title: [Low frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus--are there long-term effects?].
abstract: OBJECTIVE
  Clinical, neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterised by focal brain activation. Low frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders.
  
  
  METHODS
  Patients suffering from chronic tinnitus underwent a [ (18)F]deoxyglucose-PET (positron emission tomography). Fusioning of the individual PET scan with the structural MRI-scan (magnetic resonance imaging, T1, MPRAGE) revealed an increased metabolic activation in the primary auditory cortex as target point for rTMS. A neuronavigational system enabled the positioning of the figure of eight coil in relation to the target area. rTMS (110 % motor threshold; 1 Hz; 2000 stimuli/day over 5 days) was performed using a placebo controlled cross-over design.
  
  
  RESULTS
  Following active rTMS there was a moderate improvement of tinnitus perception. Treatment effects lasted up to six months in some patients.
  
  
  CONCLUSIONS
  Neuronavigated rTMS offers new possibilities in the understanding and treatment of chronic tinnitus.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie der Universität am Bezirksklinikum Regensburg. berthold.langguth@medbo.de
authors.forename: Berthold
authors.initials: B
authors.lastname: Langguth
authors.forename: Peter
authors.initials: P
authors.lastname: Eichhammer
authors.forename: Marc
authors.initials: M
authors.lastname: Zowe
authors.forename: Jörg
authors.initials: J
authors.lastname: Marienhagen
authors.forename: Tobias
authors.initials: T
authors.lastname: Kleinjung
authors.forename: Peter
authors.initials: P
authors.lastname: Jacob
authors.forename: Philipp
authors.initials: P
authors.lastname: Sand
authors.forename: Göran
authors.initials: G
authors.lastname: Hajak
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D001303:Auditory Cortex / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D002908:Chronic Disease; D018592:Cross-Over Studies; D004292:Dominance, Cerebral / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation; D049268:Positron-Emission Tomography; D014012:Tinnitus / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18