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Montazeri K, Farhadi M, Majdabadi A, Akbarnejad Z, Fekrazad R, Shahbazi A, Mahmoudian S. Photobiomodulation therapy in improvement of harmful neural plasticity in sodium salicylate-induced tinnitus. PLoS One 2024; 19:e0296607. [PMID: 38626075 PMCID: PMC11020422 DOI: 10.1371/journal.pone.0296607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/12/2024] [Indexed: 04/18/2024] Open
Abstract
Tinnitus is a common annoying symptom without effective and accepted treatment. In this controlled experimental study, photobiomodulation therapy (PBMT), which uses light to modulate and repair target tissue, was used to treat sodium salicylate (SS)-induced tinnitus in a rat animal model. Here, PBMT was performed simultaneously on the peripheral and central regions involved in tinnitus. The results were evaluated using objective tests including gap pre-pulse inhibition of acoustic startle (GPIAS), auditory brainstem response (ABR) and immunohistochemistry (IHC). Harmful neural plasticity induced by tinnitus was detected by doublecortin (DCX) protein expression, a known marker of neural plasticity. PBMT parameters were 808 nm wavelength, 165 mW/cm2 power density, and 99 J/cm2 energy density. In the tinnitus group, the mean gap in noise (GIN) value of GPIAS test was significantly decreased indicated the occurrence of an additional perceived sound like tinnitus and also the mean ABR threshold and brainstem transmission time (BTT) were significantly increased. In addition, a significant increase in DCX expression in the dorsal cochlear nucleus (DCN), dentate gyrus (DG) and the parafloccular lobe (PFL) of cerebellum was observed in the tinnitus group. In PBMT group, a significant increase in the GIN value, a significant decrease in the ABR threshold and BTT, and also significant reduction of DCX expression in the DG were observed. Based on our findings, PBMT has the potential to be used in the management of SS-induced tinnitus.
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Affiliation(s)
- Katayoon Montazeri
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad Farhadi
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Abbas Majdabadi
- Dentistry Research Institute, Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Zainab Akbarnejad
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Shahbazi
- Faculty of Advanced Technologies in Medicine, Department of Neuroscience, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Saeid Mahmoudian
- The Five Senses Health Institute, ENT and Head and Neck Research Center, School of Medicine, Iran University of Medical Sciences (IUMS), Tehran, Iran
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Nikookam Y, Zia N, Lotfallah A, Muzaffar J, Davis-Manders J, Kullar P, Smith ME, Bale G, Boyle P, Irving R, Jiang D, Bance M. The effect of photobiomodulation on tinnitus: a systematic review. J Laryngol Otol 2023:1-22. [PMID: 37994052 DOI: 10.1017/s0022215123002165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVE To establish outcomes following photobiomodulation therapy for tinnitus in humans and animal studies. METHODS A systematic review and narrative synthesis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The databases searched were: Medline, Embase, Cochrane Central Register of Controlled Trials ('Central'), ClinicalTrials.gov and Web of Science including the Web of Science Core collection. There were no limits on language or year of publication. RESULTS The searches identified 194 abstracts and 61 full texts. Twenty-eight studies met the inclusion criteria, reporting outcomes in 1483 humans (26 studies) and 34 animals (2 studies). Photobiomodulation therapy parameters included 10 different wavelengths, and duration ranged from 9 seconds to 30 minutes per session. Follow up ranged from 7 days to 6 months. CONCLUSION Tinnitus outcomes following photobiomodulation therapy are generally positive and superior to no photobiomodulation therapy; however, evidence of long-term therapeutic benefit is deficient. Photobiomodulation therapy enables concentrated, focused delivery of light therapy to the inner ear through a non-invasive manner, with minimal side effects.
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Affiliation(s)
- Yasmin Nikookam
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Nawal Zia
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Andrew Lotfallah
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Jameel Muzaffar
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
- Department of Clinical Neurosciences, Addenbrooke's Health Campus, University of Cambridge, Cambridge, UK
| | - Jennifer Davis-Manders
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Peter Kullar
- Department of Clinical Neurosciences, Addenbrooke's Health Campus, University of Cambridge, Cambridge, UK
| | - Matthew E Smith
- Department of Clinical Neurosciences, Addenbrooke's Health Campus, University of Cambridge, Cambridge, UK
| | - Gemma Bale
- Department of Physics, University of Cambridge, Cambridge, UK
- Department of Electrical Engineering, University of Cambridge, Cambridge, UK
| | | | - Richard Irving
- Department of Ear, Nose and Throat Surgery, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, UK
| | - Dan Jiang
- Hearing Implant Centre, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Centre for Craniofacial and Regenerative Biology, Guy's Hospital Campus, King's College London, London, UK
| | - Manohar Bance
- Department of Clinical Neurosciences, Addenbrooke's Health Campus, University of Cambridge, Cambridge, UK
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Park KW, Kullar P, Malhotra C, Stankovic KM. Current and Emerging Therapies for Chronic Subjective Tinnitus. J Clin Med 2023; 12:6555. [PMID: 37892692 PMCID: PMC10607630 DOI: 10.3390/jcm12206555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/13/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
IMPORTANCE Chronic subjective tinnitus, the perception of sound without an external source for longer than six months, may be a greatly debilitating condition for some people, and is associated with psychiatric comorbidities and high healthcare costs. Current treatments are not beneficial for all patients and there is a large need for new therapies for tinnitus. OBSERVATIONS Unlike rarer cases of objective tinnitus, chronic subjective tinnitus often has no obvious etiology and a diverse pathophysiology. In the absence of objective testing, diagnosis is heavily based on clinical assessment. Management strategies include hearing aids, sound masking, tinnitus retraining therapy, cognitive behavioral therapy, and emerging therapies including transcranial magnetic stimulation and electrical stimulation. CONCLUSIONS AND RELEVANCE Although current treatments are limited, emerging diagnostics and treatments provide promising avenues for the management of tinnitus symptoms.
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Affiliation(s)
- Ki Wan Park
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Peter Kullar
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Charvi Malhotra
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
| | - Konstantina M. Stankovic
- Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, 801 Welch Rd., Palo Alto, CA 94305, USA
- Department of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd., Palo Alto, CA 94305, USA
- Wu Tsai Neurosciences Institute, Stanford University, 290 Jane Stanford Way, Stanford, CA 94305, USA
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Bousema EJ, Koops EA, van Dijk P, Dijkstra PU. Effects of Physical Interventions on Subjective Tinnitus, a Systematic Review and Meta-Analysis. Brain Sci 2023; 13:brainsci13020226. [PMID: 36831769 PMCID: PMC9954385 DOI: 10.3390/brainsci13020226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 01/31/2023] Open
Abstract
Increasingly, patients suffering from subjective tinnitus seek help from physical therapists. Numerous randomised controlled trials (RCTs) have investigated the effect of physical interventions commonly used in physical therapy practice on subjective tinnitus. This systematic review and meta-analysis aimed to analyse the effects of physical interventions on tinnitus loudness, tinnitus annoyance, and scores on the Tinnitus Handicap Index (THI). Four databases were searched from inception up to March 2022. A total of 39 RCTs were included in the systematic review, and 23 studies were appropriate for meta-analyses. Risk of bias assessments were also performed. Interventions analysed in at least five studies were summarised, including transcutaneous electrical nerve stimulation (TENS), laser therapy, and acupuncture. Random-effects meta-analysis models were used, and effect sizes were expressed as Hedge's standardised mean differences (SMD) with 95%CI's. The quality of three-quarters of the studies was limited due to insufficient allocation concealment, lack of adequate blinding, and small sample sizes. Large, pooled effects sizes were found for acupuncture (SMD: 1.34; 95%CI: 0.79, 1.88) and TENS (SMD: 1.17; 95%CI: 0.48, 1.87) on THI as well as for acupuncture on tinnitus loudness (VAS Loudness (SMD: 0.84; 95%CI: 0.33, 1.36) and tinnitus annoyance (SMD: 1.18; 95%CI: 0.00, 2.35). There is some evidence that physical interventions (TENS and acupuncture, but not laser therapy) may be effective for tinnitus. However, the lack of high-quality studies and the risk of bias in many studies prohibits stronger conclusions.
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Affiliation(s)
- Eric J. Bousema
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Centre Groningen, 9712 CP Groningen, The Netherlands
- Fysiotherapie Sittard Oost, 6137 RX Sittard, The Netherlands
- Correspondence: ; Tel.: +31-630-878505
| | - Elouise A. Koops
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Centre Groningen, 9712 CP Groningen, The Netherlands
- Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University of Groningen, 9712 CP Groningen, The Netherlands
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Pim van Dijk
- Department of Otorhinolaryngology, Head & Neck Surgery, University of Groningen, University Medical Centre Groningen, 9712 CP Groningen, The Netherlands
- Graduate School of Medical Sciences, Research School of Behavioural and Cognitive Neurosciences, University of Groningen, 9712 CP Groningen, The Netherlands
| | - Pieter U. Dijkstra
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, 9712 CP Groningen, The Netherlands
- Department of Rehabilitation Medicine, University of Groningen, University Medical Centre Groningen, 9712 CP Groningen, The Netherlands
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Eladl HM, Elkholi SM, Eid MM, Abdelbasset WK, Ali ZA, Bahey El-Deen HA. Effect of adding a supervised physical therapy exercise program to photobiomodulation therapy in the treatment of cervicogenic somatosensory tinnitus: A randomized controlled study. Medicine (Baltimore) 2022; 101:e29946. [PMID: 35945770 PMCID: PMC9351917 DOI: 10.1097/md.0000000000029946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVES To evaluate the effectiveness of adding a supervised physical therapy exercise program to photobiomodulation therapy (PBMT) in the treatment of cervicogenic somatosensory tinnitus (CST). METHODS Forty patients suffering from CST with age 45-55 years were included in the study. They were assigned randomly into 2 groups, 20 per each. (Study group) Group (A) received a supervised physical therapy exercise program in addition to 20 minutes PBMT with a 650-nanometer wavelength and a 5 milliWatt power output, spot size of 1 cm2, and energy density of 6 Joules, 3 sessions per week for 8 consecutive weeks, plus traditional medical treatment. While (control group), group (B) received the same PBMT protocol, 3 sessions per week for 8 consecutive weeks in addition to the traditional medical treatment. Tinnitus visual analog scaling (VAS), tinnitus handicap inventory (THI), and cervical range of motion (ROM) were measured at baseline and after 8 weeks. RESULTS Mixed MANOVA showed a statistically significant reduction in tinnitus VAS, THI, and a significant improvement in cervical ROM (flexion, extension, right bending, left bending, right rotation, and left rotation) in favor of Group A (P < .05). There was a significant decrease in posttreatment VAS treatment (P > .001) MD [-2.05(-2.68:-1.41)], and THI relative to pretreatment mean difference [-5.35(-8.51: -2.19)] and a significant increase in posttreatment neck ROM in Groups A and B relative to pretreatment neck ROM (P > .001). Flexion range posttreatment MD[3.65(1.64:5.65)], Extension MD [6.55(1.35:11.75)], right bending MD[3.8(2.51:5.08)], left bending MD[1.75(0.19:3.3)], right rotation MD [3.5(1.28:5.71)] and left rotation [2.75(0.67:4.82)]. CONCLUSIONS Adding a supervised physical therapy exercise program to PBMT showed positive and beneficial effects in the treatment of CST using VAS, THI, and Cervical ROM assessment tools.
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Affiliation(s)
- Hadaya Mosaad Eladl
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Safaa M. Elkholi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Marwa M. Eid
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
- Department of Physical Therapy, College of Applied Medical Sciences, Taif University, Taif, Saudi Arabia
| | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
- Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt
- *Correspondence: Walid Kamal Abdelbasset, Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia (e-mail: )
| | - Zeinab A. Ali
- Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Science, Jouf University, Saudi Arabia
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Cairo University, Giza, Egypt
| | - Heba A. Bahey El-Deen
- Department of Physical Therapy for Surgery, Faculty of Physical Therapy, Misr University for Science and Technology, Giza, Egypt
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Talluri S, Palaparthi SM, Michelogiannakis D, Khan J. Efficacy of photobiomodulation in the management of tinnitus: A systematic review of randomized control trials. Eur Ann Otorhinolaryngol Head Neck Dis 2021; 139:83-90. [PMID: 33685826 DOI: 10.1016/j.anorl.2020.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/03/2020] [Accepted: 10/21/2020] [Indexed: 11/24/2022]
Abstract
There is a controversy in regards to the efficacy of photobiomodulation (PBM) in the management of tinnitus. The aim was to systematically review randomized controlled trials (RCTs) that assessed the efficacy of PBM (low-level laser therapy) in the management of tinnitus. The focused question was "Is PBM effective in the management of tinnitus?". Indexed databases were searched up to and including June 2020 using different combinations of the following key words: (a) laser; (b) diode; (c) low-level laser therapy; (d) photobiomodulation; (e) tinnitus; (f) medium-level laser; (g) photo-biomodulation; and (h) low-power laser; and RCTs performed on humans were included. Letters to the editor; case reports/series; commentaries; experimental studies and historic reviews were excluded. The risk of bias was assessed using the modified cochrane collaboration tool. The format of the current systematic review was personalized to summarize the appropriate information. Ten RCTs (2 single-blinded and 8 double-blinded) were included. One study reported 30% and 100% resolution of tinnitus using diode and Neodymium-doped Yttrium Aluminum Garnet lasers; respectively. One study reported that PBM was effective in relieving tinnitus for up to 3 months. Eight studies reported that PBM was ineffective in the management of chronic tinnitus. The risk of bias was high; medium and low in 4; 5 and 1 studies; respectively. The effectiveness of PBM in the management of tinnitus remains debatable. Further power-adjusted and well-designed RCTs with long-term follow-up are needed.
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Affiliation(s)
- S Talluri
- Orofacial Pain and TMJD, Eastman Institute for Oral Health, Rochester, 625 Elmwood Ave, Rochester, NY 14620, USA
| | - S M Palaparthi
- Vijay Super Specialty Dental Hospital, Guptha's square, Ongole, AP 530013, India
| | - D Michelogiannakis
- Department of Orthodontics, Eastman Institute for Oral Health, Rochester, 625 Elmwood Ave, Rochester, NY 14620, USA
| | - J Khan
- Orofacial Pain and TMJD, Eastman Institute for Oral Health, Rochester, 625 Elmwood Ave, Rochester, NY 14620, USA.
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Ferreira MC, de Matos IL, de Toledo IP, Honório HM, Mondelli MFCG. Effects of Low-Level Laser Therapy as a Therapeutic Strategy for Patients With Tinnitus: A Systematic Review. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:279-298. [PMID: 33375822 DOI: 10.1044/2020_jslhr-20-00066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose This systematic review aimed to analyze the effects of low-level laser therapy (LLLT) on the severity of tinnitus when compared to no therapy or other modalities of therapies. Method A systematic review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under the Registration Number CRD42019119376. A search was performed in each of the following databases: EMBASE, LILACS, PubMed, Science Direct, Scopus, Web of Science, Google Scholar, and ProQuest. The inclusion criteria consisted of studies in adults over 16 years of age, randomized clinical trials in which subjects presented chronic (≥ 6 months) and subjective tinnitus (unilateral or bilateral) as well as with or without bilateral sensorineural hearing loss, and studies that used only LLLT for treatment of tinnitus compared to no-therapy group or other modalities of therapy. No language or time restrictions were stipulated. The references were managed by Endnote Web and Rayyan QCRI. Results After the screening process, seven studies remained that attained the eligibility criteria. Regarding the risk of bias, only one study was categorized as low risk of bias; the six remaining studies were classified as moderate risk of bias. The seven included studies mainly assessed the LLLT effects on tinnitus by Visual Analogue Scale, Tinnitus Handicap Inventory, pitch and loudness matching, minimum masking level, and pure-tone audiometry. All the seven selected studies found different degrees of significant results regarding tinnitus severity; however, there was no consensus among the results. Conclusion Even though the LLLT showed positive effects in the tinnitus severity in some studies, it is not possible yet to make any recommendation over its uses for the treatment of tinnitus severity.
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Affiliation(s)
- Maria Carolina Ferreira
- Speech Therapy Program, Bauru School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Izabella Lima de Matos
- Speech Therapy Program, Bauru School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
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Chen CH, Huang CY, Chang CY, Cheng YF. Efficacy of Low-Level Laser Therapy for Tinnitus: A Systematic Review with Meta-Analysis and Trial Sequential Analysis. Brain Sci 2020; 10:brainsci10120931. [PMID: 33276501 PMCID: PMC7761002 DOI: 10.3390/brainsci10120931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 11/16/2022] Open
Abstract
STUDY OBJECTIVE Tinnitus is a common disorder characterized by sound in the ear in the absence of external or internal stimuli. Low-level laser therapy (LLLT) was discovered enhancing tissue repair via increasing the blood microcirculation and cell proliferation in 1960s. In the last two decades, LLLT delivered to the cochlea has frequently been used to reduce the severity of tinnitus. However, whether LLLT effectively attenuates the severity of tinnitus remains controversial. We aimed to evaluate the efficacy of low-level laser therapy on adult patients with complaints of tinnitus. DESIGN Systematic review and meta-analysis with trial sequential analysis. INTERVENTIONS Low-level laser therapy (LLLT). MEASUREMENTS Tinnitus Handicap Inventory (THI) score; improvement rates of the visual analog scale (VAS), verbal rating scale (VRS) and numeric rating scale (NRS) scores. METHODS We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library from inception through 17 September 2020. Randomized control trials that involved adult patients with complaints of tinnitus, compared LLLT to a placebo and provided sufficient information for meta-analysis were considered eligible. MAIN RESULTS Overall, 11 studies involving 670 patients were included. No significant difference in the overall effect according to the THI score (mean difference (MD), -2.85; 95% CI, -8.99 to 3.28; p = 0.362; I2 = 0%) and the rating scale score improvement rate (risk ratio (RR), 1.35; 95% CI, 0.81 to 2.27; p = 0.250; I2 = 67%) was demonstrated between patients receiving LLLT and those receiving a placebo. None of the subgroup analyses showed significant differences, regardless of underlying sensorineural hearing loss, the number of irradiation sessions or the wavelength used. CONCLUSIONS Our meta-analysis suggests that the value of LLLT in controlling the severity of tinnitus remains unclear, in part due to the relatively small number of patients and underlying heterogeneity. More large-scale investigations of LLLT for tinnitus related to inner ear disease are required to further elucidate the therapeutic effects.
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Affiliation(s)
- Chih-Hao Chen
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
| | - Chii-Yuan Huang
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
- Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| | - Chun-Yu Chang
- Department of Anesthesiology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 231, Taiwan;
| | - Yen-Fu Cheng
- Department of Otolaryngology-Head and Neck Surgery, Taipei Veterans General Hospital, Taipei 112, Taiwan; (C.-H.C.); (C.-Y.H.)
- Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan
- Department of Medical Research, Taipei Veterans General Hospital, Taipei 112, Taiwan
- Institute of Brain Science, National Yang-Ming University, Taipei 112, Taiwan
- Correspondence: ; Tel.: +886-2-2871-2121 (ext. 1292)
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Clinical practice guidelines for diagnosis and treatment of chronic tinnitus in Japan. Auris Nasus Larynx 2019; 47:1-6. [PMID: 31606294 DOI: 10.1016/j.anl.2019.09.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/23/2019] [Accepted: 09/20/2019] [Indexed: 11/24/2022]
Abstract
Clinical practice guidelines in Japan for tinnitus were published in May 2019. Effective treatment of tinnitus contributes to quality of life and may improve depression, anxiety, and cognitive function. The highest priority of treatment recommended by this guideline involves educational counseling, including an explanation of the mechanisms of tinnitus. Understanding tinnitus pathology has also been reported to be a therapeutically effective educational counseling strategy. Further, explaining how sound therapy such as tinnitus retraining therapy (TRT) works is effective. Psychological and cognitive behavioral therapies may be an option. Here, the hearing aid is coupled with a sound generator in order to administer sound therapy for patients with more-severe symptoms. In Japan, it can be difficult to perform psychotherapy alongside otorhinolaryngology, and exemplary sound therapy is more likely to be carried out. In any case, the purpose of treatment is not to eliminate tinnitus, but rather reduce distress that manifests in response to tinnitus by promoting sensory adaptation. Clinically, the most important subject is not the loudness of tinnitus, but the severity of tinnitus distress. TRT consists of educational counseling and sound therapy. The tinnitus handicap inventory (THI) is used to measure the distress level for tinnitus and to determine treatment priorities. Rehabilitation of tinnitus is important because anxiety and depression are often observed in patients with severe tinnitus. Additionally, drug administration should be avoided. As a surgical treatment, a cochlear implant can affect tinnitus symptoms. It is essential to establish a treatment policy according to the disease condition and degree of distress.
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Applications of photobiomodulation in hearing research: from bench to clinic. Biomed Eng Lett 2019; 9:351-358. [PMID: 31456894 DOI: 10.1007/s13534-019-00114-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 04/28/2019] [Accepted: 06/04/2019] [Indexed: 02/06/2023] Open
Abstract
Hearing loss is very common and economically burdensome. No accepted therapeutic modality for sensorineural hearing loss is yet available; most clinicians emphasize rehabilitation, placing hearing aids and cochlear implants. Photobiomodulation (PBM) employs light energy to enhance or modulate the activities of specific organs, and is a popular non-invasive therapy used to treat skin lesions and neurodegenerative disorders. Efforts to use PBM to improve hearing have been ongoing for several decades. Initial in vitro studies using cell lines and ex vivo culture techniques have now been supplanted by in vivo studies in animals; PBM protects the sensory epithelium and triggers neural regeneration. Many reports have used PBM to treat tinnitus. In this brief review, we introduce PBM applications in hearing research, helpful protocols, and relevant background literature.
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Montazeri K, Mahmoudian S, Razaghi Z, Farhadi M. Alterations in Auditory Electrophysiological Responses Associated With Temporary Suppression of Tinnitus Induced by Low-Level Laser Therapy: A Before-After Case Series. J Lasers Med Sci 2017; 8:S38-S45. [PMID: 29071034 DOI: 10.15171/jlms.2017.s8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. The treatment is difficult due to multiple etiologies and great psychological influence. The purpose of this study was to determine alterations in auditory physiological and electrophysiological responses associated with temporary suppression of tinnitus induced by low-level laser (LLL) irradiation. Methods: This study was conducted on 20 subjects with subjective tinnitus. All subjects signed the informed consent form and satisfied all the study eligibility criteria. Visual analog scale (VAS) for loudness, loudness matching of tinnitus (LMT), pitch matching of tinnitus (PMT), Persian-tinnitus questionnaire (P-TQ) and Persian-tinnitus handicap inventory (P-THI) were conducted pre- and post-low level laser therapy (LLLT) for all the subjects. Electrocochleography (ECochG) and distortion product otoacoustic emissions (DPOAEs) were recorded in 11 subjects. Continuous wave diode lasers, including red (630 nm) and infra-red (808 nm) were applied, and were both designed by the Canadian Optic and Laser (COL) Center. Twelve sessions of laser therapy were performed, 2 sessions per week for each subject. Total dose was 120 Joule/ ear/session. Results: LLL irradiation could cause a significant decrease in subjective tests scores consisting of VAS for loudness, PMT, P-TQ, P-THI, but did not result in a significant improvement of objective evaluating parameters except for compound action potential (CAP) amplitude. Conclusion: LLLT might be a subjectively effective treatment for short-term improvement of tinnitus. Defining a new protocol for optimizing LLLT parameters may be an option to improve parameters of objective tests.
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Affiliation(s)
- Katayoon Montazeri
- Laboratory for Auditory Neuroscience, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Mahmoudian
- Laboratory for Auditory Neuroscience, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Razaghi
- Laser Application in Medical Sciences Research Center (LAMSRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Farhadi
- Laboratory for Auditory Neuroscience, ENT and Head & Neck Research Center, Iran University of Medical Sciences, Tehran, Iran
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Demirkol N, Usumez A, Demirkol M, Sari F, Akcaboy C. Efficacy of Low-Level Laser Therapy in Subjective Tinnitus Patients with Temporomandibular Disorders. Photomed Laser Surg 2017; 35:427-431. [PMID: 28294697 DOI: 10.1089/pho.2016.4240] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE AND BACKGROUND Tinnitus is an apparent sound, perceived in the ear with no stimulus. It has been described as a sound originating from the brain. It affects 17% of the general population. Etiological factors for tinnitus include temporomandibular joint disorders (TMJ, TMD) and Costen's syndrome. The aim of treatment is to eliminate the tinnitus or at least decrease its apparent volume. MATERIALS AND METHODS In total, 46 patients referred to our department with bilateral subjective tinnitus with TMDs were selected for this study. Low-level laser therapy (LLLT) with an neodymium-doped yttrium aluminum garnet (Nd:YAG) (1064 nm) laser, LLLT with a diode laser (810 nm), and placebo treatment were applied to the patients. There were 15 patients each in the Nd:YAG and placebo groups and 16 patients in the 810 nm diode laser group. LLLT was applied for 10 days, once per day. A visual analog scale (VAS) was used, with values between 0 and 10. VAS scores were recorded before treatment, on the last day of treatment, and 1 month after treatment. The VAS scores were the same on the last day of treatment and 1 month after treatment. The VAS scores before treatment and at 1 month after treatment were compared in a statistical analysis. RESULTS There were statistically significant differences in the Nd:YAG laser (p = 0.001) and 810 nm diode laser groups (p = 0.005), but no difference in the placebo group (p = 0.065). CONCLUSIONS Both the Nd:YAG and 810 nm diode lasers were effective for the treatment of subjective tinnitus related to TMDs.
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Affiliation(s)
- Nermin Demirkol
- 1 Department of Prosthodontics, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | | | - Mehmet Demirkol
- 3 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | - Fatih Sari
- 1 Department of Prosthodontics, Faculty of Dentistry, Gaziantep University , Gaziantep, Turkey
| | - Cihan Akcaboy
- 4 Department of Prosthodontics, Faculty of Dentistry, Gazi University , Ankara, Turkey
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13
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Photobiomodulation by laser therapy rescued auditory neuropathy induced by ouabain. Neurosci Lett 2016; 633:165-173. [DOI: 10.1016/j.neulet.2016.09.039] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 08/14/2016] [Accepted: 09/22/2016] [Indexed: 12/18/2022]
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14
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Plein CT, Harounian J, Floyd E, Irizarry R, Ferzli G, Kidwai S, Rosenfeld RM. A Systematic Review of Eligibility and Outcomes in Tinnitus Trials. Otolaryngol Head Neck Surg 2015; 154:24-32. [DOI: 10.1177/0194599815608160] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 09/03/2015] [Indexed: 11/16/2022]
Abstract
Objective To analyze existing tinnitus treatment trials with regard to eligibility criteria, outcome measures, study quality, and external validity and to recognize the effect of patient demographics, symptom duration, severity, and otologic comorbidity on research findings to help practitioners apply them to patient encounters. Data Sources Systematic literature search conducted by an information specialist for development of the American Academy of Otolaryngology—Head and Neck Surgery Foundation’s tinnitus clinical practice guideline. Review Methods Articles were assessed for eligibility with the PRISMA protocol (Preferred Reporting Items for Systematic Reviews and Meta-analyses) and data extracted by 2 independent investigators. Studies were assessed for methodological quality, inclusion and exclusion criteria, patient demographics, and outcome measures. Results A total of 147 randomized trials met inclusion criteria. Nearly all studies took place in a specialist setting. More than 50% did not explicitly define tinnitus, and 44% used a subjective severity threshold, such as “severely disturbing.” Fifty-four percent required symptom duration of at least 6 months for study eligibility, and up to 33% excluded patients with “organic” hearing loss or otologic conditions. Mean age was 52.2 years, and median follow-up was 3 months. Only 20% had a low risk of bias. Conclusion Randomized trials of tinnitus interventions are most applicable to older adults with tinnitus lasting ≥6 months who are evaluated in specialty settings. High risk of bias, short follow-up, and outcome reporting raise concerns about the validity of findings and may influence how clinicians apply trial results to individual patients and establish treatment expectations, thus demonstrating the need for further quality research in this field.
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Affiliation(s)
- Colleen T. Plein
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Jonathan Harounian
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Elizabeth Floyd
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Rachel Irizarry
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - George Ferzli
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - Sarah Kidwai
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Richard M. Rosenfeld
- Department of Otolaryngology, SUNY Downstate Medical Center, Brooklyn, New York, USA
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Medium-level laser in chronic tinnitus treatment. BIOMED RESEARCH INTERNATIONAL 2013; 2013:324234. [PMID: 24294604 PMCID: PMC3835591 DOI: 10.1155/2013/324234] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 07/17/2013] [Accepted: 07/18/2013] [Indexed: 01/15/2023]
Abstract
The purpose of this study was to evaluate the effect of medium-level laser therapy in chronic tinnitus treatment. In a prospective double-blind placebo-controlled trial, either active laser (450 mW, 830 nm combined Ga-Al-As diode laser) or placebo irradiation was applied through the external acoustic meatus of the affected ear towards the cochlea. Fourty-eight patients with chronic tinnitus were studied. The main outcome was measured using the Goebel tinnitus questionnaire, visual analogue scales measuring the perceived loudness of tinnitus, the annoyance associated with tinnitus, and the degree of attention paid to tinnitus as well as psycho-acoustical matches of tinnitus pitch and loudness. The results did show only very moderate temporary improvement of tinnitus. Moreover, no statistically relevant differences between laser and placebo group could be found. We conclude that medium-level laser therapy cannot be regarded as an effective treatment of chronic tinnitus in our therapy regime considering the limited number of patients included in our study.
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16
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Low-Level Laser on Hearing: Is There an Effect? ISRN OTOLARYNGOLOGY 2013; 2013:839256. [PMID: 24319598 PMCID: PMC3844230 DOI: 10.1155/2013/839256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 10/01/2013] [Indexed: 11/17/2022]
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17
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Efficacy of low-level laser therapy in the management of tinnitus due to noise-induced hearing loss: a double-blind randomized clinical trial. ScientificWorldJournal 2013; 2013:596076. [PMID: 24288494 PMCID: PMC3830897 DOI: 10.1155/2013/596076] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Accepted: 09/12/2013] [Indexed: 12/28/2022] Open
Abstract
Background. Several remedial modalities for the treatment of tinnitus have been proposed, but an effective standard treatment is still to be confirmed. In the present study, we aimed to evaluate the effect of low-level laser therapy on tinnitus accompanied by noise-induced hearing loss. Methods. This was a double-blind randomized clinical trial on subjects suffering from tinnitus accompanied by noise-induced hearing loss. The study intervention was 20 sessions of low-level laser therapy every other day, 20 minutes each session. Tinnitus was assessed by three methods (visual analog scale, tinnitus handicap inventory, and tinnitus loudness) at baseline, immediately and 3 months after the intervention. Results. All subjects were male workers with age range of 30–51 years. The mean tinnitus duration was 1.85 ± 0.78 years. All three measurement methods have shown improved values after laser therapy compared with the placebo both immediately and 3 months after treatment. Laser therapy revealed a U-shaped efficacy throughout the course of follow-up. Nonresponse rate of the intervention was 57% and 70% in the two assessment time points, respectively. Conclusion. This study found low-level laser therapy to be effective in alleviating tinnitus in patients with noise-induced hearing loss, although this effect has faded after 3 months of follow-up. This trial is registered with the Australian New Zealand clinical trials registry with identifier ACTRN12612000455864).
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Patterns of traditional chinese medicine diagnosis in thermal laser acupuncture treatment of knee osteoarthritis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:870305. [PMID: 24069060 PMCID: PMC3771475 DOI: 10.1155/2013/870305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Revised: 08/07/2013] [Accepted: 08/14/2013] [Indexed: 11/28/2022]
Abstract
Knee osteoarthritis (OA) manifests with pain, joint stiffness, and limited function. In traditional Chinese medicine, knee OA is differentiated into three patterns: yang deficiency and cold coagulation, kidney deficiency, and blood stasis. The objective of this study was to determine whether yang deficiency cold coagulation patients respond better to thermal laser acupuncture treatment than do non-yang deficient patients. Fifty-two patients with OA were allocated to group A (yang deficient, n = 26) or B (non-yang deficient, n = 26). All patients received a 20-min thermal laser acupuncture treatment at acupoint Dubi (ST 35) three times a week for two weeks and twice a week for another four weeks. Outcome assessments were performed immediately after the first treatment, and at weeks 2, 6, and 10. Group A function scores were significantly better than those of Group B at weeks 2 (P = 0.049), 6 (P = 0.046), and 10 (P = 0.042), but no significant differences were found between the two groups in pain and stiffness scores at any time point. No significant adverse effect was observed. The combined 10.6 μm–650 nm laser treatment might be most beneficial to yang deficiency cold coagulation knee OA patients, particularly in improving function.
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Goodman SS, Bentler RA, Dittberner A, Mertes IB. The effect of low-level laser therapy on hearing. ISRN OTOLARYNGOLOGY 2013; 2013:916370. [PMID: 24024040 PMCID: PMC3658388 DOI: 10.1155/2013/916370] [Citation(s) in RCA: 248] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/27/2013] [Indexed: 11/18/2022]
Abstract
One purported use of low-level laser therapy (LLLT) is to promote healing in damaged cells. The effects of LLLT on hearing loss and tinnitus have received some study, but results have been equivocal. The purpose of this study was to determine if LLLT improved hearing, speech understanding, and/or cochlear function in adults with hearing loss. Using a randomized, double-blind, placebo-controlled design, subjects were assigned to a treatment, placebo, or control group. The treatment group was given LLLT, which consisted of shining low-level lasers onto the outer ear, head, and neck. Each laser treatment lasted approximately five minutes. Three treatments were applied within the course of one week. A battery of auditory tests was administered immediately before the first treatment and immediately after the third treatment. The battery consisted of pure-tone audiometry, the Connected Speech Test, and transient-evoked otoacoustic emissions. Data were analyzed by comparing pre- and posttest results. No statistically significant differences were found between groups for any of the auditory tests. Additionally, no clinically significant differences were found in any individual subjects. This trial is registered with ClinicalTrials.gov (NCT01820416).
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Affiliation(s)
- Shawn S. Goodman
- Department of Communication Sciences & Disorders, The University of Iowa, Iowa City, IA 52242, USA
| | - Ruth A. Bentler
- Department of Communication Sciences & Disorders, The University of Iowa, Iowa City, IA 52242, USA
| | | | - Ian B. Mertes
- Department of Communication Sciences & Disorders, The University of Iowa, Iowa City, IA 52242, USA
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20
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Peng Z, Chen XQ, Gong SS, Chen CF. Low-level laser therapy for tinnitus. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2012. [DOI: 10.1002/14651858.cd009811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Salahaldin AH, Abdulhadi K, Najjar N, Bener A. Low-level laser therapy in patients with complaints of tinnitus: a clinical study. ISRN OTOLARYNGOLOGY 2012; 2012:132060. [PMID: 23724264 PMCID: PMC3658799 DOI: 10.5402/2012/132060] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Accepted: 02/16/2012] [Indexed: 01/09/2023]
Abstract
Objective. The objective of the study was to investigate the effectiveness of low-level laser therapy (LLLT) in treating patients who were suffering from long-term complaints of tinnitus with well-understood etiology and who were not responding to conventional therapy in Qatar. Design. This is a prospective clinical study conducted during the period from May 2010 and February 2011. Setting. Audiology Clinic, Outpatient Department, Hamad General Hospital. Subjects and Methods. The study included 65 patients aged 15–76 years with chronic unilateral or bilateral tinnitus with a minimum duration of illness of one year. The investigation included 101 ears of 65 patients. A 5 mW laser with a wavelength of 650 nm was applied transmeatally for 20 minutes once daily for 3 months. The study was based on a face-to-face interview with a designed questionnaire that recorded the diagnosis of patients, clinical evaluation and audiometric test results, and side effects of low-level laser therapy (LLLT) and scored their symptoms loudness on five-point scale every two weeks. A decrease of one scale point regarding the loudness duration and degree of annoyance of tinnitus was accepted to represent an improvement; at the same time, a pure tone audiometric test was carried out and the results recorded. In addition, a record of the side effect was taken. Results. Over half of the patients (56.9%) had some form of improvement in their tinnitus symptoms. Mild improvement was reported in 33.8% of patients, moderate improvement was reported in 16.9%, and full improvement was reported in 6.15%. Of the patients who reported dizzy spells as a symptom of their tinnitus condition, 27.7% reported mild improvement and 16.9% reported full improvement. Common side effects of LLLT were noted among 20% of patients; however, all of them were mild and disappeared within a few days. Conclusion. Low-level laser therapy was found to be useful for treatment of chronic tinnitus.
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Affiliation(s)
- Ahmed H Salahaldin
- ENT and Head and Neck Surgery Department, Audiology and Balance Unit, Rumaillah Hospital and Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
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22
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Yıldırım G, Berkiten G, Uğraş H, Saltürk Z. Changes in Audiometry Results Following
Laser Therapy for Tinnitus. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2011. [DOI: 10.29333/ejgm/82757] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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23
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Fioretti A, Eibenstein A, Fusetti M. New trends in tinnitus management. Open Neurol J 2011; 5:12-7. [PMID: 21541237 PMCID: PMC3085173 DOI: 10.2174/1874205x01105010012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 11/11/2010] [Accepted: 12/02/2010] [Indexed: 11/22/2022] Open
Abstract
Tinnitus is a perception of sound in absence of sound stimulation. Tinnitus in many cases cannot be eliminated by conventional medical treatment with drugs or surgery. Some people who begin to notice tinnitus, whether spontaneous or induced by noise, trauma or other insult, will experience spontaneous resolution, but many patients will have persistent tinnitus. For some of them, tinnitus sensation will be joined by tinnitus suffering, with many adverse effects like anxiety, depression and sleep disorders. For these tinnitus sufferers the psychological and acoustic approach proposed by the Tinnitus Retraining Therapy and Acoustic Desensitization Protocol may be helpful. Periodically new treatments are suggested like low-frequency repetitive transcranial magnetic stimulation and sequential phase shift sound cancellation treatment based on the frequency and loudness matching of the tinnitus. The aim of this work is to review modern considerations for the treatment of tinnitus.
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Zhao L, Shen X, Cheng K, Deng H, Ding G, Tan M, Lao L. Validating a Nonacupoint Sham Control for Laser Treatment of Knee Osteoarthritis. Photomed Laser Surg 2010; 28:351-6. [DOI: 10.1089/pho.2009.2511] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- Ling Zhao
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Center of Acupuncture & Meridian, Shanghai, China
| | - Xueyong Shen
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Center of Acupuncture & Meridian, Shanghai, China
| | - Ke Cheng
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Center of Acupuncture & Meridian, Shanghai, China
| | - Haiping Deng
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Shanghai Research Center of Acupuncture & Meridian, Shanghai, China
| | - Guanghong Ding
- Shanghai Research Center of Acupuncture & Meridian, Shanghai, China
| | - Ming Tan
- University of Maryland School of Medicine, Baltimore, Maryland
| | - Lixing Lao
- University of Maryland School of Medicine, Baltimore, Maryland
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Edelmuth RCL, Nitsche MA, Battistella L, Fregni F. Why do some promising brain-stimulation devices fail the next steps of clinical development? Expert Rev Med Devices 2010; 7:67-97. [PMID: 20021241 DOI: 10.1586/erd.09.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Interest in techniques of noninvasive brain stimulation (NIBS) has been growing exponentially in the last decade. Recent studies have shown that some of these techniques induce significant neurophysiological and clinical effects. Although recent results are promising, there are several techniques that have been abandoned despite positive initial results. In this study, we performed a systematic review to identify NIBS methods with promising preliminary clinical results that were not fully developed and adopted into clinical practice, and discuss its clinical, research and device characteristics. We identified five devices (transmeatal cochlear laser stimulation, transcranial micropolarization, transcranial electrostimulation, cranial electric stimulation and stimulation with weak electromagnetic fields) and compared them with two established NIBS devices (transcranial magnetic stimulation and transcranial direct current stimulation) and with well-known drugs used in neuropsychiatry (pramipexole and escitalopram) in order to understand the reasons why they failed to reach clinical practice and further steps of research development. Finally, we also discuss novel NIBS devices that have recently showed promising results: brain ultrasound and transcranial high-frequency random noise stimulation. Our results show that some of the reasons for the failure of NIBS devices with promising clinical findings are the difficulty to disseminate results, lack of controlled studies, duration of research development, mixed results and lack of standardization.
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Affiliation(s)
- Rodrigo C L Edelmuth
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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