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Non-invasive neuromodulation for tinnitus: A meta-analysis and modeling studies
Mathilde Lefebvre-Demers1, Nicolas Doyon2, Shirley Fecteau1
1CERVO Brain Research Centre, Institut Universitaire En Santé Mentale de Québec, Centre Intégré Universitaire De Santé Et De Services Sociaux De La Capitale-Nationale, Canada; Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Canada.
Repetitive transcranial magnetic stimulation (rTMS) effectively reduces tinnitus, particularly when targeting the auditory cortex. This non-invasive neuromodulation shows promise for improving tinnitus management, especially in women.
Area of Science:
- Neurology
- Neuroscience
- Otolaryngology
Background:
- Tinnitus significantly impairs quality of life, often co-occurring with anxiety and depression.
- There is a critical need for novel therapeutic strategies for tinnitus management.
Purpose of the Study:
- To evaluate the efficacy of non-invasive neuromodulation for tinnitus using meta-analysis and modeling.
- To determine if real neuromodulation, compared to sham, modulates brain regions consistent with tinnitus neurobiology.
Main Methods:
- A systematic review of Pubmed, Cochrane, and PsycINFO databases was performed.
- Meta-analysis compared active and sham repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS).
- Computational modeling investigated electric field distribution for effective rTMS protocols.
Main Results:
- Active rTMS significantly reduced tinnitus compared to sham, while tDCS showed no significant difference.
- rTMS targeting the auditory cortex was the most effective protocol, inducing strong electric fields in the insula.
- rTMS demonstrated particular benefit for women, and placebo effects were highly variable.
Conclusions:
- Neuromodulation targeting the auditory cortex and insula shows clinical potential for tinnitus treatment.
- Sham-controlled trials are crucial due to significant placebo effects in tinnitus studies.
