[低频重复经颅磁刺激（rTMS）治疗慢性耳鸣——是否存在长期影响？]

[Low frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus--are there long-term effects?].

作者信息

Langguth Berthold, Eichhammer Peter, Zowe Marc, Marienhagen Jörg, Kleinjung Tobias, Jacob Peter, Sand Philipp, Hajak Göran

机构信息

Klinik für Psychiatrie und Psychotherapie der Universität am Bezirksklinikum Regensburg.

出版信息

Psychiatr Prax. 2004 Nov;31 Suppl 1:S52-4. doi: 10.1055/s-2004-828432.

DOI:10.1055/s-2004-828432

PMID:15570501

Abstract

OBJECTIVE

Clinical, neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterised by focal brain activation. Low frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders.

METHODS

Patients suffering from chronic tinnitus underwent a [ (18)F]deoxyglucose-PET (positron emission tomography). Fusioning of the individual PET scan with the structural MRI-scan (magnetic resonance imaging, T1, MPRAGE) revealed an increased metabolic activation in the primary auditory cortex as target point for rTMS. A neuronavigational system enabled the positioning of the figure of eight coil in relation to the target area. rTMS (110 % motor threshold; 1 Hz; 2000 stimuli/day over 5 days) was performed using a placebo controlled cross-over design.

RESULTS

Following active rTMS there was a moderate improvement of tinnitus perception. Treatment effects lasted up to six months in some patients.

CONCLUSIONS

Neuronavigated rTMS offers new possibilities in the understanding and treatment of chronic tinnitus.

摘要

目的

临床、神经生理学和神经影像学数据表明，慢性耳鸣类似于以局灶性脑激活为特征的神经精神综合征。低频重复经颅磁刺激（rTMS）已被提议作为治疗脑过度兴奋障碍的一种有效方法。

方法

患有慢性耳鸣的患者接受了[（18）F]脱氧葡萄糖正电子发射断层扫描（PET）。将个体PET扫描与结构磁共振成像扫描（MRI，T1，MPRAGE）融合，显示初级听觉皮层代谢激活增加，作为rTMS的靶点。神经导航系统能够将八字形线圈相对于目标区域进行定位。采用安慰剂对照交叉设计进行rTMS（110%运动阈值；1Hz；5天内每天2000次刺激）。