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θ波爆发式重复经颅磁刺激治疗慢性耳鸣的有效性

Effectiveness of theta-burst repetitive transcranial magnetic stimulation for treating chronic tinnitus.

作者信息

Chung Hsiung-Kwang, Tsai Chon-Haw, Lin Yu-Chin, Chen Jin-Ming, Tsou Yung-An, Wang Chin-Yuan, Lin Chia-Der, Jeng Fuh-Cherng, Chung Jing-Gung, Tsai Ming-Hsui

机构信息

Department of Otorhinolaryngology - Head and Neck Surgery, China Medical University Hospital, Taichung City, Taiwan, ROC.

出版信息

Audiol Neurootol. 2012;17(2):112-20. doi: 10.1159/000330882. Epub 2011 Mar 11.

DOI:10.1159/000330882
PMID:21865723
Abstract

OBJECTIVES

Repetitive transcranial magnetic stimulation (rTMS), a noninvasive method for altering cortical excitability, is becoming a therapeutic strategy in auditory research institutions worldwide. Application of inhibiting rTMS on these overactive cortical regions can result in effective tinnitus suppression. The aim of this study is to investigate the efficacy of theta-burst rTMS in patients with chronic tinnitus.

STUDY DESIGN

Parallel randomized control study.

SETTING

Tertiary referral center.

PATIENTS

We enrolled 2 female and 20 male patients in this study. The evaluative tools included tinnitus frequency- and loudness-matching, tinnitus questionnaires (TQ), and the Tinnitus Handicap Inventory (THI).

METHODS

The orthogonal projection of the auditory cortex on the scalp was focalized. A figure-eight coil was placed on the surface of the skull over the targeted region with the intensity setting at 80% of the resting motor threshold. We delivered 900 pulses of theta-burst rTMS daily for 10 business days.

MAIN OUTCOME MEASURES

Nine of twelve patients (75%) in the active-stimulation group reported tinnitus suppression following treatment with rTMS. The treatment led to reductions of 8.58 and 8.33 in the mean TQ global and THI scores, respectively. Tinnitus loudness also decreased significantly after delivering rTMS.

RESULTS

Descriptive analysis of the TQs revealed that patients experienced significant improvements in emotional distress levels and somatic symptoms.

CONCLUSIONS

Our preliminary results demonstrate that theta-burst rTMS treatments offer a method of modulating tinnitus. Patients could benefit from emotional improvements, even more than auditory perceptive relief. Further studies are needed to establish a standard protocol and to clarify nervous propagation along the auditory and psychological projection following treatment with rTMS.

摘要

目的

重复经颅磁刺激(rTMS)是一种改变皮层兴奋性的非侵入性方法,正在成为全球听觉研究机构的一种治疗策略。对这些过度活跃的皮层区域施加抑制性rTMS可有效抑制耳鸣。本研究旨在探讨theta爆发式rTMS对慢性耳鸣患者的疗效。

研究设计

平行随机对照研究。

研究地点

三级转诊中心。

患者

本研究纳入了2名女性和20名男性患者。评估工具包括耳鸣频率和响度匹配、耳鸣问卷(TQ)以及耳鸣障碍量表(THI)。

方法

确定听觉皮层在头皮上的正交投影位置。将一个8字形线圈置于颅骨表面的目标区域上方,强度设置为静息运动阈值的80%。我们每天进行900次theta爆发式rTMS脉冲,共进行10个工作日。

主要观察指标

主动刺激组12名患者中有9名(75%)报告经rTMS治疗后耳鸣得到抑制。治疗使TQ总体平均得分和THI得分分别降低了8.58和8.33。给予rTMS后耳鸣响度也显著降低。

结果

对TQ的描述性分析显示,患者在情绪困扰水平和躯体症状方面有显著改善。

结论

我们的初步结果表明,theta爆发式rTMS治疗提供了一种调节耳鸣的方法。患者可从情绪改善中获益,甚至超过听觉感知上的缓解。需要进一步研究以建立标准方案,并阐明rTMS治疗后沿听觉和心理投射的神经传导情况。

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