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Repetitive Transcranial Magnetic Stimulation (Rtms) Treatment for Chronic Tinnitus: Effects of Active Stimulation on Study Participants who Initially Received Sham Rtms

In a recently published clinical trial, 32 tinnitus patients underwent 10 sessions of active 1 Hz repetitive transcranial magnetic stimulation (rTMS)-2000 pulses per session. The control group consisted of 32 tinnitus patients who underwent 10 sessions of placebo (or “sham”) 1 Hz rTMS. When participants completed all of the follow-up assessments (26 weeks after the last rTMS session), those in the “sham” rTMS group were informed of their assignment and invited to return to undergo 10 sessions of active rTMS. This article reports results for 17 clinical trial participants (13 males, 4 females) who initially received sham rTMS, then returned and underwent 10 sessions of active rTMS. The primary outcome measure was the Tinnitus Functional Index (TFI) questionnaire. Three of these participants were “responders” to placebo rTMS during the original clinical trial, with a mean decrease of 18.8 points on TFI post-treatment. None of these 3 participants exhibited significant changes in TFI score following 10 sessions of active rTMS in the present study. Of the remaining 14 participants, 6 were responders to active rTMS, with a mean decrease of 16.8 ± 8.3 TFI points post-treatment compared to baseline scores. However, the magnitude of this improvement was not maintained throughout the 26-week follow-up period (as it was in the original clinical trial). In this study, the mean TFI score for 6 treatment responders at the 26-week assessment was only 4.4 ± 7.8 points lower than their new baseline score. This result might be due to, 1) the smaller sample size in this study, or 2) reduced susceptibility to rTMS treatment in this group of participants.

Author(s): Robert L. Folmer, Sarah M Theodoroff, Susan Griest and Jay Vachhani