Repetitive Transcranial Magnetic Stimulation Treatment for Chronic Tinnitus

Folmer, Robert L.; Theodoroff, Sarah M.; Casiana, Linda; Shi, Yunfei; Griest, Susan; Vachhani, Jay

doi:10.1001/jamaoto.2015.1219

Cited by 77 publications

(139 citation statements)

References 48 publications

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“…Several clinical studies showed a sham-controlled reduction of tinnitus severity after repeated 1 Hz rTMS applied to the left temporal cortex (30–34), but some studies were also negative (35, 36). In a meta-analysis, treatment effects were shown to be significant, but effect sizes were moderate at best and interindividual variability in treatment response is high (37).…”

Section: Introductionmentioning

confidence: 99%

Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus?

et al. 2017

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BackgroundPrefrontal and temporo-parietal repetitive transcranial magnetic stimulation (rTMS) in patients suffering from chronic tinnitus have shown significant but only moderate effectiveness with high interindividual variability in treatment response. This open-label pilot study was designed to examine the general feasibility of an individualized fronto-temporal rTMS protocol and to explore what criteria are needed for a more detailed evaluation in randomized clinical studies.MethodsDuring the first session of a 2-week rTMS protocol, we applied different rTMS protocols to the left and right temporo-parietal and dorsolateral prefrontal cortex (DLPFC) in 25 tinnitus patients. Short trains of 1, 5, 10, and 20 Hz and continuous theta burst stimulation were applied, and patients were asked for immediate tinnitus reductions after each train. If a patient reported such improvements, rTMS treatment was applied over nine sessions with a combined protocol consisting of the most effective frontal and the most effective temporo-parietal stimulation protocol. Those patients who did not improve after the test session were treated with a standard prefrontal plus temporo-parietal protocol (20 Hz over left DLPFC + 1 Hz over temporo-parietal cortex).ResultsAlmost half of the patients (12 of 25) reported immediate tinnitus reductions during the test session. In this group, the mean pre- to post-treatment amelioration in the tinnitus questionnaire was higher (medium to high effect sizes) in contrast to the patients who did not respond to the test session. Treatment outcome remained stable over a follow-up period of 10 weeks.DiscussionIndividualized rTMS was shown to be feasible and effective in chronic tinnitus. The results obtained from this study provide tentative evidence in support of an individualized rTMS treatment approach and might provide a basis for a “tailored” application of rTMS in tinnitus and other neuropsychiatric disorders.

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Section: Introductionmentioning

confidence: 99%

Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus?

et al. 2017

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“…Tinnitus may be closely linked to hearing loss (Martines et al, 2010; Schecklmann et al, 2012). Different therapeutic approaches offer the use of hearing aids, tinnitus maskers, or tinnitus instruments that combine both (Vernon and Meikle, 2003); counseling sessions (e.g., cognitive behavior therapy, see Cima et al, 2014); counseling combined with the use of sound generators [e.g., Tinnitus Retraining Therapy (TRT), see Jastreboff and Hazel, 1993]; relaxation techniques (e.g., Mindfulness Based Stress Reduction, see Roland et al, 2015); neuromodulation (e.g., the Acoustic Coordinated Reset Neuromodulation, see Tass et al, 2012); or brain stimulation (e.g., Repetitive Transcranial Magnetic Stimulation Treatment, see Folmer et al, 2015). There are many possible options for treatment; however, none of these provides immediate and constant relief for tinnitus (for further details see, e.g., Baguley et al, 2013; Maldonado Fernández et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, this questionnaire may be used by clinicians and researchers to classify patients according to tinnitus severity. Nevertheless, our goal was to provide to Polish ENT centers a tool which enables the evaluation of the effectiveness of applied treatments (see, e.g., Krings et al, 2014; Folmer et al, 2015; Overdevest et al, 2015; Roland et al, 2015; Wilson et al, 2015; Fackrell et al, 2016). …”

Section: Introductionmentioning

confidence: 99%

Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index

Wrzosek

Szymiec

Klemens³

et al. 2016

Front. Psychol.

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Objective: The need for validated measures enabling clinicians to classify tinnitus patients according to the severity of tinnitus and screen the progress of therapies in our country led us to translate into Polish and to validate two tinnitus questionnaires, namely the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI).Design: The original English versions of the questionnaires were translated into Polish and translated back to English by three independent translators. These versions were then finalized by the authors into a Polish THI (THI-Pl) and a Polish TFI (TFI-Pl). Participants from three laryngological centers in Poland anonymously answered the THI-Pl (N = 98) and the TFI-Pl (N = 108) in addition to the Polish versions of the Center for Epidemiologic Studies Depression Scale as a measure of self-perceived level of depression, and the Satisfaction With Life Scale to assess self-perceived quality of life. Both were used to determine discriminant validity. Two Visual Analog Scales were used to measure tinnitus annoyance and tinnitus loudness in order to determine convergent validity.Results: Similar to the original version of the THI, the THI-Pl showed a high internal consistency (Cronbach’s α = 0.93). The exploratory factor analysis revealed that the questionnaire has a three-factorial structure that does not correspond to the original division for functional, catastrophic, and emotional subscales. Convergent and discriminant validities were confirmed. The TFI-Pl showed high internal consistency (Cronbach’s α = 0.96) with the reliability ranging from 0.82 to 0.95 for its different subscales. Factor analysis confirmed an eight-factorial structure with factors assigning all items to appropriate subscales reported in the original version of the questionnaire. Discriminant and convergent validities were also confirmed for the TFI-Pl.Conclusion: We translated and validated the Polish versions of the THI and the TFI to make them suitable for clinical use in Poland.

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“…The TFI reflects impact of tinnitus on quality of life (Meikle et al, 2012). Both the TFI changes were not large enough to meet one suggested clinical criterion for meaningful reduction in TFI outcome scores [a 13-point reduction (Meikle et al, 2012)] but BBN did if a different criteria of 7–8 point change (Folmer et al, 2015) was applied. For most participants sound resulted in small but significant changes in secondary outcome measures of tinnitus (reduced loudness rating scale and reduced annoyance rating scale) and psychologically related measures (increased positive emotionality, reduced anxiety, reduced depression, and reduced stress).…”

Section: Discussionmentioning

confidence: 99%

A Mixed-Methods Trial of Broad Band Noise and Nature Sounds for Tinnitus Therapy: Group and Individual Responses Modeled under the Adaptation Level Theory of Tinnitus

Durai

Searchfield

2017

Front. Aging Neurosci.

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Objectives: A randomized cross-over trial in 18 participants tested the hypothesis that nature sounds, with unpredictable temporal characteristics and high valence would yield greater improvement in tinnitus than constant, emotionally neutral broadband noise.Study Design: The primary outcome measure was the Tinnitus Functional Index (TFI). Secondary measures were: loudness and annoyance ratings, loudness level matches, minimum masking levels, positive and negative emotionality, attention reaction and discrimination time, anxiety, depression and stress. Each sound was administered using MP3 players with earbuds for 8 continuous weeks, with a 3 week wash-out period before crossing over to the other treatment sound. Measurements were undertaken for each arm at sound fitting, 4 and 8 weeks after administration. Qualitative interviews were conducted at each of these appointments.Results: From a baseline TFI score of 41.3, sound therapy resulted in TFI scores at 8 weeks of 35.6; broadband noise resulted in significantly greater reduction (8.2 points) after 8 weeks of sound therapy use than nature sounds (3.2 points). The positive effect of sound on tinnitus was supported by secondary outcome measures of tinnitus, emotion, attention, and psychological state, but not interviews. Tinnitus loudness level match was higher for BBN at 8 weeks; while there was little change in loudness level matches for nature sounds. There was no change in minimum masking levels following sound therapy administration. Self-reported preference for one sound over another did not correlate with changes in tinnitus.Conclusions: Modeled under an adaptation level theory framework of tinnitus perception, the results indicate that the introduction of broadband noise shifts internal adaptation level weighting away from the tinnitus signal, reducing tinnitus magnitude. Nature sounds may modify the affective components of tinnitus via a secondary, residual pathway, but this appears to be less important for sound effectiveness. The different rates of adaptation to broadband noise and nature sound by the auditory system may explain the different tinnitus loudness level matches. In addition to group effects there also appears to be a great deal of individual variation. A sound therapy framework based on adaptation level theory is proposed that accounts for individual variation in preference and response to sound.Clinical Trial Registration: www.anzctr.org.au, identifier #12616000742471.

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Repetitive Transcranial Magnetic Stimulation Treatment for Chronic Tinnitus

Abstract: clinicaltrials.gov Identifier: NCT01104207.

Cited by 77 publications

References 48 publications

Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus?

Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus?

Polish Translation and Validation of the Tinnitus Handicap Inventory and the Tinnitus Functional Index

A Mixed-Methods Trial of Broad Band Noise and Nature Sounds for Tinnitus Therapy: Group and Individual Responses Modeled under the Adaptation Level Theory of Tinnitus

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