Abstract
In our clinic invasive transtympanal promontory positive DC stimulations were first used, with a success rate of 42%. However, non-invasive hydrotransmissive negative DC stimulations are now favored, with improvement being obtained in 37.8% directly after the treatment, and 51.3% in a follow up 1 month after treatment. The further improvement after 1 month may be due to neuroplastic changes at central level as a result of altered peripheral input. The aim of the study was to determine how/whether a single electrical stimulation of the ear influences cortical activity, and whether changes observed in tinnitus after electrical stimulation are associated with any changes in cortical activity recorded in EEG. The study included 12 tinnitus patients (F–6, M-6) divided into two groups. Group I comprised six patients with unilateral tinnitus - unilateral, ipsilateral ES was performed. Group II comprised six patients with bilateral tinnitus—bilateral ES was performed. ES was performed using a custom-made apparatus. The active, silver probe—was immersed inside the external ear canal filled with saline. The passive electrode was placed on the forehead. The stimulating frequency was 250 Hz, the intensity ranged from 0.14 to 1.08 mA. The voltage was kept constant at 3 V. The duration of stimulation was 4 min. The EEG recording (Deymed QEST 32) was performed before and after ES. The patients assessed the intensity of tinnitus on the VAS 1-10.Results: In both groups an improvement in VAS was observed—in group I—in five ears (83.3%), in group II—in seven ears (58.3%). In Group I, a significant increase in the upper and lower limit frequency of alpha band was observed in the central temporal and frontal regions following ES. These changes, however, were not correlated with improvement in tinnitus. No significant changes were observed in the beta and theta bands and in group II. Preliminary results of our research reveal a change in cortical activity after electrical stimulations of the ear. However, it remains unclear if it is primary or secondary to peripheral auditory excitation. No similar studies had been found in the literature.
Highlights
Tinnitus is one of the vaguest audiological and otological symptoms
The aim of the study was to determine how/whether a single electrical stimulation of the ear influences cortical activity, and whether changes observed in tinnitus after electrical stimulation are associated with any changes in cortical activity recorded in EEG
Following electrical stimulation (ES), in Group I, an improvement in VAS was observed in five ears (83.3%)—tinnitus disappeared in two of them (33.3%) and no change was observed in the remaining ear (16.7%)— i.e., no deterioration in tinnitus was observed
Summary
Tinnitus is one of the vaguest audiological and otological symptoms. It is defined as a phantom sound perception, which does not reflect any corresponding physical activity. Tinnitus had been a disturbing disorder since antiquity. Only peripheral—cochlear pathology was initially considered an ignition site, it appeared that tinnitus was not always relieved after cochlear nerve section (Baguley et al, 2002). Jastreboff ’s neurophysiological model of tinnitus proposed that the cochlea played a role in phantom sound generation, with the wide involvement of the central nervous system (Jastreboff, 1990). The development of such medical diagnostic methods as neurophysiological analysis and neuroimaging has stimulated the formulation of new hypotheses concerning tinnitus generation (Kaltenbach, 2011) and new original treatment modalities for patients
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