Treatment of tinnitus with electrical stimulation on acupoint in the distribution area of ear vagus nerve combining with sound masking: randomized controlled trial

Objective To observe the efficacy of treating tinnitus with electrical stimulation on acupoint in the distribution area of ear vagus nerve by combining with sound masking. Methods Sixty-three volunteers suffering from tinnitus were randomly divided into a treatment group （32 cases） and a control group （31 cases） according to envelope method. The treatment group was given the treatment with electrical stimulation on acupoint in the distribution area of ear vagus nerve by combining with sound masking while the control group was given the treatment by taking flunarizine hydrochloride capsules and oryzanol orally. The treatment for both groups lasted for eight weeks. The efficacy was evaluated before treatment, 4 weeks and 8 weeks following the treatment respectively according to ＂Tinnitus Handicap Inventory＂ and ＂Tinnitus Dysphoria Inventory＂. Results It was revealed from the Tinnitus Handicap Inventory that the differences were not statistically significant by comparing the two groups after treatment for 4 weeks （χ2=1.981, P=0.16）; After 8 weeks of the treatment, patients with mild tinnitus and severe tinnitus were significantly improved in the treatment group compared with those before treatment （χ2=25.01, P〈0.O01） while the difference in the control group was not statistically significant before and after treatment （χ2=2.986, P=0.084）, and the difference of the ratio of patients with mild tinnitus in the two groups was statistically significant （χ2=9.315, P=0.002）. It was revealed from the Tinnitus Dysphoria Inventory that dysphoria of patients in the treatment group was more alleviated than that in the control group after treatment for 4 weeks （χ2=4.661, P=0.03）; After 8 weeks of the treatment, the patients with mild dysphoria and severe dysphoria were significantly improved in the two groups （χ2=25.397, P〈O.001 and χ2=7.828, P=O.O05, respectively）, and the efficacy in the treatment group was improved more significantly than that in the control group （χ2=5.857, P=0.016）. It was shown from the comprehensive efficacy that after 8 weeks of treatment, the effective rates of the two groups were 90.63% （29/32） and 80.65% （25/31） respectively, and the difference between the two groups was not statistically significant （χ2=0.595, P=0.44）. Conclusion Handicap and dysphoria of tinnitus can be improved significantly by treating with electrical stimulation on acupoint in the distribution area of ear vagus nerve and sound masking, and the efficacy was superior to that of western medicines.

A Missense Mutation in Epsilon-subunit of Acetylcholine Receptor Causing Autosomal Dominant Slow-channel Congenital Myasthenic Syndrome in a Chinese Family

Background：Congenital myasthenic syndromes are a group orrare disorders that are clinically and genetically heterogeneous and caused by mutations in the genes encoding proteins of the neuromuscular junction.Here,we described a Chinese family that presented with phenotypes of classic slow-channel congenital myasthenic syndrome （SCCMS）.Methods：Clinical characteristics and electrophysiological features of three patients from a Chinese family were examined,and next-generation sequencing followed by direct sequencing was carried out.Results：The patients revealed variability in clinical and electrophysiological features.However,weakness,scoliosis,and repetitive-compound muscle action potential were found in all affected members in the family.A heterozygous C〉T missense mutation at nucleotide 865 in acetylcholine receptor epsilon-subunit （CHRNE） gene that causes a leucine-to-phenylalanine substitution at position 289 （L289F） was found.Conclusions：We reported a SCCMS family of Chinese origin.In the family,classical clinical phenotype with phenotypic variability among different members was found.Genetic testing could help diagnose this rare disease.