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Combined rTMS to the auditory cortex and prefrontal cortex for tinnitus control in patients with depression: a pilot study

Authors
 Sera Park  ;  Hae-Jung Park  ;  Sung-Hyon Kyeong  ;  In Seok Moon  ;  Minbum Kim  ;  Hee Nam Kim  ;  Jae-Young Choi 
Citation
 ACTA OTO-LARYNGOLOGICA, Vol.133(6) : 600-606, 2013 
Journal Title
 ACTA OTO-LARYNGOLOGICA 
ISSN
 0001-6489 
Issue Date
2013
MeSH
Adult ; Aged ; Auditory Cortex* ; Depression/complications ; Depression/therapy ; Female ; Humans ; Male ; Middle Aged ; Pilot Projects ; Positron-Emission Tomography ; Prefrontal Cortex* ; Tinnitus/complications ; Tinnitus/diagnostic imaging ; Tinnitus/therapy* ; Transcranial Magnetic Stimulation*
Keywords
Repetitive transcranial magnetic stimulation ; brain
Abstract
CONCLUSION: The study showed that combined repetitive transcranial magnetic stimulation (rTMS) on the auditory cortex and prefrontal cortex has more benefit than rTMS on the auditory cortex alone for tinnitus control in patients with depression. Further studies for the most optimal combination of stimulation on both areas are needed. OBJECTIVE: Recent studies suggest that the neuronal network changes of chronic tinnitus are beyond the auditory pathway. There is increasing evidences for the application of rTMS on multiple brain cortices in addition to the auditory cortex for the treatment of tinnitus. Sequential rTMS was performed on the auditory cortex alone as well as the auditory cortex combined with prefrontal cortex in patients with both chronic tinnitus and depression. METHODS: Patients who presented with chronic tinnitus of more than 1 year were enrolled in the present study (seven males, four females; mean age 54 years). To select the site for the rTMS, PET CT was performed. Patients received the first rTMS on the primary auditory cortex for 5 days and on the primary auditory cortex and prefrontal cortex in the second application after tinnitus relapse. The Tinnitus Handicap Inventory (THI), visual analog scale (VAS), and Beck Depression Inventory (BDI) were evaluated before and after rTMS. RESULTS: The mean THI score of the eight patients with depression changed from 77.5 ± 15 to 61.8 ± 20.1 after the second rTMS. There was statistical significance only for the second rTMS. The VAS score changed from 8.6 ± 1.6 to 6.3 ± 1.8 after the first rTMS and from 7.6 ± 2.4 to 4.6 ± 2.7 after the second rTMS, showing statistically significant changes both times. The THI changes after the second rTMS were greater than after the first rTMS, and the changes in VAS score showed a similar pattern. The changes in BDI score, which indicates the severity of depression, showed a variable pattern after rTMS. Patients with mild depression (10≤ BDI score <16, n = 4) showed significant improvement of THI with the second combined rTMS (ΔTHI = 24.5) as compared with the first rTMS on the auditory area (ΔTHI = 6). In contrast, combined rTMS did not show any better improvement on THI (ΔTHI = 6.5) than the first rTMS on the auditory cortex (ΔTHI = 7) in patients without depression (BDI <10, n = 3) and patients with moderate to severe depression (BDI ≥16, n = 4)
Full Text
http://informahealthcare.com/doi/abs/10.3109/00016489.2012.763181
DOI
10.3109/00016489.2012.763181
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Moon, In Seok(문인석) ORCID logo https://orcid.org/0000-0002-3951-5074
Park, Se Ra(박세라)
Park, Hae Jeong(박해정) ORCID logo https://orcid.org/0000-0002-4633-0756
Choi, Jae Young(최재영) ORCID logo https://orcid.org/0000-0001-9493-3458
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87697
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