Impacto de la estimulación sonora durante diferentes etapas del sueño en pacientes con acúfeno
DOI:
https://doi.org/10.3989/loquens.2018.053Palabras clave:
procesamiento auditivo central, husos de sueño, etapas N2, N3 y REMResumen
Es sabido que la información auditiva se procesa continuamente durante la vigilia y el sueño. Se ha demostrado que la estimulación con sonido que imita el tinnitus, aplicada durante el sueño, disminuye la intensidad del tinnitus y mejora la calidad de vida de los pacientes. Los mecanismos que subyacen a esta mejoría no se conocen, aunque en la etapa de sueño con husos (N2) fueron demostrados los principales cambios en los espectros de potencia y la coherencia en las ondas electroencefalográficas durante la estimulación sonora. Once pacientes que padecen tinnitus fueron estimulados por sonido (imitando el tinnitus) en diferentes etapas del sueño; 4 fueron estimulados en N2, 4 en la etapa N3 (sueño de ondas lentas) y 3 durante el sueño REM (estadio con movimientos oculares rápidos). Los pacientes fueron registrados con una polisomnografía, para el diagnóstico de etapas del sueño y la aplicación de la estimulación del sonido. Los valores de intensidad del tinnitus se compararon los días anterior y posterior a la estimulación y se analizaron estadísticamente (prueba t de Student pareada). Todos los pacientes estimulados en la etapa N2 mostraron una disminución estadísticamente significativa en la intensidad del tinnitus el día después de la estimulación, mientras que ninguno de los pacientes estimulados en la etapa N3 mostró cambios en la intensidad, y solo uno de los tres estimulados durante el sueño REM tuvo cambios. Los resultados sugieren que la etapa de sueño N2 sería el período en que el sonido estimulante interactuaría con las redes de procesamiento auditivo, reduciendo la intensidad del tinnitus.
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