Comparison of treatment outcomes between 10 and 20 EEG electrode location system-guided and neuronavigation-guided repetitive transcranial magnetic stimulation in chronic tinnitus patients and target localization in the Asian brain

Abstract

Objective: rTMS is a non-invasive method that applies a brief magnetic pulse to the cortex and is regarded as a possible therapeutic method for tinnitus control. However, it remains unclear whether the rTMS treatment effect would be the same in tinnitus patients receiving the 10–20 EEG-based target localization as in those receiving imaging-based neuronavigation target localization.

Methods: We compared the treatment outcome of the 10–20 EEG-guided rTMS (Group 1) with that of the neuronavigation-guided rTMS (Group 2). Using the individual subject's MRI data and neuronavigation system, the coordinates of the AC relative to the 10–20 EEG system were identified in Asian and compared with those of Caucasian.

Results: There was significant improvement in the THI and VAS scores in Group 1 and 2. However, there was no significant difference between the two groups. The location of the AC in Asians was significantly different to that in Caucasians.

Conclusion: The 10–20 EEG coordinates of the AC in Asians were significantly different to those in Caucasians. To accurately aim for the AC in Asians, it is recommended that the rTMS be located 1.8 cm superior to the T3 and 0.6 cm posterior to the T3-Cz line. However, because the spatial resolution of the TMS is rather low, this difference probably was not reflected in the treatment outcome.

Chinese abstract

目的：经颅磁刺激是一种非侵入性的方法, 它对皮质施以短暂的磁脉冲, 被认为是一种控制耳鸣的可能治疗方法。然而, 经颅磁刺激治疗效果对于接受10–20基于脑电信号的目标定位的耳鸣患者和那些接受基于成像的神经导航目标定位的耳鸣患者是否相同, 目前尚不清楚, 。

方法：我们比较了10–20脑电图引导rTMS（1组）和神经导航下经颅磁刺激（2组）的治疗结果。用各人的MRI数据和神经导航系统, 确定了亚洲人的相对于10–20脑电图系统的AC坐标, 并将其与白种人相比。

结果：第1组和第2组的THI和VAS评分均有明显改善。然而, 两组间的差异无统计学意义。亚洲人AC的位置与白种人显著不同。

结论：亚洲人的AC10 - 20 EEG坐标与白种人的显著不同。为了准确地针对亚洲人的AC, 建议经颅磁刺激应位于T3之上1.8厘米和T3-CZ线之后0.6厘米之处。然而, 由于TMS的空间分辨率相当低, 这种差异可能没有反映在治疗结果中。

Keywords:

• Transcranial magnetic stimulation
• coil positioning
• auditory cortex
• prefrontal cortex
• tinnitus

Acknowledgments

This research was supported by the National Research Foundation (NRF) of Korea and the Ministry of Science, ICT and Future Planning (NRF-2015R1A2A2A04003938)

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This research was supported by the National Research Foundation (NRF) of Korea and the Ministry of Science, ICT and Future Planning (NRF-2015R1A2A2A04003938)