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. 2019 Aug 21;9(1):12190.
doi: 10.1038/s41598-019-48750-9.

RTMS parameters in tinnitus trials: a systematic review

Stefan Schoisswohl  1   2 , Kushal Agrawal  3   4 , Jorge Simoes  5   4 , Patrick Neff  5   6 , Winfried Schlee  5   4 , Berthold Langguth  5   4 , Martin Schecklmann  5   4
Affiliations

RTMS parameters in tinnitus trials: a systematic review

Stefan Schoisswohl et al. Sci Rep. .

Abstract

Over the past few years extensive body of research was produced investigating the effects of repetitive transcranial magnetic stimulation (rTMS) for the treatment of chronic tinnitus with heterogeneous results. This heterogeneity is exemplified by two recently published large-scale clinical trials reporting different outcomes. Technical aspects of rTMS were suspected as a potential source for this incongruency. The aim of this systematic review is to examine the overall efficacy as well as to identify possible technical factors relevant for the effectiveness of rTMS tinnitus trials. Via a literature search appropriate original research papers were identified and rTMS parameters were extracted from each study arm for subsequent statistical analysis with respect to observed effects (significant vs. not significant pre-post rTMS effects). Our findings indicate that verum rTMS is superior to sham rTMS as demonstrated by the proportion of significant pre-post contrasts. Some relevant rTMS parameters (e.g., pulse waveform) are not reported. Lower rTMS stimulation intensity was associated with significant effects in verum rTMS arms. An additional stimulation of the DLPFC to the temporal cortex was not found to promote efficacy. Future research should consider differential effects of rTMS induced by technical parameters and strive for an exhaustive reporting of relevant rTMS parameters.

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Conflict of interest statement

The authors declare that they have no conflict of interest associated with this publication and there has been no significant financial or non-financial support that could have influenced its outcome.

Figures

Figure 1
Figure 1
Review Procedure. The procedure of this systematic review from literature identification to the final number of verum rTMS study arms for statistical analysis is depicted as a flow diagram adapted from the PRISMA guidelines.
Figure 2
Figure 2
Reported Effect & Stimulation Intensity. The distribution of the stimulation intensity used by study arms separated for the reported results (significant effects N = 51; not significant effects N = 17).
Figure 3
Figure 3
Year & Number of published Study Arms. For each year, the number of published study arms with an exclusively auditory cortex rTMS grouped for significant and not significant reported effects is illustrated.
See this image and copyright information in PMC

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