by Neil Bauman, Ph.D.
A man asked:
I was wondering if you could comment on Transcranial Magnetic Stimulation? I read in an article that this treatment has helped people with tinnitus.
A lady with Musical Ear Syndrome asked:
I have read that something called Transcranial Magnetic Stimulation reduces auditory hallucinations. Is this safe?
Good questions. People suffering with severe tinnitus or from hearing other phantom sounds (Musical Ear Syndrome (MES)) are always on the lookout for any new therapy that might alleviate their tinnitus or MES symptoms.
The new kid on the block (only developed in 1995) goes by the fancy name of repetitive Transcranial Magnetic Stimulation (rTMS for short).
Transcranial Magnetic Stimulation works on the principle that a varying magnetic field will induce an electrical current in nearby “structures.” In this case, the nearby “structures” are the cortical areas of your brain.
A doctor typically holds a powerful electromagnet (basically a coil of wire encased in plastic) over the frontal regions of your skull and delivers magnetic pulses for about 20 minutes a day for 5 days. The treatment alters the biochemistry and firing patters of neurons in the cortex—that is, the part of your brain nearest the surface.
The frequency of the stimulation determines whether it speeds up or slows down the cortical activity in your brain. Numerous studies have revealed that chronic tinnitus is associated with increased activity in the primary auditory cortex. Therefore, in the case of tinnitus and auditory hallucinations, you want to slow down this activity.
Studies show that using a low-frequency (1 Hz) rTMS actually does reduce the “excitability” of the cerebral cortex, and can cause long-lasting inhibitory effects in tinnitus perception—up to 6 months or more.
In one study, after 5 days of rTMS treatments, there was a highly significant reduction in tinnitus perception, whereas people who received the sham treatment did not show any significant changes. This is good news.
However, rTMS certainly isn’t the whole answer for tinnitus and other phantom sounds. For example, in one study it had good effects in 25% of the people studied, partial effects in 28% of the people, and no effect in 47%. If this holds true for all people with tinnitus, then rTMS won’t help half the tinnitus sufferers. However, if you are one of the lucky ones, you may receive partial or omplete reduction in your tinnitus—so you may want to pursue rTMS therapy if nothing else is working for you.
So far, rTMS therapy shows promise, but there are still many unanswered questions such as: how safe is it? How long will the suppression ultimately last? Does it work for all kinds of tinnitus?
Although it is used in other countries, here in the USA, the FDA has yet to approve rTMS for regular use, so it is only being used in clinical trials at the present.
My personal opinion is that rTMS indeed shows promise in reducing or eliminating tinnitus and auditory hallucinations. However, I’d wait until further research determines that it is totally safe. For example, I’d want to be very sure that rTMS treatments don’t slow down other parts of my brain. My brain is already running slow enough as it is!
