耳鸣分型与个体化治疗。

IF 2.8 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Su Jin Kim, Seung-Ho Shin, Sung Wan Byun, Ho Yun Lee
{"title":"耳鸣分型与个体化治疗。","authors":"Su Jin Kim, Seung-Ho Shin, Sung Wan Byun, Ho Yun Lee","doi":"10.3349/ymj.2025.0088","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to identify distinct tinnitus subtypes and determine optimal treatment approaches based on comprehensive audiometric and psychometric assessments.</p><p><strong>Materials and methods: </strong>Cluster analysis was performed on data from 311 tinnitus patients. Assessments included pure tone average (PTA), uncomfortable loudness levels, Tinnitus Handicap Inventory (THI), visual analog scales for subjective symptoms, Beck Depression Inventory (BDI), and Beck Anxiety Inventory. K-means clustering identified three distinct tinnitus subtypes. Multiple regression analyses were conducted to identify predictors of treatment response.</p><p><strong>Results: </strong>Three distinct subtypes were identified: Cluster 1 (41.8%, n=130): severe tinnitus with normal hearing (THI=61.2±20.6, PTA_R=14.7±8.1 dB); Cluster 2 (20.9%, n=65): hearing loss-dominant tinnitus (THI=53.6±22.4, PTA_R=35.4±15.9 dB); Cluster 3 (37.3%, n=116): mild psychosomatic tinnitus (THI=30.1±18.5, PTA_R=13.8±9.1 dB). Treatment efficacy varied significantly by cluster (<i>p</i><0.01), with diuretics most effective for Cluster 1 (36.2±38.8% improvement), baclofen for Cluster 2 (41.4±39.7%), and Indenol for Cluster 3 (39.5±35.8%). Hearing aids benefited Cluster 2 (26.0±35.7%) but were detrimental in Clusters 1 and 3. Initial THI score predicted improvement in Cluster 1 (β=1.45, <i>p</i><0.001) and approached significance in Cluster 2 (β=1.67, <i>p</i>=0.081), while BDI was significant in Cluster 3 (β=-7.76, <i>p</i>=0.030).</p><p><strong>Conclusion: </strong>We confirmed tinnitus heterogeneity with three distinct subtypes showing differential treatment responses. Audiometric testing provides objective criteria for patient classification and treatment selection. A precision medicine approach with cluster-specific strategies may improve tinnitus management.</p>","PeriodicalId":23765,"journal":{"name":"Yonsei Medical Journal","volume":"66 10","pages":"685-694"},"PeriodicalIF":2.8000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479191/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tinnitus Subtyping and Personalized Treatment via Audiometric and Psychometric Clustering.\",\"authors\":\"Su Jin Kim, Seung-Ho Shin, Sung Wan Byun, Ho Yun Lee\",\"doi\":\"10.3349/ymj.2025.0088\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>We aimed to identify distinct tinnitus subtypes and determine optimal treatment approaches based on comprehensive audiometric and psychometric assessments.</p><p><strong>Materials and methods: </strong>Cluster analysis was performed on data from 311 tinnitus patients. Assessments included pure tone average (PTA), uncomfortable loudness levels, Tinnitus Handicap Inventory (THI), visual analog scales for subjective symptoms, Beck Depression Inventory (BDI), and Beck Anxiety Inventory. K-means clustering identified three distinct tinnitus subtypes. Multiple regression analyses were conducted to identify predictors of treatment response.</p><p><strong>Results: </strong>Three distinct subtypes were identified: Cluster 1 (41.8%, n=130): severe tinnitus with normal hearing (THI=61.2±20.6, PTA_R=14.7±8.1 dB); Cluster 2 (20.9%, n=65): hearing loss-dominant tinnitus (THI=53.6±22.4, PTA_R=35.4±15.9 dB); Cluster 3 (37.3%, n=116): mild psychosomatic tinnitus (THI=30.1±18.5, PTA_R=13.8±9.1 dB). Treatment efficacy varied significantly by cluster (<i>p</i><0.01), with diuretics most effective for Cluster 1 (36.2±38.8% improvement), baclofen for Cluster 2 (41.4±39.7%), and Indenol for Cluster 3 (39.5±35.8%). Hearing aids benefited Cluster 2 (26.0±35.7%) but were detrimental in Clusters 1 and 3. Initial THI score predicted improvement in Cluster 1 (β=1.45, <i>p</i><0.001) and approached significance in Cluster 2 (β=1.67, <i>p</i>=0.081), while BDI was significant in Cluster 3 (β=-7.76, <i>p</i>=0.030).</p><p><strong>Conclusion: </strong>We confirmed tinnitus heterogeneity with three distinct subtypes showing differential treatment responses. Audiometric testing provides objective criteria for patient classification and treatment selection. A precision medicine approach with cluster-specific strategies may improve tinnitus management.</p>\",\"PeriodicalId\":23765,\"journal\":{\"name\":\"Yonsei Medical Journal\",\"volume\":\"66 10\",\"pages\":\"685-694\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12479191/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Yonsei Medical Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3349/ymj.2025.0088\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Yonsei Medical Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3349/ymj.2025.0088","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

摘要

目的:我们旨在识别不同的耳鸣亚型,并根据综合听力和心理测量评估确定最佳治疗方法。材料与方法:对311例耳鸣患者资料进行聚类分析。评估包括纯音平均(PTA)、不舒服的响度水平、耳鸣障碍量表(THI)、主观症状的视觉模拟量表、贝克抑郁量表(BDI)和贝克焦虑量表。k均值聚类鉴定出三种不同的耳鸣亚型。进行多元回归分析以确定治疗反应的预测因素。结果:发现了3个不同的亚型:第1组(41.8%,n=130):听力正常的重度耳鸣(THI=61.2±20.6,PTA_R=14.7±8.1 dB);第二组(20.9%,n=65):听力损失显性耳鸣(THI=53.6±22.4,PTA_R=35.4±15.9 dB);第三组(37.3%,n=116):轻度心身耳鸣(THI=30.1±18.5,PTA_R=13.8±9.1 dB)。聚类间治疗效果差异有统计学意义(ppp=0.081),聚类3组BDI差异有统计学意义(β=-7.76, p=0.030)。结论:我们证实了耳鸣的异质性,三种不同的亚型表现出不同的治疗反应。听力测试为患者分类和治疗选择提供了客观标准。精准医疗方法与集群特异性策略可以改善耳鸣管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Tinnitus Subtyping and Personalized Treatment via Audiometric and Psychometric Clustering.

Purpose: We aimed to identify distinct tinnitus subtypes and determine optimal treatment approaches based on comprehensive audiometric and psychometric assessments.

Materials and methods: Cluster analysis was performed on data from 311 tinnitus patients. Assessments included pure tone average (PTA), uncomfortable loudness levels, Tinnitus Handicap Inventory (THI), visual analog scales for subjective symptoms, Beck Depression Inventory (BDI), and Beck Anxiety Inventory. K-means clustering identified three distinct tinnitus subtypes. Multiple regression analyses were conducted to identify predictors of treatment response.

Results: Three distinct subtypes were identified: Cluster 1 (41.8%, n=130): severe tinnitus with normal hearing (THI=61.2±20.6, PTA_R=14.7±8.1 dB); Cluster 2 (20.9%, n=65): hearing loss-dominant tinnitus (THI=53.6±22.4, PTA_R=35.4±15.9 dB); Cluster 3 (37.3%, n=116): mild psychosomatic tinnitus (THI=30.1±18.5, PTA_R=13.8±9.1 dB). Treatment efficacy varied significantly by cluster (p<0.01), with diuretics most effective for Cluster 1 (36.2±38.8% improvement), baclofen for Cluster 2 (41.4±39.7%), and Indenol for Cluster 3 (39.5±35.8%). Hearing aids benefited Cluster 2 (26.0±35.7%) but were detrimental in Clusters 1 and 3. Initial THI score predicted improvement in Cluster 1 (β=1.45, p<0.001) and approached significance in Cluster 2 (β=1.67, p=0.081), while BDI was significant in Cluster 3 (β=-7.76, p=0.030).

Conclusion: We confirmed tinnitus heterogeneity with three distinct subtypes showing differential treatment responses. Audiometric testing provides objective criteria for patient classification and treatment selection. A precision medicine approach with cluster-specific strategies may improve tinnitus management.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Yonsei Medical Journal
Yonsei Medical Journal 医学-医学:内科
CiteScore
4.50
自引率
0.00%
发文量
167
审稿时长
3 months
期刊介绍: The goal of the Yonsei Medical Journal (YMJ) is to publish high quality manuscripts dedicated to clinical or basic research. Any authors affiliated with an accredited biomedical institution may submit manuscripts of original articles, review articles, case reports, brief communications, and letters to the Editor.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信