Transcranial magnetic stimulation

The main symptom of tinnitus is the perception of a whistling, buzzing, hissing or beating sound. This disorder can be debilitating, impacting daily activities by making it difficult to focus, talk and sleep.

Tinnitus can stem from a variety of known causes and others yet to be identified. It ranges from hearing loss in older individuals and prolonged exposure to loud noises to the sustained use of ototoxic drugs and neck pain resulting from incorrect posture. Factors like elevated blood pressure during pregnancy and heightened glutamate levels during significant stress also contribute to the development of tinnitus.

There are different types of tinnitus:

• Objective tinnitus affects a blood vessel near the ear and can be identified externally using a stethoscope. It is quite rare and often has a cardiovascular origin.  
• Subjective tinnitus is perceived by the patient, but its origin is impossible to identify. It can be caused by damage to the hair cells or errors in information exchange along the nervous system. Subjective tinnitus is more prevalent. 
• Acute tinnitus is a form of tinnitus that lasts no longer than three months. 
• Chronic tinnitus, whether objective or subjective, is continuous and lasts more than three months, with varying intensity.  
• Pulsatile tinnitus consists of the occasional perception of heartbeat sounds, and is categorised as objective tinnitus.

TMS operates on the principle of electromagnetic induction, aiming to either stimulate or inhibit the neuronal activity of specific brain areas with the goal of restoring normal neuronal functions. More specifically, the machine generates a magnetic impulse that reaches the cerebral cortex, activating a current that affects the activity of neurons.

There are different types of TMS treatments:

• Theta Burst Stimulation (TBS)
• Theta Burst Multi Session Treatment (SNT)
• Deep Transcranial Magnetic Stimulation (Deep TMS)
• Repetitive Transcranial Magnetic Stimulation (rTMS)

This is the most adaptive therapy and it is used to treat many disorders, including tinnitus. It uses stimulation characterised by short magnetic pulses repeated at programmable time intervals. With TMS it’s possible to intervene on very specific areas, making it an ideal asset for precision care.

Transcranial Magnetic Stimulation is the first long-lasting neurological therapy capable of acting directly on the mechanisms responsible for tinnitus. Many studies have shown that thanks to TMS it is possible to reduce the activity of the brain areas that are responsible for the noise caused by tinnitus. 

The different types of TMS can be used to treat several disorders. In 2008, TMS obtained approval for the treatment of Resistant Depression and, in 2018, for the treatment of Obsessive-Compulsive Disorder. TMS also represents an effective treatment option for pathological addictions and post-traumatic stress disorder (PTSD).

The average cost of a TMS session is about £ 100. The complete treatment varies depending on the type and extent of the disorder. For a therapy of 30 sessions the average cost is around £ 3000.

Treatment can be carried out at hospitals, diagnostic centres, nursing homes and neurology clinics.

During a TMS session, the doctor positions a coil on the patient's head. Using a stimulator, this coil generates a painless magnetic field that precisely targets specific brain structures. This magnetic influence acts on the electrical activity and plasticity of these structures, facilitating the alleviation of symptoms. Typically, a TMS session extends for 20 to 30 minutes, though the duration of individual treatments may vary based on the specific therapy. On average, a complete treatment cycle encompasses approximately 20 to 30 sessions.

The benefits of the therapy may not be immediate and the timing may depend on each person. If they occur towards the end of the first cycle, it may be useful to extend the treatment in order to avoid relapses. After a cycle, most patients report medium to long term benefits.

TMS is a completely safe procedure and doesn’t cause any notable side effects. Some patients may experience at most a mild focal headache, which can be treated with a common over-the-counter analgesic.

TMS is widely established as a safe procedure, with exceptions being noted for individuals with a history of epilepsy and those using pacemakers.