Tinnitus and Brain Stimulation

Ridder, Dirk De; Adhia, Divya Bharatkumar; Langguth, Berthold

doi:10.1007/7854_2021_219

Cited by 19 publications

(12 citation statements)

References 292 publications

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“…With respect to general treatment efficacy, we could not demonstrate a therapeutic effect of rTMS akin to past studies [ 4 , 14 ]. This is potentially driven by the given divergence between the two groups in tinnitus-related assessments - amelioration in the activate & fire group and deterioration in the control group - resulting in a disappearance of therapeutic effects on average (cf.…”

Section: Discussioncontrasting

confidence: 88%

“…Dysfunctional neural changes, such as a disparity of neuronal inhibition and excitation along the auditory pathway provoking hyperactivity in auditory cortical regions [8,9], provide a legit basis for the usage of inhibitory 1 Hz rTMS as a treatment option for tinnitus [10,11]. However, the current state of research offers no unequivocal evidence for the effectiveness of 1 Hz rTMS in tinnitus -clinical trials demonstrate diverging findings as well as a high interindividual variability in treatment responses [12][13][14][15]. In addition to tonic rTMS other magnetic stimulation approaches were investigated such as theta burst stimulation (TBS).…”

Section: Introductionmentioning

confidence: 99%

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Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

et al. 2023

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Background Low frequency repetitive transcranial magnetic stimulation (rTMS) is commonly used to inhibit pathological hyperactivity of the auditory cortex in tinnitus. Novel and supposedly superior and faster inhibitory protocols such as continuous theta burst stimulation (cTBS) were examined as well, but so far there is not sufficient evidence for a treatment application in chronic tinnitus. rTMS effects in general are dependent on the brain state immediate before stimulation. This feasibility study was designed based on the concept to shift the pathological intrinsic brain state of tinnitus patients via acoustic stimulation (“activate”) and induce inhibitory effects via cTBS (“fire”). Methods Seven tinnitus patients with response in residual inhibition received 10 consecutive daily sessions of a combinatory treatment comprised of 3-minute acoustic stimulation with white noise followed by 600 pulses of cTBS over the left temporo-parietal cortex (activate & fire). A control group of 5 patients was treated parallel to the activate & fire data collection with 10 sessions á 3000 pulses of 1 Hz rTMS over the left temporo-parietal cortex. Results The activate & fire protocol was well tolerated except in one patient with tinnitus loudness increase. This patient was excluded from analyses. No statistical superiority of the activate & fire treatment approach in alleviating tinnitus-related symptoms was evident. Power calculations showed an effect size of 0.706 and a needed sample size of 66 for statistical significant group differences. On a descriptive level the activate & fire group demonstrated a stronger decrease in tinnitus-related symptoms. Conclusion The present feasibility study showed that combining acoustic stimulation with magnetic brain stimulation may be well-tolerable in the majority of patients and represents a promising treatment approach for tinnitus by hypothetically alter the intrinsic state prior to brain stimulation.

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Section: Discussioncontrasting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

et al. 2023

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“…Following integration into the dorsal horn, nociceptive information is conducted via two phylogenetically distinct systems, the medial and the lateral systems, to the higher centers of brainstem and brain. The medial system is involved in the affective and cognitive dimension of pain, pain memory, and autonomic responses [42,43]. This medial pathway projects directly to the higher brain structures and mainly includes the spinoreticular tract, the spinomesencephalic tract, the spinoparabrachial tracts, the spinohypothalamic tract and the spinothalamic tract fibers.…”

Section: From Nociception To Painmentioning

confidence: 99%

A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain

Viseux¹,

Simoneau²,

Billot³

2022

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Motor control, movement impairment and postural control recovery targeted in rehabilitation could be affected by pain. The main objective of this comprehensive review is to provide a synthesis of the effect of experimental and chronic pain on postural control throughout the available literature. After presenting the neurophysiological pathways of pain, we demonstrated that pain, preferentially localized at low back or in the leg induced postural control alteration. While proprioceptive and cortical excitability seems modified with pain, spinal modulation assessment might provide new understanding of the pain phenomenon related to postural control. Literature highlight that the motor control of trunk muscles in patient presenting with low back pain could be dichotomized in two populations, where the first one over-activate trunk muscles, the second one under-activate trunk muscles, and both generating increase of tissues loading. Taking account all this findings, will help clinician to provide adapted treatment for managing both pain and postural control.

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“…Currently, it is not clear which rTMS protocols are most appropriate for an application in tinnitus [ 5 ]. TMS effects, in general, are governed by a multitude of subject-related and rTMS-related factors as already outlined by De Ridder et al [ 23 ]. Beyond that, tinnitus and its multifaceted manifestations with various phenotypes and etiologies potentially adds another layer of complexity to these already given interdependency of physiological and technical parameters in basic TMS investigations of the healthy brain [ 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

“…Considering that due to this heterogeneity in tinnitus manifestations and treatment responses for all treatment approaches—not only rTMS—there is up until now no common valid treatment for every single patient or a cure for tinnitus available [ 26 , 27 ]. A potential way to minimize the variability in treatment responses might be the personalization of interventions [ 23 , 28 , 29 ]. A tailored approach that is capable of adjusting intervention parameters to the necessity of the individual subject seems to constitute a promising approach to enhance the effectiveness of rTMS administration in tinnitus.…”

Section: Introductionmentioning

confidence: 99%

Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Subjective Tinnitus

et al. 2022

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Background: Personalization of repetitive transcranial magnetic stimulation (rTMS) for tinnitus might be capable to overcome the heterogeneity of treatment responses. The assessment of loudness changes after short rTMS protocols in test sessions has been proposed as a strategy to identify the best protocol for the daily treatment application. However, the therapeutic advantages of this approach are currently not clear. The present study was designed to further investigate the feasibility and clinical efficacy of personalized rTMS as compared to a standardized rTMS protocol used for tinnitus. Methods: RTMS personalization was conducted via test sessions and reliable, sham-superior responses respectively short-term reductions in tinnitus loudness following active rTMS protocols (1, 10, 20 Hz, each 200 pulses) applied over the left and right temporal cortex. Twenty pulses at a frequency of 0.1 Hz served as a control condition (sham). In case of a response, patients were randomly allocated to ten treatment sessions of either personalized rTMS (2000 pulses with the site and frequency producing the most pronounced loudness reduction during test sessions) or standard rTMS (1 Hz, 2000 pulses left temporal cortex). Those participants who did not show a response during the test sessions received the standard protocol as well. Results: The study was terminated prematurely after 22 patients (instead of 50 planned) as the number of test session responders was much lower than expected (27% instead of 50%). Statistical evaluation of changes in metric tinnitus variables and treatment responses indicated only numerical, but not statistical superiority for personalized rTMS compared to standard treatment. Conclusions: The current stage of investigation does not allow for a clear conclusion about the therapeutic advantages of personalized rTMS for tinnitus based on test session responses. The feasibility of this approach is primarily limited by the low test session response rate.

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Tinnitus and Brain Stimulation

Cited by 19 publications

References 292 publications

Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

Activate & fire: a feasibility study in combining acoustic stimulation and continuous theta burst stimulation in chronic tinnitus

A Comprehensive Review of Pain Interference on Postural Control: From Experimental to Chronic Pain

Personalization of Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Subjective Tinnitus

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