Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
Eur J Neurol. 2010 Jan;17(1):38-44. doi: 10.1111/j.1468-1331.2009.02730.x. Epub 2009 Jul 9.
Tinnitus is a frequent disorder which is very difficult to treat and there is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Targeted modulation of tinnitus-related cortical activity has been proposed as a promising new treatment approach. We aimed to investigate both immediate and long-term effects of low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) in patients with tinnitus and normal hearing.
Using a parallel design, 20 patients were randomized to receive either active or placebo stimulation over the left temporoparietal cortex for five consecutive days. Treatment results were assessed by using the Tinnitus Handicap Inventory. Ethyl cysteinate dimmer-single photon emission computed tomography (SPECT) imaging was performed before and 14 days after rTMS.
After active rTMS there was significant improvement of the tinnitus score as compared to sham rTMS for up to 6 months after stimulation. SPECT measurements demonstrated a reduction of metabolic activity in the inferior left temporal lobe after active rTMS.
These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus, by demonstrating a significant reduction of tinnitus complaints over a period of at least 6 months and significant reduction of neural activity in the inferior temporal cortex, despite the stimulation applied on the superior temporal cortex.
耳鸣是一种常见的疾病，治疗非常困难，有强有力的证据表明耳鸣与中枢神经系统的功能改变有关。针对耳鸣相关皮质活动的靶向调节已被提出作为一种有前途的新治疗方法。我们旨在研究低频（1Hz）重复经颅磁刺激（rTMS）对耳鸣且听力正常的患者的即时和长期影响。
采用平行设计，20 例患者随机分为左颞顶叶接受真刺激或假刺激 5 天。使用耳鸣残疾量表评估治疗结果。rTMS 治疗前和治疗后 14 天进行乙基半胱氨酸二聚体单光子发射计算机断层扫描（SPECT）成像。
与假刺激相比，真刺激后患者的耳鸣评分在刺激后 6 个月内显著改善。SPECT 测量显示，真刺激后左颞叶下部代谢活性降低。
这些结果支持 rTMS 作为一种新的治疗慢性耳鸣的治疗工具的潜力，因为它在至少 6 个月的时间内显著降低了耳鸣的抱怨，并且尽管在颞上皮质施加了刺激，但在颞叶下部的神经活动也显著降低。
