title: Low-frequency repetitive transcranial magnetic stimulation to the temporoparietal junction for tinnitus.
abstract: OBJECTIVE
  To examine the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (rTMS) to the temporoparietal junction in a cohort of patients with bothersome tinnitus.
  
  
  METHODS
  Crossover, double-blind, randomized clinical trial.
  
  
  METHODS
  Outpatient academic medical center.
  
  
  METHODS
  Fourteen adults aged 42 to 59 years with subjective, unilateral or bilateral, nonpulsatile tinnitus of 6 months' duration or longer and a score of 38 or greater on the Tinnitus Handicap Inventory (THI).
  
  
  METHODS
  Low-frequency (1-Hz) 110% motor threshold rTMS or sham treatment to the left temporoparietal junction for 2 weeks.
  
  
  METHODS
  The difference in the change of the THI score between active and sham rTMS.
  
  
  RESULTS
  Active treatment was associated with a median (95% confidence interval) reduction in THI score of 5 (0-14) points, and sham treatment was associated with a median reduction in THI score of 6 (-2 to 12) points. The difference in THI scores between the change associated with active and sham rTMS ranged from a 34-point reduction in THI score after active treatment to a 22-point increase after sham treatment, with a median difference change of only 1 point (-6 to 4 points).
  
  
  CONCLUSIONS
  Daily low-frequency rTMS to the left temporoparietal junction area for 2 weeks is no more effective than placebo for patients with chronic bothersome tinnitus. Possible explanations for the negative findings are short duration of treatment, failure of rTMS stimulation over the temporoparietal area to affect the auditory cortex buried within the Sylvian fissure, or more widespread cortical network changes associated with severe bothersome tinnitus not amenable to localized rTMS effects. Trial Registration clinicaltrials.gov Identifier: NCT00567892.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8115, St Louis, MO 63110, USA. piccirilloj@ent.wustl.edu
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Keith S
authors.initials: KS
authors.lastname: Garcia
authors.forename: Joyce
authors.initials: J
authors.lastname: Nicklaus
authors.forename: Katherine
authors.initials: K
authors.lastname: Pierce
authors.forename: Harold
authors.initials: H
authors.lastname: Burton
authors.forename: Andrei G
authors.initials: AG
authors.lastname: Vlassenko
authors.forename: Mark
authors.initials: M
authors.lastname: Mintun
authors.forename: Diane
authors.initials: D
authors.lastname: Duddy
authors.forename: Dorina
authors.initials: D
authors.lastname: Kallogjeri
authors.forename: Edward L
authors.initials: EL
authors.lastname: Spitznagel
mesh_terms: D000328:Adult; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009778:Occipital Lobe / Q000503:physiopathology*; D012815:Signal Processing, Computer-Assisted; D012984:Software; D013702:Temporal Lobe / Q000503:physiopathology*; D013813:Therapy, Computer-Assisted; D014012:Tinnitus / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome