Tags

Type your tag names separated by a space and hit enter

Short duration repetitive transcranial magnetic stimulation for tinnitus treatment: a prospective Asian study.
Clin Neurol Neurosurg. 2011 Sep; 113(7):556-8.CN

Abstract

BACKGROUND

Tinnitus is a subjective auditory perception of sounds or noise not triggered by external auditory stimuli. To date, treatment in severe cases is generally unsatisfactory. Characteristic functional brain imaging changes associated with tinnitus include hyperactivity encompassing both the primary auditory cortex (AC) and the secondary or associative cortex. Brief repetitive transcranial magnetic stimulation (rTMS) trains applied to the scalp overlying the hyperactive left AC is known to produce moderate tinnitus attenuation.

OBJECTIVE

Although Western studies have documented the value of rTMS in tinnitus treatment, we evaluate the efficacy of a short duration rTMS protocol for the first time in the Asian setting.

METHOD

Consecutive patients were recruited at our tinnitus clinic. Detailed history, examination, audiogram and baseline tinnitus scales were recorded. RTMS consisted of 1000 pulses/day at 1 Hz and 110% of the motor threshold, for five consecutive days over the left temporoparietal cortex. Tinnitus ratings were determined weekly for 4 weeks after rTMS.

RESULT

Fifteen patients completed the trial; none experienced significant side effects. Repeated measures ANOVA showed significant linear decrease in Tinnitus Handicap Inventory (THI) scores over the time period (F((1,14))=4.7, p=0.04). However, none of the other parameters (severity, annoyance, effect on lifestyle and overall impression: visual analogue scale) showed beneficial outcomes.

CONCLUSIONS

Our findings point to a positive effect of short duration rTMS in tinnitus treatment using the THI. However, no significant benefits were demonstrated for other subjective patient ratings. Although well tolerated and convenient, short duration rTMS may prove inadequate for modulating maladaptive plastic changes at the cortical level, and our results suggest the need for delivery of more stimuli. Future studies will utilize at least 2000 pulses/day, in line with previous experience in Western settings.

Authors+Show Affiliations

Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. simon.ting.k.s@sgh.com.sgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21507564

Citation

Ting, S K S., et al. "Short Duration Repetitive Transcranial Magnetic Stimulation for Tinnitus Treatment: a Prospective Asian Study." Clinical Neurology and Neurosurgery, vol. 113, no. 7, 2011, pp. 556-8.
Ting SK, Chan YM, Cheong PW, et al. Short duration repetitive transcranial magnetic stimulation for tinnitus treatment: a prospective Asian study. Clin Neurol Neurosurg. 2011;113(7):556-8.
Ting, S. K., Chan, Y. M., Cheong, P. W., Wong, M., Fook-Chong, S., & Lo, Y. L. (2011). Short duration repetitive transcranial magnetic stimulation for tinnitus treatment: a prospective Asian study. Clinical Neurology and Neurosurgery, 113(7), 556-8. https://doi.org/10.1016/j.clineuro.2011.03.015
Ting SK, et al. Short Duration Repetitive Transcranial Magnetic Stimulation for Tinnitus Treatment: a Prospective Asian Study. Clin Neurol Neurosurg. 2011;113(7):556-8. PubMed PMID: 21507564.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short duration repetitive transcranial magnetic stimulation for tinnitus treatment: a prospective Asian study. AU - Ting,S K S, AU - Chan,Y M, AU - Cheong,P W T, AU - Wong,M, AU - Fook-Chong,S, AU - Lo,Y L, Y1 - 2011/04/20/ PY - 2010/04/20/received PY - 2011/03/16/revised PY - 2011/03/22/accepted PY - 2011/4/22/entrez PY - 2011/4/22/pubmed PY - 2011/12/13/medline SP - 556 EP - 8 JF - Clinical neurology and neurosurgery JO - Clin Neurol Neurosurg VL - 113 IS - 7 N2 - BACKGROUND: Tinnitus is a subjective auditory perception of sounds or noise not triggered by external auditory stimuli. To date, treatment in severe cases is generally unsatisfactory. Characteristic functional brain imaging changes associated with tinnitus include hyperactivity encompassing both the primary auditory cortex (AC) and the secondary or associative cortex. Brief repetitive transcranial magnetic stimulation (rTMS) trains applied to the scalp overlying the hyperactive left AC is known to produce moderate tinnitus attenuation. OBJECTIVE: Although Western studies have documented the value of rTMS in tinnitus treatment, we evaluate the efficacy of a short duration rTMS protocol for the first time in the Asian setting. METHOD: Consecutive patients were recruited at our tinnitus clinic. Detailed history, examination, audiogram and baseline tinnitus scales were recorded. RTMS consisted of 1000 pulses/day at 1 Hz and 110% of the motor threshold, for five consecutive days over the left temporoparietal cortex. Tinnitus ratings were determined weekly for 4 weeks after rTMS. RESULT: Fifteen patients completed the trial; none experienced significant side effects. Repeated measures ANOVA showed significant linear decrease in Tinnitus Handicap Inventory (THI) scores over the time period (F((1,14))=4.7, p=0.04). However, none of the other parameters (severity, annoyance, effect on lifestyle and overall impression: visual analogue scale) showed beneficial outcomes. CONCLUSIONS: Our findings point to a positive effect of short duration rTMS in tinnitus treatment using the THI. However, no significant benefits were demonstrated for other subjective patient ratings. Although well tolerated and convenient, short duration rTMS may prove inadequate for modulating maladaptive plastic changes at the cortical level, and our results suggest the need for delivery of more stimuli. Future studies will utilize at least 2000 pulses/day, in line with previous experience in Western settings. SN - 1872-6968 UR - https://www.unboundmedicine.com/medline/citation/21507564/Short_duration_repetitive_transcranial_magnetic_stimulation_for_tinnitus_treatment:_a_prospective_Asian_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0303-8467(11)00086-2 DB - PRIME DP - Unbound Medicine ER -