Tags

Type your tag names separated by a space and hit enter

Transcranial magnetic stimulation and extradural electrodes implanted on secondary auditory cortex for tinnitus suppression.
J Neurosurg. 2011 Apr; 114(4):903-11.JN

Abstract

OBJECT

Tinnitus is a prevalent symptom, with clinical, pathophysiological, and treatment features analogous to pain. Noninvasive transcranial magnetic stimulation (TMS) and intracranial auditory cortex stimulation (ACS) via implanted electrodes into the primary or overlying the secondary auditory cortex have been developed to treat severe cases of intractable tinnitus.

METHODS

A series of 43 patients who benefited transiently from 2 separate placebo-controlled TMS sessions underwent implantation of auditory cortex electrodes. Targeting was based on blood oxygen level-dependent activation evoked by tinnitus-matched sound, using functional MR imaging-guided neuronavigation.

RESULTS

Thirty-seven percent of the patients responded to ACS with tonic stimulation. Of the 63% who were nonresponders, half benefited from burst stimulation. In total, 33% remained unaffected by the ACS. The average tinnitus reduction was 53% for the entire group. Burst stimulation was capable of suppressing tinnitus in more patients and was better than tonic stimulation, especially for noise-like tinnitus. For pure tone tinnitus, there were no differences between the 2 stimulation designs. The average pure tone tinnitus improvement was 71% versus 37% for noise-like tinnitus and 29% for a combination of both pure tone and noise-like tinnitus. Transcranial magnetic stimulation did not predict response to ACS, but in ACS responders, a correlation (r = 0.38) between the amount of TMS and ACS existed. A patient's sex, age, or tinnitus duration did not influence treatment outcome.

CONCLUSIONS

Intracranial ACS might become a valuable treatment option for severe intractable tinnitus. Better understanding of the pathophysiological mechanisms of tinnitus, predictive functional imaging tests, new stimulation designs, and other stimulation targets are needed to improve ACS results.

Authors+Show Affiliations

Brai2n, University Hospital Antwerp, Belgium.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21235318

Citation

De Ridder, Dirk, et al. "Transcranial Magnetic Stimulation and Extradural Electrodes Implanted On Secondary Auditory Cortex for Tinnitus Suppression." Journal of Neurosurgery, vol. 114, no. 4, 2011, pp. 903-11.
De Ridder D, Vanneste S, Kovacs S, et al. Transcranial magnetic stimulation and extradural electrodes implanted on secondary auditory cortex for tinnitus suppression. J Neurosurg. 2011;114(4):903-11.
De Ridder, D., Vanneste, S., Kovacs, S., Sunaert, S., Menovsky, T., van de Heyning, P., & Moller, A. (2011). Transcranial magnetic stimulation and extradural electrodes implanted on secondary auditory cortex for tinnitus suppression. Journal of Neurosurgery, 114(4), 903-11. https://doi.org/10.3171/2010.11.JNS10197
De Ridder D, et al. Transcranial Magnetic Stimulation and Extradural Electrodes Implanted On Secondary Auditory Cortex for Tinnitus Suppression. J Neurosurg. 2011;114(4):903-11. PubMed PMID: 21235318.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Transcranial magnetic stimulation and extradural electrodes implanted on secondary auditory cortex for tinnitus suppression. AU - De Ridder,Dirk, AU - Vanneste,Sven, AU - Kovacs,Silvia, AU - Sunaert,Stefan, AU - Menovsky,Tomas, AU - van de Heyning,Paul, AU - Moller,Aage, Y1 - 2011/01/14/ PY - 2011/1/18/entrez PY - 2011/1/18/pubmed PY - 2011/5/28/medline SP - 903 EP - 11 JF - Journal of neurosurgery JO - J Neurosurg VL - 114 IS - 4 N2 - OBJECT: Tinnitus is a prevalent symptom, with clinical, pathophysiological, and treatment features analogous to pain. Noninvasive transcranial magnetic stimulation (TMS) and intracranial auditory cortex stimulation (ACS) via implanted electrodes into the primary or overlying the secondary auditory cortex have been developed to treat severe cases of intractable tinnitus. METHODS: A series of 43 patients who benefited transiently from 2 separate placebo-controlled TMS sessions underwent implantation of auditory cortex electrodes. Targeting was based on blood oxygen level-dependent activation evoked by tinnitus-matched sound, using functional MR imaging-guided neuronavigation. RESULTS: Thirty-seven percent of the patients responded to ACS with tonic stimulation. Of the 63% who were nonresponders, half benefited from burst stimulation. In total, 33% remained unaffected by the ACS. The average tinnitus reduction was 53% for the entire group. Burst stimulation was capable of suppressing tinnitus in more patients and was better than tonic stimulation, especially for noise-like tinnitus. For pure tone tinnitus, there were no differences between the 2 stimulation designs. The average pure tone tinnitus improvement was 71% versus 37% for noise-like tinnitus and 29% for a combination of both pure tone and noise-like tinnitus. Transcranial magnetic stimulation did not predict response to ACS, but in ACS responders, a correlation (r = 0.38) between the amount of TMS and ACS existed. A patient's sex, age, or tinnitus duration did not influence treatment outcome. CONCLUSIONS: Intracranial ACS might become a valuable treatment option for severe intractable tinnitus. Better understanding of the pathophysiological mechanisms of tinnitus, predictive functional imaging tests, new stimulation designs, and other stimulation targets are needed to improve ACS results. SN - 1933-0693 UR - https://www.unboundmedicine.com/medline/citation/21235318/Transcranial_magnetic_stimulation_and_extradural_electrodes_implanted_on_secondary_auditory_cortex_for_tinnitus_suppression_ L2 - https://thejns.org/doi/10.3171/2010.11.JNS10197 DB - PRIME DP - Unbound Medicine ER -