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Real-time fMRI feedback training may improve chronic tinnitus

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Abstract

Objectives

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.

Methods

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.

Results

Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants.

Conclusion

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.

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Abbreviations

BOLD:

blood oxygenation level dependent

DLPFC:

dorso-lateral prefrontal cortex

EEG:

electroencephalography

EPI:

echoplanar imaging

fMRI:

functional magnetic resonance imaging

rtfMRI:

real-time functional magnetic resonance imaging

rTMS:

repetitive transcranial magnetic stimulation

VLPFC:

ventro-lateral prefrontal cortex

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Acknowledgements

We thank all subjects for participation in the study.

Conflict of interest

No conflicts of interest.

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Authors and Affiliations

  1. Institute of Radiology, Department of Neuroradiology, University Hospital Basel, Petersgraben 4, CH 4031, Basel, Switzerland

    Sven Haller & Sven Haller

  2. Institute of Neuroradiology, Department of Imaging and Medical Informatics, Geneva University Hospital, Geneva, Switzerland

    Sven Haller

  3. Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany

    Niels Birbaumer & Ralf Veit

  4. Ospedale San Camillo, Instituto di Ricovero e Cura a Carattere Scientifico, Venezia, Italy

    Niels Birbaumer

Authors
  1. Sven Haller
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  2. Niels Birbaumer
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  3. Ralf Veit
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Correspondence to Sven Haller.

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Haller, S., Birbaumer, N. & Veit, R. Real-time fMRI feedback training may improve chronic tinnitus. Eur Radiol 20, 696–703 (2010). https://doi.org/10.1007/s00330-009-1595-z

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  • DOI: https://doi.org/10.1007/s00330-009-1595-z

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