title: Low-frequency repetitive transcranial magnetic stimulation to the temporoparietal junction for tinnitus: four-week stimulation trial.
abstract: OBJECTIVE
  This research examines the impact of 4 weeks of repetitive transcranial magnetic stimulation (rTMS) stimulation to the temporoparietal junction and compares the results of this longer duration of treatment with a similar stimulus protocol of only 2 weeks' duration.
  
  
  OBJECTIVE
  To examine the effectiveness and safety of 4 weeks of low-frequency rTMS to the left temporoparietal junction in a cohort of patients with bothersome tinnitus.
  
  
  METHODS
  Crossover, double-blind, randomized controlled trial.
  
  
  METHODS
  Outpatient academic medical center.
  
  
  METHODS
  The study population comprised 14 adults aged between 22 and 59 years with subjective, unilateral or bilateral, nonpulsatile tinnitus of 6 months' duration or greater and a score of 34 or greater on the Tinnitus Handicap Inventory (THI).
  
  
  METHODS
  Low-frequency (1 Hz) 110% motor threshold rTMS or sham to the left temporoparietal junction for 4 weeks.
  
  
  METHODS
  The difference of the change in the THI score between active rTMS and sham rTMS.
  
  
  RESULTS
  Active treatment was associated with a median reduction in THI score of 10 (range, -20 to +4) points, and sham treatment was associated with a median reduction of 6 (range, -24 to +12) points. The median difference in THI score between the change associated with active and sham rTMS was 4 (95% CI, -9 to 10; and range, -32 to +14) points.
  
  
  CONCLUSIONS
  Daily low-frequency active rTMS to the left temporoparietal junction area for 4 weeks was no more effective than sham for patients with chronic bothersome tinnitus. Possible explanations for this negative study include the failure of rTMS to stimulate deeper parts of auditory cortex within the sylvian fissure and more widespread cortical network changes not amenable to localized rTMS effects.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00567892.
authors.affiliation: Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine, St Louis, MO63110, USA. piccirilloj@ent.wustl.edu
authors.forename: Jay F
authors.initials: JF
authors.lastname: Piccirillo
authors.forename: Dorina
authors.initials: D
authors.lastname: Kallogjeri
authors.forename: Joyce
authors.initials: J
authors.lastname: Nicklaus
authors.forename: Andre
authors.initials: A
authors.lastname: Wineland
authors.forename: Edward L
authors.initials: EL
authors.lastname: Spitznagel
authors.forename: Andrei G
authors.initials: AG
authors.lastname: Vlassenko
authors.forename: Tammie
authors.initials: T
authors.lastname: Benzinger
authors.forename: Jose
authors.initials: J
authors.lastname: Mathews
authors.forename: Keith S
authors.initials: KS
authors.lastname: Garcia
mesh_terms: D000328:Adult; D001303:Auditory Cortex / Q000503:physiopathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012684:Sensory Thresholds; D014012:Tinnitus / Q000503:physiopathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult