Evidence map›Paper›PMID 42625017›Full record

ReviewEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Efficacy of non-invasive neuromodulation for chronic tinnitus: a systematic review and meta-analysis of randomized controlled trials.

Mohamed Mohamed Elmoursy, Waleed Mohammed Nemr Mohamed

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In one paragraph

Review in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

Mohamed Mohamed ElmoursyAudiovestibular Medicine unit, ENT Department, Al-Azhar University, Assuit, Egypt. mohamedkasem105.el@azhar.edu.eg.ORCID http://orcid.org/0000-0003-0883-3018
Waleed Mohammed Nemr MohamedAudiovestibular Medicine unit, ENT Department, Al-Azhar University, Assuit, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic tinnitus affects approximately 14% of adults worldwide, with nearly 2% experiencing severe, persistent symptoms that impair daily functioning. Non-invasive neuromodulation techniques, such as repetitive transcranial magnetic stimulation (rTMS), transcranial direct current stimulation (tDCS), and acoustic or nerve stimulation, have emerged as potential therapies, yet their clinical effectiveness remains uncertain. This systematic review and meta-analysis synthesized evidence from randomized controlled trials (RCTs) evaluating the efficacy of neuromodulation for chronic tinnitus.

methodsPubMed, Scopus, and Web of Science were searched through September, 2025. Eligible studies were RCTs assessing non-invasive neuromodulation versus sham in adults with chronic tinnitus. The primary outcome was change in Tinnitus Handicap Inventory (THI) scores. Secondary outcomes included the Tinnitus Functional Index (TFI), Tinnitus Questionnaire (TQ), loudness measures, and anxiety and depression scales.

resultsA total of 32 trials comprising 1,561 participants were included. Neuromodulation significantly improved tinnitus severity at short-term, with a pooled THI reduction of - 6.96 points (95% CI - 10.67 to - 3.26). rTMS showed a significant benefit (MD - 4.35, 95% confidence interval [CI] - 7.36 to - 1.33), as did acoustic/nerve stimulation (MD - 8.70, 95% CI - 15.81 to - 1.60), whereas tDCS demonstrated a nonsignificant effect (MD - 9.14, p = 0.10). Benefits were most pronounced immediately post-treatment and at 1-3 months, with effects diminishing by 6 months (MD - 3.93, p = 0.06). Secondary outcomes showed no significant improvements in TFI, TQ, objective loudness, or mood scales. Subjective loudness on visual analogue scale (VAS) showed a small borderline improvement (standardized mean difference [SMD] - 0.38, 95% CI - 0.75 to 0.00).

conclusionNon-invasive neuromodulation provides modest, clinically meaningful short-term reduction in tinnitus severity, particularly with rTMS at dorsolateral prefrontal cortex area and acoustic/nerve stimulation. However, effects are inconsistent across modalities and decrease over time. Future studies should prioritize standardized protocols, optimized stimulation parameters, and personalized targeting to enhance therapeutic efficacy.

Indexed as

NeuromodulationTinnitusTinnitus Handicap Inventory (THI)Transcranial direct current stimulationTranscranial magnetic stimulation

Identifiers

PMID42625017

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.