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DrNagler
 #1 
Hi All -

I have not kept up to date at all with the literature on Transcranial Magnetic Stimulation (TMS) - so when I learned that three speakers would discussing their work in this particular area at this year's International Tinnitus Forum meeting, I decided to attend.  The speakers were Tobias Kleinjung, M.D. of the University of Regensburg in Germany, John Dornhoffer, M.D. of the University of Arkansas in Little Rock, and Dirk De Ridder, M.D. the Chief of Neurosurgery at the University of Antwerp in Belgium.

Let me try to give you a brief overview.  First of all I was very impressed with the intelligence and dedication of these fine gentlemen.  In fact, I found it very reassuring to see that more and more young highly motivated physician/researchers are getting involved in tinnitus.  That said, I was disappointed with the state of things specifically in terms of TMS.  For some reason I thought that the clinical results were more impressive than they actually are.  It seems that there is roughly a 40-50% response rate in terms of tinnitus loudness when measured on a visual analog scale and also in terms of a tinnitus severity questionnaire, but even the researchers felt that the blinding needed work.  Plus, for some reason nobody is looking at pre and post treatment tinnitus loudness matching.  And finally, whatever improvement there is is very short-lived.  The treatment effect can be prolonged somewhat using rTMS (Repetitive Transcranial Magnetic Stimulation), but it isn't the type of thing that's going to set the world on fire.  Moreover, it seems that the longer the history of tinnitus, the poorer the response.  Hearing loss also adversely affects outcome.  One point that I felt was of interest was the fact that preliminary QEEG (quantitative electroencephalography) and fMRI (functional magnetic resonance imaging) work in this area has pretty much locked down the fact that tinnitus intensity is related to gamma activity in the auditory cortex opposite the tinnitus ear, while tinnitus distress is related to beta activity in the right amygdala, right anterior cingulate gyrus and right anterior insula regardless of the location of the tinnitus.  In my opinion the real significance of this finding is that it scientifically confirms what many have felt all along - that tinnitus loudness and tinnitus distress are largely unrelated, as they involve different neural networks.

Judging from what I learned at the meeting, in my opinion TMS is at this point still largely a research tool.  I think it doubtful that it will ever find its way into the clinical armamentarium without substantial improvement.

smn
CPW151
 #2 
Since this post is not pinned does this mean that this board is up and running again?!!  Hope so.  It's been a long time or seems like that. 

Wish there was better news from the conference but I did not expect for you to come back and say, "there's a cure on the horizon."  Thanks for sharing the info with us. 

CPW
CPW151
 #3 
And I just saw the top of the page that says, "We're Open Again" and I have the distinct pleasure to make the first post! 

Welcome back every one!  Let's get this started up again.  Sure missed everyone.

CPW
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