Published online Jul 6, 2019. doi: 10.12998/wjcc.v7.i13.1582
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
The central mechanism of idiopathic tinnitus includes neural plasticity with hypersynchrony and hyperactivity of cortical and subcortical auditory and non-auditory areas.
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.
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.
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.
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.
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.
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.