TMS For Tinnitus

     Tinnitus, also called "ringing in the ears," is a common health problem that affects up to 15% of adults. Some people with tinnitus have it so bad that it makes them unable to function. This makes them much more likely to get depressed, anxious, or even suicidal. 

In tinnitus, a person hears sounds like a whooshing, buzzing, hissing, or screeching sound that can't be traced to an outside source. Most cases of tinnitus are cases of subjective tinnitus, in which only the person experiencing the sound can actually hear it.

Causes of persistent subjective tinnitus include chronic exposure to loud noise, head injury, medical conditions such as Meniere’s Disease, and aging.

A less common type of tinnitus is objective tinnitus, in which both the individual but also another person, such as a physician with a stethoscope, will hear the sound. Objective tinnitus is usually caused by a vascular disorder or some structural abnormality in the body which produces the sound.

Individuals suffering from chronic subjective tinnitus do not suffer primarily, if at all, from an ear problem, but rather a brain problem.  Researchers have identified a part of the brain known as the medial temporal lobe which is responsible for the production (Schulmann, International Tinnitus Journal, 1995) of aberrant sounds experienced by individuals with tinnitus.

     There are various modalities of tinnitus treatment which are considered standard of care. Cognitive behavioral therapy and Tinnitus Retraining Therapy are two types of psychotherapy focusing on helping an individual psychologically cope with their symptoms in a healthier manner. Noise suppression devices, such as white noise machines and masking devices, seek to make the sounds less noticeable. Medications, such as the antidepressants, are often prescribed for those experiencing secondary depressive or anxiety symptoms related to the tinnitus.

     Transcranial Magnetic Stimulation, or TMS, is a standard, FDA-approved treatment for major depressive disorder, using electromagnetic fields to elicit neuronal depolarization in specific parts of the brain. In the case of tinnitus, it is possible to target the medial temporal lobe area of the brain in a non-invasive manner, and through a series of repetitive treatments, each constituting thousands of stimulations, attempt to alter the tonality of that part of the brain.

A recent study published in the Journal of the American Medical Association found that repetitive TMS targeting the temporal lobe of individuals suffering from tinnitus for ten consecutive workdays resulted in significant improvement for 56% of study participants, compared with 22 percent in the placebo group of the study (Folmer, JAMA 2019). Impressively, the study spanned a total of 26 weeks, and those responding to the treatment experienced sustained improvement over that time. 

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