title: Neuronavigated repetitive transcranial magnetic stimulation in patients with tinnitus: a short case series.
abstract: BACKGROUND
  Clinical as well as neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterized by focal brain activation. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders by reducing cortical excitability.
  
  
  METHODS
  In three patients suffering from chronic tinnitus, the effect of magnetic resonance imaging and positron emission tomography guided neuronavigated 1 Hz rTMS on auditory cortex activity was evaluated, using a sham controlled double-blind crossover design.
  
  
  RESULTS
  Two of three patients revealed clearly increased metabolic activity in circumscript areas of the primary auditory cortex (PAC), allowing a selective stimulation of these cortical areas with low-frequency rTMS. Considerable improvement in tinnitus was achieved in these patients.
  
  
  CONCLUSIONS
  Neuronavigated rTMS of increased PAC activity may help to better understand the neuronal basis of chronic tinnitus and might offer a new option for treating auditory phantom perceptions like chronic tinnitus.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, Universitaetstrasse 84, Regensburg 93053, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Eichhammer
authors.forename: Berthold
authors.initials: B
authors.lastname: Langguth
authors.forename: Jörg
authors.initials: J
authors.lastname: Marienhagen
authors.forename: Tobias
authors.initials: T
authors.lastname: Kleinjung
authors.forename: Göran
authors.initials: G
authors.lastname: Hajak
mesh_terms: D001303:Auditory Cortex / Q000098:blood supply / Q000378:metabolism*; D001921:Brain / Q000098:blood supply / Q000378:metabolism / Q000503:physiopathology; D002908:Chronic Disease; D018592:Cross-Over Studies; D004311:Double-Blind Method; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010507:Periodicity; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D012886:Skull; D014012:Tinnitus / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*; D014055:Tomography, Emission-Computed; D050781:Transcranial Magnetic Stimulation / Q000295:instrumentation*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18