Multitarget surgical neuromodulation: Combined C2 and auditory cortex implantation for tinnitus.
Level 4 - case-series / case-control
Single case report describing combined auditory cortex and C2 electrode implantation
PubMed 25703225 · doi:10.1016/j.neulet.2015.02.034
What was done
A case report was conducted on a single patient with medically intractable tinnitus presenting as both a pure-tone and a noise-like phantom sound. The patient first received an intracranial electrode implant over the auditory cortex (tested with tonic and burst stimulation). Following a positive response to transcutaneous electrical nerve stimulation for the remaining noise-like component, a subcutaneous wire electrode was implanted at C2 and connected to the internal pulse generator to deliver dual-target stimulation.
What was found
Auditory cortex implantation alone achieved complete resolution of the pure-tone tinnitus but had no effect on the noise-like tinnitus. Adding C2 subcutaneous stimulation reduced the noise-like component by 50%, improving from 8/10 to 4/10 on an intensity scale. At 5 years of dual stimulation, the pure-tone component remained completely abolished and the noise-like component remained reduced at 4/10.
Why it matters
This report provides proof-of-concept that targeting distinct anatomical pathways simultaneously may help manage complex tinnitus presentations that fail to respond to single-site neuromodulation.
Limits
The study is limited to a single patient (n=1) with no control condition, blinding, or sham stimulation to rule out placebo effects. Findings cannot be generalized to other patients with intractable tinnitus without prospective controlled trials.
Cited by
- supports Electrical stimulation of the auditory cortex is used as an intervention to disrupt or suppress certain forms of central tinnitus.