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Multilocus Sequential rTMS Shows Promise in Treating Tinnitus, Especially in Absence of Comorbid Depression

Meagan Thistle

3 Key Takeaways:

  • Multilocus sequential rTMS demonstrates significant improvement in tinnitus symptoms, particularly in patients without comorbid MDD.
  • Patients with comorbid MDD may initially show less improvement in tinnitus symptoms compared to those without MDD, but extended rTMS treatment over 30 sessions can lead to comparable outcomes.
  • Age plays a significant role in treatment response, with older patients more likely to respond positively to multilocus rTMS therapy for tinnitus.

Multilocus sequential repetitive transcranial magnetic stimulation (rTMS) reduced tinnitus symptom severity in both patients with and without comorbid major depressive disorder (MDD) in a recent open-label treatment study published in Neuromodulation.

Patients without depression improved more quickly, but “those with depression who continued rTMS through a full 30-session course further improved, indicating that tinnitus with comorbid MDD may respond with extended treatment,” researchers from the University of California, Los Angeles, and VA Portland Medical Center said in the study.

Related: Novel Depression Treatments Focus of Psych Congress Regionals Q&A Session

The study included 40 patients (10 female) with chronic tinnitus, both with (n = 17) and without comorbid MDD (n = 23), and analyzed the efficacy of a multilocus sequential rTMS treatment protocol for tinnitus involving stimulation of both prefrontal and auditory targets.

Administered sequentially to the left dorsolateral prefrontal cortex and the auditory cortex, the protocol resulted in significant mean improvement in tinnitus symptoms at sessions 5 (mean TFI improvement 6.8 points ± 12.2, p = 0.002) and 10 (mean improvement 9.2 points ± 14.1, p = 0.002). Notably, 48% of patients responded positively within 10 treatment sessions.

Responders were significantly older than nonresponders (61.5 ± 15 years vs 51.3 ± 16 years), and patients with comorbid MDD reported significantly less improvement after 10 sessions than those without (4.3 ± 10.3 vs 14.7 ± 15.0 points, p = 0.04).

“Those with depression who continued rTMS through a full 30-session course further improved, indicating that tinnitus with comorbid MDD may respond with extended treatment,” researchers concluded.

Reference

Berman ZR, Citrenbaum C, Corlier J, Leuchter AF, Folmer RL, Leuchter MK. Sequential multilocus repetitive transcranial magnetic stimulation for treatment of tinnitus with and without comorbid major depressive disorder. Neuromodulation. Published online February 21, 2024. doi:10.1016/j.neurom.2024.01.001

Marder KG, Cho J, Chincanchan R, et al. Sequential prefrontal and temporoparietal repetitive transcranial magnetic stimulation (rtms) for treatment of tinnitus with and without comorbid depression: a case series and systematic review. Front Neurol. 2022;13:831832. Published 2022 May 19. doi:10.3389/fneur.2022.831832

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