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Smeele SJ, Adhia DB, De Ridder D. Feasibility and Safety of High-Definition Infraslow Pink Noise Stimulation for Treating Chronic Tinnitus—A Randomized Placebo-Controlled Trial. Neuromodulation 2022:S1094-7159(22)01339-3. [DOI: 10.1016/j.neurom.2022.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022]
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Lee SY, Chang M, Kwon B, Choi BY, Koo JW, Moon T, De Ridder D, Vanneste S, Song JJ. Is the posterior cingulate cortex an on-off switch for tinnitus?: A comparison between hearing loss subjects with and without tinnitus. Hear Res 2021; 411:108356. [PMID: 34600166 DOI: 10.1016/j.heares.2021.108356] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 08/14/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
As the human brain works in a Bayesian manner to minimize uncertainty toward external stimuli, the deafferented brain may generate tinnitus in an attempt to fill in missing auditory information, e.g. due to hearing loss. However, not everybody with hearing loss develops tinnitus. Understanding the differences between people with hearing loss who develop tinnitus versus those who do not offers a unique opportunity to unravel critical brain areas involved in the generation of a phantom sound. In this study, we compared resting-state quantitative electroencephalography between hearing loss patients with (HL-T) and without tinnitus (HL-NT) to identify cortical oscillatory signatures that may reveal prerequisites for the selective development of tinnitus in subjects with hearing loss. We enrolled 65 subjects with HL-NT and 65 subjects with HL-T whose tinnitus handicap inventory scores were <16 (grade 1) to minimize the bias induced by distress-induced cortical activity changes. Subjects in the HL-T and HL-NT groups were matched in terms of the bilateral hearing threshold (0.25-8 kHz) using nearest neighbor method. Compared to the HL-NT group, the HL-T group showed significantly higher activity in the right parahippocampus for the beta 1 frequency band, in the left inferior parietal lobule (IPL) for the beta 2 frequency band, and in the right IPL for the beta 3- and gamma frequency bands. Functional connectivity analyses revealed that the HL-T group had significantly higher connectivity than the HL-NT group between both parahippocampal gyri and the right IPL for the delta frequency band, and between the left posterior cingulate cortex (PCC) and right IPL for the beta 2 frequency band. These results suggest that tinnitus may be perceived only if auditory memory stored in the parahippocampus is actively linked to the IPL-based "circuit breaker" system and the circuit breaker signal is connected to the PCC-based default mode network (DMN). Thus, when the circuit breaker system regards tinnitus secondary to peripheral deafferentation as a salient event and then the DMN regards tinnitus as a norm, subjects with hearing loss may consciously perceive tinnitus. The results of this study further refine the recently proposed Bayesian model and decipher the neurobiological mechanism of the selective development of tinnitus in subjects with hearing loss.
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Affiliation(s)
- Sang-Yeon Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, 13620, Korea
| | - Munyoung Chang
- Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Chung-Ang University, Seoul, Korea
| | | | - Byung Yoon Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, 13620, Korea
| | - Ja-Won Koo
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, 13620, Korea
| | - Taesup Moon
- Department of Electrical and Computer Engineering, Seoul National University, Seoul, Korea
| | - Dirk De Ridder
- Unit of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Jae-Jin Song
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do, 13620, Korea..
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Henton A, Tzounopoulos T. What's the buzz? The neuroscience and the treatment of tinnitus. Physiol Rev 2021; 101:1609-1632. [PMID: 33769102 DOI: 10.1152/physrev.00029.2020] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Tinnitus is a pervasive public health issue that affects ∼15% of the United States population. Similar estimates have also been shown on a global scale, with similar prevalence found in Europe, Asia, and Africa. The severity of tinnitus is heterogeneous, ranging from mildly bothersome to extremely disruptive. In the United States, ∼10-20% of individuals who experience tinnitus report symptoms that severely reduce their quality of life. Due to the huge personal and societal burden, in the last 20 yr a concerted effort on basic and clinical research has significantly advanced our understanding and treatment of this disorder. Yet, neither full understanding, nor cure exists. We know that tinnitus is the persistent involuntary phantom percept of internally generated nonverbal indistinct noises and tones, which in most cases is initiated by acquired hearing loss and maintained only when this loss is coupled with distinct neuronal changes in auditory and extra-auditory brain networks. Yet, the exact mechanisms and patterns of neural activity that are necessary and sufficient for the perceptual generation and maintenance of tinnitus remain incompletely understood. Combinations of animal model and human research will be essential in filling these gaps. Nevertheless, the existing progress in investigating the neurophysiological mechanisms has improved current treatment and highlighted novel targets for drug development and clinical trials. The aim of this review is to thoroughly discuss the current state of human and animal tinnitus research, outline current challenges, and highlight new and exciting research opportunities.
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Affiliation(s)
- A Henton
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - T Tzounopoulos
- Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania
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Regional homogeneity and functional connectivity in resting-state brain activity in tinnitus patients. JOURNAL OF BIO-X RESEARCH 2020. [DOI: 10.1097/jbr.0000000000000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Abstract
Tinnitus is a common symptom. Standard therapies aim at improving the quality of life and reducing the psychological stress associated with tinnitus. Most interventions have little or no effect on the main symptom. Those affected subjects, however, want such a change and prefer a specific solution, such as pharmacologic therapy to other modalities. Scientific efforts have not yet led to significant improvement in the range of therapies. This article outlines existing efforts and develops ideas on how research for improved tinnitus therapy might look in the future.
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Affiliation(s)
- Tobias Kleinjung
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 24, Zurich CH 8091, Switzerland.
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, Interdisciplinary Tinnitus Center, University of Regensburg, Universitätsstrasse 84, Regensburg D 93053, Germany
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Schoisswohl S, Agrawal K, Simoes J, Neff P, Schlee W, Langguth B, Schecklmann M. RTMS parameters in tinnitus trials: a systematic review. Sci Rep 2019; 9:12190. [PMID: 31434985 PMCID: PMC6704094 DOI: 10.1038/s41598-019-48750-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 08/12/2019] [Indexed: 12/12/2022] Open
Abstract
Over the past few years extensive body of research was produced investigating the effects of repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus with heterogeneous results. This heterogeneity is exemplified by two recently published large-scale clinical trials reporting different outcomes. Technical aspects of rTMS were suspected as a potential source for this incongruency. The aim of this systematic review is to examine the overall efficacy as well as to identify possible technical factors relevant for the effectiveness of rTMS tinnitus trials. Via a literature search appropriate original research papers were identified and rTMS parameters were extracted from each study arm for subsequent statistical analysis with respect to observed effects (significant vs. not significant pre-post rTMS effects). Our findings indicate that verum rTMS is superior to sham rTMS as demonstrated by the proportion of significant pre-post contrasts. Some relevant rTMS parameters (e.g., pulse waveform) are not reported. Lower rTMS stimulation intensity was associated with significant effects in verum rTMS arms. An additional stimulation of the DLPFC to the temporal cortex was not found to promote efficacy. Future research should consider differential effects of rTMS induced by technical parameters and strive for an exhaustive reporting of relevant rTMS parameters.
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Affiliation(s)
- Stefan Schoisswohl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany.
| | - Kushal Agrawal
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
| | - Jorge Simoes
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
| | - Patrick Neff
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- European School for Interdisciplinary Tinnitus Research (ESIT), Regensburg, Germany
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Ding YJ, Song Y, Liu JX, Du YL, Zhu L, Ma FR. Effect of Neuronal Excitability in Hippocampal CA1 Area on Auditory Pathway in a Rat Model of Tinnitus. Chin Med J (Engl) 2018; 131:1969-1974. [PMID: 30082529 PMCID: PMC6085865 DOI: 10.4103/0366-6999.238148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background: Tinnitus is a common disorder that causes significant morbidity; however, the neurophysiological mechanism is not yet fully understood. A relationship between tinnitus and limbic system has been reported. As a significant component of the limbic system, the hippocampus plays an important role in various pathological processes, such as emotional disturbance, decreased learning ability, and deterioration of memory. This study was aimed to explore the role of the hippocampus in the generation of tinnitus by electrophysiological technology. Methods: A tinnitus model was established in rats through intraperitoneal injection of salicylate (SA). Subsequently, the spontaneous firing rate (SFR) of neurons in the hippocampal CA1 area was recorded with in vivo multichannel recording technology to assess changes in excitability induced by SA. To investigate the effect of excitability changes of hippocampus on the auditory pathway, the hippocampus was electrically stimulated and neural excitability in the auditory cortex (AC) was monitored. Results: Totally 65 neurons in the hippocampal CA1 area were recorded, 45 from the SA group (n = 5), and 20 from the saline group (n = 5). Two hours after treatment, mean SFR of neurons in the hippocampal CA1 area had significantly increased from 3.06 ± 0.36 Hz to 9.18 ± 1.30 Hz in the SA group (t = −4.521, P < 0.05), while no significant difference was observed in the saline group (2.66 ± 0.36 Hz vs. 2.16 ± 0.36 Hz, t = 0.902, P > 0.05). In the AC, 79.3% (157/198) of recorded neurons showed responses to electrical stimulation of the hippocampal CA1 area. Presumed pyramidal neurons were excited, while intermediate neurons were inhibited after electrical stimulation of the hippocampus. Conclusions: The study shows that the hippocampus is excited in SA-induced tinnitus, and stimulation of hippocampus could modulate neuronal excitability of the AC. The hippocampus is involved in tinnitus and may also have a regulatory effect on the neural center.
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Affiliation(s)
- Yu-Jing Ding
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
| | - Yu Song
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
| | - Jun-Xiu Liu
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
| | - Ya-Li Du
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
| | - Li Zhu
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
| | - Fu-Rong Ma
- Department of Otorhinolaryngology, Peking University Third Hospital, Beijing 100191, China
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Abtahi H, Okhovvat A, Heidari S, Gharagazarloo A, Mirdamadi M, Nilforoush MH, Ghazavi H. Effect of transcranial direct current stimulation on short-term and long-term treatment of chronic tinnitus. Am J Otolaryngol 2018; 39:94-96. [PMID: 29336898 DOI: 10.1016/j.amjoto.2018.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 12/04/2017] [Accepted: 01/03/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study was conducted to investigate the effectiveness of anodal and cathodal methods in reducing the intensity of tinnitus and to compare them with the control. METHODOLOGY This randomized double-blind clinical trial with case and control groups was conducted in Al-Zahra Hospital in Isfahan between 2015 and 2016. In this trial, 51 patients with tinnitus, for at least one year, were selected among those outpatients visiting the throat, nose and ear clinic within this period. Inclusion criteria were patients on electrical stimulation prohibition, with Ménière's disease, otosclerosis, chronic headache, and pulsatile tinnitus. Patients were randomly divided in three equal-sized groups: anodal stimulation group, cathodal stimulation group, and control group. The subjects received 20-min current stimulation (2 mA). Five subjects were selected from those with a significant difference between the stimulated states (anodal or cathodal) and/or control. They received weekly transcranial electrical stimulation for two months, and their long-term recovery from tinnitus was investigated. Data analysis was done with SPSS20. RESULTS Findings showed no significant between-groups difference in mean scores of tinnitus before the intervention (p = .68); whereas, this difference was significant immediately after the intervention (p = .02) and 1 h after it (p = .03). The mean score of tinnitus in the anodal stimulation group was significantly lower than the control; whereas, no significant difference was observed between the anodal and cathodal stimulation groups, and between the cathodal and control groups (p < .05). Findings also showed that the mean scores of tinnitus in two cathodal stimulation groups (p = .24) and control group (p = .62) were not significantly different at three different points of time; whereas, this score was significantly different in the anodal group at these time points (p = .01). CONCLUSION In conclusion, anodal stimulation was more effective than the cathodal and control stimulation in reducing the intensity of tinnitus in the short term.
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Affiliation(s)
- Hamidreza Abtahi
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ahmadreza Okhovvat
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somaiie Heidari
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azar Gharagazarloo
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahare Mirdamadi
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Hossein Nilforoush
- Communication Disorders Research Center, Rehabilitation Sciences Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hossein Ghazavi
- Department of Otorhinolaryngology-Head and Neck Surgery, Isfahan University of Medical Sciences, Isfahan, Iran.
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Vielsmeier V, Schecklmann M, Schlee W, Kreuzer PM, Poeppl TB, Rupprecht R, Langguth B, Lehner A. A Pilot Study of Peripheral Muscle Magnetic Stimulation as Add-on Treatment to Repetitive Transcranial Magnetic Stimulation in Chronic Tinnitus. Front Neurosci 2018. [PMID: 29515350 PMCID: PMC5826218 DOI: 10.3389/fnins.2018.00068] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
While brain stimulation techniques have been examined as treatment options for chronic tinnitus for many years, they have recently been extended to multimodal treatment approaches. As chronic tinnitus is often accompanied by comorbid muscular tension in the neck and back, we performed a one-arm pilot study to explore the feasibility of a new multimodal treatment approach. In detail, repetitive peripheral magnetic stimulation (rPMS) of the back was performed before and after each session of repetitive transcranial magnetic stimulation (rTMS) of the brain. Data of 41 patients were analyzed, all of which were treated with ten sessions of rTMS of the left prefrontal and left temporoparietal cortex followed by rPMS of the neck and back muscles. Tinnitus severity was measured using the tinnitus questionnaire (TQ). Neck pain was assessed using the neck pain and disability scale (NPAD). The new treatment approach was feasible and well accepted by the majority of patients. However, the overall patient group did not improve significantly in either of the questionnaires. If patients were divided in different subgroups depending on whether they were suffering from neck pain or somatosensory tinnitus, explorative post-hoc tests suggested differential effects: patients with both neck pain and somatosensory tinnitus had better outcomes than patients without those conditions or with neck pain only. This was true for both the TQ and the NPAD. This effect was of transient nature though: the TQ score went back to its baseline level after a follow-up period of 12 weeks. Based on our results we recommend that in studies that investigate tinnitus treatments targeting somatosensory afferents patients should be stratified according to somatic co-morbidities and somatosensory influence on the tinnitus percept. CLINICAL TRIAL REGISTRATION www.clinicaltrials.gov, NCT02306447.
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Affiliation(s)
- Veronika Vielsmeier
- Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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10
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Wang TC, Tyler RS, Chang TY, Chen JC, Lin CD, Chung HK, Tsou YA. Effect of Transcranial Direct Current Stimulation in Patients With Tinnitus: A Meta-Analysis and Systematic Review. Ann Otol Rhinol Laryngol 2017; 127:79-88. [PMID: 29192507 DOI: 10.1177/0003489417744317] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Tang-Chuan Wang
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Richard S. Tyler
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA
| | - Ta-Yuan Chang
- Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Jui-Cheng Chen
- College of Medicine, China Medical University, Taichung, Taiwan
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan
| | - Chia-Der Lin
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Hsiung-Kwang Chung
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Yung-An Tsou
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
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Landgrebe M, Hajak G, Wolf S, Padberg F, Klupp P, Fallgatter AJ, Polak T, Höppner J, Haker R, Cordes J, Klenzner T, Schönfeldt-Lecuona C, Kammer T, Graf E, Koller M, Kleinjung T, Lehner A, Schecklmann M, Pöppl TB, Kreuzer P, Frank E, Langguth B. 1-Hz rTMS in the treatment of tinnitus: A sham-controlled, randomized multicenter trial. Brain Stimul 2017; 10:1112-1120. [DOI: 10.1016/j.brs.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 01/01/2023] Open
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D’Arcy S, Hamilton C, Hughes S, Hall DA, Vanneste S, Langguth B, Conlon B. Bi-modal stimulation in the treatment of tinnitus: a study protocol for an exploratory trial to optimise stimulation parameters and patient subtyping. BMJ Open 2017; 7:e018465. [PMID: 29074518 PMCID: PMC5665258 DOI: 10.1136/bmjopen-2017-018465] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus. Bimodal neuromodulation is emerging as a promising treatment for this condition. The main objectives of this study are to investigate the relevance of interstimulus timing and the choices of acoustic and tongue stimuli for a proprietary bimodal (auditory and somatosensory) neuromodulation device, as well as to explore whether specific subtypes of patients are differentially responsive to this novel intervention for reducing the symptoms of chronic tinnitus. METHODS AND ANALYSIS This is a two-site, randomised, triple-blind, exploratory study of a proprietary neuromodulation device with a pre-post and 12-month follow-up design. Three different bimodal stimulation parameter sets will be examined. The study will enrol 342 patients, split 80:20 between two sites (Dublin, Ireland and Regensburg, Germany), to complete 12 weeks of treatment with the device. Patients will be allocated to one of three arms using a stepwise stratification according to four binary categories: tinnitus tonality, sound level tolerance (using loudness discomfort level of <60 dB SL as an indicator for hyperacusis), hearing thresholds and presence of a noise-induced audiometric profile. The main indicators of relative clinical efficacy for the three different parameter sets are two patient-reported outcomes measures, the Tinnitus Handicap Inventory and the Tinnitus Functional Index, after 12 weeks of intervention. Clinical efficacy will be further explored in a series of patient subtypes, split by the stratification variables and by presence of a somatic tinnitus. Evidence for sustained effects on the psychological and functional impact of tinnitus will be followed up for 12 months. Safety data will be collected and reported. A number of feasibility measures to inform future trial design include: reasons for exclusion, completeness of data collection, attrition rates, patient's adherence to the device usage as per manufacturer's instructions and evaluation of alternative methods for estimating tinnitus impact and tinnitus loudness. ETHICS AND DISSEMINATION This study protocol is approved by the Tallaght Hospital/St. James's Hospital Joint Research Ethics Committee in Dublin, Ireland, and by the Ethics Committee of the University Clinic Regensburg, Germany. Findings will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals and presentations at scientific and clinical conferences. TRIAL REGISTRATION NUMBER The trial is registered on ClinicalTrials.gov (NCT02669069) Pre-results.
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Affiliation(s)
| | | | | | - Deborah A Hall
- National Institute for Health Research Nottingham Biomedical Research Centre, Nottingham, UK
- Otology and Hearing Group, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Interdisciplinary Tinnitus Center of the University of Regensburg, Regensburg, Germany
| | - Brendan Conlon
- Neuromod Devices Limited, Dublin, Ireland
- ENT, Tallaght Hospital, Dublin, Ireland
- ENT, St. James’s Hospital, Dublin, Ireland
- Department of Medicine, Trinity College, Dublin, Ireland
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13
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Probst T, Pryss RC, Langguth B, Rauschecker JP, Schobel J, Reichert M, Spiliopoulou M, Schlee W, Zimmermann J. Does Tinnitus Depend on Time-of-Day? An Ecological Momentary Assessment Study with the "TrackYourTinnitus" Application. Front Aging Neurosci 2017; 9:253. [PMID: 28824415 PMCID: PMC5539131 DOI: 10.3389/fnagi.2017.00253] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 07/17/2017] [Indexed: 12/25/2022] Open
Abstract
Only few previous studies used ecological momentary assessments to explore the time-of-day-dependence of tinnitus. The present study used data from the mobile application “TrackYourTinnitus” to explore whether tinnitus loudness and tinnitus distress fluctuate within a 24-h interval. Multilevel models were performed to account for the nested structure of assessments (level 1: 17,209 daily life assessments) nested within days (level 2: 3,570 days with at least three completed assessments), and days nested within participants (level 3: 350 participants). Results revealed a time-of-day-dependence of tinnitus. In particular, tinnitus was perceived as louder and more distressing during the night and early morning hours (from 12 a.m. to 8 a.m.) than during the upcoming day. Since previous studies suggested that stress (and stress-associated hormones) show a circadian rhythm and this might influence the time-of-day-dependence of tinnitus, we evaluated whether the described results change when statistically controlling for subjectively reported stress-levels. Correcting for subjective stress-levels, however, did not change the result that tinnitus (loudness and distress) was most severe at night and early morning. These results show that time-of-day contributes to the level of both tinnitus loudness and tinnitus distress. Possible implications of our results for the clinical management of tinnitus are that tailoring the timing of therapeutic interventions to the circadian rhythm of individual patients (chronotherapy) might be promising.
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Affiliation(s)
- Thomas Probst
- Georg-Elias-Müller-Institute for Psychology, Georg-August-University GöttingenGöttingen, Germany.,Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Rüdiger C Pryss
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum RegensburgRegensburg, Germany
| | - Josef P Rauschecker
- Program in Cognitive and Computational Systems, Georgetown University WashingtonWashington, DC, United States.,Institute for Advanced Study, Technical University MunichMunich, Germany
| | - Johannes Schobel
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Manfred Reichert
- Department for Psychotherapy and Biopsychosocial Health, Danube University KremsKrems an der Donau, Austria
| | - Myra Spiliopoulou
- Department of Technical and Business Information Systems, Otto-von-Guericke-University MagdeburgMagdeburg, Germany
| | - Winfried Schlee
- Department of Psychiatry and Psychotherapy of the University of Regensburg at Bezirksklinikum RegensburgRegensburg, Germany
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14
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Galazyuk AV, Voytenko SV, Longenecker RJ. Long-Lasting forward Suppression of Spontaneous Firing in Auditory Neurons: Implication to the Residual Inhibition of Tinnitus. J Assoc Res Otolaryngol 2017; 18:343-353. [PMID: 27832500 PMCID: PMC5352609 DOI: 10.1007/s10162-016-0601-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/25/2016] [Indexed: 12/13/2022] Open
Abstract
Tinnitus is the perception of a sound that has no external source. Sound stimuli can suppress spontaneous firing in auditory neurons long after stimulus offset. It is unknown how changes in sound stimulus parameters affect this forward suppression. Using in vivo extracellular recording in awake mice, we found that about 40 % of spontaneously active inferior colliculus (IC) neurons exhibited forward suppression of spontaneous activity after sound offset. The duration of this suppression increased with sound duration and lasted about 40 s following a 30-s stimulus offset. Pure tones presented at the neuron's characteristic frequency (CF) were more effective in triggering suppression compared to non-CF or wideband noise stimuli. In contrast, non-CF stimuli often induced forward facilitation. About one third of IC neurons exhibited shorter suppression durations with each subsequent sound presentation. These characteristics of forward suppression are similar to the psychoacoustic properties of residual inhibition of tinnitus: a phenomenon of brief (about 30 s) suppression of tinnitus observed in tinnitus patients after sound presentations. Because elevated spontaneous firing in central auditory neurons has been linked to tinnitus, forward suppression of this firing with sound might be an underlying mechanism of residual inhibition.
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Affiliation(s)
- A V Galazyuk
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA.
| | - S V Voytenko
- Department of Neuronal Networks Physiology, Bogomoletz Institute of Physiology, National Academy of Sciences of Ukraine, Kiev, Ukraine
| | - R J Longenecker
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, 4209 State Route 44, Rootstown, OH, 44272, USA
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15
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Bilici S. Repetitive transcranial magnetic stimulation and drugs for tinnitus. Eur Arch Otorhinolaryngol 2017; 274:2361-2362. [PMID: 28213774 DOI: 10.1007/s00405-017-4461-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 01/09/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Suat Bilici
- Otorhinolarngology Department, Istanbul Training and Research Hospital, Istanbul, 34500, Turkey.
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16
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Schecklmann M, Giani A, Tupak S, Langguth B, Raab V, Polak T, Várallyay C, Großmann W, Herrmann MJ, Fallgatter AJ. Neuronavigated left temporal continuous theta burst stimulation in chronic tinnitus. Restor Neurol Neurosci 2016; 34:165-75. [PMID: 26890094 DOI: 10.3233/rnn-150518] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE Clinical effects of repetitive transcranial magnetic stimulation (rTMS) in chronic tinnitus are moderate. More precise coil localisation strategies, innovative stimulation protocols, and identification of predictors for treatment response were proposed as promising attempts to enhance treatment efficacy. In this pilot study we investigated neuronavigated continuous theta burst TMS (cTBS). METHODS Twenty-three patients received neuronavigated cTBS over the left primary auditory cortex in a randomized sham-controlled trial (verum = 12; sham = 11). Treatment response was evaluated with tinnitus questionnaires and numeric rating scales. Immediate change in numeric rating scales during the first session was used as predictor for treatment response. RESULTS Tinnitus was significantly reduced after treatment, but there were no superior effects between verum vs. sham treatment. Immediate change in the first treatment session predicted the response to treatment only in the verum group. CONCLUSIONS In our study, verum cTBS was not superior to sham which highlights the persistent need for improving non-invasive brain stimulation techniques for the treatment of tinnitus. Future research should focus on the transfer of positive single session effects to daily treatment trials.
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Affiliation(s)
- Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Anette Giani
- Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Sara Tupak
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Vincent Raab
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Csanád Várallyay
- Department of Neuroradiology, University of Würzburg, Würzburg, Germany.,Departments of Neurology/Radiology, Oregon Health and Science University, Portland, OR, USA
| | - Wilma Großmann
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
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17
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Cavaliere C, Aiello M, Di Perri C, Amico E, Martial C, Thibaut A, Laureys S, Soddu A. Functional Connectivity Substrates for tDCS Response in Minimally Conscious State Patients. Front Cell Neurosci 2016; 10:257. [PMID: 27857682 PMCID: PMC5093112 DOI: 10.3389/fncel.2016.00257] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/21/2016] [Indexed: 12/17/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive technique recently employed in disorders of consciousness, and determining a transitory recovery of signs of consciousness in almost half of minimally conscious state (MCS) patients. Although the rising evidences about its possible role in the treatment of many neurological and psychiatric conditions exist, no evidences exist about brain functional connectivity substrates underlying tDCS response. We retrospectively evaluated resting state functional Magnetic Resonance Imaging (fMRI) of 16 sub-acute and chronic MCS patients (6 tDCS responders) who successively received a single left dorsolateral prefrontal cortex (DLPFC) tDCS in a double-blind randomized cross-over trial. A seed-based approach for regions of left extrinsic control network (ECN) and default-mode network (DMN) was performed. tDCS responders showed an increased left intra-network connectivity for regions co-activated with left DLPFC, and significantly with left inferior frontal gyrus. Non-responders (NR) MCS patients showed an increased connectivity between left DLPFC and midline cortical structures, including anterior cingulate cortex and precuneus. Our findings suggest that a prior high connectivity with regions belonging to ECN can facilitate transitory recovery of consciousness in a subgroup of MCS patients that underwent tDCS treatment. Therefore, resting state-fMRI could be very valuable in detecting the neuronal conditions necessary for tDCS to improve behavior in MCS.
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Affiliation(s)
- Carlo Cavaliere
- Coma Science Group, GIGA-Research, University and University Hospital of LiegeLiege, Belgium; NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e NucleareNaples, Italy
| | - Marco Aiello
- NAPLab, IRCCS SDN Istituto di Ricerca Diagnostica e Nucleare Naples, Italy
| | - Carol Di Perri
- Coma Science Group, GIGA-Research, University and University Hospital of Liege Liege, Belgium
| | - Enrico Amico
- Coma Science Group, GIGA-Research, University and University Hospital of Liege Liege, Belgium
| | - Charlotte Martial
- Coma Science Group, GIGA-Research, University and University Hospital of Liege Liege, Belgium
| | - Aurore Thibaut
- Coma Science Group, GIGA-Research, University and University Hospital of LiegeLiege, Belgium; Spaulding Neuromodulation Center, Spaulding Rehabilitation Hospital/Harvard Medical SchoolBoston, MA, USA
| | - Steven Laureys
- Coma Science Group, GIGA-Research, University and University Hospital of Liege Liege, Belgium
| | - Andrea Soddu
- Department of Physics and Astronomy, Brain and Mind Institute, Western University London, ON, Canada
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18
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Milner R, Lewandowska M, Ganc M, Cieśla K, Niedziałek I, Skarżyński H. Slow Cortical Potential Neurofeedback in Chronic Tinnitus Therapy: A Case Report. Appl Psychophysiol Biofeedback 2016; 41:225-49. [PMID: 26459345 PMCID: PMC4856729 DOI: 10.1007/s10484-015-9318-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
This study is the first to demonstrate outcomes of slow cortical potential (SCP) Neurofeedback training in chronic tinnitus. A 50-year old male patient with tinnitus participated in three SCP training blocks, separated with 1-month breaks. After the training the patient reported decreased tinnitus loudness and pitch, as well as improved quality of daily life. A quantitative electroencephalography analysis revealed close to normal changes of resting state bioelectrical activity in cortical areas considered to be involved in tinnitus generation. The present case study indicates that SCP Neurofeedback training can be considered a promising method for tinnitus treatment.
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Affiliation(s)
- Rafał Milner
- Department of Experimental Audiology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland.
| | - Monika Lewandowska
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland
| | - Małgorzata Ganc
- Department of Experimental Audiology, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland
| | - Katarzyna Cieśla
- Bioimaging Research Center, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland
| | - Iwona Niedziałek
- Department of Audiology and Phoniatrics, World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland
| | - Henryk Skarżyński
- World Hearing Center, Institute of Physiology and Pathology of Hearing, Mokra 17 Str., Kajetany, 05-830, Nadarzyn, Poland
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Heimrath K, Fiene M, Rufener KS, Zaehle T. Modulating Human Auditory Processing by Transcranial Electrical Stimulation. Front Cell Neurosci 2016; 10:53. [PMID: 27013969 PMCID: PMC4779894 DOI: 10.3389/fncel.2016.00053] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 02/18/2016] [Indexed: 12/31/2022] Open
Abstract
Transcranial electrical stimulation (tES) has become a valuable research tool for the investigation of neurophysiological processes underlying human action and cognition. In recent years, striking evidence for the neuromodulatory effects of transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation has emerged. While the wealth of knowledge has been gained about tES in the motor domain and, to a lesser extent, about its ability to modulate human cognition, surprisingly little is known about its impact on perceptual processing, particularly in the auditory domain. Moreover, while only a few studies systematically investigated the impact of auditory tES, it has already been applied in a large number of clinical trials, leading to a remarkable imbalance between basic and clinical research on auditory tES. Here, we review the state of the art of tES application in the auditory domain focussing on the impact of neuromodulation on acoustic perception and its potential for clinical application in the treatment of auditory related disorders.
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Affiliation(s)
| | | | | | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke University MagdeburgMagdeburg, Germany
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20
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van Zwieten G, Smit JV, Jahanshahi A, Temel Y, Stokroos RJ. Tinnitus: Is there a place for brain stimulation? Surg Neurol Int 2016; 7:S125-9. [PMID: 26958429 PMCID: PMC4765244 DOI: 10.4103/2152-7806.176134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 01/05/2016] [Indexed: 12/16/2022] Open
Abstract
Tinnitus is the perception of a “phantom sound” and has a high prevalence. Although many therapies have been investigated within the last decades, there is still no effective standard therapy. Animal studies and human functional imaging studies revealed that tinnitus perception is associated with many complex changes in multiple brain structures. There is growing evidence that brain stimulation might be able to interrupt the local altered neuronal activity and hereby inhibit tinnitus perception. In this editorial review, an update is given on the most promising targets for brain stimulation. Promising structures for stimulation are the dorsal cochlear nucleus, the inferior colliculus and the medial geniculate body of the thalamus. For cortical stimulation, the auditory cortex is considered as a target. Nevertheless, the field is waiting for evidence from well-designed clinical trials, based on supporting evidence from experimental/mechanistic research, to support or discourage the application of brain stimulation in tinnitus.
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Affiliation(s)
- Gusta van Zwieten
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Jasper V Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
| | - Robert J Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands
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21
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Sensorineural Tinnitus: Its Pathology and Probable Therapies. Int J Otolaryngol 2016; 2016:2830157. [PMID: 26977153 PMCID: PMC4761664 DOI: 10.1155/2016/2830157] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 01/12/2016] [Indexed: 12/11/2022] Open
Abstract
Tinnitus is not a single disease but a group of different diseases with different pathologies and therefore different treatments. Regarding tinnitus as a single disease is hampering progress in understanding of the pathophysiology of tinnitus and perhaps, more importantly, it is a serious obstacle in development of effective treatments for tinnitus. Subjective tinnitus is a phantom sound that takes many different forms and has similarities with chronic neuropathic pain. The pathology may be in the cochlea, in the auditory nerve, or, most commonly, in the brain. Like chronic neuropathic pain tinnitus is not life threatening but influences many normal functions such as sleep and the ability to concentrate on work. Some forms of chronic tinnitus have two components, a (phantom) sound and a component that may best be described as suffering or distress. The pathology of these two components may be different and the treatment that is most effective may be different for these two components. The most common form of treatment of tinnitus is pharmacological agents and behavioral treatment combined with sound therapy. Less common treatments are hypnosis and acupuncture. Various forms of neuromodulation are becoming in use in an attempt to reverse maladaptive plastic changes in the brain.
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22
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Thibaut A, Di Perri C, Chatelle C, Bruno MA, Bahri MA, Wannez S, Piarulli A, Bernard C, Martial C, Heine L, Hustinx R, Laureys S. Clinical Response to tDCS Depends on Residual Brain Metabolism and Grey Matter Integrity in Patients With Minimally Conscious State. Brain Stimul 2015; 8:1116-23. [DOI: 10.1016/j.brs.2015.07.024] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/08/2015] [Accepted: 07/09/2015] [Indexed: 11/17/2022] Open
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23
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Acoustic Coordinated Reset Neuromodulation in a Real Life Patient Population with Chronic Tonal Tinnitus. BIOMED RESEARCH INTERNATIONAL 2015; 2015:569052. [PMID: 26568958 PMCID: PMC4629059 DOI: 10.1155/2015/569052] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Accepted: 01/11/2015] [Indexed: 01/31/2023]
Abstract
Purpose. Primary tinnitus has a severe negative influence on the quality of life of a significant portion of the general population. Acoustic coordinated reset neuromodulation is designed to induce a long-lasting reduction of tinnitus symptoms. To test acoustic coordinated reset neuromodulation as a treatment for chronic, tonal tinnitus under real life conditions, an outpatient study “RESET Real Life” was commissioned by ANM GmbH. Herein we present the results of this study. Methods. In a prospective, open-label, nonrandomized, noncontrolled multicenter clinical study with 200 chronic tinnitus patients, tinnitus questionnaire TBF-12 and Global Clinical Improvement-Impression Scale (CGI-I7) are used to study the safety and efficacy of acoustic coordinated reset neuromodulation. 189 patients completed the last 12-month visit, 11 patients dropped out (8 because of nontreatment related reasons; 2 because tinnitus did not change; and 1 because tinnitus got louder). Results. Acoustic coordinated reset neuromodulation caused a statistically and clinically significant decrease in TBF-12 scores as well as in CGI-I7 after 12 months of therapy under real life conditions. There were no persistent adverse events reported that were related to the therapy. Conclusion. The field study “RESET Real Life” provides evidence for safety and efficacy of acoustic coordinated reset neuromodulation in a prospective, open-label, real life setting.
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24
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Tyler RS, Keiner AJ, Walker K, Deshpande AK, Witt S, Killian M, Ji H, Patrick J, Dillier N, van Dijk P, Lai WK, Hansen MR, Gantz B. A Series of Case Studies of Tinnitus Suppression With Mixed Background Stimuli in a Cochlear Implant. Am J Audiol 2015; 24:398-410. [PMID: 26001407 DOI: 10.1044/2015_aja-15-0005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/17/2015] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Background sounds provided by a wearable sound playback device were mixed with the acoustical input picked up by a cochlear implant speech processor in an attempt to suppress tinnitus. METHOD First, patients were allowed to listen to several sounds and to select up to 4 sounds that they thought might be effective. These stimuli were programmed to loop continuously in the wearable playback device. Second, subjects were instructed to use 1 background sound each day on the wearable device, and they sequenced the selected background sounds during a 28-day trial. Patients were instructed to go to a website at the end of each day and rate the loudness and annoyance of the tinnitus as well as the acceptability of the background sound. Patients completed the Tinnitus Primary Function Questionnaire (Tyler, Stocking, Secor, & Slattery, 2014) at the beginning of the trial. RESULTS Results indicated that background sounds were very effective at suppressing tinnitus. There was considerable variability in sounds preferred by the subjects. CONCLUSION The study shows that a background sound mixed with the microphone input can be effective for suppressing tinnitus during daily use of the sound processor in selected cochlear implant users.
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Affiliation(s)
| | | | | | | | | | | | | | - Jim Patrick
- Cochlear Limited, Sydney, New South Wales, Australia
| | | | - Pim van Dijk
- University Medical Center, University of Groningen, the Netherlands
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25
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Markovitz CD, Hogan PS, Wesen KA, Lim HH. Pairing broadband noise with cortical stimulation induces extensive suppression of ascending sensory activity. J Neural Eng 2015; 12:026006. [PMID: 25686163 PMCID: PMC4359690 DOI: 10.1088/1741-2560/12/2/026006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The corticofugal system can alter coding along the ascending sensory pathway. Within the auditory system, electrical stimulation of the auditory cortex (AC) paired with a pure tone can cause egocentric shifts in the tuning of auditory neurons, making them more sensitive to the pure tone frequency. Since tinnitus has been linked with hyperactivity across auditory neurons, we sought to develop a new neuromodulation approach that could suppress a wide range of neurons rather than enhance specific frequency-tuned neurons. APPROACH We performed experiments in the guinea pig to assess the effects of cortical stimulation paired with broadband noise (PN-Stim) on ascending auditory activity within the central nucleus of the inferior colliculus (CNIC), a widely studied region for AC stimulation paradigms. MAIN RESULTS All eight stimulated AC subregions induced extensive suppression of activity across the CNIC that was not possible with noise stimulation alone. This suppression built up over time and remained after the PN-Stim paradigm. SIGNIFICANCE We propose that the corticofugal system is designed to decrease the brain's input gain to irrelevant stimuli and PN-Stim is able to artificially amplify this effect to suppress neural firing across the auditory system. The PN-Stim concept may have potential for treating tinnitus and other neurological disorders.
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Affiliation(s)
- Craig D. Markovitz
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Patrick S. Hogan
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Kyle A. Wesen
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
| | - Hubert H. Lim
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN USA
- University of Minnesota, Department of Otolaryngology-Head and Neck Surgery, Minneapolis, MN USA
- University of Minnesota, Institute for Translational Neuroscience, Minneapolis, MN USA
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26
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Krick CM, Grapp M, Daneshvar-Talebi J, Reith W, Plinkert PK, Bolay HV. Cortical reorganization in recent-onset tinnitus patients by the Heidelberg Model of Music Therapy. Front Neurosci 2015; 9:49. [PMID: 25745385 PMCID: PMC4333796 DOI: 10.3389/fnins.2015.00049] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 02/04/2015] [Indexed: 12/19/2022] Open
Abstract
Pathophysiology and treatment of tinnitus still are fields of intensive research. The neuroscientifically motivated Heidelberg Model of Music Therapy, previously developed by the German Center for Music Therapy Research, Heidelberg, Germany, was applied to explore its effects on individual distress and on brain structures. This therapy is a compact and fast application of nine consecutive 50-min sessions of individualized therapy implemented over 1 week. Clinical improvement and long-term effects over several years have previously been published. However, the underlying neural basis of the therapy's success has not yet been explored. In the current study, the therapy was applied to acute tinnitus patients (TG) and healthy active controls (AC). Non-treated patients were also included as passive controls (PTC). As predicted, the therapeutic intervention led to a significant decrease of tinnitus-related distress in TG compared to PTC. Before and after the study week, high-resolution MRT scans were obtained for each subject. Assessment by repeated measures design for several groups (Two-Way ANOVA) revealed structural gray matter (GM) increase in TG compared to PTC, comprising clusters in precuneus, medial superior frontal areas, and in the auditory cortex. This pattern was further applied as mask for general GM changes as induced by the therapy week. The therapy-like procedure in AC also elicited similar GM increases in precuneus and frontal regions. Comparison between structural effects in TG vs. AC was calculated within the mask for general GM changes to obtain specific effects in tinnitus patients, yielding GM increase in right Heschl's gyrus, right Rolandic operculum, and medial superior frontal regions. In line with recent findings on the crucial role of the auditory cortex in maintaining tinnitus-related distress, a causative relation between the therapy-related GM alterations in auditory areas and the long-lasting therapy effects can be assumed.
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Affiliation(s)
- Christoph M Krick
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Miriam Grapp
- German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
| | | | - Wolfgang Reith
- Department for Neuroradiology, Saarland University Hospital Homburg, Germany
| | - Peter K Plinkert
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital for Ear, Nose, and Throat, University of Heidelberg Heidelberg, Germany
| | - Hans Volker Bolay
- Music Therapy Tinnitus Outpatient Department, German Center for Music Therapy Research (Victor Dulger Institute) DZM Heidelberg, Germany
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27
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The olivocochlear reflex strength and cochlear sensitivity are independently modulated by auditory cortex microstimulation. J Assoc Res Otolaryngol 2015; 16:223-40. [PMID: 25663383 DOI: 10.1007/s10162-015-0509-9] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 01/21/2015] [Indexed: 12/20/2022] Open
Abstract
In mammals, efferent projections to the cochlear receptor are constituted by olivocochlear (OC) fibers that originate in the superior olivary complex. Medial and lateral OC neurons make synapses with outer hair cells and with auditory nerve fibers, respectively. In addition to the OC system, there are also descending projections from the auditory cortex that are directed towards the thalamus, inferior colliculus, cochlear nucleus, and superior olivary complex. Olivocochlear function can be assessed by measuring a brainstem reflex mediated by auditory nerve fibers, cochlear nucleus neurons, and OC fibers. Although it is known that the OC reflex is activated by contralateral acoustic stimulation and produces a suppression of cochlear responses, the influence of cortical descending pathways in the OC reflex is largely unknown. Here, we used auditory cortex electrical microstimulation in chinchillas to study a possible cortical modulation of cochlear and auditory nerve responses to tones in the absence and presence of contralateral noise. We found that cortical microstimulation produces two different peripheral modulations: (i) changes in cochlear sensitivity evidenced by amplitude modulation of cochlear microphonics and auditory nerve compound action potentials and (ii) enhancement or suppression of the OC reflex strength as measured by auditory nerve responses, which depended on the intersubject variability of the OC reflex. Moreover, both corticofugal effects were not correlated, suggesting the presence of two functionally different efferent pathways. These results demonstrate that auditory cortex electrical microstimulation independently modulates the OC reflex strength and cochlear sensitivity.
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28
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Schecklmann M, Giani A, Tupak S, Langguth B, Raab V, Polak T, Várallyay C, Harnisch W, Herrmann MJ, Fallgatter AJ. Functional near-infrared spectroscopy to probe state- and trait-like conditions in chronic tinnitus: a proof-of-principle study. Neural Plast 2014; 2014:894203. [PMID: 25478237 PMCID: PMC4248328 DOI: 10.1155/2014/894203] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/21/2014] [Accepted: 10/21/2014] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Several neuroscience tools showed the involvement of auditory cortex in chronic tinnitus. In this proof-of-principle study we probed the capability of functional near-infrared spectroscopy (fNIRS) for the measurement of brain oxygenation in auditory cortex in dependence from chronic tinnitus and from intervention with transcranial magnetic stimulation. METHODS Twenty-three patients received continuous theta burst stimulation over the left primary auditory cortex in a randomized sham-controlled neuronavigated trial (verum = 12; placebo = 11). Before and after treatment, sound-evoked brain oxygenation in temporal areas was measured with fNIRS. Brain oxygenation was measured once in healthy controls (n = 12). RESULTS Sound-evoked activity in right temporal areas was increased in the patients in contrast to healthy controls. Left-sided temporal activity under the stimulated area changed over the course of the trial; high baseline oxygenation was reduced and vice versa. CONCLUSIONS By demonstrating that rTMS interacts with auditory evoked brain activity, our results confirm earlier electrophysiological findings and indicate the sensitivity of fNIRS for detecting rTMS induced changes in brain activity. Moreover, our findings of trait- and state-related oxygenation changes indicate the potential of fNIRS for the investigation of tinnitus pathophysiology and treatment response.
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Affiliation(s)
- Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Anette Giani
- Max Planck Institute for Biological Cybernetics, 72076 Tübingen, Germany
| | - Sara Tupak
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, 48149 Münster, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany
| | - Vincent Raab
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
| | - Thomas Polak
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
| | - Csanád Várallyay
- Department of Neurosurgery, University of Würzburg, 97080 Würzburg, Germany
| | - Wilma Harnisch
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, 97080 Würzburg, Germany
| | - Martin J. Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, 97080 Würzburg, Germany
| | - Andreas J. Fallgatter
- Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany
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Lange J, Keil J, Schnitzler A, van Dijk H, Weisz N. The role of alpha oscillations for illusory perception. Behav Brain Res 2014; 271:294-301. [PMID: 24931795 PMCID: PMC4111906 DOI: 10.1016/j.bbr.2014.06.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 06/04/2014] [Accepted: 06/08/2014] [Indexed: 12/20/2022]
Abstract
Alpha oscillations are a prominent electrophysiological signal measured across a wide range of species and cortical and subcortical sites. Alpha oscillations have been viewed for a long time as an "idling" rhythm, purely reflecting inactive sites. Despite earlier evidence from neurophysiology, awareness that alpha oscillations can substantially influence perception and behavior has grown only recently in cognitive neuroscience. Evidence for an active role of alpha for perception comes mainly from several visual, near-threshold experiments. In the current review, we extend this view by summarizing studies showing how alpha-defined brain states relate to illusory perception, i.e. cases of perceptual reports that are not "objectively" verifiable by distinct stimuli or stimulus features. These studies demonstrate that ongoing or prestimulus alpha oscillations substantially influence the perception of auditory, visual or multisensory illusions.
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Affiliation(s)
- Joachim Lange
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany.
| | - Julian Keil
- Department of Psychiatry and Psychotherapy, Charité University Hospital, St. Hedwig Hospital, Große Hamburger Straße 5-11, 10115 Berlin, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Hanneke van Dijk
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University, Universitätsstraße 1, 40225 Düsseldorf, Germany
| | - Nathan Weisz
- CIMeC - Center for Mind/Brain Sciences, University of Trento, via delle Regole, 101, 38060 Mattarello, TN, Italy
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Kreuzer PM, Landgrebe M, Resch M, Husser O, Schecklmann M, Geisreiter F, Poeppl TB, Prasser SJ, Hajak G, Rupprecht R, Langguth B. Feasibility, safety and efficacy of transcutaneous vagus nerve stimulation in chronic tinnitus: an open pilot study. Brain Stimul 2014; 7:740-7. [PMID: 24996510 DOI: 10.1016/j.brs.2014.05.003] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 05/07/2014] [Accepted: 05/11/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES Vagus nerve stimulation represents an established treatment strategy for epilepsy and affective disorders. Recently, positive effects were also shown in animals and humans with tinnitus. Here we report the results of an open pilot study exploring feasibility, safety and efficacy of tVNS in the treatment of chronic tinnitus. STUDY DESIGN Fifty patients with chronic tinnitus underwent tVNS in an open single-armed pilot study which was conducted in two phases applying two different stimulating devices (Cerbomed CM02 and NEMOS). Clinical assessment was based on Tinnitus Questionnaire (TQ), Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), WHO Quality of Life, and various numeric rating scales. Primary outcome was defined as change in TQ (baseline vs. final visit in week 24). The study has been registered with clinicaltrials.gov (NCT01176734). RESULTS Primary analysis indicated mean TQ reductions of 3.7 points (phase 1) and 2.8 points (phase 2) significant for the first study phase. Secondary analyses indicated a significant BDI reduction for phase 1 (uncorrected for multiple testing), but no further systematic or significant effects. Adverse events included twitching and pressure at electrode placement site. The occurrence of one hospitalization because of palpations and the development of a left bundle branch block were considered as unrelated to the intervention. Cognitive testing revealed no significant changes. CONCLUSION Our data demonstrate the feasibility of tVNS over a period of 6 months. There was no clinically relevant improvement of tinnitus complaints. Our data suggest tVNS to be considered safe in patients without a history of cardiac disease.
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Affiliation(s)
- Peter M Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany.
| | - Michael Landgrebe
- Department of Psychiatry, Psychosomatics and Psychotherapy, kbo Lech-Mangfall-Klinik Agatharied, Germany
| | - Markus Resch
- Department of Cardiology, Internal Medicine II, University of Regensburg, Regensburg, Germany
| | - Oliver Husser
- Department of Cardiology, Internal Medicine II, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
| | - Florian Geisreiter
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
| | - Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
| | - Sarah J Prasser
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
| | - Goeran Hajak
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, Bezirksklinikum Bamberg, Bamberg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstr. 84, 93053 Regensburg, Germany
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Lehner A, Langguth B, Poeppl TB, Rupprecht R, Hajak G, Landgrebe M, Schecklmann M. Structural brain changes following left temporal low-frequency rTMS in patients with subjective tinnitus. Neural Plast 2014; 2014:132058. [PMID: 24991438 PMCID: PMC4065728 DOI: 10.1155/2014/132058] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 05/06/2014] [Accepted: 05/14/2014] [Indexed: 12/14/2022] Open
Abstract
Repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been used to treat patients with subjective tinnitus. While rTMS is known to induce morphological changes in healthy subjects, no study has investigated yet whether rTMS treatment induces grey matter (GM) changes in tinnitus patients as well, whether these changes are correlated with treatment success, and whether GM at baseline is a useful predictor for treatment outcome. Therefore, we examined magnetic resonance images of 77 tinnitus patients who were treated with rTMS of the left temporal cortex (10 days, 2000 stimuli/day, 1 Hz). At baseline and after the last treatment session high-resolution structural images of the brain were acquired and tinnitus severity was assessed. For a subgroup of 41 patients, additional brain scans were done after a follow-up period of 90 days. GM changes were analysed by means of voxel based morphometry. Transient GM decreases were detectable in several brain regions, especially in the insula and the inferior frontal cortex. These changes were not related to treatment outcome though. Baseline images correlated with change in tinnitus severity in the frontal cortex and the lingual gyrus, suggesting that GM at baseline might hold potential as a possible predictor for treatment outcome.
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Affiliation(s)
- Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Center, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Center, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
| | - Timm B. Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Center, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
| | - Göran Hajak
- Department of Psychiatry, Psychosomatics, and Psychotherapy, Social Foundation Bamberg, Buger Straße 80, 96049 Bamberg, Germany
| | - Michael Landgrebe
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Norbert-Kerkel-Platz, 83734 Hausham/Obb., Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
- Interdisciplinary Tinnitus Center, University of Regensburg, Universitaetsstraße 84, 93053 Regensburg, Germany
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32
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Schlee W, Schecklmann M, Lehner A, Kreuzer PM, Vielsmeier V, Poeppl TB, Langguth B. Reduced variability of auditory alpha activity in chronic tinnitus. Neural Plast 2014; 2014:436146. [PMID: 24967106 PMCID: PMC4055153 DOI: 10.1155/2014/436146] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Revised: 04/19/2014] [Accepted: 04/22/2014] [Indexed: 01/27/2023] Open
Abstract
Subjective tinnitus is characterized by the conscious perception of a phantom sound which is usually more prominent under silence. Resting state recordings without any auditory stimulation demonstrated a decrease of cortical alpha activity in temporal areas of subjects with an ongoing tinnitus perception. This is often interpreted as an indicator for enhanced excitability of the auditory cortex in tinnitus. In this study we want to further investigate this effect by analysing the moment-to-moment variability of the alpha activity in temporal areas. Magnetoencephalographic resting state recordings of 21 tinnitus subjects and 21 healthy controls were analysed with respect to the mean and the variability of spectral power in the alpha frequency band over temporal areas. A significant decrease of auditory alpha activity was detected for the low alpha frequency band (8-10 Hz) but not for the upper alpha band (10-12 Hz). Furthermore, we found a significant decrease of alpha variability for the tinnitus group. This result was significant for the lower alpha frequency range and not significant for the upper alpha frequencies. Tinnitus subjects with a longer history of tinnitus showed less variability of their auditory alpha activity which might be an indicator for reduced adaptability of the auditory cortex in chronic tinnitus.
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Affiliation(s)
- Winfried Schlee
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Astrid Lehner
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Peter M. Kreuzer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Veronika Vielsmeier
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Timm B. Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetsstrasse 84, 93053 Regensburg, Germany
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