Researchers discover new way to understand and diagnose patients experiencing ringing in the ears

While it’s especially common in older adults, tinnitus – a potentially devastating ringing in the ears – can affect people of all ages. Most often described as consistent buzzing, hissing or humming, tinnitus is usually caused by an underlying condition, like age-related hearing loss, an ear injury or heart disease and affects approximately one in five people in North America.

Because the noise an affected individual hears isn’t caused by an external sound and there are no discernible biomarkers, it’s extremely difficult for clinicians to assess, diagnose and treat tinnitus.

A new study led by Andrea Soddu may provide a clearer picture of the levels of distress tinnitus sufferers are experiencing. The Western medical physicist and an international team of collaborators have developed a new classification procedure for tinnitus patients using data acquired by electroencephalography (EEG), a technique that measures electrical activity in the brain using small electrodes placed on the scalp.

EEG is easier to use, less expensive and far more accessible than functional magnetic resonance imaging (fMRI), often considered the medical industry standard. The findings and new EEG testing procedure were published today in the journal Brain Communications.

“Tinnitus is usually the result of external damage to the ear and some sound frequencies can no longer be properly transmitted,” said Soddu, physicsprofessor and Western Institute for Neuroscience faculty member. “The brain tries to make sense of the lack of information and builds up its own interpretation and that’s why you get this constant whistling in your ear. Your brain is trying to help, but it actually makes things worse.”

The new procedure, designed by University of Pisa (Italy) postdoctoral researcher Andrea Piarulli, required two classifiers based on brain electrophysical activity that can accurately distinguish tinnitus patients from healthy controls, as well as tinnitus patients with low and high distress levels.

“The classifiers, employed in recognizing the brain pathology of tinnitus, relied on very different electrophysiological parameters from the ones used to classify distress levels. We are convinced this new procedure will be applicable for other neurological conditions like post-traumatic stress disorder (PTSD), chronic pain, and disorders of consciousness as it can accurately pinpoint distress biomarkers,” said Western graduate student and study co-author Idan Nemirovsky.

For the study, EEG recordings were acquired from 129 tinnitus patients and 142 healthy controls. The classifier for healthy controls and tinnitus patients performed with an average accuracy of 96 per cent and 94 per cent for the training and test sets, respectively. For the distress classifier, these average accuracies were 89 per cent and 84 per cent.

Author: Jeff Renaud
Date: February 01, 2023
Source: https://news.westernu.ca/2023/02/eeg-tinnitus/

Gain insight on concussion research from world-class medical experts.

This year's Community Symposium will provide new learnings on the topics of concussion markers, the use of technology to determine brain function and CTE

The afternoon also features an engaging panel discussion by those who originally brought See the Line to fruition. Learn more about the initial vision and goals of the event and how they have been achieved over the course of the last ten years.

Speakers and panelists to date include Drs. Amanda Black, Doug Fraser, Andrew Hrymak, Chris Nowinski, Andrea Soddu, Michael Strong and Jim Weese.

Registration deadline: Wednesday, August 3, 2022

For more information on See the Line, please contact This email address is being protected from spambots. You need JavaScript enabled to view it..

A bruised leg is relatively easy to diagnose and treat, and has a predictable recovery time; a wounded brain, much less so.

Now, a Western physicist-turned-neuroscientist has developed unique brain-imaging software that is helping a London, Ont., law firm strengthen the case for better support for clients with concussions.

Andrea Soddu, who is a professor of particle physics, researcher at Western’s multidisciplinary Brain & Mind Institute and principal investigator at the Western Institute of Neuroscience, has built a data tool that provides detailed information from brain scans – something that can help neurologists and radiologists know objectively whether, and in what ways, a patient’s neural networks differ from those of “normal,” non-injured patients.
Western neuroscientist Andrea Soddu

The software, called GraphICA, can help medically detect, locate and quantify damage by comparing the concussed brain’s function, structure and circuitry with those of healthy brains.

“We’re using state-of-the-art scanning research facilities and our new software to generate reports that will show abnormalities that a neurologist and radiologist can interpret to confirm a diagnosis,” said Soddu.

This represents a radical shift from the way the legal community deals with moderate brain injury now, said Christopher Collins, LLB’91, a personal injury lawyer with Siskinds The Law Firm, which has signed a contract for services with Soddu’s company, Brainet.

“Typically with a concussion, the doctors, occupational therapists and speech language pathologists, and other professionals that we work with are basing a lot of their diagnoses and prognoses on patients’ self-reported symptoms,” Collins said.

Patients frequently describe fatigue, headaches, depression and/or vision issues – some symptoms showing up or continuing long after the concussion took place – “but often there’s no objective way to assess that. It’s an invisible injury,” Collins said.

“Andrea and his team are helping us visualize the injury that’s there, showing us objectively if there’s damage.”

That can help corroborate a clinical diagnosis and – by helping the treatment team determine which specific brain systems or areas are having difficulties – can guide therapy more precisely.
lawyer Chris Collins

Notably, from a legal standpoint, that information can also bolster personal-injury claims, Collins said.

It has been used so far to scan about 40 patients on behalf of Siskinds, and to sway favourable decisions in half a dozen insurance cases so far.

“It’s made a significant impact” by taking guesswork and supposition out of the diagnostic equation, Collins said.

“It benefits the whole community, every person who has a concussion who is still having symptoms two or three months after their injury. It helps direct their treatment and it helps them improve their quality of life. And, if they aren’t going to get better, then ultimately it helps look after their long-term needs.”

The technology, which has not been tested in Canadian courts, is not used to provide medical diagnoses but to confirm them, Collins noted.

“What Andrea is doing here is definitely cutting edge. There are other groups that are doing similar things but he’s ahead of the pack.”

The technology

The GraphICA software synthesizes information from scans to assess abnormalities in three different brain sectors and systems:

• It uses information from magnetic resonance imaging (MRI) to understand the physical structure of the brain.
• It assesses, through functional MRI, how the brain is working while at rest, also called spontaneous activity as it doesn’t require the patient to do any specific tasks.
• It uses diffusion tensor imaging, which helps understand how well neuronal fibres support networks in communicating information within and between different regions of the brain.

Soddu likened these neural networks to airports that track arriving and departing planes from multiple airlines, while they also work out the logistics of flights connecting with other airport hubs.

If there’s a glitch affecting a small regional airport, a small number of flights and people will be affected. But if a major international flight hub were to go down, “this will have repercussions on the whole network.”

The same holds true for networks in the brain that manage memory, movement, hearing, balance or language, for example.

The software, fully automated, generates a report that outlines any of these structural, functional or network abnormalities. That’s then passed along to a third party and sent to a neurologist or radiologist to scrutinize, and then sent to Siskinds.

“Our report says, ‘here are the differences from a baseline case,’” Soddu said. “For us, it’s really important that we keep this neutrality, be as unbiased as possible. So we just take the data, analyze it and give it back. We don’t even want to know what the injury was; that’s not our job.”

Growing partnership

To conduct the work, Soddu founded Brainet with Demetrius Ribeiro de Paula, the company’s chief technology officer and developer of GraphICA.

Western professor Blaine Chronik, who specializes in medical physics and MRI, has been a driving force in the development of Brainet early on during the start-up phase.

Siskinds signed on in fall 2021 after more than a year of conversation.

Collins, a self-described “geek” always keen on exploring new technologies, was introduced to Soddu by a mutual professional acquaintance, David Corey, CEO of Brain Scan Diagnostics. “I don’t pretend I understand anywhere close to the level Andrea does, of course, but I know enough to get excited about it and to see the potential of it,” Collins said.

For Soddu, it’s gratifying to layer practical application onto basic research.

In the future, he hopes enough data can be collected so that artificial intelligence can help determine or confirm health issues, such as post-traumatic stress disorder, tinnitus or chronic pain.

“It’s always exciting to transition from research to applying the science and then applying the results to benefit people’s lives,” he said.

Author: Debora Van Brenk
Date: 2022/03/16
Source: https://news.westernu.ca/2022/03/neuroscientist-lawyer-partner-concussion-research/

An innovative concussion blood test developed by researchers at Western University is set to begin a pivotal clinical trial with the Food & Drug Administration in the U.S. in the coming weeks.

Leveraging biomarkers and artificial intelligence, the test could be a game changer for concussion diagnosis and management. Currently, there is no single test that can definitively provide a concussion diagnosis – testing methods are subjective, relying on self-reported symptoms and clinician judgement.

The non-invasive test uses a form of blood profiling called ‘metabolomics’ to identify distinct patterns in metabolites – small molecules – that indicate a concussion has occurred. With a few drops of blood from the prick of a finger, a sample is collected on a convenient filter paper device and, once submitted for lab analysis, compared to a baseline blood sample and a population reference.

It can determine if someone has suffered a concussion in about 20 minutes and has shown up to 96 per cent accuracy.

“We’re trying to make sure concussions aren’t missed,” explained Dr. Douglas Fraser, Professor in Paediatrics, Physiology and Pharmacology and Clinical Neurological Sciences, who is leading the development of the technology. “When a concussion is left untreated or a person suffers from multiple concussions, they are prone to long-lasting, debilitating symptoms.”

This research first started at Western in 2015, bringing several interdisciplinary experts together, including Dr. Lisa Fischer, Mark Daley, PhD, and Kevin Shoemaker, PhD, as well as other members of the University’s concussion study team.

In a preliminary study, the researchers collected blood samples from 12- to 14-year-old male hockey players, investigating a spectrum of 174 metabolites and showing a consistent pattern when players were concussed. 

In March 2020, Fraser co-founded Neurolytixs to commercialize the research. Working with WORLDiscoveries, the findings have been licensed and patented around the world.

The upcoming two-part clinical trial seeks to validate the group’s findings independently. The first phase will establish age and sex population references for the metabolites, something that’s never been done before. The second phase is a multi-centre, blinded trial following male and female athletes aged 13 to 17 years through a season of play.

“If we can show a similar degree of accuracy with the test, we should have a product to market in the next two to three years,” said Fraser.

The clinician-scientist projects a potential annual revenue of $1.4 billion in North America alone. “This is a great example of innovation,” he said. “We’ve taken the initial research findings, driven them forward to industry and hopefully, we can make a big impact. We see a higher number of concussions in this adolescent age group, so it’s a population that needs to be protected.”

As part of the clinical trial, Neurolytixs is also investigating if the blood test can track recovery and inform return-to-play decisions. Following non-injured adolescent athletes through a season of play, the research team will be performing multiple checks to verify that metabolites have not changed, and if a player is concussed, tracking how well their biochemical recovery correlates with their clinical recovery.

The Neurolytixs test is one of several in development to accurately diagnose and assess concussion. From saliva to urinalysis, research teams around the world are racing to bring a reliable product to market – although there are very few competitors working with the adolescent population.

“If anyone can do it, we can,” said Fraser. “The progress we’ve made in less than two years, in the middle of a pandemic, it’s been remarkable.”

In another project, Fraser and his team are working with the Canadian military on a test for blast injury, a type of trauma that results from exposure to an explosion like breaching a door, detonating a grenade, or firing a high-calibre weapon. The team is exploring two testing approaches for this population using blood and exhaled breath.

A paediatric critical care physician, Fraser says his experiences in trauma care led him to pursue brain injury research.

“We would discharge children after addressing their visible injuries, fixing their broken bones, only to find out later that their grades were slipping or they were suffering from depression,” he said. “Concussions threaten the long-term brain health of children, as well as athletes and military personnel.”

By Emily Leighton, MA'13
Date: 2022/02/01
Source: https://www.schulich.uwo.ca/about/news/2022/february/research_concussion_blood_test_begins_pivotal_clinical_trial.html