Investigación

Publicaciones

Una selección de nuestras publicaciones en revistas internacionales.

Brain Sciences

Personalized Music-Embedded Sound Therapy Based on Gating Modulation and Neural Decoupling Reduces Tinnitus Severity

Background: Tinnitus is associated with maladaptive cortical plasticity and aberrant neural synchronization across auditory and non-auditory networks. Desynchronization-based sound therapies (e.g., coordinated reset) often require prolonged daily sessions and specialized formats. We developed a modified protocol embedding therapeutic tones within music (mMIDST) to improve tolerability and engagement. Methods: Prospective, randomized, single-blind pilot trial (Hospital Clínico Universidad de Chile, Jul 2024–Jul 2025). Adults (18–75 y) with chronic non-pulsatile tinnitus received mMIDST or an active low-frequency stimulation (LFS) control, both embedded in identical music tracks, 1 h/day, 5 days/week. Tinnitus severity was assessed with the Tinnitus Handicap Inventory (THI) at baseline and at 1, 2, and 3 months. Results: Twenty-five participants completed the study (15 mMIDST, 10 LFS). The mMIDST group showed significantly greater THI reductions than LFS at two and three months (p < 0.05). Conclusions: Embedding desynchronization-based tonal stimulation within music may represent a promising, well-tolerated, non-invasive approach for chronic tinnitus management.

Frontiers in Neurology

Spatial navigation entropy suggests allocentric dysfunction in PPPD

Introduction: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve functional dysfunction of the construction of inner cognitive maps, leading to disrupted spatial cognition. Methods: Fifty-two participants (19 PPPD patients, 20 vestibular controls without PPPD, and 13 healthy volunteers) completed a virtual Morris Water Maze task in non-immersive and virtual reality modalities. Results: PPPD patients exhibited significantly worse navigation performance than both control groups, with greater impairments in predominantly allocentric tasks, and increased exploratory gaze behavior. Discussion: Findings suggest PPPD involves deficits in allocentric spatial navigation, likely due to predictive coding errors and impaired internal model updating, rather than sensory input dysfunction.

Brain Sciences

Functional Dizziness as a Spatial Cognitive Dysfunction

Background: Persistent postural-perceptual dizziness (PPPD) may involve disrupted spatial cognition as a core feature. Methods: 19 PPPD patients underwent psycho-cognitive testing (anxiety, depression, memory, attention, planning, executive functions) with emphasis on spatial navigation via a virtual Morris water maze, compared with 12 healthy controls and 20 individuals with other vestibular disorders. Results: PPPD patients demonstrated unique impairments in allocentric spatial navigation and high-demand visuospatial tasks (Towers of London, Trail Making B). Conclusions: PPPD may broadly impair higher cognitive functions, especially spatial cognition; a disruption in the creation of enriched cognitive spatial maps is discussed as a possible pathophysiology.

Frontiers in Neurology: Neuro-otology

Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness

Objective: To determine whether performance in a virtual spatial navigational task is poorer in PPPD patients than in healthy volunteers and patients with other vestibular disorders. Methods: Subjects performed three virtual Morris water maze tasks, analyzed using the cumulative search error index. Results: PPPD patients (n = 19) performed poorer in navigationally demanding tasks than healthy (n = 18) and vestibular controls (n = 19), discriminating PPPD with an AUC of 0.83. Conclusions: This distinct impairment in spatial navigation offers new insights into PPPD pathophysiology and may represent a new biomarker.

Revista Chilena de Otorrinolaringología y Cirugía de Cabeza y Cuello

Tinnitus: una patología cerebral

El tinnitus es un síntoma caracterizado por la percepción de un sonido en ausencia de un estímulo externo. Si bien su fisiopatología puede involucrar una alteración del oído interno, su percepción y el grado de molestia asociado dependen de modificaciones de redes cerebrales cognitivas y emocionales. Esta revisión aborda los cambios a nivel coclear, de tronco encefálico, tálamo y la extensa red cerebral que dan cuenta del tinnitus, y discute cómo esta conceptualización tiene importantes implicancias clínicas.

Frontiers in Neurology: Neuro-otology

An Abbreviated Diagnostic Maneuver for Posterior Benign Positional Paroxysmal Vertigo

Introduction: BPPV secondary to canalolithiasis of the posterior semicircular canal is perhaps the most frequent cause of vertigo. Here we present an abbreviated variation of the Dix–Hallpike maneuver that can be performed without an examination bed, requiring only a backed chair. Methods: A diagnostic assessment study in 163 patients presenting with vertigo or dizziness. Results: The abbreviated test had good sensitivity (80%) and high specificity (95%) for diagnosing posterior BPPV. Discussion: It may serve as a screening procedure, especially useful in primary care or overloaded otolaryngology/neurology departments.

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