School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Brisbane, Queensland 4072, Australia.
Brain Stimul. 2013 Sep;6(5):752-9. doi: 10.1016/j.brs.2013.01.015. Epub 2013 Feb 21.
On the basis that tinnitus may result from neural hyperactivity in the auditory cortex, researchers have investigated the use of low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) as a potential modulator of this hyperactivity. While these investigations show promise, investigations to date have neglected to consider the possible effect of 1 Hz rTMS on other functions of the auditory cortex of these individuals, such as auditory processing.
OBJECTIVE/HYPOTHESIS: This placebo-controlled pilot study aimed to determine whether 1 Hz rTMS applied to the primary auditory cortex (PAC), specifically Brodmann Area 41 (BA41), of adults with chronic, bilateral tinnitus would influence their auditory processing abilities.
Eight participants with bilateral, chronic tinnitus were randomized to receive a 10-day course of neuronavigationally guided active rTMS (n = 4) or placebo rTMS (n = 4) treatment applied to a focal region of the left PAC (BA41). Participants' auditory processing was measured using Time Compressed Reverberant Speech and three-pair Dichotic Digits (DD). Their tinnitus was measured using the Tinnitus Handicap Inventory (THI) and a psychoacoustic measure of tinnitus perception. All outcome measures were administered at baseline (1 week prior to rTMS), 1 week, 1, 2 and 3 months post-rTMS.
All four participants in the active rTMS (A) group, and none of the participants in the sham (placebo) rTMS (S) group, showed improved auditory processing scores at multiple assessment points post-stimulation, with the group differences in median normalized gain scores reaching significance at the 5% level from 1 week or 1 month post-stimulation onwards. Three of the four participants in the active rTMS (A) group, and none of the participants in the sham rTMS (S) group, showed improved tinnitus scores at multiple assessment points post-stimulation, with some of the group differences in median normalized gain scores reaching significance at the 5% level.
The results of this preliminary study suggest that 1 Hz rTMS applied to the PAC (BA41) has the capacity to improve both auditory processing and tinnitus perception in some adults with chronic, bilateral tinnitus.
基于耳鸣可能是听觉皮层神经活动过度的结果，研究人员已经研究了低频（1 Hz）重复经颅磁刺激（rTMS）作为这种过度活动的潜在调节剂的用途。尽管这些研究显示出了希望，但迄今为止的研究忽视了考虑 1 Hz rTMS 对这些个体听觉皮层的其他功能（例如听觉处理）的可能影响。
目的/假设：这项安慰剂对照的初步研究旨在确定将 1 Hz rTMS 施加到患有慢性双侧耳鸣的成年人的初级听觉皮层（PAC），特别是布罗德曼区 41（BA41），是否会影响他们的听觉处理能力。
将 8 名患有双侧慢性耳鸣的参与者随机分为接受为期 10 天的神经导航引导的活跃 rTMS（n = 4）或安慰剂 rTMS（n = 4）治疗的两组，治疗部位为左 PAC（BA41）的一个焦点区域。使用时间压缩混响语音和三对双音节数字（DD）来测量参与者的听觉处理能力。他们的耳鸣使用耳鸣残疾量表（THI）和耳鸣感知的心理声学测量来测量。所有结果测量均在基线（rTMS 前一周）、1 周、1、2 和 3 个月后进行。
活跃 rTMS（A）组的所有 4 名参与者，以及假 rTMS（S）组的任何参与者，在刺激后多个评估点的听觉处理分数都有所提高，从刺激后 1 周或 1 个月开始，组间中位数归一化增益分数的差异达到 5%水平的显著性。活跃 rTMS（A）组的 4 名参与者中的 3 名，以及假 rTMS（S）组的任何参与者，在刺激后多个评估点的耳鸣评分都有所提高，其中一些组间中位数归一化增益分数的差异达到了 5%水平的显著性。
这项初步研究的结果表明，将 1 Hz rTMS 施加到 PAC（BA41）具有改善某些患有慢性双侧耳鸣的成年人的听觉处理和耳鸣感知的能力。
