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Long-term repetitive transcranial magnetic stimulation therapy: new research questions arising from one tinnitus case?
  1. Douglas Richard Labar1,
  2. Mar Cortes2,
  3. Dylan Edwards2
  1. 1Department of Clinical Neurophysiology, Weill-Cornell Medical College, New York, New York, USA
  2. 2Non-invasive Brain Stimulation Laboratory, Burke Medical Research Institute, White Plains, New York, USA
  1. Correspondence to Dr Douglas Richard Labar, drlabar{at}


Tinnitus may become refractory to treatment and disabling. Brain transcranial magnetic stimulation (TMS) has shown promise as a therapy, but has been employed primarily short-term. We treated a patient with 5 weeks of weekly repetitive TMS (rTMS), followed by 6 months of monthly rTMS. He was a 75-year-old dentist with chronic tinnitus from occupational noise exposure. Physical examination and MRIs of the auditory canals and brain had revealed no lesions. The patient showed a general gradual, progressive improvement on per cent of severe tinnitus diary days (from baseline 100% to 33%), tinnitus handicap inventory (from baseline score 70 to 18), and mini-tinnitus questionnaire (from baseline score 17 to 6). No changes occurred in serial audiograms. Transient adverse events were a headache during stimulation, and dizziness 30 min after treatment. Implications and questions for future non-invasive neuromodulation clinical research raised by our case are discussed.

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