Yadollahpour Ali, Rashidi Samaneh, Saki Nader, Kunwar Pramod Singh, Mayo-Yáñez Miguel
Department of Psychology, University of Sheffield, Sheffield S1 2LT, UK.
Bioelectromagnetic Clinic, Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz 61357-15794, Iran.
Brain Sci. 2024 Apr 12;14(4):373. doi: 10.3390/brainsci14040373.
Transcranial direct current stimulation (tDCS) is a non-invasive and painless technique of brain neuromodulation that applies a low-intensity galvanic current to the scalp with the aim of stimulating specific areas of the brain. Preliminary investigations have indicated the potential therapeutic efficacy of multisession tDCS applied to the auditory cortex (AC) in the treatment of chronic tinnitus. The aim of this study was to explore the therapeutic effects of repeated sessions of bilateral tDCS targeting the AC on chronic tinnitus. A double-blinded randomized placebo-controlled trial was conducted on patients (n = 48) with chronic intractable tinnitus (>2 years duration). Participants were randomly allocated to two groups: one receiving tDCS (n = 26), with the anode/cathode placed over the left/right AC, and the other receiving a placebo treatment (n = 22). A 20 min daily session of 2 mA current was administered for five consecutive days per week over two consecutive weeks, employing 35 cm electrodes. Tinnitus handicap inventory (THI) scores, tinnitus loudness, and tinnitus distress were measured using a visual analogue scale (VAS), and were assessed before intervention, immediately after, and at one-month follow-up. Anodal tDCS significantly reduced THI from 72.93 ± 10.11 score to 46.40 ± 15.36 after the last session and 49.68 ± 14.49 at one-month follow-up in 18 out of 25 participants ( < 0.001). The risk ratio (RR) of presenting an improvement of ≥20 points in the THI after the last session was 10.8 in patients treated with tDCS. Statistically significant reductions were observed in distress VAS and loudness VAS ( < 0.001). No statistically significant differences in the control group were observed. Variables such as age, gender, duration of tinnitus, laterality of tinnitus, baseline THI scores, and baseline distress and loudness VAS scores did not demonstrate significant correlations with treatment response. Repeated sessions of bilateral AC tDCS may potentially serve as a therapeutic modality for chronic tinnitus.
经颅直流电刺激（tDCS）是一种非侵入性且无痛的脑调节技术，它通过向头皮施加低强度直流电，以刺激大脑的特定区域。初步研究表明，多次经颅直流电刺激应用于听觉皮层（AC）对慢性耳鸣具有潜在的治疗效果。本研究旨在探讨针对听觉皮层进行双侧重复经颅直流电刺激对慢性耳鸣的治疗作用。对48例慢性顽固性耳鸣（病程>2年）患者进行了一项双盲随机安慰剂对照试验。参与者被随机分为两组：一组接受经颅直流电刺激（n = 26），阳极/阴极置于左侧/右侧听觉皮层上方，另一组接受安慰剂治疗（n = 22）。每周连续5天，每天进行20分钟、2毫安电流的刺激，持续两周，使用35厘米的电极。使用视觉模拟量表（VAS）测量耳鸣障碍量表（THI）得分、耳鸣响度和耳鸣困扰程度，并在干预前、干预后立即以及1个月随访时进行评估。在25名参与者中的18名中，阳极经颅直流电刺激使最后一次治疗后THI得分从72.93±10.11显著降至46.40±15.36，1个月随访时降至49.68±14.49（<0.001）。经颅直流电刺激治疗的患者在最后一次治疗后THI改善≥20分的风险比（RR）为10.8。在困扰VAS和响度VAS方面观察到有统计学意义的降低（<0.001）。对照组未观察到统计学意义上的差异。年龄、性别、耳鸣病程、耳鸣侧别、基线THI得分以及基线困扰和响度VAS得分等变量与治疗反应无显著相关性。双侧听觉皮层重复经颅直流电刺激可能作为慢性耳鸣的一种治疗方式。
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