New hope for people with tinnitus

JAMA | April 2018 | Experimental Device Could Offer Hope for Millions With Tinnitus

A research team at the University of Michigan has developed a novel, noninvasive treatment to address tinnitus. While a trial was initially conducted on guinea pigs the scientists have now studied human subjects. They recruited 20 adults with mild to moderate somatic tinnitus—the type that patients can temporarily modulate by clenching their jaws or pushing pressure points on their face or forehead. Those maneuvers indicate that somatosensory stimuli play a role in their tinnitus because patients can increase or decrease their symptoms. About two-thirds of people with the condition have somatic tinnitus.

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The trial uses both sound and electrical stimulation to alter the brain’s circuitry and slow the firing rates of hyperactive, synchronized neurons, which suppresses the phantom ringing or buzzing of tinnitus.

The team developed  a device that participants could use at home to receive sound stimulation through earphones and mild electrical stimulation via electrodes positioned on their neck or face. They wore these for half an hour each day, six of the participants  used a bimodal protocol and the other half used a unimodal protocol. After treatment for 4 weeks followed by a month-long washout period, the participants were moved to the other treatment for a further month.
The trial was double-blinded. Weekly monitoring assessed tinnitus volume and tinnitus-related quality of life.

The device uses both sound and electrical stimulation to alter the brain’s circuitry and slow the firing rates of hyperactive, synchronized neurons, which suppresses the phantom ringing or buzzing of tinnitus.

Susan Shore, a professor of otolaryngology in the university’s Kresge Hearing Research Institute, and lead researcher in the study said, “In both groups the sound alone didn’t work,” Shore said. “But the combined bimodal stimulation showed a significant improvement in their tinnitus or reduction of their tinnitus loudness and a reduction of the impact of their tinnitus in their lives.” (JAMA)

The clinical trial is anticipated to begin in August.

The abstract is available from JAMA here

The full article can be read by NHS Athens users who have registered for a personal

JAMA account here 

Full reference:

Voelker, R., | 2018 | Experimental Device Could Offer Hope for Millions With Tinnitus | JAMA | 319 | Vol. 13 | P. 1309- 1310 | Doi:  doi:10.1001/jama.2018.1047

 

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Majority of UK parents are unaware children can have tinnitus

A survey by the British Tinnitus Association (BTA)  found just under a third of UK parents (32%) think children under the age of 10 can have tinnitus; and just 37% think it can affect children aged 10 to 16

Research commissioned by the BTA has revealed the worrying statistic, which the charity says reinforces the misconception that the hearing condition only affects older people.

The research also revealed many parents are unaware of the common signs of the hearing condition in children, such as anxiety or difficulty concentrating.
To help tackle the problem, the charity has created guidance for both parents and teachers:

  • Tinnitus: A Parents Guide:
    Includes the signs and symptoms to look out for, as well as advice on the best places to get help and support if parents suspect their child has tinnitus
  • Tinnitus: A Teachers Guide:
    Provides practical steps for use in the classroom.

Full BTA Press release here

Relationship between dietary quality, tinnitus and hearing level

The aim of this study was to examine the relationship between the healthy eating index (HEI), a measure of dietary quality based on United States Department of Agriculture recommendations and report of tinnitus | International Journal of Audiology 

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Results: Of the sample, 21.1% reported tinnitus within the past year and 11.7% reported persistent tinnitus, defined as tinnitus experienced at least monthly or greater. Controlling for age, sex, race/ethnicity, diabetes, noise exposure and smoking status, we found that with healthier diet (poorer vs. better HEI) there was decreased odds of reported persistent tinnitus [odds ratio (OR); 0.67; 95% confidence interval (CI) 0.45–0.98; p = 0.03].

Conclusions: The current findings support a possible relationship between healthier diet quality and reported persistent tinnitus.

Full reference: Spankovich, C. et al. (2017) Relationship between dietary quality, tinnitus and hearing level: data from the national health and nutrition examination survey, 1999–2002. International Journal of Audiology. Vol. 56 (Issue 10) pp. 716-722

A smartphone “App” for tinnitus management

This study’s objective was to develop and test a smartphone app that supports learning and using coping skills for managing tinnitus | International Journal of Audiology 

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Design: The app’s content was based on coping skills that are taught as a part of progressive tinnitus management (PTM). The study involved three phases: (1) develop a prototype app and conduct usability testing; (2) conduct two focus groups to obtain initial feedback from individuals representing potential users; and (3) conduct a field study to evaluate the app, with three successive groups of participants.

Results: In both the focus groups and field studies, participants responded favourably to the content. Certain features, however, were deemed too complex.

Conclusion: Completion of this project resulted in the development and testing of the delivery of PTM coping skills via a smartphone app. This new approach has the potential to improve access to coping skills for those with bothersome tinnitus.

Full reference: Henry, J.A. et al. (2017) Development and field testing of a smartphone “App” for tinnitus management. International Journal of Audiology.
Vol. 56 (Issue 10) pp. 784-792

Interaction of tinnitus suppression and hearing ability after cochlear implantation

To study the postoperative impact of cochlear implants (CIs) on tinnitus, as well as the impact of tinnitus on speech recognition with CI switched on | Acta Oto-Laryngologica 

Methods: Fifty-two postlingual deafened CI recipients (21 males and 31 females) were assessed using an established Tinnitus Characteristics Questionnaire and Tinnitus Handicap Inventory (THI) before and after cochlear implantation. The tinnitus loudness was investigated when CI was switched on and off in CI recipients with persistent tinnitus. The relation between tinnitus loudness and recipients’ satisfaction of cochlear implantation was analyzed by the visual analogue scale (VAS) score.

Results: With CI ‘OFF’, 42 CI recipients experienced tinnitus postimplant ipsilaterally and 44 contralaterally. Tinnitus was totally suppressed ipsilateral to the CI with CI ‘ON’ in 42.9%, partially suppressed in 42.9%, unchanged in 11.9% and aggravated in 2.4%. Tinnitus was totally suppressed contralaterally with CI ‘ON’ in 31.8% of CI recipients, partially suppressed in 47.7%, unchanged in 20.5%. Pearson correlation analysis showed that tinnitus loudness and the results of cochlear implant patients satisfaction was negatively correlated (r = .674, p < .001).

Conclusion: The study suggests six-month CI activation can be effective for suppressing tinnitus. The tinnitus loudness may affect patients’ satisfaction with the use of CI.

Full reference: Wang, Q. Interaction of tinnitus suppression and hearing ability after cochlear implantation. Acta Oto-Laryngologica Vol. 137 (Issue 10) pp. 1077-1082

Coping with tinnitus

Having a chronic impairment can be stressful and can trigger multiple psychological reactions related to loss of functioning, physical discomfort, and unwanted change | Journal of Rehabilitation Research & Development

This narrative article on coping with tinnitus has four primary objectives.

  • First, theoretical perspectives about defining and categorizing coping are discussed.
  • Second, an overview of the empirical research on coping with tinnitus is provided, focusing on how coping with tinnitus has been measured and on the trends that were found in research on coping with tinnitus.
  • Third, the problems related to the current state of research on coping with tinnitus are highlighted.
  • Fourth, suggestions are provided on ways that researchers can improve research on coping with tinnitus.

Full reference: Martz, E. & Henry, J.A. (2016) Coping with tinnitus. Journal of Rehabilitation Research & Development. Vol. 53 (no. 06) pp. 729 -742.

Tinnitus Management

Whereas hearing aids have long been considered effective for providing relief from tinnitus, controlled clinical studies evaluating this premise have been very limited |  Journal of the American Academy of Audiology

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Image source: jen collins – Flickr // CC BY-NC-ND 2.0

Purpose: The purpose of this study was to systematically determine the relative efficacy of conventional receiver-in-the-canal hearing aids (HA), the same hearing aids with a sound generator (HA+SG), and extended-wear, deep fit hearing aids (EWHA), to provide relief from tinnitus through a randomized controlled trial. Each of these ear-level devices was a product of Phonak, LLC.

Results: There were 18 participants in each of the HA and EWHA groups and 19 in the HA+SG group. Gender, age, and baseline TFI severity were balanced across treatment groups. Nearly all participants had a reduction in tinnitus symptoms during the study. The average TFI change (improvement) from baseline was 21 points in the HA group, 31 points in the EWHA group, and 33 points in the HA+SG group. A “clinically significant” improvement in reaction to tinnitus (at least 13-point reduction in TFI score) was seen by 67% of HA, 82% of EWHA, and 79% of HA+SG participants. There were no statistically significant differences in the extent to which the devices reduced TFI scores. Likewise, the hearing-specific questionnaires and QuickSIN showed improvements following use of the hearing aids but these improvements did not differ across device groups.

Conclusions: There is insufficient evidence to conclude that any of these devices offers greater relief from tinnitus than any other one tested. However, all devices appear to offer some improvement in the functional effects of tinnitus.

Full reference: Henry, J.A. et al. (2017) Tinnitus Management: Randomized Controlled Trial Comparing Extended-Wear Hearing Aids, Conventional Hearing Aids, and Combination Instruments. Journal of the American Academy of Audiology. Vol. 28 (no. 6) pp. 546-561