Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 8;12(22):6987.
doi: 10.3390/jcm12226987.

Personalized Neuromodulation: A Novel Strategy for Improving Tinnitus Treatment

Seung Yeon Jeon  1 , Jung Ho Choi  1 , Sun Seong Kang  1 , Yong-Hwi An  1 , Hyun Joon Shim  1
Affiliations

Personalized Neuromodulation: A Novel Strategy for Improving Tinnitus Treatment

Seung Yeon Jeon et al. J Clin Med. .

Abstract

This study evaluated the efficacy of personalized neuromodulation, where treatment modalities are chosen based on the patient's responses in a pilot trial. A total of 71 patients with tinnitus were divided into two groups: a personalized group and a randomized neuromodulation group. In the personalized group (n = 35), repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS) were assessed in a pilot trial, and responsive modalities were administered to 16 patients, while the non-responders (n = 19) were randomly assigned to rTMS, tDCS, or combined modalities. Patients in the randomized group (n = 36) were randomly allocated to rTMS, tDCS, or combined modalities. The Tinnitus Handicap Inventory (THI) score improvement after 10 sessions of each neuromodulation was significantly greater in the personalized group than in the randomized group (p = 0.043), with no significant differences in tinnitus loudness, distress, or awareness. The treatment success rate was highest in the personalized responder subgroup (92.3%), and significantly greater than that in the non-responder subgroup (53.0%; p = 0.042) and the randomized group (56.7%; p = 0.033). Personalized neuromodulation, where the treatment modality is chosen based on the patient's responses in a pilot trial, is an advantageous strategy for treating tinnitus.

Keywords: neuromodulation; tinnitus; transcranial direct-current stimulation; transcranial magnetic stimulation.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest. This paper will be used as the doctoral dissertation of the first author, Seung Yeon Jeon.

Figures

Figure 1
Figure 1
Outline of the study design. During visit 1 (V1), patients in the personalized group underwent a pilot test to determine the modality, whereas patients in the randomized group were informed about the clinical study and randomly assigned to rTMS, tDCS, or combined modalities without a pilot trial. Both groups underdwent the appropriate neuromodulation intervention for 10 sessions over 2 weeks, on five consecutive days per week. Four questionnaires: THI, Numeric Rating Scale for tinnitus loudness, distress, and awareness; three questionnaires: Numeric Rating Scale for tinnitus loudness, distress, and awareness.
Figure 2
Figure 2
CONSORT flow diagram. In the personalized group (n = 35), 16 patients who showed improvement in at least one of the four questionnaires after the pilot trial were included in the responder subgroup and received the treatment modality that elicited a response. The other 19 patients with negative responses (non-responder subgroup) were randomly assigned to one of the three neuromodulation modalities. In the randomized group (n = 36), patients were randomly allocated to rTMS (n = 13), tDCS (n = 13), or combined modalities (n = 10) without undergoing a pilot trial. rTMS, repetitive transcranial magnetic stimulation; tDCS, transcranial direct-current stimulation; N, number of patients.
Figure 3
Figure 3
Comparison of changes in the questionnaire scores between the personalized and randomized groups. The improvement in the THI score was significantly greater in the personalized group than in the randomized group (p = 0.043). There were no significant differences in the changes in tinnitus loudness, distress, or awareness scores between the two groups (p > 0.05 for all).
Figure 4
Figure 4
Comparison of changes in questionnaire scores between the personalized responder subgroup (Personalized R), the personalized non-responder subgroup (Personalized N), and the randomized group. The improvement in THI score was greatest in the responder subgroup and was significantly greater than that in the randomized group (p = 0.007). A significant improvement in the tinnitus loudness score was observed in the responder subgroup compared with the non-responder subgroup (pBonf = 0.012).
Figure 5
Figure 5
Comparison of treatment success rates among the study groups. The treatment success rates for the personalized group and the randomized group were 21/30 (70.0%) and 17/30 (56.7%), respectively, which were not significantly different (p > 0.05). When the personalized group was divided based on their response to the pilot trial, the success rate was 12/13 (92.3%) for the responder subgroup (Personalized R), 9/17 (53.0%) for the non-responder subgroup (Personalized N), and 17/30 (56.7%) for the randomized group. The response rate was significantly greater in the responder subgroup than in the non-responder subgroup (p = 0.042) and the randomized group (p = 0.033).
Figure 6
Figure 6
Comparisons of changes in questionnaire scores according to the treatment modalities. The effects of each neuromodulation modality (rTMS, tDCS, and combined modalities) were analyzed in the randomized group. There were no statistically significant differences in the changes in tinnitus loudness, distress, awareness, and THI scores between the three treatment modalities (p > 0.05 and pBonf > 0.017 for all).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. De Ridder D., Schlee W., Vanneste S., Londero A., Weisz N., Kleinjung T., Shekhawat G.S., Elgoyhen A.B., Song J.J., Andersson G., et al. Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal) Prog. Brain Res. 2021;260:1–25. doi: 10.1016/bs.pbr.2020.12.002. - DOI - PubMed
    1. Simoes J.P., Daoud E., Shabbir M., Amanat S., Assouly K., Biswas R., Casolani C., Dode A., Enzler F., Jacquemin L., et al. Multidisciplinary Tinnitus Research: Challenges and Future Directions From the Perspective of Early Stage Researchers. Front. Aging Neurosci. 2021;13:647285. doi: 10.3389/fnagi.2021.647285. - DOI - PMC - PubMed
    1. Eggermont J.J., Roberts L.E. The neuroscience of tinnitus: Understanding abnormal and normal auditory perception. Front. Syst. Neurosci. 2012;6:53. doi: 10.3389/fnsys.2012.00053. - DOI - PMC - PubMed
    1. Vanneste S., Plazier M., der Loo E., de Heyning P.V., Congedo M., De Ridder D. The neural correlates of tinnitus-related distress. Neuroimage. 2010;52:470–480. doi: 10.1016/j.neuroimage.2010.04.029. - DOI - PubMed
    1. Eggermont J.J., Roberts L.E. The neuroscience of tinnitus. Trends Neurosci. 2004;27:676–682. doi: 10.1016/j.tins.2004.08.010. - DOI - PubMed

LinkOut - more resources