Self-Administered Domiciliary tDCS Treatment for Tinnitus: A Double-Blind Sham-Controlled Study
Self-Administered Domiciliary tDCS Treatment for Tinnitus: A Double-Blind Sham-Controlled Study
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DOI：
10.1371/journal.pone.0154286
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发表时间：
2016-04-28
期刊：
影响因子：
3.7
通讯作者：
Aarnisalo, Antti A.
中科院分区：
文献类型：
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作者：
Hyvarinen, Petteri;Makitie, Antti;Aarnisalo, Antti A.
经颅直流电刺激（tDCS）已显示出提供耳鸣缓解的潜力，尽管通常仅在治疗后的短时间内观察到积极的效果。在最近的研究中，重点已经从单次实验转向多次治疗研究，采用双盲和假对照研究设计调查长期结果。传统上，tDCS由医疗保健专业人员在临床环境中进行管理，但在涉及多个治疗疗程的研究中，通常必须在样本量和运行试验所需的劳动量之间进行权衡。此外，随着需要到诊所就诊的次数增加，辍学率可能会按比例上升。本研究的目的是了解tDCS治疗耳鸣是否可以在辅助环境中进行患者管理，以及结果是否与医院治疗研究的结果相当。43例慢性（> 6个月）耳鸣患者参与了这项研究，其中35例患者的数据包括在最终分析中。患者接受20分钟的左颞区阳极（LTA）或双额叶tDCS刺激（2 mA）或假刺激（0.3 mA），连续10天。发现主要结果测量指标耳鸣障碍量表（THI）的总体降低（平均变化-5.0分，p < 0.05），但积极治疗和假治疗结果之间没有显著差异。患者发现tDCS治疗易于管理，并且他们都耐受良好。总之，自我给药辅助tDCS治疗耳鸣是安全可行的，并给出了类似于最近的随机对照长期治疗试验的结果。结果表明，更好的整体治疗反应，如测量THI，与住院治疗相比，辅助治疗，但这种优势是不相关的tDCS变异。本研究中证明的研究方案不仅限于耳鸣。
Transcranial direct current stimulation (tDCS) has shown potential for providing tinnitus relief, although positive effects have usually been observed only during a short time period after treatment. In recent studies the focus has turned from one-session experiments towards multi-session treatment studies investigating long-term outcomes with double-blinded and sham-controlled study designs. Traditionally, tDCS has been administered in a clinical setting by a healthcare professional but in studies involving multiple treatment sessions, often a trade-off has to be made between sample size and the amount of labor needed to run the trial. Also, as the number of required visits to the clinic increases, the dropout rate is likely to rise proportionally. The aim of the current study was to find out if tDCS treatment for tinnitus could be patient-administered in a domiciliary setting and whether the results would be comparable to those from in-hospital treatment studies. Forty-three patients with chronic (> 6 months) tinnitus were involved in the study, and data on 35 out of these patients were included in final analysis. Patients received 20 minutes of left temporal area anodal (LTA) or bifrontal tDCS stimulation (2 mA) or sham stimulation (0.3 mA) for ten consecutive days. An overall reduction in the main outcome measure, Tinnitus Handicap Inventory (THI), was found (mean change -5.0 points, p < 0.05), but there was no significant difference between active and sham treatment outcomes. Patients found the tDCS treatment easy to administer and they all tolerated it well. In conclusion, self-administered domiciliary tDCS treatment for tinnitus was found safe and feasible and gave outcome results similar to recent randomized controlled long-term treatment trials. The results suggest better overall treatment response-as measured by THI-with domiciliary treatment than with in-hospital treatment, but this advantage is not related to the tDCS variant. The study protocol demonstrated in the current study is not restricted to tinnitus only.