Basic Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jul 6, 2019; 7(13): 1582-1590
Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1582
Neural metabolic activity in idiopathic tinnitus patients after repetitive transcranial magnetic stimulation
Ying Kan, Wei Wang, Shu-Xin Zhang, Huan Ma, Zhen-Chang Wang, Ji-Gang Yang
Ying Kan, Wei Wang, Shu-Xin Zhang, Huan Ma, Ji-Gang Yang, Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Zhen-Chang Wang, Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
Author contributions: Kan Y, Wang ZC, and Yang JG designed the research; Kan Y, Wang W, and Zhang SX performed the research; Kan Y and Ma H analyzed the data; Kan Y wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81771860.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Beijing Friendship Hospital, Capital Medical University and adhered to the tenets of the Declaration of Helsinki.
Conflict-of-interest statement: None.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author at []. Participants gave informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Zhen-Chang Wang, MD, Chief Doctor, Professor, Department of Radiology, Capital Medical University, Beijing Friendship Hospital, No. 95, Yongan Road, Xicheng District, Beijing 100050, China.
Telephone: +86-10-63138625 Fax: +86-10-63138625
Received: March 6, 2019
Peer-review started: March 8, 2019
First decision: April 18, 2019
Revised: April 21, 2019
Accepted: May 2, 2019
Article in press: May 2, 2019
Published online: July 6, 2019
Research background

The central mechanism of idiopathic tinnitus includes neural plasticity with hypersynchrony and hyperactivity of cortical and subcortical auditory and non-auditory areas.

Research motivation

The tinnitus management strategy includes diet modification, medication, retraining and masking therapies, and repetitive transcranial magnetic stimulation (rTMS). No single inter-vention had been identified to be specifically effective against symptoms of tinnitus. rTMS has emerged as a well-tolerated, non-invasive potential treatment option for tinnitus. Different studies reported inconsistency results.

Research objectives

Our study focused on metabolic changes of neural activity in idiopathic tinnitus patients after rTMS treatment and further investigated changes in cortical activities both in and outside the target area.

Research methods

Idiopathic tinnitus patients and age-, gender-, and education-matched healthy controls were enrolled in our study. All patients underwent PET/CT scans at baseline and after 10 days of session. Statistical parametric mapping (SPM 12) were used to preprocess PET data.

Research results

Our results showed that tinnitus handicap inventory (THI) score had no significant difference before and after rTMS treatment in chronic tinnitus patients and symptom alleviation lacked.

Research conclusions

Our study used statistical parametric mapping (SPM 12) based on Matlab to process PET data. Our results showed that the activated regions were the right inferior temporal gyrus, right parahippocampa gyrus, right hippocampus, rectus gyrus, right inferior frontal gyrus, and left middle frontal gyrus in chronic idiopathic tinnitus, compared with normal controls. THI score had no significant difference before and after rTMS treatments in chronic tinnitus patients and symptom alleviation lacked.

Research perspectives

Application of 1-Hz rTMS directed to the left temporoparietal junction (TPJ) resulted no statistically significant symptom alleviation. Our results suggest that the left TPJ alone may not be sufficient for chronic idiopathic tinnitus treatment. Functional imaging-based neuro-navigational network treatment may identify the best targets for rTMS treatment.