Maintenance Rtms Can Decrease Tinnitus Chronically

Tinnitus, phantom sound perception like ringing, affects 50 million people in the U.S alone. No widely efficacious treatment for tinnitus exists. Tinnitus is linked to maladaptive reorganization of auditory cortex following peripheral injury or disease; indicated both by excessive spread of cortical activity in response to external sound and by asymmetric increases in resting metabolic activity in the temporal lobe. A week long course of low frequency rTMS applied over auditory cortex can reduce tinnitus in >50% of patients but relapse typically occurs in 5 to 10 days. No previous study of tinnitus examined change in cortical metabolism following rTMS. We obtained resting FDG PET scans before and after rTMS to determine if change in cortical metabolism relates to improvement. We also provided maintenance rTMS as symptoms returned to promote long term change.