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Feasibility of auditory cortical stimulation for the treatment of tinnitus.
Otol Neurotol. 2007 Dec; 28(8):1005-12.ON

Abstract

OBJECTIVES

To investigate the feasibility and safety of an implantable epidural cortical stimulator for the treatment of severe tinnitus.

STUDY DESIGN

Prospective, controlled, single-blinded study of cortical stimulation for 4 weeks, and then an open-label stimulation period.

SETTING

Tertiary care referral center.

PATIENTS

Adults (n = 8) with constant tinnitus of at least 1 year with a tinnitus reaction questionnaire score greater than 33. Tinnitus was predominantly unilateral with a frequency less than 8,000 Hz.

INTERVENTIONS

Surgical implantation of an investigational epidural electrode over the posterior superior temporal gyrus using functional magnetic resonance imaging targeting. A 2-week stimulation period alternated with a 2-week sham period in random order to which subjects were blinded. This was followed by continuous stimulation with parameter adjustments to maximize tinnitus suppression.

MAIN OUTCOME MEASURE

Subjective rating of tinnitus severity, loudness, and device efficacy. Objective measures of hearing thresholds, tinnitus frequency, loudness, and minimum masking levels. Outcome measures using the Tinnitus Handicap Questionnaire, Tinnitus Reaction Questionnaire, and Beck Depression Inventory.

RESULTS

There were no effects of stimulation during the 4-week blinded period. With continuous chronic stimulation, 2 patients had persistent reduction of pure-tone tinnitus, and 6 patients had short periods of total tinnitus suppression. Significant improvements in the Beck Depression Inventory and tinnitus questionnaires were found, although objective measures of tinnitus loudness remained fairly stable. No surgical or stimulation-related complications were noted.

CONCLUSION

Chronic electrical stimulation of the secondary auditory cortex seems safe and warrants further investigation as a potential therapeutic intervention for the suppression of tinnitus.

Authors+Show Affiliations

Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin and Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin 53226, USA. dfriedla@mcw.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18043428

Citation

Friedland, David R., et al. "Feasibility of Auditory Cortical Stimulation for the Treatment of Tinnitus." Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, vol. 28, no. 8, 2007, pp. 1005-12.
Friedland DR, Gaggl W, Runge-Samuelson C, et al. Feasibility of auditory cortical stimulation for the treatment of tinnitus. Otol Neurotol. 2007;28(8):1005-12.
Friedland, D. R., Gaggl, W., Runge-Samuelson, C., Ulmer, J. L., & Kopell, B. H. (2007). Feasibility of auditory cortical stimulation for the treatment of tinnitus. Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 28(8), 1005-12.
Friedland DR, et al. Feasibility of Auditory Cortical Stimulation for the Treatment of Tinnitus. Otol Neurotol. 2007;28(8):1005-12. PubMed PMID: 18043428.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Feasibility of auditory cortical stimulation for the treatment of tinnitus. AU - Friedland,David R, AU - Gaggl,Wolfgang, AU - Runge-Samuelson,Christina, AU - Ulmer,John L, AU - Kopell,Brian Harris, PY - 2007/11/29/pubmed PY - 2008/1/9/medline PY - 2007/11/29/entrez SP - 1005 EP - 12 JF - Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology JO - Otol. Neurotol. VL - 28 IS - 8 N2 - OBJECTIVES: To investigate the feasibility and safety of an implantable epidural cortical stimulator for the treatment of severe tinnitus. STUDY DESIGN: Prospective, controlled, single-blinded study of cortical stimulation for 4 weeks, and then an open-label stimulation period. SETTING: Tertiary care referral center. PATIENTS: Adults (n = 8) with constant tinnitus of at least 1 year with a tinnitus reaction questionnaire score greater than 33. Tinnitus was predominantly unilateral with a frequency less than 8,000 Hz. INTERVENTIONS: Surgical implantation of an investigational epidural electrode over the posterior superior temporal gyrus using functional magnetic resonance imaging targeting. A 2-week stimulation period alternated with a 2-week sham period in random order to which subjects were blinded. This was followed by continuous stimulation with parameter adjustments to maximize tinnitus suppression. MAIN OUTCOME MEASURE: Subjective rating of tinnitus severity, loudness, and device efficacy. Objective measures of hearing thresholds, tinnitus frequency, loudness, and minimum masking levels. Outcome measures using the Tinnitus Handicap Questionnaire, Tinnitus Reaction Questionnaire, and Beck Depression Inventory. RESULTS: There were no effects of stimulation during the 4-week blinded period. With continuous chronic stimulation, 2 patients had persistent reduction of pure-tone tinnitus, and 6 patients had short periods of total tinnitus suppression. Significant improvements in the Beck Depression Inventory and tinnitus questionnaires were found, although objective measures of tinnitus loudness remained fairly stable. No surgical or stimulation-related complications were noted. CONCLUSION: Chronic electrical stimulation of the secondary auditory cortex seems safe and warrants further investigation as a potential therapeutic intervention for the suppression of tinnitus. SN - 1531-7129 UR - https://www.unboundmedicine.com/medline/citation/18043428/Feasibility_of_auditory_cortical_stimulation_for_the_treatment_of_tinnitus_ L2 - http://dx.doi.org/10.1097/MAO.0b013e318159ebf5 DB - PRIME DP - Unbound Medicine ER -