Publications by authors named "Jose L Santacruz"

4 Publications

  • Page 1 of 1

Validation of a Dutch version of the Tinnitus Functional Index in a tertiary referral tinnitus clinic.

Heliyon 2021 Aug 10;7(8):e07733. Epub 2021 Aug 10.

Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.

Introduction: Tinnitus is a condition with a subjective nature that requires self-report questionnaires for its assessment. Aspects such as quality of life, sleep or intrusiveness have been addressed by multiple tinnitus questionnaires, but the high responsiveness to treatment effects of the Tinnitus Functional Index (TFI) makes this questionnaire part of the standard practice in tinnitus screening. To date, the TFI has been translated to more than 20 languages and used in more than 22 countries. In this study, the TFI was translated to Dutch and validated through a clinical population in the Netherlands.

Methods: After a back-translation procedure, the Dutch TFI was filled-out by 377 patients in the tinnitus outpatient clinic at the Ear, Nose and Throat (ENT) department of the University Medical Center Groningen, in the Netherlands. Reliability and construct validity of the questionnaire were assessed by correlations with one other tinnitus questionnaire (Tinnitus Handicap Inventory, THI) and with three psychological functioning questionnaires (Rand-36, Cantril's ladder and the Hospital Anxiety and Depression Scale (HADS)). The eight-factor structure of the Dutch TFI was tested by means of exploratory factor analysis using three different models (ICM-CFA, ESEM and ESEM-CFA).

Results: The Dutch TFI showed a high internal consistency (α = 0.95), and construct validity was proven by moderate-to high-convergent correlations with the THI (r = 0.47-0.79) and by moderate convergent (r = 0.55-0.67) and good-to moderate-divergent (r = 0.12-0.47) correlations with the psychological functioning questionnaires. The eight-factor structure of the TFI was confirmed for the Dutch version by the three models.

Conclusion: The Dutch version of the TFI is a reliable instrument for screening tinnitus impact in a clinical population, and its psychometric properties are comparable to the original TFI and other validated tinnitus questionnaires.
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August 2021

Investigating the relation between minimum masking levels and hearing thresholds for tinnitus subtyping.

Prog Brain Res 2021 20;263:81-94. Epub 2021 May 20.

Department of Otorhinolaryngology/Head and Neck Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; Graduate School of Medical Sciences (Research School of Behavioral and Cognitive Neurosciences), University of Groningen, Groningen, Netherlands.

Heterogeneity of tinnitus imposes a challenge for its treatment. Identifying tinnitus subtypes might help to establish individualized diagnosis and therapies. The minimum masking level (MML) is a clinical tool defined as the minimum intensity of a masking sound required to cover tinnitus. Understanding the differences among masking patterns in patients could facilitate the task of subtyping tinnitus. Here, we studied the variability of hearing thresholds and MMLs among patients with tinnitus to identify tinnitus subgroups. A population of 366 consecutive patients from a specialized tinnitus clinic were included in the analysis. Hearing thresholds and MMLs were determined for octave frequencies from 0.25 to 8kHz, as well as for 3 and 6kHz. Subjects were divided into two groups according to whether their tinnitus was maskable (M, 329 subjects) or non-maskable (NM, 37 subjects). Hearing thresholds and tinnitus loudness did not differ significantly between both groups. The dimensionality of the data was reduced by means of principal component analysis (PCA), and the largest resulting components were used for clustering the data. The cluster analysis resulted in five clusters with differences in tinnitus pitch, lateralization, hearing thresholds and MML, as well as on age and gender. Clusters differed in contours of hearing thresholds and MML, describing patterns of low or high thresholds in combination with low or high MML. The clustering solution presented a low silhouette value (0.45), implying that the clustering is weak and could be artificial. The analysis pointed out the diversity across tinnitus patients. Our results suggest that there might be a continuum of patients' characteristics rather than discrete subgroups.
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May 2021

Extracting human cortical responses to sound onsets and acoustic feature changes in real music, and their relation to event rate.

Brain Res 2021 03 6;1754:147248. Epub 2021 Jan 6.

Center for Music in the Brain, Department of Clinical Medicine, Aarhus University & The Royal Academy of Music, Aarhus/Aalborg, Denmark; Department of Education, Psychology, Communication, University of Bari Aldo Moro, Italy. Electronic address:

Evoked cortical responses (ERs) have mainly been studied in controlled experiments using simplified stimuli. Though, an outstanding question is how the human cortex responds to the complex stimuli encountered in realistic situations. Few electroencephalography (EEG) studies have used Music Information Retrieval (MIR) tools to extract cortical P1/N1/P2 to acoustical changes in real music. However, less than ten events per music piece could be detected leading to ERs due to limitations in automatic detection of sound onsets. Also, the factors influencing a successful extraction of the ERs have not been identified. Finally, previous studies did not localize the sources of the cortical generators. This study is based on an EEG/MEG dataset from 48 healthy normal hearing participants listening to three real music pieces. Acoustic features were computed from the audio signal of the music with the MIR Toolbox. To overcome limits in automatic methods, sound onsets were also manually detected. The chance of obtaining detectable ERs based on ten randomly picked onset points was less than 1:10,000. For the first time, we show that naturalistic P1/N1/P2 ERs can be reliably measured across 100 manually identified sound onsets, substantially improving the signal-to-noise level compared to <10 trials. More ERs were measurable in musical sections with slow event rates (0.2 Hz-2.5 Hz) than with fast event rates (>2.5 Hz). Furthermore, during monophonic sections of the music only P1/P2 were measurable, and during polyphonic sections only N1. Finally, MEG source analysis revealed that naturalistic P2 is located in core areas of the auditory cortex.
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March 2021

Standardised profiling for tinnitus research: The European School for Interdisciplinary Tinnitus Research Screening Questionnaire (ESIT-SQ).

Hear Res 2019 06 2;377:353-359. Epub 2019 Mar 2.

NIHR Nottingham Biomedical Research Centre, 113 The Ropewalk, Nottingham, NG1 5DU, UK; Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Building 40 University Park, Nottingham, NG7 2RD, UK; Nottingham University Hospitals NHS Trust, Queens Medical Centre, Derby Road, Nottingham, NG7 2UH, UK; University of Nottingham Malaysia, Jalan Broga, 43500, Semeniyh, Selangor Darul Ehsan, Malaysia.

Background: The heterogeneity of tinnitus is substantial. Its numerous pathophysiological mechanisms and clinical manifestations have hampered fundamental and treatment research significantly. A decade ago, the Tinnitus Research Initiative introduced the Tinnitus Sample Case History Questionnaire, a case history instrument for standardised collection of information about the characteristics of the tinnitus patient. Since then, a number of studies have been published which characterise individuals and groups using data collected with this questionnaire. However, its use has been restricted to a clinical setting and to the evaluation of people with tinnitus only. In addition, it is limited in the ability to capture relevant comorbidities and evaluate their temporal relationship with tinnitus.

Method: Here we present a new case history instrument which is comprehensive in scope and can be answered by people with and without tinnitus alike. This 'European School for Interdisciplinary Tinnitus Research Screening Questionnaire' (ESIT-SQ) was developed with specific attention to questions about potential risk factors for tinnitus (including demographics, lifestyle, general medical and otological histories), and tinnitus characteristics (including perceptual characteristics, modulating factors, and associations with co-existing conditions). It was first developed in English, then translated into Dutch, German, Italian, Polish, Spanish, and Swedish, thus having broad applicability and supporting international collaboration.

Conclusions: With respect to better understanding tinnitus profiles, we anticipate the ESIT-SQ to be a starting point for comprehensive multi-variate analyses of tinnitus. Data collected with the ESIT-SQ can allow establishment of patterns that distinguish tinnitus from non-tinnitus, and definition of common sets of tinnitus characteristics which might be indicated by the presence of otological or comorbid systemic diseases for which tinnitus is a known symptom.
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June 2019