The effect of noninvasive brain stimulation on neural connectivity in Tinnitus: A randomized trial

Abstract

Objectives/hypothesis: To explore neural connectivity changes associated with repetitive transcranial magnetic stimulation (rTMS) to the temporoparietal junction for patients with bothersome tinnitus.

Study design: Randomized, double-blind, controlled clinical trial.

Methods: Thirty patients with subjective, nonpulsatile tinnitus for 6 months duration or longer and a score of 36 or greater on the Tinnitus Handicap Inventory completed the study. Participants were randomized to receive either sham or active treatment with rTMS to the temporoparietal junction for either 2 or 4 weeks of therapy. Participants underwent resting state functional connectivity magnetic resonance imaging before therapy and immediately following treatment. Functional connectivity changes between active and sham treatment groups were compared using regions of interest in auditory, default mode, ventral attention, and executive attention networks.

Results: Sixteen patients received active rTMS treatment; 14 patients received sham treatment. There were no differences between the active and sham groups in baseline functional connectivity. Neither treatment with rTMS nor sham therapy resulted in statistically significant functional connectivity changes in the examined brain networks.

Conclusions: The analysis did not identify any changes in neural connectivity following treatment in patients with bothersome tinnitus. These results are consistent with our findings of lack of symptom changes previously reported in the same group of patients. Measures of neural connectivity may inform future work using rTMS to better understand the possible benefits of neural stimulation for tinnitus.

Level of evidence: 1b. Laryngoscope, 126:1201-1206, 2016.

Keywords: Tinnitus; functional MRI; repetitive transcranial magnetic stimulation.

Conflict of interest statement

Conflicts of interest: none

© 2015 The American Laryngological, Rhinological and Otological Society, Inc.

Figures

Figure 1

Flow diagram of participation

Figure 2

Regions of Interest (ROIs) used for functional connectivity analysis. TPJ = temporoparietal junction, IFG = inferior frontal gyrus, AUD = auditory cortex, ACC = anterior cingulate cortex, PCC = posterior cingulate cortex, aO = anterior operculum.

Figure 3

Left auditory ROI: pre-treatment, post-treatment and difference between pre and post treatment resting state functional connectivity for active and sham therapy groups.