title: Efficacy and Safety of Repeated Courses of rTMS Treatment in Patients with Chronic Subjective Tinnitus.
abstract: BACKGROUND
  Repetitive transcranial magnetic stimulation (rTMS) has shown promising effects in the treatment of chronic subjective tinnitus. However, little is known about maintenance treatment in order to achieve long-lasting improvements.
  
  
  OBJECTIVE
  This study addresses the questions whether the repeated application of rTMS treatment can contribute to the maintenance or enhancement of treatment effects and if so in which cases repetitive treatment courses are beneficial.
  
  
  METHODS
  55 patients with chronic tinnitus were treated with two rTMS treatment courses with ten treatment sessions each. The mean intertreatment interval was 20.65 ± 18.56 months. Tinnitus severity was assessed before and after each treatment course.
  
  
  RESULTS
  Both treatments were well tolerated and caused significant improvement of tinnitus severity. The main predictor for the outcome of the second treatment was the development of tinnitus distress in the phase between both treatment courses: the more patients worsened in this interval, the more they improved during the second treatment course.
  
  
  CONCLUSIONS
  Repeated application of rTMS seems to be useful in tinnitus management and should preferentially be offered to patients who experience a worsening of their tinnitus during the intertreatment interval, irrespective of their response to the first treatment course.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Lehner
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schecklmann
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Timm B
authors.initials: TB
authors.lastname: Poeppl
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Kreuzer
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Juliette
authors.initials: J
authors.lastname: Peytard
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Frank
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Regensburg, 93053 Regensburg, Germany ; Interdisciplinary Tinnitus Center, University of Regensburg, 93053 Regensburg, Germany.
authors.forename: Berthold
authors.initials: B
authors.lastname: Langguth
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000473:pathology / Q000628:therapy*; D050781:Transcranial Magnetic Stimulation / Q000009:adverse effects / Q000379:methods*