Abstract
Chronic tonal tinnitus is often accompanied by sensorineural hearing loss which is associated with altered tuning curves and bandwidth of alternating masking. In this feasibility study the so-called hearing threshold adapted coordinated reset (HTA-CR) neuromodulation was investigated. This method is based on CR neuromodulation, which has been demonstrated to be an effective treatment for chronic tonal tinnitus. It applies four stimulation tones that are determined by the patient's individual tinnitus frequency and hearing impairment. The HTA-CR neuromodulation was programmed to the Desyncra™ for Tinnitus Therapy System and treatment was applied to 25 patients for 4 months on average and 4 h daily. Regular check-ups were done every 4–6 weeks. Therapy outcome was assessed by the tinnitus questionnaire (Tinnitusfragebogen, TF) as per Goebel and Hiller. After 4 months the mean TF score was reduced by 27.4%. A reduction of ≥ 15 points was found in 40% of the patients while for further 32% of the patients a reduction of 6–14 points was found. Thus, a positive response rate of 72% was observed after 4 months of HTA-CR neuromodulation. Our results suggest that HTA-CR neuromodulation might be at least comparable to standard CR neuromodulation providing another effective therapeutic option for the treatment of chronic tonal tinnitus.
Highlights
Chronic tinnitus is an otorhinolaryngological disease affecting ∼10–15% of the general population in industrialized countries [1]
Twenty-five patients attending a specialized consultation session for tinnitus were enrolled in this clinical study on acoustic coordinated reset (CR) neuromodulation, which was conducted in a specialized center run by an ear, nose and throat (ENT) specialist located in Munich, Germany
This study investigating hearing threshold adapted coordinated reset (HTA-CR) neuromodulation with use of the DesyncraTM for Tinnitus therapy system is based on an adapted form of the standard CR neuromodulation, FIGURE 4 | Evaluation of tinnitus by numeric rating scales (NRS) for loudness (A) and annoyance (B)
Summary
Chronic tinnitus is an otorhinolaryngological disease affecting ∼10–15% of the general population in industrialized countries [1]. Because only 20% of patients with chronic tinnitus are affected by a severe impairment of quality of life [10] it is assumed that the limbic system, the “emotional brain,” and the vegetative neuronal network including the formatio recticularis impact the level of suffering experienced by Adapted Acoustic CR Neuromodulation patients [11,12,13,14] This aspect is recognized and implemented in various therapeutical approaches for tinnitus treatment such as use of psychotropic drugs, relaxation techniques (e.g., progressive relaxation, Tai Chi, etc.), physiotherapy, cognitive behavioral therapy (CBT), and tinnitus retraining therapy (TRT) [15,16,17]. Only for CBT efficiency in the treatment of tinnitus has been demonstrated in a randomized clinical trial [19]
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