[Low frequency repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus--are there long-term effects?].
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.
Langguth
Berthold
B
Klinik für Psychiatrie und Psychotherapie der Universität am Bezirksklinikum Regensburg. berthold.langguth@medbo.de
Eichhammer
Peter
P
Zowe
Marc
M
Marienhagen
Jörg
J
Kleinjung
Tobias
T
Jacob
Peter
P
Sand
Philipp
P
Hajak
Göran
G
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*
D001786:Blood Glucose; D019788:Fluorodeoxyglucose F18