目的采取1Hz低频重复经颅磁刺激(rTMS)治疗慢性主观性耳鸣并评价其治疗效果。方法对慢性主观性耳鸣患者46例行1Hz低频rTMS连续治疗2周,治疗前后分别行耳鸣残疾量表评分(THI)评分及主观疗效评估。结果rTMS对耳鸣治疗有明显效果,对主观耳鸣症状总体有效率为63.1%,其中失代偿性耳鸣(THI≥40)的有效率明显高于代偿性耳鸣(THI<40)(77%vs 45%;P<0.001),耳鸣患者治疗前后THI为(51.8±23.5 vs 37.0±18.8;t=5.94,p<0.001),VAS为(6.3±2.4 vs 4.9±1.8;t=5.27,p<0.01),治疗前后有统计学差异。失代偿组与代偿组耳鸣rTMS治疗后THI变化存在显著差异,两组差值为19.4±8.5(df=42,T=4.95,P<0.001)。结论rTMS治疗耳鸣有效,可明显降低THI得分,改善耳鸣症状,特别在失代偿性耳鸣效果更明显。
Objective:Subjective tinnitus is characterized by the perception of sound in the absence of any external auditory stimuli.This perceived sound may be related to altered intrinsic neural activity generated along the central auditory pathway.This retrospective study was designed to investigate regional homogeneity and functional connectivity in the resting-state brain activity of patients with tinnitus.Methods:We recruited tinnitus patients with normal hearing or mild hearing loss(n=17)and age-matched healthy controls(n=20),and examined regional homogeneity and functional connectivity in resting-state brain activity using resting-state functional magnetic resonance imaging data.The present study protocol was approved by the Institutional Review Board on Experimental Ethics at Sun Yat-sen University,China(approval No.SYSEC-KY-KS-2019-083).Results:Compared with normal controls,patients with tinnitus had significantly decreased regional homogeneity in the anterior lobe of the cerebellum and increased homogeneity in the inferior frontal gyrus(P<0.05 corrected at a cluster-level).In addition,tinnitus patients showed enhanced functional connectivity between the inferior frontal gyrus and the ventral striatum and midbrain,as well as increased connectivity between the cerebellum and ventromedial prefrontal cortex(P<0.05 corrected at a cluster-level).We also found decreased connectivity between the cerebellum and the anterior insula compared with controls(P<0.05 corrected at a cluster-level).Conclusion:Abnormal connectivity in non-auditory brain structures,particularly those related to emotion processing,may be associated with tinnitus persistence.
Yang HaidiLin HaiyanLin XiaofengZhang XueyuanXiong HaoZheng Yiqing
