitus: Direct and Indirect Effects of Resilience, Personality Traits, and Psychiatric Symptoms Mariana L. Martins, Melyssa K.C. Galdino, Bernardino Fernández-Calvo, Fátima C.A. Branco-Barreiro, Thiago P. Fernandes, et al. Journal of the American Academy of Audiology, 2022 Background Psychiatric conditions are common in individuals with tinnitus. Therefore, the ways individuals cope with such conditions and personality can influence the characteristics of tinnitus. Purpose The study aims to investigate the direct and indirect effects of resilience, personality traits, and psychiatric symptoms on the tinnitus perception. Research Design This is a descriptive, cross-sectional, and observational study involving quantitative results. Study Sample Thirty-seven individuals with chronic tinnitus (for more than 6 months) sought the tinnitus care service (mean age = 44.6 years; SD = 11.7 years). Data Collection and Analysis The specific anamnesis of tinnitus, adult self-report questionnaire, resilience scale, big five inventory, Tinnitus Handicap Inventory (M = 45.0; SD = 24.1), and visual analog scale (M = 6.4; SD = 2.7) were used. Psychoacoustic measurements (loudness: M = 25.4; SD = 12.8) of tinnitus were performed to characterize the condition in terms of pitch and loudness. The study analyzed the relationship between tinnitus (annoyance, severity, and loudness), psychiatric symptoms, personality, and resilience using multiple mediations. Results Resilience did not influence tinnitus severity (BCa: -1.12 to 0.51), annoyance (BCa: -0.10 to 0.11), or loudness (BCa: -0.44 to 0.28) when mediated by anxiety and depression. Additionally, there was only a direct effect of resilience for annoyance (t = - 2.14, p = 0.03; BCa: -0.10 to 0.11). There was no direct influence of anxiety and depression on the tinnitus severity (b = 0.53, p > 0.05), annoyance (b = - 0.01, p > 0.05), or loudness (b = 0.11, p > 0.05). However, there was an association of personality traits (neuroticism) with the tinnitus severity (b = 1.16, 95% CI: 0.15–2.17; t = 2.53, p = 0.02) and annoyance (b = 0.12, 95% CI: 0.003–0.24; t = 2.09, p = 0.04). Conclusion Resilience and psychiatric symptoms did not have a direct or indirect influence on the tinnitus annoyance, severity, or loudness. However with a direct association of resilience and annoyance, and neuroticism trait with the tinnitus annoyance and severity. Our results suggest that patients with chronic tinnitus and high neuroticism should receive personalized treatment.
A Study on the Reference Values and Cutoff Criteria of Masking Level Difference for Children Aged 7–12 Years Carlos Alberto Leite Filho, Mônica de Oliveira Viana, Fátima Cristina Alves Branco-Barreiro, Silvana Maria Monte Coelho Frota Journal of Clinical Medicine, 2022 The Masking Level Difference (MLD) test is one of the main instruments for investigating binaural interaction. Studies with children aged 7–12 years still disagree about the influence of age on test performance and present discordant reference values. This study aimed to verify the effect of age on the performance of children aged 7–12 years in the MLD test and to establish reference values and cutoff criteria for this age group. Fifty-nine children with normal hearing were organized in three groups according to their age: 7–8 (n = 20), 9–10 (n = 20), and 11–12 (n = 19) years. The participants completed the MLD test by Auditec®. The Kruskal–Wallis statistical test was used to compare groups. Reference values were obtained by calculating mean, standard deviation, median, mode, and percentiles, while the cutoff criterion was obtained by subtracting two standard deviations from the mean. No statistically significant differences were observed between the groups regarding the MLD test measures. The mean MLD was 10.51 ± 1.84 dB and the cutoff point was set at 7 dB. Thus, reference values for the MLD test were established for children aged 7–12 years, who presented no effect of age on test performance.
Translation, Cultural Adaptation and Validation to Brazilian Portuguese of the Tinnitus Functional Index Questionnaire Marine Raquel Diniz da Rosa, Marcelo Yugi Doi, Fátima Cristina Alves Branco-Barreiro, Patricia Simonetti, Jeanne Oiticica, et al. International Archives of Otorhinolaryngology, 2022 Introduction Tinnitus affects a large portion of the world's population. There are several questionnaires being used for the evaluation of the severity of tinnitus and its impact in quality of life; however, they do not measure treatment-related changes. So, a new self-reported questionnaire was developed, the Tinnitus Functional Index (TFI), which has been translated into several languages. Objective To perform the translation, cultural adaptation and validation of the TFI questionnaire for Brazilian Portuguese. Method This is a multicenter project divided into two stages: translation and cultural adaptation; and validation and reliability. For the validation, the Brazilian Portuguese version of the TFI was correlated with the Tinnitus Handicap Inventory (THI) domains for tinnitus and quality of life and was evaluated by the Spearman ρ test. The reliability and internal consistency were evaluated by the Cronbach α test. Result The Brazilian version of the TFI was obtained through an initial translation process, synthesis of translations, backtranslation and evaluation by a committee of experts. This version was then applied in 88 patients complaining of tinnitus from speech therapy and otorhinolaryngology outpatient clinics of the three school clinics. The Brazilian version presented high reliability, as evidenced by the Cronbach α value (α = 0.870), and strong correlation (rho = 0.760 and p = 0.000). Conclusion The high reliability found in the results demonstrates that the Brazilian Portuguese version of the TFI is a valid and reliable instrument to evaluate the severity and impact of tinnitus on quality of life and changes related to its treatment.
Masking Level Difference: test-retest reliability assessment in normal hearing female university students Silvana Maria Monte Coelho Frota, Carlos Alberto Leite Filho, Carolina Salomone Bruno, Lanna Borges Carvalho, Natalia Almeida Riegel, et al. Codas, 2022 RESUMO Objetivo Verificar a confiabilidade teste-reteste do Masking Level Difference em estudantes universitárias normo-ouvintes. Método Estudo prospectivo descritivo com 78 adultos jovens do gênero feminino sem queixas auditivas, submetidas à versão, em compact disc, do Masking Level Difference da Auditec of Saint Louis. O Masking Level Difference foi determinado por meio da diferença entre as relações sinal-ruído nos limiares auditivos encontrados nas condições antifásica e homofásica. O teste foi aplicado pelo mesmo examinador em dois momentos (teste e reteste) com intervalo de sete a 14 dias entre eles. A análise estatística inferencial incluiu comparação das situações teste e reteste por meio do teste t de Student para amostras pareadas, cálculo do coeficiente de correlação intraclasse e dos intervalos de confiança de 95% para as relações sinal/ruído nos limiares auditivos nas condições antifásica e homofásica e para o cálculo do Masking Level Difference. Resultados A média da relação sinal-ruído no limiar auditivo na condição homofásica foi -12,59 dB e -12,46 dB nas situações teste e reteste, respectivamente, e -21,54 dB e -21,08 dB na condição antifásica. A média do Masking Level Difference foi 8,95 dB no teste e 8,74 dB no reteste. Os coeficientes de correlação intraclasse obtidos foram 0,436, 0,625 e 0,577 para as condições homofásica, antifásica e Masking Level Difference, respectivamente. Conclusão O teste Masking Level Difference mostrou grau moderado de confiabilidade teste-reteste em estudantes universitárias normo-ouvintes.
Clinical randomized trial study of hearing aids effectiveness in association with Ginkgo biloba extract (EGb 761) on tinnitus improvement Camila L. Radunz, Cristina E. Okuyama, Fátima C.A. Branco-Barreiro, Regina M.S. Pereira, Susana N. Diniz Brazilian Journal of Otorhinolaryngology, 2020 INTRODUCTION Tinnitus is defined as the perception of sound without its actual presence in the environment. It has been the subject of a great number of studies, especially considering its consequences on patient's quality of life. OBJECTIVE This study aimed to investigate the effect of hearing aids and/or Ginkgo biloba extract EGb 761 on tinnitus in patients with hearing loss. METHODS This is a trial randomized-controlled treatment, parallel, double-blind, with three-arm. Thirty-three adults subjects were divided into three groups: group 1 - subjects undergoing drug therapy with G. biloba extract EGb 761; group 2 - individuals fitted with digital hearing aids; group 3 - individuals submitted to drug therapy with G. biloba extract EGb 761 and using hearing aids. The tinnitus handicap inventory and visual analogue scale were used to evaluate self-perception of tinnitus loudness and severity before treatment and 90 days after treatment. RESULTS This study demonstrated a significant correlation between tinnitus handicap inventory and visual analogue scale, before and after treatment. We observed a significant improvement in self-perception of tinnitus loudness and severity after 90 days of treatment with G. biloba extract EGb 761 and/or hearing aids. No correlation was found between tinnitus onset time and self-perception of tinnitus loudness and severity. Hearing aids were more effective in patients with a shorter tinnitus onset time and G. biloba extract was effective regardless of tinnitus duration. CONCLUSIONS It was possible to prove the effectiveness of the hearing aids and/or G. biloba extract EGb 761 treatment, which shows success in the control of tinnitus contributing to the improvement of this symptom.
Auditory attention in individuals with tinnitus Daviany Oliveira Lima, Aline Menezes Guedes Dias de Araújo, Fátima Cristina Alves Branco-Barreiro, Cláudia da Silva Carneiro, Larissa Nadjara Alves Almeida, et al. Brazilian Journal of Otorhinolaryngology, 2020 INTRODUCTION Tinnitus is characterized by the presence of a sound in the absence of external sound stimulus. In individuals with normal audiometry, it may be associated with auditory attention difficulty, especially in those who report high tinnitus annoyance. OBJECTIVE To investigate auditory attention ability in individuals with tinnitus complaint. METHODS Cross-sectional analytical observational study. We evaluated 30 volunteers with normal hearing (up to 25dBHL): 15 with tinnitus (test group) and 15 with no complaints (control group), aged between 18 and 40 years. The volunteers answered the tinnitus handicap inventory questionnaire and a visual analog scale. Subsequently, a basic audiological evaluation (meatoscopy, tonal and vocal audiometry, and imittanciometry) and psychoacoustic measures of tinnitus (loudness and pitch) were performed. To evaluate auditory attention, the following tests were performed: auditory cognitive evoked potential (P300), central auditory processing tests (dichotic digits test and speech-in-noise test) and sustained auditory attention ability test. RESULTS In the tinnitus handicap inventory, individuals with tinnitus had a mean score of 37.78 (±27.05), characterized as moderate degree. In the dichotic digits test (binaural separation), a difference was observed between the groups in both ears. Moreover, there was a difference in the speech-in-noise test in both ears (RE: p=0.044; LE: p=0.019), in P300 (p=0.049) and in total sustained auditory attention ability test (p=0.032). Also, there is a negative correlation between sustained auditory attention ability test, decrease in attentiveness and binaural integration (RE: p=0.044; LE: p=0.048). CONCLUSIONS Individuals with tinnitus had a poorer performance compared to the control group regarding auditory attention ability. Therefore, it is inferred that tinnitus is associated with poor performance in selective and sustained auditory attention in the assessed volunteers. These aspects should be considered for the management of patients with tinnitus.
Translation to brazilian Portuguese and cultural adaptation of the craniocervical dysfunction index Ana Dias, Marcelo Doi, Arthur Mesas, Michelle Fillis, Fatima Branco-Barreiro, et al. International Archives of Otorhinolaryngology, 2018 Introduction Functional disorders of the craniocervical region affect 77.78% of Brazilian teachers. Among the most common instruments used to assess craniocervical disorders in a detailed and objective way, none had been translated to Brazilian Portuguese and adapted to Brazilian culture. Objectives To translate to Brazilian Portuguese and to culturally adapt the Craniocervical Dysfunction Index (CDI). Method The first phase of the study consisted of the translation, synthesis, back-translation, and review of the contents by a committee of experts, who developed a trial version and sent all the steps to the original author. The trial version was applied to 50 teachers of an institution. The reliability and internal consistency were evaluated by Cronbach α. For the validation, the Brazilian Portuguese version of the CDI was correlated with the Visual Analogue Scale (VAS) domains for cervicalgia and evaluated by Spearman ρ. Result Some expressions were adapted to the Brazilian culture. Among the participants who did not report neck pain in the VAS, 84.21% suffered from craniocervical dysfunction acording to the CDI. Among the participants who reported neck pain in the VAS, 100% suffered from craniocervical dysfunction according to the CDI. The CDI showed good internal consistency and satisfactory reliability measured by Cronbrach α (α = 0.717). There was a strong correlation between the CDI and the VAS score (ρ = 0.735). Conclusion No difficulties were encountered in the translation and back-translation of the CDI, and no problems were observed regarding the trial version developed; therefore, the Brazilian Portuguese version of the CDI is a valid and reliable instrument to evaluate the functional alteration of the craniocervical region.
