title: Repetitive transcranial magnetic stimulation improve tinnitus in normal hearing patients: a double-blind controlled, clinical and neuroimaging outcome study.
abstract: OBJECTIVE
  Tinnitus is a frequent disorder which is very difficult to treat and there is compelling evidence that tinnitus is associated with functional alterations in the central nervous system. Targeted modulation of tinnitus-related cortical activity has been proposed as a promising new treatment approach. We aimed to investigate both immediate and long-term effects of low frequency (1 Hz) repetitive transcranial magnetic stimulation (rTMS) in patients with tinnitus and normal hearing.
  
  
  METHODS
  Using a parallel design, 20 patients were randomized to receive either active or placebo stimulation over the left temporoparietal cortex for five consecutive days. Treatment results were assessed by using the Tinnitus Handicap Inventory. Ethyl cysteinate dimmer-single photon emission computed tomography (SPECT) imaging was performed before and 14 days after rTMS.
  
  
  RESULTS
  After active rTMS there was significant improvement of the tinnitus score as compared to sham rTMS for up to 6 months after stimulation. SPECT measurements demonstrated a reduction of metabolic activity in the inferior left temporal lobe after active rTMS.
  
  
  CONCLUSIONS
  These results support the potential of rTMS as a new therapeutic tool for the treatment of chronic tinnitus, by demonstrating a significant reduction of tinnitus complaints over a period of at least 6 months and significant reduction of neural activity in the inferior temporal cortex, despite the stimulation applied on the superior temporal cortex.
authors.affiliation: Department of Otolaryngology, University of São Paulo School of Medicine, São Paulo, Brazil.
authors.forename: R A
authors.initials: RA
authors.lastname: Marcondes
authors.forename: T G
authors.initials: TG
authors.lastname: Sanchez
authors.forename: M A
authors.initials: MA
authors.lastname: Kii
authors.forename: C R
authors.initials: CR
authors.lastname: Ono
authors.forename: C A
authors.initials: CA
authors.lastname: Buchpiguel
authors.forename: B
authors.initials: B
authors.lastname: Langguth
authors.forename: M A
authors.initials: MA
authors.lastname: Marcolin
mesh_terms: D000328:Adult; D001303:Auditory Cortex / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000528:radiation effects*; D001306:Auditory Pathways / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000528:radiation effects; D001307:Auditory Perception / Q000502:physiology / Q000528:radiation effects; D001931:Brain Mapping; D002908:Chronic Disease / Q000628:therapy; D004311:Double-Blind Method; D004574:Electromagnetic Fields; D004734:Energy Metabolism / Q000502:physiology / Q000528:radiation effects; D005072:Evoked Potentials, Auditory / Q000502:physiology / Q000528:radiation effects; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D014012:Tinnitus / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D015899:Tomography, Emission-Computed, Single-Photon; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome