Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic TinnitusChung H.-K.a, d · Tsai C.-H.b, e · Lin Y.-C.b · Chen J.-M.c · Tsou Y.-A.a · Wang C.-Y.a · Lin C.-D.a, d · Jeng F.-C.g · Chung J.-G.f · Tsai M.-H.a, d
aDepartment of Otorhinolaryngology – Head and Neck Surgery, bNeuroscience Laboratory, Department of Neurology, cDepartment of Radiology, China Medical University Hospital, d Graduate Institute of Clinical Medical Sciences, eGraduate Institute of Neural and Cognitive Sciences, fDepartment of Biological Science and Technology, China Medical University, Taichung City, Taiwan, ROC; gDepartment of Communication Sciences and Disorders, Ohio University, Athens, Ohio, USA
Objectives: Repetitive transcranial magnetic stimulation (rTMS), a noninvasive method for altering cortical excitability, is becoming a therapeutic strategy in auditory research institutions worldwide. Application of inhibiting rTMS on these overactive cortical regions can result in effective tinnitus suppression. The aim of this study is to investigate the efficacy of theta-burst rTMS in patients with chronic tinnitus. Study Design: Parallel randomized control study. Setting: Tertiary referral center. Patients: We enrolled 2 female and 20 male patients in this study. The evaluative tools included tinnitus frequency- and loudness-matching, tinnitus questionnaires (TQ), and the Tinnitus Handicap Inventory (THI). Methods: The orthogonal projection of the auditory cortex on the scalp was focalized. A figure-eight coil was placed on the surface of the skull over the targeted region with the intensity setting at 80% of the resting motor threshold. We delivered 900 pulses of theta-burst rTMS daily for 10 business days. Main Outcome Measures: Nine of twelve patients (75%) in the active-stimulation group reported tinnitus suppression following treatment with rTMS. The treatment led to reductions of 8.58 and 8.33 in the mean TQ global and THI scores, respectively. Tinnitus loudness also decreased significantly after delivering rTMS. Results: Descriptive analysis of the TQs revealed that patients experienced significant improvements in emotional distress levels and somatic symptoms. Conclusions: Our preliminary results demonstrate that theta-burst rTMS treatments offer a method of modulating tinnitus. Patients could benefit from emotional improvements, even more than auditory perceptive relief. Further studies are needed to establish a standard protocol and to clarify nervous propagation along the auditory and psychological projection following treatment with rTMS.
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