Transcutaneous Electrical Nerve Stimulation Beneficial for Subjective Chronic Tinnitus

by | Mar 16, 2020 | 2020, Alternative Therapies, Ear, Nose and Throat

Written by Angeline A. De Leon, Staff Writer. Transcutaneous Electrical Nerve Stimulation (TENS) is a safe treatment for subjective tinnitus.

headache - painTinnitus is often described as a ringing, buzzing, or hissing sound, either constant or intermittent, perceived in the absence of any external source. Tinnitus is thought of as a symptom of an underlying condition, such as hearing loss or a circulatory system disorder, rather than a disorder itself 1. Besides interfering with hearing, sleep, and concentration, tinnitus can also cause disruption of social functioning and overall quality of life 2. Studies suggest that tinnitus can cause significant psychological and emotional issues in many patients, including elevated stress levels and cognitive problems 3,4. While no gold standard treatment currently exists for tinnitus, transcutaneous electrical nerve stimulation (TENS), a noninvasive therapy used for acute and chronic pain, has been shown to be effective in modulating the perception of tinnitus in some patients 5-7. By producing a neuromodulatory effect, TENS treatment appears to ameliorate symptoms of moderate tinnitus 8 and significantly improve the quality of life in patients with acute tinnitus 9. In a recent study 10 published in the American Journal of Otolaryngology, researchers in Turkey tested the efficacy of TENS therapy for treating tinnitus, specifically looking at its impact on emotional functioning and general functioning.

A total of 60 patients (mean age = 41.17 years) diagnosed with subjective chronic tinnitus (mean duration of tinnitus = 31 +/- 49 months) were enrolled in a prospective, randomized study. Participants were randomly divided into 3 groups: Group A received TENS treatment in one ear; Group B received TENS treatment in both ears; and control Group C received no electrical or sound stimulation in either ear. TENS treatment involved stimulation of the auricular branch of the vagus nerve using electrodes (frequency of 200 Hz, 1000 microsecond pulse duration, amplitude intensity of 10-30 mA), each session lasting 30 minutes, with 10 sessions administered in one month. Participants also completed the Depression Anxiety Stress Scales (DASS) and Tinnitus Handicap Inventory Score (THI).

For all three groups, DASS results for depression, anxiety, and stress showed significant reduction from baseline to post-treatment (p < 0.001 for all), and a significant difference was observed between the groups post-treatment (p < 0.05). While analyses did not indicate a significant difference between Group A and Group B on DASS measurements, group C’s DASS scores were found to be significantly higher than those of both groups (p < 0.05). THI scores were seen to significantly decline for all three groups after treatment (p < 0.05), with a significant difference in scores detected between the groups following treatment (p = 0.001). While again, no significant between-group differences were apparent for Group A and Group B, Group C showed significantly higher THI scores than both groups (p < 0.05).

Overall findings suggest a therapeutic effect of TENS treatment in patients with chronic subjective tinnitus after 10 sessions. Significant decreases were apparent for all patients in terms of anxiety, depression, and stress levels, as well as degree of tinnitus-related disability and handicap. It is important to note that placebo effects were also observed in the present study, with patients in the control group showing significant reductions on DASS and THI measures, albeit to a lesser extent. While all 40 patients in Groups A and B responded positively to TENS treatment, based on the THI and DASS scales, in the control group, only 4 patients showed significant reduction in THI score and only 3 patients showed significant reduction in DASS. Researchers conclude that placebo-controlled, comparative studies may not be sufficient to establish the efficacy of TENS for the treatment of tinnitus. Still, TENS appears to be a promising, inexpensive, and noninvasive approach to managing the condition. Primary limitations of the present study involve a relatively small sample size and the absence of a medical hearing test as an additional marker of tinnitus severity (used at baseline screening but not tracked over time).

Source: Tutar B, Atar S, Berkiten G, et al. The effect of transcutaneous electrical nerve stimulation (TENS) on chronic subjective tinnitus. Am J Otolaryngol. 2020; 41: 102326. DOI: 10.1016/j.amjoto.2019.102326.

© 2019 Elsevier Inc. All rights reserved.

Posted March 16, 2020.

Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.
Angeline A. De Leon, MA, graduated from the University of Illinois at Urbana-Champaign in 2010, completing a bachelor’s degree in psychology, with a concentration in neuroscience. She received her master’s degree from The Ohio State University in 2013, where she studied clinical neuroscience within an integrative health program. Her specialized area of research involves the complementary use of neuroimaging and neuropsychology-based methodologies to examine how lifestyle factors, such as physical activity and meditation, can influence brain plasticity and enhance overall connectivity.

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