Transcranial magnetic stimulation studied as new tinnitus treatment


Millions of people will go about their days today with an unwelcome companion: a constant ringing or buzzing in their ears which infiltrates every aspect of their lives. It’s called tinnitus, and for those who suffer from it, everything from relationships to work to sleep is negatively affected. 

Ringing in the ears
Tinnitus is a poorly understood condition.

Tinnitus is a ringing, buzzing or otherwise annoying sound in the ears that doesn’t really exist, but is only perceived. Not a disease in itself, but rather a side effect of something else going on within the ear or deep in the brain, it affects up to 20 percent of people in the US alone, mostly military veterans.

Lack of treatment options

Tinnitus is usually a side effect of another condition, doctors will often address tinnitus by first treating the underlying cause. Otherwise there is no cure for tinnitus itself, only treatments and relief strategies that can sometimes ease the symptoms. Masking the sound with other sounds, for example, has been a widely used technique.

Lack of effective treatment or cure is problematic, especially since tinnitus has such a detrimental effect on the quality of life. Depression, anxiety, lack of sleep and difficulty focusing or concentrating are just some of the issues those with tinnitus experience, leaving millions desperate for a solution.

TMS treatment study

To find a new treatment, researchers from the Oregon Health & Science University (OHSU) and the Veterans Affairs (VA) Portland Medical Center are hoping a treatment called transcranial magnetic stimulation, or TMS, may provide help for the millions of people living with tinnitus. While it has previously been used to treat depression, TMS has recently been used in clinical trials as a treatment for tinnitus, with fairly good results—though it’s still early in the research process.

During the procedure, a cone-shaped magnetic field is used to penetrate the skull. As the intensity is gradually increased, the magnetic field is able to penetrate deeply enough into the brain to affect the activity of the neurons.

In clinical tests, 64 people who had suffered from tinnitus for at least one year were given 2,000 pulses just above the ear, one per second, for 10 straight workdays. 32 participants were given an active TMS treatment, while the other 32 participants were given a placebo treatment. The results were promising; of the 32 patients who were given the active treatment, 18 reported considerable relief of their tinnitus symptoms for 6 months. In the placebo group, 7 reported considerable relief. No adverse effects were reported.

Understanding the results

The results were quantified using the Tinnitus Function Index, or TFI. The TFI uses eight subscales to rate the severity of tinnitus and its impact on the sufferer. These subscales are designed to measure perceived effects on the tinnitus sufferer on everything from quality of life to sleep disturbance to level of emotion distress. Not only does the individual’s number on the TFI measure severity and impact of the individual’s condition, it allows doctors to have a baseline to quantify any future treatment-related changes.

The good news is that those who received active treatments rather than the placebo treatments had a 31 percent decrease in TFI scores, while those who received the placebo only had a decrease in score of 7 percent.

“For some study participants, this was the first time in years that they experienced any relief in symptoms,” said Robert L. Folmer, Ph.D., research investigator with the National Center for Rehabilitative Auditory Research at the VA Portland Health Care System, and associate professor of Otolaryngology-Head and Neck Surgery in the OHSU School of Medicine.

Researchers say that while TMS cannot necessarily be looked at as a replacement for current therapies, it could be used as a supplement to other therapies or perhaps an option for those who have already tried other treatments without success.

Looking to the future 

As of right now, the FDA has only approved TMS for treatment of depression. But researchers are pleased with the outcome thus far, and hope to conduct larger clinical trials in the future. Might changes in tinnitus treatment in the near future as a product of their research? That is certainly the goal. “These promising results bring us closer to developing a long-sought treatment for this condition that affects an enormous number of Americans, including many men and women who have served in our armed forces,” said Folmer.

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