Neuromodulation treatments targeting pathological synchrony for tinnitus in adults: a systematic review

Derek J. Hoare*, Gillian W. Shorter, Giriraj S. Shekhawat, Amr El Refaie, Bas Labree, Magdalena Sereda

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

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.

Original languageEnglish
Article number748
Number of pages21
JournalBrain Sciences
Volume14
Issue number8
DOIs
Publication statusPublished - 26 Jul 2024

Keywords

  • acoustic neuromodulation
  • transcranial direct current stimulation
  • transcranial alterating current stimulation
  • vagus nerve stimulation
  • bimodal stimulation
  • systematic review
  • tinnitus

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