Li Yi, Shen Yong-Cong, Galvin John J, Liu Ji-Sheng, Tao Duo-Duo
Department of Ear, Nose, and Throat, Dushu Lake Hospital Affiliated of Soochow University, Suzhou 215000, China.
Department of Ear, Nose, and Throat, The First Affiliated of Soochow University, Suzhou 215000, China.
Brain Sci. 2022 Jun 2;12(6):733. doi: 10.3390/brainsci12060733.
The relative benefit of ipsilateral, contralateral, and bilateral repetitive transcranial magnetic stimulation (rTMS) for tinnitus treatment remains unclear, especially for patients with lateralized tinnitus. In this study, we compared outcomes after 10 sessions of 1-Hz rTMS at 110% of resting motor threshold over a two-week period. In total, 104 right-handed patients with lateralized subjective tinnitus were randomly divided into four groups according to rTMS treatment: Left (n = 29), Right (n = 23), Bilateral (n = 30), and Sham stimulation (n = 22). Outcomes included estimates of tinnitus severity, psychological state, and psychoacoustic measures. Patients with left- or right-sided tinnitus were similarly distributed across treatment groups. There were no significant changes in outcome measures for the Right or Sham treatment groups. For the Left and Bilateral groups, tinnitus severity was significantly lower after treatment (p < 0.05). The reduction in tinnitus severity was largest for ipsilateral treatment in the Left group. The overall response rate was 56.1% for the Left group, 46.7% for the Bilateral group, 8.3% for the Right group, and 8.3% for the Sham group. For the Left and Bilateral groups, the response rate was larger for patients with left- than right-sided tinnitus. Changes in tinnitus severity were best predicted by changes in anxiety, depression, and the loudness of the tinnitus. The results suggests that rTMS on the left temporoparietal cortex is more effective for patients with left-sided than with right-sided tinnitus.
同侧、对侧和双侧重复经颅磁刺激（rTMS）治疗耳鸣的相对益处仍不明确，尤其是对于耳鸣定位明确的患者。在本研究中，我们比较了在两周内以静息运动阈值的110%进行10次1赫兹rTMS治疗后的结果。总共104名右利手且耳鸣定位明确的主观性耳鸣患者根据rTMS治疗方式被随机分为四组：左侧（n = 29）、右侧（n = 23）、双侧（n = 30）和假刺激组（n = 22）。结果包括耳鸣严重程度评估、心理状态和心理声学测量。左侧或右侧耳鸣患者在各治疗组中的分布相似。右侧或假治疗组的结果测量指标无显著变化。对于左侧和双侧组，治疗后耳鸣严重程度显著降低（p < 0.05）。左侧组中同侧治疗的耳鸣严重程度降低最大。左侧组的总体有效率为56.1%，双侧组为46.7%，右侧组为8.3%，假刺激组为8.3%。对于左侧和双侧组，左侧耳鸣患者的有效率高于右侧耳鸣患者。耳鸣严重程度的变化最好通过焦虑、抑郁和耳鸣响度的变化来预测。结果表明，左侧颞顶叶皮质的rTMS对左侧耳鸣患者比对右侧耳鸣患者更有效。
