P057 Individualized rTMS: a proof-of-concept study in chronic tinnitus

• Published in: Clinical neurophysiology Vol. 128; no. 3; p. e34
• Main Authors: Kreuzer, P, Poeppl, T, Vielsmeier, V, Lehner, A, Langguth, B, Schecklmann, M
• Format: Journal Article
• Language: English
• Published: Elsevier B.V 01.03.2017
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2016.10.182

Background Prefrontal and temporoparietal repetitive transcranial magnetic stimulation (rTMS) in chronic tinnitus showed significant but only moderate effectiveness with high inter-individual variability in treatment response. This study was designed to proof the feasibility of an individualized fronto-temporal rTMS paradigm. Methods During the first session of our standard two-week rTMS setting we applied different protocols to the left and right temporoparietal and dorsolateral prefrontal cortex (DLPFC) in 25 tinnitus patients. In each protocol 200 pulses (except for 1 Hz frequency containing 50 pulses) were applied at frequencies of 1 Hz, 5 Hz, 10 Hz, 20 Hz, cTBS, sham (continuous theta burst stimulation). Patients reporting immediate tinnitus reduction were treated in an individualized manner applying a combined protocol consisting of the most effective frontal and the most effective temporoparietal stimulation protocol. Those patients who did not improve after the test session were treated with a standard fronto-temporoparietal protocol. Results Almost half of the patients (12 out of 25) reported immediate tinnitus reduction in the test session. In this group the mean pre-to-post-treatment amelioration in the tinnitus questionnaire was 8.6 ± 8.9 whereas the improvement was only 1.5 ± 8.5 in those patients who did not respond to the test session. Treatment outcome remained stable over a follow-up period of ten weeks. Discussion Individualized rTMS was shown to be feasible and effective in chronic tinnitus and might provide a basis for a “tailored” application of rTMS in tinnitus and other neuropsychiatric disorders.