Repetitive Transcranial Magnetic Stimulation for Tinnitus: A Pilot Study

Smith, Jason A.; Mennemeier, Mark; Bartel, Twyla; Chelette, Kenneth C.; Kimbrell, Tim A.; Triggs, William J.; Dornhoffer, John L.

doi:10.1097/mlg.0b013e31802f4154

Cited by 95 publications

(82 citation statements)

References 13 publications

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“…The results confirmed the theory about the auditory cortex asymmetry published in different articles [3][4][5][6][7] and the hyperactivation of the primary and secondary auditory cortex on the left side (the patient is right handed). This is the opposite side of the tinnitus.…”

Section: Acquisition Proceduressupporting

confidence: 80%

Surgical treatment by electrical stimulation of the auditory cortex for intractable tinnitus

Litré

Theret

Tran³

et al. 2009

Brain Stimulation

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Tinnitus is a public health issue in France. Around 1% of the population is affected and 30,000 people are handicapped in their daily life. The treatments available for disabling tinnitus have until now been disappointing. We are reporting on the surgical treatment by electrical stimulation of the auditory cortex of a female patient affected by disabling tinnitus that resisted classical treatments. The tinnitus appeared suddenly 10 years ago after a left ear tympanoplasty. The acouphenometry measures revealed a bilateral tinnitus, predominant on the right side, constant, with high frequency (6000 Hz). Transcranial magnetic stimulation (TMS) was performed at first with several supraliminal and infraliminal protocols. This showed promising results. Anatomic and functional magnetic resonance imaging (fMRI) of the auditory cortex before and after repetitive TMS (rTMS) demonstrated a modification of the cortical activity and where the ideal location for a cortical electrode might be, to straddle primary and secondary auditory cortex. After these investigations, two quadra polar electrodes (Resume, Medtronic Ltd, Hertfordshire, UK), connected to a stimulating device implanted under the skin (Synergy, Medtronic Ltd), were extradurally implanted. The surgical procedure was similar to the one performed for analgesic cortical stimulation. No surgical complications were reported. The activation of the stimulator provided a reduction of 65% of the tinnitus impact, with a persistent effect on the right side. The feasibility of the cortical stimulation in symptomatic treatment of tinnitus was proven by this preparatory work. The middle-and long-term therapeutic effects remain to be evaluated. Ó 2009 Elsevier Inc. All rights reserved.Keywords tinnitus; auditive cortex; electric stimulation; transcranial magnetic stimulation Tinnitus is a public health issue in France, with around 1% of the population affected and 30,000 people handicapped in their daily life.Available treatments have been disappointing for disabling tinnitus. The treatment is delicate because of the psychological and behavioral repercussions of tinnitus, which leads many physicians to wonder about the organic origin of tinnitus. However, several neuroscience case studies have demonstrated the credibility of this symptom as a peculiar entity. In particular, the relationship between tinnitus and cerebral metabolic activity. 1

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Section: Acquisition Proceduressupporting

confidence: 80%

Surgical treatment by electrical stimulation of the auditory cortex for intractable tinnitus

Litré

Theret

Tran³

et al. 2009

Brain Stimulation

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“…In this trial, patients were treated with 1-Hz rTMS because this was thought to lead to suppression of neural activity [Hallett, 2007] and thus suppression of hyperactivity underlying tinnitus. Other parameters for rTMS set-up were chosen in line with most previous studies to aid comparability: patients were treated on 110% of their motor threshold with a figure-of-eight coil [Kleinjung et al, 2005Langguth et al, 2007;Smith et al, 2007]. The handle of the coil pointed upwards [Kleinjung et al, 2005Langguth et al, 2007].…”

Section: Introductionmentioning

confidence: 99%

“…One study showed an improvement for both rTMS and placebo but did not compare the groups with each other [Anders et al, 2010]. The last Rossi [2007] 16 left TP VAS (0-100) -20 (67→47) -7 (67→60) significant effect Smith [2007] 4 most active PAC on PET TSIQ VAS (0-100)…”

Section: Introductionmentioning

confidence: 99%

“…Six randomised crossover studies have been performed on small patient groups ( table 1 ), half of them showing a positive effect [Kleinjung et al, 2005;Plewnia et al, 2007a;Rossi et al, 2007] and the other half of them showing no (significant) effect [Piccirillo et al, 2011;Plewnia et al, 2007b;Smith et al, 2007]. On average, these studies combined showed a decrease of 4 points on the TQ (20 patients) [Kleinjung et al, 2005;Plewnia et al, 2007b], an improvement on the THI of 4 points compared with placebo (14 patients) [Piccirillo et al, 2011], and a general VAS score improvement of 11 points compared with placebo (20 patients) [Rossi et al, 2007;Smith et al, 2007].…”

Section: Introductionmentioning

confidence: 99%

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Bilateral Low-Frequency Repetitive Transcranial Magnetic Stimulation of the Auditory Cortex in Tinnitus Patients Is Not Effective: A Randomised Controlled Trial

et al. 2013

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Background: Although some therapies may be beneficial for some patients in reducing tinnitus, there is no curative therapy. Repetitive transcranial magnetic stimulation (rTMS) has been applied as a treatment for chronic tinnitus, but the effect remains controversial. Material and Methods: Fifty patients were treated with rTMS or placebo. Treatment consisted of 2,000 TMS pulses on each auditory cortex, at a rate of 1 Hz and an intensity of 110% of the individual motor threshold, on 5 consecutive days. rTMS and placebo effects were evaluated directly after treatment, after 1 week, and after 1, 3 and 6 months. Primary outcome was the Tinnitus Questionnaire (TQ). Secondary outcomes were the Tinnitus Handicap Inventory (THI) and a visual analogue scale. Results: At none of the follow-up evaluation moments a significant difference between rTMS and placebo was observed with respect to changes in TQ or THI scores relative to pretreatment scores. Multilevel modelling (MLM) analyses did not show a global treatment effect either. Patients with a higher degree of burden showed slightly greater improvement after rTMS (only significant on the THI with MLM analyses). Conclusion: Bilateral low-frequency rTMS of the auditory cortex was not effective in treating tinnitus.

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“…He also reported that Grapergiesser initially suppressed tinnitus by transcutaneous electrical stimulation using Volta's Platinum-Zinc cell 4 . In fact, one of the outstanding features of this phantom sound is that it can be inhibited by auditory external stimuli such as acoustical, electrical, and magnetic fields [5][6][7][8] . It is obvious that following the offset of appropriate masking stimuli, tinnitus may remain suppressed for a short period of time.…”

Section: Introductionmentioning

confidence: 99%

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation

Mahmoudian¹,

Lenarz²,

Esser³

et al. 2013

The International Tinnitus Journal

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Repetitive Transcranial Magnetic Stimulation for Tinnitus: A Pilot Study

Cited by 95 publications

References 13 publications

Surgical treatment by electrical stimulation of the auditory cortex for intractable tinnitus

Surgical treatment by electrical stimulation of the auditory cortex for intractable tinnitus

Bilateral Low-Frequency Repetitive Transcranial Magnetic Stimulation of the Auditory Cortex in Tinnitus Patients Is Not Effective: A Randomised Controlled Trial

Alterations in early auditory evoked potentials and brainstem transmission time associated with tinnitus residual inhibition induced by auditory electrical stimulation

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