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Original Article
March 21, 2011

Low-Frequency Repetitive Transcranial Magnetic Stimulation to the Temporoparietal Junction for Tinnitus

Author Affiliations

Author Affiliations: Departments of Otolaryngology–Head and Neck Surgery (Drs Piccirillo and Kallogjeri and Mss Nicklaus and Duddy), Psychiatry (Drs Garcia and Pierce), Anatomy and Neurobiology (Dr Burton), and Radiology (Dr Vlassenko), and Mallinckrodt Institute of Radiology (Dr Mintun), Washington University School of Medicine, and Department of Mathematics, Washington University (Dr Spitznagel), St Louis, Missouri.

Arch Otolaryngol Head Neck Surg. 2011;137(3):221-228. doi:10.1001/archoto.2011.3
Abstract

Objective  To examine the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) to the temporoparietal junction in a cohort of patients with bothersome tinnitus.

Design  Crossover, double-blind, randomized clinical trial.

Setting  Outpatient academic medical center.

Participants  Fourteen adults aged 42 to 59 years with subjective, unilateral or bilateral, nonpulsatile tinnitus of 6 months’ duration or longer and a score of 38 or greater on the Tinnitus Handicap Inventory (THI).

Interventions  Low-frequency (1-Hz) 110% motor threshold rTMS or sham treatment to the left temporoparietal junction for 2 weeks.

Main Outcome Measure  The difference in the change of the THI score between active and sham rTMS.

Results  Active treatment was associated with a median (95% confidence interval) reduction in THI score of 5 (0-14) points, and sham treatment was associated with a median reduction in THI score of 6 (−2 to 12) points. The difference in THI scores between the change associated with active and sham rTMS ranged from a 34-point reduction in THI score after active treatment to a 22-point increase after sham treatment, with a median difference change of only 1 point (−6 to 4 points).

Conclusions  Daily low-frequency rTMS to the left temporoparietal junction area for 2 weeks is no more effective than placebo for patients with chronic bothersome tinnitus. Possible explanations for the negative findings are short duration of treatment, failure of rTMS stimulation over the temporoparietal area to affect the auditory cortex buried within the Sylvian fissure, or more widespread cortical network changes associated with severe bothersome tinnitus not amenable to localized rTMS effects.

Trial Registration  clinicaltrials.gov Identifier: NCT00567892

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