title: Long-term repetitive transcranial magnetic stimulation therapy: new research questions arising from one tinnitus case?
abstract: Tinnitus may become refractory to treatment and disabling. Brain transcranial magnetic stimulation (TMS) has shown promise as a therapy, but has been employed primarily short-term. We treated a patient with 5 weeks of weekly repetitive TMS (rTMS), followed by 6 months of monthly rTMS. He was a 75-year-old dentist with chronic tinnitus from occupational noise exposure. Physical examination and MRIs of the auditory canals and brain had revealed no lesions. The patient showed a general gradual, progressive improvement on per cent of severe tinnitus diary days (from baseline 100% to 33%), tinnitus handicap inventory (from baseline score 70 to 18), and mini-tinnitus questionnaire (from baseline score 17 to 6). No changes occurred in serial audiograms. Transient adverse events were a headache during stimulation, and dizziness 30 min after treatment. Implications and questions for future non-invasive neuromodulation clinical research raised by our case are discussed.
authors.affiliation: Department of Clinical Neurophysiology, Weill-Cornell Medical College, New York, New York, USA.
authors.forename: Douglas Richard
authors.initials: DR
authors.lastname: Labar
authors.affiliation: Non-invasive Brain Stimulation Laboratory, Burke Medical Research Institute, White Plains, New York, USA.
authors.forename: Mar
authors.initials: M
authors.lastname: Cortes
authors.affiliation: Non-invasive Brain Stimulation Laboratory, Burke Medical Research Institute, White Plains, New York, USA.
authors.forename: Dylan
authors.initials: D
authors.lastname: Edwards
mesh_terms: D000368:Aged; D003813:Dentistry; D006801:Humans; D008297:Male; D009622:Noise / Q000009:adverse effects; D009784:Occupational Diseases / Q000628:therapy; D016273:Occupational Exposure / Q000009:adverse effects; D014012:Tinnitus / Q000209:etiology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation