Name of treatment

Repetitive transcranial magnetic stimulation

Type of treatment

Physical intervention/device

Claims for treatment

rTMS induces electrical currents in the brain, and can decrease the high spontaneous neuronal activity in the central auditory system that may be responsible for the perception of tinnitus.

How treatment is delivered

Via device – treatment patterns vary as to number of sessions, duration of sessions and to frequency of electromagnetic pulses used.

Potential negative consequences

No serious adverse effects were reported in clinical trials with tinnitus patients.[1]

Evidence offered:

Papers available

5 (as in Cochrane review)[1]

Conclusions drawn

There is very limited support for the use of low‐frequency rTMS for the treatment of patients with tinnitus.1 ‘[this technique] is subject to too many theoretical uncertainties and issues of feasibility, which analysis of recent articles failed to resolve, for it to be recommended for routine use.’[2]

Quality of evidence[3]

A

Does the BTA recommend this treatment?

No

BTA opinion on this treatment:

There is very limited evidence to support the use of rTMS.

Would the BTA support further studies into this treatment?

Unlikely. Repeated studies have not demonstrated clinical benefit.

Verdict: Safety - is this treatment harmful?

  Regarded as safe

Verdict: Efficacy - does this treatment work?

  No evidence of effect

Comments

More randomised, placebo‐controlled, double‐blind studies with large sample sizes are needed to confirm the effectiveness of rTMS for tinnitus patients. Uniform, validated, tinnitus‐specific questionnaires and measurement scales should be used in future studies.

[1] Meng Z, Liu S, Zheng Y, Phillips JS. Repetitive transcranial magnetic stimulation for tinnitus. Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD007946. DOI: 10.1002/14651858.CD007946.pub2..

[2] Londero A, Bonfils P, Lefaucheur JP. Transcranial magnetic stimulation and subjective tinnitus. A review of the literature, 2014-2016. European Annals of Otorhinolaryngology, Head and Neck Diseases 2018, Volume 135, Issue 1. DOI: 10.1016/j.anorl.2017.12.001

[3] A = Systematic review/meta analysis. B = Randomised control studies. C = Cohort studies. D = Case control studies. E = case studies/reports. +/- to be used to indicate quality within bands

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Tinnitus_and_rTMS_April_2019.pdf

Updated 15 April 2019