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Transcranial Magnetic Stimulation May Treat Tinnitus

by Mary Beth Nierengarten • October 15, 2015

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People who suffer from chronic tinnitus may one day find relief by undergoing a treatment that currently has FDA approval only for major depressive disorder.

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In a randomized clinical trial, the treatment, repetitive transcranial magnetic pulses (rTMS), was found to significantly improve symptoms of tinnitus in patients with chronic tinnitus.

In the largest clinical trial of rTMS to treat tinnitus, 64 patients with chronic tinnitus received active rTMS (n=32) or placebo rTMS (n=32) to an area targeting the auditory cortex of the brain. Treatment consisted of one pulse per second for 10 consecutive work days for a total of 2,000 pulses per session. The majority of participants were men (n=51), with a mean age of 60.6 years.

Using the Tinnitus Functional Index (TFI) to assess symptom improvement from baseline to post-treatment, the study found that 18 of 32 (56%) of participants treated with active rTMS versus 7 of 32 (22%) of participants treated in the placebo group exhibited significant improvement in TFI after treatment compared to baseline. A significant difference was found in the percentage of responders to treatment in each group (P<0.005).

According to lead author of the study, Robert L. Folmer, PhD, associate professor of otolaryngology at Oregon Health and Science University in Portland, reparticipants with more severe tinnitus at baseline were more likely to respond positively to rTMS, as were patients who had experienced tinnitus for 11 years or more.

Overall, the study found that the improvement in symptoms experienced by the treatment responders was sustained during 26-weeks of follow-up.

“Transcranial magnetic stimulation might be a viable treatment option for some patients who experience bothersome tinnitus,” said Dr. Folmer. However, he emphasized that larger studies are needed to verify the results and refine treatment protocols before rTMS can be implemented clinically.

Commenting on the study, Michael D. Seidman, MD, an otolaryngologist and director of the division otologic/neurotologic surgery at Henry Ford Health System in Detroit, said that the rate of success of rTMS to treat tinnitus in previous studies ranges from no success to this current improvement of 56%. “Most studies show about a 40% to 50% likelihood of some improvement,” he said.

The issue with rTMS, added, is its range of penetration that only permits treating a very superficial part of the brain. “You are likely only getting the outermost 5 mm, at best, of brain tissue,” he said, adding that this doesn’t mean that the treatment can’t work.

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Filed Under: Online Exclusives, Otology/Neurotology, Practice Focus Tagged With: tinnitus

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