Transcranial Magnetic Stimulation for Tinnitus: Using the Tinnitus Functional Index to Predict Benefit in a Randomized Controlled Trial

TITLE
Transcranial Magnetic Stimulation for Tinnitus: Using the Tinnitus Functional Index to Predict Benefit in a Randomized Controlled Trial

AUTHORS
Theodoroff, Sarah M. VA RR&D, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, 3710 SW US Veterans Hospital Road (NCRAR – P5), Portland, OR, 97239, USA.  Theodoroff, Sarah M. Department of Otolaryngology, Head-Neck-Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. Griest, Susan E. VA RR&D, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, 3710 SW US Veterans Hospital Road (NCRAR – P5), Portland, OR, 97239, USA. Griest, Susan E. Department of Otolaryngology, Head-Neck-Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA. Folmer, Robert L. VA RR&D, National Center for Rehabilitative Auditory Research, VA Portland Health Care System, 3710 SW US Veterans Hospital Road (NCRAR – P5), Portland, OR, 97239, USA. Folmer, Robert L. Department of Otolaryngology, Head-Neck-Surgery, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.

ELECTRONIC ADDRESS
sarah.theodoroff@va.gov.

SOURCE
Trials [Electronic Resource]. 18(1):64, 2017 Feb 09.

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.