What is the role of repetitive transcranial magnetic stimulation (TMS) in the treatment of tinnitus?

Updated: Feb 27, 2020
  • Author: Aaron G Benson, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Answer

Transcranial magnetic stimulation (TMS) is a method of stimulating the brain through the intact scalp without causing pain at the surface. It is a minimally invasive method for depolarizing cortical neurons and is based on the principle of electromagnetic induction. The rhythmic application of a series of single stimuli is referred to as repetitive TMS (rTMS), a method that has been demonstrated to induce long-term potentiation (LTP) or long-term depression (LTD)–like changes of cortical excitability that outlast the stimulation period. rTMS has been investigated as a therapeutic tool for depression, schizophrenia, and stroke. [14]

Tinnitus is considered by some to be a result of excitability of the cerebral cortex and, more specifically, the primary auditory cortex. rTMS has proven effective in the treatment of other disorders, such as auditory hallucinations, by modification of cerebral excitability.

Studies have indicated that the technique can alleviate tinnitus in the short-term by modulating the excitability of neurons in the auditory cortex, [15]  and a report stated that the use of rTMS with neuronavigation imaging resulted in a reduction in tinnitus severity after 6 months of follow-up compared with sham therapy. [16] Further studies regarding the long-term clinical effectiveness of rTMS are required.


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