{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:09:33Z","timestamp":1760148573887,"version":"build-2065373602"},"reference-count":82,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T00:00:00Z","timestamp":1684454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Innovation and Diffusion of Mathematical Sciences Center Applied to Industry (CEPID-CeMEAI) of S\u00e3o Paulo Research Foundation (FAPESP)","doi-asserted-by":"publisher","award":["2013\/07375-0"],"award-info":[{"award-number":["2013\/07375-0"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Centro de Engenharia Aplicada a Sa\u00fade (CEAS) of the University of S\u00e3o Paulo","award":["2013\/07375-0"],"award-info":[{"award-number":["2013\/07375-0"]}]},{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior (CAPES)","award":["2013\/07375-0"],"award-info":[{"award-number":["2013\/07375-0"]}]},{"name":"Funda\u00e7\u00e3o de Apoio ao Ensino, Pesquisa e Assist\u00eancia do Hospital das Cl\u00ednicas da Faculdade de Medicina de Ribeir\u00e3o Preto da Universidade de S\u00e3o Paulo (FAEPA)","award":["2013\/07375-0"],"award-info":[{"award-number":["2013\/07375-0"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Around 30% of the general population experience subjective tinnitus, characterized by conscious attended awareness perception of sound without an external source. Clinical distress tinnitus is more than just experiencing a phantom sound, as it can be highly disruptive and debilitating, leading those affected to seek clinical help. Effective tinnitus treatments are crucial for psychological well-being, but our limited understanding of the underlying neural mechanisms and a lack of a universal cure necessitate further treatment development. In light of the neurofunctional tinnitus model predictions and transcranial electrical stimulation, we conducted an open-label, single-arm, pilot study that utilized high-definition transcranial direct current stimulation (HD-tDCS) concurrent with positive emotion induction (PEI) techniques for ten consecutive sessions to down-regulate tinnitus negative valence in patients with clinical distress tinnitus. We acquired resting-state functional magnetic resonance imaging scans of 12 tinnitus patients (7 females, mean age = 51.25 \u00b1 12.90 years) before and after the intervention to examine resting-state functional connectivity (rsFC) alterations in specific seed regions. The results showed reduced rsFC at post-intervention between the attention and emotion processing regions as follows: (1) bilateral amygdala and left superior parietal lobule (SPL), (2) left amygdala and right SPL, (3) bilateral dorsolateral prefrontal cortex (dlPFC) and bilateral pregenual anterior cingulate cortex (pgACC), and (4) left dlPFC and bilateral pgACC (FWE corrected p &lt; 0.05). Furthermore, the post-intervention tinnitus handicap inventory scores were significantly lower than the pre-intervention scores (p &lt; 0.05). We concluded that concurrent HD-tDCS and PEI might be effective in reducing tinnitus negative valence, thus alleviating tinnitus distress.<\/jats:p>","DOI":"10.3390\/brainsci13050826","type":"journal-article","created":{"date-parts":[[2023,5,19]],"date-time":"2023-05-19T10:35:11Z","timestamp":1684492511000},"page":"826","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Down-Regulation of Tinnitus Negative Valence via Concurrent HD-tDCS and PEI Technique: A Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3282-1909","authenticated-orcid":false,"given":"Zahra","family":"Vaziri","sequence":"first","affiliation":[{"name":"Department of Neuroscience and Behavior, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14048-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1441-1524","authenticated-orcid":false,"given":"Carlos E. G.","family":"Salmon","sequence":"additional","affiliation":[{"name":"InBrain Lab, Department of Physics, Faculty of Philosophy, Sciences and Letters, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14040-901, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9098-2663","authenticated-orcid":false,"given":"Iman","family":"Ghodratitoostani","sequence":"additional","affiliation":[{"name":"Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of S\u00e3o Paulo, S\u00e3o Carlos 13566-590, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio Carlos dos","family":"Santos","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Hematology and Clinical Oncology, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14049-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9688-782X","authenticated-orcid":false,"given":"Miguel A.","family":"Hyppolito","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14049-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1810-1742","authenticated-orcid":false,"given":"Alexandre C. B.","family":"Delbem","sequence":"additional","affiliation":[{"name":"Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of S\u00e3o Paulo, S\u00e3o Carlos 13566-590, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0558-3519","authenticated-orcid":false,"given":"Jo\u00e3o P.","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Neuroscience and Behavior, Faculty of Medicine of Ribeir\u00e3o Preto, University of S\u00e3o Paulo, Ribeir\u00e3o Preto 14048-900, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"370","DOI":"10.3389\/fnins.2016.00370","article-title":"Theoretical Tinnitus Framework: A Neurofunctional Model","volume":"10","author":"Ghodratitoostani","year":"2016","journal-title":"Front. 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