Non-Invasive Neuromodulation for Tinnitus

Abstract

<jats:p>Tinnitus is a prevalent disorder that has no cure currently. Within the last two decades, neuroscientific research has facilitated a better understanding of the pathophysiological mechanisms that underlie the generation and maintenance of tinnitus, and the brain and nerves have been identified as potential targets for its treatment using non-invasive brain stimulation methods. This article reviews studies on tinnitus patients using transcranial magnetic stimulation, transcranial electrical stimulation, such as transcranial direct current stimulation, alternating current stimulation, transcranial random noise stimulation as well as transcutaneous vagus nerve stimulation and bimodal combined auditory and somatosensory stimulation. Although none of these approaches has demonstrated effects that would justify its use in routine treatment, the studies have provided important insights into tinnitus pathophysiology. Moreover bimodal stimulation, which has only been developed recently, has shown promising results in pilot trials and is a candidate for further development into a valuable treatment procedure.</jats:p>

Heading for personalized rTMS in tinnitus: reliability of individualized stimulation protocols in behavioral and electrophysiological responses

“…The limited test-retest reliability corroborates the claim, that effects of rTMS in general (Maeda et al, 2000; Nettekoven et al, 2015; Polanía et al, 2018; Sommer et al, 2002; Terranova et al, 2019) but also treatment effects in tinnitus (Berthold Langguth, 2020; Soleimani et al, 2016) are subject to high variability. Thus, it is most likely that single subject impacts simply do not transfer to statistical analysis on a group level, highlighting the need and importance of personalized rTMS approaches.…”

“…Recent neuromodulation techniques attempt to reverse or modulate these pathological alterations (for a recent overview see Langguth, 2020). One of these is repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation tool with the capability to evoke neuroplastic changes by a rhythmic administration of brief electromagnetic pulses (Hallett, 2007; Hoogendam et al, 2010; Hartwig Roman Siebner & Rothwell, 2003).…”

“…Nevertheless, its clinical effectiveness is still not obvious. Recent reviews and meta-analyses conclude that there is no clear indication for an effect (Dong et al, 2020; Berthold Langguth, 2020; Zenner et al, 2017), while others report potential effectiveness for its clinical administration (Lefaucheur et al, 2014; Londero et al, 2018), especially over the auditory cortex (Lefebvre-Demers et al, 2020). This lack of evidence may be explained by the fact that there is still a certain ambiguity concerning the correct rTMS parameters (e.g., frequency or position) for the application in tinnitus.…”

Repetitive Transcranial Magnetic Stimulation for Tinnitus Treatment in Vestibular Schwannoma: A Pilot Study

“…These neuroplastic changes are thought to cause a neuronal hyperexcitability for the residual auditory input resulting in the subjective misperception (10,11,18,19). Having a central origin, TN is hardly accessible to therapy (20). In the last years, there is a growing interest in using repetitive transcranial magnetic stimulation (rTMS) in TN therapy (20)(21)(22)(23)(24).…”

“…Having a central origin, TN is hardly accessible to therapy (20). In the last years, there is a growing interest in using repetitive transcranial magnetic stimulation (rTMS) in TN therapy (20)(21)(22)(23)(24). rTMS is suggested to modify the excitability of relevant neurons and neurotransmitter systems in TN (25).…”