Effect of transcranial Direct Current Stimulation for tinnitus treatment: A systematic review and meta-analysis - 11/01/22

Doi : 10.1016/j.neucli.2021.12.005

Mariana Lopes Martins ^a,^⁎ , Dayse da Silva Souza ^b, Maria Eduarda de Oliveira Barbosa Cavalcante ^a, Hionara Nascimento Barboza ^a, Jessica Figueiredo de Medeiros ^a, Suellen Mary Marinho dos Santos Andrade ^c, Daniel Gomes da Silva Machado ^d,^{^{1
Both authors contributed equally to the present work.}}, Marine Raquel Diniz da Rosa ^a,^{^{1
Both authors contributed equally to the present work.}}
^a Department of Speech-Language Pathology, Federal University of Paraiba, João Pessoa, PB 58051-900, Brazil
^b Department of Neuroscience and Cognition, Federal University of ABC, São Paulo, SP 09606-070, Brazil
^c Department of Physiotherapy, Federal University of Paraiba, João Pessoa, PB 58051-900, Brazil
^d Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN 59056000, Brazil

^⁎Corresponding author at: Departamento de Fonoaudiologia, UFPB, Cidade Universitária, 58051-900 João Pessoa, PB, Brazil.Departamento de Fonoaudiologia, UFPB, Cidade UniversitáriaJoão PessoaPB58051-900Brazil

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Abstract

Objectives

To evaluate the effect of tDCS on tinnitus distress, loudness and psychiatric symptoms.

Methods

A systematic literature search of PubMed, Web of Science, Cochrane Library, VHL, EMBASE, PsycINFO, OVID, and CINAHL databases was carried out on articles published until July 2021. Inclusion criteria were published controlled trials using tDCS intervention with tinnitus patients, using a sham/control group, and measuring tinnitus loudness, distress and/or psychiatric symptoms. A meta-analysis was performed for the overall effect as well as to compare subgroups according to tDCS target (left temporoparietal area (LTA) and dorsolateral prefrontal cortex (DLPFC)).

Results

Fourteen articles with 1031 participants were included. Six studies applied tDCS over the DLPFC, six over the LTA and two over both areas. Although the overall meta-analysis showed that tDCS significantly decreased tinnitus loudness (SMD=-0.35; 95%CI=-0.62 to -0.08, p = 0.01) and distress (SMD=-0.50, 95%CI=-0.91 to -0.10, p = 0.02).The subgroup analysis showed a significant effect only for tDCS over LTA for loudness (SMD=-0.46, 95%CI=-0.80 to -0.12, p = 0.009), and no other area resulted in significant change. There was no significant effect of treatment on psychiatric symptoms.

Conclusion

tDCS may improve tinnitus loudness and distress with a small to moderate effect size. Despite the overall positive effect, only LTA tDCS yielded a significant effect. Further well-controlled studies with larger sample sizes and broader exploration of tDCS montages and doses are warranted.

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Keywords : Electric stimulation, Hearing disorders, Neuromodulation, tDCS, Tinnitus, Transcranial direct current stimulation