gms | German Medical Science

Introduction: The concentration of cortisol in human saliva changes during the course of the day and is characterized by a typical morning peak. The diurnal profile of cortisol can be affected by stress. In the present study we examined the long-term effect of an outpatient 7-day tinnitus therapy on the salivary cortisol concentration in patients with chronic tinnitus.

Methods: The tinnitus-related distress was evaluated using psychometric questionnaires. In addition, the patients (n = 88) were asked to collect saliva samples before and 3 months after the therapy. On each day, 4 samples were collected at 8:00, 12:00, 14:00 and 20:00 h, stored in the refrigerator at home and subsequently transferred to –80°C in the laboratory freezer until analysis (ELISA, Cortisol-LIA-Kit, IBL-Hamburg).

Results: The therapy resulted in a significant reduction of the tinnitus-related distress. Before therapy, 30 patients had a very low morning peak of free salivary cortisol (≤300 ng/dl). Three months after the end of therapy, morning cortisol of these patients increased significantly. In the 46 patients with initially higher morning concentration (>300 ng/dl), the diurnal decrease of cortisol was reduced after the therapy. The psychometric scores did only in part correlate with salivary cortisol measurements.

Conclusion: The 7-day tinnitus therapy had a significant effect on both reduction of psychometric scores and increase of salivary cortisol. This may hint at a reduced turnover of cortisol due to stress and tinnitus management respectively. We propose further studies with salivary cortisol as a possible bio-marker to monitor therapeutical effects.