Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zürich, Zürich 8091, Switzerland.
J Zhejiang Univ Sci B. 2019;20(2):116-130. doi: 10.1631/jzus.B1700117. Epub 2018 Mar 12.
Tinnitus is defined as a perception of sound without any external sound source. Chronic tinnitus is a frequent condition that can affect the quality of life. So far, no causal cure for tinnitus has been documented, and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus' impact on the quality of life. Neuromodulation, a novel therapeutic modality, which aims at alternating nerve activity through a targeted delivery of a stimulus, has emerged as a potential option in tinnitus treatment. This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options. The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine. Non-invasive methods such as repetitive transcranial magnetic stimulation, transcranial electrical stimulation, neurofeedback, and transcutaneous vagus nerve stimulation were included, as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation. Some of these neuromodulation techniques revealed promising results; nevertheless, further research is needed, especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce. Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus. Therefore, in the future, individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.
耳鸣被定义为没有任何外部声源的声音感知。慢性耳鸣是一种常见的病症,会影响生活质量。迄今为止,尚无针对耳鸣的因果治疗方法,大多数药物和身心治疗方法旨在减轻耳鸣对生活质量的影响。神经调节作为一种新的治疗方式,通过靶向刺激来改变神经活动,已成为耳鸣治疗的潜在选择。本文简要综述了目前作为耳鸣治疗选择的神经调节技术。主要目的是为在这一新兴医学领域为耳鸣患者提供咨询的医疗专业人员提供最新知识。本综述纳入了重复经颅磁刺激、经颅电刺激、神经反馈和经皮迷走神经刺激等非侵入性方法,以及植入性迷走神经刺激和侵入性脑刺激等侵入性方法。其中一些神经调节技术显示出了有希望的结果,但仍需要进一步研究,特别是关于这些神经调节技术如何发挥作用以及它们诱导哪些神经元变化的病理生理原理。各种研究表明,不同的大脑状态和网络参与了耳鸣的产生和感知。因此,在未来,针对个体差异的神经调节策略可能是耳鸣治疗的一种有前途的方法,可实现更实质性和更持久的改善。
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