title: Acoustic CR Neuromodulation Therapy for Subjective Tonal Tinnitus: A Review of Clinical Outcomes in an Independent Audiology Practice Setting.
abstract: OBJECTIVE
  To describe the quantitative treatment outcomes of patients undergoing acoustic coordinated reset (CR) neuromodulation at a single independent audiology practice over a 22- to 26-week period as part of an open label, non-randomized, non-controlled observational study.
  
  
  METHODS
  Sixty-six patients with subjective tonal tinnitus were treated with acoustic CR neuromodulation with a retrospective review of patient records being performed in order to identify changes of visual analog scale (VAS, n = 66) and in the score of the tinnitus handicap questionnaire (THQ, n = 51). Patients had their tinnitus severity recorded prior to the initiation of therapy using the tinnitus handicap inventory in order to categorize patients into slight up to catastrophic impact categories. THQ and VAS for tinnitus loudness/annoyance were obtained at the patient's initial visit, at 10-14 and 22-26 weeks.
  
  
  RESULTS
  Visual analog scale scores were significantly improved, demonstrating a 25.8% mean reduction in tinnitus loudness and a 32% mean reduction in tinnitus annoyance with a clinically significant reduction in percept loudness and annoyance being recorded in 59.1 and 72.7% of the patient group. THQ scores were significantly improved by 19.4% after 22-26 weeks of therapy compared to baseline.
  
  
  CONCLUSIONS
  Acoustic CR neuromodulation therapy appears to be a practical and promising treatment for subjective tonal tinnitus. However, due to the lack of a control group it is difficult to reach an absolute conclusion regarding to what extent the observed effects are related directly to the acoustic CR neuromodulation therapy. Also, as the observed patient group was made up of paying clients it is unknown as to whether this could have caused any additional placebo like effects to influence the final results.
authors.affiliation: The Tinnitus Clinic Ltd. , London , UK ; Neurotherapies Reset NTR GmbH, Technology Center Jülich , Jülich , Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Williams
authors.affiliation: Section of Neuromodulation, Institute of Neuroscience and Medicine, Jülich Research Center , Jülich , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hauptmann
authors.affiliation: Department of Otolaryngology, Whipps Cross University Hospital, Barts Health NHS Trust , London , UK.
authors.forename: Nitesh
authors.initials: N
authors.lastname: Patel
keywords: acoustic CR neuromodulation; neuromodulation; tinnitus; tinnitus therapy; tinnitus treatment
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