title: The impact of deep brain stimulation on tinnitus.
abstract: BACKGROUND
  Tinnitus is a disorder of the nervous system that cannot be adequately treated with current therapies. The effect of neuromodulation induced by deep brain stimulation (DBS) on tinnitus has not been studied well. This study investigated the effect of DBS on tinnitus by use of a multicenter questionnaire study.
  
  
  METHODS
  Tinnitus was retrospectively assessed prior to DBS and at the current situation (with DBS). From the 685 questionnaires, 443 were returned. A control group was one-to-one matched to DBS patients who had tinnitus before DBS (n= 61). Tinnitus was assessed by the tinnitus handicap inventory (THI) and visual analog scales (VAS) of loudness and burden.
  
  
  RESULTS
  The THI decreased significantly during DBS compared to the situation prior to surgery (from 18.9 to 15.1,P< .001), which was only significant for DBS in the subthalamic nucleus (STN). The THI in the control group (36.9 to 35.5,P= 0.50) and other DBS targets did not change. The VAS loudness increased in the control group (5.4 to 6.0P< .01).
  
  
  CONCLUSIONS
  DBS might have a modulatory effect on tinnitus. Our study suggests that DBS of the STN may have a beneficial effect on tinnitus, but most likely other nuclei linked to the tinnitus circuitry might be even more effective.
authors.affiliation: Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Jasper V
authors.initials: JV
authors.lastname: Smit
authors.affiliation: Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Marcus L F
authors.initials: ML
authors.lastname: Janssen
authors.affiliation: Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Malou
authors.initials: M
authors.lastname: Engelhard
authors.affiliation: Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Rob M A
authors.initials: RM
authors.lastname: de Bie
authors.affiliation: Department of Neurosurgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: P Richard
authors.initials: PR
authors.lastname: Schuurman
authors.affiliation: Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands.
authors.forename: Maria F
authors.initials: MF
authors.lastname: Contarino
authors.affiliation: Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands.
authors.forename: Arne
authors.initials: A
authors.lastname: Mosch
authors.affiliation: Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Yasin
authors.initials: Y
authors.lastname: Temel
authors.affiliation: Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Stokroos
keywords: Deep brain stimulation; neuromodulation; survey study; tinnitus