Universität zu Köln

Adamchic, Ilya, Toth, Timea, Hauptmann, Christian, Walger, Martin, Langguth, Berthold, Klingmann, Ingrid and Tass, Peter Alexander (2017). Acute effects and after-effects of acoustic coordinated reset neuromodulation in patients with chronic subjective tinnitus. NeuroImage-Clin., 15. S. 541 - 559. OXFORD: ELSEVIER SCI LTD. ISSN 2213-1582

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Abstract

Chronic subjective tinnitus is an auditory phantom phenomenon characterized by abnormal neuronal synchrony in the central auditory system. As shown computationally, acoustic coordinated reset (CR) neuromodulation causes a long-lasting desynchronization of pathological synchrony by downregulating abnormal synaptic connectivity. In a previous proof of concept study acoustic CR neuromodulation, employing stimulation tone patterns tailored to the dominant tinnitus frequency, was compared to noisy CR-like stimulation, a CR version significantly detuned by sparing the tinnitus-related pitch range and including substantial random variability of the tone spacing on the frequency axis. Both stimulation protocols caused an acute relief as measured with visual analogue scale scores for tinnitus loudness (VAS-L) and annoyance (VAS-A) in the stimulation-ON condition (i.e. 15 min after stimulation onset), but only acoustic CR neuromodulation had sustained long-lasting therapeutic effects after 12 weeks of treatment as assessed with VAS-L, VAS-A scores and a tinnitus questionnaire (TQ) in the stimulation-OFF condition (i.e. with patients being off stimulation for at least 2.5 h). To understand the source of the long-lasting therapeutic effects, we here study whether acoustic CR neuromodulation has different electrophysiological effects on oscillatory brain activity as compared to noisy CR-like stimulation under stimulationON conditions and immediately after cessation of stimulation. To this end, we used a single-blind, single application, cross over design in 18 patients with chronic tonal subjective tinnitus and administered three different 16-minute stimulation protocols: acoustic CR neuromodulation, noisy CR-like stimulation and low frequency range (LFR) stimulation, a CR type stimulation with deliberately detuned pitch and repetition rate of stimulation tones, as control stimulation. We measured VAS-L and VAS-A scores together with spontaneous EEG activity pre-, during-and post-stimulation. Under stimulation-ON conditions acoustic CR neuromodulation and noisy CRlike stimulation had similar effects: a reduction of VAS-L and VAS-A scores together with a decrease of auditory delta power and an increase of auditory alpha and gamma power, without significant differences. In contrast, LFR stimulation had significantly weaker EEG effects and no significant clinical effects under stimulation-ON conditions. The distinguishing feature between acoustic CR neuromodulation and noisy CR-like stimulation were the electrophysiological after-effects. Acoustic CR neuromodulation caused the longest significant reduction of delta and gamma and increase of alpha power in the auditory cortex region. Noisy CR-like stimulation had weaker and LFR stimulation hardly any electrophysiological after-effects. This qualitative difference further supports the assertion that long-term effects of acoustic CR neuromodulation on tinnitus are mediated by a specific disruption of synchronous neural activity. Furthermore, our results indicate that acute electrophysiological after-effects might serve as a marker to further improve desynchronizing sound stimulation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Adamchic, Ilya UNSPECIFIED UNSPECIFIED UNSPECIFIED Toth, Timea UNSPECIFIED UNSPECIFIED UNSPECIFIED Hauptmann, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Walger, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Langguth, Berthold UNSPECIFIED UNSPECIFIED UNSPECIFIED Klingmann, Ingrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Tass, Peter Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-245629
DOI:	10.1016/j.nicl.2017.05.017
Journal or Publication Title:	NeuroImage-Clin.
Volume:	15
Page Range:	S. 541 - 559
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	2213-1582
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DESYNCHRONIZING BRAIN-STIMULATION; AUDITORY PHANTOM PERCEPTION; RESIDUAL INHIBITION FUNCTIONS; NEURAL ACTIVITY; HEARING-LOSS; THALAMOCORTICAL DYSRHYTHMIA; SUBTHALAMIC NUCLEUS; THRESHOLD SHIFT; SYSTEMS; CORTEX Multiple languages Neuroimaging Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/24562