Neuromagnetic Source Imaging of Abnormal Spontaneous Activity in Tinnitus Patient Modulated by Electrical Cortical Stimulation

Medical College of Wisconsin, Milwaukee, WI 80305, USA.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2009; 2009:1940-4. DOI: 10.1109/IEMBS.2009.5333457
Source: PubMed

ABSTRACT Electrical cortical stimulation (CS) of the auditory cortices has been shown to reduce the severity of debilitating tinnitus in some patients. In this study, we performed MEG source imaging of spontaneous brain activity during concurrent CS of the left secondary auditory cortex of a volunteer suffering from right unilateral tinnitus. CS produced MEG artifacts which were successfully sorted and removed using a combination of sensor and source level signal separation and classification techniques. This contribution provides the first proof of concept reporting on analysis of MEG data with concurrent CS. Effects of CS on ongoing brain activity were revealed at the MEG sensor and source levels and indicate CS significantly reduced ongoing brain activity in the lower frequency range (<40Hz), and emphasized its higher (>40Hz), gamma range components. Further, our results show that CS increased the spectral correlation across multiple frequency bands in the low and high gamma ranges, and between the alpha and beta bands of the MEG. Finally, MEG sources localized in the auditory cortices and nearby regions exhibited abnormal spectral activity that was suppressed by CS. These results provide promising evidence in favor of the Thalamocortical Dysrhytmia (TCD) hypothesis of tinnitus, and suggest that CS may prove to be an effective treatment of tinnitus when targeted to brain regions exhibiting abnormal spontaneous activity.

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    ABSTRACT: Background The final common pathway in tinnitus generation is considered to be synchronized auditory oscillatory hyperactivity. Intracranial auditory cortex stimulation (iACS) via implanted electrodes has been developed to treat severe cases of intractable tinnitus targeting this final common pathway, in the hope of being a panacea for tinnitus. However, not everybody responds to this treatment. Objective: The electrical brain activity and functional connectivity at rest might determine who is going to respond or not to iACS and might shed light on the pathophysiology of auditory phantom sound generation. Method The resting state electrical brain activity of 5 patients who responded and 5 patients who did not respond to auditory cortex implantation are compared using source localized spectral activity (Z-score of log transformed current density) and lagged phase synchronization. Results sLORETA source localization reveals significant differences between responders versus non-responders for beta3 in left posterior parahippocampal, hippocampal and amygdala area extending into left insula. Gamma band differences exist in the posterior parahippocampal areas and BA 10. Functional connectivity between the auditory cortex and the hippocampal area is increased for beta2, delta and theta2 in responders, as well as between the parahippocampal area and auditory cortex for beta3. Conclusion The resting state functional connectivity and activity between the auditory cortex and parahippocampus might determine whether a tinnitus patient will respond to a cortical implant. The auditory cortex may only be a functional entrance into a larger parahippocampal based tinnitus network.
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    ABSTRACT: Tinnitus is the perception of a sound in the absence of an external sound stimulus. This phantom sound has been related to plastic changes and hyperactivity in the auditory cortex. Different neuromodulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS) have been used in an attempt to modify local and distant neuroplasticity as to reduce tinnitus symptoms. Recently, two techniques of pulsed electrical stimulation using weak electrical currents - transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) - have also shown significant neuromodulatory effects. In the present study we conducted the first head-to-head comparison of three different transcranial electrical stimulation (tES) techniques, namely tDCS, tACS, and tRNS in 111 tinnitus patients by placing the electrodes overlying the auditory cortex bilaterally. The results demonstrated that tRNS induced the larger transient suppressive effect on the tinnitus loudness and the tinnitus related distress as compared to tDCS and tACS. Both tDCS and tACS induced small and non-significant effects on tinnitus symptoms, supporting the superior effects of tRNS as a method for tinnitus suppression.
    Frontiers in Psychiatry 12/2013; 4:158. DOI:10.3389/fpsyt.2013.00158

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