Section: 
Otiology
OtiologyBimodal stimulation in chronic tinnitus: dynamics of changes in cortical activity according to functional near-infrared spectroscopy (fnirs) data
V. V. Dvoryanchikov (1), E. A. Levina (2), K. O. Samsonova (3), S. V. Levin (4), V. E. Kuzovkov (5), S. B. Sugarova (6)
(1), (2), (3), (4), (5), (6) Saint Petersburg Institute of Ear, Throat, Nose and Speech, Saint Petersburg, 190013, Russian Federation
UDK: УДК 616.28-008.28-072.7-073.584
DOI: https://doi.org/10.18692/1810-4800-2026-1-48-58
ABSTRACT
Abstract. Chronic tinnitus is a common condition associated with maladaptive neuroplasticity in the auditory system. Traditional treatment approaches often lack efficacy. Bimodal stimulation (simultaneous auditory and electrical stimulation) is considered a promising method for correcting pathological brain activity, yet its neurophysiological mechanisms remain insufficiently explored. Objective. To assess the effectiveness of bimodal neuromodulation in patients with chronic unilateral tinnitus using functional near-infrared spectroscopy (fNIRS) data. Patients and methods. Eleven patients (aged 24–56) with unilateral chronic tinnitus underwent 6 weeks of bimodal stimulation (30 sessions): individualized acoustic tones and synchronized electrical stimulation of the anterior third of the tongue. Pre- and post-treatment evaluation included questionnaires (VAS, THI) and fNIRS-based monitoring of cortical activity during auditory tasks. Results. Clinically meaningful improvement (VAS — 31%, THI — 25%) was observed in 55% of patients. fNIRS revealed ~50% reduction in hyperactivation of the auditory (A1, BA22) and prefrontal (BA9/46) cortex by ~50%, as well as restoration of lateralization of auditory responses in some patients. The correlation between the decrease in THI and the decrease in ?HbO? in A1 was r = 0.46. Conclusions. Bimodal stimulation effectively reduces both subjective tinnitus perception and its associated neurophysiological markers. The fNIRS method has proven its informative value for therapy monitoring.
Publication date:
24.02.2026
Keywords:
auditory cortex, neuroplasticity, functional neuroimaging, tinnitus, subjective tinnitus, sound therapy, bimodal stimulation, neuroimaging, fNIRS, functional imaging, functional near-infrared spectroscopy For citation:
Dvoryanchikov V. V., Levina E. A., Samsonova K. O., Levin S. V., Kuzovkov V. E., Sugarova S. B. Bimodal stimulation in chronic tinnitus: dynamics of changes in cortical activity according to functional near-infrared spectroscopy (fnirs) data. Russian Otorhinolaryngology. 2026;25(1):48-58. (In Russ.) https://doi.org/10.18692/1810-4800-2026-1-48-58