Background: Tinnitus is a common untreatable condition that originates from central maladaptive plasticity initiated by peripheral injury. Repetitive transcranial magnetic stimulation (rTMS), direct cochlear low-level laser therapy (LLLT), and acupuncture were tried for tinnitus treatment, but the results of these methods were clinically unsatisfactory.
Objective: This study aimed to test the combined effect of the 3 methods targeting both peripheral and central auditory areas as a new therapeutic strategy for tinnitus.
Methods: For this, 30 patients were randomized to 3 equal groups receiving 3 different interventions: inhibitory rTMS to the left auditory cortex, LLLT (which includes a combination of direct cochlear LLLT and laser acupuncture) to the affected ear(s), and finally, a combination of rTMS and LLLT. The Tinnitus Handicap Inventory (THI) and Visual Analogue Scale (VAS) were assessed before, immediately after, and at 2 weeks and 4 weeks after 10 consecutive every-other-day sessions for each intervention type.
Results: We found that combined stimulation was effective in tinnitus treatment. This effect remained for 4 weeks after the end of the treatment. However, each of rTMS and LLLT alone had no significant effect. Repeated-measures ANOVA showed a significant effect of Time and Time × Intervention interaction for THI and VAS scores. The post hoc t test for different time points per intervention revealed a significant difference between baseline and all postintervention measurements of both THI and VAS for the combination intervention.
Conclusion: Combined central rTMS and peripheral LLLT is more beneficial as a new method for management of tinnitus rather than these two used separately.
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