tRNS, The Next Neuromodulation Method

[markoana]

Just bumping this one because I came back from BRAI2N clinic today ... not too impressed to be honest ... didn`t know about trobalt or keppra, didn`t really know about potassium channels, didn`t know about mute button. I did get an EEG done so i`m curious about that one. have quit severe hearing loss from 5000hz going 45 degrees down ...

So now they said they used to do TMS but see much better results with this neuromodulation ... so I will do 8 sessions of this and than continue to do TMS anyway ...

whatever helps ... or not ... keeping myself bussy ...

Nills, have they done qEEG/loreta, or just EEG, from my level of knowledge first one is far away advantage, and can locate exacly place where hiperactive neurons are?
and that statement that neuromodulation has better results than TMS is strange for me :S

 

[nills]

Nills, have they done qEEG/loreta, or just EEG, from my level of knowledge first one is far away advantage, and can locate exacly place where hiperactive neurons are?
and that statement that neuromodulation has better results than TMS is strange for me :S

I asked if it was lorreta, they said yes ... but somewhere I think they didn`t know. I had to wear a hat with electrodes ... remain still for 5 minutes and than the computer registered the activity. I suspect it is around 20-30 pints of contact. not more ... i think lorreta has up to 60 something, no?

I will look for lorreta here in belgium and try that one too ...

it was like this

 

[markoana]

I asked if it was lorreta, they said yes ... but somewhere I think they didn`t know. I had to wear a hat with electrodes ... remain still for 5 minutes and than the computer registered the activity. I suspect it is around 20-30 pints of contact. not more ... i think lorreta has up to 60 something, no?

I will look for lorreta here in belgium and try that one too ...

Yes, Loreta has about 50+ pins as I know... I expected much more from bra2n clinic... Our member @Christian78 had a right saying that they are just technicians... It is obvious that they do not follow new researchs, abt pontassium chanels, new drugs etc.. :S

 

[nills]

it`s actually TDCS of Transcranial Direct Current Stimulation they advice ... repeated sessions ... of course

 

[markoana]

I Hope that EEG (whatever it was Loreta or not) is gonna locate that places of hiperactivity, and that tDCS is gonna help you!

Keep us informed about treatments progress!

btw.

this is diference TMS and tDCS :

 

[preslys]

http://neuralengr.com/wp-content/up...al-Repair-2015-Shekhawat-1545968315595286.pdf

 

[Christian78]

Yes, Loreta has about 50+ pins as I know... I expected much more from bra2n clinic... Our member @Christian78 had a right saying that they are just technicians... It is obvious that they do not follow new researchs, abt pontassium chanels, new drugs etc.. :S

Switzerland dr jeanmonod had 46 pins and it is like more MRI

Belgian is much smaller, not 3D, less centers covered

 

[InfiniteLoop]

For anybody that wants to try tRNS or the other neuromodulation modes at home:
http://www.diytdcs.com/tag/trns/
http://www.foc.us
It is not easy to get the T3, T4 configuration for the electrodes, but one can get an idea of what these methods are about.

 

[Christian78]

it`s actually TDCS of Transcranial Direct Current Stimulation they advice ... repeated sessions ... of course

Nills, I need help from you , as your fellow TT sufferer. I want to ask you a question about bra2n clinic. Is it possible?

I beg you

 

[nills]

I still seem unclear as to how this can work with t. Stimulation of the CNS seems the last thing we need for t. Enough hyperactive electricity going on as it is. Seems the reverse would be needed - calming the CNS.

stimulation doesn`t mean excitement ... stimulation can also induce a lowering of activity ... like a massage can stimulate a region of the body and releasing energy ... it all depends if the electricity rate or pulse is higher or lower than average ...

 

[Mic]

Bumping up this thread because of a trial that has been going on in Regensburg Germany since 2015 with expected results in December 2017: https://clinicaltrials.gov/ct2/show/NCT02615600

Any members on tt that have attended this trial in Germany???
...and if yes... what are your experiences???

 

[Fabrikat]

This is something people may be able to replicate themselves with relatively cheap devices available for purchase online. There are many internet pages devoted to exactly this sort of 'brain hacking', particularly those seeking to enhance cognitive functions, rather than necessarily looking for tinnitus treatments.
Of course, people would have to follow the protocols precisely, lest they succeed in making things worse. I have no doubt the technically minded on TT could find ways to try this out on themselves.

 

[Kekistan]

This is something people may be able to replicate themselves with relatively cheap devices available for purchase online. There are many internet pages devoted to exactly this sort of 'brain hacking', particularly those seeking to enhance cognitive functions, rather than necessarily looking for tinnitus treatments.
Of course, people would have to follow the protocols precisely, lest they succeed in making things worse. I have no doubt the technically minded on TT could find ways to try this out on themselves.

What exactly do you need?

 

[Fabrikat]

@Kekistan, if you check out InfiniteLoop's post a few posts above this one, you'll find a link to a business called foc.us. These folk supply DIY neuro stimulators that you can buy, which will perform various brain stimulation modalities including trns. There are a number of companies selling various types of devices. As I said previously, you need to place the electrodes and follow the protocols precisely to mimic the study. You can also read up on the process on a few sites dedicated to neuro stimulation 'brain hacking'. It's a whole sub-culture of people doing all sorts of experiments on themselves. It quite fascinating actually.

 

[Frédéric]

The efficacy and safety of multiple sessions of multisite transcranial random noise stimulation in treating chronic tinnitus

Abstract
Introduction
Random noise stimulation was reported as the more effective and safer type of electrical stimulation techniques in relieving tinnitus symptoms. The multisite protocol of transcranial random noise stimulation has shown additional favorable effects.

Objective
Here we will discuss the role of applying eight sessions of multisite transcranial random noise stimulation in decreasing tinnitus loudness and annoyance without exerting additional adverse effects.

Methods
Twenty-nine subjects (8 female), the mean age of (45.34 ± 9.57) with chronic tinnitus received transcranial random noise stimulation in the multisite protocol, 10 min of auditory-transcranial random noise stimulation applied over the T3, T4 preceded by 10 min of prefrontal-transcranial random noise stimulation applied over F4, FP1. In the first group, only one session was applied and the multiple-sessions group contained eight repeated sessions. Visual analog scale scores for loudness and distress were recorded before and immediately after the treatment. Multivariate repeated measure ANOVA test was used and minimal detectable change calculated.

Results
There was a statistically and clinically significant reduction in tinnitus loudness and annoyance in both groups (p < 0.05, effect size (η2) > 0.8), while the amount of annoyance suppression in the multiple-sessions group was significantly greater than the single-session group. The patients of the multiple-sessions transcranial random noise stimulation group reported an improvement in their sleep and lower tinnitus handicap inventory scores without experiencing any additional adverse effects of the intervention.

Conclusions
The results of this study showed a substantial improvement in tinnitus symptoms by using the multiple sessions of transcranial random noise stimulation in the multisite protocol without producing any additional side effects. We suggest further clinical trials with long-term follow-up be investigated.

Source: https://www.sciencedirect.com/science/article/pii/S1808869418303598

 

[cicou]

No placebo control group?

 

[Christiaan]

There's an upcoming trial in Switzerland for people with tinnitus. It's a study that's focused on bimodal stimulation (HD-tRNS and acoustic stimulation). Everyone who speaks fluent German can participate in this trial. Perhaps this is of interest to you, @Sevv.

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Transcranial electric and acoustic stimulation for tinnitus: study protocol for a randomized double-blind controlled trial assessing the influence of combined transcranial random noise and acoustic stimulation on tinnitus loudness and distress (Kleinjung et al., 2022)

Abstract
Background
Tinnitus is the result of aberrant neuronal activity. As a novel treatment form, neuromodulation is used to modify neuronal activity of brain areas involved in tinnitus generation. Among the different forms of electric stimulation, transcranial random noise stimulation (tRNS) has been shown to be a promising treatment option for tinnitus. In addition, recent studies indicate that the reduction in tinnitus can be more pronounced when different modalities of stimulation techniques are combined ("bimodal stimulation"). TRNS can be used in combination with acoustic stimulation (AS), a further treatment option recognized in the literature. The aim of the proposed study is to investigate whether simultaneous tRNS and AS improve levels of tinnitus loudness and distress.

Methods
The intervention consists of bilateral high-definition tRNS (HD-tRNS) over the auditory cortex combined with the application of AS which is studied in a crossover design. The visits will be performed in 26 sessions. There will be 20 treatment sessions, divided into two blocks: active and sham HD-tRNS. Within the blocks, the interventions are divided into group A: HD-tRNS and AS, and group B: HD-tRNS alone. Furthermore, in addition to the assessments directly following the intervention sessions, there will be six extra sessions performed subsequently at the end of each block, after a period of some days (follow-ups 1 and 2) and a month after the last intervention (C). Primary outcome measures are analog scales for evaluation of subjective tinnitus loudness and distress, and the audiological measurement of minimum masking level (MML). Secondary outcome measures are brain activity as measured by electroencephalography and standardized questionnaires for evaluating tinnitus distress and severity.

Discussion
To the best of our knowledge, this is the first study which uses HD-tRNS combined with AS for tinnitus treatment. The crossover design permits the comparison between HD-tRNS active vs. sham and with vs. without AS. Thus, it will be possible to evaluate the efficacy of the combined approach to HD-tRNS alone. In addition, the use of different objective and subjective evaluations for tinnitus enable more reliable and valid results.

 

[Arnaudswiss]

There's an upcoming trial in Switzerland for people with tinnitus. It's a study that's focused on bimodal stimulation (HD-tRNS and acoustic stimulation). Everyone who speaks fluent German can participate in this trial. Perhaps this is of interest to you, @Sevv.

--------------------------------------------------------------------------------------------------------
Transcranial electric and acoustic stimulation for tinnitus: study protocol for a randomized double-blind controlled trial assessing the influence of combined transcranial random noise and acoustic stimulation on tinnitus loudness and distress (Kleinjung et al., 2022)

Abstract
Background
Tinnitus is the result of aberrant neuronal activity. As a novel treatment form, neuromodulation is used to modify neuronal activity of brain areas involved in tinnitus generation. Among the different forms of electric stimulation, transcranial random noise stimulation (tRNS) has been shown to be a promising treatment option for tinnitus. In addition, recent studies indicate that the reduction in tinnitus can be more pronounced when different modalities of stimulation techniques are combined ("bimodal stimulation"). TRNS can be used in combination with acoustic stimulation (AS), a further treatment option recognized in the literature. The aim of the proposed study is to investigate whether simultaneous tRNS and AS improve levels of tinnitus loudness and distress.

Methods
The intervention consists of bilateral high-definition tRNS (HD-tRNS) over the auditory cortex combined with the application of AS which is studied in a crossover design. The visits will be performed in 26 sessions. There will be 20 treatment sessions, divided into two blocks: active and sham HD-tRNS. Within the blocks, the interventions are divided into group A: HD-tRNS and AS, and group B: HD-tRNS alone. Furthermore, in addition to the assessments directly following the intervention sessions, there will be six extra sessions performed subsequently at the end of each block, after a period of some days (follow-ups 1 and 2) and a month after the last intervention (C). Primary outcome measures are analog scales for evaluation of subjective tinnitus loudness and distress, and the audiological measurement of minimum masking level (MML). Secondary outcome measures are brain activity as measured by electroencephalography and standardized questionnaires for evaluating tinnitus distress and severity.

Discussion
To the best of our knowledge, this is the first study which uses HD-tRNS combined with AS for tinnitus treatment. The crossover design permits the comparison between HD-tRNS active vs. sham and with vs. without AS. Thus, it will be possible to evaluate the efficacy of the combined approach to HD-tRNS alone. In addition, the use of different objective and subjective evaluations for tinnitus enable more reliable and valid results.

Actually, this study is starting this fall in Zurich, Switzerland, and I'll be part of it.

They don't require you to be fluent in German as long as your English is good enough.

 

[HighFreq]

Actually, this study is starting this fall in Zurich, Switzerland, and I'll be part of it.

They don't require you to be fluent in German as long as your English is good enough.

What was your experience with the treatment?

I also participated in the experiment, and my tinnitus worsened due to the bimodal stimulation. I reported this to the assistant who conducted the treatments, but so far, no one from UZH has shown any concern.

 

[Mathilda]

I also participated in the experiment, and my tinnitus worsened due to the bimodal stimulation. I reported this to the assistant who conducted the treatments, but so far, no one from UZH has shown any concern.

Hello @HighFreq, I'm very sorry to hear about your worsening condition.

I will also be participating in the experiment starting next week, and the assistant mentioned that some participants have reported their tinnitus getting worse.

May I ask—was your worsening temporary, or is it permanent?

 

[HighFreq]

Hello @HighFreq, I'm very sorry to hear about your worsening condition.

I will also be participating in the experiment starting next week, and the assistant mentioned that some participants have reported their tinnitus getting worse.

May I ask—was your worsening temporary, or is it permanent?

Hi Mathilda,

Before participating in the experiment, my tinnitus was gradually improving, and I even experienced 2-3 days without any symptoms at times. However, since participating, those "breaks" have unfortunately disappeared. I am hopeful that it will improve again, but at the moment, I can't say whether this worsening is temporary or permanent.

I wanted to let you know that German tinnitus researchers advise against using or participating in studies involving bimodal neuromodulation. An example mentioned in this online article is Lenire:

At least 52 of the 326 study participants reported a worsening of their tinnitus, with 7 of them experiencing what the study described as a 'dramatic' aggravation. Apparently, the use of Lenire is not entirely risk-free.

→ Zweifel an Lenire: Tinnitus-Experten warnen vor Therapie (tinnitusheilen.de)

In my opinion, the researchers at UZH are not fully aware of what they are doing. As a recommendation, I would advise being very cautious. The main issue is that they design studies without involving tinnitus sufferers beforehand. I reported my problems four weeks ago, and no one has addressed them.

 

[Mathilda]

Hi Mathilda,

Before participating in the experiment, my tinnitus was gradually improving, and I even experienced 2-3 days without any symptoms at times. However, since participating, those "breaks" have unfortunately disappeared. I am hopeful that it will improve again, but at the moment, I can't say whether this worsening is temporary or permanent.

I wanted to let you know that German tinnitus researchers advise against using or participating in studies involving bimodal neuromodulation. An example mentioned in this online article is Lenire:

→ Zweifel an Lenire: Tinnitus-Experten warnen vor Therapie (tinnitusheilen.de)

In my opinion, the researchers at UZH are not fully aware of what they are doing. As a recommendation, I would advise being very cautious. The main issue is that they design studies without involving tinnitus sufferers beforehand. I reported my problems four weeks ago, and no one has addressed them.

Thank you for your response—I truly appreciate it!

I'm very sorry to hear about your bad experience. I can only imagine how frustrating it must be to participate in an experiment and then not be taken seriously afterward. I hope you receive some feedback soon, and I also wish you some quieter days ahead!

You are right; one needs to be cautious. When I spoke to the woman in charge, she mentioned that they suspect the worsening of symptoms to be temporary. Apparently, there are cases with migraine patients where their condition worsens before it improves, and they believe this might be the same with the treatment being tested.

I will definitely speak with them again before the treatment begins and ask more questions. I might decide not to participate after all.

 

[Nick47]

Have you considered that you might have received the sham treatment, and they can't get back to you until the actual treatment is completed?

 

[2noist]

What was your experience with the treatment?

I also participated in the experiment, and my tinnitus worsened due to the bimodal stimulation. I reported this to the assistant who conducted the treatments, but so far, no one from UZH has shown any concern.

Hello @HighFreq, I'm very sorry to hear about your worsening condition.

I will also be participating in the experiment starting next week, and the assistant mentioned that some participants have reported their tinnitus getting worse.

May I ask—was your worsening temporary, or is it permanent?

I'll be curious to read both of your progress reports.

@Mathilda, did the assistant mention how many are feeling better after the treatment?

 

[Mathilda]

@Mathilda, did the assistant mention how many are feeling better after the treatment?

She only mentioned that six patients had participated; some of them got better, some worse.

 

[HighFreq]

Have you considered that you might have received the sham treatment, and they can't get back to you until the actual treatment is completed?

They plan the sessions individually for each participant. In my case, the sessions are already over. Whether you receive treatment or not, and even if you feel worse, there should be support available from the principal investigator.

Thank you for your response—I truly appreciate it!

I'm very sorry to hear about your bad experience. I can only imagine how frustrating it must be to participate in an experiment and then not be taken seriously afterward. I hope you receive some feedback soon, and I also wish you some quieter days ahead!

You are right; one needs to be cautious. When I spoke to the woman in charge, she mentioned that they suspect the worsening of symptoms to be temporary. Apparently, there are cases with migraine patients where their condition worsens before it improves, and they believe this might be the same with the treatment being tested.

I will definitely speak with them again before the treatment begins and ask more questions. I might decide not to participate after all.

Thank you so much! I am very confident that my tinnitus will improve again. For me, a combination of white noise and CR neuromodulation works quite well to help me forget about the tinnitus.

Participating in a trial always carries some risk, especially when you don't know the outcome in advance. When I first spoke to the professor, he mentioned that there was a small chance the tinnitus could temporarily worsen. I understand they can't help me at the moment, but at the very least, someone should reach out, call, and talk to you.

Please let us know how it goes for you. I hope you benefit from the treatment!

 

[Mathilda]

They plan the sessions individually for each participant. In my case, the sessions are already over. Whether you receive treatment or not, and even if you feel worse, there should be support available from the principal investigator.

Thank you so much! I am very confident that my tinnitus will improve again. For me, a combination of white noise and CR neuromodulation works quite well to help me forget about the tinnitus.

Participating in a trial always carries some risk, especially when you don't know the outcome in advance. When I first spoke to the professor, he mentioned that there was a small chance the tinnitus could temporarily worsen. I understand they can't help me at the moment, but at the very least, someone should reach out, call, and talk to you.

Please let us know how it goes for you. I hope you benefit from the treatment!

Hello @HighFreq,

I'm glad to hear that you're confident your tinnitus will improve again. Wishing you all the best in your recovery!

It's disappointing that you didn't receive any feedback and that the professor didn't get back to you—definitely not very professional.

I'm a bit confused about your reliance on CR neuromodulation, as it's not a scientifically proven treatment, at least as far as I know.

I'll keep you updated here on how things go with my treatment (or if I decide not to participate in the end).

 

[HighFreq]

Hello @HighFreq,

I'm glad to hear that you're confident your tinnitus will improve again. Wishing you all the best in your recovery!

It's disappointing that you didn't receive any feedback and that the professor didn't get back to you—definitely not very professional.

I'm a bit confused about your reliance on CR neuromodulation, as it's not a scientifically proven treatment, at least as far as I know.

I'll keep you updated here on how things go with my treatment (or if I decide not to participate in the end).

You are correct; there is no systematic empirical evidence demonstrating the positive effect of CR neuromodulation on improving tinnitus. However, in my experience, listening to white noise and CR neuromodulation sounds simultaneously helps me forget about my tinnitus. I use a very low volume, keeping it below the sound level of the tinnitus itself.

I look forward to receiving an update from you.

 

[Arnaudswiss]

Thank you for your response—I truly appreciate it!

I'm very sorry to hear about your bad experience. I can only imagine how frustrating it must be to participate in an experiment and then not be taken seriously afterward. I hope you receive some feedback soon, and I also wish you some quieter days ahead!

You are right; one needs to be cautious. When I spoke to the woman in charge, she mentioned that they suspect the worsening of symptoms to be temporary. Apparently, there are cases with migraine patients where their condition worsens before it improves, and they believe this might be the same with the treatment being tested.

I will definitely speak with them again before the treatment begins and ask more questions. I might decide not to participate after all.

Hello Mathilda!

I'm supposed to start the sessions by October 21st. When will you start, and what have you decided?

What was your experience with the treatment?

I also participated in the experiment, and my tinnitus worsened due to the bimodal stimulation. I reported this to the assistant who conducted the treatments, but so far, no one from UZH has shown any concern.

Hi! I haven't started yet; I'm supposed to begin by October 21st. I feel very concerned reading your messages. How are you feeling now? Has your condition improved?

Thanks for letting me know.

 

[Mathilda]

Hello Mathilda!

I'm supposed to start the sessions by October 21st. When will you start, and what have you decided?

Hi! I haven't started yet; I'm supposed to begin by October 21st. I feel very concerned reading your messages. How are you feeling now? Has your condition improved?

Thanks for letting me know.

Hello Arnaud,

Thanks for your reply.

I'm going to start next week. I've decided to give it a try. If I no longer feel comfortable, I will stop participating.