Music Combined with Cognitive Behavioral Therapy Enhanced Functional Integration within the Frontal-Parietal-Temporal Brain Network in Patients with Chronic Subjective Tinnitus.

BACKGROUND

This study was aimed at investigating the effectiveness of music combined with cognitive behavioral therapy (music-CBT) and its underlying therapeutic mechanisms in treating chronic subjective tinnitus.

METHODS

Twenty-seven participants with chronic subjective tinnitus who underwent a 3-month music-CBT were initially involved in this retrospective study. The resting-state electroencephalograms (EEG) and behavioral assessments of pre- and post-music-CBT, including tinnitus handicap inventory (THI), tinnitus functional index (TFI), visual analog scales (VAS), Pittsburgh sleep quality index (PSQI), and Hamilton depression rating scale (HAMD-24) were collected and analyzed.

RESULTS

Following music-CBT, there was a significant reduction in global behavioral assessment scores, with median changes of ΔTHI = 26.0 (p < 0.001), ΔTFI = 23.7 (p < 0.001), ΔVAS = 2.0 (p < 0.001), ΔPSQI = 2.0 (p = 0.002), and ΔHAMD-24 = 2.0 (p < 0.001). Enhanced functional connectivity was seen among the frontal, parietal, and temporal cortices and significantly decreased characteristic path length (ΔCPL in delta = 0.016, p = 0.031; ΔCPL in theta = 0.012, p = 0.013), increased global efficiency (ΔGE in delta = -0.014, p = 0.037; ΔGE in theta = -0.006, p = 0.021), and local efficiency (ΔLE in delta = -0.015, p = 0.037; ΔLE in theta = -0.012, p = 0.015) were also noted. Additionally, associations were identified between ΔPSQI and ΔTHI (rho = 0.546, p = 0.003) and ΔTFI (rho = 0.462, p = 0.015); between ΔHAMD-24 and ΔCPL (rho = -0.389, p = 0.045), ΔGE (rho = 0.395, p = 0.041), and ΔLE (rho = 0.405, p = 0.036).

CONCLUSION

Optimized cognitive and emotional responses to tinnitus are linked to functional integration within the frontal-parietal-temporal brain network. Early node indicators for tinnitus relief may be the precuneus, middle frontal gyrus, middle temporal gyrus, and the right inferior parietal lobule.