Chronic tinnitus is linked to abnormal, over-active neural firing in the auditory cortex, which makes it a logical target for TMS. The research, however, is genuinely mixed: some studies show benefit, while the largest trials have been disappointing.
The rationale
The idea is that low-frequency, inhibitory stimulation over the temporal or auditory cortex may dampen the maladaptive hyperactivity thought to generate the phantom sound.
What the trials show
A meta-analysis of randomised controlled trials found a significant benefit for active TMS over sham, with success more likely a month after treatment. However, one of the largest sham-controlled multicentre trials found that low-frequency stimulation over the left auditory cortex was not an effective protocol, a key negative result that tempers enthusiasm.
Where it stands
Consensus guidelines assign left-temporal low-frequency TMS only a possible-efficacy rating, and the durability of any benefit beyond a few weeks to months is poorly established. Target selection appears to matter, and multi-site protocols are being studied.
TMS for tinnitus is biologically plausible and helps some patients in trials, but the evidence is inconsistent, the largest studies are negative, and durability is unproven. It should be seen as investigational, not a reliable cure.
References
- Soleimani R, et al. (2016). Therapeutic impact of rTMS on tinnitus: a systematic review and meta-analysis. European Archives of Oto-Rhino-Laryngology.
This article is for general information and is not medical advice. TMS suitability is decided by a psychiatrist on an individual basis. Speak to our team about your own situation.