Skip to main content
Top
Published in: Trials 1/2017

Open Access 01-12-2017 | Commentary

Transcranial magnetic stimulation for tinnitus: using the Tinnitus Functional Index to predict benefit in a randomized controlled trial

Authors: Sarah M. Theodoroff, Susan E. Griest, Robert L. Folmer

Published in: Trials | Issue 1/2017

Login to get access

Abstract

Background

Identifying characteristics associated with transcranial magnetic stimulation (TMS) benefit would offer insight as to why some individuals experience tinnitus relief following TMS treatment, whereas others do not. The purpose of this study was to use the Tinnitus Functional Index (TFI) and its subscales to identify specific factors associated with TMS treatment responsiveness.

Methods

Individuals with bothersome tinnitus underwent 2000 pulses of 1-Hz TMS for 10 consecutive business days. The primary outcome measure was the TFI which yields a total score and eight individual subscale scores. Analyses were performed on baseline data from the active arm (n = 35) of a prospective, double-blind, randomized placebo-controlled clinical trial of TMS for tinnitus.

Results

Baseline total TFI score and three of the eight TFI subscales were useful in differentiating between responders and nonresponders to TMS intervention for tinnitus. These findings are not definitive, but suggest potential factors that contribute to perceived benefit following TMS.

Conclusions

Overall, the main factor associated with TMS benefit was a higher tinnitus severity score for responders at baseline. The TFI subscales helped to clarify the factors that contributed to a higher severity score at baseline. Large-scale prospective research using systematic approaches is needed to identify and describe additional factors associated with tinnitus benefit following TMS.

Trial registration

ClinicalTrials.gov, ID: NCT01104207. Registered on 13 April 2010.
Literature
1.
go back to reference Kamalski DM, Hoekstra CE, van Zanten BG, Grolman W, Rovers MM. Measuring disease-specific health-related quality of life to evaluate treatment outcomes in tinnitus patients: a systematic review. Otolaryngol Head Neck Surg. 2010;143:181–5.CrossRefPubMed Kamalski DM, Hoekstra CE, van Zanten BG, Grolman W, Rovers MM. Measuring disease-specific health-related quality of life to evaluate treatment outcomes in tinnitus patients: a systematic review. Otolaryngol Head Neck Surg. 2010;143:181–5.CrossRefPubMed
3.
go back to reference Folmer RL, Theodoroff SM, Martin WH, Shi Y. Experimental, controversial, and futuristic treatments for chronic tinnitus. J Am Acad Audiol. 2014;25:106–25.CrossRefPubMed Folmer RL, Theodoroff SM, Martin WH, Shi Y. Experimental, controversial, and futuristic treatments for chronic tinnitus. J Am Acad Audiol. 2014;25:106–25.CrossRefPubMed
4.
go back to reference Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, et al. The Tinnitus Functional Index: development of a new clinical measure for chronic intrusive tinnitus. Ear Hear. 2012;33:153–76.CrossRefPubMed Meikle MB, Henry JA, Griest SE, Stewart BJ, Abrams HB, et al. The Tinnitus Functional Index: development of a new clinical measure for chronic intrusive tinnitus. Ear Hear. 2012;33:153–76.CrossRefPubMed
5.
go back to reference Mennemeier M, Munn T, Allensworth M, Lenow JK, Brown G, Allen S, Dornhoffer J, Williams DK. Laterality, frequency and replication of rTMS treatment for chronic tinnitus: pilot studies and a review of maintenance treatment. Hear Res. 2013;295:30–7.CrossRefPubMed Mennemeier M, Munn T, Allensworth M, Lenow JK, Brown G, Allen S, Dornhoffer J, Williams DK. Laterality, frequency and replication of rTMS treatment for chronic tinnitus: pilot studies and a review of maintenance treatment. Hear Res. 2013;295:30–7.CrossRefPubMed
6.
go back to reference Folmer RL, Theodoroff SM, Casiana L, Shi Y, Griest S, Vachhani J. Repetitive Transcranial Magnetic Stimulation (rTMS) treatment for chronic tinnitus: results of a randomized, placebo-controlled clinical trial. JAMA Otolaryngol Head Neck Surg. 2015;141(8):716–22. Published online 16 Jul 2015. doi:10.1001/jamaoto.2015.1219.CrossRefPubMed Folmer RL, Theodoroff SM, Casiana L, Shi Y, Griest S, Vachhani J. Repetitive Transcranial Magnetic Stimulation (rTMS) treatment for chronic tinnitus: results of a randomized, placebo-controlled clinical trial. JAMA Otolaryngol Head Neck Surg. 2015;141(8):716–22. Published online 16 Jul 2015. doi:10.​1001/​jamaoto.​2015.​1219.CrossRefPubMed
8.
go back to reference Newman CW, Sandridge SA, Jacobson GP. Assessing outcomes of tinnitus intervention. J Am Acad Audiol. 2014;25(1):76–105.CrossRefPubMed Newman CW, Sandridge SA, Jacobson GP. Assessing outcomes of tinnitus intervention. J Am Acad Audiol. 2014;25(1):76–105.CrossRefPubMed
9.
go back to reference Dobie RA. Overview: suffering from tinnitus. In: Snow JB, editor. Tinnitus: theory and management. Lewiston: BC Decker Inc; 2004. p. 1–7. Dobie RA. Overview: suffering from tinnitus. In: Snow JB, editor. Tinnitus: theory and management. Lewiston: BC Decker Inc; 2004. p. 1–7.
10.
go back to reference Henry JA, Zaugg TL, Myers PJ, et al. The role of audiologic evaluation in progressive audiologic tinnitus management. Trends Amplif. 2008;12(3):170–87.CrossRefPubMedPubMedCentral Henry JA, Zaugg TL, Myers PJ, et al. The role of audiologic evaluation in progressive audiologic tinnitus management. Trends Amplif. 2008;12(3):170–87.CrossRefPubMedPubMedCentral
11.
go back to reference Zaugg TL, Schechter MA, Fausti SA, Henry JA. Difficulties caused by patients’ misconceptions that hearing problems are due to tinnitus. In: Patuzzi R, Crawley, editor. Proceedings of the Seventh International Tinnitus Seminar. Crawley: The University of Western Australia; 2002. p. 226–228. Zaugg TL, Schechter MA, Fausti SA, Henry JA. Difficulties caused by patients’ misconceptions that hearing problems are due to tinnitus. In: Patuzzi R, Crawley, editor. Proceedings of the Seventh International Tinnitus Seminar. Crawley: The University of Western Australia; 2002. p. 226–228.
12.
go back to reference Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening tool to differentiate bothersome tinnitus from hearing difficulties. Am J Audiol. 2015;24(1):66–77.CrossRefPubMedPubMedCentral Henry JA, Griest S, Zaugg TL, Thielman E, Kaelin C, Galvez G, Carlson KF. Tinnitus and hearing survey: a screening tool to differentiate bothersome tinnitus from hearing difficulties. Am J Audiol. 2015;24(1):66–77.CrossRefPubMedPubMedCentral
13.
go back to reference Folmer RL, Griest SE, Martin WH. Chronic tinnitus as phantom auditory pain. Otolaryngol Head Neck Surg. 2001;124(4):394–400.CrossRefPubMed Folmer RL, Griest SE, Martin WH. Chronic tinnitus as phantom auditory pain. Otolaryngol Head Neck Surg. 2001;124(4):394–400.CrossRefPubMed
14.
go back to reference Theodoroff SM, Folmer RL. Repetitive transcranial magnetic stimulation as a treatment for chronic tinnitus: a critical review. Otol Neurotol. 2013;34(2):199–208.CrossRefPubMed Theodoroff SM, Folmer RL. Repetitive transcranial magnetic stimulation as a treatment for chronic tinnitus: a critical review. Otol Neurotol. 2013;34(2):199–208.CrossRefPubMed
15.
go back to reference De Ridder D, Verstraeten E, Van der Kelen K, De Mulder G, Sunaert S, Verlooy J, Van de Heyning P, Moller A. Transcranial magnetic stimulation for tinnitus: influence of tinnitus duration on stimulation parameter choice and maximal tinnitus suppression. Otol Neurotol. 2005;26:616–9.CrossRefPubMed De Ridder D, Verstraeten E, Van der Kelen K, De Mulder G, Sunaert S, Verlooy J, Van de Heyning P, Moller A. Transcranial magnetic stimulation for tinnitus: influence of tinnitus duration on stimulation parameter choice and maximal tinnitus suppression. Otol Neurotol. 2005;26:616–9.CrossRefPubMed
16.
go back to reference Kleinjung T, Steffens T, Sand P, Murthum T, Hajak G, Strutz J, Langguth B, Eichhammer P. Which tinnitus patients benefit from transcranial magnetic stimulation? Otolaryngol Head Neck Surg. 2007;137(4):589–95.CrossRefPubMed Kleinjung T, Steffens T, Sand P, Murthum T, Hajak G, Strutz J, Langguth B, Eichhammer P. Which tinnitus patients benefit from transcranial magnetic stimulation? Otolaryngol Head Neck Surg. 2007;137(4):589–95.CrossRefPubMed
17.
go back to reference Khedr EM, Abo-Elfetoh N, Rothwell JC, El-Atar A, Sayed E, Khalifa H. Contralateral versus ipsilateral rTMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: comparative study. Eur J Neurol. 2010;17:976–83.CrossRefPubMed Khedr EM, Abo-Elfetoh N, Rothwell JC, El-Atar A, Sayed E, Khalifa H. Contralateral versus ipsilateral rTMS of temporoparietal cortex for the treatment of chronic unilateral tinnitus: comparative study. Eur J Neurol. 2010;17:976–83.CrossRefPubMed
18.
go back to reference Jacobson NS, Roberts LJ, Berns SB, McGlinchey JB. Methods for defining and determining the clinical significance of treatment effects: description, application, and alternatives. J Consult Clin Psychol. 1999;67(3):300–7.CrossRefPubMed Jacobson NS, Roberts LJ, Berns SB, McGlinchey JB. Methods for defining and determining the clinical significance of treatment effects: description, application, and alternatives. J Consult Clin Psychol. 1999;67(3):300–7.CrossRefPubMed
19.
go back to reference Kazdin AE. The meaning and measurement of clinical significance. J Consult Clin Psychol. 1999;67(3):332–9.CrossRefPubMed Kazdin AE. The meaning and measurement of clinical significance. J Consult Clin Psychol. 1999;67(3):332–9.CrossRefPubMed
Metadata
Title
Transcranial magnetic stimulation for tinnitus: using the Tinnitus Functional Index to predict benefit in a randomized controlled trial
Authors
Sarah M. Theodoroff
Susan E. Griest
Robert L. Folmer
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Trials / Issue 1/2017
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-017-1807-9

Other articles of this Issue 1/2017

Trials 1/2017 Go to the issue