1 Center for Hearing Research, University of California, Irvine, CA, USA.
2 Department of Anatomy and Neurobiology, University of California, Irvine, CA, USA.
Trends Hear. 2019 Jan-Dec;23:2331216518821449. doi: 10.1177/2331216518821449.
Noninvasive transcranial or minimally invasive transtympanic electric stimulation may offer a desirable treatment option for tinnitus because it can activate the deafferented auditory nerve fibers while posing little to no risk to hearing. Here, we built a flexible research interface to generate and control accurately charge-balanced current stimulation as well as a head-mounted instrument capable of holding a transtympanic electrode steady for hours. We then investigated the short-term effect of a limited set of electric stimulation parameters on tinnitus in 10 adults with chronic tinnitus. The preliminary results showed that 63% of conditions of electric stimulation produced some degree of tinnitus reduction, with total disappearance of tinnitus in six subjects in response to at least one condition. The present study also found significant side effects such as visual, tactile, and even pain sensations during electric stimulation. In addition to masking and residual inhibition, neuroplasticity is likely involved in the observed tinnitus reduction. To translate the present electric stimulation into a safe and effective tinnitus treatment option, we need to optimize stimulation parameters that activate the deafferented auditory nerve fibers and reliably suppress tinnitus, with minimal side effects and tolerable sensations. Noninvasive or minimally invasive electric stimulation can be integrated with sound therapy, invasive cochlear implants, or other forms of coordinated stimulation to provide a systematic strategy for tinnitus treatment or even a cure.
经颅或微创鼓室内电刺激可能为耳鸣提供一种理想的治疗选择，因为它可以激活去传入的听神经纤维，同时对听力几乎没有风险。在这里，我们构建了一个灵活的研究接口，可以精确地产生和控制电荷平衡电流刺激，以及一个能够将鼓室内电极稳定地保持数小时的头戴式仪器。然后，我们研究了一组有限的电刺激参数对 10 名慢性耳鸣成人耳鸣的短期影响。初步结果表明，63%的电刺激条件产生了一定程度的耳鸣减轻，其中 6 名受试者至少对一种条件出现了耳鸣完全消失。本研究还发现了一些显著的副作用，如视觉、触觉，甚至在电刺激期间的疼痛感觉。除了掩蔽和残余抑制外，神经可塑性可能参与了观察到的耳鸣减轻。为了将目前的电刺激转化为一种安全有效的耳鸣治疗选择，我们需要优化刺激参数，激活去传入的听神经纤维，并可靠地抑制耳鸣，同时尽量减少副作用和可耐受的感觉。非侵入性或微创性电刺激可以与声音疗法、侵入性人工耳蜗植入或其他形式的协调刺激相结合，为耳鸣治疗甚至治愈提供一种系统的策略。
