Brai(2)n, TRI & Department of Neurosurgery, University Hospital Antwerp, Wilrijkstraat 10, 2650 Edegem, Belgium.
Brain Stimul. 2013 Mar;6(2):155-9. doi: 10.1016/j.brs.2012.03.019. Epub 2012 May 14.
Tinnitus related distress is associated with increased activity in the anterior cingulate cortex (ACC). In a recent study, it was demonstrated that a single session of low frequency prefrontal TMS using a double-cone coil (DCC) modulating the ACC (AC/DC TMS, anterior cingulate cortex targeted modulation by Double-Cone coil) yields a transient improvement in subjects with chronic tinnitus. An increasing number of studies demonstrated that repeated sessions of low frequency TMS to the temporoparietal area can significantly improve tinnitus complaints. Our aim is to determine the extent to which repeated sessions of AC/DC TMS can modulate tinnitus in comparison to a single session. Seventy-three tinnitus patients received a single (N = 46) or repetitive (N = 27) session(s) of TMS using a DCC placed over the prefrontal cortex. Our results indicate that both single sessions as well as multiple sessions (i.e. 8 sessions) of AC/DC TMS suppress both tinnitus distress (respectively 7.60% vs. 26.19%) and tinnitus intensity (respectively 7.12% vs. 19.60%) transiently. It was further shown that multiple sessions of AC/DC TMS generate a higher suppression effect in comparison to a single session of AC/DC TMS and that more patients responded to repeated sessions of 1 Hz stimulation in comparison to a single session. Our findings give further support to the fact that non-auditory areas are involved in tinnitus intensity and tinnitus distress and that more patients respond to repeated sessions with a higher suppression effect in comparison to patients who received a single session, suggesting that the approach of daily TMS sessions is relevant.
耳鸣相关的痛苦与前扣带皮层（ACC）的活动增加有关。在最近的一项研究中，已经证明单次使用双锥线圈（DCC）调制 ACC 的低频前额 TMS（AC/DC TMS，双锥线圈对前扣带皮层的靶向调制）可使慢性耳鸣患者的耳鸣短暂改善。越来越多的研究表明，重复使用低频 TMS 刺激颞顶区域可以显著改善耳鸣症状。我们的目的是确定与单次治疗相比，重复进行 AC/DC TMS 治疗可以在多大程度上调节耳鸣。73 名耳鸣患者接受了单次（N=46）或重复（N=27）DCC 置于前额皮质的 TMS 治疗。我们的结果表明，单次和多次（即 8 次）AC/DC TMS 均可暂时抑制耳鸣痛苦（分别为 7.60%和 26.19%）和耳鸣强度（分别为 7.12%和 19.60%）。进一步表明，与单次 AC/DC TMS 相比，多次 AC/DC TMS 可产生更高的抑制作用，与单次相比，更多的患者对 1 Hz 刺激的重复治疗有反应。我们的研究结果进一步证实了非听觉区域参与耳鸣强度和耳鸣痛苦的事实，与单次治疗相比，更多的患者对重复治疗有更高的抑制作用有反应，这表明每天进行 TMS 治疗的方法是相关的。
