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Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report.
J Neurosurg. 2004 Mar; 100(3):560-4.JN

Abstract

Tinnitus is a distressing symptom that affects up to 15% of the population for whom no satisfactory treatment exists. The authors present a novel surgical approach for the treatment of intractable tinnitus, based on cortical stimulation of the auditory cortex. Tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain, which is observed in the somatosensory system. Tinnitus is accompanied by a change in the tonotopic map of the auditory cortex. Furthermore, there is a highly positive association between the subjective intensity of the tinnitus and the amount of shift in tinnitus frequency in the auditory cortex, that is, the amount of cortical reorganization. This cortical reorganization can be demonstrated by functional magnetic resonance (fMR) imaging. Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Linked to a navigation system that is guided by fMR images of the auditory system, TMS can suppress areas of cortical plasticity. If it is successful in suppressing a patient's tinnitus, this focal and temporary effect can be perpetualized by implanting a cortical electrode. A neuronavigation-based auditory fMR imaging-guided TMS session was performed in a patient who suffered from tinnitus due to a cochlear nerve lesion. Complete suppression of the tinnitus was obtained. At a later time an extradural electrode was implanted with the guidance of auditory fMR imaging navigation. Postoperatively, the patient's tinnitus disappeared and remains absent 10 months later. Focal extradural electrical stimulation of the primary auditory cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus completely. Transcranial magnetic stimulation may be an ideal method for noninvasive studies of surgical candidates in whom stimulating electrodes might be implanted for tinnitus suppression.

Authors+Show Affiliations

Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium. dirk.de.ridder@uza.beNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15035296

Citation

De Ridder, Dirk, et al. "Magnetic and Electrical Stimulation of the Auditory Cortex for Intractable Tinnitus. Case Report." Journal of Neurosurgery, vol. 100, no. 3, 2004, pp. 560-4.
De Ridder D, De Mulder G, Walsh V, et al. Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report. J Neurosurg. 2004;100(3):560-4.
De Ridder, D., De Mulder, G., Walsh, V., Muggleton, N., Sunaert, S., & Møller, A. (2004). Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report. Journal of Neurosurgery, 100(3), 560-4.
De Ridder D, et al. Magnetic and Electrical Stimulation of the Auditory Cortex for Intractable Tinnitus. Case Report. J Neurosurg. 2004;100(3):560-4. PubMed PMID: 15035296.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Magnetic and electrical stimulation of the auditory cortex for intractable tinnitus. Case report. AU - De Ridder,Dirk, AU - De Mulder,Gert, AU - Walsh,Vincent, AU - Muggleton,Neil, AU - Sunaert,Stefan, AU - Møller,Aage, PY - 2004/3/24/pubmed PY - 2004/4/23/medline PY - 2004/3/24/entrez SP - 560 EP - 4 JF - Journal of neurosurgery JO - J Neurosurg VL - 100 IS - 3 N2 - Tinnitus is a distressing symptom that affects up to 15% of the population for whom no satisfactory treatment exists. The authors present a novel surgical approach for the treatment of intractable tinnitus, based on cortical stimulation of the auditory cortex. Tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain, which is observed in the somatosensory system. Tinnitus is accompanied by a change in the tonotopic map of the auditory cortex. Furthermore, there is a highly positive association between the subjective intensity of the tinnitus and the amount of shift in tinnitus frequency in the auditory cortex, that is, the amount of cortical reorganization. This cortical reorganization can be demonstrated by functional magnetic resonance (fMR) imaging. Transcranial magnetic stimulation (TMS) is a noninvasive method of activating or deactivating focal areas of the human brain. Linked to a navigation system that is guided by fMR images of the auditory system, TMS can suppress areas of cortical plasticity. If it is successful in suppressing a patient's tinnitus, this focal and temporary effect can be perpetualized by implanting a cortical electrode. A neuronavigation-based auditory fMR imaging-guided TMS session was performed in a patient who suffered from tinnitus due to a cochlear nerve lesion. Complete suppression of the tinnitus was obtained. At a later time an extradural electrode was implanted with the guidance of auditory fMR imaging navigation. Postoperatively, the patient's tinnitus disappeared and remains absent 10 months later. Focal extradural electrical stimulation of the primary auditory cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus completely. Transcranial magnetic stimulation may be an ideal method for noninvasive studies of surgical candidates in whom stimulating electrodes might be implanted for tinnitus suppression. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/15035296/Magnetic_and_electrical_stimulation_of_the_auditory_cortex_for_intractable_tinnitus__Case_report_ L2 - https://thejns.org/doi/10.3171/jns.2004.100.3.0560 DB - PRIME DP - Unbound Medicine ER -