H Argstatter1, C Krick, P Plinkert, H V Bolay. 1. Deutsches Zentrum für Musiktherapieforschung (Viktor Dulger Institut), Heidelberg, Deutschland. heike.argstatter@fh-heidelberg.de
Abstract
BACKGROUND: Music therapy in chronic tonal tinnitus according to the "Heidelberger model" presents an effective treatment, which is substantiated by neuroscientific and psychological evaluation. METHOD: The music therapy approach was specifically extended to include noisiform tinnitus, taking sound quality and cardiovascular influences into consideration. Outcome criteria were psychological tinnitus load, psychophysiologic parameters and brain imaging procedures. RESULTS: Psychological outcomes of the pilot study indicate that 21 of the 23 patients (i.e. more than 90%) achieved a reliable reduction of symptoms (TQ scores: pre: 40.1 ± 11.4; post: 27.9 ± 12.8; at 3-month-follow-up: 24.0 ± 12.2). Results of the imaging examinations demonstrated neuroplastic changes in the putamen and insula. Psychophysiological measurements indicate cardiovascular influences on noisiform tinnitus. DISCUSSION: Therapy success depends on the sound quality of the tinnitus; therefore, any treatment should take this into consideration. Cardiovascular influences were important insofar as active control of the heart rate was an important predictor of long-term therapy outcome. Overall, brain imaging data confirm the top-down-model of tinnitus generation.
BACKGROUND: Music therapy in chronic tonal tinnitus according to the "Heidelberger model" presents an effective treatment, which is substantiated by neuroscientific and psychological evaluation. METHOD: The music therapy approach was specifically extended to include noisiform tinnitus, taking sound quality and cardiovascular influences into consideration. Outcome criteria were psychological tinnitus load, psychophysiologic parameters and brain imaging procedures. RESULTS: Psychological outcomes of the pilot study indicate that 21 of the 23 patients (i.e. more than 90%) achieved a reliable reduction of symptoms (TQ scores: pre: 40.1 ± 11.4; post: 27.9 ± 12.8; at 3-month-follow-up: 24.0 ± 12.2). Results of the imaging examinations demonstrated neuroplastic changes in the putamen and insula. Psychophysiological measurements indicate cardiovascular influences on noisiform tinnitus. DISCUSSION: Therapy success depends on the sound quality of the tinnitus; therefore, any treatment should take this into consideration. Cardiovascular influences were important insofar as active control of the heart rate was an important predictor of long-term therapy outcome. Overall, brain imaging data confirm the top-down-model of tinnitus generation.
Authors: H-P Zenner; W Delb; B Kröner-Herwig; B Jäger; I Peroz; G Hesse; B Mazurek; G Goebel; C Gerloff; R Trollmann; E Biesinger; H Seidler; B Langguth Journal: HNO Date: 2015-06 Impact factor: 1.284