Tinnitus and Transcranial Magnetic Stimulation

ABSTRACT

Tinnitus is a frequent disorder that is very difficult to treat. Both functional imaging studies in patients and electrophysiological studies in animals suggest that hyperactivity in the central auditory system due to increased synchronicity may cause tinnitus. Targeted modulation of tinnitus-related cortical activity has been proposed as a promising new treatment. Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive method that can focally modulate cortical activity. This technique has been used to diagnose and treat tinnitus. Single sessions of high-frequency rTMS over the temporal cortex have been used to suppress tinnitus transiently and could become a useful predictor for treatment outcome of epidural stimulation. Another approach uses rTMS as a treatment for tinnitus by applying repeated sessions of low-frequency rTMS to induce a lasting reduction of excitability in the auditory cortex. Beneficial effects of treatment have been consistently demonstrated in several controlled studies. However results are characterized by high interindividual variability and only moderate effect sizes. Convincing evidence indicates that rTMS represents a promising tool for diagnosis and treatment of tinnitus. Further development of this technique will depend on a more detailed understanding of the neurobiological effects that mediate the clinical effects of TMS.

KEYWORDS

Tinnitus - transcranial magnetic stimulation - neuroplasticity - functional imaging - auditory cortex

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