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Dual-site rTMS is More Effective than Single-site rTMS in Tinnitus Patients: A Blinded Randomized Controlled Trial


Repetitive transcranial magnetic stimulation (rTMS) has been proposed as an alternative option for treating tinnitus. rTMS is a noninvasive method in which repetitive magnetic stimulation is applied to the cortex; it is considered a therapeutic strategy that modulates the loudness of tinnitus. In this study, we performed a double-blind randomized clinical trial to compare the outcome of tinnitus treatment among (1) dual-site (auditory + prefrontal) rTMS stimulation, (2) auditory cortex only rTMS stimulation (AC), and (3) sham stimulation. The left primary auditory cortex and left dorsolateral prefrontal cortex (DLPFC) were targeted independently of handedness or tinnitus laterality. Dual-site and auditory only groups were treated with a total of 12,000 pulses, 2000 pulses over the AC and 1000 pulses over the DLPFC (group 1), 3000 pulses over the AC only (group 2), and daily for 4 consecutive days. Dual-site group exhibited a significantly better ΔTinnitus Handicap Inventory (ΔTHI) score at 4, 8 weeks and 12 weeks after rTMS treatments compared with pre-treatment. However, there was no effect in the auditory only group. Also, there was no effect in sham group when THI scores were compared with that of the pre-treatment. These results are in line with the former studies that reported a better treatment effect by multiple site rTMS.

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All data in this study was managed and validated transparently.


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This research was supported by the Korea Health Industry Development Institute (KHDI) of Korean Ministry of Health and Welfare (Grant No. HI18C0626).

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Correspondence to Myung-Whan Suh.

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All authors agreed to participate in this study and participated appropriately.

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The present study was approved by the institutional review board at Seoul National University Hospital (1212-081-451) and was conducted according to the tenets of the Declaration of Helsinki. This study had been previously registered at Clinical Trials on May 28, 2013 (NCT01886092). All study procedure was done in accordance with approved guidelines.

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Noh, TS., Kyong, JS., Park, M.K. et al. Dual-site rTMS is More Effective than Single-site rTMS in Tinnitus Patients: A Blinded Randomized Controlled Trial. Brain Topogr 33, 767–775 (2020).

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  • Tinnitus
  • Transcranial magnetic stimulation
  • Auditory Cortex
  • Prefrontal cortex