Pilot Study of Deep Brain Stimulation (DBS) in Area LC for Chronic Tinnitus

[kelpiemsp]

Looks like we may be moving towards the possibility of tinnitus surgery? The preliminary findings showed reduction in actual tinnitus loudness for individuals with chronic tinnitus and a THI over 50.

Preliminary results: https://www.ncbi.nlm.nih.gov/pubmed/30738400
Acute tinnitus loudness reduction was observed at 5 caudate locations, 4 positioned at the body and 1 at the head of the caudate nucleus in normalized Montreal Neurological Institute space.

Pilot Study of Deep Brain Stimulation (DBS) in Area LC for Chronic Tinnitus
https://clinicaltrials.ucsf.edu/trial/NCT01988688
SUMMARY
This study will test the safety and effectiveness of deep brain stimulation (DBS) for patients with a big or very big problem with tinnitus (a sensation of noise in the head).

OFFICIAL TITLE
Pilot Study of Deep Brain Stimulation (DBS)in Area LC for Chronic Tinnitus

DETAILS
This is a single institution, open-label, phase I clinical trial to estimate the treatment effect size and to assess preliminary safety and tolerability of DBS in the caudate nucleus (area LC) in adults with a big or very big problem (tinnitus functional index TFI>50) with chronic tinnitus. Up to 10 subjects will be implanted. The DBS stimulation parameters are patient-specific and will be allowed to vary over the course of the treatment periods, calibrated by the TFI. During Period I, stimulation will be continuous. During Period II, there will be three stimulation OFF/ON epochs, where the stimulation will be turned OFF and then turned back ON when the tinnitus loudness returns to a certain level (based on a change in the TFI score). During Period III, stimulation will be "on demand," i.e. controlled by the subject and determined by subject preference. An important goal is to determine whether tinnitus can be controlled through optimization of stimulation parameters.

 

[EDDTEKK]

The study is performed by the guys who did the trials with the Parkinson's patients who had tinnitus and reported suppression after some stimulation at specific brain areas.

If possible I would take part but unfortunately I am not from US

However I also read that some deep brain stimulation might loose it effectiveness as experienced already in some patients before.
The tinnitus suppression lasted only some weeks, then the evil returned... I hope this time they will knock it down permanently!

 

[spedgas]

For the last 17 years I have worked with a surgeon that does DBS for Parkinson's. I've seen his methods and efficacy improve dramatically. He has acknowledged that there are patients of his that also get tinnitus relief from the Parkinson's surgery. He wrote a paper almost 10 years ago that had the results of a very small study looking at this. His paper is referenced in many of the more current papers that have been published. I don't think this is a current area of interest for him. I may have to pick his brain a little.

I can see this study as being important for us to learn about what areas of the brain need to be stimulated for tinnitus relief. The trick will be finding a successful way to stimulate those areas without being as invasive as the current treatment for Parkinson's is.

 

[Frédéric]

Just to give the link :
https://www.tinnitustalk.com/thread...ion-dbs-in-area-lc-for-chronic-tinnitus.4970/

 

[Fightthearmy]

The study is performed by the guys who did the trials with the Parkinson's patients who had tinnitus and reported suppression after some stimulation at specific brain areas

So let's assume I fake Parkinson's disease or some other malady where DBS is an already-approved treatment, I can get treated with deep brain stimulation TODAY, instead of having to wait years/decades for the DBS trials for tinnitus to finish?

(I realize nobody can "fake" Parkinson's, but hopefully my point is taken.)

 

[Roadglide]

I was in this study.

 

[Daniel Lion]

I was in this study.

And? Can you tell us about your experience. Please. Thanks

 

[linearb]

I was in this study.

what is your experience?

 

[Roadglide]

It didn't stop the noise in my head totally it stops the reaction to the noise. It definitely has changed my life for the better .I went from not wanting to live back to living a normal life.

 

[Daniel Lion]

It didn't stop the noise in my head totally it stops the reaction to the noise. It definitely has changed my life for the better .I went from not wanting to live back to living a normal life.

That's an amazing result.

How did it stop the reaction to the noise... that's what benzos do. They don't affect the noise but the reaction.

Was the surgery invasive?

 

[Mentos]

It didn't stop the noise in my head totally it stops the reaction to the noise. It definitely has changed my life for the better .I went from not wanting to live back to living a normal life.

Besides your reaction to noise, did it also change the noise i self and made it less intrusive? Or is it only your reaction to noise that improved?

 

[linearb]

it's worth noting that a bunch of people are working on ways of doing deep brain stim using noninvasive techniques. Like, rTMS is brain stim, but they can only hit surface areas -- that seems likely to change in the near future. So there's a possibility for convergence here, where what we learn from this study enables non-invasive stim of specific targeted areas.

I could have been in this study, and hemmed and hawed, but ultimately at that point I decided I was not ready to have someone cut into my brain in an experimental fashion. Much love and respect for @Roadglide and the other test pilots, and reading your summary gives me a pang of regret. Of course, it's possible that I could have done it and seen no benefit and/or been maimed, as these things go.

The simple fact that it was neurologically possible to eliminate your reaction without eliminating the sound, ought to be an interesting data point in the "severity of sound vs severity of reaction" argument we love to have on here constantly

 

[Roadglide]

The brain surgery is invasive a metal frame is attached to your head,your scalp is cut and separated two holes or drilled into your skull.The frame is attached to your head and dye injected into your arm is for a scan to get trajectory to miss the arteries in your brain.Your frame is attached to the operating table leads or inserted into your brain the surgeons listen to your brain in the area were the noise is the strongest it makes a static type noise.If you had no tinnitus it would be quiet in that area.Then they stimulate they area to see if they can modulate the noise in your head make it louder or softer.Then the leads or permanently placed in your brain.The wires or run under your scalp connected to a larger wire connected to your stimulator in your upper chest.This is all done while you or awake except for running wires threw your neck to your chest to the stimulator.I was in surgery eight hours they collected a lot of data.Spent one night in ICU moved to a room next day and was released.Your face and around your eyes swell a little from the antibiotics they put in brain cavity run down between your face and bone structure.The modulator is turned on several weeks after surgery then you start trying different settings frequencies and voltage for optime setting.Keep in mine this was to show the safety of the procedure as a treatment.I would think there would at some point a part two to this study if all is well with info collected.I don't think study results have been published yet.I don't know if any other subjects had total reduction of tinnitus. Hopefully they can fine tune target areas and have a treatment for tinnitus.I would do it all over again if necessary.

 

[Jim51042]

@Roadglide

I'm assuming you get to keep the wires attached after the study is complete or do they require that the hardware be remove?

 

[Roadglide]

No you can remove hardware if you want. But I benefit from mine so I kept mine in.