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Kreuzer, Peter M. ; Landgrebe, Michael ; Schecklmann, Martin ; Poeppl, Timm B. ; Vielsmeier, Veronika ; Hajak, Goeran ; Kleinjung, Tobias ; Langguth, Berthold

Can temporal repetitive transcranial magnetic stimulation be enhanced by targeting affective components of tinnitus with frontal rTMS? A randomized controlled pilot trial

Kreuzer, Peter M., Landgrebe, Michael, Schecklmann, Martin, Poeppl, Timm B., Vielsmeier, Veronika, Hajak, Goeran, Kleinjung, Tobias und Langguth, Berthold (2011) Can temporal repetitive transcranial magnetic stimulation be enhanced by targeting affective components of tinnitus with frontal rTMS? A randomized controlled pilot trial. Frontiers in systems neuroscience 5, S. 88.

Veröffentlichungsdatum dieses Volltextes: 11 Apr 2012 09:07
Artikel
DOI zum Zitieren dieses Dokuments: 10.5283/epub.23732


Zusammenfassung

Objectives: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been investigated as a new treatment tool for chronic tinnitus during the last years and has shown moderate efficacy. However, there is growing evidence that tinnitus is not a pathology of a specific brain region, but rather the result of network dysfunction involving both auditory and ...

Objectives: Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been investigated as a new treatment tool for chronic tinnitus during the last years and has shown moderate efficacy. However, there is growing evidence that tinnitus is not a pathology of a specific brain region, but rather the result of network dysfunction involving both auditory and non-auditory brain regions. In functional imaging studies the right dorsolateral prefrontal cortex has been identified as an important hub in tinnitus related networks and has been shown to particularly reflect the affective components of tinnitus. Based on these findings we aimed to investigate whether the effects of left low-frequency rTMS can be enhanced by antecedent right prefrontal low-frequency rTMS. Study Design: Fifty-six patients were randomized to receive either low-frequency left temporal rTMS or a combination of low-frequency right prefrontal followed by low-frequency left temporal rTMS. The change of the tinnitus questionnaire (TQ) score was the primary outcome, secondary outcome parameters included the Tinnitus Handicap Inventory, numeric rating scales, and the Beck Depression Inventory. The study is registered in clinicaltrials.gov (NCT01261949). Results: Directly after therapy there was a significant improvement of the TQ-score in both groups. Comparison of both groups revealed a trend toward more pronounced effects for the combined group (effect size: Cohen's d = 0.176), but this effect did not reach significance. A persistent trend toward better efficacy was also observed in all other outcome criteria. Conclusion: Additional stimulation of the right prefrontal cortex seems to be a promising strategy for enhancing TMS effects over the temporal cortex. These results further support the involvement of the right DLPFC in the pathophysiology of tinnitus. The small effect size might be due to the study design comparing the protocol to an active control condition.



Beteiligte Einrichtungen


Details

DokumentenartArtikel
Titel eines Journals oder einer ZeitschriftFrontiers in systems neuroscience
Verlag:Frontiers
Band:5
Seitenbereich:S. 88
Datum2011
InstitutionenMedizin > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde
Medizin > Lehrstuhl für Psychiatrie und Psychotherapie
Identifikationsnummer
WertTyp
22069382PubMed-ID
10.3389/fnsys.2011.00088DOI
Stichwörter / Keywordschronic tinnitus, dorsolateral prefrontal cortex, limbic system, transcranial magnetic stimulation, rTMS, neuromodulation
Dewey-Dezimal-Klassifikation600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin
StatusVeröffentlicht
BegutachtetJa, diese Version wurde begutachtet
An der Universität Regensburg entstandenZum Teil
URN der UB Regensburgurn:nbn:de:bvb:355-epub-237320
Dokumenten-ID23732

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