Thalamocortical dysrhythmia I. Functional and imaging aspects

Llinás, R.; Ribary, Urs; Jeanmonod, Daniel; Cancro, Robert; Kronberg, Eugene; Schulman, J.; Zonenshayn, Martin; Magnin, M.; Morel, Anne; Siegmund, Malte

doi:10.1017/s1472928801000231

Cited by 44 publications

(26 citation statements)

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“…An increase of alpha is also found in the EO condition, localized on similar areas as delta and theta and indicating thus a participation of this frequency band in the thalamocortical dysrhythmia (TCD) tinnitus process. An increase in low and high frequencies is in line with the concept of TCD and may reflect the outspoken and chronic TCD involvement of our patient group [7,10,24,56]. This may explain the differences with the study of Weisz et al [25], where only delta increase and a reduction of alpha were observed.…”

Section: Discussionsupporting

confidence: 84%

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Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

et al. 2010

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BackgroundThe physiopathological mechanism underlying the tinnitus phenomenon is still the subject of an ongoing debate. Since oscillatory EEG activity is increasingly recognized as a fundamental hallmark of cortical integrative functions, this study investigates deviations from the norm of different resting EEG parameters in patients suffering from chronic tinnitus.ResultsSpectral parameters of resting EEG of male tinnitus patients (n = 8, mean age 54 years) were compared to those of age-matched healthy males (n = 15, mean age 58.8 years). On average, the patient group exhibited higher spectral power over the frequency range of 2-100 Hz. Using LORETA source analysis, the generators of delta, theta, alpha and beta power increases were localized dominantly to left auditory (Brodmann Areas (BA) 41,42, 22), temporo-parietal, insular posterior, cingulate anterior and parahippocampal cortical areas.ConclusionsTinnitus patients show a deviation from the norm of different resting EEG parameters, characterized by an overproduction of resting state delta, theta and beta brain activities, providing further support for the microphysiological and magnetoencephalographic evidence pointing to a thalamocortical dysrhythmic process at the source of tinnitus. These results also provide further confirmation that reciprocal involvements of both auditory and associative/paralimbic areas are essential in the generation of tinnitus.

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Section: Discussionsupporting

confidence: 84%

“…This TC concept for neurogenic pain, abnormal movements, epilepsy, tinnitus and neuropsychiatric disorders was proposed [7,56,68] on the basis of experimental [26,28,29,69], and clinical evidence in the mentioned diseases [10]. It may be characterized by the following sequential set of events (schematized in Fig.…”

Section: Discussionmentioning

confidence: 99%

Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

et al. 2010

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“…Dysrhythmia may facilitate maladaptive cortical reorganization—an increase in neural activity/representation within auditory processing areas in the temporal lobe that is often asymmetric between hemispheres—leading to phantom perception of sound 13,14,16,18,19 and creating neural contrasts, or edge effects, that enhance tinnitus perception. 20 It is evident that several brain systems contribute to tinnitus phenomenology, including limbic structures, which may influence emotional aspects of tinnitus, and structures in the frontal lobe and other regions of the brain, which may influence tinnitus awareness and annoyance.…”

Section: A Theoretical Rationalementioning

confidence: 99%

Using repetitive transcranial magnetic stimulation for the treatment of tinnitus

Dornhoffer

Mennemeier

2010

The Hearing Journal

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“…In this model, the perception of tinnitus is viewed as an interaction between the limbic, auditory, and thalamic areas wherein feedback connections from limbic regions provide a “noise-cancellation” mechanism. Llinas et al 22 used magnetoencephalography in patients with tinnitus, neurogenic pain, Parkinson’s disease, or depression and controls described the presence of a thalamocortical dysrhythmia, whereby symptoms are a result of inhibitory asymmetry between high- and low-frequency thalamocortical modules at the cortical level. The identification of alterations in non-auditory cortical areas is consistent with the clinical observation that tinnitus does not habituate 23 , alters attention and memory 24–26 , and can affect emotions.…”

Section: Introductionmentioning

confidence: 99%

Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus

Piccirillo¹,

Garcia²,

Nicklaus³

et al. 2011

Arch Otolaryngol Head Neck Surg

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Objective The goal of this study was to examine the effectiveness and safety of low-frequency rTMS to the temporoparietal junction in a cohort of patients with bothersome tinnitus. Design Cross-over, double-blind, randomized clinical trial. Setting Outpatient, academic medical center Participants 14 adults between the ages of 42 and 59 with subjective, unilateral or bilateral, non-pulsatile tinnitus of 6 months duration or greater, and a score of 38 or greater on the Tinnitus Handicap Inventory (THI). Interventions Low-frequency (1 Hz) 110% motor threshold rTMS or sham to left temporoparietal junction for 2 weeks. Main Outcome Measure The difference in the change of the Tinnitus Handicap Inventory score between active and sham rTMS. Results Active treatment was associated with a median (95% CI) reduction in THI of 5 points (0 to 14) and sham treatment was associated with a median reduction in THI of 6 points (−2 to 12). The difference in THI between the change associated with active and sham rTMS ranged from 34 points reduction in THI score after active treatment when compared to THI score after sham, to an increase of 22 points, with a median difference change of only 1 point (−6 to 4). Conclusions Daily low-frequency rTMS to the left temporoparietal junction area for 2 weeks was no more effective than placebo for patients with chronic bothersome tinnitus. Possible explanations for the negative findings are short duration of treatment, failure of rTMS stimulation over the temporoparietal area to affect auditory cortex buried within the Sylvian fissure, or more widespread cortical network changes associated with severe bothersome tinnitus not amenable to localized rTMS effects.

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Thalamocortical dysrhythmia I. Functional and imaging aspects

Cited by 44 publications

References 0 publications

Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients

Using repetitive transcranial magnetic stimulation for the treatment of tinnitus

Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus

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