Evaluation of the Effectiveness of Transcranial Magnetic Stimulation in the Treatment of Subjective Tinnitus with Psychoacoustic Tests and Psychosomatic Tests

Objective: Tinnitus is a very common symptom in the society and although it can affect all age groups, it is especially common in the elderly. Due to the uncertainty in its etiopathogenesis, there is currently no definitive treatment method with proven efficacy. In this study, we aimed to evaluate the effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the suppression of increased neuronal activity. In this context, the effect of rTMS on tinnitus was analysed using various tests and scales. Materials and Methods: The study included 38 patients aged 18-70 years with tinnitus and a control group consisting of 38 age- and sex-matched healthy individuals. The frequency and severity of the symptoms of individuals with tinnitus were measured; Tinnitus Disability Questionnaire (TEA), Visual Analogue Scale (VAS) and Beck Depression Scale (BDS) were applied. The study group underwent rTMS treatment, and statistical comparisons were made between the two groups by repeating the measurements compared to pre-treatment values at both 1 and 3 months. Results: There was no statistically significant difference between the rTMS and control groups in tinnitus frequency measurements between pre-treatment and 1 and 3 months post-treatment (p > 0.05). However, a significant difference was found in tinnitus severity measurements (p < 0.05). Statistically significant differences were observed between rTMS and placebo groups in TEA, VAS and BDI scores before and after treatment (p < 0.05). When the groups were evaluated within themselves, significant time-dependent changes were found in tinnitus frequency, severity and questionnaire scores in the rTMS group (p < 0.05), while no significant change was found in these parameters in the placebo group (p > 0.05). Conclusion: In our study, rTMS treatment was shown to have favourable effects on tinnitus symptoms. However, the fact that there is still no consensus on the site, duration and frequency of application and the inconsistent results in the existing literature limit the routine clinical use of rTMS. The use of advanced neuroimaging techniques in combination with rTMS may increase the effectiveness of the treatment and allow the development of a more standardised application protocol. It is likely that rTMS, which attracts attention with its noninvasive nature and minimal side effects, will become an FDA-approved option in the treatment of tinnitus as well as depression in the future.