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Dorsolateral prefrontal cortex transcranial magnetic stimulation and electrode implant for intractable tinnitus.
World Neurosurg. 2012 May-Jun; 77(5-6):778-84.WN

Abstract

OBJECTIVE

Tinnitus is a distressing symptom that affects up to 15% of the population; no satisfactory treatment exists. We present a novel surgical approach for the treatment of intractable tinnitus based on electrical extradural stimulation of the dorsolateral prefrontal cortex via an electrode implant. Tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain in the somatosensory system. It is characterized by gamma-band activity in the frontal cortex that can be visualized with the use of electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI).

CASE DESCRIPTION

Transcranial magnetic stimulation (TMS) is a noninvasive technique capable of modulating the ongoing activity of the human brain. When linked with a neuronavigation system, fMRI-guided frontal cortex TMS can be performed in a placebo-controlled way. If it is successful in suppressing tinnitus, this focal and temporary effect can be maintained in perpetuity by implanting a cortical electrode. A neuronavigation-based auditory fMRI-guided frontal cortex TMS session was performed in a patient experiencing intractable tinnitus, yielding 50% tinnitus suppression. Two extradural electrodes were subsequently implanted, also based on auditory fMRI-guided navigation. Postoperatively the tinnitus has improved by 66.67% and progressively continues to improve for more than one year.

CONCLUSION

Focal extradural electrical stimulation of the dorsolateral prefrontal cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus partially. TMS might be a possible method for noninvasive studies of surgical candidates for implantation of stimulating electrodes for tinnitus suppression.

Authors+Show Affiliations

BRAI(2)N, University Hospital Antwerp, Antwerp, Belgium. dirk.de.ridder@uza.beNo affiliation info availableNo 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

22120273

Citation

De Ridder, Dirk, et al. "Dorsolateral Prefrontal Cortex Transcranial Magnetic Stimulation and Electrode Implant for Intractable Tinnitus." World Neurosurgery, vol. 77, no. 5-6, 2012, pp. 778-84.
De Ridder D, Vanneste S, Plazier M, et al. Dorsolateral prefrontal cortex transcranial magnetic stimulation and electrode implant for intractable tinnitus. World Neurosurg. 2012;77(5-6):778-84.
De Ridder, D., Vanneste, S., Plazier, M., Menovsky, T., van de Heyning, P., Kovacs, S., & Sunaert, S. (2012). Dorsolateral prefrontal cortex transcranial magnetic stimulation and electrode implant for intractable tinnitus. World Neurosurgery, 77(5-6), 778-84. https://doi.org/10.1016/j.wneu.2011.09.009
De Ridder D, et al. Dorsolateral Prefrontal Cortex Transcranial Magnetic Stimulation and Electrode Implant for Intractable Tinnitus. World Neurosurg. 2012 May-Jun;77(5-6):778-84. PubMed PMID: 22120273.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Dorsolateral prefrontal cortex transcranial magnetic stimulation and electrode implant for intractable tinnitus. AU - De Ridder,Dirk, AU - Vanneste,Sven, AU - Plazier,Mark, AU - Menovsky,Tomas, AU - van de Heyning,Paul, AU - Kovacs,Silvia, AU - Sunaert,Stefan, Y1 - 2011/11/07/ PY - 2011/05/13/received PY - 2011/09/03/accepted PY - 2011/11/29/entrez PY - 2011/11/29/pubmed PY - 2012/10/4/medline SP - 778 EP - 84 JF - World neurosurgery JO - World Neurosurg VL - 77 IS - 5-6 N2 - OBJECTIVE: Tinnitus is a distressing symptom that affects up to 15% of the population; no satisfactory treatment exists. We present a novel surgical approach for the treatment of intractable tinnitus based on electrical extradural stimulation of the dorsolateral prefrontal cortex via an electrode implant. Tinnitus can be considered an auditory phantom phenomenon similar to deafferentation pain in the somatosensory system. It is characterized by gamma-band activity in the frontal cortex that can be visualized with the use of electroencephalography, magnetoencephalography, and functional magnetic resonance imaging (fMRI). CASE DESCRIPTION: Transcranial magnetic stimulation (TMS) is a noninvasive technique capable of modulating the ongoing activity of the human brain. When linked with a neuronavigation system, fMRI-guided frontal cortex TMS can be performed in a placebo-controlled way. If it is successful in suppressing tinnitus, this focal and temporary effect can be maintained in perpetuity by implanting a cortical electrode. A neuronavigation-based auditory fMRI-guided frontal cortex TMS session was performed in a patient experiencing intractable tinnitus, yielding 50% tinnitus suppression. Two extradural electrodes were subsequently implanted, also based on auditory fMRI-guided navigation. Postoperatively the tinnitus has improved by 66.67% and progressively continues to improve for more than one year. CONCLUSION: Focal extradural electrical stimulation of the dorsolateral prefrontal cortex at the area of cortical plasticity is capable of suppressing contralateral tinnitus partially. TMS might be a possible method for noninvasive studies of surgical candidates for implantation of stimulating electrodes for tinnitus suppression. SN - 1878-8769 UR - https://www.unboundmedicine.com/medline/citation/22120273/Dorsolateral_prefrontal_cortex_transcranial_magnetic_stimulation_and_electrode_implant_for_intractable_tinnitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1878-8750(11)01088-6 DB - PRIME DP - Unbound Medicine ER -