Surgical Neuromodulation of Tinnitus: A Review of Current Therapies and Future Applications

Rammo, Richard; Ali, Rushna; Pabaney, Aqueel; Seidman, Michael D.; Schwalb, Jason M.

doi:10.1111/ner.12793

Cited by 18 publications

(15 citation statements)

References 68 publications

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“…There is also evidence to suggest that the Vim, locus of the caudate neurons (area LC), STN, amygdala, and hippocampus may modulate tinnitus. 26,75 There have been a number of case reports in which patients received DBS for movement disorders, and concomitantly had subsequent improvement in their comorbid tinnitus with DBS of the STN and Vim. 80,81 Similarly, there has been intraoperative evidence that tinnitus is reduced when an electrode lead passes through area LC.…”

Section: Tinnitusmentioning

confidence: 99%

Current and future directions of deep brain stimulation for neurological and psychiatric disorders

Lee

Lozano

Dallapiazza

et al. 2019

Journal of Neurosurgery

203

134

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ABBREVIATIONS ACC = anterior cingulate cortex; AD = Alzheimer's disease; ADAS-Cog = Alzheimer's Disease Assessment Scale, Cognitive Subscale; ALIC = anterior limb of the internal capsule; ANT = anterior nucleus of the thalamus; area LC = locus of the caudate neurons; BNST = bed nucleus of the stria terminalis; CMPfc = centromedian-parafascicular complex; DBS = deep brain stimulation; ET = essential tremor; GPi = globus pallidus pars interna; ITP = inferior thalamic peduncle; NAc = nucleus accumbens; nbM = nucleus basalis of Meynert; OCD = obsessive-compulsive disorder; PAG/PVG = periaqueductal gray/periventricular gray; PD = Parkinson's disease; PTSD = posttraumatic stress disorder; STN = subthalamic nucleus; VC/VS = ventral capsule/ventral striatum; Vim = ventral intermediate thalamic nucleus; VPL/VPM = ventral posterior lateral nucleus/ventral posterior medial nucleus.Deep brain stimulation (DBS) has evolved considerably over the past 4 decades. Although it has primarily been used to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia, recently it has been approved to treat obsessive-compulsive disorder and epilepsy. Novel potential indications in both neurological and psychiatric disorders are undergoing active study. There have been significant advances in DBS technology, including preoperative and intraoperative imaging, surgical approaches and techniques, and device improvements. In addition to providing significant clinical benefits and improving quality of life, DBS has also increased the understanding of human electrophysiology and network interactions. Despite the value of DBS, future developments should be aimed at developing less invasive techniques and attaining not just symptom improvement but curative disease modification.https://thejns.org/doi/abs/10.3171/2019.4.JNS181761

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Section: Tinnitusmentioning

confidence: 99%

Current and future directions of deep brain stimulation for neurological and psychiatric disorders

Lee

Lozano

Dallapiazza

et al. 2019

Journal of Neurosurgery

203

134

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“…TMS with burst mode has been successfully applied in tinnitus 23. Initially burst stimulation has been applied on auditory cortex to suppress tinnitus more effectively than tonic stimulation 22,38. De Ridder was the first who reported improvement in trigeminal anesthesia dolorosa after somatosensory cortex stimulation with burst mode, but also to the anterior cingulate cortex and dorsolateral, prefrontal cortex 24.…”

Section: Discussionmentioning

confidence: 99%

<p>Effectiveness of tonic and burst motor cortex stimulation in chronic neuropathic pain</p>

Sokal¹,

Harat²,

Malukiewicz³

et al. 2019

JPR

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Background: Motor cortex stimulation (MCS) is an intracranial, invasive method for treatment of chronic pain. Main indications for MCS are central post stroke pain, neuropathic facial pain, phantom limb pain and brachial plexus or spinal cord injury pain. Spinal cord stimulation (SCS) with burst waveform has been proved to be more effective than tonic mode in chronic pain. Necessity to replace depleted batteries of motor cortex tonic stimulators gave us an opportunity of applying burst stimulation. The objective of the pilot study was to evaluate the effects of burst stimulation applied on motor cortex in patients with chronic pain syndromes as well as comparison to tonic mode. Materials and methods: We have evaluated 6 patients (females N=3, males N=3) belonging to the group of 14 cases (females N=5, males N=9) who had undergone surgical procedure of MCS in years 2005–2017. Selected for the study were 6 patients with thalamic pain N=3, with facial pain N=3 (anaesthesia dolorosa and neuropathic trigeminal neuralgia). The patients were subjected to both modes of stimulation then they chose which one was better in relieving pain: tonic or burst. Pain intensity was assessed with the visual analogue scale (VAS) before the replacement of implanted pulse generator (IPG) and after the stimulation with tonic and burst modes. Results: In the study, 5 out of 6 patients with MCS found burst mode more effective than tonic mode. Baseline VAS score in patients that had at least 3 months depleted battery of tonic IPG was 95 mm. After implantation of a new IPG mean VAS score on tonic stimulation was 72 mm, on burst 53 mm. Conclusions: The most preferred option of MCS in selected group of patients was burst stimulation. This study has shown, that the burst stimulation of cerebral cortex is a promising modality when tonic stimulation is not sufficient in refractory, neuropathic pain.

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“…There is growing interest in the use of neuromodulation to treat chronic tinnitus; defined as the perception of sound in the absence of overt acoustic stimulation. Neuromodulation paradigms used for tinnitus suppression include but are not limited to repetitive transcranial magnetic stimulation ( r TMS), transcranial direct current stimulation ( t DCS), transcutaneous electrical nerve stimulation (TENs), cortical neurofeedback, electrical stimulation of auditory cortex, magnetic or electrical stimulation of the dorsolateral prefrontal cortex, deep‐brain stimulation (DBS), direct electrical stimulation of the vagus‐nerve paired with tones (paired‐VNS t ) 1‐13 and, other less invasive approaches like transcutaneous stimulation of the auricular branch of the vagus nerve (VN) located on the surface of the outer ear 14‐20 . These novel experimental approaches can modify the physiology and neurochemistry of the underlying tinnitus substrate and have positive impact on the psychological, social, emotional, and/or psychiatric reactions to this abnormal phantom percept.…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing

Kochilas

Cacace

Arnold

et al. 2020

Laryngoscope Investig Oto

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Objective: In individuals with chronic tinnitus, our interest was to determine whether daily low-level electrical stimulation of the vagus nerve paired with tones (paired-VNSt) for tinnitus suppression had any adverse effects on motor-speech production and physiological acoustics of sustained vowels. Similarly, we were also interested in evaluating for changes in pure-tone thresholds, word-recognition performance, and minimum-masking levels.Both voice and hearing functions were measured repeatedly over a period of 1 year. Study design: Longitudinal with repeated-measures.Methods: Digitized samples of sustained frontal, midline, and back vowels (/e/, /o/, /ah/) were analyzed with computer software to quantify the degree of jitter, shimmer, and harmonic-to-noise ratio contained in these waveforms. Pure-tone thresholds, monosyllabic word-recognition performance, and MMLs were also evaluated for VNS alterations. Linear-regression analysis was the benchmark statistic used to document change over time in voice and hearing status from a baseline condition.Results: Most of the regression functions for the vocal samples and audiometric variables had slope values that were not significantly different from zero. Four of the nine vocal functions showed a significant improvement over time, whereas three of the pure tone regression functions at 2-4 kHz showed some degree of decline; all changes observed were for the left ear, all were at adjacent frequencies, and all were ipsilateral to the side of VNS. However, mean pure-tone threshold changes did not exceed 4.29 dB from baseline and therefore, would not be considered clinically significant. In some individuals, larger threshold shifts were observed. No significant regression/slope effects were observed for word-recognition or MMLs.Meeting information: Portions of this study were presented at

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Surgical Neuromodulation of Tinnitus: A Review of Current Therapies and Future Applications

Cited by 18 publications

References 68 publications

Current and future directions of deep brain stimulation for neurological and psychiatric disorders

Current and future directions of deep brain stimulation for neurological and psychiatric disorders

<p>Effectiveness of tonic and burst motor cortex stimulation in chronic neuropathic pain</p>

Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing

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