Combined temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: A pilot study

Kleinjung, Tobias; Eichhammer, Peter; Landgrebe, Michael; Sand, Philipp; Hajak, Goeran; Steffens, Thomas; Strutz, Juergen; Langguth, Berthold

doi:10.1016/j.otohns.2007.12.022

Cited by 134 publications

(112 citation statements)

References 21 publications

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“…There are 3 mainstream methods of evaluating the outcome of tinnitus therapy: (1) questionnaires, such as TQ and THI, (2) self-rating of tinnitus, for example, 10-grading or 100-grading visual analogue scores (VAS), and (3) audiometric examinations, for instance, tinnitus frequency-and loudness-matching or residual inhibition measures [Kleinjung et al, 2005[Kleinjung et al, , 2008Lee et al, 2008;Mennemeier et al, 2008;Henkin et al, 2011]. Because measurements based on these methods are variable, and because each method contains its own inherent biases, we felt it was particularly important and useful to employ a multidirectional assessment.…”

Section: Discussionmentioning

confidence: 99%

“…A subsequent nervous propagation to other brain structures might lead to changes in tinnitus perception. Kleinjung et al [2008] also performed rTMS on both auditory (temporal) and nonauditory (dorsolateral prefrontal) cortex and demonstrated a pathophysiologic association between tinnitus and the prefrontal cortex. To resolve which of these relationships drives the success of rTMS treatment, further work are needed to investigate post-TMS neurobiological changes in emotion-related structures, such as the prefrontal area or the limbic system.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus

Chung¹,

Tsai²,

Lin³

et al. 2011

Audiol Neurotol

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus

Chung¹,

Tsai²,

Lin³

et al. 2011

Audiol Neurotol

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“…This means that tinnitus arises under the framework requirement of (1) an increased activity in the central auditory pathways together with (2) a deficient inhibitory control from the prefrontal cortex [37]. This assumption was already affirmed by brain stimulation studies demonstrating reduction of tinnitus loudness [45] and tinnitus severity [21] through repetitive transcranial magnetic stimulation of the prefrontal cortex. Also, the effect of single sessions of bifrontal transcranial direct current stimulation has been investigated in a large sample.…”

Section: Introductionmentioning

confidence: 96%

Treatment of chronic tinnitus with repeated sessions of prefrontal transcranial direct current stimulation: outcomes from an open-label pilot study

et al. 2011

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Tinnitus is the perception of sound in the absence of an environmental sound source. Abnormal activity in central auditory pathways is considered as the neuronal correlate of tinnitus. However, there is increasing evidence from neuroimaging studies for an additional involvement of the frontal cortex in the pathophysiology of tinnitus, especially concerning its attentional and emotional aspects. Recently, in a subgroup of tinnitus patients, temporary reduction of tinnitus intensity and tinnitus-related distress has been reported after bifrontal tDCS with the anode over the right and the cathode over the left dorsolateral prefrontal cortex (DLPFC). The aim of this study was to investigate whether repeated application of bifrontal tDCS results in longer-lasting reduction of tinnitus and may represent a potential treatment approach. Thirty-two patients with chronic and treatment-resistant tinnitus received six sessions of bifrontal tDCS (1.5 mA, 30 min, two sessions per week) with the anode over the right and the cathode over the left DLPFC. Treatment outcome was assessed with several standardized tinnitus questionnaires, numeric rating scales, and a depression scale. In the entire group, beneficial effects of bifrontal tDCS on tinnitus were found for numeric rating scores of loudness, unpleasantness, and discomfort, but not in tinnitus or depression scales. Exploratory analysis revealed an effect of gender on treatment effects with female patients demonstrating a better response in several scores. Our open-label pilot study suggests some beneficial effect of bifrontal tDCS (anode right and cathode left) in the treatment of severe tinnitus, warranting further controlled studies.

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“…Mixed findings have been reported when considering the efficacy of rTMS. The results of some studies suggest that rTMS might be a useful treatment for tinnitus (Kleinjung et al, 2008;Khedr et al, 2008;Lopez-Ibor et al, 2008). Lee et al, 2008 did not report statistically significant improvements.…”

Section: Transcranial Magnetic Stimulationmentioning

confidence: 96%

Bhramari Pranayama and Alternative Treatments of Tinnitus: In Pursuit of the Cure

Pandey¹

2011

Up to Date on Tinnitus

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Combined temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: A pilot study

Abstract: These results support recent data that suggest that auditory and nonauditory brain areas are involved in tinnitus pathophysiology.

Cited by 134 publications

References 21 publications

Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus

Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus

Treatment of chronic tinnitus with repeated sessions of prefrontal transcranial direct current stimulation: outcomes from an open-label pilot study

Bhramari Pranayama and Alternative Treatments of Tinnitus: In Pursuit of the Cure

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