Eleni Genitsaridi

Following cochlear implantation, measures of auditory nerve function based on implant-driven electrical stimulation can be used to characterize neural health and support longitudinal monitoring and treatment outcome assessment, with particular relevance for advanced therapies targeting neural hearing loss. This study evaluated the reliability and measurement precision of neural-health measures derived from three complementary electrode-specific tests: panoramic electrically-evoked compound action potentials (PECAPs), interphase-gap (IPG) effects, and polarity effects. Six experienced adult cochlear implant users were assessed across five sessions by trained audiologists. PECAPs were measured across all electrodes, while IPG and polarity effects were assessed at three electrodes per participant. Test-retest reliability was quantified using intraclass correlation coefficients (ICCs), with measurements repeated over intervals ranging from 1 day to several weeks. Measurement error was further characterized using the minimum detectable change (MDC), defined as the smallest change required to exceed measurement error with 95% confidence. PECAPs neural-responsiveness measure and polarity effect on comfort levels demonstrated excellent reliability (ICC > 0.90), while IPG effects on ECAP amplitude growth function (AGF) slope showed good reliability (ICC > 0.80). Other variables showed moderate reliability, including polarity effect on threshold, and IPG effects on ECAP maximum amplitude, threshold, and AGF offset. MDC estimates indicated that relatively small within-electrode changes would be sufficient to exceed measurement error at the individual participant-electrode level. Exploratory analyses showed limited associations between measures, consistent with the idea that they may reflect distinct aspects of neural status. Together, these findings establish PECAPs, IPG effects and polarity effects as reproducible and complementary measures of auditory nerve health suitable for longitudinal assessment. Their combined use provides a robust physiological framework for monitoring neural status and detecting therapy-related changes in cochlear implant users, including in clinical studies of interventions targeting neural hearing loss. Further standardization of testing and analysis protocols, alongside expansion to larger multicentre cohorts will strengthen the generalizability and facilitate broader clinical and research adoption.

Neural hearing loss, characterized by dysfunction of the auditory nerve, including the spiral ganglion neurons (SGNs) and/or their synaptic connections, is increasingly recognized as a critical contributor to auditory deficits across diverse conditions, including Auditory Neuropathy Spectrum Disorder (ANSD), presbycusis, and noise-induced hearing loss (NIHL). It is possible that neural hearing loss is underdiagnosed, due to the lack of clinical tools with sufficient sensitivity and specificity to detect poor neural health. Current interventions, such as hearing aids and cochlear implants (CIs), primarily target sensory deficits and offer limited benefit in cases of significant neural compromise. Therapeutically, there is a growing shift towards biologically driven strategies aimed at restoring neural function. Recent developments in novel therapies, including pharmacological, gene-based, neurotrophic, and cell-based approaches, have opened new possibilities demonstrating the potential to protect, repair, and/or replace damaged SGNs, and re-establish auditory pathways. This perspectives article explores the evolving understanding of neural hearing loss, emphasizing its complex pathophysiology and the limitations of current diagnostic and therapeutic approaches, while highlighting how a diverse range of emerging solutions are moving closer to clinical application.

Background: The Marie-Skłodowska-Curie Actions’ (MSCA) Innovative Training Network (ITN) is a doctoral training programme jointly implemented by academic institutions and industries from countries across Europe and beyond. To our knowledge no study has examined the experience of students participating in MSCA-ITNs. This study aims to evaluate and report MSCA-ITN Early Stage Researcher (ESR) experiences. Methods: The Innovative Training Network - Evaluation Questionnaire (ITN-EQ) was developed to assess supervision, training, collaborations and experiences of ESRs and forwarded to two tinnitus-related ITNs and seven ITNs of other disciplines. Results: Key advantages identified included better career prospects, multidisciplinary research opportunities/ collaborations, international exposure, personal/ professional development, plus generous salaries and research budgets. However, lack of a common EU framework resulted in the experience being largely dependent on the host institution, country and supervisor. Moreover, managing the dual requirements of ITNs and host institutions while completing a three-year PhD seemed challenging for most ESRs. ESR involvement in workshop and training school planning was desirable. More than 80% of ESRs rated the overall ITN experience favourably and 98.3% would recommend the same to prospective PhD students. Conclusions: This report could provide valuable insights in planning and management of future ITNs and could assist prospective students in their decision of joining an ITN for their PhD.

Corrigendum: Multidisciplinary Tinnitus Research: Challenges and Future Directions From the Perspective of Early Stage Researchers

Tinnitus can be a burdensome condition on both individual and societal levels. Many aspects of this condition remain elusive, including its underlying mechanisms, ultimately hindering the development of a cure. Interdisciplinary approaches are required to overcome long-established research challenges. This review summarizes current knowledge in various tinnitus-relevant research fields including tinnitus generating mechanisms, heterogeneity, epidemiology, assessment, and treatment development, in an effort to highlight the main challenges and provide suggestions for future research to overcome them. Four common themes across different areas were identified as future research direction: (1) Further establishment of multicenter and multidisciplinary collaborations; (2) Systematic reviews and syntheses of existing knowledge; (3) Standardization of research methods including tinnitus assessment, data acquisition, and data analysis protocols; (4) The design of studies with large sample sizes and the creation of large tinnitus-specific databases that would allow in-depth exploration of tinnitus heterogeneity.

To our knowledge, there is no published study investigating the characteristics of people experiencing tinnitus in Albania. Such a study would be important, providing the basis for further research...

Background: The Marie-Skłodowska-Curie Actions’ (MSCA) Innovative Training Network (ITN) is a doctoral training programme jointly implemented by academic institutions and industries from countries across Europe and beyond. To our knowledge no study has examined the experience of students participating in MSCA-ITNs. This study aims to evaluate and report MSCA-ITN Early Stage Researcher (ESR) experiences. Methods: The Innovative Training Network - Evaluation Questionnaire (ITN-EQ) was developed to assess supervision, training, collaborations and experiences of ESRs and forwarded to two tinnitus-related ITNs and seven ITNs of other disciplines. Results: Key advantages identified included better career prospects, multidisciplinary research opportunities/ collaborations, international exposure, personal/ professional development, plus generous salaries and research budgets. However, lack of a common EU framework resulted in the experience being largely dependent on host institution, country and supervisor. Moreover, managing the dual requirements of ITNs and host institutions while completing a three-year PhD seemed challenging for most ESRs. ESR involvement in workshop and training school planning was desirable. More than 80% of ESRs rated the overall ITN experience favourably and 98.3% would recommend the same to prospective PhD students. Conclusions: This report could provide valuable insights in planning and management of future ITNs and could assist prospective students in their decision of joining an ITN for their PhD.

BACKGROUND Characteristics of tinnitus, the perception of sound in the absence of an external acoustic stimulus, can vary from one individual to another. This heterogeneity has been blamed for the lack of success in finding a cure. To our knowledge, no previous study on tinnitus in Albania has been published, although some studies in eastern Europe are available. A study investigating the characteristics of tinnitus in this region would be important, providing the basis for further research on tinnitus in Albania and contributing to a wider understanding of tinnitus heterogeneity across different geographic locations. OBJECTIVE The objective of this study was to develop an Albania translation of a standardized questionnaire for tinnitus research (the European School for Interdisciplinary Tinnitus Research-Screening Questionnaire - ESIT-SQ) and use it to investigate characteristics of tinnitus in the Albanian population. METHODS Three translators were recruited to create the Albanian ESIT-SQ translation following good practice guidelines for translating questionnaires. This questionnaire was subsequently used to collect data from people attending otolaryngology clinics in Albania. RESULTS Self-report data from 107 people with varying degrees of tinnitus severity were collected using the Albanian ESIT-SQ. Using a Random Forest approach, we found that self-reported hearing difficulty, tinnitus duration, tinnitus pitch, and temporal manifestation of tinnitus were predictive of tinnitus symptom severity (cross-validated accuracy of 0.64, confidence Interval 0.54-0.73). CONCLUSIONS Overall, our study in an Albanian sample demonstrated that the ESIT-SQ can be used to investigate phenotypical characteristics and subgroup distinctions.

Tinnitus patients can present with various characteristics, such as those related to the tinnitus perception, symptom severity, and pattern of comorbidities. It is speculated that this phenotypic heterogeneity is associated with differences in the underlying pathophysiology and personal reaction to the condition. However, there is as yet no established protocol for tinnitus profiling or subtyping, hindering progress in treatment development. This review summarizes data on variables that have been used in studies investigating phenotypic differences in subgroups of tinnitus, including variables used to both define and compare subgroups. A PubMed search led to the identification of 64 eligible articles. In most studies, variables for subgrouping were chosen by the researchers (hypothesis-driven approach). Other approaches included application of unsupervised machine-learning techniques for the definition of subgroups (data-driven), and subgroup definition based on the response to a tinnitus treatment (treatment response). A framework of 94 variable concepts was created to summarize variables used across all studies. Frequency statistics for the use of each variable concept are presented, demonstrating those most and least commonly assessed. This review highlights the high dimensionality of tinnitus heterogeneity. The framework of variables can contribute to the design of future studies, helping to decide on tinnitus assessment and subgrouping.

The spatial percept of tinnitus is hypothesized as an important variable for tinnitus subtyping. Hearing asymmetry often associates with tinnitus laterality, but not always. One of the methodological limitations for cross-study comparisons is how the variables for hearing asymmetry and tinnitus spatial perception are defined. In this study, data from two independent datasets were combined (n= 833 adults, age ranging from 20 to 91 years, 404 males, 429 females) to investigate characteristics of subgroups with different tinnitus spatial perception focusing on hearing asymmetry. Three principle findings emerged. First, a hearing asymmetry variable emphasizing the maximum interaural difference most strongly discriminated unilateral from bilateral tinnitus. Merging lateralized bilateral tinnitus (perceived in both ears but worse in one side) with unilateral tinnitus weakened this relationship. Second, there was an association between unilateral tinnitus and ipsilateral asymmetric hearing. Third, unilateral and bilateral tinnitus were phenotypically distinct, with unilateral tinnitus being characterized by older age, asymmetric hearing, more often wearing one hearing aid, older age at tinnitus onset, shorter tinnitus duration, and higher percentage of time being annoyed by tinnitus. We recommend that careful consideration is given to the definitions of hearing asymmetry and tinnitus spatial perception in order to improve the comparability of findings across studies.