An international research team has shown that the debilitating impact of tinnitus can be effectively reduced in just weeks by a training course and sound therapy delivered via a smartphone app MindEar. The HEALTH PIONEER shares details
The team from Australian, New Zealand, French and Belgian universities reports these findings in Frontiers in Audiology and Otology, offering some hope for millions affected by tinnitus who have been told that there is nothing they can do about it; face long queues waiting for treatment, or can’t afford the costs of specialist support.
The researchers said that the initial trial worked with 30 sufferers, of whom almost two thirds experienced a ‘clinically significant improvement’. The team are now planning larger trials in the UK in collaboration with the University College London Hospital. The app is available for individuals to trial for themselves on a smartphone.
“About 1.5 million people in Australia, 4 million in the UK and 20 million in the USA have severe tinnitus,” says Dr Fabrice Bardy, an audiologist at Waipapa Taumata Rau, University of Auckland and lead author of the paper. Dr Bardy is also co-founder of MindEar, a company set up to commercialise the MindEar technology.
“One of the most common misconceptions about tinnitus is that there is nothing you can do about it; that you just have to live with it. This is simply not true. Professional help from those with expertise in tinnitus support can reduce the fear and anxiety attached to the sound patients experience,” he says.
“Cognitive behavioural therapy is known to help people with tinnitus, but it requires a trained psychologist. That’s expensive, and often difficult to access,” says Professor Suzanne Purdy, Professor of Psychology at Waipapa Taumata Rau, University of Auckland.
“MindEar uses a combination of cognitive behavioural therapy, mindfulness and relaxation exercises as well as sound therapy to help you train your brain’s reaction so that we can tune out tinnitus. The sound you perceive fades in the background and is much less bothersome,” she says.
“In our trial, two thirds of users of our chatbot saw improvement after 16 weeks. This was shortened to only 8 weeks when patients additionally had access to an online psychologist,” says Dr Bardy.
Why does it work?
Even before we are born, our brains learn to filter out sounds that we determine to be irrelevant, such as the surprisingly loud sound of blood rushing past our ears. As we grow, our brains further learn to filter out environmental noises such as a busy road, an air conditioner or sleeping partners.
Most alarms, such as those in smoke detectors, bypass this filter and trigger a sense of alert for people, even if they are asleep. This primes the fight-or-flight response, and is especially strong for sounds we associate with bad prior experiences.
Unlike an alarm, tinnitus occurs when a person hears a sound in the head or ears, when there is no external sound source or risk presented in the environment, and yet the mind responds with a similar alert response.
The sound is perceived as an unpleasant, irritating, or intrusive noise that can't be switched off. The brain focuses on it insistently, further training our mind to pay even more attention even though there is no risk. This offers the pathway for patients. By training and actively giving the tinnitus less attention, the easier it becomes to tunes out.
MindEar aims to help people to practice focus through a training program, equipping the mind and body to suppress stress hormones and responses and thus reducing the brain’s focus on tinnitus.
Although there is no known cure for tinnitus, there are management strategies and techniques that help many sufferers find relief. With the evidence of this trial, the MindEar team are optimistic that there is a more accessible, rapidly available and effective tool available for the many of those affected by tinnitus still awaiting support.
What is Tinnitus
It is not a disease in itself but is usually a symptom of another underlying health condition, such as damage to the auditory system or tensions occurring in the head and neck. Tinnitus is common, affecting up to one in four people. It is mostly experienced by older adults but can appear for children. For some, it goes away without intervention. For others, it can be debilitatingly lifechanging: affecting hearing, mood, concentration, sleep and in severe cases, causing anxiety or depression.
Types of related researches in offing
Evidence suggests that tinnitus is caused by changes in neural networks in the brain, so many research efforts are aimed at testing the benefit of magnetic or electrical stimulation of the brain.
Here are some examples of current research topics:
Electric stimulation: Cochlear implants have been shown to suppress tinnitus, in addition to restoring functional hearing in those with severe-to-profound hearing loss, but they are not suitable for the majority of tinnitus sufferers who have significant acoustic hearing. Researchers are using non-invasive electric stimulation on parts of the inner ear to suppress tinnitus while not damaging acoustic hearing.
Bimodal stimulation: Acoustic stimulation may be combined with other types of electric stimulation on the tongue, head or neck areas, or vagus nerve to provide long-term relief for tinnitus.
Deep brain stimulation (DBS): This procedure is normally used to treat people with certain types of movement disorders or neuropsychiatric conditions. Some people being treated with DBS found that the procedure unexpectedly reduced their tinnitus symptoms. Unlike rTMS, DBS is invasive and involves surgery to implant electrodes deep within the brain. While early results on the use of DBS for tinnitus have been encouraging, more research is needed to determine if the procedure is warranted for treating tinnitus alone.
Repetitive transcranial magnetic stimulation (RTMS): In this painless, noninvasive procedure, short magnetic pulses are delivered to the brain using a device called an electromagnetic coil. Preliminary trials of rTMS have yielded mixed results, so researchers are now studying the ideal coil placement and frequency of patient visits.
Medications: While there are currently no medications approved by the U.S. Food and Drug Administration for treating tinnitus, researchers are testing a number of options. Researchers have identified a drug that reduces tinnitus in mice, and they are working to develop second-generation versions that may one day prove effective in people.
Genetic risk factors: Tinnitus and hearing impairment affect many older people. Scientists are reviewing a large genetic database of people with tinnitus and age-related hearing loss to identify genetic risk factors for both conditions. Determining genetic associations with age-related hearing impairment and tinnitus may have a broad impact on risk prediction, prevention, screening, and treatment.
Personalized treatment: Tinnitus symptoms are diverse, with different people hearing different sounds in different patterns. The results of brain imaging studies in people with tinnitus also vary considerably from person to person. Using data gathered from study participants who are tracking their tinnitus using a smartphone app, along with br ain imaging data, scientists are working to characterize the many forms that the condition can take. They aim to describe distinct tinnitus profiles and to identify the most effective treatment approaches for each one.