Hanna Sahlsten1, Juuso Virtanen1, Juho Joutsa2, Katri Niinivirta-Joutsa2, Eliisa Löyttyniemi3, Reijo Johansson4, Janika Paavola5, Tero Taiminen6, Noora Sjösten4, Jaakko Salonen4, Anu Holm7, Esa Rauhala7, Satu K Jääskeläinen2. 1. a Faculty of Medicine , University of Turku , Turku , Finland. 2. b Department of Clinical Neurophysiology , Turku University Hospital and University of Turku , Turku , Finland. 3. c Department of Biostatistics , University of Turku , Turku , Finland. 4. d Department of Ear, Nose and Throat , Turku University Hospital , Turku , Finland. 5. e Department of Medical Physics , Turku University Hospital , Turku , Finland. 6. f Department of Psychiatry , Turku University Hospital , Turku , Finland , and. 7. g Department of Clinical Neurophysiology , Satakunta Central Hospital , Pori , Finland.
Abstract
OBJECTIVE:Repetitive transcranial magnetic stimulation (rTMS) may alleviate tinnitus. We evaluated effects of electric field (E-field) navigated rTMS targeted according to tinnitus pitch. No controlled studies have investigated anatomically accurate E-field-rTMS for tinnitus. DESIGN: Effects of E-field-rTMS were evaluated in a prospective randomised placebo-controlled 6-month follow-up study on parallel groups. Patients received 10 sessions of 1 Hz rTMS or placebo targeted to the left auditory cortex corresponding to tonotopic representation of tinnitus pitch. Effects were evaluated immediately after treatment and at 1, 3 and 6 months. Primary outcome measures were visual analogue scores (VAS 0-100) for tinnitus intensity, annoyance and distress, and the Tinnitus Handicap Inventory (THI). STUDY SAMPLE: Thirty-nine patients (mean age 50.3 years). RESULTS: The mean tinnitus intensity (F3 = 15.7, p < 0.0001), annoyance (F3 = 8.8, p = 0.0002), distress (F3 = 9.1, p = 0.0002) and THI scores (F4 = 13.8, p < 0.0001) decreased in both groups over time with non-significant differences between the groups. After active rTMS, 42% and 37% of the patients showed excellent response at 1 and 3 months against 15% and 10% in the placebo group (p = 0.082 and p = 0.065). CONCLUSIONS: Despite the significant effects of rTMS on tinnitus, differences between active and placebo groups remained non-significant, due to large placebo-effect and wide inter-individual variation.
RCT Entities:
OBJECTIVE: Repetitive transcranial magnetic stimulation (rTMS) may alleviate tinnitus. We evaluated effects of electric field (E-field) navigated rTMS targeted according to tinnitus pitch. No controlled studies have investigated anatomically accurate E-field-rTMS for tinnitus. DESIGN: Effects of E-field-rTMS were evaluated in a prospective randomised placebo-controlled 6-month follow-up study on parallel groups. Patients received 10 sessions of 1 Hz rTMS or placebo targeted to the left auditory cortex corresponding to tonotopic representation of tinnitus pitch. Effects were evaluated immediately after treatment and at 1, 3 and 6 months. Primary outcome measures were visual analogue scores (VAS 0-100) for tinnitus intensity, annoyance and distress, and the Tinnitus Handicap Inventory (THI). STUDY SAMPLE: Thirty-nine patients (mean age 50.3 years). RESULTS: The mean tinnitus intensity (F3 = 15.7, p < 0.0001), annoyance (F3 = 8.8, p = 0.0002), distress (F3 = 9.1, p = 0.0002) and THI scores (F4 = 13.8, p < 0.0001) decreased in both groups over time with non-significant differences between the groups. After active rTMS, 42% and 37% of the patients showed excellent response at 1 and 3 months against 15% and 10% in the placebo group (p = 0.082 and p = 0.065). CONCLUSIONS: Despite the significant effects of rTMS on tinnitus, differences between active and placebo groups remained non-significant, due to large placebo-effect and wide inter-individual variation.
Entities:
Keywords:
TMS; Tinnitus; electric field navigated; therapy; transcranial magnetic stimulation
Authors: Hanna Sahlsten; Anu Holm; Esa Rauhala; Mari Takala; Eliisa Löyttyniemi; Max Karukivi; Johanna Nikkilä; Kirsi Ylitalo; Janika Paavola; Reijo Johansson; Tero Taiminen; Satu K Jääskeläinen Journal: Trends Hear Date: 2019 Jan-Dec Impact factor: 3.293