Bimodal Auditory Electrical Stimulation for the Treatment of Tinnitus: Preclinical and Clinical Studies
Tinnitus, or the phantom perception of sound, arises from pathological neural activity. Neurophysiological research has shown increased spontaneous firing rates and synchronization along the auditory pathway correlate strongly with behavioral measures of
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Contents 1 Introduction 1.1 Animal Model Development of Tinnitus Treatments 1.2 Translating Animal Studies to Humans 2 Discussion References
Abstract Tinnitus, or the phantom perception of sound, arises from pathological neural activity. Neurophysiological research has shown increased spontaneous firing rates and synchronization along the auditory pathway correlate strongly with behavioral measures of tinnitus. Auditory neurons are plastic, enabling external stimuli to be utilized to elicit long-term changes to spontaneous firing and synchrony. Pathological plasticity can thus be reversed using bimodal auditory plus nonauditory stimulation to reduce tinnitus. This chapter discusses preclinical and clinical evidence for efficacy of bimodal stimulation treatments of tinnitus, with highlights on sham-controlled, double-blinded clinical trials. The results from these studies have shown some efficacy in reducing the severity of tinnitus, based on subjective and objective outcome measures including tinnitus questionnaires and psychophysical tinnitus measurements. While results of some studies have been positive, the degree
T. L. Riffle, D. T. Martel, and G. R. Jones Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA S. E. Shore (*) Department of Otolaryngology, University of Michigan, Ann Arbor, MI, USA Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA Departments of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA Kresge Hearing Research Institute, Ann Arbor, MI, USA e-mail: [email protected] © Springer Nature Switzerland AG 2020 Curr Topics Behav Neurosci https://doi.org/10.1007/7854_2020_180
T. L. Riffle et al.
of benefit and the populations that respond to treatment vary across the studies. Directions and implications of future studies are discussed. Keywords Auditory-somatosensory · Bimodal · Clinical trial · Plasticity · Tinnitus
1 Introduction Tinnitus is the phantom perception of sound commonly referred to as “ringing” in the ears. Nearly 50 million people in the United States alone have tinnitus (Shargorodsky et al. 2010), which can be devastating to many sufferers. While commonly associated with and triggered by hearing loss (Eggermont and Roberts 2004), tinnitus can occur in participants with clinically normal audiograms (Schaette and McAlpine 2011; Gu et al. 2012), suggesting that the disorder arises from pathological neural activity in the central auditory pathway (Shore et al. 2016). Mounting evidence, from many labs, implicates pathologically altered homeostatic plasticity in tinnitus generation (Eggermont and Roberts 2004; Roberts et al. 2010; Wu et al. 2016b). This chapter first discusses the role of neural plasticity in generating tinnitus as demonstrated in animal model preclinical studies. We will then highlight peerreviewed, translational studies emanating from these rigorous preclinical studies to demonstrate how counteracting pathological plasticity can reduce and, in some cases, eliminate tinnitus. Detailed studies of
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