Nikakhlagh Soheila, Fatahiasl Jafar, Saki Malehi Amal, Tabibzadeh Seyed Mohammad
Hearing Research Center, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran.
Indian J Otolaryngol Head Neck Surg. 2023 Apr;75(Suppl 1):409-415. doi: 10.1007/s12070-023-03503-z. Epub 2023 Feb 4.
Tinnitus is usually associated with different comorbidities such as anxiety, annoyance and depression. Evidences have targeted two main places for tinnitus treatment, namely the auditory cortex and the dorsolateral prefrontal cortex (DLPFC). Transcranial direct current stimulation (tDCS) has been reportedly associated with improvement of cognitive functions in individuals. This study was conducted to evaluate the therapeutic effects of repeated sessions of anodal bifrontal tDCS on tinnitus symptoms. Furthermore, the tDCS impacts on the comorbid depression and anxiety of the patients were investigated. Forty-two voluntaries that suffers from chronic tinnitus were randomly assigned into "real tDCS" (n = 21) and "sham tDCS" (n = 21) groups. The tDCS group, received tDCS with the protocol consisted of 2 mA current, daily one session of 20 min, 6 consecutive days per week and for 4 consecutive weeks. The tinnitus handicap inventory (THI) scale, was measured before the first tDCS session and at one-week and two weeks follow-up. With the same intervals; the distress-related tinnitus was evaluated using visual analogue scale. Depression and anxiety scores were also measured using the Beck depression inventory and Beck anxiety inventory scales, respectively. Our findings indicated that THI score, depression and anxiety level has been gradually diminished across subsequent measurement intervals. We also find significant reduction of distress-related tinnitus in the real-tDCS group after treatment. We conclude that application of tDCS to the bilateral DLPFC region alleviates chronic tinnitus and it should be considered in patients with refractory tinnitus.
耳鸣通常与焦虑、烦恼和抑郁等不同的合并症相关。有证据表明耳鸣治疗的两个主要靶点，即听觉皮层和背外侧前额叶皮层（DLPFC）。据报道，经颅直流电刺激（tDCS）与个体认知功能的改善有关。本研究旨在评估重复阳极双额叶tDCS治疗对耳鸣症状的疗效。此外，还研究了tDCS对患者合并的抑郁和焦虑的影响。42名患有慢性耳鸣的志愿者被随机分为“真实tDCS”组（n = 21）和“假tDCS”组（n = 21）。tDCS组接受的tDCS方案为：电流2 mA，每天1次，每次20分钟，每周连续6天，共连续4周。在第一次tDCS治疗前、治疗后1周和2周进行耳鸣障碍量表（THI）评分。以相同的时间间隔，使用视觉模拟量表评估与痛苦相关的耳鸣。抑郁和焦虑评分分别使用贝克抑郁量表和贝克焦虑量表进行测量。我们的研究结果表明，在随后的测量间隔中，THI评分、抑郁和焦虑水平逐渐降低。我们还发现，治疗后真实tDCS组与痛苦相关的耳鸣显著减少。我们得出结论，将tDCS应用于双侧DLPFC区域可缓解慢性耳鸣，对于难治性耳鸣患者应考虑使用。
