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Human caudate nucleus subdivisions in tinnitus modulation.

Philip L Perez1, Sarah S Wang2, Susan Heath3

  • 1Departments of1Otolaryngology-Head and Neck Surgery and.

Journal of Neurosurgery
|February 10, 2019
PubMed
Summary

Electrical stimulation of the caudate nucleus body effectively reduced tinnitus loudness. The caudate body shows stronger functional connectivity to the auditory cortex, informing deep brain stimulation for tinnitus.

Keywords:
caudate nucleusdeep brain stimulationfMRIfunctional neurosurgeryresting-state functional connectivitytinnitus

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Area of Science:

  • Neuroscience
  • Neurosurgery
  • Auditory Neuroscience

Background:

  • Tinnitus is a prevalent condition often refractory to medical treatment.
  • Deep brain stimulation (DBS) is an emerging neuromodulation strategy for intractable tinnitus.
  • The caudate nucleus's role in tinnitus modulation is not well understood.

Purpose of the Study:

  • To identify specific caudate nucleus locations responsive to electrical stimulation for modulating tinnitus loudness.
  • To correlate these responsive locations with functional connectivity patterns to the auditory cortex.

Main Methods:

  • Analysis of 6 participants undergoing DBS for tinnitus, with acute stimulation at 20 caudate nucleus locations.
  • Functional MRI (fMRI) to assess resting-state connectivity between caudate subdivisions and the auditory cortex.
  • Comparison of connectivity in DBS participants and 14 additional participants with severe tinnitus.

Main Results:

  • Tinnitus loudness reduction was achieved by stimulating 5 locations within the caudate nucleus, predominantly in its body.
  • Electrical stimulation of the caudate head was less effective in reducing tinnitus loudness.
  • The caudate nucleus body demonstrated significantly stronger functional connectivity to the auditory cortex compared to the caudate head.

Conclusions:

  • Electrical stimulation of the caudate nucleus body is a promising target for tinnitus loudness reduction.
  • Enhanced functional connectivity between the caudate body and auditory cortex underlies its efficacy.
  • These findings support a basal ganglia-centric neuromodulation approach for medically refractory tinnitus.