Kreuzer, Peter M. and Poeppl, Timm B. and Rupprecht, Rainer and Vielsmeier, Veronika and Lehner, Astrid and Langguth, Berthold and Schecklmann, Martin (2017) Individualized Repetitive Transcranial Magnetic Stimulation Treatment in Chronic Tinnitus? FRONTIERS IN NEUROLOGY, 8: 126. ISSN 1664-2295,
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Background: Prefrontal and temporo-parietal repetitive transcranial magnetic stimulation (rTMS) in patients suffering from chronic tinnitus have shown significant but only moderate effectiveness with high interindividual variability in treatment response. This open-label pilot study was designed to examine the general feasibility of an individualized fronto-temporal rTMS protocol and to explore what criteria are needed for a more detailed evaluation in randomized clinical studies. Methods: During the first session of a 2-week rTMS protocol, we applied different rTMS protocols to the left and right temporo-parietal and dorsolateral prefrontal cortex (DLPFC) in 25 tinnitus patients. Short trains of 1, 5, 10, and 20 Hz and continuous theta burst stimulation were applied, and patients were asked for immediate tinnitus reductions after each train. If a patient reported such improvements, rTMS treatment was applied over nine sessions with a combined protocol consisting of the most effective frontal and the most effective temporo-parietal stimulation protocol. Those patients who did not improve after the test session were treated with a standard prefrontal plus temporo-parietal protocol (20 Hz over left DLPFC + 1 Hz over temporo-parietal cortex). results: Almost half of the patients (12 of 25) reported immediate tinnitus reductions during the test session. In this group, the mean pre- to post-treatment amelioration in the tinnitus questionnaire was higher (medium to high effect sizes) in contrast to the patients who did not respond to the test session. Treatment outcome remained stable over a follow-up period of 10 weeks. Discussion: Individualized rTMS was shown to be feasible and effective in chronic tinnitus. The results obtained from this study provide tentative evidence in support of an individualized rTMS treatment approach and might provide a basis for a "tailored" application of rTMS in tinnitus and other neuropsychiatric disorders.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | POSITRON-EMISSION-TOMOGRAPHY; TEMPOROPARIETAL CORTEX; REPEATED SESSIONS; CLINICAL-TRIALS; MULTISITE RTMS; FOLLOW-UP; SUPPRESSION; QUESTIONNAIRE; PERCEPTION; GENERATION; chronic tinnitus; repetitive transcranial magnetic stimulation; individualized repetitive transcranial magnetic stimulation; neuromodulation; neurostimulation |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde Medicine > Lehrstuhl für Psychiatrie und Psychotherapie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 14 Dec 2018 13:11 |
| Last Modified: | 21 Feb 2019 14:18 |
| URI: | https://pred.uni-regensburg.de/id/eprint/1046 |
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