Could Tinnitus Have a Genetic Predisposition?

[Gl0w0ut]

I have sometimes seen the idea that tinnitus has a genetic basis for development in some of the papers I have breezed over.

Both of my parents have tinnitus (my mother has two forms, regular and pulsate) and since I was a baby I was prone to common ear infections. While I have not uncovered any twin studies (the common research method for determining whether a disease has a genetic basis or not) on the matter. Twin studies are effective (usually in the case of monozygotic or single egg twins) in determining this because if one monozygotic twin has one disorder and the other one has the same disorder in, say, 68% of the cases, then it strongly suggests a genetic basis for that disorder and its heritability.

In regards to tinnitus, the comorbidity of tinnitus and depress is about twice as high compared to the general population. Neuroimaging studies have shown that those with tinnitus has grey matter (neuron reduction) in areas of the brain's limbic system (the emotion center of the frontal lobe) have some reduction. Those with tinnitus tend to have a smaller left hippocampus (among other areas), but this same thing is observed in those with major depression, anxiety disorders, PTSD, and so forth.

Josef Raushecker's 2010 study that showed a massive loss in tissue volume in the ventral-medial-prefrontal cortex (vmPFC) was believed to be related to the failure of certain thalamic areas (specifically the MGN and TRN) to suppress a tinnitus signal from reaching consciousness. This led to a "gate keeping" theory of tinnitus pathology and formation, and drew more attention to the role of the limbic system in tinnitus. While I disagree with Rauschecker that the limbic system plays a primary role in tinnitus development, I think it does have effect on personal affect (emotional state) and coping ability. I refute his idea of the limbic system and thalamus "gate keeper" on the basis that antidepressants that boost serotonin fail to restore this alleged "gate keeper" mechanism. A study from last year even suggested serotonin could worsen tinnitus by further agonizing hyperactivity in the dorsal cochlear nucleus (DCN).

So where does this fit into my post? Those who have under-active limbic systems (or overactive, as the amygdala [a brain region associated with fear and fight or flight responses] is hyperactive in depression and stays that way after the depression subsides), or genetic predisposition to such phenomenons such as under-active serotonin, dopamine, and norepinephrine production may have less down regulation of these feelings of dread. Some people with short alleles of the serotonin transporter gene are more at risk for depression and anxiety. People with less stable basilar membranes (the inner ear cochlear structure that displaces itself to generate action potentials, converting sound from mechanical sound waves into neurological energy to be read) may be more prone to losing their hearing and have less resilient hair cells.

All of these neurobiological factors are complicated to combine together. In some sense it creates a "chicken vs. egg" scenario. Do dysfunctional changes in the brain's limbic system come before or after tinnitus onset? Does being more neurotic lead to the development of tinnitus more often if people are more depressed, anxious, and demonstrate cognitive biases that direct their attention primarily towards negative things (as mine does from what you all have seen)?

Is there a genetic bases for tinnitus? It can obviously happen to anyone, but why do some get it with hearing loss while others can go deaf without it developing?

What do you guys think?

 

[Ed209]

I have sometimes seen the idea that tinnitus has a genetic basis for development in some of the papers I have breezed over.

Both of my parents have tinnitus (my mother has two forms, regular and pulsate) and since I was a baby I was prone to common ear infections. While I have not uncovered any twin studies (the common research method for determining whether a disease has a genetic basis or not) on the matter. Twin studies are effective (usually in the case of monozygotic or single egg twins) in determining this because if one monozygotic twin has one disorder and the other one has the same disorder in, say, 68% of the cases, then it strongly suggests a genetic basis for that disorder and its heritability.

In regards to tinnitus, the comorbidity of tinnitus and depress is about twice as high compared to the general population. Neuroimaging studies have shown that those with tinnitus has grey matter (neuron reduction) in areas of the brain's limbic system (the emotion center of the frontal lobe) have some reduction. Those with tinnitus tend to have a smaller left hippocampus (among other areas), but this same thing is observed in those with major depression, anxiety disorders, PTSD, and so forth.

Josef Raushecker's 2010 study that showed a massive loss in tissue volume in the ventral-medial-prefrontal cortex (vmPFC) was believed to be related to the failure of certain thalamic areas (specifically the MGN and TRN) to suppress a tinnitus signal from reaching consciousness. This led to a "gate keeping" theory of tinnitus pathology and formation, and drew more attention to the role of the limbic system in tinnitus. While I disagree with Rauschecker that the limbic system plays a primary role in tinnitus development, I think it does have effect on personal affect (emotional state) and coping ability. I refute his idea of the limbic system and thalamus "gate keeper" on the basis that antidepressants that boost serotonin fail to restore this alleged "gate keeper" mechanism. A study from last year even suggested serotonin could worsen tinnitus by further agonizing hyperactivity in the dorsal cochlear nucleus (DCN).

So where does this fit into my post? Those who have under-active limbic systems (or overactive, as the amygdala [a brain region associated with fear and fight or flight responses] is hyperactive in depression and stays that way after the depression subsides), or genetic predisposition to such phenomenons such as under-active serotonin, dopamine, and norepinephrine production may have less down regulation of these feelings of dread. Some people with short alleles of the serotonin transporter gene are more at risk for depression and anxiety. People with less stable basilar membranes (the inner ear cochlear structure that displaces itself to generate action potentials, converting sound from mechanical sound waves into neurological energy to be read) may be more prone to losing their hearing and have less resilient hair cells.

All of these neurobiological factors are complicated to combine together. In some sense it creates a "chicken vs. egg" scenario. Do dysfunctional changes in the brain's limbic system come before or after tinnitus onset? Does being more neurotic lead to the development of tinnitus more often if people are more depressed, anxious, and demonstrate cognitive biases that direct their attention primarily towards negative things (as mine does from what you all have seen)?

Is there a genetic bases for tinnitus? It can obviously happen to anyone, but why do some get it with hearing loss while others can go deaf without it developing?

What do you guys think?

I think you need to stop researching tinnitus and focus on other things. Your brain is like a spotlight. Everytime you think about tinnitus or read about it, it highlights yours because you are attaching significance to it. Your amygdala will associate all the negative emotions you feel towards it which will only intensify it. It's a vicious loop.

 

[Tempest]

I had many ear infections when I was young and I also recently learn my aunt had tinnitus for a short while (due stress after a family member died). So I wouldn't be surprised if it has to do with genetics.

 

[Gl0w0ut]

I think you need to stop researching tinnitus and focus on other things. Your brain is like a spotlight. Everytime you think about tinnitus or read about it, it highlights yours because you are attaching significance to it. Your amygdala will associate all the negative emotions you feel towards it which will only intensify it. It's a vicious loop.

I mean, until we have meaningful treatment for the tinnitus and the hearing loss I'm not going to stop looking. I don't deny its depressing to read about, but if I'm to research it myself some day I must be familiar with the literature. Also, being familiar with it helps with getting into a graduate program.

 

[Ed209]

I mean, until we have meaningful treatment for the tinnitus and the hearing loss I'm not going to stop looking. I don't deny its depressing to read about, but if I'm to research it myself some day I must be familiar with the literature. Also, being familiar with it helps with getting into a graduate program.

I spent a year or more researching it. I think for most people it's part of the natural recovery curve. At some point you realise that nothing can be done (at the moment), and realise that reading about it daily doesn't help at all. In fact, it does the total opposite. I was told this by someone on here around 2 and half years ago, and they were right. I didn't listen though; I still spent all my time obsessively sifting through a load of research papers. And I know you will do exactly the same. I'm just trying to save you time on the recovery curve because it really is worth skipping this part out. Maybe it's just something we need to get out of our system before we really can move on. Who knows?

 

[GregCA]

I spent a year or more researching it. I think for most people it's part of the natural recovery curve. At some point you realise that nothing can be done (at the moment), and realise that reading about it daily doesn't help at all. In fact, it does the total opposite. I was told this by someone on here around 2 and half years ago, and they were right. I didn't listen though; I still spent all my time obsessively sifting through a load of research papers. And I know you will do exactly the same. I'm just trying to save you time on the recovery curve because it really is worth skipping this part out. Maybe it's just something we need to get out of our system before we really can move on. Who knows?

I have an opposite approach to this and encourage people to learn as much as they can about the condition, available treatments, and how it relates to their own case.
In my case, if I hadn't researched it and pushed the doctors for 6th opinions (I'm not joking on the number 6), I would perhaps be in a much worse shape as I am today (and that says something!). It took half a dozen doctors to find one who would see something abnormal on a CT, and he was right. All the other ones told me there was nothing wrong, that it was all normal, and sent me my merry way home without any actionable item. It takes a special kind of stubbornness to tell 5 doctors "yeah thanks for your work and I know you're all agreeing, but let me ask another guy".

It was also my own research that helped me assess the risk vs reward in stapedotomies. I felt much more in control about my own destiny because I had information in my hands. Doctors tend to gloss over this data because there's just too much data out there to fit in a consultation slot.

I'd say that if you're the hypochondriac kind who will not have an analytic approach to swallowing data, perhaps "ignorance is bliss", but there are other kinds of people who can benefit from learning a lot about their condition. It's their lives, and nobody will have as much incentive as they do to learn everything they can as it relates to themselves. Then they can be part of the diagnosis and part of the treatment: I have participated in discussions with my surgeon and he always gave me props for coming in informed at the appointments and we worked together to craft a treatment for me. He doesn't have the time (and probably motivation) to do all that research for me, but he does have the time to review my findings with me and help me figure out if that approach makes sense or not. That's one way I've found that I can leverage my motivation with his knowledge so that we can be a team that works optimally towards my goals.

As usual, YMMV!

 

[Ed209]

I have an opposite approach to this and encourage people to learn as much as they can about the condition, available treatments, and how it relates to their own case.
In my case, if I hadn't researched it and pushed the doctors for 6th opinions (I'm not joking on the number 6), I would perhaps be in a much worse shape as I am today (and that says something!). It took half a dozen doctors to find one who would see something abnormal on a CT, and he was right. All the other ones told me there was nothing wrong, that it was all normal, and sent me my merry way home without any actionable item. It takes a special kind of stubbornness to tell 5 doctors "yeah thanks for your work and I know you're all agreeing, but let me ask another guy".

It was also my own research that helped me assess the risk vs reward in stapedotomies. I felt much more in control about my own destiny because I had information in my hands. Doctors tend to gloss over this data because there's just too much data out there to fit in a consultation slot.

I'd say that if you're the hypochondriac kind who will not have an analytic approach to swallowing data, perhaps "ignorance is bliss", but there are other kinds of people who can benefit from learning a lot about their condition. It's their lives, and nobody will have as much incentive as they do to learn everything they can as it relates to themselves. Then they can be part of the diagnosis and part of the treatment: I have participated in discussions with my surgeon and he always gave me props for coming in informed at the appointments and we worked together to craft a treatment for me. He doesn't have the time (and probably motivation) to do all that research for me, but he does have the time to review my findings with me and help me figure out if that approach makes sense or not. That's one way I've found that I can leverage my motivation with his knowledge so that we can be a team that works optimally towards my goals.

As usual, YMMV!

There's benefits for sure. Knowledge is power, but there's still nothing you can know that helps in any objective way. In my opinion. It just keeps your life fixated on a condition that's had no forward leap in decades. Also, I'm noting the detrimental effect that Gl0w0uts research is already having on him. I seriously think he needs to take a step back and take a break from all tinnitus related activity.

 

[GregCA]

Knowledge is power, but there's still nothing you can know that helps in any objective way.

It depends what you are suffering from. My knowledge did help me in very objective ways: I credit it for taking away my hyperacusis, half of my severe hearing loss, and to have somewhat arrested the progress of the sensorineural losses brought on by my degenerative condition.
Also I find that I get anxiety from people who tell me to stay away from information.
To each his own.

 

[Ed209]

It depends what you are suffering from. My knowledge did help me in very objective ways: I credit it for taking away my hyperacusis, half of my severe hearing loss, and to have somewhat arrested the progress of the sensorineural losses brought on by my degenerative condition.
Also I find that I get anxiety from people who tell me to stay away from information.
To each his own.

There are good valid reasons to have extensive knowledge of a condition you suffer with. I'm glad that I know what I know, but in hindsight (in my case), I believe that it prolonged my progress. For T that's sensorineural - which is the majority of us - there's nothing really significant that one can learn, other than to stay away from loud noise, and to try and avoid certain doses of ototoxic drugs. Recovery-wise, nothing is clinically proven. For example: LLLT, stem cell implantation, TMS, ACRN, Vagus nerve stimulation, notched music therapy, and the many trialled drugs have no real clinical significance. There are many other devices which are sold that are equally disappointing. Possibly the only decent news is Susan Shores device, but even that will only provide temporary relief if it works.

On the other hand, if one has tinnitus caused by problems such as: otosclerosis, a vascular issue, an acoustic neuroma, a cholesteatoma, compacted ear wax, ETD, TMD, TTTS, Ménière's disease, a neck problem, or stress, etc, then it's possible the tinnitus can be reduced or eliminated.

It's best to get thoroughly assessed by an ENT to see if a cause can be found. If not, then there's only so much knowledge you can acquire before it seems to turn into a lifelong obsession. And with a condition like tinnitus my belief is that it's better to cut the cord sooner rather than later. If a real breakthrough is made then we'll all hear about it in the media anyway. Obviously, that's just my opinion which can be debated.

 

[Lurius]

So, basically, my mom has had tinnitus for 15 years. This used to scare the beejesus out of me, but not so much anymore. I thought that because she has had it for "forever", I'm genetically disposed to experience the same thing now that I also got tinnitus and I was totally depressed over this "fact".

I've since changed my mind about this. However, through this forum and many other places, I've befriended a lot of people with tinnitus and I've found that some of them also have parents with tinnitus. So it can't be totally unrelated either. How much does biology really matter when it comes to tinnitus? Can you inherit "tinnitus-genes?" Or is it just random, bad luck? If anyone has any idea about this, I would love to hear more about it.

 

[KMc24]

Before my mother passed away from cancer at 74 years old she told me she could hear ringing at night in silence. I suspect the drugs for treating her cancer that were causing it. My dad, on the hand, worked in a factory for 40 years, and used a chainsaw frequently without any ear protection whatsoever. He had some hearing loss, and not an ounce of tinnitus. There's no rhyme or reason to it. Mine was brought on by a number of things, but high frequency hearing loss is the main culprit. I do believe that there may potentially be a genetic component involved.

My mother's sister also reports some tinnitus.