A1 Refereed original research article in a scientific journal
Neuronavigated Versus Non-navigated Repetitive Transcranial Magnetic Stimulation for Chronic Tinnitus: A Randomized Study
Authors: Hanna Sahlsten, Anu Holm, Esa Rauhala, Mari Takala, Eliisa Löyttyniemi, Max Karukivi, Johanna Nikkilä, Kirsi Ylitalo, Janika Paavola, Reijo Johansson, Tero Taiminen, Satu K. Jääskeläinen
Publisher: Sage
Publication year: 2019
Journal: Trends in Hearing
Volume: 23
Issue: 1-14
Number of pages: 14
ISSN: 2331-2165
eISSN: 2331-2165
DOI: https://doi.org/10.1177/2331216518822198(external)
Web address : 10.1177/2331216518822198
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/38778908(external)
Repetitive transcranial magnetic stimulation (rTMS) has shown variable effect on tinnitus. A prospective, randomized 6-month follow-up study on parallel groups was conducted to compare the effects of neuronavigated rTMS to non-navigated rTMS in chronic tinnitus. Forty patients (20 men, 20 women), mean age of 52.9 years (standard deviation [SD] = 11.7), with a mean tinnitus duration of 5.8 years (SD = 3.2) and a mean tinnitus intensity of 62.2/100 (SD = 12.8) on Visual Analog Scale (VAS 0–100) participated. Patients received 10 sessions of 1-Hz rTMS to the left temporal area overlying auditory cortex with or without neuronavigation. The main outcome measures were VAS scores for tinnitus intensity, annoyance, and distress, and Tinnitus Handicap Inventory (THI) immediately and at 1, 3, and 6 months after treatment. The mean tinnitus intensity (hierarchical linear mixed model: F3 = 7.34, p = .0006), annoyance (F3 = 4.45, p = .0093), distress (F3 = 5.04, p = .0051), and THI scores (F4 = 17.30, p < .0001) decreased in both groups with non-significant differences between the groups, except for tinnitus intensity (F3 = 2.96, p = .0451) favoring the non-navigated rTMS. Reduction in THI scores persisted for up to 6 months in both groups. Cohen’s d for tinnitus intensity ranged between 0.33 and 0.47 in navigated rTMS and between 0.55 and 1.07 in non-navigated rTMS. The responder rates for VAS or THI ranged between 35% and 85% with no differences between groups (p = .054–1.0). In conclusion, rTMS was effective for chronic tinnitus, but the method of coil localization was not a critical factor for the treatment outcome.
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