A Chart Review to Assess the Response of Veterans Suffering from Tinnitus to Alpha Burst Transcranial Magnetic Stimulation

Objective:
The purpose of this chart review was to assess the response of veterans suffering from tinnitus to Magnetic EEG/EKGguided resonance therapy and Alpha Burst Stimulation (ABS), while also investigating the safety profile of this therapy combination. EEG/EKG-guided Repetitive Transcranial Magnetic Stimulation (rTMS) delivers high-energy electromagnetic pulses to induce current flow in the neocortex. ABS provides rTMS pulses in short, high-frequency bursts.

Materials and methods:
All equipment used to evaluate and treat participants are either FDA-cleared or are exempt from clearance and listed with the United States FDA. Stimulation was delivered with a MagPro R30 and an MCF-B65 butterfly coil. Charts were reviewed from patients who had received a combination of EEG/EKG-guided rTMS and ABS therapy to relieve symptoms of tinnitus. Paired samples t-tests were performed on the Tinnitus Functional Index (TFI) and Neurobehavioral Symptom Inventory (NSI) scales. Treatment logs and therapy notes were reviewed for safety data. Adverse events or side effects were extracted from therapy notes. Linear regression was used to analyze the relationship between number of therapy sessions, and reported patient symptoms.

Results:
Eighteen of the 23 patients reported significant improvements in tinnitus symptoms. For patients reporting improvements, there was an average 44% reduction in tinnitus symptoms and a 60% reduction in NSI scores following intervention. No patients experienced adverse side effects. The most common side effects were headache and fatigue.

Conclusion:
Based on the results from this study, noninvasive neuromodulation holds promise as a potential treatment for tinnitus. Additional investigation in controlled studies may be warranted.

Keywords: Alpha-Burst Stimulation (ABS); EEG/EKG-guided; Tinnitus; neuromodulation,; rTMS.

PMID: 33206487 DOI: 10.5935/0946-5448.20200008