Tinnitus Treatment Report

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RISE OF THE PLACEBOS: repetitive Transcranial Magnetic Stimulation (rTMS) is NOT an effective treatment for chronic tinnitus, new research suggests

https://www.ncbi.nlm.nih.gov/pubmed/31225821?dopt=Abstract

Treatment of Tinnitus Using Theta Burst Based Repetitive Transcranial Magnetic Stimulation-A Single Blinded Randomized Control Trial.

Otol Neurotol

Treatment of Tinnitus Using Theta Burst Based Repetitive Transcranial Magnetic Stimulation-A Single Blinded Randomized Control Trial.

Otol Neurotol. 2019 Jun;40(5S Suppl 1):S38-S42

Authors: Godbehere J, Sandhu J, Evans A, Twigg V, Scivill I, Ray J, Barker A

Abstract

OBJECTIVE: To determine whether theta burst repetitive transcranial magnetic stimulation is an effective treatment for chronic tinnitus compared with a control stimulus.

STUDY DESIGN: A two-arm, single-blind, randomized controlled trial comparing an active treatment group to a placebo control group.

SETTING: Neurotology department of a tertiary referral center.

PATIENTS: Forty new and existing patients with chronic unilateral or bilateral tinnitus were recruited from specialist hearing and balance clinics.

INTERVENTIONS: The subjects were randomized into two groups representing the treatment and sham subcategories. Two 40 second trains, 15 minutes apart of transcranial stimulation was provided using a super rapid stimulator (2.2. Tesla, Magstim Inc., Wales, UK) using a circular delivery coil. Treatment was provided over 5 consecutive days.

MAIN OUTCOME MEASURE: Tinnitus functional index (TFI) scores were recorded before treatment, immediately after treatment, 2 weeks, and at 4 weeks following treatment and compared.

RESULTS: TFI scores were analyzed using the Shapiro-Wilk test and found to be normally distributed. A paired Student t test was then performed. Both the active treatment group and control group had a significant improvement in their TFI scores following treatment; however, there was no significant difference between active treatment and sham treatment groups.

CONCLUSION: This study demonstrated a significant placebo effect following treatment with sham therapy and may suggest that repetitive transcranial magnetic stimulation does not have a therapeutic use in treating chronic tinnitus.

PMID: 31225821 [PubMed – in process]

PubMed:31225821

Article found on June 22, 2019.

Pilot Study of Deep Brain Stimulation (DBS) in Area LC for Chronic Tinnitus [Completed]

https://clinicaltrials.gov/ct2/show/NCT01988688?type=Intr&cond=Tinnitus&phase=012345&lupd_s=04%2F04%2F2019&lupd_d=14

Condition :   Tinnitus

Intervention :   Device: Deep Brain Stimulation (DBS)

Sponsor :   Paul Larson

Completed

Pilot Study of Deep Brain Stimulation (DBS) in Area LC for Chronic Tinnitus

NCT01988688

Wed, 20 Nov 2013 12:00:00 EST

Last update posted: April 18, 2019

Does Conservative Temporomandibular Therapy Affect Tinnitus Complaints? A Systematic Review

https://www.ncbi.nlm.nih.gov/pubmed/30978269?dopt=Abstract

Does Conservative Temporomandibular Therapy Affect Tinnitus Complaints? A Systematic Review.

J Oral Facial Pain Headache

Does Conservative Temporomandibular Therapy Affect Tinnitus Complaints? A Systematic Review.

J Oral Facial Pain Headache. 2019 Apr 12;:

Authors: Michiels S, Nieste E, Van de Heyning P, Braem M, Visscher C, Topsakal V, Gilles A, Jacquemin L, De Hertogh W

Abstract

AIMS: To investigate whether temporomandibular disorders treatment can positively influence tinnitus complaints.

METHODS: Four online databases (PubMed, Web of Science, Scopus, and the Cochrane Library) were searched up to August 2018 for relevant studies. Two independent reviewers extracted the data and performed a risk of bias assessment.

RESULTS: A total of 11 studies were included. These studies showed an overall positive effect of the combination of splint therapy and exercise treatment on tinnitus severity and intensity (as measured on a visual analog or numeric rating scale), as well as on global perceived effect. One study specified that the treatment effect was only present in patients with severe to very severe tinnitus, while the others found an effect in the overall study group. The risk of bias in the included studies was high, mainly due to lack of statistical analyses between groups and before vs after treatment, incomplete presentation of the data, and selective reporting. Additionally, most included studies showed a lack of information concerning blinding of the subjects, therapists, and investigators. The heterogeneity of the inclusion criteria, outcome measurements, and treatments made data pooling and meta-analysis impossible.

CONCLUSION: There is low-quality evidence for a positive effect of conservative temporomandibular disorders treatment on tinnitus complaints. The combination of splint therapy and exercise treatment is currently the best investigated treatment approach, showing a decrease in tinnitus severity and intensity. Despite the low level of evidence and the methodologic issues in the included studies, it is noteworthy that all included studies show positive treatment effects.

PMID: 30978269 [PubMed – as supplied by publisher]

PubMed:30978269

The etiology, pathogeneses, and treatment of objective tinnitus: Unique case series and literature review

https://www.sciencedirect.com/science/article/pii/S0196070919300729?via%3Dihub

https://www.ncbi.nlm.nih.gov/pubmed/30981445?dopt=Abstract

The etiology, pathogeneses, and treatment of objective tinnitus: Unique case series and literature review.

Am J Otolaryngol

The etiology, pathogeneses, and treatment of objective tinnitus: Unique case series and literature review.

Am J Otolaryngol. 2019 Apr 05;:

Authors: Salehi PP, Kasle D, Torabi SJ, Michaelides E, Hildrew DM

Abstract

We present two unique cases of myoclonus-induced objective tinnitus (OT), along with a comprehensive literature review on the topic. Primary goals include: explore the relationship between palatal myoclonus (PM) and middle ear myoclonus (MEM), highlight the embryologic, neurologic, and anatomical relationship between the involved peri-tubular muscles, exemplify the first case of OT which documents video evidence demonstrating the link between objective tinnitus and eustachian tube movement. Also, we discuss available treatment interventions and why they often do not fully resolve patients’ symptoms. Finally we introduce a novel way to objectively quantify the severity of OT. Ultimately, our series hopes to inform future diagnostic and treatment guidelines.

PMID: 30981445 [PubMed – as supplied by publisher]

PubMed:30981445

The Efficacy of Neurofeedback to Reduce Tinnitus Loudness and Distress – a Double-blind Randomized Controlled Trial

https://clinicaltrials.gov/ct2/show/NCT03550430?type=Intr&cond=Tinnitus&phase=012345&lupd_s=03%2F11%2F2019&lupd_d=14

Conditions :   Tinnitus;   Subjective Tinnitus;   Chronic Tinnitus

Interventions :   Behavioral: alpha/delta neurofeedback;   Behavioral: beta/theta neurofeedback;   Other: Diary completion

Sponsors :   Philipps University Marburg Medical Center;   Eriksholm Research Centre;   Linkoeping University;   University Hospital of Gießen and Marburg

Recruiting

Neurofeedback for Tinnitus – Does Frequency Specificity Matter?

NCT03550430

Fri, 08 Jun 2018 12:00:00 EDT

Increased Metabolic Activity and Hysteretic Enhanced GABAA Receptor Binding in A Rat Model of Salicylate-induced Tinnitus

These findings indicate that enhanced neural activity in the auditory and limbic system may contribute to the development of tinnitus, while the hysteretic increase of GABAA receptor binding in specific areas of the CNS may be a compensation for hyperactivity, which may be involved in tinnitus relieving.

https://www.sciencedirect.com/science/article/pii/S0166432818314955?via%3Dihub

https://www.ncbi.nlm.nih.gov/pubmed/30797852?dopt=Abstract [Read more…] about Increased Metabolic Activity and Hysteretic Enhanced GABAA Receptor Binding in A Rat Model of Salicylate-induced Tinnitus

19 Channel Z-Score and LORETA Neurofeedback: Does the Evidence Support the Hype?

https://link.springer.com/article/10.1007%2Fs10484-018-9420-6

19 Channel Z-Score and LORETA Neurofeedback: Does the Evidence Support the Hype?

https://www.ncbi.nlm.nih.gov/pubmed/30255461?dopt=Abstract

Appl Psychophysiol Biofeedback

Related Articles

19 Channel Z-Score and LORETA Neurofeedback: Does the Evidence Support the Hype?

Appl Psychophysiol Biofeedback. 2018 Sep 25;:

Authors: Coben R, Hammond DC, Arns M

Abstract

Neurofeedback is a well-investigated treatment for ADHD and epilepsy, especially when restricted to standard protocols such as theta/beta, slow cortical potentials and sensori-motor rhythm neurofeedback. Advances in any field are welcome and other techniques are being pursued. Manufacturers and clinicians are marketing ‘superior’ neurofeedback approaches including 19 channel Z-score neurofeedback (ZNFB) and 3-D LORETA neurofeedback (with or without Z-scores; LNFB). We conducted a review of the empirical literature to determine if such claims were warranted. This review included the above search terms in Pubmed, Google scholar and any references that met our criteria from the ZNFB publication list and was restricted to group based studies examining improvement in a clinical population that underwent peer review (book chapters, magazine articles or conference presentations are not included since these are not peer reviewed). Fifteen relevant studies emerged with only six meeting our criterion. Based on review of these studies it was concluded that empirical validation of these approaches is sorely lacking. There is no empirical data that supports the notion that 19-channel z-score neurofeedback is effective or superior. The quality of studies for LNFB was better compared to ZNFB and some suggestion for efficacy was demonstrated for ADHD and Tinnitus distress. However, these findings need to be replicated, extended to other populations and have yet to show any “superiority.” Our conclusions continue to emphasize the pervasive lack of evidence supporting these approaches to neurofeedback and the implications of this are discussed.

PMID: 30255461 [PubMed – as supplied by publisher]

PubMed:30255461

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