Bolandi Masoud, Javanbakht Mohanna, Shaabani Moslem, Bakhshi Enayatollah
Department of Audiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran.
Department of Audiology, University of Social Welfare and Rehabilitation Science, Tehran, Iran; Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Science, Tehran, Iran.
Am J Otolaryngol. 2024 Nov-Dec;45(6):104449. doi: 10.1016/j.amjoto.2024.104449. Epub 2024 Jul 31.
The dorsal cochlear nucleus (DCN) is the interaction site of auditory and somatosensory system inputs. According to the stochastic resonance theory, hearing loss increases the neural activity of the somatosensory system in the DCN and causes tinnitus. it is possible to modulate this neural hyperactivity by applying random noise through the auditory and somatosensory systems (bimodal stimulation). Therefore, this study aimed to investigate the effectiveness of the bimodal intervention based on the theory of stochastic resonance.
The study divided 34 participants into unimodal and bimodal groups with 17 subjects in each. The bimodal group received customized acoustic stimulation along with transcutaneous auricular vagus nerve stimulation (tAVNS) and the unimodal group received customized acoustic stimulation along with tAVNS as a sham. The treatment sessions in both groups were 6 sessions and each session lasted for 20 min. The participants were evaluated before, immediately after, and one month after the completion of the intervention sessions, using the Tinnitus Handicap Inventory (THI) questionnaire and the mismatch negativity (MMN) test.
After the intervention sessions, the results indicated a statistically significant decrease in THI scores and a significant increase in the MMN amplitude in the bimodal group compared to the unimodal group. No significant changes in MMN latency were observed between the two groups. These changes were stable in the one-month follow-up visit.
Our study showed that bimodal stimulation is a better intervention option compared to unimodal stimulation. Bimodal stimulation may be an effective intervention method for some subjects with tinnitus, especially people with hearing loss who have tonal tinnitus.
蜗背侧核（DCN）是听觉和体感系统输入的交互部位。根据随机共振理论，听力损失会增加DCN中体感系统的神经活动并导致耳鸣。通过听觉和体感系统施加随机噪声（双峰刺激）来调节这种神经活动亢进是有可能的。因此，本研究旨在探讨基于随机共振理论的双峰干预的有效性。
本研究将34名参与者分为单峰组和双峰组，每组17名受试者。双峰组接受定制的声刺激以及经皮耳迷走神经刺激（tAVNS），单峰组接受定制的声刺激以及作为假刺激的tAVNS。两组的治疗疗程均为6次，每次疗程持续20分钟。在干预疗程开始前、结束后立即以及结束后一个月，使用耳鸣障碍量表（THI）问卷和失配负波（MMN）测试对参与者进行评估。
干预疗程结束后，结果表明，与单峰组相比双峰组的THI评分在统计学上显著降低，MMN波幅显著增加。两组之间MMN潜伏期未观察到显著变化。这些变化在为期一个月的随访中保持稳定。
我们的研究表明，与单峰刺激相比，双峰刺激是更好的干预选择。双峰刺激可能是一些耳鸣患者，尤其是患有音调性耳鸣的听力损失患者的有效干预方法。
