ISSN 1308-8734 | E-ISSN 1308-8742
Case Report
Bilateral Dorsomedial Prefrontal Cortex rTMS for Tinnitus Treatment: A Successful Case
1 Laboratory of Panic & Respiration (LABPR), Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil  
2 Juiz de Fora Federal University; Physical Activity Neuroscience, Physical Activity Sciences Postgraduate Program - Salgado de Oliveira University, Niterói, Brazil  
Eurasian J Med ; : -
DOI: 10.5152/eurasianjmed.2018.18073
Key Words: Tinnitus, prefrontal cortex, transcranial magnetic stimulation


We present a successful tinnitus treatment case with intensity and distress reduction in a patient subjected to bilateral 10 Hz repetitive transcranial magnetic stimulation (rTMS) to the dorsomedial prefrontal cortex (DMPFC). Subjective tinnitus is the perception of sound in the ears or head when no corresponding external stimulus exists. Approximately 1%–2% of the population report severe tinnitus with daily life impairment. Sham-controlled studies have revealed benefits using rTMS in tinnitus, although the improvement is moderate or temporary, indicating the need for new strategies. Evidence that the DMPFC is important in tinnitus pathophysiology makes this area a promising target. A 51-year-old male patient with a 4-year history of treatment-resistant moderate bilateral tinnitus was treated with 20 sessions of bilateral 10 Hz DMPFC rTMS. The patient showed important reduction and sustained 4-month response in tinnitus loudness and annoyance, 24 point drop in tinnitus handicap inventory, visual analog scale reduction to zero, and tinnitus loudness of 1 dB compared to baseline 15 dB. Tinnitus treatment is challenging and new alternatives are needed. To our knowledge, this is the first report using rTMS to the DMPFC for tinnitus. In this protocol, important and sustained reduction of tinnitus annoyance and loudness was obtained. This outcome of the case suggests that this approach is promising for treating tinnitus and is worth further investigation.



Cite this article as: Ciminelli P, Sender D, Palmeira M, et al. Bilateral Dorsomedial Prefrontal Cortex rTMS for Tinnitus Treatment: A Successful Case. Eurasian J Med 2018; 50: 10.5152/eurasianjmed.2018.18073.

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