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Variable changes in PET activity before and after rTMS treatment for tinnitus.

Mark Mennemeier1, Kenneth C Chelette, Shawn Allen

  • 1Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA. msmennemeier@uams.edu

The Laryngoscope
|February 3, 2011
PubMed
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Low-frequency repetitive transcranial magnetic stimulation (rTMS) significantly reduced tinnitus loudness. However, positron emission tomography (PET) did not confirm reduced neural activity at the stimulation site, questioning its utility for guiding rTMS treatment.

Area of Science:

  • Neuroscience
  • Medical Imaging
  • Auditory System Research

Background:

  • Tinnitus is a prevalent auditory disorder often linked to altered neural activity in the temporal cortex.
  • Repetitive transcranial magnetic stimulation (rTMS) is explored as a therapeutic intervention for tinnitus.
  • Positron emission tomography (PET) is investigated for its potential to guide rTMS treatment by identifying relevant brain regions.

Purpose of the Study:

  • To assess if low-frequency rTMS reduces tinnitus by decreasing neural activity in auditory processing regions.
  • To evaluate the utility of PET in targeting rTMS treatment for tinnitus.

Main Methods:

  • A randomized, sham-controlled crossover study involving patients with tinnitus.
  • Participants received active and sham 1-Hz rTMS to the temporal cortex over five days.

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  • Tinnitus loudness (Visual Analogue Ratings) and regional brain blood flow/glucose metabolism (via PET) were measured before and after treatments.

    • Main Results:

    • Active rTMS significantly decreased tinnitus loudness compared to sham treatment.
    • 43% of patients experienced at least a 33% reduction in tinnitus loudness, with the secondary auditory cortex (Brodmann Area 22) being a key response site.
    • PET findings did not consistently support the hypothesis; changes in brain activity beneath the coil did not correlate with tinnitus reduction and were observed in control sites and after sham stimulation.

    Conclusions:

    • Low-frequency rTMS effectively reduces tinnitus loudness.
    • PET imaging utility for targeting rTMS in tinnitus treatment is questionable due to inconsistent findings and lack of correlation with clinical response.
    • Further research is needed to refine targeting strategies for rTMS in tinnitus management.