Affiliations: [a] Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany | [b] Max Planck Institute for Biological Cybernetics, Tübingen, Germany | [c] Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany | [d] Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany | [e] Department of Neuroradiology, University of Würzburg, Würzburg, Germany | [f] Departments of Neurology/Radiology, Oregon Health and Science University, Portland, OR, USA | [g] Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University of Würzburg, Würzburg, Germany | [h] Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Correspondence:
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Corresponding author: Martin Schecklmann, Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany. Tel.: +49 941 941 2054; Fax: +49 941 941 2065; E-mail: [email protected].
Abstract: Purpose: Clinical effects of repetitive transcranial magnetic stimulation (rTMS) in chronic tinnitus are moderate. More precise coil localisation strategies, innovative stimulation protocols, and identification of predictors for treatment response were proposed as promising attempts to enhance treatment efficacy. In this pilot study we investigated neuronavigated continuous theta burst TMS (cTBS). Methods: Twenty-three patients received neuronavigated cTBS over the left primary auditory cortex in a randomized sham-controlled trial (verum = 12; sham = 11). Treatment response was evaluated with tinnitus questionnaires and numeric rating scales. Immediate change in numeric rating scales during the first session was used as predictor for treatment response. Results: Tinnitus was significantly reduced after treatment, but there were no superior effects between verum vs. sham treatment. Immediate change in the first treatment session predicted the response to treatment only in the verum group. Conclusions: In our study, verum cTBS was not superior to sham which highlights the persistent need for improving non-invasive brain stimulation techniques for the treatment of tinnitus. Future research should focus on the transfer of positive single session effects to daily treatment trials.
Keywords: Transcranial magnetic stimulation, TMS, theta burst stimulation, TBS, ringing in the ears, tinnitus, neuronavigation, auditory cortex
