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Updated: Aug 15, 2026
Neuronavigation-guided Repetitive Transcranial Magnetic Stimulation for Aphasia
Published on: May 6, 2016
[Treatment of chronic tinnitus with neuronavigated repetitive Transcranial Magnetic Stimulation (rTMS)]
T Kleinjung1, T Steffens, B Langguth
1Klinik für HNO-Heilkunde der Universität Regensburg, Regensburg. tobias.kleinjung@klinik.uni-regensburg.de
Background And Objective:
Idiopathic tinnitus is a frequent and debilitating disorder of largely unknown pathophysiology. Focal brain activation in the auditory cortex has recently been demonstrated in chronic tinnitus. Low-frequency rTMS can reduce cortical hyperexcitability.
Patients And Methods:
In 12 patients with chronic tinnitus, fusion of [18F]deoxyglucose-PET and structural MRI (T1, MPRAGE) scans allowed the area of increased metabolic activity in the auditory cortex to be exactly identified; this area was selected as the target for rTMS. A neuronavigational system adapted for TMS positioning enabled the relative positions of the figure-8 coil and the target area to be monitored. Repetitive TMS (110% motor threshold; 1 Hz; 2000 stimuli per day over 5 days) was performed using a placebo-controlled crossover design. A sham coil system was used for the placebo stimulation. Treatment outcome was assessed with a specific tinnitus questionnaire (Goebel and Hiller).
Results:
In all 12 patients an asymmetrically increased metabolic activation of the gyrus of Heschl was detected. The tinnitus score was significantly improved after 5 days of active rTMS, an effect not seen after placebo stimulation.
Conclusion:
These preliminary results show that neuronavigated rTMS may improve our understanding and treatment of chronic tinnitus.
