Maintenance repetitive transcranial magnetic stimulation can inhibit the return of tinnitus.
Maintenance repetitive transcranial magnetic stimulation can inhibit the return of tinnitus.
复制标题
维持重复经颅磁刺激可以抑制耳鸣的复发。
DOI：
10.1097/mlg.0b013e318170f8ac
复制
发表时间：
2008
期刊：
影响因子：
--
通讯作者：
Dornhoffer,John
中科院分区：
文献类型：
--
作者：
Mennemeier,Mark;Chelette,KennethC;Myhill,Jeffery;Taylor-Cooke,Patricia;Bartel,Twyla;Triggs,William;Kimbrell,Timothy;Dornhoffer,John
目的/假设：对单个患者进行了测试，以检查使用低频重复经颅磁刺激维持治疗的安全性和可行性研究设计：中断时间序列多次重复。方法：使用视觉模拟等级（VAR）评估耳鸣响度，0 =无耳鸣，100 =经历过最大声耳鸣;在后部以1Hz和110%运动阈值递送1，800个TMS脉冲，受试者右半球的上级外侧颞回，直到主观耳鸣下降到VAR 25。当耳鸣恢复到VAR 25或更高时，重新应用TMS。脑代谢测定使用正电子发射断层扫描治疗前后。结果：在这个病人，耳鸣可以减少到VAR为6或更低，每次使用一到三个维护会议的rTMS再次发生。耳鸣响度保持在或低于VAR 25，并且在第三轮和最后一轮维持治疗后4个月进行最后一次评估时，报告在日常生活中不显眼。治疗后右半球的不对称性脑代谢增加减少，耳鸣改善。维持治疗耐受性良好，没有副作用。结论：虽然一个案例研究不能建立治疗效果，这项研究首次表明，它是可行的，使用维护rTMS来管理慢性耳鸣。维持性rTMS可能会阻碍耳鸣频率向邻近皮层区域的皮层扩展，但需要进行小组研究来证实这一推测。
Objectives/Hypothesis:A single patient was tested to examine the safety and feasibility of using maintenance sessions of low‐frequency repetitive transcranial magnetic stimulation (1 Hz rTMS) to reduce tinnitus loudness and prevent its return over time.Study Design:Interrupted time series with multiple replications.Methods:Tinnitus loudness was assessed using a visual analogue rating (VAR) with 0 = no tinnitus, and 100 = loudest tinnitus experienced; 1,800 TMS pulses delivered at 1 Hz and 110% of motor threshold were administered over the posterior, superior lateral temporal gyrus of the subject's right hemisphere until subjective tinnitus fell to a VAR of 25. TMS was reapplied as tinnitus returned to a VAR of 25 or higher. Cerebral metabolism was measured using positron emission tomography before and after treatment.Results:In this patient, tinnitus could be reduced to a VAR of 6 or lower each time it reoccurred using one to three maintenance sessions of rTMS. Tinnitus loudness remained at or below a VAR of 25 and was reported to be unobtrusive in daily life when last assessed 4 months after the third and final round of maintenance treatment. Asymmetric increased cerebral metabolism in the right hemisphere reduced following treatment and as tinnitus improved. Maintenance treatment was well tolerated with no side effects.Conclusions:Although a case study cannot establish treatment efficacy, this study demonstrates for the first time that it is feasible to use maintenance rTMS to manage chronic tinnitus. Maintenance rTMS might impede cortical expansion of the tinnitus frequency into adjacent cortical areas, but group studies are necessary to confirm this speculation.