Acta Pharmacologica Sinica 2008 December; 29 (12): 1409-1418; doi: 10.1111/j.1745-7254.2008.00893.x

Aim: The purpose of the present study was to explore how lidocaine as a therapeutic drug for tinnitus targets voltage- and ligand-gated ion channels and changes the excitability of central auditory neurons.

Methods: Membrane currents mediated by major voltage- and ligand-gated channels were recorded from primary cultured neurons of the inferior colliculus (IC) in rats with whole-cell patch-clamp techniques in the presence and absence of lidocaine. The effects of lidocaine on the current-evoked firing of action potentials were also examined.

Results: Lidocaine at 100 µmol/L significantly suppressed voltage-gated sodium currents, transient outward potassium currents, and the glycine-induced chloride currents to 87.66%±2.12%, 96.33%±0.35%, and 91.46%±2.69% of that of the control level, respectively. At 1 mmol/L, lidocaine further suppressed the 3 currents to 70.26%±4.69%, 62.80%±2.61%, and 89.11%±3.17% of that of the control level, respectively. However, lidocaine at concentrations lower than 1 mmol/L did not significantly affect GABA- or aspartate-induced currents. At a higher concentration (3 mmol/L), lidocaine slightly depressed the GABA-induced current to 87.70%±1.87% of that of the control level. Finally, lidocaine at 100 µmol/L was shown to significantly suppress the current-evoked firing of IC neurons to 58.62%±11.22% of that of the control level, indicating that lidocaine decreases neuronal excitability.

Conclusion: Although the action of lidocaine on the ion channels and receptors is complex and non-specific, it has an overall inhibitory effect on IC neurons at a clinically-relevant concentration, suggesting a central mechanism for lidocaine to suppress tinnitus.

Keywords: lidocaine; tinnitus; inferior colliculus; sodium channel; potassium channel; glycine receptor; GABA_A receptor; N-methyl-D-aspartate receptor; whole-cell patch-clamp