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Treatment of tinnitus with gabapentin: a pilot study. Otol Neurotol. 2007 Jan;28(1):11-5. Witsell DL, Hannley MT, Stinnet S, Tucci DL Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, Durham, North Carolina, USA. witse001@mc.duke.edu

Objective: To evaluate the effectiveness of gabapentin (Neurontin) improve the disease-specific quality of life in patients with moderate tinnitus. Study design: Randomized, double blind, placebo-controlled clinical trial. Setting: Single-center academic outpatient otolaryngology practice. Intervetnion: Gabapentin 1800 mg daily versus placebo. Main outcome messures: The study design is a randomized, double blind placebo controlled single site trial conducted in an academic medical center. Inclusion criteria included patients between ages 18 and 70 with a complaint of nonpulsatile, subjective tinnitus, bilateral or unilateral, greater than 3 months in duration. The primary outcome measure is the Tinnitus Handicap Inventory; secondary measures include the Profile of Mood States (POMS) rating scale, subjective tinnitus severity. The null hypothesis addressed in this study is that the drug would not result in significant alleviation of the symptom of tinni- tus. Results: Seventy-six patients completed the trial; of these 52 received the drug. No significant diffe- rences were found between the two groups after 5 weeks of treatment with gabapentin. Conclusion: There is insufficient evidence to support the effectiveness of gabapentin in the treatment of tinnitus.

II Auditive stimulation

Cerebral activity in response to a masking sound in patients with intractable tinnitus. (Abstract of ARO Meeting Denver, Colorado) Mikio Suzuki1, Hideaki Kouzaki2, Minao Tamaki1, Ken Uehara1 1University of the Ryukyus, 2Shiga University of Medical Science

Functional magnetic resonance imaging was performed in twelve patients with intractable tinnitus and normal subjects to determine the tinnitus-related regions where cerebral activity showed a positive or negative correlation to monaural masking noise stimulus. A blood oxygenation level-dependent (BOLD) signal increase was observed in the exclusive contralateral auditory cortex. There was no significant difference of the BOLD signal increase between normal subjects and patients in the conjunction analysis using random effect model. Cerebral regions that showed a BOLD signal decrease in normal subjects were the cuneus, cingulate gyrus, and paracentral lobule. In the patients group, the cerebral regions that showed a BOLD signal decrease were the postcentral gyrus, bilateral thalamus, and bilateral lingual gy- rus. A conjunction analysis using random effect model was performed to compare the decrease in BOLD signals between the tinnitus patients and controls, and revealed that the only significant difference in BOLD decrement was in the bilateral thalamus. Although the relationship between tinnitus and thalamic activity is not fully understood, such thalamic activity is consistent with the findings about other peripheral neural injuries.

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