title: Real-time fMRI feedback training may improve chronic tinnitus.
abstract: OBJECTIVE
  Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms.
  
  
  METHODS
  Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation.
  
  
  RESULTS
  Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants.
  
  
  CONCLUSIONS
  These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results.
authors.affiliation: Institute of Radiology, Department of Neuroradiology, University Hospital Basel, Petersgraben 4, CH 4031 Basel, Switzerland. shaller@uhbs.ch
authors.forename: Sven
authors.initials: S
authors.lastname: Haller
authors.forename: Niels
authors.initials: N
authors.lastname: Birbaumer
authors.forename: Ralf
authors.initials: R
authors.lastname: Veit
mesh_terms: D000328:Adult; D001676:Biofeedback, Psychology / Q000379:methods*; D002908:Chronic Disease; D003199:Computer Systems; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013813:Therapy, Computer-Assisted / Q000379:methods*; D014012:Tinnitus / Q000175:diagnosis* / Q000534:rehabilitation*