Brai2n & TRI, University Hospital Antwerp, Belgium.
Neuromodulation. 2012 Jul;15(4):350-60. doi: 10.1111/j.1525-1403.2012.00447.x. Epub 2012 Apr 11.
OBJECTIVE: Nonpulsatile tinnitus is an auditory phantom percept characterized as a tone, or a noise-like sound such as a hissing or buzzing sound or polyphonic, in the absence of any objective physical sound source. Although advances have been made in symptomatic pharmacologic and nonpharmacologic treatments, these treatments are unable to eliminate the tinnitus sensation in most patients. A novel approach using noninvasive and invasive neuromodulation has emerged as an interesting and promising modality for tinnitus relief. METHODOLOGY: We review noninvasive neuromodulation techniques including transcranial magnetic stimulation, transcranial direct current stimulation, transcutaneous electrical nerve stimulation, and cortical neurofeedback, as well as invasive neuromodulation techniques including auditory cortex stimulation, dorsolateral prefrontal cortex stimulation, subcutaneous occipital nerve stimulation, and deep brain stimulation, as potential treatments of tinnitus. CONCLUSION: Although the different techniques introduced revealed promising results, further research is needed to better understand how these techniques work and how the brain responds to neuromodulation. More sophisticated stimulation regimens and parameters should be developed to dynamically stimulate various regions at different frequencies and intensities, physiologically tailored to the patient's brain state in an attempt to maximize efficacy.
目的:非搏动性耳鸣是一种听觉幻觉,表现为没有任何客观物理声源的音调或类似噪声的声音,如嘶嘶声或嗡嗡声或多音。尽管在症状性药物和非药物治疗方面取得了进展,但这些治疗方法无法消除大多数患者的耳鸣感。一种使用非侵入性和侵入性神经调节的新方法已成为一种有趣且有前途的耳鸣缓解方式。
方法:我们回顾了非侵入性神经调节技术,包括经颅磁刺激、经颅直流电刺激、经皮神经电刺激和皮质神经反馈,以及侵入性神经调节技术,包括听觉皮层刺激、背外侧前额叶皮层刺激、皮下枕神经刺激和深部脑刺激,作为耳鸣的潜在治疗方法。
结论:尽管介绍的不同技术显示出有希望的结果,但需要进一步研究以更好地了解这些技术的工作原理以及大脑对神经调节的反应。应该开发更复杂的刺激方案和参数,以动态地以不同的频率和强度刺激各种区域,根据患者的大脑状态进行生理调整,以最大限度地提高疗效。
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