Repetitive transcranial magnetic stimulation (rTMS) for treatment of chronic tinnitus
Repetitive transcranial magnetic stimulation (rTMS) for treatment of chronic tinnitus
复制标题
DOI：
10.1016/j.anl.2010.09.007
复制
发表时间：
2011-06-01
影响因子：
1.7
通讯作者：
Ogawa, Kaoru
中科院分区：
文献类型：
--
作者：
Minami, Shujiro B.;Shinden, Seiichi;Ogawa, Kaoru
目的：有令人信服的证据表明耳鸣与中枢神经系统的功能改变有关。重复经颅磁刺激（rTMS）是一种有效的工具，可以改变受刺激区域和沿着功能解剖连接的距离的神经活动。根据刺激参数的不同，皮层网络的活动在功能上可能受到干扰或调节。低频rTMS已被证明会导致皮质兴奋性降低。这项技术可以通过调节听觉皮层神经元的兴奋性来缓解耳鸣。我们的目的是研究低频rTMS对患者的影响，并确定预测rTMS治疗有益结果的因素。方法：16例慢性耳鸣患者（男10例，女6例）采用低频（1hz） rTMS（强度：110%运动阈值，刺激次数：1200）对左侧听觉皮层进行刺激。采用响度、恼人度和持续时间视觉模拟量表（VAS）、响度平衡测试和耳鸣障碍量表（THI）评估治疗效果。根据患者的临床特点对治疗效果进行研究。结果：rTMS后VAS（响度和烦恼）立即显著降低，7天后逐渐恢复到预处理水平。与年龄相关性听力损失患者相比，突发性耳聋耳鸣患者对rTMS治疗有明显的抵抗。结论：这些结果支持rTMS作为治疗慢性耳鸣的新工具的潜力。由于这项研究的样本量较小，并且在治疗效果上显示出高度的个体差异，因此在推荐该技术用于临床应用之前，还需要进一步发展该技术。2010爱思唯尔爱尔兰有限公司版权所有。
Objective: There is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Repetitive transcranial :magnetic stimulation (rTMS) is a potent tool for modifying neural activity at the stimulated area and at a distance along the functional anatomical connections. Depending on the stimulation parameters, cortical networks can be functionally disturbed or modulated in their activities. Low-frequency rTMS has been shown to result in a decrease in cortical excitability. The technique can alleviate tinnitus by modulating the excitability of neurons in the auditory cortex. We aimed to investigate the effects of low-frequency rTMS in patients and determine the factors that predict a beneficial outcome with rTMS treatment.Methods: Sixteen patients (male 10, female 6) with chronic tinnitus underwent low-frequency (1 Hz) rTMS (intensity: 110% motor threshold; number of stimuli: 1200) to the left auditory cortex. The treatment outcome was assessed with a visual analog scale (VAS) of loudness, annoyance and duration, loudness balance test, and tinnitus handicap inventory (THI). Therapeutic success was studied according to the patients' clinical characteristics.Results: A significant reduction in the VAS (loudness and annoyance) occurred immediately after rTMS, with a gradual return to pretreatment levels after 7 days. The tinnitus patients with sudden deafness were significant resistant to rTMS treatment compared with those diagnosed with age-related hearing loss.Conclusion: These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus. Because this study was performed with a small sample size and showed high interindividual variability in treatment effects, further development of the technique is needed before it can be recommended for clinical applications. (C) 2010 Elsevier Ireland Ltd. All rights reserved.