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联合经颅直流电刺激(tDCS)和定制缺口音乐训练(TMNMT)对耳鸣患者的听力学、心理测量和认知指标的疗效。

The effectiveness of the combined transcranial direct current stimulation (tDCS) and tailor-made notched music training (TMNMT) on psychoacoustic, psychometric, and cognitive indices of tinnitus patients.

机构信息

Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Department of Audiology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.

出版信息

Am J Otolaryngol. 2022 Jan-Feb;43(1):103274. doi: 10.1016/j.amjoto.2021.103274. Epub 2021 Oct 20.

Abstract

PURPOSE

Tinnitus network(s) consists of pathways in the auditory cortex, frontal cortex, and the limbic system. The cortical hyperactivity caused by tinnitus may be suppressed by neuromodulation techniques. Due to the lack of definitive treatment for tinnitus and limited usefulness of the individual methods, in this study, a combination of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) and tailor-made notched music training (TMNMT) was used.

MATERIAL AND METHODS

In this descriptive-analytic study, 26 patients with chronic unilateral tinnitus of the right ear were randomly divided into the clinical trial group (CTG) and the control group (CG). In both groups, six sessions of tDCS with 2 mA intensity for 20 min, with anode on F4 and cathode on F3, were conducted. Simultaneous with tDCS sessions, and based on TMNMT, the participant was asked to listen passively for 120 min/day, to a CD containing her/his favorite music with a proper notch applied in its spectrum according to the individual's tinnitus The treatment outcome was measured by, psychoacoustic (loudness-matching), psychometric (awareness, loudness and annoyance Visual Analogue Scale (VAS) scores, and Tinnitus Handicap Inventory (THI)) scores, and cognitive assessments (randomized dichotic digits test (RDDT) and dichotic auditory-verbal memory test (DAVMT)). Repeated measurement test was used for statistical analyses.

RESULTS

In the CTG, the tinnitus loudness and annoyance VAS scores, and THI were reduced significantly (p = 0.001). In addition, the DAVMT and RDDT scores were enhanced (p = 0.001). Such changes were not observed in the CG (p > 0.05).

CONCLUSION

The combination of tDCS and TMNMT led to a reduction in the loudness, awareness, annoyance, and also disability induced by tinnitus in CTG. Furthermore, this method showed an improvement of cognitive functions (auditory divided attention, selective attention and working memory) in the CTG.

摘要

目的

耳鸣网络由听觉皮层、额叶皮层和边缘系统中的通路组成。耳鸣引起的皮层过度活跃可以通过神经调节技术来抑制。由于缺乏针对耳鸣的明确治疗方法,且个体方法的效果有限,因此在这项研究中,我们使用了经颅直流电刺激(tDCS)联合定制带阻音乐训练(TMNMT)。

材料和方法

在这项描述性分析研究中,我们将 26 名右耳单侧慢性耳鸣患者随机分为临床试验组(CTG)和对照组(CG)。在两组中,都进行了 6 次 2 mA 强度的 tDCS 治疗,阳极置于 F4,阴极置于 F3,每次 20 分钟。在进行 tDCS 治疗的同时,根据 TMNMT,参与者被要求每天被动聆听 120 分钟,聆听包含其个人喜爱音乐的 CD,根据个体耳鸣的频谱适当应用带阻。使用心理声学(响度匹配)、心理计量学(意识、响度和烦恼视觉模拟量表(VAS)评分,以及耳鸣残疾量表(THI))评分和认知评估(随机双音数字测试(RDDT)和双音听觉言语记忆测试(DAVMT))来衡量治疗效果。采用重复测量检验进行统计分析。

结果

在 CTG 中,耳鸣响度和烦恼 VAS 评分以及 THI 显著降低(p=0.001)。此外,DAVMT 和 RDDT 评分也得到了提高(p=0.001)。而 CG 中没有观察到这些变化(p>0.05)。

结论

tDCS 联合 TMNMT 可降低 CTG 中的耳鸣响度、意识、烦恼和残疾程度。此外,这种方法还改善了 CTG 的认知功能(听觉分散注意力、选择性注意力和工作记忆)。

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