title: Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.
abstract: In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn.
authors.affiliation: Psychiatry Department of Shafa Hospital, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Robabeh
authors.initials: R
authors.lastname: Soleimani
authors.affiliation: Sinonasal Disease Research Center, Amiralmomenin Hospital, Guilan University of Medical Sciences, Rasht, Iran. mmjalali@gmail.com.
authors.forename: Mir Mohammad
authors.initials: MM
authors.lastname: Jalali
authors.affiliation: Medical Faculty, Guilan University of Medical Sciences, Rasht, Iran.
authors.forename: Tolou
authors.initials: T
authors.lastname: Hasandokht
mesh_terms: D002908:Chronic Disease; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000175:diagnosis / Q000628:therapy; D050781:Transcranial Magnetic Stimulation / Q000379:methods*; D016896:Treatment Outcome
keywords: Auditory cortex; Randomized clinical trials; Repetitive; Tinnitus; Transcranial magnetic stimulation