• Otol. Neurotol. · Dec 2007

    Randomized Controlled Trial

    Feasibility of auditory cortical stimulation for the treatment of tinnitus.

    • David R Friedland, Wolfgang Gaggl, Christina Runge-Samuelson, John L Ulmer, and Brian Harris Kopell.
    • Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin and Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin 53226, USA. dfriedla@mcw.edu
    • Otol. Neurotol. 2007 Dec 1; 28 (8): 1005-12.

    ObjectivesTo investigate the feasibility and safety of an implantable epidural cortical stimulator for the treatment of severe tinnitus.Study DesignProspective, controlled, single-blinded study of cortical stimulation for 4 weeks, and then an open-label stimulation period.SettingTertiary care referral center.PatientsAdults (n = 8) with constant tinnitus of at least 1 year with a tinnitus reaction questionnaire score greater than 33. Tinnitus was predominantly unilateral with a frequency less than 8,000 Hz.InterventionsSurgical implantation of an investigational epidural electrode over the posterior superior temporal gyrus using functional magnetic resonance imaging targeting. A 2-week stimulation period alternated with a 2-week sham period in random order to which subjects were blinded. This was followed by continuous stimulation with parameter adjustments to maximize tinnitus suppression.Main Outcome MeasureSubjective rating of tinnitus severity, loudness, and device efficacy. Objective measures of hearing thresholds, tinnitus frequency, loudness, and minimum masking levels. Outcome measures using the Tinnitus Handicap Questionnaire, Tinnitus Reaction Questionnaire, and Beck Depression Inventory.ResultsThere were no effects of stimulation during the 4-week blinded period. With continuous chronic stimulation, 2 patients had persistent reduction of pure-tone tinnitus, and 6 patients had short periods of total tinnitus suppression. Significant improvements in the Beck Depression Inventory and tinnitus questionnaires were found, although objective measures of tinnitus loudness remained fairly stable. No surgical or stimulation-related complications were noted.ConclusionChronic electrical stimulation of the secondary auditory cortex seems safe and warrants further investigation as a potential therapeutic intervention for the suppression of tinnitus.

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