Real-time fMRI feedback training may improve chronic tinnitus
- 1.3k Downloads
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.
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.
Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants.
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.
KeywordsfMRI BOLD Biofeedback Tinnitus Neurofeedback
blood oxygenation level dependent
dorso-lateral prefrontal cortex
functional magnetic resonance imaging
real-time functional magnetic resonance imaging
repetitive transcranial magnetic stimulation
ventro-lateral prefrontal cortex
We thank all subjects for participation in the study.
Conflict of interest
No conflicts of interest.
- 7.Rossi S, De Capua A, Ulivelli M et al (2007) Effects of repetitive transcranial magnetic stimulation on chronic tinnitus. A randomised, cross over, double blind, placebo-controlled study. J Neurol, Neurosurg PsychiatryGoogle Scholar
- 9.Miller NE (1975) Clinical applications of biofeedback: Voluntary control of heart rate, rhythm, and blood pressure. In: Russel HI (ed) New horizons in cardiovascular practice. University Park Press, Baltimore, pp 239–249Google Scholar
- 10.Kubler A, Kotchoubey B, Hinterberger T et al (1999) The thought translation device: a neurophysiological approach to communication in total motor paralysis. Exp Brain Res 2:223–232Google Scholar
- 18.Goebel G, Hiller W (1994) [The tinnitus questionnaire. A standard instrument for grading the degree of tinnitus. Results of a multicenter study with the tinnitus questionnaire]. HNO 3:166–172Google Scholar
- 28.Sitaram R, Caria A, Veit R et al (2007) FMRI brain-computer interface: a tool for neuroscientific research and treatment. Comput Intell Neurosci 25487Google Scholar
- 30.Dohrmann K, Weisz N, Schlee W et al (2007) Neurofeedback for treating tinnitus. Prog Brain Res 473–485Google Scholar