Abstract
Repetitive transcranial magnetic stimulation (rTMS) and transcutaneous direct current stimulation (tDCS) are non-invasive treatments for chronic tinnitus based on neuromodulation of cortical activity. Both are considered effective, but with heterogeneous results due to lack of established protocols. Because the target groups for both modalities overlap, it is difficult to recommend one of them. We tried to unify the inclusion criteria and treatment schedules to compare the two modalities. The medical charts of 36 patients who underwent rTMS as part of clinical routine were reviewed and data for 34 patients who underwent tDCS about 7 years later were collected prospectively. Both groups had chronic unilateral tinnitus refractory to medication. Patients were treated for 5 consecutive days, and tinnitus symptoms were evaluated by survey both at the end of the treatment schedule and 1 month after the treatment. The ratio of responders who showed >20% reduction in tinnitus handicap inventory scores were compared. At the end of the treatment, the rTMS group showed a rapid response compared to the tDCS group (rTMS, 30.6%; tDCS, 12.1%; p = 0.054). However, both groups showed a significant and similar reduction in tinnitus symptoms 1 month after the treatment (rTMS, 47.2%; tDCS, 36.4%; p = 0.618). As both groups showed comparable results for tinnitus reduction, tDCS may be superior in terms of cost-effectiveness.
Highlights
Published: 7 February 2021Tinnitus is a common acoustic problem which occurs in up to 21% of adults in their lifetime [1]
Patients: A total of 70 patients were enrolled in this study: 36 underwent Repetitive transcranial magnetic stimulation (rTMS) as part of our institution clinical routine for treatment of refractory chronic tinnitus from
The same inclusion criteria were applied to both treatment groups: (1) unilateral chronic subjective tinnitus (tinnitus handicap inventory (THI) > 38, >6 months), and (2) tinnitus symptoms refractory to more than 2 months of medication (Gingko biloba and/or selective serotonin reuptake inhibitor)
Summary
Tinnitus is a common acoustic problem which occurs in up to 21% of adults in their lifetime [1]. It is represented by phantom hearing without any external stimulation. In some patients, this can be explained by a maladaptive plastic brain that results from hearing impairment [2]. Tinnitus still has many factors to be elucidated, including treatment. Tinnitus does not seem to deteriorate hearing itself, tinnitus has significantly jeopardized psychological health in previous reports [3]. Evidence of a generally accepted treatment modality for tinnitus is still lacking
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