2MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
The opic o inni us is common bu complex, wi h h ee
p e ious bulle ins al eady dealing wi h his mul i ac o ial symp om.
We ecommend you ead he p e ious ma e ials and he e e ences
consul ed a he end o his bulle in.
Con inuing his opic, he objec i e o his bulle in is o
discuss he ole o neu omodula ion ea men s in cases o pa ien s
su e ing om Tinni us Diso de .
Milaine Dominici San ins, Pio Hen yk Ska zynski
and Anna Ca olina Ma ques Pe ella de Ba os.
TINNITUS: THE PHANTOM SOUND
(PART IV) – DOES NEUROMODULATION
REALLY HAVE A BENEFICIAL AND
SCIENTIFICALLY PROVEN ROLE
IN CASES OF TINNITUS?
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Neu omodula ion is ela ed o he al e a ion o ne ous
ac i i y h ough elec ical, magne ic, acous ic, o chemical
s imuli di ec ed o speci ic a eas o he ne ous sys em. The goal
is o adjus , egula e, o no malize neu al unc ion ha has been
impai ed due o inju y, disease, o dys unc ion. Neu omodula ion
can be in asi e (e.g., deep b ain s imula ion) o non-in asi e.
WHAT IS
NEUROMODULATION?
4MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
Neu omodula ion ea men s a e based on undamen al p inciples ha aim o al e
he ac i i y o he ne ous sys em o es o e unc ions, elie e symp oms, and imp o e
quali y o li e. The bases o hese ea men s a e as ollows.
This bulle in aims o add ess mo e speci ically he s uc u al and unc ional
changes in he b ain esul ing om neu omodula ion by elec ical o magne ic s imuli.
Be o e we do so, i is essen ial o unde s and b ain elec ophysiology, speci ic neu al
a ge s, and some impo an echnical e ms.
1) NEUROPLASTICITY
Neu oplas ici y is he b ain's na u al abili y o change and o m new neu al connec ions
h oughou li e, in esponse o en i onmen al modi ica ions, whe he in e nal o ex e nal
o he subjec . In e nal modi ica ions can include inju y o illness, and ex e nal
modi ica ions can include expe iences such as lea ning. Neu omodula ion akes ad an age
o his h ough:
• Induc ion o adap i e changes: Neu omodula ion a emp s o s eng hen
o weaken synap ic connec ions, al e he le el o exci a ion o neu ons,
and s imula e he g ow h o new neu al pa hways h ough elec ical, magne ic,
acous ic s imuli, o chemical agen s.
• Reo ganiza ion o b ain ci cui s: Neu al ci cui s may no wo k p ope ly in
people who ha e su e ed some ype o b ain inju y o ch onic pain. The goal
o neu omodula ion is o ees ablish o " ecalib a e" hese ci cui s so ha hey
wo k no mally again o o compensa e o any p oblems.
WHAT IS THE BASIS
OF NEUROMODULATION
TREATMENTS?
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San ins, Ska zynski e Hall, 2025
6MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
2) BRAIN ELECTROPHYSIOLOGY
The ne ous sys em ac s as a ansmi e o elec ical and chemical signals. Elec ical signals
in ol e ac ion po en ials, while chemical signals de i e om neu o ansmi e s. In his sense,
neu omodula ion has a di ec e ec on elec ophysiological p ocesses, such as:
• Modula ion o neu onal exci abili y: Neu omodula ion echniques use elec ic
cu en s o magne ic ields o al e he ac i i y o ce ain neu ons o neu al
ne wo ks, making hem mo e ac i e (exci a o y) o less ac i e (inhibi o y).
• In e e ence wi h abno mal ac i i y pa e ns: People wi h epilepsy, essen ial
emo , o Pa kinson's disease ha e abno mal b ain ac i i y. Neu omodula ion
can dis up o co ec hese pa e ns ha a e no wo king p ope ly.
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3) SPECIFIC NEURAL TARGETS
Neu omodula ion ea men s a e a ge ed o speci ic pa s o he b ain, spinal co d,
o pe iphe al ne es ha a e in ol ed in disease. To do so, hey mus :
4) THE ABILITY TO CHANGE AND FLIP
Many neu omodula ion he apies, especially hose ha use implan s, a e designed o be
e e sible and adjus able. By adjus ing he pa ame e s, i is possible o minimize possible
ad e se e ec s.
• Iden i y dys unc ional ci cui s: Neu ological esea ch and ad anced
neu oimaging allow us o iden i y b ain egions and neu al ne wo ks ha
a e comp omised in a ious condi ions (e.g., he basal ganglia in Pa kinson's
disease, he mo o co ex in ch onic pain).
• Selec i e s imula ion and maximiza ion o bene i s: Neu omodula ion
de ices and me hods a e designed o send signals only o hese speci ic
a ge s, which maximizes he apeu ic e ec s and minimizes side e ec s.
• Pa ame e adjus men s: You can change he equency, in ensi y, pulse wid h,
and du a ion o s imula ion o ge he bes he apeu ic esponse and mee he
pa ien 's e ol ing needs o e ime.
• Minimizing ad e se e ec s: The abili y o change pa ame e s makes i
possible o adjus ea men and dec ease he isk o side e ec s, making
he apy sa e and mo e pe sonalized o he indi idual.
8MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
5) DIFFERENT STIMULATION MODES
The e a e di e en modes o s imula ion and, depending on he p oposed app oach
model, each has a he apeu ic objec i e. Some modes o s imula ion a e:
• Pe iphe al Ne e S imula ion: Focuses on speci ic ne es (e.g., agus ne e,
pe iphe al ne es) ha , when s imula ed, indi ec ly in luence b ain ac i i y.
• Di ec D ug Adminis a ion: In a hecal d ug adminis a ion (as by an
in usion pump) is no s ic ly elec ical, bu i quali ies as a ype o chemical
neu omodula ion as i al e s neu al ac i i y in a speci ic a ea.
• Senso y Subs i u ion/Bio eedback: The e a e sys ems ha induce
plas ici y and b ain eo ganiza ion which ac in an indi ec way o modula e
he sys em. This is he case o sys ems such as he Tongue Display Uni (TDU)
o e en B ainPo ha do no apply he s imulus di ec ly o he b ain o
neu omodula ion; ins ead hey p o ide modula ed senso y in o ma ion
which indi ec ly modula es he sys em.
• Di ec S imula ion: Applica ion o elec ical cu en .
E.g: Deep B ain S imula ion (DBS), Spinal Co d S imula ion (SCS), T ansc anial
Di ec Cu en S imula ion ( DCS), o magne ic ields such as T ansc anial
Magne ic S imula ion (TMS)] o di ec ly modula e neu al ac i i y.
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Fo ea ing inni us, neu omodula ion p esen s i sel as a new and
p omising echnique. The main objec i e is o al e b ain ac i i y h ough he s imula ion
o speci ic neu obiological subs a es. Because inni us is mul i ac o ial, i is impo an o
seek ea men s ha add ess all aspec s o his symp om.
The expe ience o inni us can be al e ed by he use o neu omodula ion, which
wo ks by di ec ly supp essing o econs uc ing abno mal b ain ac i i y o e ime.
This app oach adds o he cu en ools o managing inni us, and is
inno a i e in ha i emphasizes he modi ica ion o cen al neu ophysiological
subs a es, di e ging om cu en ly a ailable ea men s which ocus on pa ien
beha io in esponse o inni us. The objec i e o neu omodula ion is o ac
di ec ly on neu al ne wo ks ha ha e been al e ed and a e ela ed o he
unde lying mechanisms. In his way, i add esses a c i ical de iciency in cu en ly
a ailable he apeu ic op ions and, o his eason, i is he subjec o cu en
scien i ic s udies.
I is impo an o no e ha he mechanisms unde lying inni us
a e s ill unde s udy and, he e o e, he e a e no de ini i e p o ocols
o he use o elec ical o magne ic neu omodula ion in inni us.
NEUROMODULATION AND TINNITUS
16 MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
3) Vagus Ne e S imula ion (VNS) and T anscu aneous Vagus Ne e
S imula ion ( VNS)
Vagus Ne e S imula ion (VNS) is a neu omodula ion echnique ha can be pe o med
in asi ely o non-in asi ely. In asi e VNS consis s o he su gical inse ion o a de ice and an
elec ode designed o s imula e he ce ical agus ne e. This p ocedu e has FDA app o al o
he ea men o epilepsy and dep ession.
In con as , T anscu aneous Vagus Ne e S imula ion ( VNS), also known as
T anscu aneous Au icula Vagus Ne e S imula ion (a -VNS), is a non-in asi e app oach. I
s imula es he au icula b anch o he agus ne e (ABVN) loca ed in he ou e ea . VNS is
conside ed sa e and mo e cos -e ec i e han VNS, as i does no equi e gene al anes hesia and
a su gical implan a ion p ocedu e. Mul iple neu oimaging s udies ha e con i med ha VNS
ac i a es he same b ain ne wo ks and pa hways as di ec VNS, making i a iable al e na i e.
The neu ophysiological mechanisms o VNS and VNS in he ea men o inni us
a e closely linked o he p omo ion o neu oplas ici y and he modula ion o neu o ansmi e
elease. VNS induces he elease o neu omodula o s in he b ain, including ace ylcholine,
no epineph ine, se o onin, and b ain-de i ed neu o ophic ac o . These subs ances play
c ucial oles in p omo ing plas ic changes in he b ain (Hoa e e al., 2024; Yakunina and Cheol
Nam, 2021).
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MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
As o s udies wi h inni us pa ien s, i was obse ed ha VNS and VNS seem o pe o m
well in he p e en ion and e e sal o cases; in addi ion some s udies ha e demons a ed
a dec ease in he se e i y o symp oms. Howe e , acco ding o Yakunina and Cheol
Nam (2021), exis ing s udies ha e impo an laws, such as he absence o a con ol g oup,
small sample size, lack o andomiza ion, among o he s. Simila ly, he e is no eliable e idence
o da e showing ha VNS alone, wi hou pai ed sound s imuli, is e ec i e o he ea men
o inni us.
18 MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
FINAL THOUGHTS AND
FUTURE DIRECTIONS
The s udy o neu omodula ion in inni us pa ien s is s ill unde de elopmen , and
he e a e many gaps o be illed. Tinni us is a complex and debili a ing condi ion whose
neu ophysiological unde pinning is s ill a ma e o in es iga ion, meaning ha he sea ch
o an e ec i e neu omodula o y in e en ion is challenging.
Based on analysis o subjec i e measu es o ou comes, Repe i i e T ansc anial
Magne ic S imula ion ( TMS) has shown po en ial in educing inni us, especially o e he
sho e m, when di ec ed o he audi o y co ex. Howe e , he e is s ill a need o p o e
long- e m ou comes. The possible iden i ica ion o neu ophysiological bioma ke s, such as
inc eased alpha powe in he audi o y co ex, p esen s a p omising s a egy o pe sonalizing
and op imizing TMS in e en ions.
A he p esen ime, T ansc anial Di ec Cu en S imula ion ( DCS), su e s om
a lack o s anda dized p o ocols, despi e i s neu ophysiological mechanisms being ela i ely
well unde s ood. S udies a e needed ha analyze he long- e m esul s o obus and
consis en clinical ou comes.
Vagus Ne e S imula ion (VNS) and i s non-in asi e o m, VNS, ep esen an inno a i e
app oach, bu he esul s in humans a e con adic o y, and hey equi e be e scien i ic
s udies.
Thus, neu omodula ion o e s a he apeu ic app oach o inni us, seeking i s
o co ec neu al dys unc ions a he han jus managing symp oms. Howe e , we need
cu ing-edge esea ch ha ocuses on s anda diza ion o p o ocols, iden i ica ion o objec i e
bioma ke s o guide and pe sonalize ea men , and andomized con olled ials wi h la ge
samples and long- e m ollow-ups.
De ailed unde s anding o neu ophysiological mechanisms and op imiza ion o
applica ion s a egies a e essen ial s eps o ans o m he po en ial o neu omodula ion in o
e ec i e and long-las ing clinical solu ions o inni us pa ien s.
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QUIZ: NEUROMODULATION AND TINNITUS
1. Which o he ollowing mos accu a ely desc ibes he concep o neu oplas ici y
in he con ex o neu omodula ion?
a) The b ain's abili y o emain unchanged h oughou li e, esis ing any ex e nal s imulus.
b) The abili y o he ne ous sys em o gene a e andom elec ical impulses wi hou a
speci ic pu pose.
c) The way he b ain o ms new neu al connec ions and changes i s s uc u e in esponse
o expe iences, inju ies o diseases, being exploi ed by neu omodula ion o induce adap i e
changes.
d) The p ocess o neu onal degene a ion ha occu s na u ally wi h aging.
e) The abili y o ce ain a eas o he b ain o unc ion independen ly o o he s, wi hou any
in e connec ion.
2. In he con ex o he pa hophysiology
o inni us, how does audi o y
dea e en a ion (loss o ne e
connec ions due o pe iphe al hea ing
loss) impac he neu onal ac i i y
o he cen al audi o y sys em?
a) Inc eases la e al inhibi ion in
speci ic equency anges, esul ing
in less synch oniza ion and neu onal
hypoexci abili y.
b) I causes a signi ican dec ease in
neu onal ac i i y, leading o comple e
inac i i y o audi o y neu ons.
c) I s eng hens synap ic connec ions,
no malizing he b ain's abili y o p ocess
sound.
d) I weakens la e al inhibi ion in
ce ain equency anges, leading o
synch oniza ion and hype exci abili y o
neu ons in he cen al audi o y sys em.
e) I has no impac on he neu onal ac i i y
o he cen al audi o y sys em, i only a ec s
he pe cep ion o sound.
20 MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
3. Which o he ollowing neu onal oscilla ion bands has been iden i ied
as he bes objec i e p edic o o changes in inni us, acco ding o s udies
using echniques such as MEG and EEG?
a) Be a band (13–30 Hz)
b) The a band (4–7 Hz)
c) Del a band (1–3 Hz)
d) Alpha band (8–12 Hz)
e) Gamma Band (40–90 Hz)
4.Low- equency Repe i i e T ansc anial Magne ic S imula ion ( TMS) could
be indica ed o he ea men o inni us due o which o i s e ec s?
a) I s abili y o induce neu onal exci a ion and inc ease b ain hype ac i i y.
b) I s ac ion o di ec ly inducing he g ow h o new complex neu al pa hways,
wi hou modula ion o exis ing exci abili y.
c) I s inhibi o y e ec s on neu oplas ici y and educ ion o neu onal hype ac i i y
implica ed in he pe cep ion o inni us.
d) I s ex emely high cos , which limi s i s applica ion o a ew esea ch cen e s.
e) I s need o su gical implan a ion, making i an in asi e echnique.
5. Wha is one o he main gaps and challenges in he use o T ansc anial Di ec
Cu en S imula ion ( DCS) o he ea men o inni us, as discussed in he ex ?
a) I s high cu en in ensi y, which causes signi ican pain and se e e side e ec s.
b) The lack o s udies p o ing any neu ophysiological e ec o DCS on he b ain.
c) The absence o s anda dized p o ocols, long- e m s udies, and obus and consis en
clinical esul s, hinde ing e ec i e analysis and applica ion.
d) The need o gene al anes hesia o i s applica ion, making i a high- isk p ocedu e.
e) The ac ha DCS di ec ly induces neu al ac i i y, which is coun e p oduc i e
in he ea men o inni us.
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REFERÊNCIAS CONSULTADAS:
Ga cia MV, Ska zynski PH, San ins MD. Tinni us:
The phan om sound (pa I). MEDINCUS.
2023 Feb;1. DOI: 10.13140/RG.2.2.14473.52325.
Disponí el em: h ps://www. esea chga e.
ne /publica ion/368812328_Tinni us_The_
Phan om_Sound_Pa _I
San ins MD, Soa es A, Ska zysnki PH. Tinni us:
The phan om sound (pa II) – Audi o y
E oke Po en ials o sho la ency. MEDINCUS.
2023 Jun;5. DOI: 10.13140/RG.2.2.13437.54243.
Disponí el em: h ps://www. esea chga e.
ne /publica ion/371607598_Tinni us_The_
phan om_sound_pa _II_-_Audi o y_E oke_
Po en ials_o _sho _la ency
Ska zynska MB, Ska zynski PH, San ins
MD. Tinni us: The phan om sound (pa III)
– Pha macological T ea men o Tinni us.
MEDINCUS. 2023 Jul;6. DOI: 10.13140/
RG.2.2.11663.15526. Disponí el em: h ps://www.
esea chga e.ne /publica ion/372076007_
Tinni us_The_phan om_sound_pa _III_-_
Pha macological_T ea men _o _Tinni us
Ba ke AT, Jalinous R, TMS IS. Non-in asi e
magne ic s imula ion o he human b ain.
Lance . 1999;353(9164):1597-8.
Halle M, Chok o e y S. Magne ic s imula ion
o he human ne ous sys em. Ox o d
Uni e si y P ess; 2010.
Geo ge MS, Sackeim HA, P icha d CL.
Repe i i e ansc anial magne ic s imula ion
( TMS) o he p e on al co ex o dep ession: a
e iew. J Neu o he . 2000;4(1):21-39.
Pos A, Keck ME, Dannon PN. Repe i i e
ansc anial magne ic s imula ion in he
ea men o obsessi e-compulsi e diso de . J
Clin Psychia y. 2001;62(7):541-8.
Ro h Y, Pascual-Leone A, Halle M. The
he apeu ic po en ial o epe i i e ansc anial
magne ic s imula ion. Neu oscien is .
2000;6(4):283-93.
Jawish R, Smid M, Go don A, Shang aw K,
Mickey BJ. Jou nal o Medical Case Repo s.
2024;18:512. DOI: 10.1186/s13256-024-04855-y.
Disponí el em: h ps://jmedicalcase epo s.
biomedcen al.com/a icles/10.1186/s13256-024-
04855-y
La Ma a M, Monda A, Monda M, Villano
I, Chie i S, Ricci M, e al. T ansc anial
Magne ic S imula ion: A New Possibili y
in Obesi y T ea men . Open Neu ol J.
2024;18:e1874205X309047. DOI: 10.2174/01187
4205X309047240503104533. Disponí el em:
h ps://opennj.com/con en s/ olumes/V18/
ONJ-18-e1874205X309047.pd
B i ish Socie y o Audiology. P ac ice
Guidance: Tinni us in Adul s. 2021. Disponí el
em: h ps://www. hebsa.o g.uk/guidance-and-
esou ces/cu en -guidance/
Na ional Ins i u e o Heal h and Ca e
Excellence (NICE). Tinni us: assessmen and
managemen . NICE guideline [NG155]. 2020
Ma 11. Disponí el em: h ps://www.nice.o g.
uk/guidance/ng155
Mazu ek B, Hesse G, Sa el H, K a zsch
V, Lahmann C, Dobel C. S3 Guideline:
Ch onic Tinni us: Ge man Socie y o
O o hinola yngology, Head and Neck Su ge y
e. V. (DGHNO-KHC). HNO. 2022 No ;70(11):795-
827. DOI: 10.1007/s00106-022-01207-4.
Na ional Guideline Cen e (UK). E idence
e iew o neu omodula ion: Tinni us:
assessmen and managemen : E idence
e iew O. London: Na ional Ins i u e o
Heal h and Ca e Excellence (NICE); 2020.
Pe e N, Kleinjung T. Neu omodula ion o
inni us ea men : an o e iew o in asi e
and non-in asi e echniques. J Zhejiang Uni
Sci B. 2019 Feb;20(2):116-130. DOI: 10.1631/jzus.
B1700117. Epub 2018 Ma 12. PMID: 29770647;
PMCID: PMC6380997.
Hoa e DJ, Sho e GW, Shekhawa
GS, El Re aie A, Lab ee B, Se eda M.
Neu omodula ion T ea men s Ta ge ing
Pa hological Synch ony o Tinni us in Adul s:
A Sys ema ic Re iew. B ain Sci. 2024 Jul
26;14(8):748. DOI: 10.3390/b ainsci14080748.
PMID: 39199443; PMCID: PMC11352582.
Le eb e-Deme s M, Doyon N, Fec eau S.
Non-in asi e neu omodula ion o inni us:
A me a-analysis and modeling s udies. B ain
S imul. 2021;14(1). DOI: 10.1016/j.b s.2020.11.014.
He Z, Liao D, Ji Q, Yan S, Ai S. E icacy o
epe i i e ansc anial magne ic s imula ion
o subjec i e ch onic inni us: a andomized
con olled ial me a-analysis. F on
Neu osci. 2025;19:1579846. DOI: 10.3389/
nins.2025.1579846.
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
11.
12.
13.
14.
15.
16.
17.
18.
22 MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
19.
20.
21.
22.
23.
24.
25.
26.
Yakunina N, Nam EC. Di ec and
T anscu aneous Vagus Ne e S imula ion o
T ea men o Tinni us: A Scoping Re iew. F on
Neu osci. 2021 May 28;15:680590. DOI: 10.3389/
nins.2021.680590. PMID: 34122002; PMCID:
PMC8193498.
Mulle N, Lo enz I, Langgu h B, Weisz N.
TMS Induced Tinni us Relie Is Rela ed o an
Inc ease in Audi o y Co ical Alpha Ac i i y.
PLoS ONE. 2013;8(2):e55557. DOI: 10.1371/jou nal.
pone.0055557.
Heiland LD, Owen JM III, Nguyen SA, Labadie
RF, Lambe PR, Meye TA. Neu omodula ion
o T ea men o Tinni us: A Sys ema ic Re iew
and Me a-Analysis. O ola yngol Head Neck
Su g. 2024;170(5):1234–45. DOI: 10.1002/ohn.671.
Disponí el em: h ps://jou nals.sagepub.com/
doi/abs/10.1002/ohn.671
May A, Hajak G, Gänssbaue S, S e ens T,
Langgu h B, Kleinjung T, e al. S uc u al b ain
al e a ions ollowing 5 days o in e en ion:
Dynamic aspec s o neu oplas ici y. Ce eb
Co ex. 2007;17(1):205–10. DOI: 10.1093/ce co /
bhj138.
Meng Z, Liu S, Zheng Y, Phillips JS. Repe i i e
ansc anial magne ic s imula ion o inni us.
Coch ane Da abase Sys Re . 2011;5:CD007946.
DOI: 10.1002/14651858.CD007946.pub2.
Yin L, Chen X, Lu X, An Y, Zhang T, Yan J. An
upda ed me a-analysis: Repe i i e ansc anial
magne ic s imula ion o ea ing inni us.
J In Med Res. 2021;49:1221799101. DOI:
10.1177/0300060521999549.
Qi S, Cao L, Wang Q, Sheng Y, Yu J, Liang Z.
The Physiological Mechanisms o T ansc anial
Di ec Cu en S imula ion o Enhance Mo o
Pe o mance: A Na a i e Re iew. Biology.
2024;13:790. DOI: 10.3390/biology13100790.
Disponí el em: h ps://www.mdpi.com/2079-
7737/13/10/790
Lab ee B, Hoa e DJ, Gascoyne LE, e al.
De e mining he e ec s o ansc anial di ec
cu en s imula ion on inni us and inni us-
ela ed ou comes: p o ocol o a sys ema ic
e iew. BMJ Open. 2021;11:e047191. DOI: 10.1136/
bmjopen-2020-047191. Disponí el em: h ps://
bmjopen.bmj.com/con en /11/2/e047191
27.
28.
29.
Ma es T, Alb ech J, Buday J, Podgo na
G, Le TH, Magya o a E, Posho K, Halik J,
Buna J, Capek V, Kos ylko a L, Klaso a J,
Fabian V, Ande s M. Long- e m e ec o
ansc anial di ec cu en s imula ion
in he ea men o ch onic inni us: A
andomized, placebo-con olled ial. F on
Psychia y. 2022;13:969800. DOI: 10.3389/
psy .2022.969800.
Ylikoski J, Ma kkanen M, Pi ola U, Leh imäki
JA, Ylikoski M, Jing Z, Sinkkonen ST, Mäki ie
A. S ess and Tinni us; T anscu aneous
Au icula Vagal Ne e S imula ion A enua es
Tinni us-T igge ed S ess Reac ion. F on
Psychol. 2020;11:570196. DOI: 10.3389/
psyg.2020.570196.
COLOCAR A REFERÊNCA FORTES E
SANFINS, 2025
Respos as Co e as do Quiz
1. co ec answe : c
2. co ec answe : d
3. co ec answe : c
4. co ec answe : c
5. co ec answe : d
23
MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
1. Ga cia MV, Ska zynski PH, San ins
MD. Tinni us: The phan om sound (pa
I). MEDINCUS. 2023 Feb;1. DOI: 10.13140/
RG.2.2.14473.52325. Disponí el em: h ps://
www. esea chga e.ne /publica ion/368812328_
Tinni us_The_Phan om_Sound_Pa _I
2. San ins MD, Soa es A, Ska zysnki
PH. Tinni us: The phan om sound (pa II) –
Audi o y E oke Po en ials o sho la ency.
MEDINCUS. 2023 Jun;5. DOI: 10.13140/
RG.2.2.13437.54243. Disponí el em: h ps://
www. esea chga e.ne /publica ion/371607598_
Tinni us_The_phan om_sound_pa _II_-_
Audi o y_E oke_Po en ials_o _sho _la ency
3. Ska zynska MB, Ska zynski PH,
San ins MD. Tinni us: The phan om sound
(pa III) – Pha macological T ea men o
Tinni us. MEDINCUS. 2023 Jul;6. DOI: 10.13140/
RG.2.2.11663.15526. Disponí el em: h ps://www.
esea chga e.ne /publica ion/372076007_
Tinni us_The_phan om_sound_pa _III_-_
Pha macological_T ea men _o _Tinni us
4. Ba ke AT, Jalinous R, TMS IS. Non-
in asi e magne ic s imula ion o he human
b ain. Lance . 1999;353(9164):1597-8.
5. Halle M, Chok o e y S. Magne ic
s imula ion o he human ne ous sys em.
Ox o d Uni e si y P ess; 2010.
6. Geo ge MS, Sackeim HA, P icha d CL.
Repe i i e ansc anial magne ic s imula ion
( TMS) o he p e on al co ex o dep ession: a
e iew. J Neu o he . 2000;4(1):21-39.
7. Pos A, Keck ME, Dannon PN.
Repe i i e ansc anial magne ic s imula ion
in he ea men o obsessi e-compulsi e
diso de . J Clin Psychia y. 2001;62(7):541-8.
8. Ro h Y, Pascual-Leone A, Halle M. The
he apeu ic po en ial o epe i i e ansc anial
magne ic s imula ion. Neu oscien is .
2000;6(4):283-93.
9. Jawish R, Smid M, Go don A, Shang aw
K, Mickey BJ. Jou nal o Medical Case Repo s.
2024;18:512. DOI: 10.1186/s13256-024-04855-y.
Disponí el em: h ps://jmedicalcase epo s.
biomedcen al.com/a icles/10.1186/s13256-024-
04855-y
10. La Ma a M, Monda A, Monda M,
Villano I, Chie i S, Ricci M, e al. T ansc anial
Magne ic S imula ion: A New Possibili y
in Obesi y T ea men . Open Neu ol J.
2024;18:e1874205X309047. DOI: 10.2174/01187
4205X309047240503104533. Disponí el em:
h ps://opennj.com/con en s/ olumes/V18/ONJ-
18-e1874205X309047.pd
11. B i ish Socie y o Audiology. P ac ice
Guidance: Tinni us in Adul s. 2021. Disponí el
em: h ps://www. hebsa.o g.uk/guidance-and-
esou ces/cu en -guidance/
01.
02.
03.
04.
05.
06.
07.
08.
09.
1. Ga cia MV, Ska zynski PH, San ins
MD. Tinni us: The phan om sound (pa
I). MEDINCUS. 2023 Feb;1. DOI: 10.13140/
RG.2.2.14473.52325. Disponí el em: h ps://
www. esea chga e.ne /publica ion/368812328_
Tinni us_The_Phan om_Sound_Pa _I
2. San ins MD, Soa es A, Ska zysnki
PH. Tinni us: The phan om sound (pa II) –
Audi o y E oke Po en ials o sho la ency.
MEDINCUS. 2023 Jun;5. DOI: 10.13140/
RG.2.2.13437.54243. Disponí el em: h ps://
www. esea chga e.ne /publica ion/371607598_
Tinni us_The_phan om_sound_pa _II_-_
Audi o y_E oke_Po en ials_o _sho _la ency
3. Ska zynska MB, Ska zynski PH,
San ins MD. Tinni us: The phan om sound
(pa III) – Pha macological T ea men o
Tinni us. MEDINCUS. 2023 Jul;6. DOI: 10.13140/
RG.2.2.11663.15526. Disponí el em: h ps://www.
esea chga e.ne /publica ion/372076007_
Tinni us_The_phan om_sound_pa _III_-_
Pha macological_T ea men _o _Tinni us
4. Ba ke AT, Jalinous R, TMS IS. Non-
in asi e magne ic s imula ion o he human
b ain. Lance . 1999;353(9164):1597-8.
5. Halle M, Chok o e y S. Magne ic
s imula ion o he human ne ous sys em.
Ox o d Uni e si y P ess; 2010.
6. Geo ge MS, Sackeim HA, P icha d CL.
Repe i i e ansc anial magne ic s imula ion
( TMS) o he p e on al co ex o dep ession: a
e iew. J Neu o he . 2000;4(1):21-39.
7. Pos A, Keck ME, Dannon PN.
Repe i i e ansc anial magne ic s imula ion
in he ea men o obsessi e-compulsi e
diso de . J Clin Psychia y. 2001;62(7):541-8.
8. Ro h Y, Pascual-Leone A, Halle M. The
he apeu ic po en ial o epe i i e ansc anial
magne ic s imula ion. Neu oscien is .
2000;6(4):283-93.
9. Jawish R, Smid M, Go don A, Shang aw
K, Mickey BJ. Jou nal o Medical Case Repo s.
2024;18:512. DOI: 10.1186/s13256-024-04855-y.
Disponí el em: h ps://jmedicalcase epo s.
biomedcen al.com/a icles/10.1186/s13256-024-
04855-y
10. La Ma a M, Monda A, Monda M,
Villano I, Chie i S, Ricci M, e al. T ansc anial
Magne ic S imula ion: A New Possibili y
in Obesi y T ea men . Open Neu ol J.
2024;18:e1874205X309047. DOI: 10.2174/01187
4205X309047240503104533. Disponí el em:
h ps://opennj.com/con en s/ olumes/V18/ONJ-
18-e1874205X309047.pd
11. B i ish Socie y o Audiology. P ac ice
Guidance: Tinni us in Adul s. 2021. Disponí el
em: h ps://www. hebsa.o g.uk/guidance-and-
esou ces/cu en -guidance/
01.
02.
03.
04.
05.
06.
07.
08.
09.
1. Ga cia MV, Ska zynski PH, San ins
MD. Tinni us: The phan om sound (pa
I). MEDINCUS. 2023 Feb;1. DOI: 10.13140/
RG.2.2.14473.52325. Disponí el em: h ps://
www. esea chga e.ne /publica ion/368812328_
Tinni us_The_Phan om_Sound_Pa _I
2. San ins MD, Soa es A, Ska zysnki
PH. Tinni us: The phan om sound (pa II) –
Audi o y E oke Po en ials o sho la ency.
MEDINCUS. 2023 Jun;5. DOI: 10.13140/
RG.2.2.13437.54243. Disponí el em: h ps://
www. esea chga e.ne /publica ion/371607598_
Tinni us_The_phan om_sound_pa _II_-_
Audi o y_E oke_Po en ials_o _sho _la ency
3. Ska zynska MB, Ska zynski PH,
San ins MD. Tinni us: The phan om sound
(pa III) – Pha macological T ea men o
Tinni us. MEDINCUS. 2023 Jul;6. DOI: 10.13140/
RG.2.2.11663.15526. Disponí el em: h ps://www.
esea chga e.ne /publica ion/372076007_
Tinni us_The_phan om_sound_pa _III_-_
Pha macological_T ea men _o _Tinni us
4. Ba ke AT, Jalinous R, TMS IS. Non-
in asi e magne ic s imula ion o he human
b ain. Lance . 1999;353(9164):1597-8.
5. Halle M, Chok o e y S. Magne ic
s imula ion o he human ne ous sys em.
Ox o d Uni e si y P ess; 2010.
6. Geo ge MS, Sackeim HA, P icha d CL.
Repe i i e ansc anial magne ic s imula ion
( TMS) o he p e on al co ex o dep ession: a
e iew. J Neu o he . 2000;4(1):21-39.
7. Pos A, Keck ME, Dannon PN.
Repe i i e ansc anial magne ic s imula ion
in he ea men o obsessi e-compulsi e
diso de . J Clin Psychia y. 2001;62(7):541-8.
8. Ro h Y, Pascual-Leone A, Halle M. The
he apeu ic po en ial o epe i i e ansc anial
magne ic s imula ion. Neu oscien is .
2000;6(4):283-93.
9. Jawish R, Smid M, Go don A, Shang aw
K, Mickey BJ. Jou nal o Medical Case Repo s.
2024;18:512. DOI: 10.1186/s13256-024-04855-y.
Disponí el em: h ps://jmedicalcase epo s.
biomedcen al.com/a icles/10.1186/s13256-024-
04855-y
10. La Ma a M, Monda A, Monda M,
Villano I, Chie i S, Ricci M, e al. T ansc anial
Magne ic S imula ion: A New Possibili y
in Obesi y T ea men . Open Neu ol J.
2024;18:e1874205X309047. DOI: 10.2174/01187
4205X309047240503104533. Disponí el em:
h ps://opennj.com/con en s/ olumes/V18/ONJ-
18-e1874205X309047.pd
11. B i ish Socie y o Audiology. P ac ice
Guidance: Tinni us in Adul s. 2021. Disponí el
em: h ps://www. hebsa.o g.uk/guidance-and-
esou ces/cu en -guidance/
01.
02.
03.
04.
05.
06.
07.
08.
09.
1. Ga cia MV, Ska zynski PH, San ins
MD. Tinni us: The phan om sound (pa
I). MEDINCUS. 2023 Feb;1. DOI: 10.13140/
RG.2.2.14473.52325. Disponí el em: h ps://
www. esea chga e.ne /publica ion/368812328_
Tinni us_The_Phan om_Sound_Pa _I
2. San ins MD, Soa es A, Ska zysnki
PH. Tinni us: The phan om sound (pa II) –
Audi o y E oke Po en ials o sho la ency.
MEDINCUS. 2023 Jun;5. DOI: 10.13140/
RG.2.2.13437.54243. Disponí el em: h ps://
www. esea chga e.ne /publica ion/371607598_
Tinni us_The_phan om_sound_pa _II_-_
Audi o y_E oke_Po en ials_o _sho _la ency
3. Ska zynska MB, Ska zynski PH,
San ins MD. Tinni us: The phan om sound
(pa III) – Pha macological T ea men o
Tinni us. MEDINCUS. 2023 Jul;6. DOI: 10.13140/
RG.2.2.11663.15526. Disponí el em: h ps://www.
esea chga e.ne /publica ion/372076007_
Tinni us_The_phan om_sound_pa _III_-_
Pha macological_T ea men _o _Tinni us
4. Ba ke AT, Jalinous R, TMS IS. Non-
in asi e magne ic s imula ion o he human
b ain. Lance . 1999;353(9164):1597-8.
5. Halle M, Chok o e y S. Magne ic
s imula ion o he human ne ous sys em.
Ox o d Uni e si y P ess; 2010.
6. Geo ge MS, Sackeim HA, P icha d CL.
Repe i i e ansc anial magne ic s imula ion
( TMS) o he p e on al co ex o dep ession: a
e iew. J Neu o he . 2000;4(1):21-39.
7. Pos A, Keck ME, Dannon PN.
Repe i i e ansc anial magne ic s imula ion
in he ea men o obsessi e-compulsi e
diso de . J Clin Psychia y. 2001;62(7):541-8.
8. Ro h Y, Pascual-Leone A, Halle M. The
he apeu ic po en ial o epe i i e ansc anial
magne ic s imula ion. Neu oscien is .
2000;6(4):283-93.
9. Jawish R, Smid M, Go don A, Shang aw
K, Mickey BJ. Jou nal o Medical Case Repo s.
2024;18:512. DOI: 10.1186/s13256-024-04855-y.
Disponí el em: h ps://jmedicalcase epo s.
biomedcen al.com/a icles/10.1186/s13256-024-
04855-y
10. La Ma a M, Monda A, Monda M,
Villano I, Chie i S, Ricci M, e al. T ansc anial
Magne ic S imula ion: A New Possibili y
in Obesi y T ea men . Open Neu ol J.
2024;18:e1874205X309047. DOI: 10.2174/01187
4205X309047240503104533. Disponí el em:
h ps://opennj.com/con en s/ olumes/V18/ONJ-
18-e1874205X309047.pd
11. B i ish Socie y o Audiology. P ac ice
Guidance: Tinni us in Adul s. 2021. Disponí el
em: h ps://www. hebsa.o g.uk/guidance-and-
esou ces/cu en -guidance/
01.
02.
03.
04.
05.
06.
07.
08.
09.
Au o es
- Adjunc P o esso o he Discipline o Hea ing Diso de s
o he Speech-Language Pa hology and Audiology Cou se
a he Fede al Uni e si y o São Paulo (UNIFESP);
- Memb o do g upo de pesquisa do Ins i u e o Physiology
and Pa hology o Hea ing and Wo ld Hea ing Cen e ,
Kaje any, Poland.
- P o esso o he Pos g adua e Cou se in Clinical
Audiology a he Is aeli Ins i u e o Teaching and Resea ch
o he Albe Eins ein Hospi al.
- Pos doc o al ellow a he Wo ld Hea ing Cen e , Wa saw,
Poland;
- Sandwich doc o a e om he Facul y o Medical
Sciences, S a e Uni e si y o Campinas (FCM-UNICAMP)
and om he Uni e si à degli S udi di Fe a a/I aly;
PROF. DRA. MILAINE DOMINICI SANFINS
- Specialis in Audiology by he Fede al Council o Speech-
Language Pa hology and Audiology;
- Bachelo 's and Mas e 's deg ee om he Facul y o
Medicine o he Uni e si y o São Paulo (FMUSP);
- Membe o he eaching and esea ch commi ee o he
B azilian Academy o Audiology (2024-2026);
- Rappo eu o he Resea ch E hics Commi ee o he
Fede al Uni e si y o São Paulo;
- Re iewe o scien i ic a icles and book chap e s in he
a ea o Audiology, Elec ophysiology, Neu oaudiology
and Neu oscience;
- Ins ag am @misan ins / email: msan [email protected]
e msan ins@uni esp.b
- Clinical Speech The apis ;
- PhD and Mas e o Science om he G adua e P og am
in Human Communica ion Diso de s a he Fede al
Uni e si y o São Paulo/ Paulis a School o Medicine
(UNIFESP/EPM);
- Specialis in Clinical Audiology and O oneu ology
by he Fede al Council o Speech-Language
Pa hology and Audiology);
- Deg ee in Speech-Language Pa hology and
Audiology om he Pon i ical Ca holic Uni e si y
o São Paulo (PUCSP);
FGA. DR. ANNA CAROLINA MARQUES PERRELLA DE BARROS
- P o esso o he Specializa ion Cou se in Clinical
Audiology (Albe Eins ein Is aeli Ins i u e o Teaching
and Resea ch and CEAFI College) and ex ension cou ses
(Fonoaudiálogo).
- Membe o he S udy and Resea ch G oup on Tinni us
and Sound Sensi i i y P o . Yo aka Fukuda, om he
Fede al Uni e si y o São Paulo.
24 MEDINCUS - DOI: 10.5281/ZENODO.17101649 - VOL.27, NOVEMBER/2025
- P o esso , ENT, Mas e and Doc o a e by Medical
Uni e si y o Wa saw;
- Resea ch, didac ic, clinical, and o ganiza ional wo k
in Wo ld Hea ing Cen e o Ins i u e o Physiology and
Pa hology o Hea ing, Ins i u e o Senso y O gans and
Medical Uni e si y o Wa saw;
- Specialis in ENT, pedia ic ENT, audiology and
phonia ics, and public heal h. Pa icipa ed in he 3 d
S akeholde s Consul a ion mee ing du ing which he
Wo ld Hea ing Fo um o WHO was announced;
- Membe o he Ros e o Expe s on Digi al Heal h o
WHO, Vice-P esiden and Ins i u ional Rep esen a i e o
IS TeH;
- P esiden -elec o In e na ional Ad iso y Boa d o AAO-
HNS, membe o Cong ess and Mee ing Depa men o
EAONO, Regional Rep esen a i e o Eu ope o ISA, Vice-
P esiden o Hea Ring G oup, Audi o o EFAS, membe o
he Facial Ne e S imula ion S ee ing Commi ee;
PROF. DR. PIOTR HENRYK SKARZYNSKI
- Boa d Sec e a y o he Polish Socie y o
O o hinola yngologis s, Phonia is s and Audiologis s.
Membe o Hea ing Commi ee (2018–19);
- Goodwill Ambassado ep esen ing Poland a he
AAO-HNSF 2021 Annual Mee ing & OTO Expe ience, and
since 2021 a membe o Implan able Hea ing De ices
Commi ee and O ology & Neu o ology Educa ion
Commi ee o AAO-HNS;
- Consul an Commi ee o In e na ional Expe s o
CPAM-VBMS (by special in i a ion), hono a y membe o
ORL Danube Socie y, and hono a y membe o Socié é
F ançaise d’O o-Rhino-La yngologie;
- Membe o he Council o Na ional Science Cen e ;
- Expe and membe o nume ous na ional o ganiza ions.
