Efficacy of different protocols of transcranial magnetic stimulation for the treatment of tinnitus: Pooled analysis of two randomized controlled studies
Efficacy of different protocols of transcranial magnetic stimulation for the treatment of tinnitus: Pooled analysis of two randomized controlled studies
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DOI：
10.3109/15622975.2012.708438
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发表时间：
2014-05-01
影响因子：
3.1
通讯作者：
Kleinjung, T.
中科院分区：
文献类型：
--
作者：
Langguth, B.;Landgrebe, M.;Kleinjung, T.
目标。耳鸣与听觉和非听觉大脑区域的神经元活动的改变有关。通过重复经颅磁刺激（rTMS）对这些区域进行有针对性的调节已被提议作为慢性耳鸣的新治疗方法。方法。随后进行了两项随机、双盲、平行组对照临床试验并汇总进行分析。总共 192 名耳鸣患者被随机分配接受 10 次刺激，分别是假 rTMS、基于 PET 的神经导航 1 Hz rTMS、左听觉皮层 1 Hz rTMS，或左额叶皮层组合 20 Hz rTMS，然后左听觉皮层 1 Hz rTMS。结果。 rTMS 治疗耐受性良好，未观察到严重副作用。与基线相比，所有主动 rTMS 治疗都会导致 TQ 显着降低。治疗组之间的比较未能达到显着差异。与假手术 (6%) 相比，颞叶 rTMS (38%) 以及额叶和颞叶联合 rTMS (43%) 治疗有反应的人数较多。结论。这项大型研究证明了 rTMS 治疗慢性耳鸣患者的安全性和耐受性。虽然整体效果并未证明优于安慰剂，但次要结果参数有利于主动刺激组，特别是额叶和颞叶联合 rTMS 方案。
Objectives. Tinnitus is related to alterations in neuronal activity of auditory and nonauditory brain areas. Targeted modulation of these areas by repetitive transcranial magnetic stimulation (rTMS) has been proposed as a new therapeutic approach for chronic tinnitus. Methods. Two randomized, double-blind, parallel-group, controlled clinical trials were performed subsequently and pooled for analysis. A total of 192 tinnitus patients were randomly allocated to receive 10 stimulation sessions of either sham rTMS, PET-based neuronavigated 1 Hz rTMS, 1Hz rTMS over the left auditory cortex, or combined 20 Hz rTMS over the left frontal cortex, followed by 1 Hz rTMS over the left auditory cortex. Results. rTMS treatment was well tolerated and no severe side effects were observed. All active rTMS treatments resulted in significant reduction of the TQ as compared to baseline. The comparison between treatment groups failed to reach significant differences. The number of treatment responders was higher for temporal rTMS(38%) and combined frontal and temporal rTMS (43%), as compared to sham (6%). Conclusions. This large study demonstrates the safety and tolerability of rTMS treatment in patients with chronic tinnitus. While the overall effect did not prove superior to placebo, secondary outcome parameters argue in favour of the active stimulation groups, and specifically the combined frontal and temporal rTMS protocol.