Alterations in brain single-photon emission computed tomography perfusion pattern pre- and post-transcranial magnetic stimulation in tinnitus participants

Background and Aim: It have been shown that changes in organization of high stimulation related to tinnitus in special areas in brain can be eliminated using protocols based on transcranial magnetic stimulation (TMS). The current study aims to assess the pattern of brain perfusion and effects of TMS on brain activity in tinnitus participants as measured by single-photon emission computed tomography (SPECT) as well as evaluate the efficacy of TMS on severity of tinnitus. Methods: This was a cross-sectional randomized clinical trial, which was performed in 15 patients that referred to tinnitus clinic of Rasoul Akram Hospital during March 2017 to April 2018. These participant were randomly divided into two groups of active treatment with TMS and placebo. In each studied group, the variables of the brain perfusion, tinnitus handicap index (THI), pitch-matching test, loudness match of tinnitus, minimum masking level, and residual inhibition were investigated for all included tinnitus participants before and after TMS. Results: In all tinnitus participants, we had increased uptake in temporal lobes (unilateral or bilateral). In active treatment group, SPECT variables in hotspots were significantly decreased in comparison with placebo group (P < 0.05). Visual analog scale of tinnitus was significantly decreased in active group rather than placebo group (P = 0.023). Conclusion: Our findings showed that tinnitus patients have abnormal brain perfusion increased uptake in temporal lobes that decreased with treatment with TMS and therefore this modality could be an appropriate therapeutic option for the improvement of tinnitus in these patients and efficacy of therapy could assessed by brain perfusion scan as well.