Comparison of the outcomes of repetitive transcranial magnetic stimulation to the ipsilateral and contralateral auditory cortex in unilateral tinnitus
Comparison of the outcomes of repetitive transcranial magnetic stimulation to the ipsilateral and contralateral auditory cortex in unilateral tinnitus
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DOI：
10.3109/15368378.2013.801353
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发表时间：
2014-09-01
影响因子：
1.7
通讯作者：
Moon, In Seok
中科院分区：
文献类型：
--
作者：
Kim, Bo Gyung;Kim, Deog Young;Moon, In Seok
经颅磁刺激（TMS）是一种非侵入性的激活或停用人类大脑的焦点区域的方法。重复TMS（rTMS）应用于颞顶皮层已被报道显示耳鸣的治疗效果。我们比较了单侧耳鸣患者对侧或同侧有症状的耳朵的1 Hz rTMS的效果。本研究纳入了40例不对称性听力损失和非脉动性耳鸣患者，这些患者局限于持续时间≥ 6个月的较差耳，并且对药物治疗无效。患者被随机分配到两个治疗组中的一个：1 Hz刺激施加同侧（n = 21）或对侧（n = 19）的颞顶交界处的症状耳。每天600次脉冲，连续5d。分别于治疗前、治疗后即刻及治疗后1个月对耳鸣障碍量表（THI）和响度、意识和烦恼的视觉模拟自评评分（VAS）的变化进行分析。同侧和对侧刺激组患者的显著改善率无显著差异。此外，在rTMS后即刻或1个月，两组之间THI评分和VAS的降低量无显著差异。最后，与治疗前相比，两组在rTMS后1个月观察到THI评分和大多数VAS显著降低。每日治疗1 Hz rTMS同侧和对侧耳鸣都有显着的有益效果。1 Hz rTMS刺激的偏侧性不是缓解症状的决定性因素。
Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Repetitive TMS (rTMS) applied over the temporoparietal cortex has been reported to show therapeutic effects on tinnitus. We compared the effects of 1 Hz rTMS delivered either contralaterally or ipsilaterally to the symptomatic ear in patients with unilateral tinnitus. Forty patients with asymmetric hearing loss and non-pulsatile tinnitus localized to poorer ear of 6 months in duration or greater who were refractory to medication were enrolled in this study. Patients were assigned randomly to one of two treatment groups: with 1 Hz stimulation applied the temporoparietal junction either ipsilaterally (n = 21) or contralaterally (n = 19) to the symptomatic ear. The patients were given 600 pulses per session daily for 5 d. Changes in the tinnitus handicap inventory (THI) and self-rating visual analog scores (VAS) for loudness, awareness and annoyance were analyzed before, immediately after and 1 month after treatment. There was no significant difference in the rate of patients with marked improvement between ipsilateral and contralateral stimulation groups. In addition, there were no significant differences in the amount of decreases in THI scores and VAS between the two groups immediately or 1 month after rTMS. Finally, significant decreases in THI scores and most VAS were observed 1 month after rTMS in both groups compared to pretreatment. Daily treatment with 1 Hz rTMS ipsilaterally and contralaterally to the side of tinnitus both had significant beneficial effects. The laterality of stimulation with 1 Hz rTMS is not the decisive factor in relieving symptoms.