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Transcranial Electrical and Acoustic Stimulation for Tinnitus (tEAS)

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ClinicalTrials.gov Identifier: NCT04551404
Recruitment Status : Recruiting
First Posted : September 16, 2020
Last Update Posted : November 28, 2022
Information provided by (Responsible Party):
University of Zurich

Brief Summary:

Transcranial electrical stimulation (tES) is an umbrella term for non-invasive brain stimulation using weak currents. It comprises transcranial direct current stimulation (tDCS), which is the most established and used method applying constant direct current, transcranial alternating current stimulation (tACS) with sinusoidal current in a fixed frequency, and finally transcranial random noise stimulation (tRNS), which is a subform of tACS generating a random range of low and high frequency alternating currents.

A pilot study conducted by Shekhawat and colleagues in 2015 tested the effects of simultaneous electrical and acoustic stimulation. Using tDCS and bilateral broadband noise simultaneously, they found that more tinnitus patients report an improvement in tinnitus perception in comparison to conditions only using tDCS or sham. Further similar approaches very published in recent years, namely a pilot study conducted by Teissmann et al in 2014; study protocols of Rabau et al. in 2015 and Shekhawat et al. in 2015; and an experimental study by Lee et al. in 2017. Results were indicative of a superior efficacy of combined electrical and acoustic approaches, while large-scale controlled studies have not been performed. The need for extension and replication of these approaches is therefore timely.

The aim behind our proposed approach, similar to the bimodal approaches above, is to couple the effects of tRNS and acoustic stimulation (AS) for better temporary tinnitus suppression and possible reversal of maladaptive neuroplasticity related to tinnitus. We aim at targeting the (bilateral) auditory cortex with tRNS as in former studies and combine it with white noise (WN) stimulation. This specific combination is novel in its nature and is building on cortical excitability following tRNS.

Condition or disease Intervention/treatment Phase
Tinnitus Tinnitus, Subjective Other: transcranial Random Noise Stimulation (tRNS) with acoustic stimulation (AS) Other: transcranial Random Noise Stimulation (tRNS) without acoustic stimulation (AS) Not Applicable

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Study Type : Interventional
Estimated Enrollment : 40 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Intervention Model Description:

The crossover within-person design with 2 groups, 2 active conditions and appropriate control/pseudo-placebo/sham session is double-blinded. Overall, participants will undergo 20 stimulation visits and 6 additional assessment visits.

Prior to conducting the above study, a pilot study of 40 patients and just 6 visits will be conducted to validate clinical procedures and outcomes. This procedure was approved by the ethics committee.

Masking: Single (Participant)
Primary Purpose: Treatment
Official Title: Transcranial Electrical and Acoustic Stimulation for Tinnitus: A Randomized Double Blind Clinical Trial
Actual Study Start Date : February 1, 2021
Estimated Primary Completion Date : December 1, 2024
Estimated Study Completion Date : December 1, 2024

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Noise Tinnitus

Arm Intervention/treatment
Experimental: Study Intervention(s) A

TRNS bilateral temporal regions combined with AS for 20 minutes

Sham-tRNS bilateral temporal regions combined with Sham-AS for 20 minutes

Other: transcranial Random Noise Stimulation (tRNS) with acoustic stimulation (AS)
The study intervention consists of a bilateral tRNS application over temporal regions, parallel to the application of AS with WN 15 dB above the individual MML in one study arm. TRNS will be applied using two electrodes (35 qcm, 0,9% saline -soaked). Stimulus intensity will be below individual sensation threshold, but max. 2 mA. AS will never surpass 85 dB SPL at the ears.

Experimental: Study Intervention(s) B = Control Intervention

TRNS bilateral temporal regions for 20 minutes

Sham-tRNS bilateral temporal regions for 20 minutes

Other: transcranial Random Noise Stimulation (tRNS) without acoustic stimulation (AS)
The study intervention consists of a bilateral tRNS application over temporal regions

Primary Outcome Measures :
  1. Change of self-report Visual Analogue Scale (VAS) ratings on tinnitus severity (loudness, distress) [ Time Frame: up to 6 months ]
    Minmum value = 1, maximum value =10. The higher scores means a worse outcome.

  2. Change of minimum masking level (MML) [ Time Frame: up to 6 months ]

Secondary Outcome Measures :
  1. event-related EEG power in alpha band [ Time Frame: up to 6 months ]
    The influence of simultaneous tRNS and AS stimulation on neurophysiology will be investigated as a secondary outcome. Resting state and event-related EEG (auditory oddball) (Attias et al., 1993) will be recorded for that purpose.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male and female patients 18 years to 75 years of age
  • Persistent chronic tinnitus with duration of more than 3 months
  • Signed Informed Consent after being informed about the study
  • Fluent in German
  • Tinnitus with a THI Grade 2 to 4 (18-76 points)
  • Willing and able to attend the study visits

Exclusion Criteria:

  • Actual neurological or psychiatric disorders
  • Hyperacusis
  • Regular intake of medication influencing the central nervous system (e.g. neuroleptics, hypnotics, sedatives, and anti-epileptics)
  • Implanted pacemaker
  • Surgical implants in the head region, such as cochlea implants
  • Asymmetrical hearing (more than 20dB side difference), pantonal hearing loss > 40dB in any measured frequency up to 2kHz
  • Women who are pregnant or breast feeding
  • Intention to become pregnant during the course of the study
  • Known or suspected non-compliance, drug or alcohol abuse
  • Participation in another study with investigational drug within the 30 days preceding and during the present study,
  • Enrolment of the investigator, his/her family members, employees and other dependent persons

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04551404

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University Hospital Zurich, University Zurich Recruiting
Zurich, Switzerland, 8091
Contact: Nicole Peter, MD    +41432538826    nicole.peter-siegrist@usz.ch   
Contact: Tobias Kleinjung, Prof.    +41432539146    tobias.kleinjung@usz.ch   
Sponsors and Collaborators
University of Zurich

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
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Responsible Party: University of Zurich
ClinicalTrials.gov Identifier: NCT04551404    
Other Study ID Numbers: tEAS
First Posted: September 16, 2020    Key Record Dates
Last Update Posted: November 28, 2022
Last Verified: November 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Hearing Disorders
Ear Diseases
Otorhinolaryngologic Diseases
Sensation Disorders
Neurologic Manifestations
Nervous System Diseases