Langguth Berthold, Zowe Marc, Landgrebe Michael, Sand Philipp, Kleinjung Tobias, Binder Harald, Hajak Göran, Eichhammer Peter
Department of Psychiatry, Psychotherapy and Psychosomatics, University of Regensburg, Universitätsstrasse 84, 93053 Regensburg, Germany.
Brain Topogr. 2006 Summer;18(4):241-7. doi: 10.1007/s10548-006-0002-1. Epub 2006 Jul 15.
Auditory phantom perceptions are associated with hyperactivity of the central auditory system. Neuronavigation guided repetitive transcranial magnetic stimulation (rTMS) of the area of increased activity was demonstrated to reduce tinnitus perception. The study aimed at developing an easy applicable standard procedure for transcranial magnetic stimulation of the primary auditory cortex and to investigate this coil positioning strategy for the treatment of chronic tinnitus in clinical practice. The left gyrus of Heschl was targeted in 25 healthy subjects using a frameless stereotactical system. Based on individual scalp coordinates of the coil, a positioning strategy with reference to the 10--20-EEG system was developed. Using this coil positioning approach we started an open treatment trial. 28 patients with chronic tinnitus received 10 sessions of rTMS (intensity 110% of motor threshold, 1 Hz, 2000 Stimuli/day). Being within a range of about 20 mm diameter, the scalp coordinates for stimulating the primary auditory cortex allowed to determine a standard procedure for coil positioning. Clinical validation of this coil positioning method resulted in a significant improvement of tinnitus complaints (p<0.001). The newly developed coil positioning strategy may have the potential to offer a more easy-to-use stimulation approach for treating chronic tinnitus as compared with highly sophisticated, imaging guided treatment methods.
听觉幻听与中枢听觉系统的过度活跃有关。经证实,在神经导航引导下对活动增强区域进行重复经颅磁刺激(rTMS)可减轻耳鸣感知。该研究旨在开发一种易于应用的标准程序用于对初级听觉皮层进行经颅磁刺激,并在临床实践中研究这种线圈定位策略用于治疗慢性耳鸣。使用无框架立体定向系统对25名健康受试者的左侧颞横回进行定位。基于线圈的个体头皮坐标,制定了一种参照10 - 20脑电图系统的定位策略。采用这种线圈定位方法,我们启动了一项开放性治疗试验。28例慢性耳鸣患者接受了10次rTMS治疗(强度为运动阈值的110%,1Hz,每天2000次刺激)。刺激初级听觉皮层的头皮坐标在直径约20毫米的范围内,这使得能够确定一种线圈定位的标准程序。这种线圈定位方法的临床验证结果显示耳鸣症状有显著改善(p<0.001)。与高度复杂的成像引导治疗方法相比,新开发的线圈定位策略可能有潜力提供一种更易于使用的刺激方法来治疗慢性耳鸣。
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