Wang Hui, Li Bei, Wu Hongmin, Shi Haibo, Yin Shankai
Department of Otolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Department of Otolaryngology Head and Neck Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
Auris Nasus Larynx. 2016 Jun;43(3):254-8. doi: 10.1016/j.anl.2015.09.004. Epub 2015 Oct 1.
We aimed to evaluate gaps in noise (GIN) detection and visual analog scale (VAS) for measuring perceived tinnitus loudness and annoyance caused thereby. We quantified the outcomes and effectiveness of repetitive transcranial magnetic stimulation (rTMS) on chronic tinnitus.
Fourteen tinnitus patients with normal hearing underwent a 10 day course of active 1-Hz rTMS to the left region of the temporoparietal cortex. GIN (in which the matched pitch and loudness of tinnitus was used to determine the frequency and intensity of background noise) and VAS was used to assess tinnitus loudness and the extent of annoyance caused thereby. Both ten patients with tinnitus who underwent left temporoparietal sham stimulation and fifteen volunteers with normal hearing without tinnitus participated with GIN detection as a control. Correlations between VAS scores and GIN detection were determined via Spearman's correlation analysis.
The mean GIN thresholds of tinnitus-affected (5.87 ms) ears and the ears of control subjects (4.85 ms) differed significantly. In the tinnitus group, 42.8% (6/14) patients experienced significant reductions in tinnitus annoyance, as assessed by VAS. 71.4% (10/14) patients experienced significant reductions in tinnitus loudness, as evidenced by GIN evaluation. Three tinnitus subjects (21.4%) achieved 30% decrease of the threshold of GIN detection. There was no significant change in GIN detection and VAS scores after sham stimulation. A significant positive correlation was evident between GIN data and VAS scores (r=0.84, p<0.001).
Gaps in noise detection, combined with VAS scores, affords a promising sensitive method by which to evaluate tinnitus loudness and annoyance. Low frequency rTMS significantly decreased tinnitus after the active, but not the sham, treatment.
我们旨在评估噪声间隙（GIN）检测以及视觉模拟量表（VAS）在测量感知到的耳鸣响度及其所致烦恼方面的差异。我们对重复经颅磁刺激（rTMS）治疗慢性耳鸣的结果和有效性进行了量化。
14名听力正常的耳鸣患者接受了为期10天的对左侧颞顶叶皮质进行1赫兹主动rTMS治疗。使用GIN（利用耳鸣匹配的音高和响度来确定背景噪声的频率和强度）和VAS来评估耳鸣响度及其所致烦恼程度。10名接受左侧颞顶叶假刺激的耳鸣患者以及15名听力正常且无耳鸣的志愿者参与GIN检测作为对照。通过Spearman相关分析确定VAS评分与GIN检测之间的相关性。
受耳鸣影响的耳朵（5.87毫秒）和对照组受试者耳朵（4.85毫秒）的平均GIN阈值存在显著差异。在耳鸣组中，通过VAS评估，42.8%（6/14）的患者耳鸣烦恼程度显著降低。通过GIN评估，71.4%（10/14）的患者耳鸣响度显著降低。3名耳鸣受试者（21.4%）GIN检测阈值降低了30%。假刺激后GIN检测和VAS评分无显著变化。GIN数据与VAS评分之间存在显著正相关（r = 0.84，p < 0.001）。
噪声间隙检测结合VAS评分，为评估耳鸣响度和烦恼程度提供了一种很有前景的敏感方法。低频rTMS在主动治疗而非假治疗后能显著降低耳鸣。
