Effect of gabapentin on the sensation and impact of tinnitus
Effect of gabapentin on the sensation and impact of tinnitus
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DOI：
10.1097/01.mlg.0000216812.65206.cd
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发表时间：
2006-05-01
期刊：
影响因子：
2.6
通讯作者：
Brozoski, TJ
中科院分区：
文献类型：
--
作者：
Bauer, CA;Brozoski, TJ
目的/假设：本研究评估了加巴喷丁治疗两种人群慢性耳鸣的有效性：伴有耳鸣伴声损伤的受试者和伴有耳鸣伴声损伤的受试者。假设加巴喷丁在创伤组会降低耳鸣的主观和客观特征，但在非创伤组效果较差。研究设计：前瞻性、安慰剂对照、单盲临床试验。方法：使用纯音听力图和个人病史将耳鸣的病因分类为继发于听觉创伤或与听觉创伤无关。参与者被限制为中度至重度耳鸣至少1年的患者。所有参与者接受加巴喷丁的逐步上升-下降剂量系列，持续超过20周（峰值剂量为2,400 mg/d）。结果。创伤组在耳鸣烦恼方面有显著改善（P = 0.05）。耳鸣的其他主观方面在两组中都没有明显的影响。受试者之间治疗反应的可变性相当大。然而，考虑到主观响度评分，19名非创伤参与者中的4名和20名创伤参与者中的6名表现出20%或更好的改善。考虑到心理声学响度估计，19名非创伤参与者中的3名和20名创伤参与者中的6名表现出20 dB HL或更高的改善。将每组平均分为高反应组和低反应组，创伤高反应组在1800和2400 mg/d时响度有显著改善（P = 0.007）。其他亚组无明显改善。结论：加巴喷丁对某些个体的主观和客观耳鸣均有明显的缓解作用，其中伴有声损伤的个体疗效最好。
Objectives/Hypothesis: This study evaluated the effectiveness of gabapentin in treating chronic tinnitus in two populations: participants with tinnitus with associated acoustic trauma and participants with tinnitus without associated acoustic trauma. The hypothesis was that gabapentin would decrease both subjective and objective features of tinnitus in the trauma group but would be less effective in the nontrauma group. Study Design: Prospective, placebo-controlled, single-blind clinical trial. Methods: Pure-tone audiograms and personal histories were used to categorize tinnitus etiology as either secondary to acoustic trauma or not associated with acoustic trauma. Participants were restricted to those with moderate to severe tinnitus for at least 1 year. All participants received gabapentin in a graduated ascending-descending dose series extending over 20 weeks (peak dose of 2,400 mg/d). Results. There was a significant improvement in tinnitus annoyance for the trauma group (P = .05). Other subjective aspects of tinnitus were not significantly affected in either group. Between-subject variability of therapeutic response was considerable. Nevertheless, in consideration of subjective loudness ratings, 4 of 19 nontrauma participants and 6 of 20 trauma participants showed an improvement of 20% or better. In consideration of psychoacoustic loudness estimates, 3 of 19 nontrauma and 6 of 20 trauma participants showed an improvement of 20 dB HL or greater. Evenly dividing each group into high and low responders revealed significant improvement in loudness at 1,800 and 2,400 mg/day for the trauma high-response subgroup (P = .007). No significant improvement was obtained for other subgroups. Conclusion: Gabapentin is effective in reducing subjective and objective aspects of tinnitus in some individuals, with the best therapeutic response obtained in individuals with associated acoustic trauma.