gms | German Medical Science

60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit den Benelux-Ländern und Bulgarien

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

24. - 27.05.2009, Münster

Robot assisted stimulation of the auditory cortex for the treatment of chronic tinnitus

Meeting Abstract

  • D. Rasche - Neurochirurgische Klinik, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck
  • P. Trillenberg - Neurologische Klinik, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck
  • L. Matthaeus - Institut für Robotik, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck
  • L. Richter - Institut für Robotik, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck
  • S. Gottschalk - Institut für Neuroradiologie, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck
  • V. Tronnier - Neurochirurgische Klinik, Campus Lübeck, Universitätsklinikum Schleswig-Holstein, Lübeck

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocMI.03-03

DOI: 10.3205/09dgnc179, URN: urn:nbn:de:0183-09dgnc1794

Veröffentlicht: 20. Mai 2009

© 2009 Rasche et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Chronic tinnitus is a very severe and restricting condition, which can be compared with chronic pain syndromes. In many cases the pathological cause is unknown. Treatment options are most pharmacological and psychological but often ineffective. In cases with refractory unilateral tinnitus stimulation of the auditory cortex can lead to reduction or even complete resolution of these phenomenon. In this prospective series we offered repetitive transcranial cortical stimulation (rTCS) to these patients.

Methods: A total number of 20 patients have been examined with functional MRI for visualization of the auditory cortex. These data were matched with a neuronavigation data set of the patients brain. A robot arm with a fixed magnetic coil was navigated to the auditory cortex as target. RTCS was performed on five consecutive days using 80% of the intensity of motor cortex threshold, 1 Hertz and 30 minutes stimulation time. Intensity of tinnitus and any changes were documented using a patient diary and a special questionnaire.

Results: In 18/20 patients fMRI was able to demonstrate the auditory cortex and these data were sufficient for neuronavigation. In 10 patients rTCS was performed. In 8 of these patients a change in tinnitus with reduction varying from 30-80% was noted. One patient stopped rTCS because of unpleasant tinnitus during the first minutes of stimulation. No critical side effects like seizures were observed.

Conclusions: Chronic tinnitus is a severe disorder and significant social problem. If conservative or standard methods fail transcranial stimulation can be offered to the patients. Based on our first results modulation of tinnitus by rTCS is possible and further investigation with larger patient sample will be performed.