Henin Simon, Fein Dovid, Smouha Eric, Parra Lucas C
Department of Biomedical Engineering, City College of New York, 160 Convent Avenue, New York, New York 10027, United States of America.
Department of Otolaryngology, Head and Neck Surgery, Mount Sinai Medical Center, New York, NY, United States of America.
PLoS One. 2016 Nov 10;11(11):e0166208. doi: 10.1371/journal.pone.0166208. eCollection 2016.
Tinnitus correlates with elevated hearing thresholds and reduced cochlear compression. We hypothesized that reduced peripheral input leads to elevated neuronal gain resulting in the perception of a phantom sound.
The purpose of this pilot study was to test whether compensating for this peripheral deficit could reduce the tinnitus percept acutely using customized auditory stimulation. To further enhance the effects of auditory stimulation, this intervention was paired with high-definition transcranial direct current stimulation (HD-tDCS).
A randomized sham-controlled, single blind study was conducted in a clinical setting on adult participants with chronic tinnitus (n = 14). Compensatory auditory stimulation (CAS) and HD-tDCS were administered either individually or in combination in order to access the effects of both interventions on tinnitus perception. CAS consisted of sound exposure typical to daily living (20-minute sound-track of a TV show), which was adapted with compressive gain to compensate for deficits in each subject's individual audiograms. Minimum masking levels and the visual analog scale were used to assess the strength of the tinnitus percept immediately before and after the treatment intervention.
CAS reduced minimum masking levels, and visual analog scale trended towards improvement. Effects of HD-tDCS could not be resolved with the current sample size.
The results of this pilot study suggest that providing tailored auditory stimulation with frequency-specific gain and compression may alleviate tinnitus in a clinical population. Further experimentation with longer interventions is warranted in order to optimize effect sizes.
耳鸣与听力阈值升高和耳蜗压缩功能降低相关。我们推测外周输入减少会导致神经元增益增加，从而产生幻听。
本初步研究的目的是测试使用定制的听觉刺激急性补偿这种外周缺陷是否可以减少耳鸣感知。为了进一步增强听觉刺激的效果，该干预与高清经颅直流电刺激（HD-tDCS）相结合。
在临床环境中对成年慢性耳鸣患者（n = 14）进行了一项随机假对照单盲研究。单独或联合给予补偿性听觉刺激（CAS）和HD-tDCS，以了解两种干预措施对耳鸣感知的影响。CAS包括日常生活中典型的声音暴露（20分钟的电视节目音轨），根据每个受试者的个体听力图通过压缩增益进行调整，以补偿缺陷。在治疗干预前后，使用最小掩蔽水平和视觉模拟量表来评估耳鸣感知的强度。
CAS降低了最小掩蔽水平，视觉模拟量表有改善趋势。当前样本量无法确定HD-tDCS的效果。
本初步研究结果表明，提供具有频率特异性增益和压缩的定制听觉刺激可能会减轻临床人群的耳鸣。有必要进行更长时间干预的进一步实验，以优化效应大小。
