The Effect of rTMS on Auditory Processing in Adults with Chronic, Bilateral Tinnitus: A Placebo-Controlled Pilot Study

Barwood, Caroline H S; Wilson, Wayne J.; Malicka, Alicja N.; McPherson, Bradley; Munt, Katherine; Murdoch, Bruce E.

doi:10.1016/j.brs.2013.01.015

Cited by 30 publications

(25 citation statements)

References 34 publications

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“…One could speculate that speech comprehension in cocktail party situations requires functional inhibitory systems in the neural auditory pathways to actively filter out irrelevant sounds and this function is impaired in tinnitus patients and particularly in tinnitus patients with hyperacusis. This “Central Inhibitory Deficit”—hypothesis would fit with the reported improvement of speech-in-noise perception after successful tinnitus reduction (Barwood et al, 2013; Mertens et al, 2013b). …”

Section: Discussionmentioning

confidence: 54%

“…Another study revealed that masking of tinnitus by sound improved speech comprehension (Ryu et al, 2012). An improvement of speech comprehension in noise was also observed in patients with unilateral cochlear implants when tinnitus loudness was reduced by activation of cochlear implants (Mertens et al, 2013a) or in patients whose tinnitus was successfully suppressed by rTMS treatment (Barwood et al, 2013). Wearing hearing aids over a time of 3 months showed amelioration of the performance in two speech comprehension tests for elderly patients (Araujo and Iório, 2016).…”

Section: Introductionmentioning

confidence: 91%

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Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Vielsmeier

Kreuzer

Haubner

et al. 2016

Front. Aging Neurosci.

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Objective: Many tinnitus patients complain about difficulties regarding speech comprehension. In spite of the high clinical relevance little is known about underlying mechanisms and predisposing factors. Here, we performed an exploratory investigation in a large sample of tinnitus patients to (1) estimate the prevalence of speech comprehension difficulties among tinnitus patients, to (2) compare subjective reports of speech comprehension difficulties with behavioral measurements in a standardized speech comprehension test and to (3) explore underlying mechanisms by analyzing the relationship between speech comprehension difficulties and peripheral hearing function (pure tone audiogram), as well as with co-morbid hyperacusis as a central auditory processing disorder.Subjects and Methods: Speech comprehension was assessed in 361 tinnitus patients presenting between 07/2012 and 08/2014 at the Interdisciplinary Tinnitus Clinic at the University of Regensburg. The assessment included standard audiological assessments (pure tone audiometry, tinnitus pitch, and loudness matching), the Goettingen sentence test (in quiet) for speech audiometric evaluation, two questions about hyperacusis, and two questions about speech comprehension in quiet and noisy environments (“How would you rate your ability to understand speech?”; “How would you rate your ability to follow a conversation when multiple people are speaking simultaneously?”).Results: Subjectively-reported speech comprehension deficits are frequent among tinnitus patients, especially in noisy environments (cocktail party situation). 74.2% of all investigated patients showed disturbed speech comprehension (indicated by values above 21.5 dB SPL in the Goettingen sentence test). Subjective speech comprehension complaints (both for general and in noisy environment) were correlated with hearing level and with audiologically-assessed speech comprehension ability. In contrast, co-morbid hyperacusis was only correlated with speech comprehension difficulties in noisy environments, but not with speech comprehension difficulties in general.Conclusion: Speech comprehension deficits are frequent among tinnitus patients. Whereas speech comprehension deficits in quiet environments are primarily due to peripheral hearing loss, speech comprehension deficits in noisy environments are related to both peripheral hearing loss and dysfunctional central auditory processing. Disturbed speech comprehension in noisy environments might be modulated by a central inhibitory deficit. In addition, attentional and cognitive aspects may play a role.

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Section: Discussionmentioning

confidence: 54%

Section: Introductionmentioning

confidence: 91%

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Vielsmeier

Kreuzer

Haubner

et al. 2016

Front. Aging Neurosci.

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“…Protocol stimulation intensity was 100% of the resting motor threshold (MT). This intensity was chosen to be central within the range of intensities previously used (80% MT to 120% MT) (6)(7)(8)(9)(10)(11)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Resting MT was determined using surface electromyography, and was defined as the stimulator intensity (2% steps of maximum stimulator output, ascending and descending order) that elicited a response with >50 mV amplitude (peak-peak) in at least five of ten stimuli (24); with the center of the coil located over the optimal site for the abductor pollicis brevis muscle.…”

Section: Rtms Treatment and Schedulesmentioning

confidence: 99%

“…After completion of the initial five weeks of weekly rTMS, another five weeks of follow-up with no rTMS then was instituted (study weeks 5-10). If at the end of those five weeks (at study week 10), a subject met predefined criteria for "responder" (see below), they entered the monthly phase of the study treatments (study weeks [10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. The same type of rTMS sessions were then scheduled monthly for those next five months.…”

Section: Rtms Treatment and Schedulesmentioning

confidence: 99%

“…For example, Cristancho et al reported a pilot study of five tinnitus subjects treated with high‐frequency stimulation over the left dorsolateral prefrontal cortex in conjunction with low‐frequency stimulation over the left temporoparietal cortex; three subjects were responders. Barwood et al reported improved auditory processing, in addition to improved tinnitus symptoms per se , in eight subjects receiving rTMS therapy. We now also undertook a small pilot feasibility study, in our case of a long‐term distributed schedule of rTMS therapy sessions for this illness.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Distributed Repetitive Transcranial Magnetic Stimulation for Tinnitus: A Feasibility Study

Labar

Edwards

2016

Neuromodulation: Technology at the Neural Interface

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Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis

Soleimani

Jalali

Hasandokht

2015

Eur Arch Otorhinolaryngol

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In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn.

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The Effect of rTMS on Auditory Processing in Adults with Chronic, Bilateral Tinnitus: A Placebo-Controlled Pilot Study

Cited by 30 publications

References 34 publications

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Speech Comprehension Difficulties in Chronic Tinnitus and Its Relation to Hyperacusis

Long-Term Distributed Repetitive Transcranial Magnetic Stimulation for Tinnitus: A Feasibility Study

Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis

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