Abstract
Acupuncture is recommended for the relief of chronic tinnitus in traditional Chinese medicine, but the underlying neural mechanism remains unclear. The human brain is a dynamic system, and it’s unclear about acupuncture’s effects on the dynamic functional connectivity (DFC) of chronic tinnitus. Therefore, this study based on resting-state functional magnetic resonance imaging (fMRI) investigates abnormal DFC in chronic tinnitus patients and the neural activity change evoked by acupuncture treatment for tinnitus. In this study, 17 chronic tinnitus patients and 22 age- and sex-matched normal subjects were recruited, and their tinnitus-related scales and hearing levels were collected. The fMRI data were measured before and after acupuncture, and then sliding-window and k-means clustering methods were used to calculate DFC and perform clustering analysis, respectively. We found that, compared with the normal subjects, chronic tinnitus patients had higher temporal variability of DFC between the supplementary motor area and medial part of the superior frontal gyrus, and it positively correlated with hearing loss. Clustering analysis showed higher transition probability (TP) between connection states in chronic tinnitus patients, and it was positively correlated with tinnitus severity. Furthermore, the findings showed that acupuncture treatment might improve tinnitus. DFC between the posterior cingulate gyrus and angular gyrus in chronic tinnitus patients after acupuncture showed significantly decreased, and it positively correlated with the improvement of tinnitus. Clustering analysis showed that acupuncture treatment might promote chronic tinnitus patients under lower DFC state, and it also positively correlated with the improvement of tinnitus. This study suggests that acupuncture as an alternative therapy method might decrease the tinnitus severity by decreasing the time variability of DFC in chronic tinnitus patients.
Highlights
The scores of tinnitus disturbance inventory (TDI) and visual analog scales (VAS) were significantly decreased in chronic tinnitus patients after acupuncture compared with before acupuncture (TDI: Z = –2.251, P < 0.05; VAS: T = –3.040, P < 0.01, Table 2)
No significant difference for Static functional connectivity (SFC) was found in chronic tinnitus patients before acupuncture compared with normal subjects after FDR correction
We found that the transition probability (TP) from state 2 to state 3 in chronic tinnitus patients before acupuncture was higher (T = 2.303, P = 0.028, uncorrected, Figure 5C)
Summary
Tinnitus is defined as the perception of non-speech sound in the absence of an external acoustic stimulus. It is a common medical symptom that can be debilitating, and approximately 1 in 10 adults have had the experience of tinnitus (Bhatt et al, 2016; Yang et al, 2018). No effective drug therapy is available for the tinnitus (Baguley et al, 2013), and various treatment options are applied, including education and counseling, sound therapy, cognitive behavioral therapy (CBT), medications, dietary supplementation, and acupuncture (Tunkel et al, 2014; Lv et al, 2021). The researchers assessed the effect of deqi for patients who received acupuncture to alleviate tinnitus by the randomization procedure, large sample, and standardized protocol (Xie et al, 2014). Lin et al (2019) explored factors influencing the efficiency of acupuncture in tinnitus patients and found that the combination of acupoints and the number of acupuncture sessions contributed to a considerably better outcome
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