Transcranial Magnetic Stimulation is used to modulate both the auditory and non-auditory neural pathways contributing to the perception of phantom sounds.
Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. It is a frequent problem which can interfere significantly with the ability to lead a normal life. Treatment remains difficult. Most available therapies focus on habituation rather than treating the cause. Tinnitus has been shown to be associated with functional reorganization of auditory neural pathways and tonotopic maps in the central auditory system. Consequently, low-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) applied to the temporoparietal areas has been investigated for the treatment of tinnitus. Additionally, there is growing evidence that a neural network of both auditory and non-auditory cortical areas is involved in the pathophysiology of chronic subjective tinnitus. Targeting several core regions of this network by rTMS might constitute a promising strategy to enhance treatment effects. A new multisite treatment protocol which is supposed to have an effect on both auditory and non-auditory cortical areas will be examined with regard to feasibility, safety and clinical efficacy in patients suffering from chronic tinnitus in a controlled pilot trial.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
50
Low frequency rTMS (Magventure Mag Pro Option) applied over left temporoparietal cortex: 3000 stimuli of 1Hz rTMS (110% motor threshold); 1 minute break after 1000 and 2000 stimuli. Arms: single site rTMS
Repetitive transcranial magnetic stimulation (Magventure Mag Pro Option): 1000 stimuli of 20 Hz rTMS over the left DLPFC (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over the left temporoparietal cortex (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over right temporoparietal cortex (110% motor threshold). Arms: multisite rTMS
University of Regensburg- Dept of Psychiatry
Regensburg, Germany
Number of treatment responders (TQ reduction ≥5, contrast baseline versus day 12)
Time frame: Day 12
Change of tinnitus severity as measured by the Tinnitus Questionnaire of Goebel&Hiller (contrast baseline versus day 12)
Time frame: Day 12
Change of depressive symptoms as measured by the Major Depression Inventory (MDI)
Time frame: Day 12
Change in quality of life as measured by the WHOQoL
Time frame: Day 12
Change in hyperacusis as measured by the German questionnaire "Geräuschüberempfindlichkeitsfragebogen"
Time frame: Day 12
Number of treatment responders (TQ reduction ≥5, contrast Baseline versus day 90)
Time frame: Day 90
Change of tinnitus severity as measured by the Tinnitus Handicap Inventory (THI) and Tinnitus Severity Scale
Time frame: Day 12
Change of tinnitus severity as measured by the Tinnitus Handicap Inventory (THI) and Tinnitus Severity Scale
Time frame: Day 90
Change of tinnitus severity as measured by the Tinnitus Handicap Inventory (THI) and Tinnitus Severity Scale
Time frame: Day 180
Change of depressive symptoms as measured by the Major Depression Inventory (MDI)
Time frame: Day 180
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Change of depressive symptoms as measured by the Major Depression Inventory (MDI)
Time frame: Day 90
Change in quality of life as measured by the WHOQoL
Time frame: Day 90
Change in quality of life as measured by the WHOQoL
Time frame: Day 180
Change in hyperacusis as measured by the German questionnaire "Geräuschüberempfindlichkeitsfragebogen"
Time frame: Day 90
Change in hyperacusis as measured by the German questionnaire "Geräuschüberempfindlichkeitsfragebogen"
Time frame: Day 180
Number of treatment responders (TQ reduction ≥5, contrast Baseline versus day 180)
Time frame: Day 180
Change of tinnitus severity as measured by the Tinnitus Questionaire of Goebel&Hiller
Time frame: Day 90
Change of tinnitus severity as measured by the Tinnitus Questionaire of Goebel&Hiller
Time frame: Day 180