Combined central and peripheral stimulation for treatment of chronic tinnitus: a randomized pilot study

• Published in: Neurorehabilitation and neural repair Vol. 29; no. 3; p. 224
• Main Authors: Thabit, Mohamed N, Fouad, Naglaa, Shahat, Badawy, Youssif, Mostafa
• Format: Journal Article
• Language: English
• Published: United States 01.03.2015
• Subjects: Acoustic Stimulation; Acupuncture Therapy; Adult; Chronic Disease; Combined Modality Therapy; Female; Humans; Low-Level Light Therapy; Male; Middle Aged; Pilot Projects; Tinnitus - therapy; Transcranial Magnetic Stimulation; Treatment Outcome; acupuncture; rehabilitation; transcranial magnetic stimulation; tinnitus; low-level laser therapy
• ISSN: 1552-6844
• DOI: 10.1177/1545968314542616

Tinnitus is a common untreatable condition that originates from central maladaptive plasticity initiated by peripheral injury. Repetitive transcranial magnetic stimulation (rTMS), direct cochlear low-level laser therapy (LLLT), and acupuncture were tried for tinnitus treatment, but the results of these methods were clinically unsatisfactory. This study aimed to test the combined effect of the 3 methods targeting both peripheral and central auditory areas as a new therapeutic strategy for tinnitus. For this, 30 patients were randomized to 3 equal groups receiving 3 different interventions: inhibitory rTMS to the left auditory cortex, LLLT (which includes a combination of direct cochlear LLLT and laser acupuncture) to the affected ear(s), and finally, a combination of rTMS and LLLT. The Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were assessed before, immediately after, and at 2 weeks and 4 weeks after 10 consecutive every-other-day sessions for each intervention type. We found that combined stimulation was effective in tinnitus treatment. This effect remained for 4 weeks after the end of the treatment. However, each of rTMS and LLLT alone had no significant effect. Repeated-measures ANOVA showed a significant effect of Time and Time × Intervention interaction for THI and VAS scores. The post hoc t test for different time points per intervention revealed a significant difference between baseline and all postintervention measurements of both THI and VAS for the combination intervention. Combined central rTMS and peripheral LLLT is more beneficial as a new method for management of tinnitus rather than these two used separately.