Considerations on tinnitus retraining therapy and transcranial magnetic stimulation

Introduction. Tinnitus is a subjective perception of sound in the absence of an external acoustic stimulus. It has negative behavioral feelings associated, e.g., depression, insomnia, difficulty of concentration, anxiety, irritability, and panic. The feelings impact negatively on the social and economic life of individuals. Empirical data suggest that disorders in the auditory cortex and its neural pathways give rise to abnormal spontaneous activations associated with tinnitus. Understanding the causes remains challenging. However, the current hypothesis suggests that clusters of neural networks and subnetworks are involved in tinnitus generation. Central dynamic neuroplasticity induced by a peripheral loss of auditory input can cause tinnitus noise. To date, there is no widespread consensus about the most effective therapy for treating tinnitus. Objective. To reflect on two tinnitus therapies: Tinnitus Retraining Therapy (TRT) and Transcranial Magnetic Stimulation (TMS). Method. A narrative review. Explicit and systematic criteria were not adopted in searching for the theoretical framework. Results. TMS is promising compared to TRT because TMS acts on tinnitus neural mechanisms. TRT is effective on a behavioral level since it relieves mild and moderate tinnitus' negative feelings. Conclusion. TRT does not advance on the neural source, but only on the tinnitus perception. TMS acts directly on the neural causes. Both therapies have limitations and can work for some patients. However, the effect of TMS seems more efficient, although transient.