Arterial Spin Labeling Cerebral Perfusion Changes in Chronic Tinnitus With Tension-Type Headache

Abstract

Purpose: Tinnitus is along with tension-type headache that will influence the cerebral blood flow (CBF) and accelerate the tinnitus severity. However, the potential associations between tension-type headache and tinnitus is still unknown. The current study will explore whether abnormal CBF exists in tinnitus patients and examine the effects of headache on CBF in tinnitus patients. Materials and Methods: Resting-state perfusion magnetic resonance imaging was performed in 40 chronic tinnitus patients and 50 healthy controls using pseudocontinuous arterial spin labeling. Regions with CBF differences between tinnitus patients and healthy controls were investigated. The effects of headache on tinnitus for CBF changes were further explored. Correlation analyses revealed the relationship between CBF values and tinnitus distress as well as CBF values and headache degree. Results: Relative to healthy controls, chronic tinnitus showed decreased CBF, mainly in right superior temporal gyrus (STG), left middle frontal gyrus (MFG), and left superior frontal gyrus (SFG); the CBF in the right STG and the left MFG was negatively correlated with THQ scores (r = -0.553, p = 0.001; r = -0.399, p = 0.017). We also observed a significant effect of headache on tinnitus for CBF in the right STG. Furthermore, the headache degree was correlated positively with tinnitus distress (r = 0.594, p = 0.020). Conclusion: Decreased CBF in auditory and prefrontal cortex was observed in chronic tinnitus patients. Headache may accelerate CBF reductions in tinnitus, which may form the basis for the neurological mechanism in chronic tinnitus with tension-type headache.

Keywords: arterial spin labeling; cerebral blood flow; functional magnetic resonance imaging; headache; tinnitus.

Figure 1

The CBF differences between the chronic tinnitus patients and controls. The tinnitus patients showed reduced CBF in right superior temporal gyrus (STG), left middle frontal gyrus (MFG) and left superior frontal gyrus (SFG) (FWE correction, p < 0.01).

Figure 2

The CBF values of the chronic tinnitus patients and non-tinnitus controls in the right STG (1.07 ± 0.17 vs. 1.16 ± 0.17), left MFG (1.02 ± 0.16 vs. 1.12 ± 0.21), right MFG (1.04 ± 0.17 vs. 1.21 ± 0.19), and left SFG (1.03 ± 0.09 vs. 1.16 ± 0.22) (p < 0.01). *means significant differences of CBF values between two groups.

Figure 3

Significant brain regions showing interaction effects on CBF between tinnitus and headache in the right STG and left MFG (FWE correction, p < 0.01).

Figure 4

The correlations between the CBF alterations and tinnitus characteristics. (A) CBF in right STG was negatively correlated with THQ scores (r = −0.553, p = 0.001); (B) CBF in right MFG was negatively correlated with THQ scores (r = −0.399, p = 0.017); (C) The HIT-6 scores were positively associated with the THQ scores (r = 0.594, p = 0.020).