Repetitive Transcranial Magnetic Stimulation (rTMS) treatment for chronic tinnitus.

Tinnitus is a phantom auditory perception of meaningless sound, meaning that there is registration of sound in the absence of an external or internal acoustic stimulus. It is a common problem (prevalence 7-19%) which may interfere with the ability to lead a normal life. Unfortunately, it is a very difficult symptom to treat because there are hardly any therapeutic options for the cause of tinnitus. Most therapies focus on alleviating the condition rather than treating the cause. Tinnitus is thought to be generated in the brain, as a result of functional reorganization of auditory neural pathways and tonotopic maps in the central auditory system, following damage to the peripheral auditory system. Repetitive Transcranial magnetic stimulation (rTMS) is a therapy, based on this concept of reorganization in the auditory cortex. It uses a pulsed magnetic field to disrupt the neural circuit and to thereby (temporarily) excite or inhibit certain brain areas, leading to the suppression of tinnitus. With this study we intend to answer the question whether rTMS can be an effective treatment for tinnitus.

rTMS suppresses neural circuits using a pulsed magnetic field which temporarily excites or inhibits a certain brain area. It is thought that tinnitus is generated in the brain as a result of functional reorganization of auditory neural pathways and tonotopic pathways, leading to a hyperactivity in the central auditory system, following damage to the peripheral auditory system. It is hypothesized that rTMS can supress this hyperactivity and thereby supress tinnitus.

last rTMS treatment, 1 week after treatment, 1, 3 and 6 months

(VAS's daily for the first three months and monthly for the second three months)

rTMS: bilateral 1Hz, 110% MT, 2000 stimuli on five subsequent days.