tRNS, The Next Neuromodulation Method

Discussion in 'Research News' started by daedalus, Jan 7, 2014.

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    1. daedalus

      daedalus Member

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      Front Psychiatry. 2013 Dec 18;4:158. doi: 10.3389/fpsyt.2013.00158.
      Head-to-Head Comparison of Transcranial Random Noise Stimulation, Transcranial AC Stimulation, and Transcranial DC Stimulation for Tinnitus.
      Vanneste S1, Fregni F2, De Ridder D3.
      Author information
      Abstract

      Tinnitus is the perception of a sound in the absence of an external sound stimulus. This phantom sound has been related to plastic changes and hyperactivity in the auditory cortex. Different neuromodulation techniques such as transcranial magnetic stimulation and transcranial direct current stimulation (tDCS) have been used in an attempt to modify local and distant neuroplasticity as to reduce tinnitus symptoms. Recently, two techniques of pulsed electrical stimulation using weak electrical currents - transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) - have also shown significant neuromodulatory effects. In the present study we conducted the first head-to-head comparison of three different transcranial electrical stimulation (tES) techniques, namely tDCS, tACS, and tRNS in 111 tinnitus patients by placing the electrodes overlying the auditory cortex bilaterally. The results demonstrated that tRNS induced the larger transient suppressive effect on the tinnitus loudness and the tinnitus related distress as compared to tDCS and tACS. Both tDCS and tACS induced small and non-significant effects on tinnitus symptoms, supporting the superior effects of tRNS as a method for tinnitus suppression.



      All right... So after having said that tDCS and tACS were more ore less promising now it is the tRNS which is superior and the two precedent methods which give "small and non-significant effects". I know there no contradiction between saying "method X warrants further examination" and then conclude by "After all, method Y show better results, x isn't so great" but it's funny to read.



      I just have the abstract so no figures. Now way of telling what they consider a more significant relief.
       
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    2. Markku
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      Markku Director Staff Benefactor Hall of Fame Team Trobalt Team Tech Team Awareness Team Research

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    3. daedalus

      daedalus Member

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      How lazy of me ! :) Thank you.
       
    4. Hudson
      Cowboy

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      very cool! Although I feel this is heaping more confirmation onto the pile of knowledge that researchers have now figured out: tinnitus can be modulated through the use of directed noise. The fact that Microtransponder and the University of Michigan are looking at systems which couple directed noise with a nervous system stimulation device tells me these treatments have real potential. It is very cool that there are researchers approaching the problem from this perspective, as well as some attacking it from a drug delivery method as well. Keep us posted!
       
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    5. Robb
      Question it

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      Great work Guys!

      I know understand tRNS as subject headline had a brief read through the article.
      And of the three methods tested this one had the best reduction results etc. tRNS,
      this is so inspiring and motivating.

      What i especially like about it is that this treatment seems to be viable regardless duration of T
       
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    6. Erlend
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      Can someone write a summary of this? What is this?
       
    7. daedalus

      daedalus Member

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      I see there is a confusion. The word "noise" is the "statistical" term. It is electrical noise, not mechanical.
       
    8. Robb
      Question it

      Robb Member Benefactor

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      Mini Summary
      (i read it quickly)

      They have tested three different methods of transcranial stimulation. Basically messing around with electrodes outside the head around the auditory cortex area.

      Transcranial Random Noise Stimulation showed the better results!

      Average time people had T in these tests was 4 years, mixed type of persons what caused T and no age focus.


      lets hope this is something solid and gets rolled out quickly! :pompus:

       
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    9. Erlend
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      Erlend Member Benefactor

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      What were the results? Some got 10% reduction, or significant reduction in several patients?
       
    10. Denny

      Denny Member

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      Seems like all new developments are at the least minimally invasive??
       
    11. Robb
      Question it

      Robb Member Benefactor

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      The better of the three treatments had a significant reduction, in my humble opinion this should be around 30%. As 10% is not really to be measured is my opinion..

      @ Denny yes minimally invasive as it's not tangible those tiny f*cking hyperactive neurons in our head..

      Evasive things I hope will florish when nano science steps in..
       
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    12. SISKO
      Suicidal

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      there are many other fields where tRNS is tested with positive results in the Internet. Especially degenerative and neurological diseases.

      Does anybody some more about these trials? Maybe someone took part in the trial? Or got detailed feedback by the clinic , doc or patients?
       
    13. exodus
      Cold

      exodus Member

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      is there any device we can buy for doing tRNS at home?
       
    14. SISKO
      Suicidal

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      Here u are: http://www.neuroconn.de/startseite_en/

      But I would be very carefull by own Trial. Once this treatment is successfull for a patient, there is suggestion later by own stimulation from home with a specific cap.

      By the way: I have contact to one patient who gets this treatment. After 5 sessions he feels no difference or any positive changes. He will report to me after the full sessions of 10.

      Anyway .. Doesn't sound so promising as claimed :(
       
    15. nills
      Barefooter

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      I think a lot of treatments out there are not specific enough. they influence a large of field to have effect on this little bit part of neurons. The ultimate treatment will be something very targeted. But they have to understand more about how tinnitus works I guess. Although I had the impression they did ... somewhere I even saw a video where the doctor (Asian guy) said they can take a picture/mri/scan of the brain and precisely pin point where the tinnitus is ... so imo just zap it! (HIFU)
       
    16. daedalus

      daedalus Member

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      The research continues...

      http://www.ncbi.nlm.nih.gov/pubmed/25245591

      It's Elsevier so i doubt you will find the full text for free.

      Electroencephalographic Effects of Transcranial Random Noise Stimulation in the Auditory Cortex.
      Van Doren J1, Langguth B2, Schecklmann M3.
      Author information
      Abstract

      BACKGROUND:
      Transcranial random noise stimulation (tRNS) is an innovative technique of non-invasive electrical stimulation. tRNS over the parietal cortex has improved cognitive function in healthy controls and, applied to the auditory cortex, tRNS has shown beneficial effects on tinnitus.

      OBJECTIVE/HYPOTHESIS:
      Here we aimed to investigate the effects of tRNS over the auditory cortex on resting state and evoked activity in healthy subjects.

      METHODS:
      We used EEG to measure tRNS induced changes in resting state activity and in auditory steady state responses (ASSRs). Stimuli were 1000 Hz carrier frequency tones, amplitude modulated at 20 Hz and 40 Hz and applied in randomized order. Fourteen subjects participated in a placebo-controlled randomized design study; each received 20 min of tRNS applied over auditory cortices with 2 mA, with a one week interval between real and sham stimulation.

      RESULTS:
      We found a significant increase in the ASSR in response to 40 Hz frequency modulated tone and a non-significant trend toward an increase in mean theta band power and variability of the theta band power for the resting state data.

      CONCLUSIONS:
      Our finding of tRNS induced increased excitability in the auditory cortex parallels previous findings of tRNS effects on motor cortex excitability and is in line with current concepts of tRNS mechanisms such as increase of stochastic resonance.

      Copyright © 2014 Elsevier Inc. All rights reserved.
       
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    17. Lisa88

      Lisa88 Member

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      I still seem unclear as to how this can work with t. Stimulation of the CNS seems the last thing we need for t. Enough hyperactive electricity going on as it is. Seems the reverse would be needed - calming the CNS.
       
    18. Zimichael

      Zimichael Member Benefactor

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      Lisa...somewhat in agreement with you here, but that may be that I just have not looked into this deeply enough.

      Was also just doing a search on TMS (jazz got me going on that) which seems like a "magnetic" cousin of this "electrical" stimulation. No silver bullet so far.

      However @Robb 's note above that average T duration of trialees in this "variation of a theme" was four years, is indeed good news, as the longer time aspect of chronic tinnitus seems to make it more of a she-dog to treat!

      "Bring it on"...wherever and whatever it takes to help or cure T!

      Zimichael
       
    19. Robb
      Question it

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      Hi @Zimichael please explain in which context i am tagged, cant figure it out..
       
    20. Zimichael

      Zimichael Member Benefactor

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      This one! In your "Mini Summary" 11 posts above this one, (if I can still count = 'questionable')... Zimichael
       
    21. Robb
      Question it

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      :) please PM me and explain in dumbo jumbo language can't follow it at all, sorry!
       
    22. jazz
      No Mood

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      Here is a definition of stochastic resonance. From my reading, it looks like the goal is to enhance the signal so that the brain will be able to filter it out more easily:

      Stochastic resonance (SR) is a phenomenon where a signal that is normally too weak to be detected by a sensor, can be boosted by adding white noise to the signal, which contains a wide spectrum of frequencies. The frequencies in the white noise corresponding to the original signal's frequencies will resonate with each other, amplifying the original signal while not amplifying the rest of the white noise (thereby increasing the signal-to-noise ratio which makes the original signal more prominent). Further, the added white noise can be enough to be detectable by the sensor, which can then filter it out to effectively detect the original, previously undetectable signal.

      This phenomenon of boosting undetectable signals by resonating with added white noise extends to many other systems, whether electromagnetic, physical or biological, and is an area of intense research.[1]

      See the full wikipedia reference:


      Stochastic resonance is also discussed in the following article:

       
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    23. t-man
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      Sounds like mumbo jumbo.
       
    24. jazz
      No Mood

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      No, it's real science and very promising. Most neuromodulation modalities (e.g., rTMS, tDCS) have not worked well or only offered short term benefits.
       
    25. t-man
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      I hope it benefits us greatly. I'm just at a point where I'm skeptical of anything not invasive or chemical.
       
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    26. lapidus

      lapidus Member

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      Isnt this invasive at all but just some electrodes on your head? What would make this so promising Jazz? Isnt that scam product Mute button also something like that, but you put it on your tounge?
       
    27. jazz
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      @lapidus

      No, tRNS isn't at all like the Mute Button.:) tRNS also has been studied in other diseases with promising results. Though the treatment is considered novel, it has been and is being tested on tinnitus, depression, and chronic pain. See, for example, this reference:
      Currently, rTNS for tinnitus is being tested in another clinical trial, which should be completed soon. Below is a description of the trial:

      Daily Bi-temporal Transcranial Random Noise Stimulation in Tinnitus (tRNS-tin)

      http://clinicaltrials.gov/ct2/show/NCT01965028?term=tinnitus tRNS&rank=1

      Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. It is a frequent problem which can interfere significantly with the ability to lead a normal life. Tinnitus has been shown to be generated in the brain, as a result of functional reorganization of auditory neural pathways and the central auditory system. These changes are represented by hyper-activity and hyper-synchronicity in the auditory pathway. Treatment remains difficult. Non-invasive brain stimulation methods has shown to be effective in the treatment of chronic tinnitus with moderate effect size. Preliminary data presented on international conferences suggest the use of transcranial random noise stimulation (tRNS) over both auditory cortices as new and highly effective treatment. High-frequency (hf; 100-650Hz) tRNS might be highly effective in tackling hyper-synchronised cell assemblies. Daily Hf-tRNS (2 weeks) will be examined with regard to feasibility, safety and clinical efficacy in patients suffering from chronic tinnitus in an one-arm pilot trial.​

      tRNS also possesses some advantages over other non-invasive neuromodulation devices. In some studies, for example, tRNS' effects were longer lasting than tDCS. And tRNS might be safer long term than rTMS. Finally, it is possible that rTMS could be manufactured for home usage. With chronic tinnitus sufferers, like myself, it might be necessary to re-tune the brain periodically.

      Here is an excerpt from an article about tRNS and neuropathic pain:

      Some potential strengths of tRNS are the same as for tDCS, being a method that is noninvasive, easy to use, and with the possibility that inexpensive devices for home treatment can be manufactured. In addition, if the excitatory effect of tRNS is unrelated to the orientation of the neurons in relation to the current, tRNS may have the effect of exciting a larger number of cortical neurons compared with tDCS, independent of the cortical folding, and in both hemispheres. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3699251/)​

      Finally, tRNS is being studied for cognitive enhancement. For a picture of a current tRNS device, see the link below. It looks very formidable. I wonder how they will turn it into something suitable for home use, but this is the eventual goal as long as research continues to be promising.

       
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    28. lapidus

      lapidus Member

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      Thanks @jazz :)

      Wow, the gizmo looked really clumsy and primitive in that picture. I would say they have some way left to go if they want to make it into an "household item" :p

      "transcranial random noise" isnt real nosie right? This therapy does not rely on matching the T-sound?
       
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    29. jazz
      No Mood

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      No, I don't believe so. :) But here is an interesting excerpt from the Head-to-Head article cited above:

      It is known that for healthy subjects the resting state electrical brain activity is more like a noise like signal in the auditory cortex (5658), while for tinnitus patients it has been proposed that hyper-synchronization is present within the auditory cortex (811, 17, 52, 59). Hence, a possibility is that adding noise to the ongoing hyper-synchronization might disrupt this synchronization, while adding random noise to spontaneous noisy activity in healthy subjects might result in an opposite or no effect. This effect may be similar to effects of TMS and tDCS over the motor cortex for neuropathic pain; but interestingly here the effects of tRNS were larger than tDCS and tACS and in fact the only technique that induced significant effects.

      ...

      In conclusion, our findings show clear superiority effects of tRNS as compared to tACS or tDCS in suppressing tinnitus transiently when applying the electrodes over the auditory cortex bilaterally. The results of this study are important as it compares for the first time in head-to-head trial three different techniques of tES using weak currents.​

      In other words, these neuromodulation techniques seek to "break the static" caused by tinnitus. And rTNS accomplished this goal best.

      Hope that helps!

      Reference

       
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    30. nills
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      Just bumping this one because I came back from BRAI2N clinic today ... not too impressed to be honest ... didn`t know about trobalt or keppra, didn`t really know about potassium channels, didn`t know about mute button. I did get an EEG done so i`m curious about that one. have quit severe hearing loss from 5000hz going 45 degrees down ...

      So now they said they used to do TMS but see much better results with this neuromodulation ... so I will do 8 sessions of this and than continue to do TMS anyway ...

      whatever helps ... or not ... keeping myself bussy ...
       

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