Tinnitus: Is there a place for brain stimulation?

Abstract

Tinnitus is the perception of a “phantom sound” and has a high prevalence. Although many therapies have been investigated within the last decades, there is still no effective standard therapy. Animal studies and human functional imaging studies revealed that tinnitus perception is associated with many complex changes in multiple brain structures. There is growing evidence that brain stimulation might be able to interrupt the local altered neuronal activity and hereby inhibit tinnitus perception. In this editorial review, an update is given on the most promising targets for brain stimulation. Promising structures for stimulation are the dorsal cochlear nucleus, the inferior colliculus and the medial geniculate body of the thalamus. For cortical stimulation, the auditory cortex is considered as a target. Nevertheless, the field is waiting for evidence from well-designed clinical trials, based on supporting evidence from experimental/mechanistic research, to support or discourage the application of brain stimulation in tinnitus.

Alleviation of Tinnitus With High-Frequency Stimulation of the Dorsal Cochlear Nucleus: A Rodent Study

“…Interestingly, in Parkinson’s disease, a positive effect can also be obtained when different targets within the cortico-basal ganglia thalamic loop are stimulated ( Chiken & Nambu, 2014 ; Vitek, 2002 ). It can be postulated that tinnitus is also a network disorder, and disrupting the pathological information flow within the auditory network at any structure may suppress tinnitus ( van Zwieten et al., 2016 ). The exact mechanisms underlying the effects of high-frequency brain stimulation remain unclear.…”

“…Despite decades of efforts to develop an effective therapy, it is still highly challenging to treat tinnitus. Multiple preclinical and clinical studies suggested deep brain stimulation (DBS) as a promising treatment option in severe, refractory tinnitus ( Smit et al., 2016 ; van Zwieten et al., 2018 ; van Zwieten, Smit, Jahanshahi, Temel, & Stokroos, 2016 ). Furthermore, electrical stimulation of the DCN with an auditory brainstem implant (ABI), which is used to elicit auditory sensations, can alter tinnitus loudness.…”

Inhibition of Experimental Tinnitus With High Frequency Stimulation of the Rat Medial Geniculate Body

“…Deep brain stimulation (DBS) has been proposed as a promising treatment option in severe, refractory tinnitus (21,22). Several reports on the effect of DBS in tinnitus have already been reported in humans (23)(24)(25).…”

The effect of noise trauma and high-frequency stimulation on thalamic sensory gating in rodents

“…Deep brain stimulation (DBS) is a potential method of exerting a modulatory influence on auditory SG in tinnitus. DBS has recently emerged as a promising treatment option for tinnitus [15][16][17]. High-frequency stimulation (HFS) applied to the auditory pathway has been shown to effectively reduce tinnitus-like behavior in rats [18][19][20].…”