Article
Repetitive Transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus: a new coil positioning method
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Published: | September 22, 2005 |
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Introduction: Chronic tinnitus is associated with hyperactivity of the central auditory system. Neuronavigated transcranial magnetic stimulation of the area of increased activity within the primary auditory cortex was able to reduce tinnitus perception. The aim of this study was to determine wether the complex neuronavigated approach of the target area can be replaced by a standard procedure for targeting the primary auditory cortex based on the 10-20 EEG system.
Methods: In the first part of the study the position of left Heschl gyrus was targeted in 25 healthy subjects using a frameless stereotactical neuronavigation system. On the basis of the individual scalp coordinates a positioning strategy adapted from the 10-20 EEG system was developed. Finally 11 patients suffering from chronic tinnitus received 10 sessions of low frequency rTMS (110% motor threshold, 1 HZ, 2000 stimuli/d) to their left auditory cortex using the newly developed method for coil positioning.
Results: The scalp coordinates for the primary auditory cortex, as specified by neuronavigation in 25 healthy subjects, could be detected within a 20 mm diameter. By means of these data a standard procedure for coil positioning could be determined. Clinical validation of this positioning method resulted in a significant improvement in tinnitus complaints after 10 sessions of rTMS as demonstrated by the Goebel and Hiller score.
Conclusions: The standard coil positioning strategy resulted in clinical improvement of tinnitus complaints comparable to the sophisticated neuronavigational positioning method. The easily applicable positioning strategy promises a simplification of the procedure.