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使用功能近红外光谱评估针刺治疗慢性主观性耳鸣的疗效及潜在机制:一项随机对照试验的研究方案

Evaluating the Efficacy and Underlying Mechanisms of Acupuncture for Chronic Subjective Tinnitus Using Functional Near-Infrared Spectroscopy: Study Protocol for a Randomized Controlled Trial.

作者信息

Hu Hantong, Lin Xiaoqi, Fang Lianqiang, Li Yang, Gao Hong

机构信息

Department of Acupuncture and Moxibustion, the Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou City, People's Republic of China.

Department of Neurobiology and Acupuncture Research, Zhejiang Chinese Medical University, Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Hangzhou City, People's Republic of China.

出版信息

J Pain Res. 2023 Oct 4;16:3367-3378. doi: 10.2147/JPR.S433048. eCollection 2023.

Abstract

OBJECTIVE

This study aims to evaluate the efficacy and safety of acupuncture for chronic subjective tinnitus and explore the central mechanism underlying acupuncture for chronic subjective tinnitus using functional near-infrared spectroscopy (fNIRS).

METHODS

We will randomly assign 60 tinnitus patients to either an acupuncture group or a waiting-list control group. The acupuncture group will undergo 12 treatment sessions over 4 weeks, whereas the waiting-list control group will receive no intervention concurrently. Clinical outcome measures include the Tinnitus Handicap Inventory (THI) score, tinnitus loudness assessed by 11-point NRS, average pure-tone threshold, and Hamilton Anxiety Scale (HAM-A) score. Neuroimaging outcomes assessed by fNIRS included blood oxygen concentration and resting-state functional connectivity (RSFC). All outcome measurements will be assessed at the baseline, after 4-week treatment, and at 3-month follow-ups.

RESULTS

Our investigation will determine if significant differences exist between the two groups regarding THI, NRS, average pure-tone threshold, and HAM-A scores. Moreover, the analysis will reveal whether the acupuncture group demonstrates significant change in blood oxygen concentration and RSFC between specific brain regions compared to the waiting-list control group.

CONCLUSION

With the novel technique of fNIRS, in addition to efficacy evaluation of acupuncture, this study's findings are anticipated to partly elucidate the neural mechanisms underlying acupuncture treatment for subjective tinnitus and offer an objective assessment method for its therapeutic impact, thereby contributing to filling the research gap.

TRIAL REGISTRATION

Clinicaltrials registry (identification code NCT05829278).

摘要

目的

本研究旨在评估针刺治疗慢性主观性耳鸣的疗效和安全性,并使用功能近红外光谱技术(fNIRS)探索针刺治疗慢性主观性耳鸣的中枢机制。

方法

我们将60名耳鸣患者随机分为针刺组或等待名单对照组。针刺组将在4周内接受12次治疗,而等待名单对照组在此期间不接受任何干预。临床结局指标包括耳鸣障碍量表(THI)评分、用11点数字评定量表(NRS)评估的耳鸣响度、平均纯音听阈以及汉密尔顿焦虑量表(HAM - A)评分。通过fNIRS评估的神经影像学结局包括血氧浓度和静息态功能连接(RSFC)。所有结局测量将在基线、4周治疗后以及3个月随访时进行评估。

结果

我们的研究将确定两组在THI、NRS、平均纯音听阈和HAM - A评分方面是否存在显著差异。此外,分析将揭示针刺组与等待名单对照组相比,特定脑区之间的血氧浓度和RSFC是否有显著变化。

结论

借助fNIRS这项新技术,除了评估针刺疗效外,本研究结果有望部分阐明针刺治疗主观性耳鸣的神经机制,并为其治疗效果提供一种客观评估方法,从而有助于填补研究空白。

试验注册

临床试验注册库(识别码NCT05829278)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d43/10560467/e7fc230c8724/JPR-16-3367-g0001.jpg

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