Division of Neuropsychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Otorhinolaryngology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
Restor Neurol Neurosci. 2020;38(4):283-299. doi: 10.3233/RNN-200992.
Alpha/delta neurofeedback has been shown to be a potential treatment option for chronic subjective tinnitus. Traditional neurofeedback approaches working with a handful of surface electrodes have been criticized, however, due to their low spatial specificity.
The purpose of this study was to evaluate an innovative tomographic neurofeedback protocol that combines neural activity measured across the whole scalp with sLORETA source estimation.
Forty-eight tinnitus patients participated in 15 neurofeedback training sessions as well as extensive pre, post, and follow-up testing. Patients were randomly assigned to either a tomographic (TONF) or a traditional electrode-based neurofeedback (NTNF) group. Main outcome measures of this study were defined as tinnitus-related distress measured with the Tinnitus Handicap Inventory (THI) and Tinnitus Questionnaire (TQ), tinnitus loudness, and resting-state EEG activity in trained frequency bands.
For both groups a significant reduction of tinnitus-related distress and tinnitus loudness was found. While distress changes remained persistent irrespective of group, loudness levels returned to baseline in the follow-up period. No significant between-group differences between the 2 neurofeedback applications (TONF vs. NTNF) were found, which suggests a similar contribution to symptom improvement. The trained alpha/delta ratio increased significantly over the course of the training and remained stable in the follow-up period. This effect was found irrespective of group on both surface and source levels with no meaningful differences between the 2 groups.
Our study shows that a tomographic alpha/delta protocol should be considered a promising addition to tinnitus treatment but that more individually specific neurofeedback protocols should be developed.
阿尔法/德尔塔神经反馈已被证明是治疗慢性主观性耳鸣的一种潜在治疗选择。然而，由于其空间特异性低，传统的使用少数表面电极的神经反馈方法受到了批评。
本研究旨在评估一种创新的断层神经反馈方案，该方案结合了整个头皮上测量的神经活动和 sLORETA 源估计。
48 名耳鸣患者参加了 15 次神经反馈训练课程以及广泛的预、后和随访测试。患者被随机分配到断层（TONF）或传统基于电极的神经反馈（NTNF）组。本研究的主要观察指标定义为耳鸣相关困扰，用耳鸣残疾量表（THI）和耳鸣问卷（TQ）测量，耳鸣响度，以及训练频率带的静息状态 EEG 活动。
两组患者的耳鸣相关困扰和耳鸣响度均显著降低。虽然困扰的变化仍然持续存在，与组无关，但在随访期间，响度水平恢复到基线。两种神经反馈应用（TONF 与 NTNF）之间没有发现显著的组间差异，这表明它们对症状改善的贡献相似。在训练过程中，训练的阿尔法/德尔塔比值显著增加，并在随访期间保持稳定。这种效应在表面和源水平上都被发现，两组之间没有明显的差异。
我们的研究表明，断层阿尔法/德尔塔方案应被视为耳鸣治疗的一种有前途的补充方法，但应开发更具个体特异性的神经反馈方案。
