Triple-site rTMS for the treatment of chronic tinnitus: a randomized controlled trial

Astrid Lehner, Martin Schecklmann, Mark W Greenlee, Rainer Rupprecht, Berthold Langguth, Astrid Lehner, Martin Schecklmann, Mark W Greenlee, Rainer Rupprecht, Berthold Langguth

Abstract

Recent research indicates that tinnitus is related to alterations of neural networks including temporal, parietal, and prefrontal brain regions. The current study examines a rTMS protocol which targets three central nodes of these networks in a two-arm randomized parallel group trial. Overall, 49 patients with chronic tinnitus were randomized to receive either triple-site stimulation (left dorsolateral prefrontal stimulation, 1000 pulses, 20 Hz plus left and right temporoparietal stimulation, 1000 pulses each, 1 Hz) or single-site stimulation (left temporoparietal stimulation, 3000 pulses, 1 Hz). Both groups were treated in ten sessions. Tinnitus severity as measured by the tinnitus questionnaire was assessed before rTMS (day1), after rTMS (day12) and at two follow-up visits (day 90 and day 180). The triple-site protocol was well tolerated. There was a significant reduction in tinnitus severity for both treatment groups. The triple-site group tended to show a more pronounced treatment effect at day 90. However, the measurement time point x group interaction effect was not significant. The current results confirm former studies that indicated a significant reduction of tinnitus severity after rTMS treatment. No significant superiority of the multisite protocol was observed. Future approaches for the enhancement of treatment effects are discussed.

Figures

Figure 1. Reduction in the TQ sum…
Figure 1. Reduction in the TQ sum score from day 1 to all subsequent measurement time points (for the placebo group only data for day 12 and day 90 were available).

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