Neuromodulation for tinnitus treatment: an overview of invasive and non-invasive techniques

Abstract

Tinnitus is defined as a perception of sound without any external sound source. Chronic tinnitus is a frequent condition that can affect the quality of life. So far, no causal cure for tinnitus has been documented, and most pharmacologic and psychosomatic treatment modalities aim to diminish tinnitus' impact on the quality of life. Neuromodulation, a novel therapeutic modality, which aims at alternating nerve activity through a targeted delivery of a stimulus, has emerged as a potential option in tinnitus treatment. This review provides a brief overview of the current neuromodulation techniques as tinnitus treatment options. The main intention is to provide updated knowledge especially for medical professionals counselling tinnitus patients in this emerging field of medicine. Non-invasive methods such as repetitive transcranial magnetic stimulation, transcranial electrical stimulation, neurofeedback, and transcutaneous vagus nerve stimulation were included, as well as invasive methods such as implanted vagus nerve stimulation and invasive brain stimulation. Some of these neuromodulation techniques revealed promising results; nevertheless, further research is needed, especially regarding the pathophysiological principle as to how these neuromodulation techniques work and what neuronal change they induce. Various studies suggest that individually different brain states and networks are involved in the generation and perception of tinnitus. Therefore, in the future, individually tailored neuromodulation strategies could be a promising approach in tinnitus treatment for achieving a more substantial and longer lasting improvement of complaints.

Profiling intermittent tinnitus: a retrospective review

“…On the other hand, as continuous tinnitus cannot yet be abolished, converting it to intermittent tinnitus may be something to strive for since this might increase the functionality of patients. Some neuromodulation techniques appear promising in this respect, as temporary decreases in the tinnitus percept and suffering are reported (Peter and Kleinjung 2019).…”

Invasive Neuromodulation as a Treatment for Tinnitus: A Systematic Review

“…For some diseases, it has already been proven to be effective , and for a number of diseases, research is still ongoing, as it is for tinnitus. To the best of our knowledge, there is only one review available bundling the latest studies on invasive and noninvasive neuromodulation for this indication, in a nonsystematic narrative way . This present study aims to give an overview of the existing literature on invasive neuromodulation for tinnitus at this moment, by performing a systematic literature search and evaluating study quality.…”

Single Sided Deafness: A Treatment Option

“…Early childhood is a critical and sensitive time for brain development, and loss of auditory input either acquired or congenital during the developing time has serious bad impact on growth of the cortex, and synaptic development [7,34,35] which leads to changes in auditory and other brain parts [34,[36][37][38][39][40] and as the brain works as a whole and not in isolation parts as stated by Kral et al [33] who presented the connectome model, the changes in the auditory and other brain parts could be manifested as affected functional connectivity of the brain responsible for executive functioning, cognition, and language comprehension [41].…”

“…The most widely used questionnaires among different questionnaires used to evaluate the tinnitus either exclusively or in combination were the THI [85]and the visual analog scale (VAS) [86]. The Tinnitus Handicap Inventory (THI) was graded according to the following scores: slight (0-16), mild (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), moderate (38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56), severe (58)(59)(60)(61)(62)(63)(64)(65)(66)…”