Somatic Modulation of Tinnitus: Test Reliability and Results after Repetitive Muscle Contraction Training

Sánchez, Tanit Ganz; Lima, Alisson Padilha de; Brandão, Ana Laura; Lorenzi, Maria Cecília; Bento, Ricardo Ferreira

doi:10.1177/000348940711600106

Cited by 56 publications

(79 citation statements)

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“…The identification of a somatic origin for her tinnitus thanks to the matching of self-reported history and modulation in the same somatic regions helped in addressing this patient to multidisciplinary somatic evaluation and treatment. Furthermore, the characteristics of tinnitus modulation found in this patient are consistent with what reported in the literature by some authors 32,33,41,42 . TMJ maneuvers induced an increase in tinnitus loudness, while NECK maneuvers induced a decrease of loudness.…”

Section: Comments On This Casesupporting

confidence: 92%

“…This case demonstrates that tinnitus modulation can be found even when no somatic disorder is present; in fact, somatic modulation of tinnitus is a widespread condition that can be present with or without underlying somatic disorders 31,40 . Furthermore, as previously discussed, several authors reported a large capability of somatic tinnitus modulation in multiple patient series ranging between 65.3% and 83.3% 32,35,[41][42][43]45,47,61,65 . In this patient, the negative history for self-reported somatic disorder suggests caution while taking into account a somatic origin for his tinnitus.…”

Section: Comments On This Casesupporting

confidence: 53%

“…These patients are considered to have otic tinnitus 2 ; extensive research has been done to identify protective drugs and management strategies for patients with tinnitus and hearing loss [26][27][28][29][30] . Tinnitus can be evoked or modulated by inputs from the somato-sensory, somato-motor and visualmotor systems in some individuals [31][32][33][34][35][36][37][38][39] . This means that the psychoacoustic attributes of tinnitus (loudness and pitch) might change-though often only temporarilyfollowing external stimuli, such as the forceful muscle contractions of head, neck and limbs 31,[40][41][42][43][44] , orofacial movements 45 , eye movements in the horizontal or vertical axis 46,47 , pressure on myofascial trigger points 48,49 , cutaneous stimulation of the hand/fingertip region 50 , and of the face 43 ; electrical stimulation of the median nerve and hand or finger movements 51 .…”

Section: Introductionmentioning

confidence: 99%

“…When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus 32,43,44,52 .…”

Section: Introductionmentioning

confidence: 99%

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Somatic Tinnitus

Ralli¹,

Greco²,

Cialente³

et al. 2017

The International Tinnitus Journal

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Modulation of tinnitus characteristics such as pitch and loudness has been extensively described following movements of the head, neck and limbs, vertical or horizontal eye gaze, pressure on myofascial trigger points, cutaneous stimulation of the hands, electrical stimulation of the median nerve, and transcranial direct current stimulation. Modulation of tinnitus follows complex interactions between auditory and somatosensory afferents and can be favored by underlying somatic disorders. When tinnitus appears to be preceded or strictly linked to a somatic disorder, and therefore related to problems of the musculoskeletal system rather than of the ear, it is defined somatic tinnitus. A correct diagnosis and treatment of somatic disorders underlying tinnitus play a central role for a correct management of somatic tinnitus. However, the identification of somatic tinnitus may be complex in some cases. In this paper, after a general review of the current evidences for somatic tinnitus available in the literature, we present and discuss some cases of patients in which somatic modulation of tinnitus played a role-although different from case to case-in their tinnitus, describing the diagnostic and therapeutic approaches followed in each individual case and the results obtained, also highlighting unexpected findings and pitfalls that may be encountered when approaching somatic tinnitus patients.

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Section: Comments On This Casesupporting

confidence: 92%

Section: Comments On This Casesupporting

confidence: 53%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Somatic Tinnitus

Ralli¹,

Greco²,

Cialente³

et al. 2017

The International Tinnitus Journal

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show abstract

“…Recent converging evidences suggest that the tinnitus-related neural activity is more complex and can be provoked or modulated by inputs from somatosensory, somatomotor and visual-motor system (Rocha and Sanchez, 2007;Sanchez et al, 2007;Sanchez and Rocha, 2011). Electroencephalographic (EEC) studies in tinnitus have highlighted several abnormalities regarding the background cerebral oscillations in various frequency bands, such as theta, delta, alpha, beta or gamma. Although previous EEC or magnetoencephalographic (MEG) studies on tinnitus sufferers reported conflicting data, a general tendency is a concentration of abnormalities mainly over the temporo-parietal (Shulman and Goldstein, 2002;Shulman et al, 2006;Schlee et al, 2009;Moazami-Goudarzi et al, 2010) and frontal regions (Shulman and Goldstein, 2002;Shulman et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

Involvement of cortico-subcortical circuits in normoacousic chronic tinnitus: A source localization EEG study

Houdayer

Teggi

Velikova

et al. 2015

Clinical Neurophysiology

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HIGHLIGHTS• We used sLORETA to study the cerebral activity in normoacousic tinnitus sufferers.• EEG sources were decreased in left temporal and inferior parietal gyri in patients.• Cortico-thalamo-cortical circuits can be involved without thalamic deafferentation. ABSTRACTObjective: To better characterize brain circuits dysfunctions in normoacousic tinnitus sufferers. Methods: 17 normoacousic chronic, unilateral high-pitched tinnitus sufferers (6 females, 43.6 ± 9.8 y.o, disease duration 22 ±35 months) underwent a 29-channel resting-state electroencephalography (EEG -5 min opened-eyes, 5 min closed-eyes) and auditory oddball paradigm for event-related potentials analyses (ERPs -NI, P2 and P300). Cortical 3D distribution of current source density was computed with sLORETA. Results were compared with 17 controls (9 females, 45.7 ± 15.1 y.o). Results: Eyes opened, tinnitus sufferers had lower alpha and beta sources in the left inferior parietal lobule. Eyes closed, tinnitus sufferers had decreased alpha sources in the left inferior temporal and post-central gyri, and low gamma sources in the left middle temporal gyrus. EEG data did not correlate with tinnitus sufferers' clinical features. Subjects with tinnitus had shorter Nl and P2 latencies. P300 did not differ between groups. sLORETA solutions showed decreased sources of these ERPs in the left inferior temporal gyrus in the tinnitus group. Conclusions: We showed cortico-thalamo-cortical involvements in normoacousic tinnitus with hyperexcitability of the left auditory cortex and inferior temporal gyrus. Significance: This might reflect processes of maladaptive cortical plasticity and memory consolidation. Further validation is needed to establish the value of this tool in customizing therapeutic approach.

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Reversing Synchronized Brain Circuits Using Targeted Auditory-Somatosensory Stimulation to Treat Phantom Percepts

et al. 2023

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ImportanceAnimal models have shown altered dorsal cochlear nucleus circuitry in animals that develop tinnitus; however, precise treatment using bisensory (auditory and somatosensory) stimuli can reverse altered neural patterns and lessen tinnitus.ObjectiveTo confirm and extend the findings of a pilot study, which suggested an increased efficacy of bisensory stimulation, to a clinical trial with a greater duration and greater number of participants.Design, Setting, and ParticipantsThis double-blind, crossover, single-center randomized clinical trial was conducted from March 2019, with a 3-month follow-up per participant ending in July 2022. Eligible adults were recruited from the University of Michigan Health System in Ann Arbor, Michigan. Eligibility criteria included bothersome tinnitus (Tinnitus Functional Index [TFI] score, ≥17 points), somatic tinnitus, normal to moderate hearing loss, and no other tinnitus treatments in the 6 months prior to the trial. Included participants were randomized to either treatment group 1, which received active (bisensory) treatment, or group 2, which received the control (auditory-only) treatment. Results were analyzed using intent-to-treat (ITT) and per protocol (PP) populations.InterventionPrecisely timed bisensory (combined auditory and somatosensory) treatment was delivered through a portable, custom, take-home device that was provided to each participant for daily, at-home treatments. Group 1 participants received 30 minutes per day of the bisensory treatment for 6 weeks, followed by a 6-week washout phase, and then 30 minutes per day of the auditory-only treatment followed by a second 6-week washout phase. Group 2 participants received the auditory-only treatment first, followed by a washout phase, and then the bisensory treatment followed by a second washout phase.Main Outcomes and MeasuresPrimary end points were changes in TFI score and tinnitus loudness level from baseline through week 6 and week 12.ResultsOf 337 screened individuals, 99 (mean [SD] age, 47 [12.7] years; 59 males [60%]; 85 with non-Hispanic White [86%] race and ethnicity) were enrolled into the study and randomized to treatment group 1 (n = 49) or group 2 (n = 50). The active but not the control treatment resulted in clinically significant decreases in TFI scores at week 6 of phase 1 (ITT population: –12.0 [95% CI, –16.9 to –7.9] points; P &lt; .001; PP population: –13.2 [95% CI, –16.0 to –10.5] points; P &lt; .001). Decreases in tinnitus loudness level were greater than 6 dB sensation level (SL; &gt;half as loud) at week 6 for the bisensory treatment group, with little effect for the auditory-only treatment control group at week 6 of phase 1 (ITT population: –5.8 [95% CI, –9.5 to –2.2] dB; P = .08; PP population: –7.2 [95% CI, –11.4 to –3.1] dB; P = .03), and up to 11 dB SL at week 12 of phase 2 (ITT population: –10.9 [95% CI, –15.2 to –6.5] dB; P = .001; PP population: –14.1 [95% CI, –18.4 to –9.8] dB; P &lt; .001). Decreased tinnitus loudness level and TFI scores extended into the washout phase, indicating a prolonged treatment effect.Conclusions and RelevanceThis trial found that precisely timed bisensory treatment using stimuli and timing developed in a validated animal model was effective for adults with somatic tinnitus. Prolonged reduction in tinnitus symptoms can result from using an extended treatment duration.Trial RegistrationClinicalTrials.gov Identifier: NCT03621735

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Somatic Modulation of Tinnitus: Test Reliability and Results after Repetitive Muscle Contraction Training

Abstract: Maneuvers of head and neck muscle contractions evoked tinnitus modulation in a frequent and reliable manner. Also, the repetition of such maneuvers for 2 months altered the pattern of modulation.

Cited by 56 publications

References 13 publications

Somatic Tinnitus

Somatic Tinnitus

Involvement of cortico-subcortical circuits in normoacousic chronic tinnitus: A source localization EEG study

Reversing Synchronized Brain Circuits Using Targeted Auditory-Somatosensory Stimulation to Treat Phantom Percepts

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