Tag: tinnitus

Categories : NeurologyTags :

Study Tests a Simple, Personalised Approach to Tinnitus Treatment

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A recent study published in JAMA Network Open suggests that relief might be possible for debilitating cases of tinnitus by using a bi-sensory approach, combining mild but bothersome electrical stimulation with sound.

The study, by researchers at the University of Michigan’s Kresge Hearing Research Institute, was based on research into the processing of bi-sensory information, which could be used for personalised stimulation to treat tinnitus.

In a double-blind, randomised clinical trial, researchers recruited 99 individuals with somatic tinnitus, which 70% of tinnitus sufferers have. In this form, movements such as clenching the jaw, or applying pressure to the forehead, cause a noticeable change in pitch or loudness of experienced sounds.

Susan Shore, PhD, Professor Emerita in Michigan Medicine’s Department of Otolaryngology and U-M’s Departments of Physiology and Biomedical Engineering, led the research, in which candidates with bothersome, somatic tinnitus, as well as normal-to-moderate hearing loss, were eligible to participate.

“After enrolment, participants received a portable device developed and manufactured by in2being, LLC, for in-home use,” she said. “The devices were programmed to present each participant’s personal tinnitus spectrum, which was combined with electrical stimulation to form a bi-sensory stimulus, while maintaining participant and study team blinding.”

Study participants were randomly assigned to one of two groups. The active group received bi-sensory treatment first, while the control group received sound-only treatment first.

For the first six weeks, participants were instructed to use their devices for 30 minutes each day. The next six weeks gave participants a break from daily use, followed by six more weeks of the treatment not received in the beginning of the study.

Participants completed the Tinnitus Functional Index (TFI), and Tinnitus Handicap Inventory (THI) to measure the daily impact of tinnitus. Participants also had their tinnitus loudness assessed during this time.

The team found that when participants received the bi-sensory treatment, they consistently reported improved quality of life, lower handicap scores and significant reductions in tinnitus loudness. These effects were not seen in the control group.

Additionally, more than 60% of participants reported significantly reduced tinnitus symptoms after the six weeks of active – treatment, but not for the control. This matches earlier work from Shore’s team, which showed that the longer participants received active treatment, the greater the reduction in their tinnitus symptoms.

“This study paves the way for the use of personalised, bi-sensory stimulation as an effective treatment for tinnitus, providing hope for millions of tinnitus sufferers,” said Shore.

Source: Michigan Medicine – University of Michigan

Categories : Environmental EffectsTags :

Traffic Noise may Increase the Risk of Tinnitus

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There is a correlation between traffic noise and risk of developing tinnitus, researchers have found. They point to a vicious cycle involving stress reactions and sleep disturbance as a potential cause. Living near a busy road, it may increase stress levels and affect sleep – and during times of stress and poor sleep, people may be at a higher risk of developing tinnitus.

Published in Environmental Health Perspectives, a new study with data from 3.5 million Danes has revealed that the more traffic noise Danish residents are exposed to in their homes, the more they are at risk of developing tinnitus.

Tinnitus is most clearly manifested by annoying whistling tones in the ears, which are disturbing for many.

Risk increases with noise levels

It is the first time that researchers have found a link between residential traffic noise exposure and hearing-related outcomes.

“In our data, we have found more than 40 000 cases of tinnitus and can see that for every ten decibels more noise in people’s home, the risk of developing tinnitus increases by six percent,” says Manuella Lech Cantuaria, PhD, Assistant Professor at the Mærsk Mc-Kinney-Møller Institute.

She and her colleague Jesper Hvass Schmidt, Associate Professor at the Department of Clinical Research and Chief Physician at Odense University Hospital (OUH) are concerned about the many health problems that traffic noise seems to cause. In 2021, they found a correlation between traffic noise and dementia.

“There is a need for more focus on the importance of traffic noise for health. It is alarming that noise seems to increase the risk of tinnitus, cardiovascular diseases and dementia, among other diseases,” says Jesper Hvass Schmidt.

Tip of the iceberg

Only the worst cases of tinnitus are referred from their own doctor or an otorhinolaryngologist. The high number of reported cases of tinnitus are probably only the tip of the iceberg, he believes.

“In general, about ten percent of the population experience tinnitus from time to time. It is associated with stress and poor sleep, which can be worsened by traffic noise, and here we have a potential cycle.”

More studies are needed so that researchers can be sure that traffic noise causes tinnitus, and how this happens.

“But we know that traffic noise can make us stressed and affect our sleep. And that tinnitus can get worse when we live under stressful situations and we do not sleep well,” Jesper Hvass Schmidt says.

Nighttime noise is worse

The researchers believe that noise at nighttime can be even worse for health. It affects our sleep, which is so important for restoring both our physical and mental health. “Therefore, it is worth considering whether you can do something to improve your sleep if you live next to a busy road,” Manuella Lech Cantuaria says.

What to do

In the study, higher associations were found when noise was measured at the quiet side of their houses, that is, the side facing away from the road. This is where most people would place their bedroom whenever possible, therefore researchers believe this is a better indicator of noise during sleep.

“There are different things one can do to reduce noise in their homes, for example by sleeping in a room that does not face the road or by installing soundproof windows,” says Manuella Lech Cantuaria.

But not everyone has those options, so she says that traffic noise should be considered a health risk to be taken into account in urban planning and political decision-making.

Electric cars will not make cities quieter

The Danish guidance level for harmful traffic noise is 58 decibels. It is a myth that replacing fuel cars by electric cars can significantly reduce traffic noise exposure at people’s houses. The noise comes mainly from the contact between the tires and the road.

Source: University of Southern Denmark Faculty of Health Sciences

Categories : Diseases, Syndromes and ConditionsTags :

A Breakthrough Tinnitus Therapy – on a Smartphone

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After 20 years searching for a cure for tinnitus, for which there is no pharmacological treatment, there are ‘encouraging results’ from a clinical trial of a smartphone app therapy, the results of which have been published in Frontiers in Neurology.

The study randomised 61 patients to one of two treatments, the prototype of the new ‘digital polytherapeutic’ or a popular self-help app producing white noise. On average, the group with the polytherapeutic (31 people) showed clinically significant improvements at 12 weeks, while the other group (30 people) did not.

“This is more significant than some of our earlier work and is likely to have a direct impact on future treatment of tinnitus,” said Associate Professor in Audiology at the Universirt of Auckland, Dr Grant Searchfield.

Key to the new treatment is an initial assessment by an audiologist who develops the personalised treatment plan, combining a range of digital tools, based on the individual’s experience of tinnitus.

“Earlier trials have found white noise, goal-based counselling, goal-oriented games and other technology-based therapies are effective for some people some of the time,” says Dr Searchfield.

“This is quicker and more effective, taking 12 weeks rather than 12 months for more individuals to gain some control.”

“What this therapy does is essentially rewire the brain in a way that de-emphasises the sound of the tinnitus to a background noise that has no meaning or relevance to the listener,” Dr Searchfield says.

Audiology research fellow Dr Phil Sanders says the results are exciting and he found running the trial personally rewarding.

“Sixty-five percent of participants reported an improvement. For some people, it was life-changing – where tinnitus was taking over their lives and attention.”

Some people didn’t notice an improvement and their feedback will inform further personalisation, Dr Sanders noted.

Tinnitus is a phantom noise and its causes are complex. It has so far defied successful treatment.

While most people experience tinnitus, or ringing in the ears at least on occasions, around five percent experience it to a distressing degree. Impacts can include trouble sleeping, difficulty carrying out daily tasks and depression.

Dr Searchfield says seeing his patients’ distress and having no effective treatment to offer inspired his research. “I wanted to make a difference.”

The next step will be to refine the prototype and proceed to larger local and international trials with a view to FDA approval.

The researchers hope the app will be clinically available in around six months.

Source: University of Auckland

Categories : UncategorizedTags :

Tinnitus reduced by electric stimulation of Tongue

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Science reports that a serendipitous discovery by Hubert Lim, a biomedical engineer at the University of Minnesota has led to a new treatment of tinnitus: using electrical shocks in other parts of the body.

It’s “really important” work, says Christopher Cederroth, a neurobiologist at the University of Nottingham, University Park, who was not involved with the study. The finding, he says, joins other research that has shown “bimodal” stimulation—which uses sound alongside some kind of gentle electrical shock—can help the brain discipline misbehaving neurons.

The experiment involved 326 people with tinnitus receiving electrical shocks to their tongue whilst listening to background noise on headphones.

Over the 12 weeks of treatment, the patients’ tinnitus symptoms improved dramatically. More than 80% of those who complied with the prescribed regimen saw an improvement. And they saw an average drop of about 14 points on a tinnitus severity score of one to 100, the researchers report today in Science Translational Medicine. When the team followed up after 12 months, 80% of the participants still had lower tinnitus scores, with average drops of 12.7 and 14.5 points.

The results are “quite impressive,” Cederroth says. The reduction in symptoms is larger than other studies have found for bimodal stimulation, he says, and it’s the first evidence of such long-term effects. A 2018 paper that stimulated the skin on the neck and cheek over a shorter time improved patients’ tinnitus, but there was a smaller dip in severity scores, he notes, of only about seven points. And cognitive behavioral therapy, a kind of talk therapy that is currently the only clinically validated tinnitus therapy, improves severity scores by about 10 points on average.

Still, University of Oxford neuroscientist Victoria Bajo notes there was no control group in the trial. Without that, she says, it’s impossible to know how much patients would have improved on their own or with a placebo. The work is good, she says, “but this is the beginning.”