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Efficacy Analysis of Transcutaneous Auricular Vagus Nerve Stimulation Combined With Tailor-Made Notched Music Therapy in the Treatment of Chronic Subjective Tinnitus
Efficacy Analysis of Transcutaneous Auricular Vagus Nerve Stimulation Combined With Tailor-Made Notched Music Therapy in the Treatment of Chronic Subjective Tinnitus: A Multicenter, Randomized, Double-Blind Controlled Clinical Trial
The goal of this multicenter, randomized, double-blind clinical trial is to compare two treatments for adults with chronic subjective tinnitus. Researchers will determine whether transcutaneous auricular vagus nerve stimulation (taVNS) plus Tailor-Made Notched Music therapy (TMNMT) provides greater relief than the same music therapy combined with sham taVNS.
A total of 444 participants aged 18 to 70 years will be enrolled at multiple study centers. Participants will be randomly assigned in a 1:1 ratio to receive taVNS plus TMNMT or sham taVNS plus the same TMNMT. The treatment period will last 3 months.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Geschat)
Fase
- Niet toepasbaar
Contacten en locaties
Studiecontact
- Naam: Yuexin Cai, Doctor
- Telefoonnummer: 86+13825063663
- E-mail: caiyx25@mail.sysu.edu.cn
Studie Contact Back-up
- Naam: Qianhui Xu, MD
- Telefoonnummer: 86+13719908396
- E-mail: xuqh9@mail2.sysu.edu.cn
Studie Locaties
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Shanghai, China
- Eye & ENT Hospital, Fudan University
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Contact:
- Shan Sun
- Telefoonnummer: 86+18917786102
- E-mail: Shansun@fudan.edu.cn
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Guangdong
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Guangzhou, Guangdong, China, 510120
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
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Contact:
- Qianhui Xu, MD
- Telefoonnummer: 13719908396
- E-mail: xuqh9@mail2.sysu.edu.cn
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Huizhou, Guangdong, China
- Huizhou First People's Hospital
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Contact:
- Jia Fu
- Telefoonnummer: +86 15820715830
- E-mail: Jiaggfu1985@163.com
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Jieyang, Guangdong, China
- Jieyang People's Hospital
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Contact:
- Jiongcong Yuan
- Telefoonnummer: +86 13480311910
- E-mail: jiongcongyuan@126.com
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Zhongshan, Guangdong, China
- Zhongshan City People's Hospital
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Contact:
- Guoping Chen
- Telefoonnummer: 86+15019918918
- E-mail: cgping345@163.com
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Zhuhai, Guangdong, China, 519000
- Zhuhai Integrated Traditional Chinese and Western Medicine Hospital
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Contact:
- Binbin Xiong
- Telefoonnummer: 86+13926935096
- E-mail: xiongbb2015@126.com
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria
- Patients with tinnitus as the primary chief complaint and the reason for seeking medical consultation.
- Patients with chronic subjective tinnitus duration of 6 months or longer.
- Age between 18 and 70 years.
- Tinnitus frequency within the range of 125-8000 Hz.
- Hearing threshold ≤ 70 dB HL.
- Tinnitus Handicap Inventory (THI) score ≥ 38.
Exclusion Criteria
- Patients with conductive hearing loss, history of middle ear surgery, pulsatile tinnitus due to vascular malformations, or Meniere's disease-related tinnitus.
- History of head trauma, central nervous system disorders, or substance abuse/dependence. Patients with severe primary psychiatric disorders or acute episodes of severe psychological disturbances requiring priority specialist intervention. Patients with severe anxiety symptoms (Beck Anxiety Inventory [BAI] score ≥26), severe depressive symptoms (Beck Depression Inventory [BDI] score ≥29), or suicidal ideation identified during clinical interview will be excluded.
- Patients unwilling or unable to comply with study protocol requirements.
- Patients with peripheral auditory pathway or central space-occupying lesions identified by imaging, such as acoustic neuroma, middle ear cholesteatoma, or meningioma.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Verviervoudigen
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: taVNS + TMNMT Group
Participants receive active transcutaneous auricular vagus nerve stimulation (taVNS) combined with Tailor-Made Notched Music therapy (TMNMT) for 3 months.
taVNS is administered at 0.1 Hz, with a pulse width of 250-1000 ms and an intensity of 0-0.5 mA.
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Participants receive transcutaneous auricular vagus nerve stimulation (taVNS) combined with Tailor-Made Notched Music Therapy (TMNMT) for 3 months.
taVNS is administered at 0.1 Hz, with a pulse width of 250-1000 ms and an intensity of 0-0.5 mA.
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Sham-vergelijker: Sham taVNS + TMNMT Group
Participants receive sham transcutaneous auricular vagus nerve stimulation (taVNS) combined with the same Tailor-Made Notched Music therapy (TMNMT) as the experimental arm for 3 months.
The initial sham stimulation parameters are 0.1 Hz, a pulse width of 250-1000 ms, and an intensity of 0-0.5 mA.
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Participants receive sham transcutaneous auricular vagus nerve stimulation (sham taVNS) combined with Tailor-Made Notched Music Therapy (TMNMT) for 3 months.
The initial sham stimulation parameters are 0.1 Hz, a pulse width of 250-1000 ms, and an intensity of 0-0.5 mA.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Effective Rate of Tinnitus Improvement at 3 Months
Tijdsspanne: Baseline and 3 months after treatment initiation
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Treatment response was defined as a reduction of ≥7 points in the THI score from baseline after 3 months of treatment (based on the internationally recognized minimal clinically important difference threshold).
Effective rate (%) = (Number of responders / Total number of patients in the corresponding group) x 100%.
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Baseline and 3 months after treatment initiation
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Effective Rate of Tinnitus Improvement at 6 and 12 Months
Tijdsspanne: Baseline, 6 months, and 12 months after treatment initiation
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Treatment response was defined as a reduction of ≥7 points in the THI score from baseline after 6 and 12 months of treatment (based on the internationally recognized minimal clinically important difference threshold).
Effective rate (%) = (Number of responders / Total number of patients in the corresponding group) x 100%.
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Baseline, 6 months, and 12 months after treatment initiation
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Change in Visual Analog Scale (VAS) Score for Tinnitus Loudness
Tijdsspanne: Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in tinnitus loudness assessed using a 10-point Visual Analog Scale (VAS), ranging from 0 (barely perceptible) to 10 (unbearably loud).
The change score (ΔVAS) is calculated as the difference between post-treatment/follow-up scores and baseline.
Higher scores indicate greater perceived loudness; a decrease in VAS score indicates improvement in loudness perception.
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Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in Acoustic Tinnitus Match Loudness
Tijdsspanne: Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in acoustic tinnitus match loudness assessed using a calibrated audiometer in a standard sound-proof environment.
The change in loudness threshold is calculated relative to baseline.
Assessment method: audiologist-assessed.
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Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in Beck Anxiety Inventory (BAI) Score
Tijdsspanne: Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in anxiety symptoms assessed using the Beck Anxiety Inventory (BAI), a 21-item self-reported questionnaire measuring the severity of anxiety symptoms over the past week.
Higher scores indicate greater anxiety severity.
The change score (ΔBAI) is calculated as the difference between post-treatment/follow-up scores and baseline.
Assessment method: self-reported.
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Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in Beck Depression Inventory (BDI) Score
Tijdsspanne: Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in depressive symptoms assessed using the Beck Depression Inventory (BDI).
The change score (ΔBDI) is calculated as the difference between post-treatment/follow-up scores and baseline.
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Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in Pittsburgh Sleep Quality Index (PSQI) Score
Tijdsspanne: Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in sleep quality assessed using the Pittsburgh Sleep Quality Index (PSQI).
The change score (ΔPSQI) is calculated as the difference between post-treatment/follow-up scores and baseline.
Assessment method: self-reported.
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Baseline, 3 months, 6 months, and 12 months after treatment initiation
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Change in Resting-State EEG Features
Tijdsspanne: Baseline, 3 months, and 6 months after treatment initiation
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Change in resting-state EEG features, including power spectrum entropy and oscillatory characteristics, from baseline to post-treatment and follow-up.
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Baseline, 3 months, and 6 months after treatment initiation
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Change in MRI Features
Tijdsspanne: Baseline, 3 months, and 6 months after treatment initiation
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Change in MRI features from baseline to post-treatment and follow-up.
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Baseline, 3 months, and 6 months after treatment initiation
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Safety Outcomes: Incidence of Treatment-Related Adverse Events
Tijdsspanne: From treatment initiation through 3 months (end of treatment)
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Incidence of treatment-related adverse events, including auditory system-related events (e.g., ear canal or auricle burns, otalgia, hearing loss, tinnitus worsening) and non-auditory system-related events (e.g., dizziness, headache, palpitations, vomiting) occurring during the treatment period.
Adverse event rate (%) = (Number of patients experiencing treatment-related adverse events / Total number of patients receiving treatment) × 100%.
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From treatment initiation through 3 months (end of treatment)
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Andere uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change From Baseline in Gut Microbiome Shannon Diversity Index
Tijdsspanne: Baseline, 3 months, and 6 months after treatment initiation
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Gut microbial alpha diversity will be assessed using the Shannon diversity index in stool samples collected at baseline, 3 months, and 6 months.
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Baseline, 3 months, and 6 months after treatment initiation
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Change From Baseline in Blood Metabolite Abundance
Tijdsspanne: Baseline, 3 months, and 6 months after treatment initiation
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Blood metabolite abundance will be assessed at baseline, 3 months, and 6 months using metabolomic profiling.
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Baseline, 3 months, and 6 months after treatment initiation
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Change From Baseline in Blood Protein Abundance
Tijdsspanne: Baseline, 3 months, and 6 months after treatment initiation
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Blood protein abundance will be assessed at baseline, 3 months, and 6 months using proteomic profiling.
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Baseline, 3 months, and 6 months after treatment initiation
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Medewerkers en onderzoekers
Onderzoekers
- Studie stoel: Yuexin Cai, Doctor, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Studie record data
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Meer informatie
Termen gerelateerd aan deze studie
Andere studie-ID-nummers
- SYSKY-2025-917-02
Plan Individuele Deelnemersgegevens (IPD)
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