Functional MRI Neurofeedback Outperforms Cognitive Behavioral Therapy for Reducing Tinnitus Distress: A Prospective Randomized Clinical Trial

Article Article scientifique Article Functional MRI Neurofeedback Outperforms Cognitive Behavioral Therapy for Reducing Tinnitus Distress: A Prospective Randomized Clinical Trial eng 2024-02-01 author Gninenko Nicolas 0000-0001-5091-575X 701252 author Trznadel Stéphanie 763339 author Daskalou Dimitrios 0000-0003-3618-9776 403884 Département des neurosciences cliniques (OTONO) author Gramatica Luca 0009-0009-7617-1897 author Vanoy Julie 0009-0000-5525-6650 author Voruz François Jean Albert 0000-0003-2774-5507 927844 author Robyn Claudia Lardi author Spadazzi Anne 510604 Département de psychiatrie (PSYAT) author Yulzari Aude 0009-0001-1674-2784 871038 author Sitaram Ranganatha 0000-0002-8577-8035 author Van De Ville Dimitri 0000-0002-2879-3861 638484 Département de radiologie et informatique médicale (RADIO) author Senn Pascal 0000-0002-4619-3341 822485 Département des neurosciences cliniques (OTONO) author Haller Sven 0000-0001-7433-0203 711086 Département de radiologie et informatique médicale (RADIO) e231143 10.1148/radiol.231143 38349241 0033-8419 http://pubs.rsna.org/doi/10.1148/radiol.231143 Background Cognitive behavioral therapy (CBT) is the current standard treatment for chronic severe tinnitus; however, preliminary evidence suggests that real-time functional MRI (fMRI) neurofeedback therapy may be more effective. Purpose To compare the efficacy of real-time fMRI neurofeedback against CBT for reducing chronic tinnitus distress. Materials and Methods In this prospective controlled trial, participants with chronic severe tinnitus were randomized from December 2017 to December 2021 to receive either CBT (CBT group) for 10 weekly group sessions or real-time fMRI neurofeedback (fMRI group) individually during 15 weekly sessions. Change in the Tinnitus Handicap Inventory (THI) score (range, 0-100) from baseline to 6 or 12 months was assessed. Secondary outcomes included four quality-of-life questionnaires (Beck Depression Inventory, Pittsburgh Sleep Quality Index, State-Trait Anxiety Inventory, and World Health Organization Disability Assessment Schedule). Questionnaire scores between treatment groups and between time points were assessed using repeated measures analysis of variance and the nonparametric Wilcoxon signed rank test. Results The fMRI group included 21 participants (mean age, 49 years ± 11.4 [SD]; 16 male participants) and the CBT group included 22 participants (mean age, 53.6 years ± 8.8; 16 male participants). The fMRI group showed a greater reduction in THI scores compared with the CBT group at both 6 months (mean score change, -28.21 points ± 18.66 vs -12.09 points ± 18.86; P = .005) and 12 months (mean score change, -30 points ± 25.44 vs -4 points ± 17.2; P = .01). Compared with baseline, the fMRI group showed improved sleep (mean score, 8.62 points ± 4.59 vs 7.25 points ± 3.61; P = .006) and trait anxiety (mean score, 44 points ± 11.5 vs 39.84 points ± 10.5; P = .02) at 1 month and improved depression (mean score, 13.71 points ± 9.27 vs 6.53 points ± 5.17; P = .01) and general functioning (mean score, 24.91 points ± 17.05 vs 13.06 points ± 10.1; P = .01) at 6 months. No difference in these metrics over time was observed for the CBT group (P value range, .14 to >.99). Conclusion Real-time fMRI neurofeedback therapy led to a greater reduction in tinnitus distress than the current standard treatment of CBT. ClinicalTrials.gov registration no.: <a href="http://clinicaltrials.gov/show/NCT05737888" rel="noopener noreferrer" target="_blank">NCT05737888</a>; Swiss Ethics registration no.: BASEC2017-00813 © RSNA, 2024 Dewey 616.8 Dewey 616.89 Dewey 616.0757 Dewey 616 61 Département des neurosciences cliniques 226 62 Département de radiologie et informatique médicale 227 56 Département de médecine 221 60 Département de psychiatrie 225 false 948 Groupe Pascal Senn 954 552 Traitement d'images médicales 893 https://clinicaltrials.gov/study/NCT05737888 Radiology 310 2 651dcc06-0a43-4a2f-9266-4ed66b361a68 Article (Published version) Public Article-scientifique-from-crossref.pdf 1428558 application/pdf Restricted 2024-08-02 c146b9772ff258105d180cc2d313b1980ddd213808aead9543bdb8a8899fa3d0 d750f030-d863-4895-9372-a3aaeb60c633 Appendix Public ry231143suppa1.pdf 319186 application/pdf Restricted 2024-08-02 1897df8e695e993e4a9fa1505ede63d11b5e18b28eebca6baaff0bcd1dc196ed Vignette Public images_large_radiol.231143.va.jpeg 112233 image/png openAccess Faculté de médecine / Section de médecine clinique / Département des neurosciences cliniques Faculté de médecine / Section de médecine clinique / Département de radiologie et informatique médicale Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département de psychiatrie

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Functional MRI Neurofeedback Outperforms Cognitive Behavioral Therapy for Reducing Tinnitus Distress: A Prospective Randomized Clinical Trial	Radiology			2024	183	780

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