title: Transcranial Direct Current Stimulation for the Treatment of Chronic Tinnitus: A Randomized Controlled Study.
abstract: BACKGROUND
  Tinnitus is an often disabling condition for which there is no effective therapy. Current research suggests that tinnitus may develop due to maladaptive plastic changes and altered activity in the auditory and prefrontal cortex. Transcranial direct current stimulation (tDCS) modulates brain activity and has been shown to transiently suppress tinnitus in trials.
  
  
  OBJECTIVE
  To investigate the efficacy and safety of tDCS in the treatment of chronic subjective tinnitus.
  
  
  METHODS
  In a randomized, parallel, double-blind, sham-controlled study, the efficacy and safety of cathodal tDCS to the auditory cortex with anode over the prefrontal cortex was investigated in five sessions over five consecutive days. Tinnitus was assessed after the last session on day 5, and at follow-up visits 1 and 3 months post stimulation using the Tinnitus Handicap Inventory (THI, primary outcome measure), Subjective Tinnitus Severity Scale, Hospital Anxiety and Depression scale, Visual Analogue Scale, and Clinical Global Impression scale.
  
  
  RESULTS
  42 patients were investigated, 21 received tDCS and 21 sham stimulation. There were no beneficial effects of tDCS on tinnitus as assessed by primary and secondary outcome measures. Effect size assessed with Cohen's d amounted to 0.08 (95% CI: -0.52 to 0.69) at 1 month and 0.18 (95% CI: -0.43 to 0.78) at 3 months for the THI.
  
  
  CONCLUSIONS
  tDCS of the auditory and prefrontal cortices is safe, but does not improve tinnitus. Different tDCS protocols might be beneficial.
authors.affiliation: Clinic of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Natassja
authors.initials: N
authors.lastname: Pal
authors.affiliation: Clinic of Otolaryngology, Head Neck & Ear Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Raphael
authors.initials: R
authors.lastname: Maire
authors.affiliation: Clinic of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Marianne A
authors.initials: MA
authors.lastname: Stephan
authors.affiliation: Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, University Hospitals and University of Geneva, Geneva, Switzerland.
authors.forename: François R
authors.initials: FR
authors.lastname: Herrmann
authors.affiliation: Clinic of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Electronic address: David.Benninger@chuv.ch.
authors.forename: David H
authors.initials: DH
authors.lastname: Benninger
mesh_terms: D001007:Anxiety / Q000628:therapy; D001303:Auditory Cortex / Q000502:physiology*; D002908:Chronic Disease / Q000628:therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017397:Prefrontal Cortex / Q000502:physiology*; D014012:Tinnitus / Q000628:therapy*; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects*
keywords: Chronic tinnitus; Non-invasive brain stimulation; Plasticity; Therapeutic study; Transcranial direct current stimulation (tDCS)