TY - JOUR
T1 - Neuromodulation treatments targeting pathological synchrony for tinnitus in adults: a systematic review
AU - Hoare, Derek J.
AU - Shorter, Gillian W.
AU - Shekhawat, Giriraj S.
AU - El Refaie, Amr
AU - Labree, Bas
AU - Sereda, Magdalena
PY - 2024/7/26
Y1 - 2024/7/26
N2 - Background: Tinnitus involves the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source. For many people tinnitus is a disorder associated with symptoms of emotional distress, cognitive dysfunction, autonomic arousal, behavioural changes, and functional disability. Many symptoms can be addressed effectively using education or cognitive behavioural therapy. However, there is no treatment that effectively reduces or alters tinnitus-related neurophysiological activity and thus the tinnitus percept. In this systematic review we evaluated effectiveness of neuromodulation therapies that explicitly target pathological synchronous activity to reduce tinnitus.Methods: Multiple databases were searched for randomised controlled trials of neuromodulation interventions for tinnitus in adults, with 24 trials included. Risk of bias was assessed and where appropriate meta-analyses were performed.Results: Few trials used acoustic, vagal nerve, transcranial alternating current stimulation, or bimodal stimulation techniques, with limited evidence of neuromodulation or clinical effectiveness. Multiple trials of transcranial direct current stimulation (tDCS) were identified, and synthesis gave significant improvement in tinnitus symptom severity in favour of tDCS versus control, although heterogeneity was high.Discussion: Neuromodulation for tinnitus is an emerging but promising field. Electrical stimulation techniques are particularly interesting given recent advances in current flow modelling that can be applied to future studies.
AB - Background: Tinnitus involves the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source. For many people tinnitus is a disorder associated with symptoms of emotional distress, cognitive dysfunction, autonomic arousal, behavioural changes, and functional disability. Many symptoms can be addressed effectively using education or cognitive behavioural therapy. However, there is no treatment that effectively reduces or alters tinnitus-related neurophysiological activity and thus the tinnitus percept. In this systematic review we evaluated effectiveness of neuromodulation therapies that explicitly target pathological synchronous activity to reduce tinnitus.Methods: Multiple databases were searched for randomised controlled trials of neuromodulation interventions for tinnitus in adults, with 24 trials included. Risk of bias was assessed and where appropriate meta-analyses were performed.Results: Few trials used acoustic, vagal nerve, transcranial alternating current stimulation, or bimodal stimulation techniques, with limited evidence of neuromodulation or clinical effectiveness. Multiple trials of transcranial direct current stimulation (tDCS) were identified, and synthesis gave significant improvement in tinnitus symptom severity in favour of tDCS versus control, although heterogeneity was high.Discussion: Neuromodulation for tinnitus is an emerging but promising field. Electrical stimulation techniques are particularly interesting given recent advances in current flow modelling that can be applied to future studies.
KW - acoustic neuromodulation
KW - transcranial direct current stimulation
KW - transcranial alterating current stimulation
KW - vagus nerve stimulation
KW - bimodal stimulation
KW - systematic review
KW - tinnitus
U2 - 10.3390/brainsci14080748
DO - 10.3390/brainsci14080748
M3 - Article
SN - 2076-3425
VL - 14
JO - Brain Sciences
JF - Brain Sciences
IS - 8
M1 - 748
ER -