Connectome-guided high-definition tDCS for the treatment of tinnitus

连接组引导的高清 tDCS 治疗耳鸣

• 批准号: 9651680
• 负责人: Amber Michelle Leaver
• 金额: $ 15.65万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-07-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9651680
• 关键词: Connectome; guided; definition; tDCS; treatment

PROJECT SUMMARY Chronic subjective tinnitus is a common and sometimes disabling condition, with few effective treatments and no cure. Tinnitus is thought to involve dysfunction in central brain networks subsequent to peripheral injury or interference; thus, neurostimulation therapies that directly target central circuits are receiving growing interest. Of these, transcranial direct current stimulation (tDCS) is an attractive option, due to its relative affordability, mobility, and safety profile. A growing number of studies have demonstrated that tDCS of temporal/auditory cortex is effective at transiently reducing tinnitus symptoms, including tinnitus loudness and tinnitus distress. However, the results of previous clinical trials are variable, and a mechanistic understanding of tDCS and its therapeutic effects remains elusive. The main goal of this research is to lay the groundwork for improved, patient-centered approaches to noninvasive neurostimulation therapy for chronic tinnitus. Ultimately, we plan to use each patient’s unique brain-connectivity patterns to inform the placement of neurostimulation electrodes and improve therapeutic outcome. To accomplish this, we will first determine how the intrinsic activity and connectivity of auditory networks are affected during simultaneous tDCS-fMRI of auditory cortex, specifically targeting those patients who experience reduced tinnitus symptoms after tDCS (Aim 1). Then, we will perturb those networks with more focal stimulation using high-definition (HD) tDCS, using each patient’s unique functional neuroanatomy to position HD tDCS electrodes. Perturbation of target networks will be assessed with simultaneous HD tDCS-fMRI, and effects on clinical outcome will be measured (Aim 2). Though the primary goal of the proposed research is to optimize tDCS for the treatment of tinnitus, these studies will also provide a wealth of information regarding tinnitus pathophysiology and the mechanisms of tDCS more generally, which is being investigated for the treatment of a wide variety of brain disorders and injuries.

项目摘要 慢性耳鸣是一种常见的，有时致残的条件，很少有有效的治疗， 无法治愈耳鸣被认为涉及外周损伤后的中枢脑网络功能障碍， 干扰;因此，直接靶向中央回路的神经刺激疗法正受到越来越多的关注。 其中，经颅直流电刺激（tDCS）是一个有吸引力的选择，由于其相对负担得起， 移动性和安全性。越来越多的研究表明，时间/听觉tDCS 耳鸣的症状有哪些？耳鸣的症状有哪些？耳鸣的症状有哪些？ 然而，以前的临床试验的结果是可变的，并且对tDCS及其机制的理解是可能的。 治疗效果仍然难以捉摸。这项研究的主要目标是为改进， 以患者为中心的方法，以非侵入性神经刺激治疗慢性耳鸣。最终，我们计划 使用每个患者独特的大脑连接模式来通知神经刺激电极的放置 并改善治疗效果。为了做到这一点，我们将首先确定内在活动和 听觉网络的连接性在听觉皮层的同步tDCS-fMRI中受到影响，特别是 针对那些在tDCS后耳鸣症状减轻的患者（目标1）。然后，我们将扰动 使用高清（HD）tDCS，使用每个患者独特的 功能神经解剖学定位HD tDCS电极。目标网络的扰动将通过以下方式进行评估： 同时进行HD tDCS-fMRI，并测量对临床结果的影响（目标2）。虽然主要 建议研究的目标是优化tDCS治疗耳鸣，这些研究也将提供一个 关于耳鸣的病理生理学和更普遍的tDCS机制的丰富信息， 正在研究用于治疗各种各样的大脑疾病和损伤。