Transcranial Stimulation Treatments (rTMS & tDCS & tACS)

[cjbhab]

many researchers don't head in to the field of tinnitus. It's not 'sexy' or 'glamorous' enough.

I think it would be very sexy and very glamorous if I invented a pill that cured tinnitus and I charged you all $50 a day for silence.

 

[Nick47]

Novel 'infraslow pink noise' stimulation found to be safe and feasible in chronic tinnitus

A novel brain stimulation technique called high-definition transcranial infraslow pink noise stimulation (HD-tIPNS) was recently evaluated in a placebo-controlled pilot study, and found to be both safe and feasible in the treatment of chronic tinnitus.

Not really impressive...

 

[Nick47]

There is a 3-year project culminating in January 2024 using HD-tDCS, funded by the RNID.

I thought this method had been studied some and seemed to not yield great results. Isn't it also already offered at Brai3n?

Anyway, here is the project.

I'm not enthused...

 

[Nick47]

Meanwhile in the UK a top university perseveres with tDCS that leaves us generally feeling flat and unenthused.

 

[Nick47]

Conclusion

As measured by the Tinnitus Handicap Index, our findings suggest the effects of transcutaneous electrical nerve stimulation and transcranial direct current stimulation reach significant benefit in the short term, whereas repetitive transcranial magnetic stimulation reaches significant benefit in the long term. Based on the BDI, transcranial direct current stimulation significantly reduces comorbid depression in patients with tinnitus.

→ Neuromodulation for Treatment of Tinnitus: A Systematic Review and Meta-Analysis

 

[HighleyTall]

There is a 3-year project culminating in January 2024 using HD-tDCS, funded by the RNID.

I thought this method had been studied some and seemed to not yield great results. Isn't it also already offered at Brai3n?

Anyway, here is the project.

I'm not enthused...

Dr Shekhawat has conducted a number of preliminary studies to investigate whether a specific type of non-invasive brain stimulation, 'transcranial direct current stimulation', or tDCS, is effective in treating tinnitus. In these studies, some participants experienced complete silencing of their tinnitus for up to three days.

Would be interesting to know what type of tinnitus these patients have? I doubt this works for reactive tinnitus.

 

[Nick47]

Small but significant improvements, especially in non-MDD patients. Averaged around 9 points on a TFI. It may be better in conjunction with other treatments rather than as a standalone.

Conclusions:

Patients showed significant improvement in tinnitus from multilocus sequential rTMS treatment, and those with tinnitus alone improved more quickly. 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.

→ Sequential Multilocus Repetitive Transcranial Magnetic Stimulation for Treatment of Tinnitus With and Without Comorbid Major Depressive Disorder

 

[Nick47]

Abstract

Tinnitus remains a notoriously difficult to treat clinical entity. 1-2% of the entire population report relevant emotional distress due to tinnitus, and causal treatments are lacking. Repetitive transcranial magnetic stimulation (rTMS), most commonly of auditory cortical areas, has shown mixed results in the past. Prefrontal rTMS, including intermittent theta burst stimulation (iTBS) has shown more promising results in the treatment of depression, and clinical data suggests a meaningful overlap between tinnitus and depression. Therefore, we performed a feasibility study of 28 consecutive patients with tinnitus treated with an iTBS protocol over the left dorsolateral prefrontal cortex for three weeks.

After treatment, we observed significant ameliorations of tinnitus distress as measured by the Tinnitus Handicap Inventory Questionnaire (THI), the Tinnitus Functional Index (TFI), the Mini-Tinnitus Questionnaire (Mini-TQ) and also of depression as measured by the Major Depression Inventory (MDI). Effect sizes were small to moderate and short-lived. Treatment response rates, defined as improvement of the THI of at least 7 points, were 35.7%. At follow-up twelve weeks after end of treatment, severity of tinnitus and depression returned to approximately baseline level on a descriptive level. Amelioration of depressive symptoms correlated only with TFI change, but not that of other measures of tinnitus distress. The data suggest that a prefrontal iTBS protocol might be applied in the treatment of tinnitus and open avenues for future neurostimulatory treatments other than those of auditory regions.

→ Left prefrontal intermittent theta burst stimulation ameliorates tinnitus distress and symptoms of depression - A feasibility study

 

[HighleyTall]

7 point THI improvement. I think that is what I experience overnight. If I have a really good night, maybe 10 points.

When 75% of the patients experience 50-point THI improvement, please let me know.

 

[Nick47]

Another company flogging a dead horse.

Neuralia TMS, a leading healthcare provider focused on innovative treatments, is pleased to announce the introduction of Repetitive Transcranial Magnetic Stimulation (rTMS) for tinnitus in Perth neuraliatms.com.au/tms-therapy/for-tinnitus/. Directed by Dr. Shanek Wick, Neuralia TMS aims to provide a breakthrough solution for individuals grappling with the challenges of persistent tinnitus.

Tinnitus, often described as a ringing or vibration in the ears, affects a significant number of Australians, impacting their daily lives and overall well-being. Dr. Shanek Wick, the Director of Neuralia TMS, stated, "Tinnitus is a pervasive condition that can severely affect the quality of life for those experiencing it. At Neuralia TMS, the team is excited to introduce rTMS as an innovative and non-invasive treatment option to help individuals find relief from this persistent condition."

Repetitive Transcranial Magnetic Stimulation is a neurostimulation technique that utilises pulsed magnetic fields to target specific regions of the brain. In the case of treating tinnitus, rTMS is designed to stimulate the auditory cortex, the part of the brain responsible for processing sound. This targeted stimulation aims to modulate neural activity, potentially reducing the perception of tinnitus and providing relief to individuals burdened by its effects.

TMS treatments at Neuralia TMS involve a series of sessions that leverage the brain's neuroplasticity, allowing it to adapt and respond to the stimulation positively. Dr. Wick emphasised the potential impact of rTMS on tinnitus sufferers, stating, "The goal is to not only alleviate the symptoms of tinnitus but to enhance the overall well-being of individuals who have been grappling with the challenges posed by this condition."

While tinnitus treatments have often been elusive, rTMS offers a non-invasive and promising avenue for those seeking relief. Neuralia TMS's commitment to innovation and patient-centric care positions the facility at the forefront of providing cutting-edge solutions for neurological and auditory conditions.

As the medical community continues to explore non-invasive treatment options, Neuralia TMS is poised to play a crucial role in advancing the field of neurostimulation. Dr. Wick shared his insights on the future outlook of Neuralia TMS, stating, "The vision extends beyond treating tinnitus. The team envisioned Neuralia TMS as a hub for pioneering research and advanced treatments in neurostimulation. The commitment to improving the lives of individuals with neurological conditions remains steadfast, and are actively exploring additional applications of rTMS in various neurological disorders."

Neuralia TMS invites individuals dealing with tinnitus to explore the possibilities offered by rTMS treatments.

→ Neuralia TMS Announces Tinnitus Treatment in Perth

 

[DeanD]

Another company flogging a dead horse.

Until there is a real test that shows tinnitus and its severity, companies will continue to exploit the market looking to make as much cash as they can.

The self-proclaimed hype and press releases (which, unfortunately, some are hitting mainstream) about 'amazing new treatments' by way of a CBT app, will remain frustratingly rife in this space, and each one, with a positive message how tinnitus isn't that bad and using said app or treatment fixes the problem, is a continued blow for severe sufferers looking to be heard.

 

[Nick47]

These are pretty impressive results. The group was moderate-sized, and the p-value was highly significant (1 in 1000 odds that the results were just by chance).

Anodal tDCS significantly reduced THI from 72.93 ± 10.11 score to 46.40 ± 15.36 after the last session and 49.68 ± 14.49 at one-month follow-up in 18 out of 25 participants (p < 0.001). The risk ratio (RR) of presenting an improvement of ≥20 points in the THI after the last session was 10.8 in patients treated with tDCS. Statistically significant reductions were observed in distress VAS and loudness VAS (p < 0.001).

→ Repeated Bilateral Transcranial Direct Current Stimulation over Auditory Cortex for Tinnitus Treatment: A Double-Blinded Randomized Controlled Clinical Trial

 

[Muggumbo]

These are pretty impressive results. The group was moderate-sized, and the p-value was highly significant (1 in 1000 odds that the results were just by chance).

→ Repeated Bilateral Transcranial Direct Current Stimulation over Auditory Cortex for Tinnitus Treatment: A Double-Blinded Randomized Controlled Clinical Trial

I think this is the same study from this thread. The device they used is commercially available for $500.

 

[Note]

→ Repeated Bilateral Transcranial Direct Current Stimulation over Auditory Cortex for Tinnitus Treatment: A Double-Blinded Randomized Controlled Clinical Trial

tDCS was administered using a pair of surface sponges (35 cm2) soaked in saline solution and delivered via a specially developed battery-powered constant current stimulator capable of a maximum output of 4 mA. The tDCS device utilized in this study was the OASIS ProTM device manufactured by Mind Alive Inc. (Edmonton, AB, Canada).

The tDCS protocol involved a 2 mA current administered daily for 20 min over five consecutive days per week, for a duration of two consecutive weeks. In the anodal tDCS condition, the anode was positioned over the left auditory cortex (midway between T3 and F7), while the cathode was placed over the right auditory cortex (midway between T4 and F8), using 35 cm2 electrodes.

More information about the placement: 10-20-System

 

[BuzzyBee]

Do the studies say anything about how long the results last? I was told that TMS works for certain people, but that the tinnitus tends to come right back.

 

[Nick47]

Do the studies say anything about how long the results last? I was told that TMS works for certain people, but that the tinnitus tends to come right back.

It's not TMS. The results sustained a short while after, as described in the paper.

 

[streifzug]

Has anyone on Tinnitus Talk tried tDCS for depression? Did it help? I tried Amitriptyline this year, but it worsened my tinnitus, so that's not an option for me. I'm considering trying the Flow Headset for depression, as it lists tinnitus as a side effect in only 0.6% of its users. Is that a significant number?

→ Flow Neuroscience: Flow Headset

Besides hoping it could treat my depression, another thing has caught my interest. Flow uses the same montage (placement of electrodes and current settings) as described by the authors of this study.

The setup in the study not only helps with depression but also seems to slightly improve tinnitus. It's not a significant improvement, but any relief would be welcome. Maybe I'll get lucky and experience both a reduction in tinnitus and an improvement in depression. However, I'm not looking to take any major risks at the moment. What do you think?

 

[Nick47]

Has anyone on Tinnitus Talk tried tDCS for depression? Did it help? I tried Amitriptyline this year, but it worsened my tinnitus, so that's not an option for me. I'm considering trying the Flow Headset for depression, as it lists tinnitus as a side effect in only 0.6% of its users. Is that a significant number?

I would not spend a penny on anything without good evidence. Depending on where you are, you may be able to get tDCS delivered by a healthcare professional. If it is effective, then you can buy the device afterward.

 

[dd314]

tDCS has some solid evidence that it helps tinnitus, but very few mentions of it in the community for some reason.

I would trust tDCS WAY before I'd trust TMS. I personally know of three cases where TMS made the patients' tinnitus worse; two were former patients of my audiologist, and one was a pretty scary story here on Tinnitus Talk. TMS machines can also be extremely loud, like MRI machines.

 

[Ozhe]

TMS machines can also be extremely loud

120-130 dB.

 

[Ozhe]

The hospital where my neurologist treats me has told me that they are having very good results with TMS for treating tinnitus. I have an appointment at the end of the month, and I am thinking about it. They must guarantee that I will not suffer any adverse effects on my tinnitus.

 

[GregCA]

The hospital where my neurologist treats me has told me that they are having very good results with TMS for treating tinnitus. I have an appointment at the end of the month, and I am thinking about it. They must guarantee that I will not suffer any adverse effects on my tinnitus.

I would avoid anybody who guarantees no adverse effects.

 

[MiaVIL]

The hospital where my neurologist treats me has told me that they are having very good results with TMS for treating tinnitus. I have an appointment at the end of the month, and I am thinking about it. They must guarantee that I will not suffer any adverse effects on my tinnitus.

Can you give us more information on this?

 

[Nick47]

The hospital where my neurologist treats me has told me that they are having very good results

Ask for some written data on the results.

 

[Nick47]

Systematic review of tRNS:

Conclusions: The evidence for the effects of tRNS on people with chronic non-pulsatile tinnitus is promising. Administering tRNS with an intensity of 1-2 mA, high-frequency (101-650 Hz), using a 35 cm² electrode size over the auditory cortex and DLPFC, for 20 min with eight sessions may demonstrate the desired tRNS effects. The tRNS stimulation should be contralateral for unilateral tinnitus and bilaterally for bilateral tinnitus. Combining tRNS with other concurrent interventions may show superior effects in reducing tinnitus compared to tRNS alone. Further high-quality studies with larger sample sizes are strongly needed.

→ The efficacy of transcranial random noise stimulation in treating tinnitus

 

[BB23]

TMS has permanently harmed some people. There's a Facebook group with some horror stories.

@JoeBattams had to take his own life due to the hearing loss he suffered because of it, giving him suicidal tinnitus.

 

[Nick47]

TMS has permanently harmed some people. There's a Facebook group with some horror stories.

The latest study I posted is not TMS.

 

[withintention]

I see this place in Germany is still offering TMS as a treatment. Has anyone tried it? Does anyone know of a comparable option available Stateside?