rTMS for Depression and Chronic Tinnitus

[Ecip]

https://www.sciencedaily.com/releases/2015/07/150716124118.htm

Same study?

 

[Golly]

I am not sure if this has already been posted, but I came across a very recent JAMA (reputable journal) study that examined the efficacy of rTMS as a tinnitus treatment. The link to the paper is here:

http://jama.jamanetwork.com/article.aspx?articleid=2484665

I believe you need to purchase the article, but the results and conclusion are posted on the site:

Results Overall, 18 of 32 participants (56%) in the active rTMS group and 7 of 32 participants (22%) in the placebo rTMS group were responders to rTMS treatment. The difference in the percentage of responders to treatment in each group was statistically significant (χ21 = 7.94, P < .005).

Conclusions and Relevance Application of 1-Hz rTMS daily for 10 consecutive workdays resulted in a statistically significantly greater percentage of responders to treatment in the active rTMS group compared with the placebo rTMS group. Improvements in tinnitus severity experienced by responders were sustained during the 26-week follow-up period. Before this procedure can be implemented clinically, larger studies should be conducted to refine treatment protocols.
________

I have not read the paper, but I am happy to explain these results to anyone who is uncomfortable with statistics. The bottom line, however, is that rTMS appears to be responsible for reducing the Tinnitus Functional Index (TFI) in some patients.

-Golly

 

[Aaron123]

The paper is available here: http://www.metroatlantaotolaryngology.org/journal/feb16/Transcranial Magnet Tinnitus.pdf

I read this when it came out. I find it odd that the abstract focused on the percentage of "responders". A "responder" is defined as someone whose TFI falls by at least 7 points, but there is no information on why that cutoff was chosen. There's no discussion of whether a 7 point drop is clinically significant - after all, statistical significance does not guarantee clinical significance. To get some sense of magnitude, it is about 1/3 of a standard deviation of the baseline TFI.

It's also odd because Table 2 and Figure 2 suggest durable effects at 26 weeks. To me this is the more interesting result. That said, it is a bit perplexing why there would be no significant effect right after treatment, significant effects at 1 and 2 weeks, no significant effects at 4 and 13 weeks, and a significant effect at 26 weeks.

It's also notable that none of their other measures showed any effect. It's annoying that all of this other information is in "Supplement 2".

Lastly, randomization did not work so well for TMS intensity or duration of tinnitus. The controls were much more likely to have had tinnitus for at least 20 years. I didn't look up what TMS intensity is so I am not sure how that difference might affect things.

 

[Golly]

The paper is available here: http://www.metroatlantaotolaryngology.org/journal/feb16/Transcranial Magnet Tinnitus.pdf

I read this when it came out. I find it odd that the abstract focused on the percentage of "responders". A "responder" is defined as someone whose TFI falls by at least 7 points, but there is no information on why that cutoff was chosen. There's no discussion of whether a 7 point drop is clinically significant - after all, statistical significance does not guarantee clinical significance. To get some sense of magnitude, it is about 1/3 of a standard deviation of the baseline TFI.

It's also odd because Table 2 and Figure 2 suggest durable effects at 26 weeks. To me this is the more interesting result. That said, it is a bit perplexing why there would be no significant effect right after treatment, significant effects at 1 and 2 weeks, no significant effects at 4 and 13 weeks, and a significant effect at 26 weeks.

It's also notable that none of their other measures showed any effect. It's annoying that all of this other information is in "Supplement 2".

Lastly, randomization did not work so well for TMS intensity or duration of tinnitus. The controls were much more likely to have had tinnitus for at least 20 years. I didn't look up what TMS intensity is so I am not sure how that difference might affect things.

That link is to a similar 2015 study; but your points are well taken. I would be curious to know if these same limitations apply to the 2016 research that I referenced. -G

 

[Aaron123]

That link is to a similar 2015 study; but your points are well taken. I would be curious to know if these same limitations apply to the 2016 research that I referenced. -G

The link you provided is to someone (Piccirillo) summarizing the 2015 paper. It is not new research (unfortunately).

 

[Golly]

The link you provided is to someone (Piccirillo) summarizing the 2015 paper. It is not new research (unfortunately).

You are absolutely right! Thanks for clarifying. -G

 

[glynis]

@ibelievetoo
You might like to Read this thread ..lots of love glynis