Fax +41 61 306 12 34 E-Mail karger@karger.ch www.karger.com Original Paper Audiol Neurotol 2012;17:112–120 DOI: 10.1159/000330882 Effectiveness of Theta-Burst Repetitive Transcranial Magnetic Stimulation for Treating Chronic Tinnitus Hsiung-Kwang Chung   a, d Chon-Haw Tsai   b, e Yu-Chin Lin   b Jin-Ming Chen   c Yung-An Tsou   a Chin-Yuan Wang   a Chia-Der Lin   a, d Fuh-Cherng Jeng   g Jing-Gung Chung   f Ming-Hsui Tsai   a, d a  Department of Otorhinolaryngology – Head and Neck Surgery, b  Neuroscience Laboratory, Department of Neurology, c  Department of Radiology, China Medical University Hospital, d  Graduate Institute of Clinical Medical Sciences, e  Graduate Institute of Neural and Cognitive Sciences, f  Department of Biological Science and Technology, China Medical University, Taichung City, Taiwan, ROC; g Department of Communication Sciences and Disorders, Ohio University,  Athens, Ohio, USA placed on the surface of the skull over the targeted region with the intensity setting at 80% of the resting motor thresh- old. We delivered 900 pulses of theta-burst rTMS daily for 10 business days. Main Outcome Measures: Nine of twelve patients (75%) in the active-stimulation group reported tinnitus suppression following treatment with rTMS. The treatment led to reductions of 8.58 and 8.33 in the mean TQ global and THI scores, respectively. Tinnitus loudness also decreased significantly after delivering rTMS. Results: De- scriptive analysis of the TQs revealed that patients experi- enced significant improvements in emotional distress levels and somatic symptoms. Conclusions: Our preliminary re- sults demonstrate that theta-burst rTMS treatments offer a method of modulating tinnitus. Patients could benefit from emotional improvements, even more than auditory percep- tive relief. Further studies are needed to establish a standard protocol and to clarify nervous propagation along the audi- tory and psychological projection following treatment with rTMS. Copyright © 2011 S. Karger AG, Basel Key Words Primary auditory cortex  Tinnitus  Repetitive transcranial magnetic stimulation  Electroencephalography  Theta-burst Abstract Objectives: Repetitive transcranial magnetic stimulation (rTMS), a noninvasive method for altering cortical excitabil- ity, is becoming a therapeutic strategy in auditory research institutions worldwide. Application of inhibiting rTMS on these overactive cortical regions can result in effective tin- nitus suppression. The aim of this study is to investigate the efficacy of theta-burst rTMS in patients with chronic tinni- tus. Study Design: Parallel randomized control study. Set- ting: Tertiary referral center. Patients: We enrolled 2 female and 20 male patients in this study. The evaluative tools in- cluded tinnitus frequency- and loudness-matching, tinnitus questionnaires (TQ), and the Tinnitus Handicap Inventory (THI). Methods: The orthogonal projection of the auditory cortex on the scalp was focalized. A figure-eight coil was Received: March 11, 2011 Accepted: June 13, 2011 Published online: August 25, 2011 Neurotology Audiology Chon-Haw Tsai Department of Neurology, China Medical University Hospital No. 2 Yu-Te Road Taichung City 404, Taiwan (ROC) Tel. +886 4 2205 2121, E-Mail hugo.chung  @  msa.hinet.net © 2011 S. Karger AG, Basel 1420–3030/12/0172–0112$38.00/0 Accessible online at: www.karger.com/aud