Department of Otorhinolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea. ; Department of Otorhinolaryngology, Eulji University Hospital, Eulji University, Daejeon, Korea.
Clin Exp Otorhinolaryngol. 2013 Jun;6(2):63-7. doi: 10.3342/ceo.2013.6.2.63. Epub 2013 Jun 14.
The short-term effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) in the patients with catastrophic and intractable tinnitus were investigated.
Fifteen participants were recruited among patients with catastrophic intractable tinnitus to receive 1 Hz rTMS treatment. Tinnitus severity was assessed before rTMS and directly after sham or real rTMS using the tinnitus handicap inventory (THI) and visual analog scale (VAS).
There was no statistical difference in the THI score before and after sham stimulation. However, after 5 replications of real rTMS there was statistically significant reduction in THI score. Eight patients showed a decrease of more than 10 in THI score. Patients who showed a vast change in THI score after rTMS also showed a large decrease in their VAS score (r=0.879, P<0.001). Duration of tinnitus and change of THI score showed statistically significant moderate negative correlation (r=-0.637, P=0.011). But in case of VAS, there was no significant difference between VAS and duration of tinnitus.
Among total 15 patients with catastrophic intractable chronic tinnitus, eight patients showed some improvement in symptoms after 1 Hz rTMS. rTMS can be considered management modality for intractable tinnitus even with distress as severe as catastrophic stage.
研究低频重复经颅磁刺激（rTMS）对灾难性和难治性耳鸣患者的短期影响。
从患有灾难性难治性耳鸣的患者中招募了 15 名参与者，接受 1Hz rTMS 治疗。使用耳鸣残疾量表（THI）和视觉模拟量表（VAS）在 rTMS 治疗前和假刺激或真实 rTMS 后直接评估耳鸣严重程度。
假刺激前后 THI 评分无统计学差异。然而，经过 5 次真 rTMS 重复后，THI 评分有统计学显著降低。8 名患者的 THI 评分下降超过 10 分。在 rTMS 后 THI 评分发生巨大变化的患者，其 VAS 评分也有较大下降（r=0.879，P<0.001）。耳鸣持续时间与 THI 评分变化呈统计学显著中度负相关（r=-0.637，P=0.011）。但在 VAS 方面，VAS 与耳鸣持续时间之间无显著差异。
在 15 名患有灾难性难治性慢性耳鸣的患者中，有 8 名患者在 1Hz rTMS 后症状有所改善。rTMS 可被视为即使是灾难性阶段的严重困扰的难治性耳鸣的治疗方式。
