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rTMS - Enhanced synchronization


Cause of tinnitus and plasticity model: Enhanced synchronization of the auditory cortex neurons

 

One of the tinnitus models a patient is exposed to experience after 2-3 years of living with tinnitus is enhanced synchronization of neurons in the auditory cortex. If the nervous system within 2-3 years after sudden hearing loss doesn’t receive a proper stimulation from the auditory cells, it starts to look for another way to sustain the stimulation. In such a case, the structure of fibers between an auditory cell and neurons weakens. However, neurons from this range of the auditory cortex aren’t deprived and, despite lack of stimulation from the range with hearing loss, they’re trying to find an access to stimulation in frequencies free of hearing loss. A great population of neurons lacking proper stimulation, connects with a range of properly working cells. A big population of neurons is created and disposed to the same frequencies. Despite being connected to an audible range, neurons which lack a proper stimulation, can increase their due to activity disproportions in a stimulation level. When a stimulation is insufficiently high and unable to handle its role, all of the neurons additionally connected to a healthy auditory range start to increase their activity. As a consequence, a patient begins to hear either hiss or shriek.

 

Typical symptoms: Auditory Hypersensitivity

Type of tinnitus: Tinnitus has changed its tone from hiss to high-pitched shriek, or the other way around

Reduction technology

  • 76%

    Patients with reduce tinnitus in TQ score with 8.5-8.3 point's equal or higher
  • 24%

    Patients with reduce tinnitus in TQ score with 8.5-8.3 point's below

Effectiveness of rTMS stimulation in  reduction of  tinnitus  enhanced synchronization model in clinical research :

Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus (Chung H.-K.· Tsai C.-H. Lin Y.-C. Chen J.-M.· Tsou Y.-A. Wang C.-Y.· Lin C.-D. · Jeng F.-C.· Chung J.-G. Tsai M.-H.)

 

 

Tinnitus Reduction TQ score

10 points - Tinnitus reduction in 100 %

9 points - TInnitus reduction in 90 %

8 points - Tinnitus reduction in 80 %

7 points - Tinnitus reduction in 70 %

6 points - TInnitus reduction in 60 %

Transcranial stimulation was known back in the 1980’s as a device used for brain activity measurements. The device remains widely used in treating a variety of disorders, such as depression, schizophrenia, ADHD, dyslexia and tinnitus. First examinations using this technology weren’t sufficiently effective due to a lack of proper selection of this technologyin relation to the enhanced synchronization of neurons in the auditory cortex we are familiar with now. Preliminary results of first research studies by (Efectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus Chung H.K, Tsai C.H, Lin Y.C, Chen J.M) showed, if diagnostics is appropriate and we use rTMS transcranial stimulation, we can achieve highly satisfying results in tinnitus reduction.  

 

rTMS  tinnitus treatment  catalog  

 

 

 

 

Why transcranial magnetic stimulation (TMS) isn’t used in Poland?

The reason for not using this particular technology for depression treatment in Poland remains unknown. In fact, many overseas clinics use it on a daily basis and its effectiveness is supported by numerous research studies. The rTMS technology needs to be equipped with an additional device called Neuronavigation, and both of them are relatively expensive. Such devices require qualified audiologists or psychiatrists, when it comes to depression treatment, in order to make full use of them. Except rTMS and Neuronavigation, we must have a broad knowledge of neurobiology (basic information about brain anatomy, type of neurons and brain connectivity). It doesn’t make a decision of using those devices any easier. Both of them are characterized by unlimited therapeutic and diagnostic possibilities; however, an effectiveness of rTMS depends upon the main therapist’s qualifications. In most cases, they turn out to be insufficient to perform the stimulation in a responsible and effective manner.

Is rTMS stimulation device safe?

Alongside research studies, safety report of using rTMS technology is found in libraries. In comparison with magnetic resonance imaging (MRI), rTMS stimulation is ten times less, thus, is considered safe.

Does this device generate loud sound during therapy?

Of course, it does. However, the level of loudness is acceptable and it complies with CE requirements. During the stimulation process, a patient wears rubber stoppers and the device itself is placed in a soundproof room. Thus, the sound perception is really convenient under such conditions, namely at normal conversation level of 60-70 dB.

Can rTMS stimulation be used in depression treatment before the beginning of a tinnitus therapy?

Of course, it can. Please note that rTMS stimulation is used only in extreme depression cases when the BDNF protein level is remarkably low, to the extent it’s impossible to function normally, keep a healthy diet or do physical exercises. In such cases it helps to increase BDNF-NT 3 neurotrophic factors. We regard this as a last resort action, and the whole process is supervised by a qualified psychiatrist.

Can we use different technology you provide instead of rTMS stimulation to reduce tinnitus generated in the same way?

Yes, you could use Synaptic Adaptation Arc Therapy instead. A disadvantage concerning this option is the fact that a therapy process will last longer due to spontaneous activity. In the first months, acoustic stimulation will be responsible for making auditory cells active to rebuild connections between a cell and neuron. Then, it becomes possible to activate adaptation program to reduce tinnitus. Such therapy may last from 12 to 16 months. In order to influence this structure in an effective way, we need a cell-neuron path rebuilt.

Do we know of any cases in which rTMS didn’t help?

Of course, we do, but it depends on how we understand lack of help. Well-selected technology with a specialist’s guidance, keeping a balanced diet and exercising physically always brings effects. Thus, if we consider 60% tinnitus reduction as a failure, we can say there are cases in which rTMS didn’t help. We haven’t had a patient whose tinnitus wouldn’t be reduced at all. To which extent we were able to help and succeed, lies with a patient and a professional therapist.

Reduction technology of tinnitus caused by enhanced synchronization

After you were diagnosed with enhanced synchronization tinnitus model (either clinically or online), you need to contact our audiologist and dietician in order to receive useful clues about your diet and physical activity. Having completed a preparatory period of the nervous system, we are ready to start a therapy with rTMS transcranial stimulation. It’s a well-known and appreciated technology of reducing depression in the whole world, especially in the Great Britain and France, where it was supported by the British Government.

Research studies show that a choice of this technology to a tinnitus model caused by enhanced synchronization, we are able to reduce every patient’s tinnitus in 60 – 90%. A patient visits our clinic three times a week and is required to have magnetic response imaging test before a therapy begins. MRI test enables creating special three-dimensional models of brain and therapeutic program, in this case, we’re talking about depolarizing brain regions by rTMS stimulation. During depression treatment we use stimulation above 10 Hz; in contrast, this technology requires stimulation of 1 Hz. It’s a safe stimulation of the lowest range which causes activity decline of neurons. In comparison with higher stimulation frequencies (above 10 Hz used in depression treatment), it causes no negative symptoms. A therapy program and the number of sessions depends upon years and neurons which have to be depolarized.

 

An average therapy time in sessions: 8 sessions, each lasting from 20 to 30 minutes

The cost of a single session: 200 Euro

Necessary medical tests: fMRI / MRI