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外2015 IF 4.36 重复经颅磁刺激可改善突发性感音神经性聋患者的听力功能和耳鸣知觉 CCY-I Dai Zhang & Yuewen Ma
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1 Scientific RepoRts | 5:14796 | DOi: 10.1038/srep14796 www.nature.com/scientificreports Repetitive transcranial magnetic stimulation improves both hearing function and tinnitus perception in sudden sensorineural hearing loss patients Dai Zhang & Yuewen Ma The occurrence of sudden sensorineural hearing loss (SSHL) affects not only cochlear activity but also neural activity in the central auditory system. Repetitive transcranial magnetic stimulation (rTMS) above the auditory cortex has been reported to improve auditory processing and to reduce the perception of tinnitus, which results from network dysfunction involving both auditory and non- auditory brain regions. SSHL patients who were refractory to standard corticosteroid therapy (SCT) and hyperbaric oxygen (HBO) therapy received 20 sessions of 1 Hz rTMS to the temporoparietal junction ipsilateral to the symptomatic ear (rTMS group). RTMS therapy administered in addition to SCT and HBO therapy resulted in significantly greater recovery of hearing function and improvement of tinnitus perception compared SCT and HBO therapy without rTMS therapy. Additionally, the single photon emission computed tomography (SPECT) measurements obtained in a subgroup of patients suggested that the rTMS therapy could have alleviated the decrease in regional cerebral brain flow (rCBF) in SSHL patients. RTMS appears to be an effective, practical, and safe treatment strategy for SSHL. Sudden sensorineural hearing loss (SSHL) is typically defined as > 30 dB sensorineural hearing loss at 3 contiguous frequencies within an interval of < 3 days. SSHL affects from 5 to 160 cases per 100,000 people per year1,2. Approximately 50% of SSHL cases may spontaneously recover3. The causes of most cases of SSHL cannot be identified and are considered to be idiopathic. The most common hypotheses regarding the causes of idiopathic SSHL (ISSHL) are circulatory disturbance to the end artery of the cochlea and viral infection. Based on these hypotheses, corticosteroids are provided as an initial therapy for ISSHL, and hyperbaric oxygen (HBO) therapy is implemented as an adjunctive treatment for ISSHL1. However, a recent meta-analysis of various medical treatments, including corticosteroids, showed that medical therapy produced a slight but not statistically significant improvement in audiograms compared with placebo4. Additionally, a recent randomized triple-blind placebo-controlled clinical trial demon- strated that corticosteroids administered at a customary dosage did not influence hearing recovery5. Therefore, new strategies to treat ISSHL are needed. Recently, strategies to treat ISSHL have been proposed that are based on the reorganization of the auditory cortex after the occurrence of ISSHL6. In ISSHL patients, magnetoencephalography (MEG)7,8 and functional magnetic resonance imaging (fMRI)9 studies demonstrated that reorganization of the auditory cortex developed within a few days after the onset of hearing loss. This reorganization is a relatively rapid plastic event that begins within hours after cochlear trauma in an animal model10. These Department of Rehabilitation Medicine, The First Affiliated Hospital, China Medical University, Shenyang, China. Correspondence and requests for materials should be addressed to Y.M. (email: yuewen_m@126.com) received: 23 September 2014 accepted: 09 September 2015 Published: 14 October 2015 OPEN

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