Classical neuromodulation consists of applying electrical or magnetic stimuli to the nervous system to modulate ongoing activity and connectivity. However, recently, an exciting novel neuromodulation technique was developed in which stimulation of the vagal nerve was paired with simultaneous presentation of tones, demonstrating that it reverses a tinnitus
percept in noise-exposed rats.
To determine whether this therapy could also be effective in humans, we delivered a similar therapy in a patient with chronic tinnitus
unresponsive to previous therapies. In this report, we describe the case of a 59-year-old man who suffered from bilateral tinnitus
for 14 years that arose after a cervical fusion operation. Pharmacotherapy, transcranial magnetic stimulation, transcranial direct current stimulation, neurofeedback, and bilateral auditory cortex stimulation via implanted electrodes did not improve the tinnitus
. After implanting the vagal nerve stimulator, the patient received daily vagus nerve stimulation
tone pairings for 4 weeks in a non–placebo-controlled way.
At the end of therapy, the patient experienced a significant reduction in tinnitus
symptoms that lasted for 2 months after treatment. Tinnitus
Handicap Inventory and Tinnitus
Reaction Questionnaire were reduced by 48% and 68%, respectively. Symptoms of depression were also improved by 40%, as quantified by the Beck Depression Inventory. Three months after ending therapy, placebo stimulation was performed consisting of only tone presentation without the simultaneous electrical stimuli. This resulted in further continuation of the gradual relapse to the baseline state, without renewed improvement.
Our results suggest that vagus nerve stimulation
paired with tones could become an effective therapy for the treatment of tinnitus