Transcranial magnetic stimulation for the treatment of tinnitus: 4-year follow-up in treatment responders-a retrospective analysis
Brain Stimulation, 10/31/2011
Burger J et al. – These data underscore the clinical relevance of Repetitive transcranial magnetic stimulation(rTMS) in the treatment of tinnitus. A potential explanation for the observed long–lasting clinical effects is that rTMS interferes with tinnitus related neuronal activity and thus facilitates the intrinsic ability of the brain to restore normal function.Methods
- Results from 235 patients, who were treated with rTMS because of chronic tinnitus were analysed.
- Patients received either a standard protocol of low-frequency rTMS (n=188; 110% motor threshold, 1 Hz, 2000 stimuli/day) over the left temporal cortex or combined frontal and temporal rTMS (n=47; 110% motor threshold, 1000 stimuli at 20 Hz, left dorsolateral prefrontal cortex plus 1000 stimuli at 1 Hz left temporal cortex).
- Response criterion was defined as an improvement of at least 10 points in the tinnitus questionnaire (TQ) score between baseline and the follow-up assessment 90 days after treatment.
- For the entire study group there was a highly significant effect of treatment on the TQ score.
- Fifty patients (21.3%) were responders according to the above mentioned definition.
- Response criterion was fulfilled by 19.7% of the patients receiving left temporal rTMS and by 26% of the patients receiving combined rTMS.
- Only significant difference between responders and nonresponders was a higher baseline score of the TQ in the responder group.
- There were no significant differences in all other assessed patient parameters (gender, age, tinnitus duration, tinnitus laterality, motor threshold, handedness).
- Ninety days after treatment the average TQ reduction in the responder group was 18.2 points as compared with baseline.
- At the two long-term follow-up assessments (2.12± 1.17 years and 3.9± 1.17 years after treatment) the improvement in the responder group was still 14.2, respective 14.4 points.