INTRODUCTION: Tinnitus is an intrusive and chronic illness affecting a significant portion of the population, decreasing affected individuals' quality of life and socioeconomic functioning. Transcranial Direct Current Stimulation (tDCS) is a non-invasive neuromodulatory method utilizing weak electrical currents to elicit short and long-term central nervous system changes. Several studies have proven its effect on tinnitus. We aimed to broaden the knowledge and provide data on the effect and its retention. METHODS: In the randomized, double-blinded, sham-controlled trial, 39 patients (active n = 19, sham n = 20) underwent bifrontal tDCS (anode over right dorsolateral prefrontal cortex (DLPFC), cathode left DLPFC, current of 1.5 mA, 20 min, 6 sessions in 2 weeks). Tinnitus Functional Index (TFI), Iowa Tinnitus Handicap Questionnaire (ITHQ), Beck Anxiety Inventory (BAI), Zung Self-Rating Depression Scale (SDS), and WHO-Quality of Life-BREF were employed in 4 evaluation points, including the follow-ups of 6 weeks and 6 months. RESULTS: We reached a delayed, significant long-term improvement (p < 0.05) in auditory difficulties associated with tinnitus and noticed it even after 6 months compared to placebo. We also reached a short-term, negative effect in the psychological domain of WHO-Quality of Life-BREF (p < 0.05). Not all subdomains of TFI and ITHQ reached statistical significance during the data analysis, even though specific positive trends were noticed. CONCLUSION: We proved partial, positive, long-term effects of tDCS on tinnitus and short-term, negative, transient effect on a specific aspect of the general quality of life. We expanded upon the results of previous trials and provided data concerning the longevity and the precise effect of multiple sessions, bifrontal DLPFC tDCS. Our sample size (n = 39) was limited, which might have contributed to the lesser statistical power of the analyzed items. CLINICAL TRIAL REGISTRATION: [www.ClinicalTrials.gov], identifier [NCT05437185].

1st Faculty of Medicine Charles University Prague Czechia

3rd Faculty of Medicine Charles University Prague Czechia

Department of Internal Medicine 1st Faculty of Medicine Charles University and Military University Hospital Prague Czechia

Department of Physics Faculty of Electrical Engineering Czech Technical University Prague Prague Czechia

Department of Psychiatry 1st Faculty of Medicine Charles University and General University Hospital Prague Prague Czechia

Department of Psychiatry Krajska zdravotni a s Most Hospital Most Czechia

National Institute of Mental Health Klecany Czechia

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Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical management. PubMed

Lewis JE, Stephens SD, McKenna L. Tinnitus and sucide. PubMed

Stouffer JL, Tyler RS. Characterization of tinnitus by tinnitus patients. PubMed

Møller AR, Langguth B, DeRidder D, Kleinjung T.

Kreuzer PM, Goetz M, Holl M, Schecklmann M, Landgrebe M, Staudinger S, et al. Mindfulness-and body-psychotherapy-based group treatment of chronic tinnitus: a randomized controlled pilot study. PubMed DOI PMC

Michiels S, Naessens S, Van de Heyning P, Braem M, Visscher CM, Gilles A, et al. The effect of physical therapy treatment in patients with subjective tinnitus: a systematic review. PubMed DOI PMC

Langguth B, Elgoyhen AB. Current pharmacological treatments for tinnitus. PubMed

Bartels H, Staal MJ, Holm AF, Mooij JJ, Albers FW. Long-term evaluation of treatment of chronic, therapeutically refractory tinnitus by neurostimulation. PubMed DOI

Møller MB, Møller AR, Jannetta PJ, Jho HD. Vascular decompression surgery for severe tinnitus: selection criteria and results. PubMed

Langguth B. Treatment of tinnitus. PubMed

Lefaucheur JP, Aleman A, Baeken C, Benninger DH, Brunelin J, Di Lazzaro V, et al. Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): an update (2014–2018). PubMed

Lefaucheur JP, Antal A, Ayache SS, Benninger DH, Brunelin J, Cogiamanian F, et al. Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS). PubMed

Salazar JW, Meisel K, Smith ER, Quiggle A, McCoy DB, Amans MR. Depression in patients with tinnitus: a systematic review. PubMed PMC

Zirke N, Seydel C, Arsoy D, Klapp BF, Haupt H, Szczepek AJ, et al. Analysis of mental disorders in tinnitus patients performed with composite international diagnostic interview. PubMed DOI

Langguth B, Landgrebe M, Kleinjung T, Sand GP, Hajak G. Tinnitus and depression. PubMed

Salkovskis PM. The cognitive approach to anxiety: threat beliefs, safety-seeking behavior, and the special case of health anxiety and obsessions. In: Salkovskis PM. editor. DOI

McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. PubMed DOI PMC

Pattyn T, Van Den Eede F, Vanneste S, Cassiers L, Veltman DJ, Van De Heyning P, et al. Tinnitus and anxiety disorders: a review. PubMed

Bikson M, Inoue M, Akiyama H, Deans JK, Fox JE, Miyakawa H, et al. Effects of uniform extracellular DC electric fields on excitability in rat hippocampal slices in vitro. PubMed DOI PMC

Nitsche MA, Lampe C, Antal A, Liebetanz D, Lang N, Tergau F, et al. Dopaminergic modulation of long-lasting direct current-induced cortical excitability changes in the human motor cortex. PubMed DOI

Nitsche MA, Kuo MF, Grosch J, Bergner C, Monte-Silva K, Paulus W. D1-receptor impact on neuroplasticity in humans. PubMed PMC

Nitsche MA, Kuo MF, Karrasch R, Wächter B, Liebetanz D, Paulus W. Serotonin affects transcranial direct current–induced neuroplasticity in humans. PubMed DOI

Kuo MF, Grosch J, Fregni F, Paulus W, Nitsche MA. Focusing effect of acetylcholine on neuroplasticity in the human motor cortex. PubMed PMC

Nitsche MA, Fricke K, Henschke U, Schlitterlau A, Liebetanz D, Lang N, et al. Pharmacological modulation of cortical excitability shifts induced by transcranial direct current stimulation in humans. PubMed DOI PMC

Nitsche MA, Müller-Dahlhaus F, Paulus W, Ziemann U. The pharmacology of neuroplasticity induced by non-invasive brain stimulation: building models for the clinical use of CNS active drugs. PubMed DOI PMC

Terney D, Chaieb L, Moliadze V, Antal A, Paulus W. Increasing human brain excitability by transcranial high-frequency random noise stimulation. PubMed PMC

Polanía R, Paulus W, Nitsche MA. Modulating cortico-striatal and thalamo-cortical functional connectivity with transcranial direct current stimulation. PubMed DOI PMC

Haydon PG, Carmignoto G. Astrocyte control of synaptic transmission and neurovascular coupling. PubMed

Ruohonen J, Karhu J. tDCS possibly stimulates glial cells. PubMed

Andreasen M, Nedergaard S. Dendritic electrogenesis in rat hippocampal CA1 pyramidal neurons: functional aspects of Na+ and Ca2+ currents in apical dendrites. PubMed DOI

Fertonani A, Miniussi C. Transcranial electrical stimulation: what we know and do not know about mechanisms. PubMed PMC

Jacobson L, Koslowsky M, Lavidor M. tDCS polarity effects in motor and cognitive domains: a meta-analytical review. PubMed DOI

Yamada Y, Sumiyoshi T. Neurobiological mechanisms of transcranial direct current stimulation for psychiatric disorders; neurophysiological, chemical, and anatomical considerations. PubMed DOI PMC

Knotkova H, Nitsche MA, Bikson M, Woods AJ.

Palm U, Kumpf U, Behler N, Wulf L, Kirsch B, Wörsching J, et al. Home use, remotely supervised, and remotely controlled transcranial direct current stimulation: a systematic review of the available evidence. PubMed DOI

Charvet LE, Shaw MT, Bikson M, Woods AJ, Knotkova H. Supervised transcranial direct current stimulation (tDCS) at home: a guide for clinical research and practice. PubMed DOI

Hordacre B. The role of telehealth to assist in-home tDCS: opportunities, promising results and acceptability. PubMed DOI PMC

Riggs A, Patel V, Paneri B, Portenoy RK, Bikson M, Knotkova H. At-home transcranial direct current stimulation (tDCS) with telehealth support for symptom control in chronically-ill patients with multiple symptoms. PubMed DOI PMC

Ortega G, Rodriguez JA, Maurer LR, Witt EE, Perez N, Reich A, et al. Telemedicine, COVID-19, and disparities: policy implications. PubMed PMC

Faber M, Vanneste S, Fregni F, De Ridder D. Top down prefrontal affective modulation of tinnitus with multiple sessions of tDCS of dorsolateral prefrontal cortex. PubMed DOI

Song JJ, Vanneste S, Van de Heyning P, De Ridder D. Transcranial direct current stimulation in tinnitus patients: a systemic review and meta-analysis. PubMed PMC

Wang TC, Tyler RS, Chang TY, Chen JC, Lin CD, Chung HK, et al. Effect of transcranial direct current stimulation in patients with tinnitus: a meta-analysis and systematic review. PubMed

Shekhawat GS, Stinear CM, Searchfield GD. Modulation of perception or emotion? A scoping review of tinnitus neuromodulation using transcranial direct current stimulation. PubMed

Garin P, Gilain C, Van Damme JP, De Fays K, Jamart J, Ossemann M, et al. Short-and long-lasting tinnitus relief induced by transcranial direct current stimulation. PubMed DOI PMC

De Ridder D, Vanneste S, Langguth B, Llinas R. Thalamocortical dysrhythmia: a theoretical update in tinnitus. PubMed DOI PMC

Ashton H, Reid K, Marsh R, Johnson I, Alter K, Griffiths T. High frequency localised ,,;hot spots“ in temporal lobes of patients with intractable tinnitus: a quantitative electroencephalographic (QEEG) study. PubMed

Moazami-Goudarzi M, Michels L, Weisz N, Jeanmonod D. Temporo-insular enhancement of EEG low and high frequencies in patients with chronic tinnitus. QEEG study of chronic tinnitus patients. PubMed DOI PMC

Shekhawat GS, Vanneste S. Optimization of transcranial direct current stimulation of dorsolateral prefrontal cortex for tinnitus: a non-linear dose-response effect. PubMed DOI PMC

Shekhawat GS, Vanneste S. Optimization of transcranial direct current stimulation for tinnitus management.

Matsumoto H, Ugawa Y. Adverse events of tDCS and tACS: a review. PubMed PMC

Kane SP.

Haahr M.

Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, McArdle R, et al. The tinnitus functional index: development of a new clinical measure for chronic, intrusive tinnitus. PubMed DOI

Fackrell K, Hall DA, Barry JG, Hoare DJ. Psychometric properties of the tinnitus functional index (TFI): assessment in a UK research volunteer population. PubMed PMC

Kuk FK, Tyler RS, Russell D, Jordan H. The psychometric properties of a tinnitus handicap questionnaire. PubMed

Kennedy V, Wilson C, Stephens D. Quality of life and tinnitus.

Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. PubMed DOI

Zung WW. Zung self-rating depression scale and depression status inventory. In: Sartorius N, Ban TA. editors.

Whoqol Group. Development of the world health organization WHOQOL-BREF quality of life assessment. PubMed

Goes M, Lopes M, Marôco J, Oliveira H, Fonseca C. Psychometric properties of the WHOQOL-BREF (PT) in a sample of elderly citizens. PubMed DOI PMC

James KE, Bloch DA, Lee KK, Kraemer HC, Fuller RK. An index for assessing blindness in a multi-centre clinical trial: disulfiram for alcohol cessation—a VA cooperative study. PubMed DOI

R Core Team.

Caumo W, Souza IC, Torres IL, Medeiros L, Souza A, Deitos A, et al. Neurobiological effects of transcranial direct current stimulation: a review. PubMed DOI PMC

Li MS, Du XD, Chu HC, Liao YY, Pan W, Li Z, et al. Delayed effect of bifrontal transcranial direct current stimulation in patients with treatment-resistant depression: a pilot study. PubMed DOI PMC

Anders M, Dvorakova J, Rathova L, Havrankova P, Pelcova P, Vaneckova M, et al. Efficacy of repetitive transcranial magnetic stimulation for the treatment of refractory chronic tinnitus: a randomized, placebo controlled study. PubMed

Falkenberg ES, Wie OB. Anxiety and depression in tinnitus patients: 5-year follow-up assessment after completion of habituation therapy. PubMed DOI PMC

Razza LB, Palumbo P, Moffa AH, Carvalho AF, Solmi M, Loo CK, et al. A systematic review and meta-analysis on the effects of transcranial direct current stimulation in depressive episodes. PubMed

Moossavi A, Najafi S. Transcranial direct current stimulation in treatment of tinnitus.

Zobrazit více v PubMed

ClinicalTrials.gov
NCT05437185