Differential mechanisms of continuous theta burst stimulation and low-frequency repetitive transcranial magnetic stimulation for chronic tinnitus: preliminary efficacy dissociation by local focalization vs. network dispersion

This study aimed to preliminarily compare clinical efficacy and neural mechanisms of continuous theta-burst stimulation (cTBS) and low-frequency repetitive transcranial magnetic stimulation (rTMS) targeting the auditory cortex in chronic subjective tinnitus. Differential effects on tinnitus loudness and distress, as well as the moderating role of disease duration, were explored.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

This is a preliminary efficacy study; findings are too early to justify changing clinical protocols for tinnitus management — no actionable change at this stage.

✦ Why It Matters ✦

Understanding whether cTBS and low-frequency rTMS work via distinct neural mechanisms could eventually guide more personalized, targeted brain-stimulation protocols for chronic tinnitus sufferers.

✦ Key Points ✦

01Preliminary study comparing cTBS vs. low-frequency rTMS for chronic tinnitus treatment.
02cTBS may work via local brain focalization; low-frequency rTMS may act through broader network dispersion.
03Study explicitly described as preliminary — effect sizes and patient numbers should be interpreted cautiously.
04Both modalities showed some clinical efficacy signals, but direct comparison requires larger controlled trials.
05Published in Frontiers in Neurology (doi: 10.3389/fneur.2026.1921227).

✦ Claims & Evidence ✦

ClaimEvidenceSupport

cTBS and low-frequency rTMS produce differential efficacy outcomes for chronic tinnitus through distinct neural mechanisms.

studypartially supported

cTBS acts via local brain focalization while low-frequency rTMS acts via network dispersion.

studyunclear

✦ Research metadata ✦

PMID: 42876536
DOI: 10.3389/fneur.2026.1921227.
Journal: Frontiers in Neurology
Publication type: research_article
Evidence level: 4
Population: Adults with chronic tinnitus
Intervention: Continuous theta-burst stimulation (cTBS)
Comparator: Low-frequency repetitive transcranial magnetic stimulation (rTMS)

Primary outcomes

Clinical efficacy of cTBS vs. low-frequency rTMS for chronic tinnitus; Neural mechanism differentiation (local focalization vs. network dispersion)

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