Study shows promising treatment for tinnitus

Tinnitus, the ringing, buzzing or hissing sound of silence, varies from slightly annoying in some to utterly debilitating in others. Up to 15% of adults in the United States have tinnitus, where nearly 40% of sufferers have the condition chronically and actively seek relief.

A recent study from researchers at the University of Michigan's Kresge Hearing Research Institute suggests relief may be possible.

Susan Shore, Ph.D., Professor Emerita in Michigan Medicine's Department of Otolaryngology and U-M's Departments of Physiology and Biomedical Engineering, led research on how the brain processes bi-sensory information, and how these processes can be harnessed for personalized stimulation to treat tinnitus.

Her team's findings were published in JAMA Network Open.

The study, a double-blind, randomized clinical trial, recruited 99 individuals with somatic tinnitus, a form of the condition in which movements such as clenching the jaw, or applying pressure to the forehead, result in a noticeable change in pitch or loudness of experienced sounds. Nearly 70% of tinnitus sufferers have the somatic form.

According to Shore, candidates with bothersome, somatic tinnitus, as well as normal-to-moderate hearing loss, were eligible to participate.

"After enrollment, 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 first group received bi-sensory, or active, treatment first, while the second received sound-alone, or control, treatment.

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.

Shore notes that every week, participants completed the Tinnitus Functional Index, or TFI, and Tinnitus Handicap Inventory, or THI, which are questionnaires that measure the impact tinnitus has on individuals' lives. 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. However, these effects were not seen when receiving sound-only stimulation.

Further, more than 60% of participants reported significantly reduced tinnitus symptoms after the six weeks of active treatment, but not control treatment. This is consistent with an earlier study by 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 personalized, bi-sensory stimulation as an effective treatment for tinnitus, providing hope for millions of tinnitus sufferers," said Shore.

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Breakthrough in search for tinnitus cure

After 20 years searching for a cure for tinnitus, researchers at the University of Auckland are excited by 'encouraging results' from a clinical trial of a mobile-phone-based therapy. 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. The results have just been published in Frontiers in Neurology. "This is more significant than some of our earlier work and is likely to have a direct impact on future treatment of tinnitus," Associate Professor in Audiology Grant Searchfield says.

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."

There is no pill that can cure tinnitus. "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 says.

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."

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