Tinnitus treatment by vagus nerve stimulation: A systematic review

Abstract

Background Tinnitus is a phantom sensation of sound, which can have a negative impact on quality of life of those affected. No curative treatments are currently known. Neuromodulation by vagus nerve stimulation has emerged as a new treatment option for tinnitus, though till date the effectiveness remains unclear. Therefore, we aim to review the effect of vagus nerve stimulation on tinnitus distress and tinnitus symptom severity in patients with chronic tinnitus. Methods We searched Pubmed, Embase and the Cochrane Library systematically for RCTs, observational studies and case studies on the effect of VNS treatment for tinnitus on October 29, 2019. Studies including adult patients with subjective tinnitus, comparing transcutaneous or implantable VNS to placebo or no treatment or before and after application of VNS treatment on tinnitus distress and tinnitus symptom severity measured with a validated questionnaire were eligible. The risk of bias was assessed with the appropriate tool for each type of study. Results Our search identified 9 primary studies of which 2 RCTs, 5 cohort studies and 2 case series or reports. 5 studies used transcutaneous VNS treatment and 4 used implanted VNS treatment. 6 studies combined VNS treatment with sound therapy. There was a serious risk of bias in all studies, especially on confounding. Most studies reported a small decrease in tinnitus distress or tinnitus symptom severity. Conclusion Due to methodological limitations and low reporting quality of the included studies, the effect of VNS on tinnitus remains unclear. To draw conclusions for which patient population and to what extent (t)VNS is beneficial in the treatment of tinnitus, a randomised controlled trial should be considered.

Impact of Transcutaneous Auricular Vagus Nerve Stimulation on Large-Scale Functional Brain Networks: From Local to Global

“…Non-invasiveness, reversibility and the possibility of a rapid start of therapy broaden the spectrum of symptoms and diseases that can be treated. Clinical applications and investigations span from cardiovascular and digestive system diseases (Kaniusas et al, 2019 ; Wang et al, 2020 ), insomnia (Wu et al, 2021 ), tinnitus (Stegeman et al, 2021 ), pain (Kaniusas et al, 2019 ), migraine (Straube et al, 2015 ) as well as to disorders of consciousness (Briand et al, 2020 ), aging (Bretherton et al, 2019 ), and cognitive impairment (Colzato and Beste, 2020 ).…”

Current therapeutic trends for tinnitus cure and control – a scoping review

“…Three major treatment options from collected evidence included: 1. Electric/magnetic stimulation (28–32,34,36,41,47,50,52–54,57,61,64,65,67,68) 2. Herbal, Complementary & Alternative Medicine (CAM), and Nutritional therapy (8,19,37,39,40,42,49,59,60,63), and 3.…”

Direct and Transcutaneous Vagus Nerve Stimulation for Treatment of Tinnitus: A Scoping Review

“…As of now, there is no evidence showing effectiveness of either treatment in relieving tinnitus as all existing studies are of poor quality, which is confirmed by a recent systematic review (Stegeman et al, 2021). Future studies should follow the Consolidated Standards of Reporting Trials (CONSORT) recommendations, which provide guidelines for designing and reporting randomized control trials that include double blinding and a suitable sample size (Schulz et al, 2010).…”

“…A recent systematic review reviewed nine studies on (t)VNS effect in reducing tinnitus symptoms (Stegeman et al, 2021). The review concluded that due to methodological limitations and low reporting quality of the studies, the effect of VNS on tinnitus remains unclear.…”