Winfried Schlee

Universität Regensburg | UR · Department of Psychiatry and Psychotherapy

Tinnitus affects a considerable part of the population and develops into a severe disorder in some sufferers. App-based interventions are able to provide low-threshold, cost-effective, and location-independent care for tinnitus patients. Therefore, we developed a smartphone app combining structured counseling with sound therapy and conducted a pilo...

The advent of chatbots (also called conversational agents) has been recognized to support various treatment procedures in the medical and psychological fields. Chatbots may be particularly useful before and after medical procedures when patients are at home. For example, while being in the preparation phase of a colonoscopy, a chatbot might answer...

Tinnitus is a condition associated with a continuous noise in the ears or head and can arise from many different medical disorders. The perception of tinnitus can vary within and between days. In the recent years, Ecological Momentary Assessments of tinnitus have been used to investigate these tinnitus variations during the daily life of the patien...

Optimization of dietary intake is an essential component in the multidimensional effort to prevent and manage chronic disease. Recently, demand has increased for nutrition-focused management strategies for chronic tinnitus. The primary aim of this study was to evaluate 10 dietary items for their association with changes in subjective tinnitus sever...

Aims/Hypothesis Identifying risk factors for tinnitus could facilitate not only the recommendations for prevention measures, but also identifying potential pathways for new interventions. This study reports the first comprehensive systematic review of analytical observational studies able to provide information about causality (i.e., case–control a...

Background Tinnitus is a leading cause of disease burden globally. Several therapeutic strategies are recommended in guidelines for the reduction of tinnitus distress; however, little is known about the potential increased effectiveness of a combination of treatments and personalized treatments for each tinnitus patient. Methods Within the Unifica...

Clinical records frequently include assessments of the characteristics of patients, which may include the completion of various questionnaires. These questionnaires provide a variety of perspectives on a patient's current state of well-being. Not only is it critical to capture the heterogeneity given by these perspectives, but there is also a growi...

Previous studies have shown a high prevalence of sleep disturbances in tinnitus patients. However , no study has yet evaluated subjective sleep satisfaction. The present study aimed to investigate associations of self-reported sleep satisfaction with sociodemographic factors, tinnitus-related distress, depression, and self-reported quality of life....

Background and aim COVID-19 is a respiratory disease caused by the new coronavirus SARS-CoV-2, for which the first cases were reported in China, by December 2019. The spectrum of clinical presentations is wide, ranging from asymptomatic cases to a severe acute respiratory syndrome, sometimes with multiple systems involvement. Viral infections, incl...

Importance: To date, no systematic review has taken a meta-analytic approach to estimating the prevalence and incidence of tinnitus in the general population. Objective: To provide frequency estimates of tinnitus worldwide. Data sources: An umbrella review followed by a traditional systematic review was performed by searching PubMed-MEDLINE an...

Recently the use of mobile technologies in Ecological Momentary Assessments (EMA) and Interventions (EMI) has made it easier to collect data suitable for intra-individual variability studies in the medical field. Nevertheless, especially when self-reports are used during the data collection process, there are difficulties in balancing data quality...

Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences...

Tinnitus is the perception of sound when no actual external noise is present. Tinnitus is highly prevalent, with more than 1 in 7 adults in the EU having tinnitus, and it causes negative effects on quality of life for many individuals. However, there is currently no cure for tinnitus and its pathophysiology and genesis are unknown. Auditory evoked...

Tinnitus is the conscious perception of a phantom sound in absence of an external or internal stimulus. More than 1 in 7 adults in the EU experience tinnitus and for a large proportion of them tinnitus is an intrusive, persistent, and disabling condition, which impairs their life quality. Therefore, tinnitus is posed as a major global burden, which...

Background: The COVID-19 symptom monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health platform, the first free app that provides easy access to valid information about the risk of infect...

Tinnitus treatment, diagnosis and management across Europe varies significantly. The lack of national clinical guidelines for tinnitus management in most European countries and the absence of a common language across all disciplines involved is reflected in the diversification of healthcare practices. Interprofessional Training for Tinnitus Researc...

Background Tinnitus is a heterogeneous condition which may be associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by capturing the fluctuations of tinnitus symptoms, such as di...

Background Tinnitus is a highly prevalent symptom, affecting 10–15% of the adult population. Tinnitus influenced by alterations in somatosensory afference from the neck or jaw is referred to as somatic tinnitus (ST). ST is known to respond positively to physiotherapy treatment; however, it is challenging to motivate patients to systematically perfo...

The European School for Interdisciplinary Tinnitus Research (ESIT) is an EU-funded doctoral training network. ESIT is a consortium of 12 universities, over 30 commercial and not‐for‐profit organizations, and 15 PhD students providing cutting-edge education across 10 European countries to develop highly knowledgeable and innovative experts in the fi...

Background: Somatosensory or somatic tinnitus (ST) is a type of tinnitus where changes in somatosensory afference from the cervical spine or temporomandibular area alter the tinnitus perception. Very recently, the diagnostic value of a set of 16 diagnostic criteria for ST was determined. The next step in the development of easily applicable diagno...

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility st...

Background: Chronic tinnitus is a clinically multidimensional phenomenon that entails audiological, psychological and somatosensory components. Previous research has demonstrated age and female gender as potential risk factors, although studies to this regard are heterogeneous. Moreover, whilst recent research has begun to identify clinical “phenot...

Background Tinnitus is a heterogeneous condition associated with moderate to severe disability, but the reasons why only a subset of individuals is burdened by the condition are not fully clear. Ecological momentary assessment (EMA) allows a better understanding of tinnitus by allowing individualized models and by capturing the fluctuations of tinn...

Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educative counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasability stud...

Background Chronic tinnitus is an increasing worldwide health concern, causing a significant burden to the health care system each year. The COVID-19 pandemic has seen a further increase in reported cases. For people with tinnitus, symptoms are exacerbated because of social isolation and the elevated levels of anxiety and depression caused by quara...

Recent digitization technologies empower mHealth users to conveniently record their Ecological Momentary Assessments (EMA) through web applications, smartphones, and wearable devices. These recordings can help clinicians understand how the users’ condition changes, but appropriate learning and visualization mechanisms are required for this purpose....

Background Tinnitus represents a relatively common condition in the global population accompanied by various comorbidities and severe burden in many cases. Nevertheless, there is currently no general treatment or cure, presumable due to the heterogeneity of tinnitus with its wide variety of etiologies and tinnitus phenotypes. Hence, most treatment...

Background Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare re...

Tinnitus is attributed by the perception of a sound without any physical source causing the symptom. Symptom profiles of tinnitus patients are characterized by a large heterogeneity, which is a major obstacle in developing general treatments for this chronic disorder. As tinnitus patients often report severe constraints in their daily life, the lac...

Tinnitus is the perception of a phantom sound and the individual's reaction to it. Although much progress has been made, tinnitus remains an unresolved scientific and clinical issue, affecting more than 10% of the general population and having a high prevalence and socioeconomic burden. Clinical decision support systems (CDSS) are used to assist cl...

More and more observational studies exploit the achievements of mobile technology to ease the overall implementation procedure. Many strategies like digital phenotyping, ecological momentary assessments or mobile crowdsensing are used in this context. Recently, an increasing number of intervention studies makes use of mobile technology as well. For...

Electronic health records (EHR) often include multiple perspectives on a patient's current state of well-being (e.g. vital signs and subjective indicators measured by questionnaires). In this study, we use these perspectives to build phenotypes of chronic tinnitus patients and investigate how these phenotypes are associated with response to treatme...

Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this long...

Tinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data...

Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this long...

More and more observational studies exploit the achievements of mobile technology to ease the overall implementation procedure. Many strategies like digital phenotyping, ecological momentary assessments or mobile crowdsensing are used in this context. Recently, an increasing number of intervention studies makes use of mobile technology as well. For...

Background: Tinnitus can be influenced by changes in somatosensory afference from the cervical spine or temporomandibular area, then called somatosensory or somatic tinnitus (ST). In 2018, a new set of diagnostic criteria for ST was agreed upon by a large group of ST experts. Currently, however, it still requires extensive and specific expertise t...

Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing suc...

The comprehension of business process models is crucial for enterprises. Prior research has shown that children as well as adolescents perceive and interpret graphical representations in a different manner compared to grown-ups. To evaluate this, observations in the context of business process models are presented in this paper obtained from a stud...

Current evidence on efficacy of hearing aids (HAs) on tinnitus perception and annoyance is considered insufficient due to the heterogeneity of tinnitus characteristics and of methods used in the relevant clinical studies. This is a scoping review focused on the methodological aspects of clinical studies evaluating the value of HA fitting as part of...

Tinnitus disability is a heterogeneous and complex condition, affecting more than 10% and compromising the quality of life of 2% of the population, with multiple contributors, often unknown, and enigmatic pathophysiology. The available treatment options are unsatisfactory, as they can, at best, reduce tinnitus severity, but not eliminate its percep...

More research, including a randomized controlled trial, is needed to further investigate the the combined treatment and gain better understanding of the treatment mechanisms.

Citation: Holfelder, M.; Mulansky, L.; Schlee, W.; Baumeister, H.; Schobel, J.; Greger, H.; Hoff, A.; Pryss, R. Medical Abstract: Within the healthcare environment, mobile health (mHealth) applications (apps) are becoming more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the COVID-19 pandemic h...

The original version of this chapter unfortunately contained two errors: in author name and order of author.

Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing suc...

Background Tinnitus represents a relatively common condition in the global population accompanied by various comorbidities and severe burden in many cases. Nevertheless, there is currently no general treatment or cure, presumable due to the heterogeneity of tinnitus with its wide variety of etiologies and tinnitus phenotypes. Hence, most treatment...

Within the healthcare environment, mobile health (mHealth) applications (apps) are more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the Covid-19 pandemic has led to an enormous amount of app releases. Notably, in most countries, mHealth applications have to be already compliant with several re...

Objective To investigate oscillatory brain activity changes following acoustic stimulation in tinnitus and whether these changes are associated with behavioral measures of tinnitus loudness. Moreover, differences in ongoing brain activity between individuals with and without residual inhibition (RI) are examined (responders vs. non-responders). Me...

Although a wide range of tinnitus management interventions is currently under research and a variety of therapeutic interventions have already been applied in clinical practice, no optimal and universal tinnitus treatment has been reached yet. This fact is to some extent a consequence of the high heterogeneity of the methodologies used in tinnitus...

Tinnitus is a common symptom of a phantom sound perception with a considerable socioeconomic impact. Tinnitus pathophysiology is enigmatic and its significant heterogeneity reflects a wide spectrum of clinical manifestations, severity and annoyance among tinnitus sufferers. Although several interventions have been suggested, currently there is no u...

Through lockdowns and other severe changes to daily life, almost everyone is affected by the COVID-19 pandemic. Scientists and medical doctors are - among others - mainly interested in researching, monitoring, and improving physical and mental health of the general population. Mobile health apps (mHealth), and apps conducting ecological momentary a...

This volume has highlighted the many recent advances in tinnitus theory, models, diagnostics, therapies, and therapeutics. But tinnitus knowledge is far from complete. In this chapter, contributors to the Behavioral Neuroscience of Tinnitus consider emerging topics and areas of research needed in light of recent findings. New research avenues and m...

Recent developments in Brain-Computer Interfaces (BCI)—technologies to collect brain imaging data—allow recording of Electroencephalography (EEG) data outside of a laboratory setting by means of mobile EEG systems. Brain imaging has been pivotal in understanding the neurobiological correlates of human behavior in many complex disorders. This is als...

Little is known about the trajectory of tinnitus over time. This study addressed (1) how often tinnitus remitted in patients with chronic tinnitus; (2) how subjective reported tinnitus characteristics, such as loudness, laterality, and type and measures of burden, such as tinnitus distress, depression, and quality of life, changes over time; (3) ho...

As 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 entit...

Background: Acoustic stimulation was shown to be effective in short-term suppression of tinnitus. However, tinnitus cannot be suppressed in all patients. Recent insights from mental health research suggests that personality traits may be important factors in prediction of treatment outcomes or improvement of tinnitus over time. No previous acoustic...

As 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 entit...

BACKGROUND: Tinnitus suppression following acoustic stimulation is a well-known phenomenon also termed residual inhibition (RI). Some individuals may experience prolonged RI (PRI), which can last for several hours or even days, after a single short-term acoustic stimulation. Exact mechanisms of this phenomenon are unknown and current evidence anecd...

Introduction: Tinnitus, a perception of ringing and buzzing sound in the ear, has not been completely understood yet. It is well known that tinnitus-related distress and loudness can change over time. However, proper comparability for the data collection approaches requires further focused studies. In this context, technology such as the use of mob...