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A Protocol for the Administration of Real-Time fMRI Neurofeedback Training

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Functional MRI Neurofeedback Outperforms Cognitive Behavioral Therapy for Reducing Tinnitus Distress: A Prospective

Nicolas Gninenko¹, Stéphanie Trznadel¹, Dimitrios Daskalou¹

¹From the Medical Image Processing Laboratory, Neuro-X Institute, École Polytechnique Fédérale de Lausanne, Campus Biotech, Chemin des Mines 9, Geneva 1202, Switzerland (N.G., D.V.D.V.); Department of Radiology and Medical Informatics (N.G., D.V.D.V.) and Department of Medicine (S.H.), University of Geneva, Geneva, Switzerland; Department of Neurology, Psychosomatic Medicine Unit, Inselspital Bern University Hospital, University of Bern, Bern, Switzerland (N.G.); Wyss Center for Bio and Neuroengineering, Campus Biotech, Geneva, Switzerland (S.T., A.Y.); Service of Otorhinolaryngology-Head and Neck Surgery, Department of Clinical Neurosciences (D.D., L.G., J.V., F.V., P.S.) and Department of Psychiatry (C.L.R., A.S.), Geneva University Hospitals, Geneva, Switzerland; Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, Tenn (R.S.); Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland (S.H.); and Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden (S.H.).

|February 13, 2024

Summary

Real-time fMRI neurofeedback significantly reduced chronic tinnitus distress more than cognitive behavioral therapy (CBT). This novel therapy improved tinnitus handicap, sleep, anxiety, and depression symptoms compared to CBT.

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Area of Science:

Neurology
Psychiatry
Medical Imaging

Background:

Cognitive behavioral therapy (CBT) is the established treatment for chronic severe tinnitus.
Emerging evidence suggests real-time functional MRI (fMRI) neurofeedback may offer superior efficacy.
This study directly compares the effectiveness of fMRI neurofeedback against CBT for tinnitus distress.

Purpose of the Study:

To compare the efficacy of real-time fMRI neurofeedback versus CBT in reducing chronic tinnitus distress.
To evaluate the impact of both treatments on secondary quality-of-life measures.

Main Methods:

A prospective controlled trial randomized participants with chronic severe tinnitus to either CBT or real-time fMRI neurofeedback.
Treatments involved 10 weekly CBT sessions or 15 weekly individual fMRI neurofeedback sessions.
Tinnitus Handicap Inventory (THI) scores and quality-of-life questionnaires were assessed at baseline, 6, and 12 months.

Main Results:

The fMRI group demonstrated a significantly greater reduction in THI scores at both 6 and 12 months compared to the CBT group.
Participants in the fMRI group showed significant improvements in sleep, trait anxiety, depression, and general functioning.
No significant improvements in secondary outcomes were observed in the CBT group over time.

Conclusions:

Real-time fMRI neurofeedback therapy is more effective in reducing tinnitus distress than standard CBT.
fMRI neurofeedback offers significant benefits for sleep, anxiety, depression, and overall functioning in tinnitus patients.
This study supports fMRI neurofeedback as a promising alternative treatment for chronic severe tinnitus.