Cranial nerve noninvasive neuromodulation efficacy on tinnitus patientes: double blind randomized clinical trial

• Grant number: 13/15933-2
• Support Opportunities: Regular Research Grants
• Start date: February 01, 2014
• End date: January 31, 2016
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Jeanne da Rosa Oiticica Ramalho
• Grantee: Jeanne da Rosa Oiticica Ramalho
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• City of the host institution: São Paulo
• Associated researchers: Sandra Lira Bastos de Magalhães

Abstract

Tinnitus is a symptom that can be defined as any auditory perception in the absence of corresponding external sound source in the environment. About 80% of these patients do not bother with the symptoms, but in 20% of cases tinnitus is established as a chronic symptom and causes significant effects on quality of life, which can affect sleep, concentration, emotional balance and the usual social activities Despite the high prevalence, still not a consensus on the neurophysiological origin of tinnitus. It is not yet clear whether dysfunction restricted to the auditory system are sufficient to explain the pathophysiology of chronic tinnitus and disabling. Apparently, evidence points to the additional involvement of other neural networks, including, in particular, the limbic system. Therefore, despite the phantom sensation to result primarily from a peripheral deafferentation, this state of consciousness is achieved only when the increase in neural activity in primary sensory cortex spreads to a network of global cerebral wider attention, involving frontal and parietal area. It is imperative, therefore, to identify strategies and stimuli through neuromodulation that may ameliorate aberrant connections between these multiple neural networks. The neuromodulation can be defined as the physiological process by which a particular neuron uses different neurotransmitters to regulate simultaneously many different populations of neurons in the central nervous system (CNS). It can be obtained in a number of emerging medical therapies that act on the CNS to restore function, relieve pain, manage symptoms, as in the case of electrical stimulation of the tongue, known as non-invasive neuromodulation of cranial nerve (CN-NINM, Cranial Nerve Non-Invasive Neuromodulation), is of interest in this project. Our hypothesis is that the sustained neuromodulation via CN-NINM may be more effective than placebo stimulation to treat patients with chronic tinnitus and bother; possible by modulating activity of the cochlear nucleus deaferentado and reorganization of the sensory along the central auditory pathways. Because it is a symptom rather prevalent in the general population, in some cases with significant impact on quality of life of the patient; scientific contributions that broaden therapeutic options viable are of fundamental importance in everyday clinical practice. (AU)