Transcranial magnetic stimulation: summary of the proceedings of the Twenty-Sixth Annual Meeting of the International Tinnitus Forum.

he theme of the Twenty-sixth Annual Meeting of the International Tinnitus Forum (ITF) that took place in Chicago, Illinois, on September 20, 2008, was “Translational Research in Tinnitus Therapy IV—Transcranial Magnetic Stimulation.” For the first time, principal investigators from three of the five major centers in several countries were able, in a roundtable format, to present and discuss among an audience of tinnitus professionals their involvement with transcranial magnetic stimulation (TMS) attempting tinnitus relief. Each speaker who presented at the meeting is a notable leader in the field of TMS and tinnitus, and each presented his individual experiences to date and speculated on his expectations for the future. The presentations, panel discussion, and questions and answers that comprised the meeting are summarized here. Claus F. Claussen, MD, PhD, affiliated with the University of Wurzburg and the Neurootologisches Forschungsinstitut der 4-G-Forschung e.V., Bad Kissingen, Germany, presented “Tinnitus-Related Changes in Equilibrium Dysregulations Such As Vestibular Recruitment and Decruitment.” Prof. dr. Claussen classified tinnitus into two types—endogenous (responding to tinnitus maskers) and exogenous (responding to hearing aids)— for tinnitus relief. He reminded the audience that Hippocrates considered tinnitus to be related to epilepsy and presented the interaction in the brain of auditory and vestibular inputs as a working “human space concept,” focusing on the clinical application of the results of vestibular testing for diagnosis and treatment of tinnitus. Professor Claussen described caloric vestibular testing with electronystagmography and simultaneous electrocardiography, recording the nystagmus in a “butterfly” format. Diagnostic differentiation is achieved between a