Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial

Souza, Dayse da Silva; Almeida, Alexandre Alex; Andrade, Suellen Marinho; Machado, Daniel Gomes da Silva; Leitão, Márcio Martins; Sánchez, Tanit Ganz; Rosa, Marine Raquel Diniz da

doi:10.1016/j.neucli.2020.07.002

Cited by 14 publications

(12 citation statements)

References 44 publications

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“…However, only three studies described the specific methods that were used. Two studies 20 , 22 clearly described concealment of allocation. Regarding blinding of participants and personnel, eight studies 20 , 22 – 28 had an explicit double-blind design, one study 21 had a single-blind design and two studies 19 , 29 did not clearly describe the blinding method that was used.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies 20 , 22 clearly described concealment of allocation. Regarding blinding of participants and personnel, eight studies 20 , 22 – 28 had an explicit double-blind design, one study 21 had a single-blind design and two studies 19 , 29 did not clearly describe the blinding method that was used. In the domain of incomplete outcome data and selective reporting, all the studies were judged as ‘low’.…”

Section: Resultsmentioning

confidence: 99%

“…The THI is a three-label category scale questionnaire (functional, emotional and catastrophic) involving 25 items to generate a total score. Patients can be classified into five grades based on a transformation into a 100point scale: slight (0-16), mild (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36), moderate (38-56), severe (58-76) and catastrophic (78-100). 12 The VAS was used to evaluate tinnitus loudness and distress.…”

Section: Statistical Outcomesmentioning

confidence: 99%

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Electrical stimulation to treat tinnitus: a meta-analysis and systemic review of randomized controlled trials

Yang

Jin

Wang

et al. 2021

Therapeutic Advances in Chronic Disease

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Background and aims: Tinnitus is one of the most common otological symptoms that patients experience, and it can be debilitating. No effective drug treatments are available for tinnitus, although considerable research investigating its mechanisms and possible treatments is underway. Electrical stimulation has been considered a promising and well-tolerated therapeutic strategy for tinnitus. This meta-analysis study was aimed to investigate the efficacy, safety and tolerability of electrical stimulation in patients with tinnitus. Methods: Relevant studies were retrieved from the Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature (CBM), Wanfang and Weipu databases. The Tinnitus Handicap Inventory (THI) and the visual analogue scale (VAS) which focus on loudness and distress evaluation (0–10 points) were used to assess perceived tinnitus suppression after treatment. Subgroup analysis was also performed based on different stimulating areas and methods, follow-up times, tinnitus duration and electrical current intensity. Review Manager 5.4 software was used for data synthesis, and Stata 15.1 software was used for analyses of publication bias and sensitivity. Results: Our meta-analysis included 11 studies involving a total of 447 patients with tinnitus. The results showed that electrical stimulation significantly reduced THI scores [mean difference (MD) = −9.69; 95% confidence interval (CI) = −14.25, −5.13; p < 0.0001; I2 = 80%] and VAS scores between the two groups (VAS loudness scores, MD = −0.72; 95% CI = −1.20, −0.25; VAS distress scores, MD = −0.90; 95% CI = −1.17, −0.63). In addition, subgroup analysis showed that THI scores in electrical stimulation group of different stimulating areas and methods follow-up times, tinnitus duration and electrical current intensity were generally reduced, regardless of the acute or subacute tinnitus group or left temporoparietal area (LTA) group with no statistical significance between two groups. Conclusion: Overall, electrical stimulation may be an effective and well-tolerated treatment option for tinnitus.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Statistical Outcomesmentioning

confidence: 99%

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Electrical stimulation to treat tinnitus: a meta-analysis and systemic review of randomized controlled trials

Yang

Jin

Wang

et al. 2021

Therapeutic Advances in Chronic Disease

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“…In particular, the tDCS group did not conduct a sham protocol, unlike the rTMS group. Although the tinnitus suppression effect of sham and real tDCS seems to be distinctive based on previous studies, the absence of sham tDCS could significantly bias results [ 13 , 14 , 15 , 28 ]. Thus, the significance of the present study has to be limited to the approachability of clinical use, not to the superiority of the treatment efficacy.…”

Section: Discussionmentioning

confidence: 96%

Comparison of Treatment Outcome between Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcutaneous Direct Current Stimulation (tDCS) in Intractable Tinnitus

Bae

Moon

Lee

et al. 2021

JCM

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Repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) are non-invasive treatments for chronic tinnitus based on neuromodulation of cortical activity. Both are considered effective, but with heterogeneous results due to lack of established protocols. Because the target groups for both modalities overlap, it is difficult to recommend one of them. We tried to unify the inclusion criteria and treatment schedules to compare the two modalities. The medical charts of 36 patients who underwent rTMS as part of clinical routine were reviewed and data for 34 patients who underwent tDCS about 7 years later were collected prospectively. Both groups had chronic unilateral tinnitus refractory to medication. Patients were treated for 5 consecutive days, and tinnitus symptoms were evaluated by survey both at the end of the treatment schedule and 1 month after the treatment. The ratio of responders who showed >20% reduction in tinnitus handicap inventory scores were compared. At the end of the treatment, the rTMS group showed a rapid response compared to the tDCS group (rTMS, 30.6%; tDCS, 12.1%; p = 0.054). However, both groups showed a significant and similar reduction in tinnitus symptoms 1 month after the treatment (rTMS, 47.2%; tDCS, 36.4%; p = 0.618). As both groups showed comparable results for tinnitus reduction, tDCS may be superior in terms of cost-effectiveness.

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“…Changes in frequency bands in the frontal, temporoparietal and limbic regions were found using sLORETA and negative correlations were observed between baseline EEG frequency bands and tDCS-induced change in tinnitus annoyance and severity. 39 MEG has also been used to investigate oscillatory neural activity in tinnitus. One prominent finding from MEG studies of tinnitus is a possible association between slow-wave oscillatory activity and tinnitus.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Determining the effects of transcranial direct current stimulation on tinnitus and tinnitus-related outcomes: protocol for a systematic review

et al. 2021

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IntroductionTinnitus is the awareness of a sound in the ear or head in the absence of an external source. It affects around 10%–15% of people. About 20% of people with tinnitus also experience symptoms such as depression or anxiety that negatively affect their life. Transcranial direct current stimulation (tDCS) is a technique involving constant low-intensity direct current delivered via electrodes on the head. It is postulated to modulate (suppress or enhance) neural activity in the region between electrodes. As such, it represents a potential treatment option for tinnitus, as well as comorbid depression or anxiety. This systematic review will estimate the effects of tDCS on outcomes relevant to tinnitus. In addition, it will determine whether there is any relationship between stimulation parameters (electrode montage, current intensity, and length and frequency of stimulation sessions) and the effect of tDCS on these outcomes.Methods and analysisElectronic searches for peer-reviewed journal articles will be performed in the Cochrane Register of Studies online (the Cochrane Ear, Nose and Throat Disorders Group Register and CENTRAL, current issue), PubMed, EMBASE, CINAHL, LILACS, KoreaMed, IndMed, PakMediNet, CNKI, AMED, PsycINFO, Web of Science, ClinicalTrials.gov, ICTRP and Google Scholar using the following search terms: transcranial Direct Current Stimulation OR tDCS AND tinnitus OR depression OR anxiety OR quality of life OR adverse effects OR neurophys*.Searches were not limited by date. Methods are reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). Randomised controlled trials will be included if they report at least one of the following outcomes: tinnitus symptom severity, anxiety or depression as measured by relevant validated instruments. Where available, data on quality of life, adverse effects and neurophysiological changes will also be reviewed. In addition to an analysis of the effect of each parameter, an analysis will be performed to uncover any interactions between parameters. Where appropriate, meta‐analyses will be performed.Ethics and disseminationThis systematic review will make use of secondary data only. As no data will be obtained from participants directly, ethical approval has not been sought. No other ethical issues are foreseen. Findings will be submitted for peer-reviewed publication and presented at academic conferences. The results of this review will inform future research.PROSPERO registration numberCRD42020185567.

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Transcranial direct current stimulation improves tinnitus perception and modulates cortical electrical activity in patients with tinnitus: A randomized clinical trial

Cited by 14 publications

References 44 publications

Electrical stimulation to treat tinnitus: a meta-analysis and systemic review of randomized controlled trials

Electrical stimulation to treat tinnitus: a meta-analysis and systemic review of randomized controlled trials

Comparison of Treatment Outcome between Repetitive Transcranial Magnetic Stimulation (rTMS) and Transcutaneous Direct Current Stimulation (tDCS) in Intractable Tinnitus

Determining the effects of transcranial direct current stimulation on tinnitus and tinnitus-related outcomes: protocol for a systematic review

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