The use of tDCS as a therapeutic option for tinnitus: a systematic review

Santos, Amanda dos Humildes Maia; Santos, Afonso Paranhos Silva; Santos, Henrique Souza; Silva, Adriana Campos da

doi:10.1016/j.bjorl.2018.02.003

Cited by 16 publications

(8 citation statements)

References 21 publications

(34 reference statements)

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“…Some of the primary effects of tonic, subthreshold DC fields are changes in excitability and conduction velocity, which can create plastic changes in cortical networks (Radman et al, 2007; Jackson et al, 2016). Non-invasive DC has been explored as a potential therapy for tinnitus, but existing evidence suggests it is not consistently efficacious at reducing symptoms for most patients (Song et al, 2012; Santos et al, 2018). One problem is that neural changes in tinnitus may be highly heterogeneous across local cortical regions (Møller, 2007a; De Ridder et al, 2014).…”

Section: Potential Applications For DC Modulationmentioning

confidence: 99%

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Aplin

Fridman

2019

Front. Neurosci.

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Implantable neuroprostheses such as cochlear implants, deep brain stimulators, spinal cord stimulators, and retinal implants use charge-balanced alternating current (AC) pulses to recover delivered charge and thus mitigate toxicity from electrochemical reactions occurring at the metal-tissue interface. At low pulse rates, these short duration pulses have the effect of evoking spikes in neural tissue in a phase-locked fashion. When the therapeutic goal is to suppress neural activity, implants typically work indirectly by delivering excitation to populations of neurons that then inhibit the target neurons, or by delivering very high pulse rates that suffer from a number of undesirable side effects. Direct current (DC) neural modulation is an alternative methodology that can directly modulate extracellular membrane potential. This neuromodulation paradigm can excite or inhibit neurons in a graded fashion while maintaining their stochastic firing patterns. DC can also sensitize or desensitize neurons to input. When applied to a population of neurons, DC can modulate synaptic connectivity. Because DC delivered to metal electrodes inherently violates safe charge injection criteria, its use has not been explored for practical applicability of DC-based neural implants. Recently, several new technologies and strategies have been proposed that address this safety criteria and deliver ionic-based direct current (iDC). This, along with the increased understanding of the mechanisms behind the transcutaneous DC-based modulation of neural targets, has caused a resurgence of interest in the interaction between iDC and neural tissue both in the central and the peripheral nervous system. In this review we assess the feasibility of in-vivo iDC delivery as a form of neural modulation. We present the current understanding of DC/neural interaction. We explore the different design methodologies and technologies that attempt to safely deliver iDC to neural tissue and assess the scope of application for direct current modulation as a form of neuroprosthetic treatment in disease. Finally, we examine the safety implications of long duration iDC delivery. We conclude that DC-based neural implants are a promising new modulation technology that could benefit from further chronic safety assessments and a better understanding of the basic biological and biophysical mechanisms that underpin DC-mediated neural modulation.

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Section: Potential Applications For DC Modulationmentioning

confidence: 99%

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Aplin

Fridman

2019

Front. Neurosci.

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“…In the case of clinical applications, tDCS has been shown to ameliorate the symptoms of a range of conditions from tinnitus to depression (Antal et al 2011;Boggio et al 2012;Faber et al 2012;Loo et al 2012;Loo et al 2010;Mondino et al 2015b;Vanneste and De Ridder 2011). However, findings regarding tDCS are often equivocal and difficult to replicate with a number of recent meta-analyses suggest that tDCS may have small effects if any (Berlim et al 2013;Horvath et al 2015;Medina and Cason 2017;Santos et al 2018). Furthermore, a recent special issue of frontiers of neuroscience provided 56 papers detailing null effects of neuromodulation Electronic supplementary material The online version of this article (https://doi.org/10.1007/s41465-019-00154-3) contains supplementary material, which is available to authorized users.…”

Section: Introductionmentioning

confidence: 99%

Investigating the Effects of tDCS on Visual Orientation Discrimination Task Performance: “the Possible Influence of Placebo”

et al. 2019

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The non-invasive neuromodulation technique tDCS offers the promise of a low-cost tool for both research and clinical applications in psychology, psychiatry, and neuroscience. However, findings regarding its efficacy are often equivocal. A key issue is that the clinical and cognitive applications studied are often complex and thus effects of tDCS are difficult to predict given its known effects on the basic underlying neurophysiology, namely alterations in cortical inhibition-excitation balance. As such, it may be beneficial to assess the effects of tDCS in tasks whose performance has a clear link to cortical inhibition-excitation balance such as the visual orientation discrimination task (ODT). In prior studies in our laboratory, no practice effects were found during 2 consecutive runs of the ODT, thus in the current investigation, to examine the effects of tDCS, subjects received 10 min of 2 mA occipital tDCS (sham, anode, cathode) between a first and second run of ODT. Surprisingly, subjects' performance significantly improved in the second run of ODT compared to the first one regardless of the tDCS stimulation type they received (anodal, cathodal, or sham-tDCS). Possible causes for such an improvement could have been due to either a generic "placebo" effect of tDCS (as all subjects received some form of tDCS) or an increased delay period between the two runs of ODT of the current study compared to our previous work (10-min duration required to administer tDCS as opposed to~2 min in previous studies as a "break"). As such, we tested these two possibilities with a subsequent experiment in which subjects received 2-min or 10-min delay between the 2 runs (with no tDCS) or 10 min of sham-tDCS. Only sham-tDCS resulted in improved performance thus these data add to a growing literature suggesting that tDCS has powerful placebo effect that may occur even in the absence of active cortical modulation.

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“…Three major treatment options from collected evidence included: 1. Electric/magnetic stimulation (28–32,34,36,41,47,50,52–54,57,61,64,65,67,68) 2. Herbal, Complementary & Alternative Medicine (CAM), and Nutritional therapy (8,19,37,39,40,42,49,59,60,63), and 3.…”

Section: Resultsmentioning

confidence: 99%

Current therapeutic trends for tinnitus cure and control – a scoping review

Va¹,

Patel²,

Mehta

et al. 2021

Preprint

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Background: The inherent complexities of conditions such as tinnitus with cause and mechanism not known, presents a lack of high-level evidence to make an inference on the treatment approaches. A comprehensive review cannot be performed owing to an insufficient number of trials. Hence a scoping review approach was adopted to provide a broad overview of approaches for tinnitus management. Objective: To review the current evidence on prevalent treatment strategies used for tinnitus management and determine barriers and facilitators for the adoption of treatment approaches in developed and developing countries. Methods: The present scoping review was performed in compliance with the PRISMA ScR checklist. A literature search was carried out in PubMed, Scopus, Google Scholar, and Cochrane databases. Articles published between 2010-2021 mentioning treatment strategies were included. However, therapies concentrating on symptomatic management were excluded. Evidence with the highest scientific hierarchy such as systematic reviews (SRs) and randomized-controlled trials (RCTs) was considered. The context for the ScR was study-region based and included studies from high-income and low and middle-income countries (HICs, LMICs) Results: A total of 20 records were included with 11 SRs and 9 RCTs. Non-pharmacological interventions demonstrated moderate efficacy, including transcranial magnetic- (TMS) and direct current stimulation (tDCS), hearing aids (combined with a sound generator or alone). No specific drug was found to have a mode of action about the target root cause due to a lack of clinical knowledge. Most of the trials used the same tools for tinnitus severity. Conclusion: Although several scoping reviews are published with an exclusive focus on individual therapies, authors recommend an umbrella review of systematic reviews to generate evidence-based practice consensus for tinnitus.

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The use of tDCS as a therapeutic option for tinnitus: a systematic review

Abstract: Based on literature studied, there is no therapeutic response of tinnitus to transcranial direct current stimulation.

Cited by 16 publications

References 21 publications

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Implantable Direct Current Neural Modulation: Theory, Feasibility, and Efficacy

Investigating the Effects of tDCS on Visual Orientation Discrimination Task Performance: “the Possible Influence of Placebo”

Current therapeutic trends for tinnitus cure and control – a scoping review

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