Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University, Seoul, Korea.
Audiology Institute, Hallym University of Graduate Studies, Seoul, Korea.
J Int Adv Otol. 2024 Sep 26;20(5):397-404. doi: 10.5152/iao.2024.231051.
Pain associated with subjective tinnitus is known to be alleviated by treatments using a repetitive transcranial magnetic stimulation (rTMS). However, the mechanisms underneath are still on debate. We investigated the mechanism of tinnitus alleviation using time-frequency analyses. Twenty-four patients were randomly assigned to the dual-site stimulation group (temporal and frontal stimulation, TF), singlesite stimulation group (temporal stimulation, T), or sham stimulation group. An age-matched control group was also included (n = 12). Electroencephalography (EEG) was recorded and patient data were analyzed before and after treatment. A frontal increase in EEG power was observed in the alpha (8-12 Hz) frequency band domain after treatment; this increase was most pronounced in the TF group, followed by the T group. The TF and T groups showed increased alpha power in the fronto-central channels only in the silent period between paired-pulse tones. The TF and T groups showed decreases in alpha power in the temporal region, particularly in the neural response to the first of the paired-pulse tones. The difference in tinnitus handicap index between pre- and post-treatment was positively correlated with the alpha power of the silent period in the frontal and fronto-central channels. Dual-site stimulation showed the greatest alleviation of tinnitus-related discomfort, followed by single-site stimulation. Additionally, the modulation of alpha power was prominent in the active stimulation groups. Low frequency rTMS can alleviate tinnitus by increasing alpha band power and reducing hyperactivity.
与主观性耳鸣相关的疼痛已知可通过使用重复经颅磁刺激 (rTMS) 的治疗得到缓解。然而，其背后的机制仍存在争议。我们通过时频分析来研究耳鸣缓解的机制。24 名患者被随机分配到双部位刺激组（颞部和额部刺激，TF）、单部位刺激组（颞部刺激，T）或假刺激组。还包括一个年龄匹配的对照组（n=12）。记录脑电图 (EEG)，并在治疗前后分析患者数据。治疗后观察到 alpha（8-12 Hz）频段的脑电图功率在前额增加；这种增加在 TF 组最为明显，其次是 T 组。TF 和 T 组仅在成对脉冲音之间的静默期显示额-中央通道的 alpha 功率增加。TF 和 T 组在颞区的 alpha 功率降低，特别是在对第一个成对脉冲音的神经反应中。治疗前后耳鸣残疾指数的差异与额叶和额中央通道静默期的 alpha 功率呈正相关。双部位刺激显示对耳鸣相关不适的缓解最大，其次是单部位刺激。此外，alpha 功率的调制在主动刺激组中很明显。低频 rTMS 通过增加 alpha 频段功率和降低过度活跃来缓解耳鸣。
