Contralateral versus ipsilateral rTMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: comparative study
Contralateral versus ipsilateral rTMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: comparative study
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DOI：
10.1111/j.1468-1331.2010.02965.x
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发表时间：
2010-07-01
影响因子：
5.1
通讯作者：
Khalifa, H.
中科院分区：
文献类型：
--
作者：
Khedr, E. M.;Abo-Elfetoh, N.;Khalifa, H.
背景：应用于左颞顶皮层的重复经颅磁刺激（rTMS）已被报道对耳鸣有长期的治疗效果。我们比较的影响，1和25 Hz的rTMS提供对侧或同侧的症状在62例单侧慢性tinnitization.Material和方法：患者被随机分配到四个治疗组之一：在1或25 Hz的刺激适用于同侧或对侧的症状。每天给予2000次脉冲，持续2周。每月测量耳鸣障碍量表（THI）、响度、意识和烦恼自评评分的变化，持续10个月。结果：两组间存在显著的时间主效应（P < 0.0001）和显著的时间×副效应（P = 0.032）。这是因为对侧刺激对THI的影响大于同侧刺激;也上级左侧刺激（P = 0.027）。对侧rTMS后响度评分改善更多（P = 0.037）。20例患者在3个月后没有残留耳鸣;其余患者RI显著增加。耳鸣史最短的患者往往对rTMS反应更好。THI评分的变化与汉密尔顿焦虑和抑郁scores.Conclusion的变化之间有显着的相关性：1和25 Hz的rTMS对侧耳鸣的一方，每天治疗10个症状比同侧或左侧刺激有更大的有益效果。
Background:Repetitive transcranial magnetic stimulation (rTMS) applied over left temporoparietal cortex has been reported to have a long-term therapeutic effect on tinnitus. We compare the impact of 1 and 25 Hz rTMS delivered either contralateral or ipsilateral to symptoms in 62 patients with unilateral chronic tinnitus.Material and methods:Patients were randomly assigned to one of four treatment groups: with stimulation at 1 or 25 Hz applied either ipsilateral or contralateral to symptoms. Two thousand pulses per session were given daily for 2 weeks. Changes in tinnitus handicap inventory (THI), self-rating scores of loudness, awareness, and annoyance were measured monthly for 10 months. Duration of residual inhibition (RI) and psychiatric morbidity were evaluated monthly for 3 months.Results:There was a significant main effect of time (P < 0.0001) and a significant time x side interaction (P = 0.032) between groups. This was because of the fact that contralateral stimulation had a greater effect on THI than ipsilateral stimulation; it was also superior to left side stimulation (P = 0.027). Ratings of loudness improved more after contralateral rTMS (P = 0.037). Twenty patients had no remaining tinnitus after 3 months; the remainder had a significant increase in RI. Patients with the shortest history of tinnitus tended to respond better to rTMS. There was a significant correlation between changes in THI score and changes in Hamilton anxiety and depression scores.Conclusion:Ten daily treatments of 1 and 25 Hz rTMS contralateral to the side of tinnitus have a greater beneficial effect on symptoms than either ipsilateral or left side stimulation.