Auditory cortex stimulation to suppress tinnitus: Mechanisms and strategies

Developing an assessment approach for perceptual changes to tinnitus sound characteristics for adult cochlear implant recipients

“…Kleinjung et al (2009) reported a case in which a CI recipient experienced a total suppression of their tinnitus after a period of about three months post-implantation. This suggests a tinnitus mechanism influenced by plastic reorganization of the central auditory nervous system as a result of the CI electrical stimulation (Syka, 2002;Kral et al, 2006;Zhang, 2013). Zeng et al (2011) describes tinnitus suppression of a single CI recipient when an 80 Hz electrical stimulation is utilized but not when this is replaced by a 200 Hz electrical stimulation.…”

Descending and tonotopic projection patterns from the auditory cortex to the inferior colliculus

“…These studies also have clinical implications for treating hearing disorders such as tinnitus. To date, over 50 patients have been implanted with electrode arrays that electrically stimulate secondary cortical regions to treat tinnitus (Friedland et al, 2007;De Ridder et al, 2011;Vanneste and De Ridder, 2012;Zhang, 2013;Engelhardt et al, 2014). A greater understanding of the functional organization of descending and modulatory projections from these secondary or non-core cortical regions to the auditory system could help identify more appropriate neural targets and more effective stimulation strategies for treating tinnitus.…”

“…Understanding the varying roles of the descending pathways from different cortical regions will improve our understanding of how the brain modulates ascending coding of auditory information for perception and learning. Clinically, it could also open up new targets and improve neural stimulation devices for treating hearing disorders, considering that patients are currently being implanted with electrode arrays that stimulate non-core or secondary auditory cortical regions for treating tinnitus (Friedland et al, 2007;De Ridder et al, 2011;Vanneste and De Ridder, 2012;Zhang, 2013;Engelhardt et al, 2014) but with very little understanding of the modulatory effects on the auditory system.…”

New Treatment Approaches in Tinnitus: The Place of Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation

“…However, since there are many cortical cell types in the brain, the combined effect of tDCS may be complex. It affects neural plasticity by having an impact on synaptic transmission over long-term potentiation (LTP) and long-term depression (LTD) (27) by changing intracellular cAMP-mediated calcium levels (25) and by regulating neurotransmitter pathways, such as the NMDA, catecholaminergic, GABAergic, and dopaminergic pathways (27,28). The duration Turk Arch Otolaryngol 2014; 52: 98-105 of these effects may last from minutes to hours.…”

“…For instance, the question of whether to stimulate the regions excluding the auditory cortex of the other group of patients while stimulating the primary auditory cortex of a group of patients is one of the major limitations that future researchers are expected to respond to (27). In fact, these limitations, leading to the need for organizing individual treatment, remind us about the study of Tyler et al (51), recommending the determination of subgroups for tinnitus patients and organizing the clinical treatment according to these subgroups.…”