Influence of Treatment Duration and Stimulation Frequency on rTMS in Chronic Tinnitus
Condition: Chronic Tinnitus
MeSH terms: Tinnitus
Study type: Interventional

Summary: 
      Patients receive two weeks of treatment (prefrontal high-frequency and bilateral
      low-frequency rTMS vs. prefrontal high-frequency and bilateral high-frequency rTMS). After
      two weeks of treatment they can decide if they want to quit the treatment or if they want to
      proceed with the treatment for another two weeks.
    

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. Tinnitus has been shown to be generated in the brain, as a
      result of functional reorganization of auditory and non-auditory neural pathways.
      Low-frequency repetitive transcranial magnetic stimulation (rTMS) applied to the
      temporoparietal areas has been investigated for the treatment of tinnitus based on the
      rationale to reduce increased activity of the auditory system. Furthermore, high-frequency
      stimulation of the left frontal cortex was added to this standard treatment based on rTMS
      studies in affective disorders and the association of tinnitus distress with depressivity.
      Thus, high-frequency stimulation of the left prefrontal cortex and low-frequency stimulation
      of bilateral temporoparietal cortex was introduced as new treatment scheme in chronic
      tinnitus (multisite standard).

      Additionally, there is also evidence that high-frequency stimulation of the temporoparietal
      cortex is effective in chronic tinnitus. Furthermore, standard treatment in chronic tinnitus
      is two weeks (ten treatment days) which is shorter than the standard in rTMS in affective
      disorders. Thus, the aim of the present trial is to investigate the influence of
      high-frequency stimulation of the temporoparietal cortex and of increasing the number of
      treatment days.

      Patients receive two weeks of treatment (prefrontal high-frequency and bilateral
      low-frequency rTMS vs. prefrontal high-frequency and bilateral high-frequency rTMS). After
      two weeks of treatment they can decide if they want to quit the treatment or if they want to
      proceed with the treatment for another two weeks.
    

Intervention name(s): standard multisite four weeks; high-frequency multisite four weeks; standard multisite two weeks; high-frequency multisite two weeks
Intervention type(s): Other; Other; Other; Other
Intervention description(s): Repetitive transcranial magnetic stimulation (Magventure): 1000 stimuli of 20 Hz rTMS over the left DLPFC (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over the left temporoparietal cortex (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over right temporoparietal cortex (110% motor threshold). Patients continue treatment after two weeks for further two weeks of treatment (20 treatment days).; Repetitive transcranial magnetic stimulation (Magventure): 1000 stimuli of 20 Hz rTMS over the left DLPFC (110% motor threshold) followed by 1000 stimuli of 20 Hz rTMS over the left temporoparietal cortex (110% motor threshold) followed by 1000 stimuli of 20 Hz rTMS over right temporoparietal cortex (110% motor threshold). Patients continue treatment after two weeks for further two weeks of treatment (20 treatment days).; Repetitive transcranial magnetic stimulation (Magventure): 1000 stimuli of 20 Hz rTMS over the left DLPFC (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over the left temporoparietal cortex (110% motor threshold) followed by 1000 stimuli of 1 Hz rTMS over right temporoparietal cortex (110% motor threshold). Patients discontinue treatment after two weeks (10 treatment days).; Repetitive transcranial magnetic stimulation (Magventure): 1000 stimuli of 20 Hz rTMS over the left DLPFC (110% motor threshold) followed by 1000 stimuli of 20 Hz rTMS over the left temporoparietal cortex (110% motor threshold) followed by 1000 stimuli of 20 Hz rTMS over right temporoparietal cortex (110% motor threshold). Patients discontinue treatment after two weeks (10 treatment days).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: tinnitus; transcranial random noise stimulation; rTMS; multisite stimulation; non-invasive brain stimulation