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Transcranial Magnetic stimulation (TMS ) for Tinnitus

Timothy C. Hain, MD. Hearing Page Page last modified: May 6, 2017

Tinnitus sufferers have long tried numerous unlikely treatments for their malady. Because magnets are perceived as being both mysterious and powerful, they have often been advocated as a treatment.

A recent variant involves using powerful magnetic pulses to temporarily inhibit circuits in the brain. This is called "TMS", for transcutaneous magnetic stimulation. TMS has also been explored as treatment for other relatively intractable illnesses, such as severe depression. The target is auditory cortex, and presumably the idea is to shut down central auditory processing for a few hours.

With respect to tinnitus, as of 2015, there were roughly 120 published papers concerning use of TMS for tinnitus. Many of these seem ridiculous, combining rather obvious placebos (such as laser treatment to the skin), with TMS. Nevertheless, in a recent systemic review, Soleimani et al (2015) stated that "These data underscore the clinical effect of rTMS in the treatment of tinnitus".

Tentative conclusions:

rTMS appears to benefit some patients. The mechanism probably includes some elements of placebo effect, some effects of modulating mood, and least likely of all, some effect on central auditory circuits. It does not appear to be harmful. We have no objections to using the placebo effect -- improvement is improvement. Frequent, repetitive TMS that is administered over many weeks is more likely to be superior to placebo than occasional, weak TMS.

Due to the high cost of rTMS, and the relatively low benefit, it does not presently have a solid indication for treatment. Other approachs that might include placebos and standard antidepressants are more rational choices.

References:

Copyright May 6, 2017 , Timothy C. Hain, M.D. All rights reserved. Last saved on May 6, 2017