• Douglas Labar, Amy S Labar, and Dylan Edwards.
• Non-invasive Brain Stimulation Laboratory, Burke Medical Research Institute, White Plains, NY, USA.
• Neuromodulation. 2016 Apr 1; 19 (3): 249-53.

ObjectivesTo assess feasibility and tolerability of long-term distributed therapeutic rTMS for refractory tinnitus, distributed over seven months.Materials And MethodsEight subjects with refractory tinnitus underwent five weekly sessions of 1800 pulses of 1 Hz rTMS targeted toward the temporoparietal junction. Five weeks later (study week 10), subjects meeting predefined responder criteria entered a monthly rTMS treatment phase, for the next five months. Outcome measures were subject satisfaction and compliance, tinnitus severity daily diaries, standardized tinnitus self-rating scales, and adverse events.ResultsSubject satisfaction was high, and compliance was virtually 100%. The tinnitus handicap inventory and mini-tinnitus questionnaire scores improved significantly at study week 5 compared with baseline. There were four responders at study week 5; three responders at study week 10; and one responder at study week 30. There were no serious adverse events.ConclusionsOur study demonstrated that rTMS can be delivered in a distributed schedule that is well-tolerated, feasible and may prove to be clinically beneficial. A long-term distributed rTMS schedule for tinnitus may warrant investigation as an alternative to the short-term aggregated treatment schedules more frequently used previously. For the many varied therapeutic uses of rTMS (established and investigational), treatment schedules are relatively unexplored, and deserve further attention.© 2016 International Neuromodulation Society.

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