{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T16:24:37Z","timestamp":1790267077694,"version":"4.1.0"},"reference-count":64,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T00:00:00Z","timestamp":1779321600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the effectiveness and safety of neuromodulation and bimodal stimulation for chronic subjective tinnitus in randomized controlled trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>PubMed\/MEDLINE, Web of Science, and EMBASE (January 2015\u2013December 2025) searched per PRISMA 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Adult RCTs (\u2265\u200918\u2009years) with chronic subjective tinnitus (&gt;\u20093\u2009months) assessing validated outcomes (THI, TFI, TQ) for neuromodulation\/bimodal interventions vs. sham\/controls. Two\u2010stage screening, Cochrane RoB\u20102 risk\u2010of\u2010bias assessment. Random\u2010effects meta\u2010analyses (REML) were performed when \u2265\u20093 comparable trials were available; effects reported as standardized mean differences (SMD) with 95% CIs. Main Outcomes and measures included change in tinnitus severity (THI\/TFI\/TQ) while secondary outcomes included loudness (VAS\/NRS), durability, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010six RCTs (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091576) met criteria: tES (11;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009372), rTMS (8;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009432), acoustic coordinated reset (1;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100), vagus nerve stimulation (2;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200990), and bimodal stimulation (4;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009582). Meta\u2010analysis showed a nonsignificant pooled effect for tDCS (SMD \u22120.36; 95% CI \u22120.75 to 0.02;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200951%) and rTMS (SMD \u22120.15; 95% CI \u22120.37 to 0.07;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Single\u2010trial evidence for coordinated reset showed no advantage over broadband noise. VNS demonstrated modest benefits with safety concerns limited to implanted approaches. Bimodal stimulation yielded consistent, clinically meaningful reductions (often \u2265\u200910\u201320 points on THI\/TFI), with durability up to 12\u2009months. Adverse events were mild\/transient across noninvasive modalities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Noninvasive neuromodulation appears safe with average benefits; among modalities, bimodal stimulation shows the most consistent and durable clinical improvements. Standardized, adequately powered RCTs with harmonized protocols and long\u2010term follow\u2010up are needed to refine targets and dosing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>1.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.70633","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T01:50:38Z","timestamp":1779414638000},"page":"4152-4166","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Neuromodulation for Subjective Tinnitus: A Systematic Review and Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1002","volume":"136","author":[{"given":"Dimitrios","family":"Kitsis","sequence":"first","affiliation":[{"name":"General Hospital of Ioannina \u201cHatzikosta\u201d Otolaryngology Department  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5748-091X","authenticated-orcid":false,"given":"Giorgos","family":"Sideris","sequence":"additional","affiliation":[{"name":"National &amp; Kapodistrian University of Athens, School of Medicine \u201cAttikon\u201d University Hospital, 2nd Otolaryngology Department  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agapi","family":"Skouloudaki","sequence":"additional","affiliation":[{"name":"National &amp; Kapodistrian University of Athens, School of Medicine \u201cAttikon\u201d University Hospital, 2nd Otolaryngology Department  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Delides","sequence":"additional","affiliation":[{"name":"National &amp; Kapodistrian University of Athens, School of Medicine \u201cAttikon\u201d University Hospital, 2nd Otolaryngology Department  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petros","family":"Vlastarakos","sequence":"additional","affiliation":[{"name":"National &amp; Kapodistrian University of Athens, School of Medicine \u201cAttikon\u201d University Hospital, 2nd Otolaryngology Department  Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,21]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.pbr.2020.12.002"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.2189"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.3766\/jaaa.18.3.7"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0b013e3181888f83"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0029966"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12793"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00164.2013"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.11310.1"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2014.05.013"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2012.09.010"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2015.00124"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0168-0102(90)90031-9"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12206555"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1460-9568.2005.04142.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2015.06.005"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106-019-0633-7"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2006.01414.x"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2013.04.328"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/09602011.2011.557292"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinph.2015.02.001"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12874"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00422-012-0479-5"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2012.00070"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.heares.2012.10.001"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12227117"},{"key":"e_1_2_10_27_1","doi-asserted-by":"crossref","unstructured":"M. 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