Wanna get your brain zapped?


Tinnitus is one of the most common neurologic conditions, affecting 15% (45 million) of the U.S. population, according to the CDC. Commonly described as ringing in the ears, tinnitus can be any phantom sound, including roaring, hissing, or clicking.

Current treatments, including medications, hearing aids, sound therapy, behavioral therapy, and lifestyle modifications, have limited and inconsistent efficacy. As a result, 67% of those suffering from tinnitus report symptom duration of greater than a year, 26% have constant or near constant tinnitus, and 30% describe their condition as a “moderate” to “very big” problem in their lives…

The study looked at repetitive transcranial magnetic stimulation (TMS) therapy for those suffering from chronic tinnitus. TMS works by inducing an electrical current within the brain corresponding to the rate of change in magnetic field produced by the magnetic coils within the TMS device.

Did you get that? Or do you have to be a physicist to understand what they’re talking about?

An increasing number of neurologic and psychiatric conditions are being studied for treatment response to TMS, and TMS is FDA-approved for the treatment of both migraine and depression. There are more than 10,000 studies looking at TMS as a treatment modality, and in 2014 they were being published at a rate of 24 papers per week.

Over the past few years, otolaryngology has jumped on the TMS bandwagon and numerous researchers have sought to determine whether repetitive TMS (rTMS) could be a viable treatment for tinnitus. Results have been rather mixed…

One of the biggest problems is measurement. Tinnitus is most commonly a subjective condition, making it very hard to compare severity between patients or measure change in severity within a patient. A number of tools have been developed to standardize assessment, measure disability, and evaluate treatment outcomes including the Tinnitus Handicap Inventory, Tinnitus Questionnaire, Tinnitus Severity Index, and Tinnitus Functional Index (TFI), among many others.

One problem of studies thus far has been the choice of test – some have chosen only one of these assessment tools, others have not used a test at all, relying on visual analogue scales or numeric rating scales to measure tinnitus severity…

The greatest reduction in TFI was at the 26-week point. The active rTMS group experienced a 30.8% reduction in TFI at 26 weeks compared with only a 7.1% reduction in TFI for the placebo group. However, other measurement tools did not demonstrate a significant change, suggesting that TFI may be a more reliable tool to assess treatment response than other modalities.

The jury is still out on rTMS as a treatment for chronic tinnitus, and larger sample sizes studied at multiple centers for longer periods of time will help sort out whether this option is really viable…


First, a layperson’s explanation of each therapy might help. TMS uses magnetic coils to create electrical currents that stimulate the brain. A TMS patient will usually have 20-30 treatments. In the first treatment, the patient has a slightly longer session (1.5 hours approximately) followed by 5 days a week for 45 minutes per session. Dr. Oz did an episode on TMS…

On a sheer treatment basis, TMS is clearly less expensive than ECT. These prices vary by provider, but TMS is typically in the range of $400-500 per session for a total cost of about $15,000. ECT around $2,500 per session, $25,000 for ten sessions, plus the cost of one week hospital stay in some cases…

The most common side effects of TMS are scalp irritation or headaches, but these usually subside within the first week. With ECT, headaches and muscle aches often occur. Some complain of cognition issues up to one month after the last treatment. Typically short-term memory is impacted during this month period, but most patients feel functioning is back to normal within six weeks. Some patients complain of long-term loss of some autobiographical information, but these are in the minority. In my travels talking about my book, I have found people who claim their memory has improved with ECT…

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