Treatment: Pharmacological, Repetitive Transcranial Magnetic Stimulation, Epidural Stimulation, and Deep Brain Stimulation

Abstract

Available treatments for the management of tinnitus are diverse. These include counseling and cognitive– behavioral therapies; different forms of sound therapies; methods that attempt to increase input to the auditory system, such as hearing aids and cochlear implants (for use in patients whose tinnitus is caused by deprivation of signals to the auditory nervous system); pharmacological treatment; neurobiofeedback; and various forms of electrical stimulation of brain structures, either through implanted electrodes or by inducing electrical current in the brain with transcranial magnetic stimulation. The existence of many different treatment approaches derives from the fact that there exist different subgroups of tinnitus that differ in their pathophysiology and their response to treatment. In clinical practice it is frequently difficult to choose the optimal treatment approach for an individual patient. The treatment approaches presented in this chapter (pharmacological, magnetic, or electrical brain stimulation) are all at early stages of development. The further development of these new treatment options will depend on the extent to which we understand the pathophysiology of the different forms of tinnitus.