Conventional Repetitive Transcranial Magnetic Stimulation for Tinnitus Treatment (MagTIN)
Assessment of Conventional Repetitive Transcranial Magnetic Stimulation for the Treatment of Chronic Tinnitus
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
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Lyon, France, 69437
- Département d'ORL et de Chirurgie Cervico-Maxillo-Faciale, Hôpital Edouard Herriot
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Pierre-Bénite, France, 69495
- Service d'Audiologie et Explorations Orofaciales, Centre Hospitalier Lyon Sud
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Pierre-Bénite, France, 69495
- Service d'Oto-Rhino-Laryngologie, Centre Hospitalier Lyon-Sud
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Men and women between the ages of 18 and 75 years old;
- Adequate medical condition (ASA P1 or P2 in Physical Status Classification System);
- Disabling tinnitus (STSS > 8/16 or THQ > 50%), with the following characteristics: continuous, subjective, non-pulsatile; unilateral (or bilateral with unilateral predominance), chronic (duration for at least one year), refractory for usual treatments taken for at least six months;
- Naive regarding TMS;
- Able to provide informed consent.
Exclusion Criteria:
- Objective tinnitus or tinnitus with treatable cause;
- Presence of intracranial or intraocular ferromagnetic materiel or particles (with the exception of dental fillings and MRI-compatible stapedectomy prosthesis);
- Cardiac pacemaker or other electronic implants (including cochlear implant);
- Serious heart disease or other unstable major medical condition;
- Personal history of central nervous system disorder, head injury, stroke or seizures (including childhood febrile seizures);
- Familial history of epilepsy;
- Concomitant medication with antidepressants and antipsychotics;
- Possibility of pregnancy;
- Known claustrophobia;
- Others known contraindications to rTMS or brain MRI;
- Refusal to be informed about the results of anatomical MRI
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
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Experimental: Active rTMS
48 subjects will receive active temporal rTMS, applied with the following combined parameters:
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The study is based on a dual procedure consisting of comparisons between active and sham rTMS on the one hand and between four increasing levels of magnetic "pseudo-dose" on the other hand.
Each level comprises 16 patients randomly assigned to active rTMS group (12 patients) or sham rTMS group (4 patients).
The transition from one level to another is authorized by an independent oversight committee charged with checking the tolerability of rTMS sessions for the tested level.
The neuronavigated rTMS use either active or sham figure-eight coil and is centered over the primary auditory cortex contralateral to the perceived predominant side of tinnitus.
This target is located through anatomical brain MRI and neuronavigated brain system.
According to the stimulation parameters, each rTMS session can last from 5 to 112 minutes and the whole rTMS intervention from 1 to 20 weeks.
The follow-up is spread over twelve months.
Other Names:
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Sham Comparator: Sham rTMS
16 subjects will receive sham rTMS, applied with the same combination of parameters as active rTMS, except for the number of stimulations per session (300 or 900)
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Same sound level as active rTMS, but magnetic field strongly attenuated
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Change from baseline in tinnitus perception, as measured over time using a visual analog rating scale (subjective loudness of tinnitus)
Time Frame: At subject enrollment; daily for 2 weeks before the intervention; before and after each rTMS session, once at the end of each week and at the end of intervention; during follow-up: twice a week for 6 months, and 1 year after the end of intervention
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The time between enrollment and rTMS intervention will vary from one subject to another (expected average of 4 months); depending on the protocol, the end of the intervention corresponds to the end of week 1, 4, 5 or 20 (first day of rTMS as reference)
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At subject enrollment; daily for 2 weeks before the intervention; before and after each rTMS session, once at the end of each week and at the end of intervention; during follow-up: twice a week for 6 months, and 1 year after the end of intervention
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Tolerance of rTMS, evaluated through a semi-structured interview on specific and nonspecific adverse events
Time Frame: After the first rTMS session; before and after each following session and at the end of intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Depending on the protocol, the end of the intervention corresponds to the end of week 1, 4, 5 or 20 (first day of rTMS as reference)
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After the first rTMS session; before and after each following session and at the end of intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Auditory status, evaluated through tonal audiometry (pure-tone average)
Time Frame: At subject enrollment; before the first rTMS session and after the last rTMS session (for all types of protocols), and every five sessions of rTMS (for long protocols)
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The time between enrollment and rTMS intervention will vary from one subject to another (expected average of 4 months)
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At subject enrollment; before the first rTMS session and after the last rTMS session (for all types of protocols), and every five sessions of rTMS (for long protocols)
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Change in severity of tinnitus, measured through a multidimensional self-questionnaire: Subjective Tinnitus Severity Scale (STSS)
Time Frame: At subject enrollment; before the first rTMS session, in the middle and at the end of intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Depending on the protocol, middle (respectively, end) of the intervention corresponds to day 3, day 12, beginning of week 3 or beginning of week 11 (respectively, end of week 1, 4, 5 or 20), with the first day of rTMS as reference
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At subject enrollment; before the first rTMS session, in the middle and at the end of intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Change in handicap related to tinnitus, measured through a multidimensional self-questionnaire: Tinnitus Handicap Questionnaire (THQ)
Time Frame: At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Change in hyperacusis, measured through a multidimensional self-questionnaire: Auditory Hypersensitivity Questionnaire
Time Frame: At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Change in anxiety and depression, measured through a two-dimensional self-questionnaire: Hospital Anxiety and Depression Scale (HADS)
Time Frame: At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Personality, assessed through a multidimensional self-questionnaire: Mini-Mult (short form of the MMPI)
Time Frame: At subject enrollment
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The time between enrollment and rTMS intervention will vary from one subject to another (expected average of 4 months)
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At subject enrollment
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Change in tinnitus spectrum (loudness and pitch), characterized through psychoacoustical measurements: tinnitometry
Time Frame: At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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At subject enrollment; at the beginning, in the middle and at the end of rTMS intervention period; 1, 4 or 5, and 20 weeks after the start of intervention; 1, 3, 6 months and 1 year after the end of intervention
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Motivation level, assessed through a short self-questionnaire (Likert-type scale)
Time Frame: At the beginning of intervention period (before the first rTMS session) (day 1)
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At the beginning of intervention period (before the first rTMS session) (day 1)
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Satisfaction degree, assessed through a short self-questionnaire (Likert-type scale) Time Frame: At the end of SMTr intervention
Time Frame: At the end of intervention period (end of week 1, 4, 5 or 20, with the first day of rTMS as reference)
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At the end of intervention period (end of week 1, 4, 5 or 20, with the first day of rTMS as reference)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Xavier PERROT, MD, PhD, Service d'Audiologie et Explorations Orofaciales (Pr. COLLET) - Centre Hospitalier Lyon Sud - Hospices Civils de Lyon
Publications and helpful links
General Publications
- Tringali S, Perrot X, Collet L, Moulin A. Repetitive transcranial magnetic stimulation (rTMS) noise: a relevance for tinnitus treatment? Brain Stimul. 2012 Oct;5(4):655-6. doi: 10.1016/j.brs.2011.10.006. Epub 2012 Feb 22. No abstract available.
- Tringali S, Perrot X, Collet L, Moulin A. Repetitive transcranial magnetic stimulation noise levels: methodological implications for tinnitus treatment. Otol Neurotol. 2012 Sep;33(7):1156-60. doi: 10.1097/MAO.0b013e318263d37d.
- Tringali S, Perrot X, Collet L, Moulin A. Repetitive transcranial magnetic stimulation: hearing safety considerations. Brain Stimul. 2012 Jul;5(3):354-363. doi: 10.1016/j.brs.2011.06.005. Epub 2011 Jul 26.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2004.365
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