Lack of Evidence to Support the Beneficial Role of Intratympanic Dexamethasone Injection in Acute Peripheral Facial Palsy

Abstract

The rTMS protocol effectively suppressed tinnitus in the dual-site rTMS (AC+FC) group but not in the single-site rTMS (DLPFC) group. Although recent evidence has shown that non-auditory cortices in the tinnitus network play an important role in the generation of tinnitus, our findings indicate that rTMS on non-auditory cortical sites alone may not be sufficient for treatment. Thus, dual-site rTMS in the AC and DLPFC may be preferable for controlling this condition.

Neuronavigated Versus Non-navigated Repetitive Transcranial Magnetic Stimulation for Chronic Tinnitus: A Randomized Study

“…Our main findings are in line with another study on tinnitus comparing nrTMS with non-navigated rTMS (Noh, Rah, et al., 2017). Similar to us, they reported significant improvement of THI and VAS scores in both groups but no differences between the groups.…”

“…Based on our study and the previous literature, it seems that the coil localization method is not a crucial factor in the treatment outcome of rTMS for tinnitus (Langguth et al., 2014; Noh, Rah, et al., 2017) for several reasons. First, the optimal target for rTMS stimulation in tinnitus still remains open (Langguth et al., 2010).…”

“…In addition to the AC, multisite stimulation, including the dorsolateral prefrontal cortex, may increase efficacy (Lehner, Schecklmann, Greenlee, Rupprecht, & Langguth, 2016; Lehner et al., 2013). Although non-auditory areas participate in tinnitus pathophysiology, rTMS on non-auditory cortical sites alone may be insufficient for tinnitus treatment (Noh, Kyong, et al., 2017).…”

“…Non-navigated methods are inaccurate (by 1–2 cm) with regard to the anatomical cortical targets actually stimulated (Ahdab, Ayache, Brugieres, Goujon, & Lefaucheur, 2010; Langguth et al., 2006). Currently, the few available studies do not demonstrate superiority of nrTMS for tinnitus treatment (Langguth et al., 2006, 2010, 2014; Noh, Rah, et al., 2017). One reason for this may be uncertainty regarding the optimal target for suppressing tinnitus.…”

Neural activity during attentional conflict predicts reduction in tinnitus perception following rTMS

“…In fact, targeting the temporal cortex alone appears to have as much of an effect on questionnaire surveys of tinnitus symptoms as does a combined approach of temporal and frontal lobe stimulation, although the combined approach may have more durable effects. (21) This outcome might be due to the fact that targeting the superior temporal gyrus, as is common in rTMS studies of tinnitus, can influence attentional processing via its connections with the dorsolateral frontal cortex. The middle and posterior regions of the superior temporal gyrus (STG) project to the lateral (periarcuate) prefrontal cortex and to the posterior, dorsolateral premotor cortex, respectively.…”