Combined temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: a pilot study.
OBJECTIVE
Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been proposed as a new treatment strategy for patients with chronic tinnitus. However, functional abnormalities in tinnitus patients also involve brain structures used for attentional and emotional processing, such as the dorsolateral prefrontal cortex. Therefore, we have developed a new rTMS treatment strategy for tinnitus patients that consists of a combination of high-frequency prefrontal and low-frequency temporal rTMS.


METHODS
A total of 32 patients received either low-frequency temporal rTMS or a combination of high-frequency prefrontal and low-frequency temporal rTMS. Treatment effects were assessed with a standardized tinnitus questionnaire (TQ).


RESULTS
Directly after therapy there was an improvement of the TQ-score for both groups, but no differences between groups. An evaluation after 3 months revealed a remarkable benefit from the use of combined prefrontal and temporal rTMS treatment.


CONCLUSIONS
These results support recent data that suggest that auditory and nonauditory brain areas are involved in tinnitus pathophysiology.
Kleinjung
Tobias
T
Department of Otorhinolaryngology, University of Regensburg, Regensburg, Germany. tobias.kleinjung@klinik.uni-regensburg.de
Eichhammer
Peter
P
Landgrebe
Michael
M
Sand
Philipp
P
Hajak
Goeran
G
Steffens
Thomas
T
Strutz
Juergen
J
Langguth
Berthold
B
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D017397:Prefrontal Cortex / Q000503:physiopathology; D013702:Temporal Lobe / Q000503:physiopathology; D014012:Tinnitus / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome