Correlation of Tinnitus Loudness and Onset Duration with …


Purpose. Subjective tinnitus has different forms and degrees of severity. Many studies in the literature have assessed psychoacoustic characteristics of tinnitus but hardly any of them had focused on the association of audiological profile with onset duration and loudness perception. The aim of this study was to evaluate existence of any association between tinnitus loudness/onset duration and audiological profile to explain differences in prognosis. Method. Study design was prospective. The sample consisted of 26 subjects having tinnitus, which was divided into tinnitus and nontinnitus ears. Audiological profile included pure-tone audiometry, speech audiometry, tympanometry, acoustic reflex test, and auditory evoked potentials (early and middle latency). Unpaired t-test was applied to compare two subgroups. Correlation and association between tinnitus onset duration/loudness perception and audiological profile were also assessed by calculating Spearman’s coefficient and Fischer exact value. Results. The two subgroups had significant differences for pure-tone and speech audiometry hearing thresholds. A significant association was observed between the high frequency/extended high frequency and tinnitus loudness/onset duration. Conclusion. The changes in hearing thresholds and auditory pathway are associated with an increase in tinnitus loudness and its onset duration. This knowledge would be helpful to differentiate between severity and chronicity of the patients for planning therapeutic management and predicting prognosis.

1. Introduction

Subjective tinnitus is the perception of sounds by the patient without any physical presence of acoustic stimulus [1]. The perceived localization of tinnitus is reported as from one ear, from both the ears with the same or different intensity, or from inside the head [2]. It might be perceived as a weak pure tone, ringing of bells, shrill birds’ chirping, noise of whizzing air, or loud noise of a jet engine. Subjective tinnitus has different forms and degrees of severity, and the diagnosis has to be made solely on the information provided by the patient [3, 4]. The severity is classified by the patient’s own estimate as slight, moderate, and severe depending on the problem and annoyance faced [5]. A particular treatment that helps one patient may fail for others, suggesting that there are different forms of tinnitus which differ in their pathophysiology and their response to specific treatments [6]. The clinical subtypisation of different forms of tinnitus is an important step towards the goal of individualized promising treatment [6].

Subjective ratings of tinnitus loudness, using visual analogue scales, have been found to correlate with distress [7], although little correlation between tinnitus loudness and the impact of tinnitus on daily life was reported [8]. The usefulness of tinnitus loudness was questioned by Andersson [9], but it was stated that future research on tinnitus should focus on differences between patients with high and low annoyance [10]. Psychological treatment for tinnitus was reported as effective for loudness perception, negative affect and sleep where the improvement in loudness perception was small which disappeared at follow-up [11].

Many aspects of tinnitus are yet to be answered completely as what are the differences in tinnitus ear and nontinnitus ear; how the loudness perceived is relevant to treatment; whether it is associated with auditory changes; whether the onset was recent or long standing; and how these differences affect the prognosis of tinnitus. It was observed in our tinnitus therapy clinics that these differences seemed to play some role in prognosis and this information might help in planning focused and effective management of the subjects with tinnitus. Therefore the objective of the present study was to find any possible correlation of the perceived loudness and onset duration of tinnitus with audiological profile and its role in treatment. The null hypothesis was made of no correlation between the variables and had no impact on treatment plan.

2. Material and Methods

This was a nonrandomized study which included 30 subjects who were seeking treatment for their tinnitus problem in outdoor patient services of the institute. A prior approval of the institute ethics committee was obtained before commencement of the study. Due to the time constraints of the study, a small sample was selected and consisted of subjects of either sex from rural and urban backgrounds. There was a dropout of 4 subjects; hence analysis was done with 26 subjects. All the subjects had chief complaint of idiopathic subjective tinnitus with or without hearing loss. The inclusion criteria were healthy external or middle ear on clinical examination, consistent tinnitus of more than 10-week duration, and those who gave their written consent for the study. Patients with external or middle ear pathology, suspected Meniere’s disease or otosclerosis, history of ototoxicity, sudden hearing loss, or ear trauma or having any systemic disorders were excluded.

The cases were subjected to a complete clinical and audiological assessment. The audiological assessment consisted of pure-tone audiometry (conventional audiometry), high frequency audiometry (HFA), extended high frequency audiometry (EHA), speech audiometry (speech reception threshold (SRT), speech discrimination score (SDS), most comfortable level (MCL), and uncomfortable level (UCL)), Tympanometry, acoustic reflex testing (ART) (ipsi and contra, reflex decay), auditory brainstem responses (ABR), middle latency responses (MLR), tinnitus matching (pitch and loudness), and residual inhibition (RI). Otoacoustic emission (OAEs) and magnetic resonance imaging (MRI) were done in few selected cases. The different equipment used for the audiological investigations included Madsen orbiter 922 clinical audiometer, Siemens SD 30 tympanometer, evoked potential system developed by Intelligent Hearing System, USA, and otoacoustic system developed by Intelligence Hearing System, USA. The assessment also included subjective scaling (5-point scale) of annoyance and sleep disturbance due to tinnitus. These investigations were done in two visits of 50–60 minutes each prior to start of treatment. The management was planned as combination of masking therapy, environment enrichment with music, and cognitive behavior therapy.

Statistical Analysis. The data was subjected to the values of mean and median for central tendency and standard deviation (SD) for variability. Unpaired t-test was applied for comparison of tinnitus and nontinnitus ears. Spearman’s correlation coefficient (rho) was calculated between psychoacoustic characteristics and the audiological profile of tinnitus ears. Fischer’s exact test was used as a nonparametric inferential test to verify any association between tinnitus onset duration and type of hearing loss. Similarly it was also used to verify any association of tinnitus loudness with the type of hearing loss. All significance tests were two tailed and conducted at or above the 95% significance level ().

3. Observations and Results

The 26 subjects included in the study ranged from 16 to 45 years of age with a mean 37.12 years ± SD of 8.57. Males and females were equally distributed.

4. Psychoacoustic Characteristics of Tinnitus

The psychoacoustic characteristics included tinnitus ear, duration of tinnitus since onset, pitch matching, loudness matching, and residual inhibition of tinnitus. 28% of the subjects had tinnitus in the right ear, 40% had in the left ear, and 32% had tinnitus perception binaurally. The sample was divided into two groups, tinnitus ears (35 ears) and nontinnitus ears (17 ears).

The majority of tinnitus ears (72%) had onset duration longer than six months. 22.9% of the ears had duration of tinnitus perception <0.5 yrs (2.5 months–6 months), 25.7% of the ears had tinnitus perception since 0.5 to 1 year, 2.9% since 1.0 to 1.5 years, 14.3% since 1.5 to 2 years, 17.1% since 2.0 to 5.0 years, and 17.1% since >5 years.

Tinnitus matching was done where 44% of the ears had pitch perception <6000 Hz and 48% had perception ≥6000 Hz. Loudness matching showed that 24% of the subjects had faint tinnitus perception ≤30 dB HL, 44% had loud (31 to 50 dB HL), 20% had too loud (51 to 70 dB HL), and 12% had extremely loud level (71 to 90 dB HL). Loudness matching was done contralaterally in hearing level (HL) units rather than in sensation level units (SL) [12] as the minimum masking level was measured ipsilaterally in SL [11]. Residual inhibition was considered positive when after masking there was a decrease in perceived loudness by ≥5–7 dB or change in pitch >100 Hz and he/she reported subjective decrease in loudness and/or pitch change. It was found positive in 68% of the subjects. The rest of the 32% of the subjects did not show residual inhibition.

5. Subjective Rating

The level of annoyance was subjectively reported by the individuals on a 5-point scale, where 0 = no annoyance, 1 = little annoyance, 2 = average annoyance, 3 = high annoyance, and 4 = intolerable. All of the subjects reported level of annoyance as average or more than average, that is, ≥2. The sleep disturbance due to tinnitus was rated on a 5-point scale as 0 = never affected, 1 = rarely affected, 2 = sometimes affected, 3 = mostly affected, and 4 = always affected. Out of the total 26 subjects, 22 reported sleep disturbance as sometimes affected due to tinnitus, two of the patients reported as mostly affected (since <6 weeks), and one reported as always affected (since 2 weeks).

6. Pure-Tone Audiometry

Based on pure-tone audiometric thresholds, PTA1 (average of 500, 1000, and 2000 Hz) was calculated for both right and left ears (conventional audiometry), and hearing status of the subjects was categorized into mild, moderate, moderate to severe, severe, and profound (WHO Classification, 1980; ISO-R.389: 1970) [13]. Similarly the average of 4000, 8000, and 10000 Hz was calculated as PTA2 (high frequency audiometry) and the average of 12000, 14000, and 16000 Hz as PTA3 (extended high frequency audiometry) for both ears.

The data shows that 60% (21 ears) of tinnitus ears had normal hearing on conventional audiometry (PTA1), 20% (7) ears had mild hearing loss, 11.4% (4) had moderate hearing loss, and 8.6% (3) of tinnitus ears had severe hearing loss. None of the tinnitus ears had profound hearing loss (Figure 1). The data of nontinnitus ears show that on conventional audiometry (PTA1), 88.2% (15) ears had normal hearing and 11.8% (2) ears had mild hearing loss (Figure 2).

On high frequency audiometry (PTA2), 34.3% (12 ears) of the tinnitus ears had normal hearing, 17.1% (6 ears) had mild hearing loss, 14.3% (5) ears had moderate hearing loss, 17.1% (6) ears had moderate to severe hearing loss, 11.4% (4) ears had severe hearing loss, and 5.7% (2) of the tinnitus ears had profound hearing loss (Figure 1). For nontinnitus ears on PTA2, 64.7% (11) had normal hearing, 17.6% (3) ears had mild hearing loss, 11.8% (2) ears had moderate hearing loss, and 5.9% (1) ears had severe hearing loss (Figure 2).

According to extended high frequency audiometry (PTA3), 5.7% (2 ears) of the tinnitus ears had normal hearing, 20% (7) ears had mild hearing loss, 17.1% (6) ears had moderate hearing loss, 28.6% (10) ears had moderate to severe hearing loss, 17.1% (6) ears had severe hearing loss, and 11.4% (4) of the tinnitus ears had profound hearing loss. For nontinnitus ears on PTA3, 23.5% (4) had normal hearing, 35.5% (6) ears had mild hearing loss, 17.6% (3) ears had moderate hearing loss, 17.6% (3) ears had moderate to severe hearing loss, and 5.8% (1) ear had profound hearing loss (Figure 2).

7. Speech Audiometry

The speech reception threshold (SRT) was normal, that is, ≤25 dBHL in 57.1% (20 ears) of the tinnitus ears, and 17.1% (6) of the tinnitus ears had SRT between 26 and 40 dBHL. It shows that the majority (74.2%) of tinnitus ears had good speech reception at general conversational levels (Figure 1). Speech discrimination score (SDS) was good (≥90%) in the majority of the tinnitus ears, that is, 71.4% (25 ears). SDS was found between 80 and 90% in 20% (7) of the tinnitus ears. That means that 91.4% of the tinnitus ears had good discrimination of speech. Only 8.6% (3) of tinnitus ears had SDS below 80%. Uncomfortable level (UCL) was observed to be normal (≥100 dBHL) in 80% of the tinnitus ears while the rest 20% had UCL 90–100 dBHL. Otoacoustic emissions (OAEs) were done for these 20% subjects to ensure the outer hair cells’ (OHC) intactness. Those subjects with OHC poor functioning (absent/reduced DPOAEs) were excluded from the study. Uncomfortable level (UCL) was ≥90 dBHL in all of the tinnitus ears (100%).

The SRT was normal, that is, ≤25 dBHL in 82.3% (14ears) of the nontinnitus ears, and the rest 17.64% (3) of the ears had SRT between 26 and 40 dBHL (Figure 2). Speech discrimination score SDS was good (≥90%) in all of the nontinnitus ears. UCL was observed normal (≥100 dBHL) in 85% of the non-tinnitus ears, while the rest 15% had UCL 90–100 dBHL. Otoacoustic emissions (OAEs) were done for these 15% subjects to ensure the outer hair cells’ (OHC) intactness. All of the non-tinnitus ears (100%) had UCL ≥90 dBHL.

8. Auditory Brainstem Evoked Responses (ABR)

The interpeak latency (IPL) of wave I-III was considered normal as 1.6–2.4 ms, shortened as <1.6 ms, and prolonged as >2.4 ms. Wave III-V IPL was normal as 1.8–2.2 ms, shortened as <1.8 ms, and prolonged as >2.2 ms. The IPL of wave I–V was normal as 3.6–4.4 ms, shortened as <3.6 ms, and prolonged as >4.4 ms. The correction (0.1 ms for every 10 dB of hearing loss above 50 dB) was applied to calculate the absolute latency of wave V when the subject had hearing loss greater than 50 dBHL at 4000 Hz [14].

The IPL of wave I–III was observed as normal in 82.8% (29 ears) of the tinnitus ears, prolonged in 8.6% (3) ears, and no response in 8.6% (3) ears. None of the ears had shortened wave I–III interpeak latency. In non-tinnitus interpeak latency of wave I–III was normal in 94.1% of the ears (16 ears), and prolonged in 5.9% (1) of the ears. None of the ears had shortened IPL of wave I–III.

Wave III–V interpeak latency was normal in 17 tinnitus ears (48.6%), shortened in 16 ears (45.7%), and prolonged in one tinnitus ear (2.8%) and there was no response in one ear (2.8%). In non-tinnitus ears wave III–V was observed as normal in 10 ears (58.8%) and shortened in seven ears (41.2%).

Data shows IPL of wave I–V as normal in 30 tinnitus ears (85.7%), shortened in one ear (2.8%), prolonged in one ear (2.8%), and no response in three ears (8.6%). IPL of wave I–V in non-tinnitus was normal in 88.2% (15) of the ears, shortened in 5.9% (1), ears and prolonged in 5.9% (1) of the ears. MRI was normal in this one subject. Magnetic resonance imaging (MRI) was recommended in subjects with unexplained prolonged IPL of waves to ensure no retrocochlear pathology. Those with retrocochlear pathology were excluded from the study.

9. Middle Latency Evoked Responses (MLR)

Peaks observed during MLR were Na, Pa and Nb waves, out of these amplitude of waves Na and Pa were analyzed. The amplitude of waves Na and Pa was considered normal as ≥0.50 μV and abnormal as <0.50 μV.

Wave Na had normal amplitude in 94.3% (33 ears) of the tinnitus ears, abnormally low in 2.8% (1) of the ears, and no response in 2.8% (1) of the tinnitus ears. Amplitude of wave Pa was normal in 32 ears (91.4%), abnormal in 2 ears (5.7%), and of no response in 1 tinnitus ear (2.8%). In non-tinnitus the amplitude of waves Na and Pa was observed to be as normal in all of the 17 ears (100%).

10. Comparison between Tinnitus and Nontinnitus Ears (Table 1)

The two groups tinnitus and non-tinnitus ears were compared with unpaired “t”-test. The comparison was made between all the measured audiological parameters, but the results of statistically significant findings are depicted in the tables. Table 1 shows that the two groups had significant differences for pure-tone audiometry and speech audiometry. For ABR and MLR measurements, only absolute latency of wave V was significantly different between the two groups, and all of the rest parameters were found nonsignificant.

11. Correlation between Onset Duration of Tinnitus and Audiological Profile (Table 2)

Positive correlation was observed between tinnitus onset duration and high frequency thresholds (4000, 8000, and 10000 Hz and high frequency average PTA2). Similarly positive correlation was also observed for extended high frequency threshold (12000 and 14000 and EHF average PTA3). Positive correlation was also observed between tinnitus duration and absolute latencies of waves III and V of ABR (Table 2).

Negative correlation was observed between duration and speech discrimination score (SDS) in tinnitus ears. None of the correlation coefficient values was statistically significant between tinnitus duration and interpeak latencies of ABR waves. Similarly, none of the correlation coefficient values was statistically significant between duration and amplitude of middle latency evoked response (MLR) waves Na and Pa.

12. Correlation of Tinnitus Loudness with Audiological Profile (Table 3)

Significant correlation was observed between perceived tinnitus loudness and conventional audiometric thresholds and average. Similarly significant correlation was found for high frequency and extended high frequency thresholds. As shown in Table 3, tinnitus loudness was also significantly correlated with speech reception threshold (SRT), speech discrimination score (SDS), and most comfortable level (MCL). None of the ABR and MLR parameters were significantly correlated with tinnitus loudness.

13. Association between Tinnitus Onset Duration and Audiological Profile (Table 4)

Fischer’s exact test was used to evaluate the association between tinnitus onset duration and type of hearing loss. Statistically significant association value (, ) was found between duration and conventional hearing loss (PTA1). Similarly significant value (, ) between duration and high frequency hearing loss (PTA2) was observed. Association of duration with extended high frequency hearing loss (PTA3) () was nonsignificant.

14. Association between Tinnitus Loudness and Audiological Profile (Table 4)

Fischer’s exact test was also used to assess association of perceived tinnitus loudness with type of hearing loss. Association was significant between loudness and conventional hearing loss (PTA1) (; ). Association was also statistically significant (; ) between tinnitus loudness and high frequency hearing loss. It was nonsignificant for extended high frequency hearing loss ().

15. Therapeutic Variations

To control the variability, therapy was given by one clinician to all subjects. Combination management of masking therapy, environment enrichment (with music before sleep to shift attention from tinnitus/interference) and individual cognitive behavior therapy (CBT) was given for two weeks. Improvement was defined objectively as change in loudness level ≥15 dBHL plus subjectively as improvement on a 5-point scale of annoyance rating and a 5-point scale of sleep disturbance. When the loudness level was faint or loud and onset duration was <0.5 years, the prognosis reported by the subjects was good immediately after completing therapy and six months later. Given similar management the subjects with loudness perception of 51 dB HL to 70 db HL (too loud) and/or onset duration 0.5–1 year reported fair improvement immediately after the therapy and some relapse by 2-3 months hence needed further therapeutic management. When onset duration of tinnitus was longer than 2 years and/or loudness was 71−90 dbHL (extremely loud) with this therapeutic plan, there was hardly any improvement and the subjects were shifted to other management strategies after 2 weeks like combination with electrical stimulation.

16. Discussion

In the study, the majority (60% of tinnitus ears and 80% of non-tinnitus ears) of the subjects had normal hearing on conventional pure-tone average (PTA1) which goes in accordance with the results published by Roberts et al. [15]. Other studies have reported contradictory findings showing an increased prevalence of hearing loss with tinnitus perception [16]. Reason might be because of the frequencies tested that were not divided into different regions of the spectrum as has been done in our study. However, comparison of tinnitus and non-tinnitus ears showed that hearing thresholds at 1000 Hz, 2000 Hz, PTA1, SRT, and SDS had significant differences explaining the increased prevalence of hearing loss with tinnitus, as observed in previous studies [16].

Hearing thresholds were poorer in high frequency region 4000, 8000, and 12000 Hz. Roberts et al. [15] also reported similar findings that tinnitus subjects had high frequency hearing loss. In the present study, these thresholds were higher when duration since onset was longer or when perception of tinnitus was louder. This suggests that tinnitus is associated with changes in the auditory system as the duration and loudness increase or viceversa.

Most of the tinnitus subjects in our study had hearing loss in both ears by extended high frequency (EHF) average (94.2% of tinnitus ears and 76.5% of non-tinnitus ears). However, on comparison of tinnitus and non-tinnitus ears, significant differences were observed for extended high frequency hearing thresholds and PTA3. Barnea et al. [17] found that extended high frequency hearing thresholds in tinnitus and non-tinnitus subjects were not significantly different. The disagreement with the present study might be the difference of tinnitus duration, as observed by positive correlation between duration and EHF thresholds, that is, longer the tinnitus onset duration higher was the extended high frequency thresholds or EHF average (PTA3). It was also found with correlation based on tinnitus loudness that louder tinnitus was associated with higher thresholds at EHFs. The findings of the present study disagree with the previous study [8] concluding little correlation between tinnitus loudness and the impact of tinnitus on daily life as measured by tinnitus handicap inventory. The differences might be due to correlating tinnitus loudness with the degree of hearing loss in the present study instead of the handicap in daily living. The positive correlations of the present study indicate that duration and loudness of tinnitus are associated with high frequency and extended high frequency processing sites of the auditory system.

ABR studies in the literature do not reveal any shortening of IPL I–III, III–V, or I–V waves. However, we found wave III–V interpeak latency shortening (<1.8 msec) in many subjects (45.7% in tinnitus ears and 41.2% in non-tinnitus ears). This indicates lesser conduction time of auditory stimulus at higher brainstem level. Moller [18] studied the compound action potential and brainstem evoked potentials from exposed eighth nerve in patients with intractable tinnitus. They reported that absolute latency of wave III was unchanged but latency of wave V was significantly shorter due to hyperactivity of some structures in ascending auditory pathway [18]. The shortening of III–V IPL observed in both tinnitus and non-tinnitus ears in the present study can be explained by crossover of neural network leading to binaural representation at high brainstem level. Positive correlation was seen between tinnitus duration and absolute latency of waves III and V, indicating that, as the onset duration increases, ABR latencies get worse and this worsening is not due to poorer hearing threshold as latency correction was applied according to Selters and Brackmann (1977) formula [14]. No significant correlation was observed for MLR waves Na and Pa amplitude in the present study although a previous study by Gerken et al. [19] reported that there is a selective alteration of MLR generators in different forms of tinnitus.

It therefore becomes clear that tinnitus perception is associated with changes in auditory pathway especially the areas responsible for high frequencies and extended high frequencies processing. And these changes are correlated with prolongation of time and increase in intensity of tinnitus perception.

According to psychological models, promising treatment for tinnitus is to modify the central nervous substrate of tinnitus and consequently its percept [20]. Tyler [21] reported that the psychological factors to be considered are habituation, learning, attention (failure to shift away attention from tinnitus), and cognitive aspects (nonadaptive and less functional ways of thinking about tinnitus). One previous study added the use of a noisegenerator to a 10-session CBT group treatment, although the noise generator was found helpful for patients with a co-occurrence of hyperacusis [7]. The same was done in the present study by giving combination of masking and CBT. It was observed that when loudness and/or onset duration was higher, the improvement was either slow, less, or required an other combination of therapeutic strategies. Thus, this indicates that onset duration and loudness of tinnitus are important aspects in planning treatment.

This study has some limitations which could be addressed in future studies. Though a thorough case history of the subjects was taken, the possibility of pretinnitus hearing loss or audiological problems cannot be fully ruled out. Inclusion of radiological investigations particularly functional MRI would have been beneficial and would have added to the validity of the changes. The bigger sample would be safe to generalize the findings.

17. Conclusions

The duration and/or loudness of tinnitus perception has strong association with changes of auditory system. There might be progressive changes on hearing and auditory pathway due to longer onset duration/tinnitus loudness or vice versa. This information should be collected during assessment to be used for planning management in a focused and effective manner. It might also be used for predicting prognosis.

Conflict of Interests

The authors have no direct financial relation that might lead to a conflict of interests. Dr. Sanjay K. Munjal is the Assistant Professor and Incharge Speech and Hearing Unit Deptartment of Otolaryngology, PGIMER, Chandigarh, India.


The authors are thankful to the research approval committee and ethical committee of the Institute for their considerations. They also acknowledge the guidance of the statisticians from the Research Department for the data analysis of the study.

Summer Research Opportunities Enhance Academic Experience …

When the end of May arrives and all finals for Spring Semester have been taken, a majority of the 2,500 students at Gustavus Adolphus College scatter across the country to where they call home for the summer.

But a growing trend over the last decade has seen more and more Gustavus students remain on campus for the summer months to conduct research alongside various faculty members. The stories below are a just a sampling of the research projects taking place on campus this summer.

In The Prairie

Reina Nielsen '16

Reina Nielsen ’16

Sophomore biology major Reina Nielsen ’16 has spent her summer conducting research at a 25-acre experimental prairie near the towns of Kensington and Hoffman in Western Minnesota, with biology and environmental studies professor Pam Kittelson. Her research project involves comparing photosynthetic rates, transpiration rates, and herbivory between three different genetic crosses of Echinacea angustifolia.

“The purpose of this research is to understand how fragmentation of prairies, on which Echinacea reside, affect their offspring survival rates and the future of Echinacea on the prairies,” Nielsen said.

A typical day for Nielsen can range from entering data on a computer to taking a machine that measures photosynthetic rates outside to an experimental garden.

“I have various tasks that range from organizing supplies for the day to actually using the machine to take photosynthetic rates,” Nielsen said. “This experience has been extremely beneficial for me because it has given me hands on experience in the field and has confirmed for me my career goals. I have also been able to apply what I have learned in the classroom to the field as well as dig deeper into these subjects.”

The opportunity to work closely with a Gustavus faculty member is one that Nielsen says every Gustie should experience.

“I have developed a great relationship with Professor Kittelson. She has been extremely helpful in guiding me through this research,” Nielsen said. “She is always willing to take the time to explain the answer to any question I may have whether it be biology or career related. I believe this to be important because having a professor you can trust who knows you can be one of the greatest resources that one can have both on campus and after graduation.”

Herbicides and the Environment

Chemistry professor Amanda Nienow received a grant from the National Science Foundation last year that included funding for two summer student research positions.

Sophomore Alexa Peterson ’16 and junior Amy Christiansen ’15 were chosen to work with Nienow this summer. They are analyzing how imidazolinone herbicides degrade in aqueous solution, on wax surfaces, and in the future, on plants in order to see what affects herbicides might impose to the environment.

Junior Amy Christiansen '15, sophomore Alexa Peterson '16 and professor Amanda Nienow analyze data in one of the College's chemistry labs (Photo by Matt Thomas '00).

Junior Amy Christiansen ’15, sophomore Alexa Peterson ’16 and professor Amanda Nienow analyze data in one of the College’s chemistry labs (Photo by Matt Thomas ’00).

“Degradation is studied under various conditions such as wavelengths of light and different pH values,” Peterson said. “We first have been studying the degradation rates in aqueous solution and then comparing the results to the wax surfaces of corn and soybeans. Over time, analysis of various growing conditions for the corn and soybean plants and degradation of the herbicides when directly applied to the plant will be studied. After analyzing the rate constants for the herbicides photodegradation, the photoproducts and possible degradation pathways will be identified.”

On a typical day, Peterson and Christiansen prepare various solutions of the herbicides to be tested at 254nm and 310nm wavelengths. After collecting the samples from various time points, they are analyzed on a high performance liquid chromatograph (HPLC) to determine a rate constant. From there, they are able to identify which herbicide degrades most quickly and at which conditions. They also test the herbicides on the wax surfaces and again analyze the samples to determine a rate constant and compare results.

“Having this research opportunity has been an amazing experience,” Peterson said. “I have been able to meet many of the upper level chemistry professors, learn first hand what doing research is all about, and see science in a very applicable manner. It has been beneficial to my academic career to see how science is applied outside of the classroom. I am so thankful for all the experiences Gustavus has to offer.”

Along with honing her skills in the laboratory, Peterson knows that developing a relationship with a professor like Nienow is equally as important.

“Working for Dr. Nienow seems like anything but work. She is passionate about what she does, creates a fun environment, and has been an influential advisor this summer,” Peterson said. “Having the opportunity to make a connection with her as a first-year student has opened the door for future collaboration. It is great to know that as a student at Gustavus you have professors who are eager to help students learn and succeed.”

Chronic Ear Ringing

Ever heard of Tinnitus? It’s the phantom perception of chronic ear ringing, which is produced internally within the brain and can be debilitating for millions of people. It’s the focus of an ongoing research project for sophomore Travis Sigafoos ’16.

“With the knowledge that symptoms worsen at night for tinnitus patients, our goal is to utilize a model system to investigate a possible relationship between chronic ear ringing and the mammalian body clock,” Sigafoos said. “We would like to ultimately gain better understanding of the neural networks involved in tinnitus and how the brain reorganizes. More specifically, our research aims to investigate the relationship between salicylate-induced tinnitus and circadian rhythmicity by means of the acoustic startle paradigm.”

Travis Sigafoos '16

Travis Sigafoos ’16

Sigafoos has been working on the project since he arrived at Gustavus in the fall of 2012 under the supervision of biology professor Michael Ferragamo and psychological science professor Janine Wotton. This summer is serving as a phase of data collection where Sigafoos is mainly responsible for running two experiments daily at two differently scheduled times.

“Our research has often involved working at very odd hours of the night, so this summer has proven to be particularly useful opposed to during the academic year,” Sigafoos said.

Sigafoos, who plans to double-major in biology and psychological science, minor in neuroscience, and eventually attend graduate school for behavioral neuroscience, has found his unique research experience to be extremely beneficial.

“The opportunity to collaborate with two professors from two different departments continues to be very rewarding,” Sigafoos said. “Professors Ferragamo and Wotton provide two unique perspectives on our scientific questions in neuroscience. I believe that my research experience continues to be a superb example of the unparalleled student-faculty relationship that a liberal arts college like Gustavus is able to offer. I am working directly with two very dedicated and outstanding professors on publishable research, which is an invaluable experience for an undergraduate student.”




Media Contact: Media Relations Manager Matt Thomas

Acupuncture Tinnitus Research : Hearing Aid Help Is Available For …

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How to Deal with Tinnitus – Ringing in the ears, although considered as a great ear ache, is not really a significant ear trouble. Still tinnitus still needs quick attention. This condition may be characterized by the constant calling regarding one’s hearing. The actual calling is not the real trouble right here; this is a indicator. The true problem is the medical issue to it. To acquire to the remedy, you need to know very first the main cause of the situation.

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How to Get Rid of Tinnitus – My Success Story | Tinnitus Treatment

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tinnitus research | HOW CURE TINNITUS AT HOME

tinnitus research – Are you suffering from tinnitus for some time now? If you have, you will need to know how distressing and frustrating dozens of noises in the ear could be. They can strike anytime from the day, and becomes worse in the night time. You would likely give anything to get some relief. But that’s of course easier said than done. The remedies suggested through the physician can provide some relief. Even so the noises always return.

tinnitus research – So can be the noises regarding tinnitus getting in your nerves? Its period you considered alternate tinnitus remedies. You should know that your medical doctor practicing conventional treatments may not cure you from the many noises. Sure ample, your noises can decrease with treatment, nonetheless they will always revisit. At best, you can get some temporary respite from conventional treatment : nothing more. You would be very happy to know that there are a few wonderful alternative tinnitus remedies that have worked very well for many people sufferers like people. There’s no answer why they can’t do the job.

Consider These Alternative Tinnitus Remedies

Herbal treatments – These treatment options are developed coming from herbs.. For a large number of years, in old India, Tiongkok in addition to far away, herbal remedies have got treated many people by a myriad of ailments. Many of us can not really ignore that. Herbal solutions also normally do not bring about just about any uncomfortable side effects. Perhaps modern medicine is now agreeing of which a number of herbs get preventive beliefs and possess a huge part to be able to participate in. Your ginkgo biloba natural herb can be hugely powerful inside managing tinnitus. It could possibly boost circulation of blood and take care of vertigo – both equally these kinds of problems are linked to ringing in the ears. Ginkgo biloba may relaxed ones sensory faculties and ease the symptoms. Around the adverse area even so, herbal remedies most likely are not because successful for all.

Alternative tinnitus treatments may work. But there’s a problem. In most cases, when using alternative remedies for tinnitus, the root contributing factors that caused all those noises remain, and so the sounds will come back as soon as you have stopped following these treatments.

The only way you could ever get rid of your tinnitus for good is by following the holistic approach to healing. By using a multidimensional treatment for tinnitus, we are tackling all tinnitus causative factors and eliminating these triggering elements from the root. This is the only path for permanent freedom from tinnitus.

tinnitus research

Tinnitus Treatments: Tinitus : Tinnitus Chiropractic – This Will …

Tinitus : Tinnitus Chiropractic – This Will Possibly Be The Latest Position – Unfortunately There’s no cure or magic pill which will aid the people that have from what i understand in tinnitus to no longer listen to the noises within the mind. The excellent announcement is tinnitus is attaining significantly more attention and new exploration is at the moment bringing about spot in an work to think about within the tinnitus cure. Even though scientists proceed to lookup for that cure, tinnitus sufferers may possibly maybe submit consolation in Understanding that in a couple of scenarios, tinnitus can be quiete … [Read More – Tinitus]

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treatment for tinnitus – Dear Tinnitus Sufferer, You’re about to uncover what may possibly be essentially the most effective tinnitus treatment program at any time developed. It’s the extremely same system thousands of males and females, the same as you, have utilized to permanently heal their tinnitus and attain long lasting flexibility in the ringing of their ears|I’ve designed a sure-fire, clinically researched process that’s certainly backed by forty five,000+ multiple hours of powerful wellness care research for eliminating tinnitus for good. This might be a really unusual, extremely unique and potently effective tinnitus therapeutic system, which only a few people even know exists|Dear Thomas, I had been in the conclude of my wits with all the continuous ear ringing which i seasoned for multiple years. Within the advice of my medical professional, I began taking anti-depressant medication that only worsened my ringing to an unbearable degree. I unintentionally stumbled on your World wide web site and i have found the stage by action holistic method to be extremely useful. In lower than 3 months the continuous ringing has completely gone. I now live a traditional lifestyle with no the terrible ringing sounds that utilized to push me nuts. I’d previously suggested your information to my cousin in Australia who at the same time suffers from Tinnitus, and i have carried out so with no reservation. Notice which i have experimented with practically equite strategy known to male just before commencing your software but to no avail. Other guides around the topic gave me no hope both}

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Medications that (Might) Help Tinnitus? | Fauquier ENT Blog

The blunt answer is that there is no drug or supplement that has been consistently found to help with tinnitus (ringing of the ears).

Here’s a partial table showing all the research that has been done either proving or disproving effectiveness to treat tinnitus (info collected from this review paper).

For a more comprehensive list going over 17 drugs, click here.

Drug Research That Supports Research That Disputes Conclusion
Benzodiazepines (alprazolam, diazepam, clonazepam) #1, #2, #3, #4 #1, #2, #3 Caution due to addiction and may worsen tinnitus if stopped.
Antidepressants (nortriptyline, amitriptyline, trimipramine, sertraline, paroxetine) #1, #2, #3, #4, #5 #1, #2, #3, #4, #5, #6 TCA may benefit only in patients with depression symptoms
Anticonvulsants (carbamazepine, gabapentin, vigabatrin, tiagabine) #1, #2, #3, #4, #5, #6, #7, #8, #9 #1, #2, #3, #4, #5, #6, #7 Mixed results
Antiglutamatergics (caroverine, memantine, acamprosate) #1, #2, #3, #4 #1, #2, #3, #4 No conclusion.
(Anti)Dopaminergics (sulpiride, piribedil) #1, #2, #3 #1 Studies are weak.
Ginkgo Biloba #1, #2 #1, #2, #3 Not effective.
Melatonin #1, #2, #3 #1 Potentially helpful.

For more meds, click here.

What's that Tinny Sound in My Ear? | UA Magazine

Posted on July 2, 2013

What’s that Tinny Sound in My Ear?

Modern medicine has yet to come up with a comprehensive treatment for tinnitus.

damaged ossicles, tinny sound in ears

Anyone that has ever been to a long, loud concert or a club with an appropriately large sound system has no doubt experienced that constant, high, tinny sound reverberating inside the ear drums. However, people who have been exposed to loud enough noise for a long enough time might have had the misfortune of contracting tinnitus, a condition in which the sufferer hears a constant or intermittent noise coming from inside their ears.

The first big breakthrough for sufferers of tinnitus was the medical world first realizing it was an actual condition. Anecdotes from earlier centuries claim that people with tinnitus were originally thought to be possessed by demons and spirits, and generally deemed as crazy. Centuries later, many doctors still blamed tinnitus on the patient’s mental state, convinced that the constant ringing sound was a figment of the patient’s imagination. Modern medicine and science has recognized tinnitus as a condition, but have yet to come up with a comprehensive method for treatment.

The constant ringing noise is caused by damaged nerves inside the ear, who begin sending a continuous signal of sound to other nerves and brain sensors. Sometimes the damage causes the nerve to send out a response signal to a sound that is not actually being transmitted to the ear. This constant looping between the nerves and brain sensors is the root of the constant ringing or whooshing sound that tinnitus patients report.

The damage is caused by sounds exceeding the range of frequencies previously established by the brain and inner ear nerves. Once the eardrum grows accustomed to hearing sounds within a certain decibal and frequency range, sounds outside that ordained limit can upset those nerves to varying degrees.

Dr. Winfried Schlee, a German neuroscientist, is at the forefront of tinnitus research. Schlee and his team have recognized that tinnitus is a problem equally intertwined with the brain as much as the ears and auditory system. Employing a technique called magnetoencephalography (MEG), Schlee studies the tiny electromagnetic fields that are created when brain neurons send and receive messages. By studying changes and inconsistencies within these electromagnetic fields, Schlee and his colleagues hope to get closer to a cure for tinnitus.



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Research for Tinnitus | Tinnitus Cure


When undertaking quantitative research a researcher should take into consideration ethical issues such as confidentiality and anonymity, an appropriate data collection method such as questionnaires and interview should be selected. Another factor to consider is the sampling method to be used and how this will aid in answering the research question. Data collected should be accurate and this can be achieved by choosing probability sampling method and proper formulation of questions. Finally information collected should be confidential and respondents should remain anonymous.


This paper highlights the factors that should be taken into consideration when undertaking quantitative research, research questions are subdivided into two broad categories and they include descriptive research that is aimed at answering what exists in the society and explanatory research that aims at explaining why this exist in society. Research studies will in most cases include descriptive and explanatory research whereby they will highlight what exist in the society and also why this exists. The following are some factors that need to be taken into consideration when undertaking quantitative research.

Variables and units:

Quantitative research is based on the fact that social phenomenal can be quantified and expressed numerically and therefore can be analyzed using statistical methods, quantitative research involves identification of observations units example individuals and households, variables are also identified that measure specific characteristics of the unit. The researcher should also classify variable collected into independent and dependent variables, this will help in answering the research question whereby the independent variable are collected to show their relationship with the dependent variable therefore the research study will identify the causal effect in the study. (Fowler, 2008)

The Process:

The research process entails a number of steps which include the research question, literature review, research design, data collection, data analysis, interpretation of results and answering the research question. (Hughes, 2006)

From the above diagram it is evident that there are steps that should be followed when undertaking quantitative research, these steps are discussed below: (Creswell, 2003)

1) Selection of topic:

The first step when undertaking quantitative research is the identification of the research topic, this involves designing the research question, the selection of the topic will depend on a number of factors and they include topic selection due to interest of an individual, significance of the social phenomena, research based on existing theories and the ability to research on the topic. (Creswell, 2003)

2) Literature review:

The next step is to undertake research on previous theories that have been developed based on the selected research topic. This step will also involve selection of the theoretical approach that will be used in the study. This step will also involve formulation of questions that will be answered in the study, at this point a literature review will be prepared in order to identify previous studies and theories that support the research questions and methods that will used in the study. (Creswell, 2003)

3) Research design:

Research design is determined by the research question, this involves identifying the most appropriate way to structure the quantitative research in order to answer the research question, the research question will also determine the type of data to be collected and analyzed.

4) Data collection methods:

The research design will involve selection of the most appropriate data collection method. Data collection methods include Questionnaires, Structured Interview, and Observation and analyzing documents

i) Questionnaires:

Questionnaires involve the formulation of questions that aid in the collection of data, questionnaires can be administered to respondents or mailed to the respondents, questionnaires are prepared and pre tested to determine whether questions are biased. Questions formulated will be based on the research question whereby they will aid in the collection of data that will help answer the research questions. Questions will either be closed or open ended, open ended questions are those questions that will require the respondent to input his own answers to the questions whereas closed questions are those questions whereby the respondent will choose from a list of answers highlighted in the questionnaire. (Fowler, 2008)

ii) Interviews:

An interview can be undertaken to collect data, there are two types of interviews and they include face to face interview and telephone interview, a face to face interview will involve collection of data whereby the respondent and research administrator sit together, a telephone interview on the other hand will involve calling the respondent and answers obtained over the phone, a face to face interview is considered more expensive given that the research administrator may be required to travel and also this process may be time consuming. (Fowler, 2008)

Interview are further subdivided into structured and unstructured interview, structured interview involves setting up a set of questions that will be administered while unstructured involve asking the respondent to elaborate on certain issues. (Fowler, 2008)

iii) Observation

Observation is another method of collecting data, this method involves observing participants and recording data, for example collecting data on the number of vehicles that use a certain highway will involve the observation method of collecting data. (Fowler, 2008)

iv) Analyzing documents:

This is secondary data collection method that involves collecting data from published documents example journals and a book, other sources include online databases which are relatively cheap methods of obtaining data, this method is preferred given that it is less time consuming and also less costly. This method however have a disadvantage given that it may given rise to accuracy problems, data accuracy will depend on the purpose of the data collected and that there may rise problem when data may unavailable and therefore a researcher will be required to use primary sources of data which include interview and questionnaires. (Fowler, 2008)

When designing the research data collection methods it is important that the researcher takes into consideration the respondent attitude, data collection methods such as questionnaires should be designed taking into consideration the reaction of the respondents when a certain question is directed to them, also the research questions should be clear and simple and should not be leading questions.

The other factor that should be taken into consideration is the cost, when selecting the data collection method one should take into consideration the cost associated with that method and whether there exist ways to reduce such costs, face to face interview sometimes may be costly and time consuming and therefore questionnaires that are relatively cheap may be preferred, also the questionnaires may be more appropriate given that they are less time consuming given that a lot of data can be collected at once, for example a study that involves participants from different regions and the respondent sends the questionnaires to the respondents. (Fowler, 2008)

5) Sampling:

Sampling in social research refers to the selection of a few respondents from a population, in some studies it is impossible to collect data from the entire population and therefore a sample is selected, when an appropriate sample is selected it results will represent the entire population, a sample reduces the cost associated with data collection and also reduces time consumed while collecting data. There are two types of sampling and they include probability sampling methods and non probability sampling methods.

In probability sampling the sampling error can be estimated and a confidence interval established for the entire population, probability sampling methods include random sampling, systematic sampling, stratified sampling and clustered sampling. (Stuart, 1994)

i) Simple random sampling:

In simple random sampling the population respondents or units are identified and a random number generator is used, each unit in the population is assigned a number and the unit corresponding with the random number generator is included in the sample. The appropriate sample size is calculated using the expected error and therefore the number of total units selected corresponds to the calculated sample size. (Stuart, 1994)

ii) Systematic sampling:

This is a probability sampling method that involves the selection of the sample using intervals, the first step in undertaking a systematic sample is assigning each unit a number, the researcher then decides on the appropriate sample size and then the sample is selected using intervals, example a study may use systematic sample with a ten unit interval, this means that the first number to be selected will be 1, the next 11, the next 21, if the interval is 5 then the first number will be 1 then 6 then 11 etc. (Stuart, 1994)

iii) Stratified sampling:

Stratified sampling is also an acceptable probability sampling method, this method involves subdividing the entire population using certain characteristics example stratifying data into regions or gender, the next step involves undertaking simple random sampling on the categories and selecting the appropriate sample size. (Maxwell, 2005)

iv) Snowball sampling:

Snowball sampling is another sampling method which is a non probability sampling method, this method involves selecting the first respondent and then asking the respondent to refer you to another respondent, a good example where Snowball sampling is used where we have certain units with unique characteristics, example a research study on gay marriages will use these sampling method, or a study on prostitution will involve this sampling method given that the respondents will refer you to people they know who have the same characteristics. (Stuart, 1994)

6) Ethical issues:

In research there are some ethical issues that need to be taken into consideration, this includes confidentiality, cause no harm to respondents, anonymity and consent. A researcher should treat information collected with confidentiality, this means that the researcher should not state that a particular respondents made a certain statement. The other ethical issue to observe is anonymity whereby the respondent should not given out their names or reference numbers that may identify them as the particular individual that gave certain statements. (Punch, 2005)

The other ethical issue is consent. Participants should be briefed on the purpose of the study and also be informed on any recording that may take place, this way the researcher should gain the consent of the participants by briefing them on the purpose of the study and also how the information will be recorded. Finally the research should not cause harm to the individuals, this takes place whereby the researcher should not ask questions that offend the participants. (Fowler, 2008)

7) Data analysis:

When data has been collected the next step is to analyze data using statistical techniques such as calculating the mean, variance, correlation and regression analysis, all the data collected should be analyzed but some exceptions are made for example cases where we have incomplete questionnaires are rejected and not included in the analysis. In this stage the researcher should report accurately the results obtained and should not in any way alter variables collected in achieving desired results. Data should be presented as they are and a report written to show how the data respond to the research question or topic. (Bamberger, 2000)

8)Other factors to consider:

A good research study will be free from bias, this means that the information and data collected from the study should not vary in any systematic way, and bias in a study may be eliminated through the use of random sampling and also eliminating biased treatment of participants that may affect their responses. (Flick, 2006)


From the above discussion it is evident that when undertaking quantitative research one has to take into consideration a number of factors, the first step is to formulate a research question, the next step involves literature review where a researcher should search for information on previous studies undertaken on the chosen research question. The next step involves research design where the data collection method and the sampling method is chosen, a researcher may chose to use questionnaires, interview or observation to collect data.

Research design also involves choosing an appropriate sampling method when the population is large, sampling methods include random sampling, quota sampling, systematic sampling and stratified sampling. Sampling helps in reducing costs associated with collecting data from the entire population and also is less time consuming whereby the study is undertaken only a few participants. After sampling and preparation of the data collection method the next step is data analysis and interpretation, this involves recording all the data collected and analyzing data to make statistical inferences and descriptive statistics, results should also report on how the data has helped answer the research question.


Donald Stuart. 1994. Statistics: An introduction. Oxford: Blackwell press.

Floyd Fowler. 2008. Survey research methods. London: Sage Publishers.

John Creswell .2003.Research design: qualitative, quantitative and mixed method approaches. Oxford: Blackwell press.

Joseph Alex Maxwell. 2005. Qualitative and quantitative research design: an interactive approach. Cambridge: Cambridge university press

Keith Punch. 2005. Introduction to social research: quantitative and qualitative approaches. Oxford: Wiley and sons.

Loraine Blaxter, Christina Hughes and Malcolm Tight. 2006. How to research. Cambridge: Cambridge university press

Michael Bamberger .2000. Integrating quantitative and qualitative research. London: Butterworth Heinemann.

Uwe Flick. 2006. An introduction to qualitative research. Oxford: Blackwell press.

research for tinnitus

The Hearing Journal: Noise-Induced Tinnitus Linked to Lower …

The Hearing Journal: Noise-Induced Tinnitus Linked to Lower Potassium Channel Activity

New research has identified a particular cellular mechanism associated with the induction of tinnitus in an animal model, representing an important step forward in the effort to better understand and treat this common auditory disorder.

“What had been known from others and our work is that once mice are exposed to loud sounds, some of them develop tinnitus, and the ones that develop tinnitus have hyperactive auditory systems,” said Thanos Tzounopoulos, PhD, senior author of the study, which was published in Proceedings of the National Academy of Sciences.“We wanted to figure out the cellular mechanism that leads to this hyperactivity,” said Dr. Tzounopoulos, who is associate professor of otolaryngology and neurobiology at the University of Pittsburgh.

In the study, 51.4 percent of 35 mice exposed to noise showed behavioral evidence of tinnitus. Using brain slices that contained the dorsal cochlear nucleus—an auditory brainstem nucleus previously implicated in tinnitus induction—Dr. Tzounopoulos and colleagues showed a reduction in KCNQ potassium channel activity in mice with tinnitus compared with control mice and mice who did not develop tinnitus after noise exposure. This decreased activity was restricted to the same regions that showed tinnitus-specific hyperactivity—those sensitive to high-frequency sounds.

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