Combined rTMS and Relaxation in Chronic Tinnitus
- Conditions
- Chronic Tinnitus
- Interventions
- Device: Left DLPFC Butterfly Coil
- Registration Number
- NCT01907022
- Lead Sponsor
- University of Regensburg
- Brief Summary
Repetitive Transcranial Magnetic Stimulation in combination with relaxation therapy is used to modulate the neural pathways contributing to the perception and distress of phantom sounds.
- Detailed Description
Tinnitus is the phantom auditory perception of sound in the absence of an external or internal acoustic stimulus. It is a frequent problem which can interfere significantly with the ability to lead a normal life. One significant modulator of tinnitus is stress. Tinnitus has been shown to be generated in the brain, as a result of functional reorganization of auditory neural pathways and the central auditory system. Also non-auditory cortical areas of attention allocation and emotional processing was shown to be involved. Treatment remains difficult. The most effective treatment in chronic tinnitus is cognitive behavioral therapy including elements of relaxation therapy. Repetitive transcranial magnetic stimulation (rTMS) is also effective in treatment of tinnitus with moderate effect size. Pilot data were positive for low-frequency rTMS applied to the temporoparietal areas and high-frequency rTMS applied to the left frontal cortex. Newer findings indicate that exercise-combined non-invasive brain stimulation might show superior effects in contrast to rTMS or exercise alone. Combination of relaxation and two-sided (frontal and temporo-parietal) rTMS will be examined with regard to feasibility, safety and clinical efficacy in patients suffering from chronic tinnitus in a pilot trial.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 42
- Diagnosis of bothersome, subjective chronic tinnitus
- Duration of tinnitus more than 6 months
- Objective tinnitus
- Treatable cause of the tinnitus
- Involvement in other treatments for tinnitus at the same time
- Clinically relevant psychiatric comorbidity
- Clinically relevant unstable internal or neurological comorbidity
- History of or evidence of significant brain malformation or neoplasm, head injury
- Cerebral vascular events
- Neurodegenerative disorder affecting the brain or prior brain surgery
- Metal objects in and around body that can not be removed
- Pregnancy
- Alcohol or drug abuse
- Prior treatment with TMS
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Left dorsolateral prefrontal cortex (DLPFC) Butterfly Coil Left DLPFC Butterfly Coil High frequency rTMS ( Alpine Biomed Mag Pro Option): 2000 stimuli of 20 Hz over the left DLPFC (each session), Butterfly-water-cooled-Coil, 110% motor threshold; followed by: low frequency rTMS ( Alpine Biomed Mag Pro Option) applied over left temporoparietal cortex, Butterfly-water-cooled-Coil (2000 Stimuli of 1 Hz each session), 110% motor threshold. Relaxation therapy during the 1Hz stimulation with external audio tape instructions.
- Primary Outcome Measures
Name Time Method Number of treatment responders (TQ reduction > 5, contrast Baseline versus end of treatment) Week 12
- Secondary Outcome Measures
Name Time Method Change of tinnitus severity as measured by the Tinnitus Severity Scale Week 12 Change of depressive symptoms as measured by the Major Depression Inventory (MDI) Week 2 Change of tinnitus severity as measured by the Tinnitus Handicap Inventory (THI) Week 12 Change in quality of life as measured by the World Health Organization Quality of Life (WHOQoL) Week 12 Change in quality of life as measured by the World Health Organization Quality of Life(WHOQoL) Week 4 Change of tinnitus severity as measured by the Tinnitus Questionaire of Goebel&Hiller Week 12
Trial Locations
- Locations (1)
University of Regensburg - Dept of Psychiatry
🇩🇪Regensburg, Germany