Intervention lessens severity of tinnitus

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Individuals with chronic tinnitus who received treatment that involved the delivery of electromagnetic pulses had a greater improvement in tinnitus severity compared to a placebo group, according to a study published online by JAMA Otolaryngology-Head & Neck Surgery.

Tinnitus is perceived by 10–15% of the adult population. Of those individuals who experience chronic tinnitus, approximately 20% consider it to be a “clinically significant” problem. Because chronic tinnitus is a condition that negatively affects the quality of life for millions of people worldwide, a safe and effective treatment has been sought for decades, according to background information in the article.

Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and involves delivering electromagnetic pulses through a coil to the patient’s scalp. Low-frequency rTMS is known to reduce brain activity in directly stimulated regions and has been proposed as an innovative treatment strategy for medical conditions associated with increased cortical activity, including tinnitus.

Robert L Folmer, of the Portland Veterans Affairs Medical Center and Oregon Health & Science University, Portland, USA, and colleagues randomly assigned 70 study participants with chronic tinnitus to receive 2,000 pulses per session of active or placebo rTMS on 10 consecutive workdays. Follow-up assessments were done at one, two, four, 13 and 26 weeks after the last treatment session. Sixty-four participants were included in the final analyses. No participants withdrew from the study because of adverse effects of rTMS. Severity of tinnitus was measured with the Tinnitus Functional Index (TFI).

The researchers found that the active rTMS group as a whole exhibited a 31% reduction in the TFI at the 26-week follow-up compared with baseline and the placebo rTMS group as a whole exhibited a 7% reduction. Overall, 18 of 32 participants (56%) in the active rTMS group and 7 of 32 participants (22%) in the placebo rTMS group responded to rTMS treatment (defined as participants who improved a certain amount on the total TFI from baseline to the end of their last rTMS session).

“If rTMS continues to demonstrate efficacy as a treatment for tinnitus, future investigations should include multisite clinical trials. If these larger clinical trials replicate efficacy of rTMS that has been demonstrated in the present study, then steps should be taken to implement the procedure as a clinical treatment for chronic tinnitus,” the authors write.

“We do not believe that rTMS should be viewed as a replacement for effective tinnitus management strategies that are available now. Instead, rTMS could augment existing tinnitus therapies and provide a viable option for patients who do not respond favourably to other treatments.”

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