title: A comparison study of repetitive transcranial magnetic stimulation for tinnitus treatment in an Asian population.
abstract: BACKGROUND
  Tinnitus, a subjective auditory perception of sounds or noise not triggered by external auditory stimuli, carries considerable morbidity. To date, pharmacological, physical or behavioral therapy is the mainstay of management.
  
  
  METHODS
  We compared repetitive transcranial magnetic stimulation (rTMS) of 1000 or 2000 stimulations/day at 1 Hz and 110% of the motor threshold for 5 consecutive days over the left auditory cortex. Ratings based on the Tinnitus Handicap Inventory (THI) rating scale were completed weekly for 4 weeks. None of the patients had significant hearing impairment.
  
  
  RESULTS
  All 28 patients (age range 21-72; 18 men) tolerated rTMS well and no adverse effects were observed. Analysis of variance (ANOVA) showed significant decrease in THI scores over the entire time period (F (1,26)=11.33, p=0.002). At every weekly time point of evaluation, ANOVA with repeated measures demonstrated significantly lower THI score compared to baseline (p<0.02 for all). RTMS treatment had resulted in tinnitus reduction in the range of 15-25% over the 4 week period. Separately, ANOVA also demonstrated significantly reducing THI for both the 1000 pulse (F (1,14)=4.8, p=0.04) and 2000 pulse (F (1,14)=6.56, p=0.02) rTMS treatment arms. Comparison of THI ratings between the 2 treatment arms did not result in significant difference (F (1,26)=1.48, p=0.24).
  
  
  CONCLUSIONS
  The present study has revalidated the efficacy and safety of rTMS for improving tinnitus up to 4 weeks post-treatment in Asians. However, there was no significant difference with THI evaluation between the 1000 pulse and 2000 pulse treatment arms.
authors.affiliation: Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. Electronic address: gnrlyl@sgh.com.sg.
authors.forename: Y L
authors.initials: YL
authors.lastname: Lo
authors.affiliation: Department of Neurology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors.forename: P W T
authors.initials: PW
authors.lastname: Cheong
authors.affiliation: Department of Otolaryngorhinology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors.forename: M
authors.initials: M
authors.lastname: Wong
authors.affiliation: Department of Clinical Research, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors.forename: S
authors.initials: S
authors.lastname: Fook-Chong
authors.affiliation: Department of Otolaryngorhinology, Changi General Hospital, Singapore, Singapore.
authors.forename: H W
authors.initials: HW
authors.lastname: Yuen
authors.affiliation: Department of Otolaryngorhinology, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
authors.forename: Y M
authors.initials: YM
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D001303:Auditory Cortex; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Tinnitus; Transcranial magnetic stimulation; Treatment; Trial