TANIT GANZ SANCHEZ
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina
6 resultados
Resultados de Busca
Agora exibindo 1 - 6 de 6
- Long-lasting total remission of tinnitus: A systematic collection of cases(2021) SANCHEZ, Tanit Ganz; VALIM, Caroline C. A.; SCHLEE, WinfriedBackground: Clinical observation suggests that total remission of tinnitus may exist, but a systematic analysis of these cases is missing. We aimed to identify subjects with long lasting total remission of tinnitus. Methods: By publishing announcements, we included volunteers of any gender and age who have had daily perception of tinnitus for over 3 months and have been in total remission (lack of tinnitus perception, even in silence and with deliberate attention to it) for over 6 months. We excluded individuals in a state of habituation or masking. We applied a structured interview to standardize information about tinnitus and its remission. Follow-up interviews took place after 6, 12, and 18 months. Results: Eighty individuals (56 females; age = 54.2 +/- 16.8 years) were included. History of bilateral tinnitus accounted for 51.4% of cases. Total remission occurred in subjects whose tinnitus lasted for 49.0 +/- 73.5 months. Remission occurred gradually in 78.6% of cases and suddenly in 22%. During the further 18-month follow-up, 7.9% reported recurrence of tinnitus and 92.1% remained symptom free. Conclusion: Different than the knowledge obtained from clinical trials, this study showed that long-lasting total remission of tinnitus may occur. This status was reached by individuals of any gender and age range, with any location and duration of tinnitus, mostly as a gradual process. Future studies should better clarify how each treatment modality may achieve the best results.
- Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)(2021) RIDDER, Dirk De; SCHLEE, Winfried; VANNESTE, Sven; LONDERO, Alain; WEISZ, Nathan; KLEINJUNG, Tobias; SHEKHAWAT, Giriraj Singh; ELGOYHEN, Ana Belen; SONG, Jae-Jin; ANDERSSON, Gerhard; ADHIA, Divya; AZEVEDO, Andreia Aparecida de; BAGULEY, David M.; BIESINGER, Eberhard; BINETTI, Ana Carolina; BO, Luca Del; CEDERROTH, Christopher R.; CIMA, Rilana; EGGERMONT, Jos J.; FIGUEIREDO, Ricardo; FULLER, Thomas E.; GALLUS, Silvano; GILLES, Annick; HALL, Deborah A.; HEYNING, Paul Van de; HOARE, Derek J.; KHEDR, Eman M.; KIKIDIS, Dimitris; KLEINSTAEUBER, Maria; KREUZER, Peter M.; LAI, Jen-Tsung; LAINEZ, Jose Miguel; LANDGREBE, Michael; LI, Lieber Po-Hung; LIM, Hubert H.; LIU, Tien-Chen; LOPEZ-ESCAMEZ, Jose Antonio; MAZUREK, Birgit; MOLLER, Aage R.; NEFF, Patrick; PANTEV, Christo; PARK, Shi Nae; PICCIRILLO, Jay F.; POEPPL, Timm B.; RAUSCHECKER, Josef P.; SALVI, Richard; SANCHEZ, Tanit Ganz; SCHECKLMANN, Martin; SCHILLER, Axel; SEARCHFIELD, Grant D.; TYLER, Richard; VIELSMEIER, Veronika; VLAEYEN, Johan W. S.; ZHANG, Jinsheng; ZHENG, Yiwen; NORA, Matteo de; LANGGUTH, BertholdAs for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: ""Tinnitus"" for the former and ""Tinnitus Disorder"" for the latter. The proposed definition then becomes ""Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder ""when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability."". In other words ""Tinnitus"" describes the auditory or sensory component, whereas ""Tinnitus Disorder"" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.
- Total remission or persistence of tinnitus and decreased sound level tolerance in adolescents with normal audiograms: A follow-up study(2021) SANCHEZ, Tanit Ganz; ROBERTS, Larry E.Background: Tinnitus may reflect hidden cochlear synaptic injury that does not express in the audiogram, but leads to neuroplastic changes in auditory pathways that, in turn, reduce tolerance to sounds. Such injury may follow the exposure to loud sounds. The aim of this study was to follow-up adolescents enrolled in a private school to evaluate the prevalence of tinnitus and reduced sound level tolerance (SLT) with 1-year interval, as well as to observe rates of tinnitus persistence, remission and incidence of new cases by repeat measurements. Methods: In Study 1 (Sanchez et al., 2016), we evaluated 170 adolescents by a questionnaire about tinnitus and reduced tolerance to ordinary sounds and by measurements in a sound booth: audiometry (0.25-16kHz), Loudness Discomfort Levels (LDL, 0.5-4kHz) and tinnitus pitch/loudness matching (if present). Tinnitus measured in the booth was then called ""confirmed tinnitus."" In Study 2, we revaluated 54 adolescents who returned voluntarily 1 year later to repeat all measurements. Results: From Study 1 to 2, the prevalence of confirmed tinnitus reduced from 28.8% (49/170) to 14.9% (8/54) in retested subjects, which includes the cases of persisting tinnitus (confirmed tinnitus in both studies, n = 6/54 = 11.2%) and the new cases of tinnitus (confirmed tinnitus just at Study 2, n = 2/54 = 3.7%). Among the 15 adolescents with confirmed tinnitus at Study 1 who returned for Study 2, 40% had persistent tinnitus (n = 6) and 60% did not (remitted tinnitus, n = 9). SLT was reduced by 17.3dB in cases with persistent tinnitus (P < 0.0002), similar to the findings of Study 1, and returned to normal levels in subjects with remitted tinnitus. Hearing thresholds averaged 4.37dBHL and were <20dBHL in 97% of ears and all frequencies. At 14 and 16kHz thresholds were bilaterally elevated at Study 1 (5.07dB) and 2 (5.56dB) in adolescents with confirmed tinnitus. Conclusions: Tinnitus and reduced sound tolerance could feature early signals of hidden synaptic injury that is prevalent among adolescents and hidden from the audiogram. The strong relationship between both symptoms, in addition to low-level increases in hearing thresholds at high frequencies in the extended audiogram, poses a challenge for future hearing health and should be further evaluated as a possible intrinsic vulnerability for lesions following exposure to loud sounds. Moreover, the relationship between their spontaneous remissions may signal a possible synaptic repair, which has been reported in animal models.
- Theoretical Tinnitus Framework: A Neurofunctional Model(2016) GHODRATITOOSTANI, Iman; ZANA, Yossi; DELBEM, Alexandre C. B.; SANI, Siamak S.; EKHTIARI, Hamed; SANCHEZ, Tanit G.Subjective tinnitus is the conscious (attended) awareness perception of sound in the absence of an external source and can be classified as an auditory phantom perception. Earlier literature establishes three distinct states of conscious perception as unattended, attended, and attended awareness conscious perception. The current tinnitus development models depend on the role of external events congruently paired with the causal physical events that precipitate the phantom perception. We propose a novel Neurofunctional Tinnitus Model to indicate that the conscious (attended) awareness perception of phantom sound is essential in activating the cognitive-emotional value. The cognitive-emotional value plays a crucial role in governing attention allocation as well as developing annoyance within tinnitus clinical distress. Structurally, the Neurofunctional Tinnitus Model includes the peripheral auditory system, the thalamus, the limbic system, brainstem, basal ganglia, striatum, and the auditory along with prefrontal cortices. Functionally, we assume the model includes presence of continuous or intermittent abnormal signals at the peripheral auditory system or midbrain auditory paths. Depending on the availability of attentional resources, the signals may or may not be perceived. The cognitive valuation process strengthens the lateral-inhibition and noise canceling mechanisms in the mid-brain, which leads to the cessation of sound perception and renders the signal evaluation irrelevant. However, the ""sourceless"" sound is eventually perceived and can be cognitively interpreted as suspicious or an indication of a disease in which the cortical top-down processes weaken the noise canceling effects. This results in an increase in cognitive and emotional negative reactions such as depression and anxiety. The negative or positive cognitive-emotional feedbacks within the top-down approach may have no relation to the previous experience of the patients. They can also be associated with aversive stimuli similar to abnormal neural activity in generating the phantom sound. Cognitive and emotional reactions depend on general personality biases toward evaluative conditioning combined with a cognitive-emotional negative appraisal of stimuli such as the case of people with present hypochondria. We acknowledge that the projected Neurofunctional Tinnitus Model does not cover all tinnitus variations and patients. To support our model, we present evidence from several studies using neuroimaging, electrophysiology, brain lesion, and behavioral techniques.
article 24 Citação(ões) na Scopus Musical hallucination associated with hearing loss(2011) SANCHEZ, Tanit Ganz; ROCHA, Savya Cybelle Milhomem; KNOBEL, Keila Alessandra Baraldi; KII, Marcia Akemi; SANTOS, Rosa Maria Rodrigues dos; PEREIRA, Cristiana BorgesIn spite of the fact that musical hallucination have a significant impact on patients' lives, they have received very little attention of experts. Some researchers agree on a combination of peripheral and central dysfunctions as the mechanism that causes hallucination. The most accepted physiopathology of musical hallucination associated to hearing loss (caused by cochlear lesion, cochlear nerve lesion or by interruption of mesencephalon or pontine auditory information) is the disinhibition of auditory memory circuits due to sensory deprivation. Concerning the cortical area involved in musical hallucination, there is evidence that the excitatory mechanism of the superior temporal gyrus, as in epilepsies, is responsible for musical hallucination. In musical release hallucination there is also activation of the auditory association cortex. Finally, considering the laterality, functional studies with musical perception and imagery in normal individuals showed that songs with words cause bilateral temporal activation and melodies activate only the right lobe. The effect of hearing aids on the improvement of musical hallucination as a result of the hearing loss improvement is well documented. It happens because auditory hallucination may be influenced by the external acoustical environment. Neuroleptics, antidepressants and anticonvulsants have been used in the treatment of musical hallucination. Cases of improvement with the administration of carbamazepine, meclobemide and donepezil were reported, but the results obtained were not consistent.- Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial(2020) SOUZA, Dayse da Silva; ALMEIDA, Alexandre Alex; ANDRADE, Suellen Marinho dos Santos; MACHADO, Daniel Gomes da Silva; LEITAO, Marcio; SANCHEZ, Tanit Ganz; ROSA, Marine Raquel Diniz daObjectives. -This study aims to determine whether transcranial direct current stimulation (tDCS): a) is effective in the treatment of tinnitus by decreasing its annoyance and severity; b) modulates the cortical electrical activity of such individuals. Methods. -A double-blind, placebo-controlled clinical trial was conducted with 24 patients with tinnitus, randomized into two groups: Group 1 (n =12) received anodal tDCS over the left temporoparietal area (LTA) and cathodal tDCS over the right dorsolateral prefrontal cortex (DLPFC) and Group 2 (n =12) received placebo intervention. Tinnitus perception using a visual analog scale (VAS) and the Tinnitus Handicap Inventory (THI) questionnaire, in addition to electroencephalogram (EEG) was measured with eyes opened and closed at baseline and after the intervention. For the treatment, patients were subjected to five consecutive sessions of tDCS with the anodal electrode over the LTA and cathodal electrode over the right DLPFC (7 x 5 cm, 2 mA for 20 min). tDCS was turned off after 30s in the sham group. Results. -Active tDCS significantly improved tinnitus annoyance and severity. It was associated with decreased beta and theta EEG frequency bands with eyes opened and decreased alpha frequency with eyes closed. sLORETA identified changes in frequency bands in the frontal, temporoparietal, and limbic regions. Finally, there were negative correlations between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. Conclusions. - These results demonstrate that tDCS modulates the EEG activity and alleviates tinnitus perception. This effect may be related to baseline EEG activity.