Neuronavigated repetitive transcranial magnetic stimulation in patients with tinnitus: a short case series

Biol Psychiatry. 2003 Oct 15;54(8):862-5. doi: 10.1016/s0006-3223(02)01896-6.


Background: Clinical as well as neurophysiological and neuroimaging data suggest that chronic tinnitus resembles neuropsychiatric syndromes characterized by focal brain activation. Low-frequency repetitive transcranial magnetic stimulation (rTMS) has been proposed as an efficient method in treating brain hyperexcitability disorders by reducing cortical excitability.

Methods: In three patients suffering from chronic tinnitus, the effect of magnetic resonance imaging and positron emission tomography guided neuronavigated 1 Hz rTMS on auditory cortex activity was evaluated, using a sham controlled double-blind crossover design.

Results: Two of three patients revealed clearly increased metabolic activity in circumscript areas of the primary auditory cortex (PAC), allowing a selective stimulation of these cortical areas with low-frequency rTMS. Considerable improvement in tinnitus was achieved in these patients.

Conclusions: Neuronavigated rTMS of increased PAC activity may help to better understand the neuronal basis of chronic tinnitus and might offer a new option for treating auditory phantom perceptions like chronic tinnitus.

Publication types

  • Case Reports
  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Auditory Cortex / blood supply
  • Auditory Cortex / metabolism*
  • Brain / blood supply
  • Brain / metabolism
  • Brain / physiopathology
  • Chronic Disease
  • Cross-Over Studies
  • Double-Blind Method
  • Fluorodeoxyglucose F18 / pharmacokinetics
  • Humans
  • Male
  • Middle Aged
  • Periodicity*
  • Radiopharmaceuticals / pharmacokinetics
  • Skull
  • Tinnitus / metabolism
  • Tinnitus / physiopathology
  • Tinnitus / therapy*
  • Tomography, Emission-Computed
  • Transcranial Magnetic Stimulation / instrumentation*


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18