The International Tinnitus Journal

Prefrontal Alpha Stabilization and Postmidpoint Improvement in Tinnitus/Hearing Outcomes: A Single-Case Report with Bayesian Changepoint Analysis

Kyoungyoon Lee

This single-case report conceptualizes tinnitus not as a solitary output of the auditory cortex but as a systems-level phenomenon arising from the interplay among attentional, affective, and cognitive networks. Over 12 months, the patient received combined acupuncture, pharmacopuncture, herbal medicine, prefrontal alpha–centric neurofeedback, and Reve 134–based sound retraining (2–3 sessions/week, approximately 30 min/session). Prefrontal electroencephalography (EEG) alpha peak frequency (Hz), Tinnitus/Hearing Difficulty VAS (0–10), and minimum masking level (MML, dB SL) were evaluated at three prespecified time points: baseline, midpoint (≈5.5 months postbaseline), and final (≈11.7 months postbaseline). The findings indicated postmidpoint temporal coupling: the alpha peak stabilized from 10 to 11 Hz, the VAS scores declined (tinnitus 5→4→2; hearing difficulty 8→6→3), and the right-ear MML improved after a plateau (79→79→54 dB SL). Contrarily, the left ear did not require masking at the final time point. A Bayesian changepointslope model favored a midpoint changepoint, with posterior directionality consistent with acceleration in the second segment (EEG increased; VAS/MML decreased; see Appendix). Within the caveats of a single case, EEG emerges as a treatment-agnostic biomarker for guiding and monitoring responses across different modalities.