Niedrigfrequente repetitive transkranielle Magnetstimulation

Zusammenfassung

Der chronische Tinnitus ist eine häufige Erkrankung, deren Pathophysiologie nicht im Detail geklärt ist. Funktionell bildgebende Untersuchungen verweisen auf neuroplastische Veränderungen mit gesteigerter neuronaler Aktivität im Bereich des auditorischen Kortex. Pilotstudien haben gezeigt, dass neuronavigierte PET und NMR-gestützte niedrigfrequente repetitive transkranielle Magnetstimulation (rTMS) zu einer signifikanten Tinnitusreduktion führt. Im Rahmen der vorliegenden Studie soll untersucht werden, ob rTMS auch unter Verwendung einer einfacher durchführbaren Spulenlokalisationsmethode in der Lage ist, Tinnitus zu reduzieren. Elf Patienten fmit chronischem Tinnitus wurden mit rTMS behandelt (110% Motorschwelle, 1Hz, 2 000 Stimuli/Tag, 10 Tage). Die Positionierung der Spule zur Stimulation des linken auditorischen Kortex erfolgte mithilfe anatomischer Landmarken. Therapieeffekte wurden mit dem Tinnitusfragebogen nach Goebel und Hiller erfasst. Nach rTMS Behandlung kam es zu einer signifikanten Verminderung des Tinnitusschweregrades. Niedrigfrequente rTMS über dem linken auditorischen Kortex stellt ein vielversprechendes innovatives Instrument zur Behandlung des chronischen Tinnitus dar.

Summary

Idiopathic tinnitus isa frequent and debilitating disorder of largely unknown pathophysiological conditions. Recent studies demonstrated neuroplastic changes with increased activation in the central auditory system of patients suffering from chronic tinnitus. Pilot studies have demonstrated that tinnitus can be reduced by MRI and PET guided low frequency repetitive transcranial magnetic stimulation (rTMS). Eleven patients with chronic tinnitus were treated with low frequency rTMS (110% motor threshold, 1 Hz, 2 000 Stimuli/day, 10 days). The TMS coil was positioned over the left auditory cortex by using anatomical landmarks. Treatment effects were assessed with the Tinnitus Severity Questionnaire. After rTMS treatmenta significant reduction of tinnitus severity was observed, outlasting the stimulation period by at least two weeks. Low frequency rTMS of the left auditory cortex seems to be a promising new method for the treatment of chronic tinnitus.

Schlüsselwörter

Tinnitus - transkranielle Magnetstimulation - Neuroplastizität

Keywords

Tinnitus - transcranial magnetic stimulation - neuroplasticity

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