Striatal networks for tinnitus treatment targeting

Abstract

Neuromodulation treatment effect size for bothersome tinnitus may be larger and more predictable by adopting a target selection approach guided by personalized striatal networks or functional connectivity maps. Several corticostriatal mechanisms are likely to play a role in tinnitus, including the dorsal/ventral striatum and the putamen. We examined whether significant tinnitus treatment response by deep brain stimulation (DBS) of the caudate nucleus may be related to striatal network increased functional connectivity with tinnitus networks that involve the auditory cortex or ventral cerebellum. The first study was a cross‐sectional 2‐by‐2 factorial design (tinnitus, no tinnitus; hearing loss, normal hearing, n = 68) to define cohort level abnormal functional connectivity maps using high‐field 7.0 T resting‐state fMRI. The second study was a pilot case–control series (n = 2) to examine whether tinnitus modulation response to caudate tail subdivision stimulation would be contingent on individual level striatal connectivity map relationships with tinnitus networks. Resting‐state fMRI identified five caudate subdivisions with abnormal cohort level functional connectivity maps. Of those, two connectivity maps exhibited increased connectivity with tinnitus networks—dorsal caudate head with Heschl's gyrus and caudate tail with the ventral cerebellum. DBS of the caudate tail in the case‐series responder resulted in dramatic reductions in tinnitus severity and loudness, in contrast to the nonresponder who showed no tinnitus modulation. The individual level connectivity map of the responder was in alignment with the cohort expectation connectivity map, where the caudate tail exhibited increased connectivity with tinnitus networks, whereas the nonresponder individual level connectivity map did not.

Multimodal quantitative magnetic resonance imaging of the thalamus in tinnitus patients with different outcomes after sound therapy

“…As core areas of the striatum or striatal network, the lentiform nucleus and caudate (especially the caudate) are crucial in tinnitus perception 34 . When the caudate nucleus is targeted using deep brain stimulation, significant reduction in tinnitus loudness 35 and increased connectivity with the tinnitus network were reportedly observed 36 . Data from an animal model also proved that the caudate‐putamen nucleus plays a sensory gating role in tinnitus 37 …”

“…34 When the caudate nucleus is targeted using deep brain stimulation, significant reduction in tinnitus loudness 35 and increased connectivity with the tinnitus network were reportedly observed. 36 Data from an animal model also proved that the caudate-putamen nucleus plays a sensory gating role in tinnitus. 37 The thalamus and hippocampus, as important parts of the limbic system, are closely related to tinnitus generation and are indispensable to the tinnitus frontostriatal gating system.…”

Auditory corticostriatal connections in the human brain

“…With resting state functional MRI approaches, Gordon et al (Gordon et al 2021) mapped cortical functional connectivity with striatum, finding a putamen cluster that strongly connects functionally to the cortical language network. Hinkley et al (Hinkley et al 2015; Hinkley et al 2021) similarly used functional connectivity to investigate corticostriatal interactions and found ventral striatal connectivity effects in tinnitus participants. A follow up study (Hinkley et al 2021) found that targeted electrical stimulation of the caudal-most caudate tail provided significant benefits to participants with tinnitus.…”

“…Hinkley et al (Hinkley et al 2015; Hinkley et al 2021) similarly used functional connectivity to investigate corticostriatal interactions and found ventral striatal connectivity effects in tinnitus participants. A follow up study (Hinkley et al 2021) found that targeted electrical stimulation of the caudal-most caudate tail provided significant benefits to participants with tinnitus. In children with developmental stuttering, a disorder with both motor and perceptual deficits, decreased functional and structural connectivity with motor, speech, and auditory cortical regions has been observed (Chang and Zhu 2013).…”

Multi-tasking Deep Network for Tinnitus Classification and Severity Prediction from Multimodal Structural Images

“…In its chronic phase, tinnitus manifests as a central nervous system disorder. Some prevailing hypotheses include maladaptive neuroplasticity, misappropriated attention, and dysfunctional striatal gating [1]- [3]. While hearing loss association is common, tinnitus severity or distress is often modulated by comorbid anxiety, depression, or mood disturbance.…”