A Systematic Review and Meta-analysis of Randomized Controlled Trials on the Effect of Transcranial Magnetic Stimulation on Tinnitus Management

Salma Galal, Naema Ismail, Ghada Niel

Abstract


Introduction: Tinnitus occurs in 10-15% of the world’s population. It may lead to hearing loss, depression, and suicidal tendencies, as well as reduced quality of life. The aim of this study was to assess whether Transcranial Magnetic Stimulation (TMS) effectively reduces tinnitus handicapping after six months or more of follow-up.

Methods: A systematic review of randomized controlled trials with follow-up of six months was undertaken. The review took place through searching Medline, Science Direct, and Google Scholar databases using the keywords “tinnitus” and “Transcranial Magnetic Stimulation” and limiting the search results to randomized controlled trials (RCTs) conducted on adults (19 years and older) published between 2005-2015. Meta-analysis was performed on the similarly designed studies.

Results: Five RCTs with six month follow-up were found conforming to the inclusion criteria. In total, there were 119 patients in the TMS arms and 115 in the placebo arms. However, designs were different between the studies and were therefore not all comparable. Different parameters were used to measure the severity of tinnitus and depression scores. Tinnitus handicapped inventory (THI) was the common measured outcome parameter used in all studies. THI score decreased after the TMS in four studies. Meta-analysis was performed on three similarly designed RCTs with the overall effect being insignificant.

Conclusion: TMS reduced the THI score and decreased the severity of tinnitus in 45% of patients and lead to a complete recovery in 32% of cases in one study. However, the meta-analysis demonstrated lack of significant effect of TMS on tinnitus management.


Keywords


Tinnitus; TMS; Transcranial Magnetic Stimulation; Magnetic Field Therapy

Full Text:

PDF

References


Crummer R, Hassan G. Diagnostic approach to tinnitus. American Family Physician. 2004;

(1),120-6.

Atik A, Pathophysiology and Treatment of Tinnitus: An Elusive Disease. Indian J

Otolaryngol Head Neck Surg. 2014 Jan; 66(Suppl 1): 1–5.

Kehrle H, Granjeiro R, Sampaio A, Bezerra R, Almeida V, Oliveira C. Comparison of

auditory brainstem response results in normal-hearing patients with and without tinnitus.

Arch Otolaryngol Head Neck Surg, 2008;134 (6), 647–651.

Mazurek B, Stöver T, Haupt H, Gross J, Szczepek A. The role of cochlear

neurotransmitters in tinnitus. HNO 2007; 55(12):964–71.

Moller A. Pathophysiology of tinnitus. Otolaryngol Clin North Am. 2003; 36, 249–266,

v–vi.

McCormack A, Edmondson-Jones M , Somerset S , Hall D. A systematic review of the

reporting of tinnitus prevalence and Severity. Hearing Research 337 (2016) 70e79

Zelaya CE, Lucas JW, Hoffman HJ, MMWR QuickStats: Percentage of adults with

selected hearing problems, by type of problem and age group—National Health Interview

Survey, United States, 2014. MMWR. 2015;64(37):1058. Available from

https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6437a8.htm.

Mahboubi H, Oliaei S, Kiumehr S, Dwabe S, Djalilian HR. The prevalence and

characteristics of tinnitus in the youth population of the United States. Laryngoscope.

;123(8):2001–8.13

Meng Z, Liu S, Zheng Y, Phillips JS. Repetitive transcranial magnetic stimulation for

tinnitus (Review). The Cochrane Collaboration. 2011. JohnWiley & Sons, Ltd.

Langguth B, Kreuzer PM, Kleinjung T, De Ridder D. Tinnitus: causes and clinical

management. Lancet Neurol. 2013 Sep;12(9):920-930. doi:

1016/S1474-4422(13)70160-1

Baguley D, McFerran D, Hall D. Tinnitus. The Lancet. 2013; 382, (9904),1600–1607.

Li Y, Zeng RF, Zheng D. Acupuncture for tinnitus.Cochrane Database of Systematic

Reviews2009, Issue 4. Art. No.:CD008149. DOI:

1002/14651858.CD008149

Kobayashi M and Pascual-Leone A. Transcranial magnetic stimulation in neurology. THE

LANCET Neurology Vol 2 March 2003

Kleinjung T, Eichhammer P, Landgrebe M, Sand P, Hajak G, Steffens T. Combined

temporal and prefrontal transcranial magnetic stimulation for tinnitus treatment: a pilot study.

Otolaryngology - Head and Neck Surgery. 2008; 138(4), 497–501.

Eichhammer P, Hajak G, Kleinjung T, Landgrebe M, Langguth B. Functional imaging of

chronic tinnitus: the use of positron emission tomography. Prog Brain Res. 2007; 166, 83–88.

Miller, M. Magnetic stimulation: a new approach to treating depression? Harvard Health

Publications. 2012.

Rossi S, Hallett M, Rossini PM, Pascual-Leone A, The Safety of TMS Consensus Group.

Safety, ethical considerations, and application guidelines for the use of transcranial magnetic

stimulation in clinical practice and research, Clin Neurophysiol. 2009 Dec; 120(12):

–2039.

Andres M, Dvorakova J, Rathova L, Havrankova P, Pelcova P, Vaneckova M. Efficacy of

repetitive transcranial magnetic stimulation for the treatment of refractory chronic tinnitus: a

randomized, placebo controlled study. Neuro Endocrinol Lett. 2010; 31,238–249.

Hoekstra C, Versnel H, Neggers S, Niesten M, Van Zanten G. Bilateral Low-Frequency

Repetitive Transcranial Magnetic Stimulation of the Auditory Cortex in Tinnitus Patients Is

Not Effective: A Randomised Controlled Trial. Audiol Neurotol. 2013; 18,362–373.

Khedr E, AboElfetoh N, Rothwell J, El-Atar A, Sayed E, Khalifa H. Contralateral versus

ipsilateral TMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: a

comparative study. European Journal of Neurology. 2010; 17, 976–983.

Kim HJ, Kim DY, Kim HI, Hee S, Sim NS, Moon IS. Long-Term Effects of Repetitive

Transcranial Magnetic Stimulation in Unilateral Tinnitus. The Laryngoscope. 2014; 124,

-2160.

Marcondes R, Sanchez T, Ono C, Buchpiguel C, Langguth B. (). Repetitive transcranial

magnetic stimulation improve tinnitus in normal hearing patients: a double-blind controlled,

clinical and neuroimaging outcome study. European Journal of Neurology. 2010; 17, 38–44.

Landgrebe M, Binder H, Koller M, Eberl Y, Kleinjung T, Eichhammer P. Design of a

placebo-controlled, randomized study of the efficacy of repetitive transcranial magnetic

stimulation for the treatment of chronic tinnitus. BMC Psychiatry. 2008; 8, 23–31.

Krieg SM, Shiban E, Buchmann N, Gempt J, Foerschler A, Meyer B, Ringel F. Utility

of presurgical navigated transcranial magnetic brain stimulation for the resection of tumors in

eloquent motor areas. J Neurosurg 116:994–1001, 2012

Smith J, Mennemeier M, Bartel T, Chelette K, Kimbrell T, Triggs W, et al. Repetitive

transcranial magnetic stimulation for tinnitus: a pilot study. Laryngoscope. 2007; 117(3),

– 534.

Lehner A, Schecklmann M, Landgrebe M, Kreuzer P, Poeppl T, Frank E, et al. Predictors

for rTMS response in chronic tinnitus. Front Syst Neurosci. 2012; 6, 11.

De Ridder D, Vertraeten E, Der Kelen V. Transcranial magnetic stimulation for tinnitus:

influences of tinnitus duration on stimulation parameter choice and maximal tinnitus

suppression. Otol Neurol, 2005; (26), 616–619.

Plewnia C, Reimold M, Najib A, Reischl G, Plontke S, Gerloff C. Moderate therapeutic

efficacy of positron emission tomographynavigated repetitive transcranial magnetic

stimulation for chronic tinnitus: a randomised, controlled pilot study. J NeurolNeurosurg

Psychiatry. 2007; 78, 152–156.

Khedr E, Rothwell J, Ahmed M, El-Atar A. Effect of daily repetitive transcranial

magnetic stimulation for treatment of tinnitus: comparison of different stimulus frequencies. J

Neurol Neurosurg Psychiatry. 2008; 79, 212–215.

Schlee W, Hartmann T, Langguth B, Weisz N. Abnormal resting-state cortical coupling

in chronic tinnitus. BMC Neurosci. 2009; Feb 19,10,11. doi: 10.1186/1471-2202-10-11.

Roberts L, Eggermont J, Caspary D, Shore S, Melcher J, Kaltenbach J. Ringing ears: the

neuroscience of tinnitus. J Neurosci. 2010; 30, 14972–14979.

De Ridder D, Elgoyhen A, Romo R, Langguth B. Phantom percepts: tinnitus and pain as

persisting aversive memory networks. Proc Natl Acad Sci USA. 2011; 108, 8075–8080.

Leaver A, Renier L, Chevillet M, Morgan S, Kim H, Rauschecker J. Dysregulation of

limbic and auditory networks in tinnitus. Neuron. 2011; 69, 33–43.

Cuny C, Norena A, El Massioui F, Chéry-Croze S. Reduced attention shift in response to

auditory changes in subjects with tinnitus. Audiol Neurotol. 2004; 9, 294–302.

Searchfield G, Morrison-Low J, Wise K. Object identification and attention training for

treating tinnitus. Prog Brain Res. 2007; 166, 441–460.

Loo C, Mitchell P. A review of the efficacy of transcranial magnetic stimulation (TMS)

treatment for depression, and current and future strategies to optimize efficacy. J Affect

Disord, 2005; 88, 255–267.




DOI: https://doi.org/10.5195/cajgh.2020.356

Refbacks

  • There are currently no refbacks.




Copyright (c) 2020 Salma Galal, Naema Ismail, Ghada Niel

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.