SS02: TINNITUS: MECHANISMS AND TREATMENT

TREATMENT OF TINNITUS WITH REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (rTMS)

Tobias Kleinjung

Department of Otorhinolaryngology, University of Regensburg, Germany.

The pathophysiology of tinnitus remains incompletely understood and treatment is elusive. Recent neurophysiological and neuroimaging data suggest that some forms of tinnitus are associated with synchronized hyperactivity in the auditory cortex. Therefore targeted modulation of tinnitus-related cortical hyperactivity has been considered as a new promising treatment strategy. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive method for modifying neural activity at the stimulated area and at a distance along functional anatomical connections.

The technique can be applied in two different ways in diagnosing and treating tinnitus patients. One approach uses single sessions of high-frequency rTMS applied to the temporal cortex. This method has shown to be successful in suppressing tinnitus transiently during the time of stimulation and could therefore be used as a predictor for treatment outcome of direct electrical epidural stimulation with implanted electrodes. Low-frequency rTMS is an efficient method to selectively reduce the abnormally increased activity in cortical areas. Several small controlled studies demonstrated beneficial effects in tinnitus patients after repeated sessions of low-frequency rTMS. In some patients consistent treatment effects could outlast the stimulation period for six months. However, results of available studies show high inter-individual variability of treatment effects and only moderate effect sizes.  

This presentation will summarize the “Regensburg” experience with this technique.