Pre-treatment structural brain biomarkers predict response to repetitive transcranial magnetic stimulation in subjective tinnitus

Variable efficacy of repetitive transcranial magnetic stimulation (rTMS) for tinnitus necessitates predictive biomarkers. Pre-treatment brain structural features may predict rTMS outcomes, given that tinnitus involves structural brain alterations and rTMS can induce neuroplastic changes. OBJECTIVE: To identify pre-treatment brain structural biomarkers predictive of rTMS efficacy in subjective tinnitus.

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Pre-treatment structural brain imaging biomarkers show promise for predicting rTMS response in tinnitus, but this is a preliminary finding — clinicians should not use these biomarkers to guide rTMS patient selection until prospective validation in larger, independent cohorts is available.

✦ Why It Matters ✦

Identifying reliable predictors of rTMS response could transform tinnitus treatment by enabling personalized selection of candidates, reducing ineffective interventions and their costs.

✦ Key Points ✦

01Structural brain MRI biomarkers measured before rTMS treatment can predict tinnitus treatment response.
02Study is the first to link pre-treatment brain structure to rTMS outcomes in subjective tinnitus.
03Published in Frontiers in Neurology; design and sample size details are not fully disclosed.
04Could enable patient stratification before offering rTMS for tinnitus.
05Requires external validation before clinical adoption.

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Pre-treatment structural brain biomarkers can predict response to rTMS in patients with subjective tinnitus.

studypartially supported

✦ Research metadata ✦

PMID: 42422200
DOI: 10.3389/fneur.2026.1808769.
Journal: Frontiers in Neurology
Publication type: research_article
Evidence level: 4
Population: Patients with subjective tinnitus undergoing rTMS treatment
Intervention: Repetitive transcranial magnetic stimulation (rTMS) for subjective tinnitus

Primary outcomes

Prediction of rTMS treatment response using pre-treatment structural brain biomarkers; Identification of structural MRI features associated with tinnitus treatment outcomes

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