Hanne Vermeersch’s research while affiliated with University of Antwerp and other places

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Publications (5)


Contralateral hearing aid use in adult cochlear implant recipients: retrospective analysis of auditory outcomes
  • Article

May 2023

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31 Reads

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3 Citations

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Charis Clement

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Objective: To investigate retrospectively the frequency of usage of bimodal stimulation among cochlear implant (CI) users, as well its clinical benefit relative to unilateral use. Design: All subjects had been monitored with the clinical Minimal Outcome Measurements test battery. Study samples: 103 adults with bilateral postlingual profound sensorineural hearing loss and unilateral CI use were extracted from the local database. These were divided into two groups: those who only used a CI and those who used bimodal stimulation. Results: The preoperative contralateral residual hearing in the bimodal group was significantly better than that of the CI-only group. In both groups, speech perception in quiet and in noise improved after CI, with no significant difference between postoperative unimodal conditions. For the bimodal group, an additional significant improvement was found for the bimodal condition compared to the unimodal. Conclusion: Given the observed auditory benefit of bimodal stimulation in comparison to unimodal stimulation and given the finding that degree of residual hearing is not correlated with bimodal benefits, it is recommended to encourage CI recipients to continue contralateral HA use after CI. As a result of expanding CI criteria worldwide, the population of bimodal users is expected to grow in the near future.


Figure 1 Consort flow diagram. Trial profile of 101 patients who were screened for eligibility. A total of 77 participants completed the study.
Figure 2 Evolution of TFI scores from baseline to follow-up. (A) In both active and sham HD-tDCS groups, TFI scores decreased significantly from baseline to follow-up (paired t-test for all participants: P = 0.0012). (B) ΔTFI scores, i.e. the difference in TFI scores from baseline to follow-up, did not differ significantly between active and sham HD-tDCS groups (linear regression model: P = 0.86).
Figure 3 Evolution of matched loudness from baseline to follow-up. (A) Only in the active treatment group, matched loudness levels decreased from baseline to follow-up. (B) Δ matched loudness levels, i.e. the difference in matched loudness from baseline to follow-up, differed significantly between active and sham HD-tDCS groups (linear regression model: P corr = 0.11). Matched loudness levels are presented in dB sensation level (dB SL).
Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial
  • Article
  • Full-text available

December 2022

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124 Reads

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8 Citations

Brain

Transcranial direct current stimulation (tDCS) has been proposed as a potential intervention for subjective tinnitus, but supporting evidence remains limited. We aimed to investigate the effect of anodal high-definition tDCS of the left temporal area and right dorsolateral prefrontal cortex on tinnitus severity. This double-blind randomized controlled trial included 77 patients (age range 18–79, 43 male) with chronic subjective tinnitus as their primary complaint. Thirty-eight subjects received six consecutive sessions of dual-site sequential high-definition-tDCS with electrodes positioned over the left temporal area and right dorsolateral prefrontal cortex. Both areas were stimulated for 15 min per session, with total stimulation time amounting to 30 min. Thirty-nine subjects received sham stimulation. The primary outcome measure was the change in tinnitus severity, as evaluated by the Tinnitus Functional Index, from baseline to a follow-up visit at 8 ± 2 weeks after treatment completion. Secondary outcomes included changes in perceived tinnitus loudness, as measured with a visual analogue scale and a tinnitus matching procedure, as well as scores on the Hospital Anxiety and Depression Scale, and the Hyperacusis Questionnaire. No differences in Tinnitus Functional Index change scores were identified between the active treatment and sham control groups (linear regression: P = 0.86). The Tinnitus Functional Index scores decreased significantly over time in both groups (P = 0.0012), indicating the presence of a considerable placebo effect. These change scores were significantly influenced by sex (linear regression: P = 0.037) and baseline symptoms of anxiety (linear regression: P = 0.049) in both groups. In general, Tinnitus Functional Index scores decreased more profoundly in males and in subjects with a higher degree of anxiety at baseline. None of the included secondary measures differed significantly between experimental arms. Our results suggest that dual-site sequential high-definition-tDCS of the left temporal area and right dorsolateral prefrontal cortex does not alleviate tinnitus severity. Interestingly, in our study population, fluctuations in tinnitus severity were influenced by gender and concurrent mental condition. It is therefore important to take these factors into account when conducting or planning randomized controlled trials in tinnitus populations.

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Schematic presentation of the trial course
A Change after traction modulation in loudness of the presented sound. B Change after traction modulation in intrusiveness of the presented sound
Change after isometric lateroflexion right modulation in intrusiveness of the presented sound
Change after isometric extension modulation in intrusiveness of the presented sound
VAS results intrusiveness of the presented sound at baseline (BL) and after each modulation for patient 13
Pilot study on the role of somatic modulation in hyperacusis

October 2022

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105 Reads

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1 Citation

European Archives of Oto-Rhino-Laryngology

Background Hyperacusis is a reduced tolerance to sounds that often co-occurs with tinnitus. Both symptoms have convergent as well as divergent characteristics. Somatic modulation, changes in pitch or loudness during certain movements, is common in patients with a primary complaint of tinnitus. However, thus far, this is not documented in patients with hyperacusis. Objectives This study aimed to examine the influence of somatic manoeuvres on the perception of external sounds in patients with a primary complaint of hyperacusis. Methodology In this prospective cross-sectional pilot study, 18 patients with a primary complaint of hyperacusis were recruited at the Tinnitus Treatment and Research Center Antwerp (TINTRA). While patients listened to a 1 kHz broadband noise of 30 dB sensation level, six neck manoeuvres (flexion, extension, lateroflexion left/right, traction and compression), three jaw manoeuvres (protrusion, laterotrusion left/right) and one placebo manoeuvre (hand on head) were performed. The primary outcome measure was the change in the perception of the presented sound in terms of loudness and intrusiveness between baseline and each modulation measured by a visual analogue scale (VAS). Results No overall significant changes were found; however, individual results indicated that five patients presented a clinically relevant change of more than three points out of ten on VAS in terms of hyperacusis after at least one of the executed somatic manoeuvres. Conclusions This pilot study did not demonstrate an overall significant change in hyperacusis after somatic manoeuvres but does not rule out the possibility of somatic modulation in some hyperacusis patients. Trial registration: The protocol of this prospective cross-sectional pilot study was registered on clinicaltrials.gov with registration number NCT04693819.


Consort flow diagram for patients’ enrollment and data analysis.
Effect of treatment on primary and secondary outcome measures.
Effectiveness of bimodal auditory and electrical stimulation in patients with tinnitus: A feasibility study

August 2022

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313 Reads

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10 Citations

Background Tinnitus is a common symptom, affecting about 10–15% of the adult population. When input from the somatosensory system can influence and/or elicit tinnitus, this type of subjective tinnitus is called somatosensory tinnitus. Recently, a new type of bimodal neurostimulation treatment has shown promising results for a specific subgroup within the somatosensory tinnitus population. It is, however, not clear if this bimodal stimulation is also effective in patients with other types of subjective tinnitus. Aim The aim of this study was to evaluate the feasibility and efficacy of non-invasive bimodal auditory-somatosensory stimulation in reducing tinnitus severity among a general population of people with subjective tinnitus. Methods Chronic subjective tinnitus patients were recruited from the ENT department of the Antwerp University Hospital. Somatosensory stimulation was delivered by Transcutaneous Electrical Nerve Stimulation (TENS), and it was combined with auditory stimulation via headphones. The therapy comprised six sessions of thirty minutes twice a week for a period of 3 consecutive weeks. Follow up measurements were scheduled 9–12 weeks after the last treatment session. The change of the Tinnitus Functional Index (TFI) score, a questionnaire evaluating tinnitus burden and effects on the quality of life, was the primary outcome measure. Results Twenty-nine patients were enrolled in the study. A linear mixed-effects model was used to analyze the efficacy of bimodal treatment. The results of this analysis showed a statistically significant decrease (by 6, 9 points) in average TFI score at the follow up visit when compared to baseline. The ability to modulate tinnitus did not have an influence on the treatment results. Conclusion Our study showed that bimodal stimulation is a feasible and safe method of tinnitus treatment. The method might be an effective treatment for some participants with tinnitus, especially those who have accompanying neck/temporomandibular problems, although, the evidence from this trial is quite weak. Additional research is needed toward establishing the optimal treatment protocol, as well as selecting the most appropriate inclusion criteria.


Study flowchart. TFI, Tinnitus Functional Index; ST, somatic tinnitus; FUV, follow-up visit; uMARS, user version of Mobile Application Rating Scale
Schedule of enrolment, interventions and assessments in accordance with the SPIRIT 2013 guidelines
Cost-effectiveness of a smartphone Application for Tinnitus Treatment (the CATT trial): a study protocol of a randomised controlled trial

May 2022

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164 Reads

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3 Citations

Trials

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 perform home exercises correctly, and the necessary tinnitus counselling is often lacking. The aim of this study is twofold, namely to investigate both the effectiveness and cost-effectiveness of a blended physiotherapy program for ST, including a smartphone application designed to increase exercise therapy compliance and provide tinnitus counselling. Methods This study is designed as a single-blind two-arm 1:1 randomised controlled trial (RCT). Adult patients diagnosed with ST, without psychiatric comorbidities and with experience in using a smartphone, will be recruited at the Ear Nose Throat (ENT) department of the Antwerp University Hospital (UZA). Patients will be randomised into two groups. The experimental group will receive the blended physiotherapy program comprising six in-clinic physiotherapy sessions over a period of 12 weeks (1x/2 weeks) and an exercise and counselling program provided by the smartphone application. The control group will receive the standard care program comprising twelve weekly in-clinic physiotherapy sessions. Each physiotherapy session has a duration of 30 min. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Additionally, a cost-effectiveness analysis will be performed from a societal perspective considering both direct and indirect costs. There will be follow-up assessments at one and 3 months after the final treatment session. Discussion Our study is the first to combine both tinnitus counselling and neck/jaw treatment provided by a digital application in a blended physiotherapy program. This, in order to empower ST patients to improve and better manage their own health and, possibly, reduce economic costs by alleviating the tinnitus burden that ST patients experience. The strengths of the planned RCT are the high-quality methodological design, the large sample size and the expertise of the involved multidisciplinary research team. Trial registration Clinicaltrials.gov NCT05245318. Registered on 26 January 2022.

Citations (5)


... The free-field test is repeated after a minimum of two weeks. The speech intelligibility benefit is expressed as the difference in the percentage of correctly repeated words in the presence of a hearing aid and without a hearing aid [28]. ...

Reference:

Combining MUSHRA Test and Fuzzy Logic in the Evaluation of Benefits of Using Hearing Prostheses
Contralateral hearing aid use in adult cochlear implant recipients: retrospective analysis of auditory outcomes
  • Citing Article
  • May 2023

... Most studies recruited participants with chronic tinnitus; however, the definition of chronic tinnitus differed from, for example, tinnitus as lasting 3 months or over' [43,44,46], to 6 months or over' [29,33,[35][36][37]45,47,50], 1 year or over' [28,40,48,49], and more than 2 years' [32,41,51]. One study did not specify the minimum duration for chronic tinnitus [30]. ...

Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial

Brain

... Recent advancements have introduced new therapeutic approaches that show promise in controlling CST. Neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcutaneous electrical nerve stimulation (TENS), attempt to alter brain activity and lessen tinnitus perception [23]. Newer regenerative therapeutic approaches, including stem cell treatment and platelet-rich plasma (PRP) injections, are being explored for their potential to repair and regenerate damaged cervical spine tissues, potentially reducing CST symptoms. ...

Effectiveness of bimodal auditory and electrical stimulation in patients with tinnitus: A feasibility study

... Tinnitus, commonly described as a ringing, hissing, sizzling, humming, whistling, wind blowing, or buzzing in the ears without external sound, affects a significant portion, i.e. about 10% to 15% of the general population, and can rise as high as 18% in industrialized areas, leading to various degrees of discomfort and disability. [1,2] The etiology is multifactorial, with auditory and nonauditory systems playing a role in its perception and impact. [3] Further, the most common classification of tinnitus is subjective or objective tinnitus based on whether other people can perceive it. ...

Cost-effectiveness of a smartphone Application for Tinnitus Treatment (the CATT trial): a study protocol of a randomised controlled trial

Trials