Variable changes in PET activity before and after rTMS treatment for tinnitus.
Variable changes in PET activity before and after rTMS treatment for tinnitus.
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DOI：
10.1002/lary.21425
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发表时间：
2011-04
期刊：
影响因子：
2.6
通讯作者：
Dornhoffer, John
中科院分区：
文献类型：
--
作者：
Mennemeier, Mark;Chelette, Kenneth C.;Allen, Shawn;Bartel, Twyla B.;Triggs, William;Kimbrell, Timothy;Crew, Joseph;Munn, Tiffany;Brown, Ginger J.;Dornhoffer, John
确定低频rTMS是否通过减少颞叶皮层听觉处理区域的神经活动和PET靶向治疗的效用来改善耳鸣。随机、假手术对照交叉。患者接受为期5天的活动和假1 Hz rTMS（1800个脉冲，运动阈值的110%）到颞叶皮层，一周的活动和假治疗间隔。在基线和每个治疗周结束时评估耳鸣响度的视觉模拟评级（VARL）;在刺激线圈和对照部位下方的感兴趣区域（ROI）治疗前后测量局部脑血流量（rBBF）和葡萄糖代谢（通过PET）。两耳的VARL在主动治疗后显著降低，但假治疗后没有显著降低。响应者包括43%的患者，经历了至少33%的耳鸣响度下降。与积极反应最相关的部位是两侧半球的次级听觉皮层（布罗德曼22区）。PET不对称性在患者中是可变的，并且不总是可用于rTMS。而PET活性显着降低刺激线圈下积极治疗后，类似的变化发生在对照部位和假刺激后。耳鸣感知的变化与治疗部位ROI的PET活性变化无显著相关性。主动经颅磁刺激导致耳鸣响度显著降低，但PET扫描未能支持低频rTMS通过减少刺激部位的皮层激活来改善耳鸣的假设，质疑PET用于靶向rTMS的效用。
Determine whether low-frequency rTMS improves tinnitus by decreasing neural activity in auditory processing regions of the temporal cortex and the utility of PET for targeting treatment. Randomized, sham-controlled crossover. Patients received a 5-day course of active and sham 1-Hz rTMS (1800 pulses at 110% of motor threshold) to the temporal cortex, with a week separating active and sham treatment. Visual analogue ratings of tinnitus loudness (VARL) were assessed at baseline and the end of each treatment week; regional brain blood flow (rBBF) and glucose metabolism (via PET) were measured before and after treatment in regions of interest (ROI) beneath the stimulating coil and control sites. The VARL for both ears significantly decreased after active but not sham treatment. Responders comprised 43% of patients, experiencing at least a 33% drop in tinnitus loudness. The site most consistently associated with a positive response was the secondary auditory cortex (Brodmann Area 22) in either hemisphere. PET asymmetries were variable across patients and not always accessible to rTMS. Whereas PET activity decreased significantly beneath the stimulating coil following active treatment, similar changes occurred at control sites and after sham stimulation. Change in tinnitus perception did not correlate significantly with change in PET activity at the treatment site ROI. Active TMS led to a significant reduction in tinnitus loudness, but PET scans failed to support the hypothesis that low-frequency rTMS improves tinnitus by reducing cortical activation at the stimulation site, questioning the utility of PET for targeting rTMS.
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影响因子：
5.1
作者：
Marcondes, R. A.;Sanchez, T. G.;Marcolin, M. A.
通讯作者：
Marcolin, M. A.
DOI：
10.1073/pnas.95.17.10340
发表时间：
1998-08-18
影响因子：
11.1
作者：
Mühlnickel, W;Elbert, T;Flor, H
通讯作者：
Flor, H
DOI：
10.1159/000276835
发表时间：
1996-07-01
期刊：
ORL-JOURNAL FOR OTO-RHINO-LARYNGOLOGY AND ITS RELATED SPECIALTIES
影响因子：
--
作者：
Arnold, W;Bartenstein, P;Schwaiger, M
通讯作者：
Schwaiger, M
影响因子：
15.9
作者：
Rauschecker, JP
通讯作者：
Rauschecker, JP
影响因子：
2.6
作者：
Richter, Gresham T.;Mennemeier, Mark;Dornhoffer, John L.
通讯作者：
Dornhoffer, John L.