Early data on stimulation of Heschl’s gyrus are promising, but more research is needed
Explore this issue:May 2006
Direct electrical stimulation of the auditory cortex to relieve symptoms of severe tinnitus has been successfully demonstrated in two patients by Michael Seidman, MD, Director, of Otologic/Neurotologic Surgery in the Department of Otolaryngology-Head and Neck Surgery at the Henry Ford Health System in West Bloomfield, Mich.
Currently there is no cure for tinnitus, which affects nearly 50 million Americans. Of these, about 3% to 4% are severely debilitated, with none of the conventional and alternative types of therapy able to relieve the aberrant noise and sounds characteristic of the condition.
For those patients who have failed conventional management, Dr. Seidman believes that electrical stimulation of the auditory cortex could potentially be an option to treat intractable tinnitus.
In his procedure, two patients, a 50-year-old male and a 40-year-old female with debilitating tinnitus refractory to conventional therapies, were evaluated with validated questionnaires, psychoacoustic measures, magnetoencephalography (MEG), and functional magnetic resonance imaging (fMRI). The male’s hyperexcitable area of Heschl’s gyrus was implanted with a pisces quadripolar electrode; the female was implanted with a four contact electrode. Following the procedures, the male experienced near elimination of tinnitus while the female patient noted a 30% to 35% improvement.
Dr. Seidman presented his findings formally at the 2005 Combined Otolaryngological Spring Meeting in Boca Raton, Fla., and informally with updates at the April International Otology-Audiology Spring Conference in Shanghai, China, and the September International Tinnitus Forum Meeting in Los Angeles, Calif.
The auditory cortex may not be the only site for electrical stimulation.
Reaction from the Field
Following the Los Angeles program, well-known tinnitus researcher Abraham Shulman, MD, Professor Emeritus at SUNY-Downstate in Brooklyn, NY, and Director of Otology and Neurotology at the Martha Entenmann Tinnitus Research Center in Forest Hills, NY, noted in an editorial that notwithstanding that the study was limited to two single cases, the report was exciting.
In an interview with ENToday, Dr. Shulman said Dr. Seidman is to be congratulated for his effort and that the procedure was a significant step forward, but it is premature at this time to think of this as a treatment for tinnitus. The procedure is an ongoing research project. Its significance for tinnitus relief will be determined by the long-term clinical course of the tinnitus, as reported by patients following the procedure.
He also indicated that for success of the procedure in achieving tinnitus relief, patient selection will be critical and the reported tinnitus relief will most likely be individual and variable.