Transcranial Stimulation Treatments (rTMS & tDCS & tACS)

Discussion in 'Treatments' started by exodus, Apr 18, 2012.

    1. Localboy

      Localboy Member Benefactor

      Tinnitus Since:
      2010
      Cause of Tinnitus:
      hearing loss from concerts, hunting, tools, and accident
      Has tDCS helped anyone really?
       
    2. Pleasure_Paulie

      Pleasure_Paulie Member

      Location:
      Australia
      Tinnitus Since:
      06/2016
      Cause of Tinnitus:
      Noise or maybe... unicorns!
      rTMS has according to studies. How well conducted and how long those results last is potentially another question.
       
    3. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      I found this link on the web today for our Iranian fellows.

      Repeated sessions of bilateral transcranial direct current stimulation on intractable tinnitus: a study protocol for a double-blind randomized controlled trial:
      https://f1000research.com/articles/7-317
       
      • Informative Informative x 1
    4. DimitarIV
      Creative

      DimitarIV Member

      Tinnitus Since:
      2018
      Cause of Tinnitus:
      Unknown
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    5. Contrast

      Contrast Member Benefactor Hall of Fame

      Location:
      Retrovile
      Tinnitus Since:
      late 2017
      Cause of Tinnitus:
      injury from noxious noise
    6. ee9892

      ee9892 Member

      Tinnitus Since:
      01/2018
      Cause of Tinnitus:
      Noise Induced
      This seems like broscience. Anything that evidences effectiveness?
       
    7. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      I found this article yesterday. Unfortunately bad results:

      Combined transcranial magnetic stimulation in the treatment of chronic tinnitus
      Martin Formánek
      Petra Migaľová
      Petra Krulová
      Michal Bar
      Debora Jančatová
      Hana Zakopčanová‐Srovnalová
      Hana Tomášková
      Karol Zeleník
      Pavel Komínek
      First published: 08 June 2018

      Abstract
      Objective
      Repetitive transcranial magnetic stimulation (rTMS) is currently being tested for suppressing the symptoms of subjective chronic primary tinnitus, although its effect is controversial. The aim of this randomized double‐blinded controlled trial was to determine the effect of rTMS with unique settings for tinnitus treatment.

      Methods
      Fifty‐three adult patients suffering from chronic subjective unilateral or bilateral nonpulsatile primary tinnitus for at least 6 months were randomly assigned to rTMS (group 1, n = 20), sham stimulation (group 2, n = 12), or medicament therapy only (group 3, n = 21). The dorsolateral prefrontal cortex (frequency 25 Hz, 300 pulses, and 80% resting motor threshold [RMT]) on the left side and primary auditory cortex (1 Hz, 1000 pulses, 110% RMT) were stimulated on both sides in patients in group 1 for 5 consecutive days. The Tinnitus Reaction Questionnaire (TRQ), Tinnitus Handicap Questionnaire (THQ), Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI), pure‐tone audiometry with Fowler scoring of hearing loss, and tinnitus analysis were used to evaluate tinnitus in all patients. Data were recorded the day the patient was included in the study and at 1‐ and 6‐month follow‐up.

      Results
      The study groups were homogenous. No significant effect of rTMS was found at 1 or 6 months based on the BDI, THQ, and TRQ scores or tinnitus masking. There was a significant but clinically irrelevant effect on the THI score after 1 and 6 months.

      Interpretation
      No significant effect of bilateral low‐frequency rTMS of the primary auditory cortex and high‐frequency stimulation of the left dorsolateral prefrontal cortex was demonstrated.

      full article: https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.587
      also in pdf file.
       
    8. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      Effects of Electrical Stimulation in Tinnitus Patients: Conventional Versus High-Definition tDCS
      Abstract
      Background. Contradictory results have been reported for transcranial direct current stimulation (tDCS) as treatment for tinnitus. The recently developed high-definition tDCS (HD tDCS) uses smaller electrodes to limit the excitation to the desired brain areas. Objective. The current study consisted of a retrospective part and a prospective part, aiming to compare 2 tDCS electrode placements and to explore effects of HD tDCS by matched pairs analyses. Methods. Two groups of 39 patients received tDCS of the dorsolateral prefrontal cortex (DLPFC) or tDCS of the right supraorbital–left temporal area (RSO-LTA). Therapeutic effects were assessed with the tinnitus functional index (TFI), a visual analogue scale (VAS) for tinnitus loudness, and the hyperacusis questionnaire (HQ) filled out at 3 visits: pretherapy, posttherapy, and follow-up. With a new group of patients and in a similar way, the effects of HD tDCS of the right DLPFC were assessed, with the tinnitus questionnaire (TQ) and the hospital anxiety and depression scale (HADS) added. Results. TFI total scores improved significantly after both tDCS and HD tDCS (DLPFC: P< .01; RSO-LTA: P < .01; HD tDCS: P = .05). In 32% of the patients, we observed a clinically significant improvement in TFI. The 2 tDCS groups and the HD tDCS group showed no differences on the evolution of outcomes over time (TFI: P = .16; HQ: P = .85; VAS: P = .20). Conclusions. TDCS and HD tDCS resulted in a clinically significant improvement in TFI in 32% of the patients, with the 3 stimulation positions having similar results. Future research should focus on long-term effects of electrical stimulation.

      Keywords:
      tinnitus, neuromodulation, noninvasive brain stimulation, transcranial direct current stimulation (tDCS), high-definition transcranial direct current stimulation (HD tDCS), treatment

      Source: http://journals.sagepub.com/doi/abs/10.1177/1545968318787916
       
    9. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma

      Attached Files:

      • Informative Informative x 1
    10. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma

      Attached Files:

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    11. Krolo

      Krolo Member Benefactor

      Location:
      Sweden
      Tinnitus Since:
      1999 , Worse in September 2018
      Cause of Tinnitus:
      Loud Volume
      Has anyone tried HD-Tdcs or similar?
       
    12. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      Transcranial direct current stimulation for the treatment of tinnitus: a review of clinical trials and mechanisms of action

      Background
      Tinnitus is the perception of sound in the absence of any external acoustic stimulation. Transcranial direct current stimulation (tDCS) has shown promising though heterogeneous therapeutic outcomes for tinnitus. The present study aims to review the recent advances in applications of tDCS for tinnitus treatment. In addition, the clinical efficacy and main mechanisms of action of tDCS on suppressing tinnitus are discussed.

      Methods
      The study was performed in accordance with the PRISMA guidelines. The databases of the PubMed (1980–2018), Embase (1980–2018), PsycINFO (1850–2018), CINAHL, Web of Science, BIOSIS Previews (1990–2018), Cambridge Scientific Abstracts (1990–2018), and google scholar (1980–2018) using the set search terms. The date of the most recent search was 20 May, 2018. The randomized controlled trials that have assessed at least one therapeutic outcome measured before and after tDCS intervention were included in the final analysis.

      Results
      Different tDCS protocols were used for tinnitus ranging single to repeated sessions (up to 10) consisting of daily single session of 15 to 20-min and current intensities ranging 1–2 mA. Dorsolateral prefrontal cortex (DLPFC) and auditory cortex are the main targets of stimulation. Both single and repeated sessions showed moderate to significant treatment effects on tinnitus symptoms. In addition to improvements in tinnitus symptoms, the tDCS interventions particularly bifrontal DLPFC showed beneficial outcomes on depression and anxiety comorbid with tinnitus. Heterogeneities in the type of tinnitus, tDCS devices, protocols, and site of stimulation made the systematic reviews of the literature difficult. However, the current evidence shows that tDCS can be developed as an adjunct or complementary treatment for intractable tinnitus. TDCS may be a safe and cost-effective treatment for tinnitus in the short-term application.

      Conclusions
      The current literature shows moderate to significant therapeutic efficacy of tDCS on tinnitus symptoms. Further randomized placebo-controlled double-blind trials with large sample sizes are needed to reach a definitive conclusion on the efficacy of tDCS for tinnitus. Future studies should further focus on developing efficient disease- and patient-specific protocols.

      Source: https://bmcneurosci.biomedcentral.com/articles/10.1186/s12868-018-0467-3
       
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    13. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      Transcranial Magnetic Stimulation as a Therapeutic Option for Neurologic and Psychiatric Illnesses
       

      Attached Files:

      • TMS.pdf
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    14. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      Neuronavigated Versus Non-navigated Repetitive Transcranial Magnetic Stimulation for Chronic Tinnitus: A Randomized Study

      Abstract Repetitive transcranial magnetic stimulation (rTMS) has shown variable effect on tinnitus. A prospective, randomized 6- month follow-up study on parallel groups was conducted to compare the effects of neuronavigated rTMS to non-navigated rTMS in chronic tinnitus. Forty patients (20 men, 20 women), mean age of 52.9 years (standard deviation [SD] ¼ 11.7), with a mean tinnitus duration of 5.8 years (SD ¼ 3.2) and a mean tinnitus intensity of 62.2/100 (SD ¼ 12.8) on Visual Analog Scale (VAS 0–100) participated. Patients received 10 sessions of 1-Hz rTMS to the left temporal area overlying auditory cortex with or without neuronavigation. The main outcome measures were VAS scores for tinnitus intensity, annoyance, and distress, and Tinnitus Handicap Inventory (THI) immediately and at 1, 3, and 6 months after treatment. The mean tinnitus intensity (hierarchical linear mixed model: F3 ¼ 7.34, p ¼.0006), annoyance (F3 ¼ 4.45, p ¼.0093), distress (F3 ¼ 5.04, p ¼.0051), and THI scores (F4 ¼ 17.30, p <.0001) decreased in both groups with non-significant differences between the groups, except for tinnitus intensity (F3 ¼ 2.96, p ¼.0451) favoring the non-navigated rTMS. Reduction in THI scores persisted for up to 6 months in both groups. Cohen’s d for tinnitus intensity ranged between 0.33 and 0.47 in navigated rTMS and between 0.55 and 1.07 in non-navigated rTMS. The responder rates for VAS or THI ranged between 35% and 85% with no differences between groups (p ¼.054–1.0). In conclusion, rTMS was effective for chronic tinnitus, but the method of coil localization was not a critical factor for the treatment outcome. Keywords tinnitus, transcranial magnetic stimulation, TMS, rTMS, neuronavigated Date received: 17 August 2018; revised: 26 November 2018; accepted: 5 December 2018

      Full article: see attached file.
       

      Attached Files:

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    15. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma

      Attached Files:

    16. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      Tinnitus Treatment Using Noninvasive and Minimally Invasive Electric Stimulation: Experimental Design and Feasibility
       

      Attached Files:

      • Informative Informative x 3
    17. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
    18. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
    19. Emrethal

      Emrethal Member

      Tinnitus Since:
      12/2015
      Cause of Tinnitus:
      Brain
      I tried the R-TMS in Istanbul around 2018. 10 sessions in total, did not help me, but I met a lady there while waiting who told me that hers got much better.
       
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    20. Frédéric

      Frédéric Member Benefactor

      Location:
      Marseille, France
      Tinnitus Since:
      11/19/2012
      Cause of Tinnitus:
      acoustic trauma
      As far as I understand, theta-burst stimulation is a type of rTMS. So I put this article in this thread.

      Clinical review: The therapeutic use of theta-burst stimulation in mental disorders and tinnitus

      https://doi.org/10.1016/j.pnpbp.2019.01.014Get rights and content

      Highlights
      This comprehensive clinical review comprises 47 theta-burst stimulation (TBS) studies.
      In depression, first evidence for the effectiveness of TBS and non-inferiority to conventional rTMS exists.
      Evidence for the therapeutic efficacy of TBS in other mental disorders and tinnitus remains weak due to a large heterogeneity between studies.
      Promising further applications for TBS include auditory verbal hallucinations and negative symptoms of schizophrenia.

      Abstract

      Repetitive Transcranial Magnetic Stimulation (rTMS) is a neuromodulatory treatment intervention, which can be used to alleviate symptoms of mental disorders. Theta-burst stimulation (TBS), an advanced, patterned form of TMS, features several advantages regarding applicability, treatment duration and neuroplastic effects. This clinical review summarizes TBS studies in mental disorders and tinnitus and discusses effectivity and future directions of clinical TBS research. Following the PRISMA guidelines, the authors included 47 studies published until July 2018. Particularly in depression, evidence for the effectiveness of TBS and non-inferiority to conventional rTMS exists. Evidence for therapeutic efficacy of TBS in other mental disorders remains weak due to a large heterogeneity between studies. Rigorous reporting standards and adequately powered controlled trials are indispensable to foster validity and translation in clinical use. Nevertheless, TBS remains a promising instrument to target maladaptive brain networks and to ameliorate psychiatric symptoms.

      Keywords
      Theta-burst stimulation
      rTMS
      Clinical review
      Mental disorder
      Non-invasive brain stimulation
      Abbreviations
      rTMS repetitive transcranial magnetic stimulation
      TBS theta-burst stimulation
      iTBS intermittent theta-burst stimulation
      cTBS continuous theta-burst stimulation
      tDCS transcranial direct current stimulation
      DLPFC dorsolateral prefrontal cortex
      DMPFC dorsomedial prefrontal cortex
      ACC anterior cingulate cortex
      OFC orbitofrontal cortex
      TPJ temporal-parietal junction
      pSTS posterior superior temporal sulcus
      LTP long term potentiation
      LTD long term depression
      MEP motor evoked potentials
      rMT resting motor threshold
      fNIRS functional near-infrared spectroscopy
      RCT randomized controlled trial
      CBT cognitive behavioral therapy
      MRI magnetic resonance imaging
      BOLD blood-oxygen-level dependent
      AVH auditory verbal hallucinations
      OCD Obsessive-Compulsive Disorder
      SANS Scale for the Assessment of Negative Symptoms
      CDSS Calgary Depression Rating Scale for Schizophrenia
      PANSS Positive and Negative Syndrome Scale
      Y-BOCS Yale-Brown Obsessive Compulsive Scale
      RBS-R Repetitive Behavior Scale-Revised
      HDRS Hamilton Depression Rating Scale
      ARCI Addiction Research Center Inventory
       
    21. Abby
      Doubtful

      Abby Member

      Tinnitus Since:
      11/2015
      Cause of Tinnitus:
      Ototoxic
      Hi, what was the cause of your tinnitus? How long have you had it? Could you give me the name and contact of the clinic in Istanbul. Thanks.
       
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    22. Emrethal

      Emrethal Member

      Tinnitus Since:
      12/2015
      Cause of Tinnitus:
      Brain
      Of course, contact: Op. Ahmet Sirin (he is Turkish, must sure know English, he goes to meetings etc. worldwide.

      My cause of tinnitus was brain nerves not related with my ear. And rTMS did not help me.
      First he examined me (hearing test etc.) , then he gave me some supplement and let me try them for 6 months (Ginkgo biloba, antidepressants)

      Then neither my hearing nor my tinnitus changed and he sent me to a close by (20min taxi) hospital where they have 3 Tesla MR capability and they took some fMRI images (basically they give sound to your ears and see the signals from your ear to your auditory cortex).

      This is how I learned that I have hearing loss related with my brain (ear is healthy surprisingly) and "most probably" tinnitus is caused by these damaged nerves. And he suggested rTMS (3 floors down in the same apartment) and told me that, it may help or may not. Anyways 10 days in a row, I received rTMS, each takes around 20 mins. Did not help me.

      Let me know if you need further info. I think I went under rTMS between Feb-March 2018.

      His website in English:
      http://www.ahmetsirin.com/en
       
    23. Ozlem Senturk

      Ozlem Senturk Member

      Tinnitus Since:
      2 months
      Cause of Tinnitus:
      loud noise, eustachian tube blockage
      I tried rTMS in Istanbul with the same doctor as well and since my tinnitus is noise induced, and as rTMS makes some noise (a metal ball hits the metal coverage on top of your head), it made my tinnitus worse so I stopped the treatment without taking the required 10 sessions.
       
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    24. djuubis

      djuubis Member

      Tinnitus Since:
      01/2017
      Cause of Tinnitus:
      SHL
      Anyone else tried rTMS?
      i am suppposed to try that next week so any info appreciated
      Especialy am worried about comments where it made T worse...
       
    25. petalweaver
      Sad

      petalweaver Member

      Tinnitus Since:
      2003
      Cause of Tinnitus:
      unknown
      I am in Boston, ma USA, My husband is struggling with severe tinnitus. I am just reaching out.. We have been to many specialist and they all say same thing, learn to live with it. He has tried diets, vitamins, music, meditation, had to leave work last year as he cant focus or sleep. Now that he has waited 4 months to see a specialist who said nothing can be done, go see a psychiatrist, he feels like he was given a death sentence. This is so hard. I have researched so much, and now I see maybe transcranial magnetic stimulation. What type of doctor would do that? psychiatrist? Neurologist? Feeling desperate, Any info greatly appreciated
       
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    26. GregCA
      Jaded

      GregCA Member Benefactor Hall of Fame

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      What have you done to root cause it (tests/results)? What is the diagnosis?
       
    27. petalweaver
      Sad

      petalweaver Member

      Tinnitus Since:
      2003
      Cause of Tinnitus:
      unknown
      Root cause was most likely loud sounds. Had brain MRI, showed nothing,. several hearing specialists. All said nothing can be done, He has very high depression and anxiety now. They all seem to want to send him to a psychiatrist. Cant sleep, very fatigued and stressed said cant live this way :(
       
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    28. JRC1

      JRC1 Member

      Tinnitus Since:
      2016
      Cause of Tinnitus:
      medication
      I suggest you read the “mutebutton” thread. It appears to be something which will truly improve symptoms. It is not yet available but is supposed to be available in Ireland some time soon. Very best wishes.
       
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    29. GregCA
      Jaded

      GregCA Member Benefactor Hall of Fame

      Tinnitus Since:
      03/2016
      Cause of Tinnitus:
      Otosclerosis
      Hearing tests? Results?

      If the root cause is loud sounds then I'm afraid there isn't much that can be done today, other than protect his hearing and keep an eye on upcoming research: some tries to restore hearing, others try to simply squelch the noise (that won't lead to better hearing, but hopefully better quality of life).

      T often gets better on its own, so that should be a positive fact for him.

      The reason they are sending him to psy help is exactly because of this dire situation: he needs to learn tools to cope. There are a few things that can help, such as CBT. Fatigue, sleeplessness, stress, anxiety, etc... are extremely common. Pretty much everyone in here is affected.
       
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    30. Melike
      Studious

      Melike Member

      Location:
      Istanbul, Turkey
      Tinnitus Since:
      17 / 03 /2017
      Cause of Tinnitus:
      Most probably TMJD and neck issues that came with it.
      I received the same r-TMS treatment with @Ozlem Senturk and @Emrethal in İstanbul from Dr. Ahmet Şirin. No effect on tinnitus either. I have contacted with him last week for some other issue but also mentioned that my tinnitus is still the same (more or less) and he said; just stop by and we should re-evaluate your situation, lol. Nah.
       
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