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Randomized Controlled Trial
, 8 (12), e82995

Psychoacoustic Assessment to Improve Tinnitus Diagnosis

Randomized Controlled Trial

Psychoacoustic Assessment to Improve Tinnitus Diagnosis

Charles-Édouard Basile et al. PLoS One.


The diagnosis of tinnitus relies on self-report. Psychoacoustic measurements of tinnitus pitch and loudness are essential for assessing claims and discriminating true from false ones. For this reason, the quantification of tinnitus remains a challenging research goal. We aimed to: (1) assess the precision of a new tinnitus likeness rating procedure with a continuous-pitch presentation method, controlling for music training, and (2) test whether tinnitus psychoacoustic measurements have the sensitivity and specificity required to detect people faking tinnitus. Musicians and non-musicians with tinnitus, as well as simulated malingerers without tinnitus, were tested. Most were retested several weeks later. Tinnitus pitch matching was first assessed using the likeness rating method: pure tones from 0.25 to 16 kHz were presented randomly to participants, who had to rate the likeness of each tone to their tinnitus, and to adjust its level from 0 to 100 dB SPL. Tinnitus pitch matching was then assessed with a continuous-pitch method: participants had to match the pitch of their tinnitus to an external tone by moving their finger across a touch-sensitive strip, which generated a continuous pure tone from 0.5 to 20 kHz in 1-Hz steps. The predominant tinnitus pitch was consistent across both methods for both musicians and non-musicians, although musicians displayed better external tone pitch matching abilities. Simulated malingerers rated loudness much higher than did the other groups with a high degree of specificity (94.4%) and were unreliable in loudness (not pitch) matching from one session to the other. Retest data showed similar pitch matching responses for both methods for all participants. In conclusion, tinnitus pitch and loudness reliably correspond to the tinnitus percept, and psychoacoustic loudness matches are sensitive and specific to the presence of tinnitus.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Instructions displayed on the touchscreen for performing tinnitus matching using the likeness rating method.
Participants initiated a trial by pressing the green button. They had to rate how the tone contributed to their tinnitus on the 10-point scale. Then, they had to match its loudness by moving the gauge on the left side. When this was done, they could press the red button to initiate the next trial.
Figure 2
Figure 2. A schematic view of the tinnitus matching procedure using the slider.
Each trial included three rounds. In the first round, the slider was set between 500 Hz and 20 kHz for all participants. In the second round, the range was limited to two octaves around the final tone chosen by the participant in round one (here, two octaves around 8 kHz). Once the final tone was chosen in round two, the third round was further limited to one octave around this tone (here, one octave around 8 kHz).
Figure 3
Figure 3. The tinnitus spectrum (gray dotted line) mirrors hearing loss for both musicians (A) and non-musicians (B).
Pure-tone thresholds (black line) are reported for the right ear. All groups rated the predominant tinnitus pitch in the high frequencies (>8 kHz). For simulated malingerers (C), tinnitus loudness matching (clear line) is well above the one of tinnitus participants. Error bars represent the standard error of the mean.
Figure 4
Figure 4. Likeness ratings for the three groups.
Simulated malingerers differed from tinnitus participants in the low frequency range (*p<.05; **p<.01). Error bars represent the standard error of the mean.
Figure 5
Figure 5. Differences in cents between target and matched frequencies using the slider for musicians, non-musicians, and simulated malingerers (test session).
Error bars represent the standard error of the mean.

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    1. El Refaie A, Davis A, Kayan A, Baskill J, Lovell E et al. (2004) A questionnaire study of the validity of life and quality of family life of individuals complaining of tinnitus pre- and post- attendance at a tinnitus clinic. Int J Audiol 43: 410-416. doi:10.1080/14992020400050052. PubMed: 15515640. - DOI - PubMed
    1. Holgers K-M, Barrenäs M-L, Svedlund J, Zöger S (2003) Clinical Evaluation of Tinnitus: a Review. Audiological Medicine 2: 101-106.
    1. Aparecida de Azevedo A, Langguth B, Mello de Oliveira P, Figueiredo RR (2009) Tinnitus Treatment with Piribedil Guided by electrocochleography and Acoustic Otoemissions. Otology and Neurotology 30: 676-680. doi:10.1097/MAO.0b013e3181ab8fd5. PubMed: 19574947. - DOI - PubMed
    1. Henry JA, Fausti SA, Flick CL, Helt WJ, Ellingson RM (2000) Computer-Automated Clinical Technique for Tinnitus Quantification. Am J Audiol 9: 36-49. doi:10.1044/1059-0889(2000/002). PubMed: 10943023. - DOI - PubMed
    1. Henry JA, Flick CL, Allison Gilbert M, Ellingson RM, Fausti SA (2001) Comparison of two computer-automated procedures for tinnitus pitch matching. J Rehabil Res Dev 38: 557--566. PubMed: 11732833. - PubMed

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Grant support

This research was partly supported by a grant from the Caroline-Durand Foundation to S. Hébert and a studentship from Institut de recherche Robert-Sauvé en Santé et en Sécurité du Travail du Québec (IRSST) and Fonds de Recherche Santé du Québec (FRQS) to P.F. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.