Direct electrical stimulation of Heschl's gyrus for tinnitus treatment.
OBJECTIVE
The purpose of the study was to determine the effect of electrical stimulation of the auditory cortex in patients with tinnitus.


METHODS
Nonrandomized clinical trial.


METHODS
Two patients with debilitating tinnitus refractory to conventional therapies were treated. Patients were evaluated with validated questionnaires and psychoacoustic measures to determine the frequency and pitch of their tinnitus. Tones at these frequencies were then presented to the first patient (RP) under magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) to determine the tonotopic map for these frequencies in Heschl's gyrus. These tonotopic sites were targeted for implant with a quadripolar electrode. In the second patient (MV), only the fMRI tonotopic map was performed. These fMRI results detected an area of increased activity, which was selected as the site for the implanted bipolar electrode.


RESULTS
Patient RP (bilateral tinnitus for 2 years) has experienced a sustained reduction to near elimination of tinnitus with intracerebral implanted electrodes, whereas patient MV (unilateral tinnitus for 7 years) had an unsustained reduction in her tinnitus.


CONCLUSIONS
These findings suggest that the perception and annoyance of tinnitus may be modulated or reduced through electrical stimulation of the auditory cortex. These unsustained effects for patient MV may have been influenced by the longstanding nature of her tinnitus or by another reason as yet undetermined.
Seidman
Michael D
MD
Department of Otolaryngology-Head and Neck Surgery, Henry Ford Health System, Detroit, MI 48323, USA. mseidma1@hfhs.org
Ridder
Dirk De
DD
Elisevich
Kost
K
Bowyer
Susan M
SM
Darrat
Ilaaf
I
Dria
Jason
J
Stach
Brad
B
Jiang
Quan
Q
Tepley
Norman
N
Ewing
James
J
Seidman
Marlee
M
Zhang
Jinsheng
J
D000328:Adult; D001303:Auditory Cortex; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019736:Prostheses and Implants; D014012:Tinnitus / Q000175:diagnosis / Q000628:therapy*