Combined temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: A pilot study

TLDR

Low‑frequency rTMS of the temporal cortex has been proposed as a new treatment for chronic tinnitus, but tinnitus also involves attentional and emotional brain regions such as the dorsolateral prefrontal cortex. The study aimed to evaluate a combined high‑frequency prefrontal and low‑frequency temporal rTMS strategy versus low‑frequency temporal rTMS alone in chronic tinnitus patients. The intervention involved 32 patients receiving either low‑frequency temporal rTMS or the combined prefrontal‑temporal protocol, with outcomes measured by the standardized tinnitus questionnaire immediately post‑therapy. Immediately post‑therapy both groups improved on the TQ, but only the combined protocol showed a significant 3‑month benefit, supporting the role of auditory and non‑auditory areas in tinnitus.

Abstract

Low-frequency repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex has been proposed as a new treatment strategy for patients with chronic tinnitus. However, functional abnormalities in tinnitus patients also involve brain structures used for attentional and emotional processing, such as the dorsolateral prefrontal cortex. Therefore, we have developed a new rTMS treatment strategy for tinnitus patients that consists of a combination of high-frequency prefrontal and low-frequency temporal rTMS.A total of 32 patients received either low-frequency temporal rTMS or a combination of high-frequency prefrontal and low-frequency temporal rTMS. Treatment effects were assessed with a standardized tinnitus questionnaire (TQ).Directly after therapy there was an improvement of the TQ-score for both groups, but no differences between groups. An evaluation after 3 months revealed a remarkable benefit from the use of combined prefrontal and temporal rTMS treatment.These results support recent data that suggest that auditory and nonauditory brain areas are involved in tinnitus pathophysiology.