Subjective tinnitus is a phantom sensation experienced without any external source of sound that profoundly impacts the quality of life. Some investigations have claimed that transcranial direct current stimulation (tDCS) reduces tinnitus, but studies on tDCS have demonstrated variable results. This meta-analysis aimed to examine the effect of tDCS on patients with tinnitus.
Methods:
We searched for articles published through January 5, 2016, in Medline, Cochrane, EMBASE, and Google Scholar using the following keywords: tinnitus, transcranial direct current stimulation, and tDCS. The study outcomes were change in magnitude estimates of loudness (loudness), tinnitus-related distress (distress), and Tinnitus Handicap Inventory (THI).
Results:
Pooled results demonstrated that tDCS did not have a beneficial effect on loudness (pooled standardized difference in means = 0.674, 95% CI, –0.089 to 1.437, P = .083). Further, the pooled results demonstrated a greater reduction in distress for the tDCS group (pooled standardized difference in means = 0.634, 95% CI, 0.021-1.247, P = .043).
Conclusions:
We conclude that the pooled results demonstrated a greater reduction in distress for groups treated with tDCS as compared with those administered a sham treatment.
RabauSVan RompaeyVVan de HeyningP. The effect of transcranial direct current stimulation in addition to tinnitus retraining therapy for treatment of chronic tinnitus patients: a study protocol for a double-blind controlled randomised trial. Trials. 2015;16(1):514.
2.
SongJJVannesteSVan de HeyningPDe RidderD. Transcranial direct current stimulation in tinnitus patients: a systemic review and meta-analysis. Scientific World Journal. 2012;2012:427941.
3.
GarinPGilainCVan DammeJPet al. Short- and long-lasting tinnitus relief induced by transcranial direct current stimulation. J Neurol. 2011;258(11):1940-1948.
4.
ShekhawatGSSundramFBiksonMet al. Intensity, duration, and location of high-definition transcranial direct current stimulation for tinnitus relief. Neurorehabil Neural Repair. 2016;30(4):349-359.
5.
ShekhawatGSStinearCMSearchfieldGD. Modulation of perception or emotion? A scoping review of tinnitus neuromodulation using transcranial direct current stimulation. Neurorehabil Neural Repair. 2015;29(9):837-846.
6.
ShekhawatGSKobayashiKSearchfieldGD. Methodology for studying the transient effects of transcranial direct current stimulation combined with auditory residual inhibition on tinnitus. J Neurosci Methods. 2015;239:28-33.
7.
ShekhawatGSSearchfieldGDStinearCM. Randomized trial of transcranial direct current stimulation and hearing aids for tinnitus management. Neurorehabil Neural Repair. 2013;28(5):410-419.
8.
ShekhawatGSStinearCMSearchfieldGD. Transcranial direct current stimulation intensity and duration effects on tinnitus suppression. Neurorehabil Neural Repair. 2013;27(2):164-172.
9.
FrankESchecklmannMLandgrebeMet al. Treatment of chronic tinnitus with repeated sessions of prefrontal transcranial direct current stimulation: outcomes from an open-label pilot study. J Neurol. 2012;259(2):327-333.
10.
LangguthBDe RidderD. Tinnitus: therapeutic use of superficial brain stimulation. Handb Clin Neurol. 2013;116:441-467.
11.
KuoMFPaulusWNitscheMA. Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases. Neuroimage. 2014;85(Pt 3):948-960.
Negrila-MezeiAEnacheRSarafoleanuC. Tinnitus in elderly population: clinic correlations and impact upon QoL. J Med Life. 2011;4(4):412-416.
14.
CavalcantiKBrasil-NetoJPAllamNBoechat-BarrosRA. Double-blind, placebo-controlled study of the effects of daily tDCS sessions targeting the dorsolateral prefrontal cortex on Tinnitus Handicap Inventory and visual analog scale scores. Brain Stimul. 2015;8(5):978-980.
15.
JoosKDe RidderDVandeHeyningPVannesteS. Polarity specific suppression effects of transcranial direct current stimulation for tinnitus. Neural Plast. 2014;2014:930860.
16.
StoufferJLTylerRS. Characterization of tinnitus by tinnitus patients. J Speech Hear Disord. 1990;55(3):439-453.
17.
RyanDBauerCA. Neuroscience of tinnitus. Neuroimaging Clin N Am. 2016;26(2):187-196.
18.
HusainFT. Neural networks of tinnitus in humans: elucidating severity and habituation. Hear Res. 2016;334:37-48.
19.
LangguthBElgoyhenAB. Current pharmacological treatments for tinnitus. Expert Opin Pharmacother. 2012;13(17):2495-2509.
20.
NoreñaAJFarleyBJ. Tinnitus-related neural activity: theories of generation, propagation, and centralization. Hear Res. 2013;295:161-171.
21.
NitscheMAFrickeKHenschkeUet al. Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. J Physiol. 2003;553(Pt 1):293-301.
22.
MoliadzeVAndreasSLyzhkoEet al. Ten minutes of 1 mA transcranial direct current stimulation was well tolerated by children and adolescents: Self-reports and resting state EEG analysis. Brain Res Bull. 2015;119(Pt A):25-33.
23.
ZaehleTBerettaMJänckeLHerrmannCSSandmannP. Excitability changes induced in the human auditory cortex by transcranial direct current stimulation: direct electrophysiological evidence. Exp Brain Res. 2011;215(2):135-140.
24.
DaumanRTylerRS. Some considerations on the classification of tinnitus. In: AranJ-MDaumanR eds. Tinnitus 91—Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications;1992:225-229.
25.
TylerRSAranJ-MDaumanR. Recent advances in tinnitus. Am J Audiol. 1992;1(4):36-44.
26.
GrewalRSpielmannPMJonesSEHussainSS. Clinical efficacy of tinnitus retraining therapy and cognitive behavioural therapy in the treatment of subjective tinnitus: a systematic review. J Laryngol Otol. 2014;128(12):1028-1033.
27.
CimaRFAnderssonGSchmidtCJHenryJA. Cognitive-behavioral treatments for tinnitus: a review of the literature. J Am Acad Audiol. 2014;25(1):29-61.
28.
AdamchicILangguthBHauptmannCTassPA. Psychometric evaluation of visual analog scale for the assessment of chronic tinnitus. Am J Audiol. 2012;21(2):215-225.
29.
TylerRSConrad-ArmesD. The determination of tinnitus loudness considering the effects of recruitment. J Speech Hear Res. 1983;26(1):59-72.
30.
Cochrane Handbook for Systematic. Reviews of Interventions. Version 5.1.0. http://handbook-5-1.cochrane.org/. Accessed November 15, 2017.
31.
HusainFT. Neural networks of tinnitus in humans: elucidating severity and habituation. Hear Res. 2016;334:37-48.
32.
MinamiSBOishiNWatabeTUnoKKagaKOgawaK. Auditory resting-state functional connectivity in tinnitus and modulation with transcranial direct current stimulation. Acta Otolaryngol. 2015;135(12):1286-1292.
33.
VannesteSWalshVVanDeHeyningPDe RidderD. Comparing immediate transient tinnitus suppression using tACS and tDCS: a placebo-controlled study. Exp Brain Res. 2013;226(1):25-31.
34.
VannesteSFregniFDe RidderD. Head-to-head comparison of transcranial random noise stimulation, transcranial AC stimulation, and transcranial DC stimulation for tinnitus. Front Psychiatry. 2013;4:158.
35.
ForoghBMirshakiZRaissiGRShiraziAMansooriKAhadiT. Repeated sessions of transcranial direct current stimulation for treatment of chronic subjective tinnitus: a pilot randomized controlled trial. Neurol Sci. 2016;37(2):253-259.
36.
PalNMaireRStephanMAHerrmannFRBenningerDH. Transcranial direct current stimulation for the treatment of chronic tinnitus: a randomized controlled study. Brain Stimul. 2015;8(6):1101-1107.
37.
De RidderDVannesteS. EEG driven tDCS versus bifrontal tDCS for tinnitus. Front Psychiatry. 2012;3:84.
38.
VannesteSDe RidderD. Bifrontal transcranial direct current stimulation modulates tinnitus intensity and tinnitus-distress-related brain activity. Eur J Neurosci. 2011;34(4):605-614.
39.
HyvärinenPMendonçaCSantalaOPulkkiVAarnisaloAA. Auditory localization by subjects with unilateral tinnitus. J Acoust Soc Am. 2016;139(5):2280-2289.
40.
KnightRTScabiniDWoodsDL. Prefrontal cortex gating of auditory transmission in humans. Brain Res. 1989;504(2):338-342.
41.
MitchellTVMoreyRAInanSBelgerA. Functional magnetic resonance imaging measure of automatic and controlled auditory processing. Neuroreport. 2005;16(5):457-461.
42.
Van der LooEGaisSCongedoMet al. Tinnitus intensity dependent gamma oscillations of the contralateral auditory cortex. PLoS One. 2009;4(10):e7396.
43.
FregniFGimenesRValleACet al. A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia. Arthritis Rheum. 2006;54(12):3988-3998.
44.
TylerRSNobleWGCoelhoC. Considerations for the design of clinical trials for tinnitus. Acta Otolaryngol. 2006;126(sup556):44-49.
45.
TylerRSOlesonJNobleWCoelhoCJiH. Clinical trials for tinnitus: study populations, designs, measurement variables, and data analysis. Prog Brain Res. 2007;166:499-509.
46.
SongJJVannesteSVandeHeyningPDe RidderD. Transcranial direct current stimulation in tinnitus patients: a systemic review and meta-analysis. Scientific World Journal. 2012;2012:427941.
47.
FullerTEHaiderHFKikidisDet al. Different teams, same conclusions? A systematic review of existing clinical guidelines for the assessment and treatment of tinnitus in adults. Front Psychol. 2017;8:206.
48.
LefaucheurJPAntalAAyacheSSet al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). Clin Neurophysiol. 2017;128(1):56-92.
49.
ZennerHPDelbWKröner-HerwigBet al. A multidisciplinary systematic review of the treatment for chronic idiopathic tinnitus. Eur Arch Otorhinolaryngol. 2017;274(5):2079-2091.
50.
HeninSFeinDSmouhaEParraLC. The effects of compensatory auditory stimulation and high-definition transcranial direct current stimulation (HD-tDCS) on tinnitus perception—a randomized pilot study. PLoS One. 2016;11(11):e0166208.
51.
DeeksJJHigginsJPTAltmanDG. Analysing data and undertaking meta-analyses. In: HigginsJPTGreenS. Cochrane Handbook for Systematic Reviews of Interventions. Version 5.1.0. London: Cochrane Collaboration; 2011.
52.
HallDAHaiderHSzczepekAJet al. Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. Trials. 2016;17(1):270.
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