Prof. Dirk De Ridder is one of the most cited tinnitus researchers, a very eloquent speaker, and a passionate advocate for people with tinnitus. He also runs his own brain research centre and clinic Brai3n.

We spoke with Dirk about how the brain can create phantom perceptions like pain and tinnitus, and the different schools of thought in this area. He also highlights the role of epigenetics and explains how tinnitus can become intertwined with our sense of self, and how effective treatment should attempt to break that connection.

In terms of clinical work, he describes how he works with patients and what he can offer them. Although he does not see Lenire and similar devices as the solution, he does see promising developments in psychedelics-based treatments and suppressing chronic neuroinflammation.

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Skip to: 00:00 Introducing Dirk De Ridder.

My main interest is the interaction between how the brain creates phantom sounds and phantom pain as a way to resolve inherent uncertainty in a changing environment.

Skip to: 06:41 Different theories of tinnitus originates.

Skip to: 31:12 The role of epigenetics in causing tinnitus.

The environment changes the way how your genes are expressed and that’s why not everybody with the same risk genes will develop tinnitus.

Skip to: 39:42 How to unify tinnitus research.

Skip to: 45:02 How tinnitus is related to self-perception.

Skip to: 52:24 Dirk’s clinical work.

If you only have a hammer, everything looks like a nail, and then everybody gets the same treatment and it doesn’t work for everybody.

Skip to: 66:06 Why silence should be the ultimate goal.

Skip to: 69:13 The pros and cons of medication to treat tinnitus.

Skip to: 75:26 Transcranial Magnetic Stimulation and Neuromodulation.

Bimodal neuromodulation treatments only treat the distress, even though the claims will be different…

Skip to: 84:31 Will hearing regeneration help tinnitus?

Skip to: 88:35 Other potentially promising treatments – neuroinflammation.

Discuss on Tinnitus Talk Forum

Or share your thoughts on the episode below!

Comments (43)
  1. Once again you guys have proven your talent and insight! It’s incredible you are able to create these LONG interviews that I have no trouble focusing on.

    After this I think I might need to book an appointment with the Professor, seems like he knows his stuff!

    Thanks for giving me hope (and I think tinnitus is a brain thing!)

  2. Extremely interesting interview from start to finish. Hazel is also a great interviewer. Unfortunately nothing in the near term pipeline that looks promising for reducing the sound of tinnitus. Thanks for doing the interview and posting it here.

  3. Up all night from distressing constant loud tinnitus for 5+ years. Thanks for the interview and information. I try to hold out for hope, as that is all anyone can do. Tinnitus is a destroyer of the mind.

    • Hi Patri

      Same here, had it chronic for 5+ years, is always there, however it modulates from mild to severe usually throughout the course of the day. Lying down makes it worse. Anyway it began at 64 years, am just about 70 years. Am retired Dr. of Naturopathy and Holistic Medicine. Have tried many approaches, mainly based upon related to the HP.Axis biochemistry. Am somewhat now convinced most of my tinnitus is due to neural inflammation factors. In this vein am getting some good relief of late, but of course not a cure.

    • Thanks, Martin! It’s really encouraging to get positive feedback. We’re just a bunch of people suffering from tinnitus, doing this in our spare time next to our day jobs, so we can use the encouragement 🙂

  4. Hello, what specific medication does Dr. De Ridder prescribe for tinnitus sufferers?
    I’ve had tinnitus for ten years now and it’s killing me slowly.

    Thank you!

    Best wishes,

    • Hi, same here. Loved the interview, but this is driving me crazy. First it was only in one ear… now in both. It’s spreading to my head and I feel like locking myself up because sometimes I cannot hear. It’s painful sometimes and nobody really understand and say it’s my imagination. I just want to be heard so that my doctor and family hear me and believe. I have chronic pain from my neck up to my head daily. 😪

  5. All great! I hope you can circulate this around Australian GPs.

    Although at this stage there is no drug that completely cure this, there is a drug that can considerably reduce the intensity and a bit of the
    regularity. I found Betaserc does it.

  6. Thanks Hazel. Great interview. Interested in which antidepressants don’t increase your tinnitus. Can you advise? Pity there is no clinic in Australia to help us.

    • Hi Joe, I’m not really the right person to advise on this. I suspect it varies from person to person, and I’m afraid you would have to try and find out what works for you. Beware that some of these drugs can have all kinds of nasty side effects; so make sure you get good advice from a qualified clinician.

  7. Thank you so much for this fascinating interview! I have been suffering of tinnitus for more than a decade, although it only began to really bother me three or four years ago.

    I am a translator from English and French into Spanish. I would like to transcribe this interview to Spanish, so that I can send it to my association APAT (Asociación de Personas afectadas por el Tinnitus).

    Thank you again!
    All best!

    • Thanks for the positive feedback, Isabel! Feel free to translate the transcript.

      In case you were not aware, we always provide English transcriptions, which you can download by clicking the “CC” button to the right hand side of the audio player. So you could take this transcript and then translate it.

      Let us know if you end up publishing this; you can contact us at

  8. I’m on 1200 mg Gabapentin and 3 mg Clonazepam for tinnitus which helps to a certain degree. I have had tinnitus for 3 years and I find the management of stress is vital. Sleep is so important as well. CBT is something I am looking into with my GP. This is ongoing. I’ve been on Betahistine 16 mg x 3 times a day which is useless. But, medications affect everybody in different ways. Also, with tinnitus you must avoid smoking, alcohol, and loud music. Mindfulness may be another option. A walk a day is good, but no gym. Hope this helps.

  9. The exacerbation of stress spikes tinnitus so it’s imperative that stress is avoided. I have found when stressed that my tinnitus manifests itself to a louder extent.

    • That is exactly what happens.

      It is in the brain, so Valerian root herbs help and are safe, natural, and not addictive at all. Time released CBD gummies help. I take 42 different herbs each day which are also good for the heart and not being anemic. This helps avoid diabetes. With 42 herbs a day and until age 69, I am far away from diabetes while others in my family all got it.

      The tinnitus has been the most difficult thing, as some think, it seems. I have no idea but I find a low grade headache goes with the tinnitus, so a non-aspirin medicine for headache might help. I agree sleep is important and it adds up. The more days with little sleep, the harder it is to tame tinnitus. I love DD Coffee with caffeine, so I make it worse as that is not the best for tinnitus. I still think that herbs for tinnitus helps as well. Herbs are relatively inexpensive, especially compared to prescription, if you had to pay out of pocket that is.

  10. This Tinnitus Talk Podcast episode with Dr. De Ridder was the best I’ve experienced. I developed tinnitus 12-24-2011 after being hit from behind by a large truck, placing me in the center of a five vehicle wreck. I was very shaken and noticed ear ringing the next day, which has never stopped. After suffering the first 5 years, I visited UT Southwestern Callier Center for Communication Disorders, and was fitted with hearing aids that masked the sound during the day with a rain sound, and at night helped put me to sleep with an ocean sound. I always hear the high pitched ring in my right ear, which many times feels hot and painful. I receive no tinnitus signals in my left ear.

    I also developed vestibular migraine headaches and balance issues and read a book by Dr. Shen Bey called Victory Over Migraines. I joined a Facebook group for Migraines and learned how important it was for me to reduce anything that caused inflammation. I had to reduce sugar, carbs, and caffeine. Water became my primary liquid. I take supplements recommended by my neurologist and try to eat clean and healthy.

    I learned massage helps my tinnitus and my headaches.

    I welcome any studies that you have where I can participate online as I am based in Ft. Worth, Texas.

    • Hi Terry, what a story re the car crash; sorry to hear about your troubles. Thank you for taking the time to tell us how much you valued this podcast!

      We conduct online studies from time to time. You can keep informed by subscribing to our newsletter; if you’re not on our mailinglist you can reach us at

  11. My tinnitus started after an 8 month severe, intense, withdrawal from a drug called Lyrica (Pregablin). I literally thought I was going to lose my mind or die which at the time would have been a terrifying relief. It’s one of those issues unless you’ve been there it’s unexplainable & even less understood. It’s like trying to explain what it feels like to lose your eyesight to a person with 20/20 vision. You can have & express compassion towards the person & obtain all the book knowledge available but it is not an obtainable goal. I found some relief by taking a benzodiazepine type drug. My tinnitus was/is the type that comes with hyperacusis, the Sound of my heart pounding in my ears, and a high frequency pitch that can change without any provocation or method to the madness. I’ve noticed chewing food can cause the pitch to go up or down. If I take certain medications of the benzo type the pitch will stabilize, even out, then become less violent in nature. I had extensive paid research studies (paid volunteer) done by the University of South Florida including wearing an EEG type gel cradle. Not related to my tinnitus. I believe certain areas of my brain regions were damaged initially by taking the pregablin for nerve related pain and am not seeking legal avenues or assigning blame due to the tinnitus acquired post pregablin use. I simply am looking for answers & solutions. I also have a complex chronic pain issue which with the “War On Drugs”, the VA decided to stop using morphine to treat pain and began using buprenorphine due to it having a better safety profile.

    I understand completely the complexities of the issues surrounding tinnitus & possible areas of the brain that are affected. I also understand as with any new areas of brain research and the complexities involved how this will take a lot of time, money, and research. I do not have money, research capabilities, just have time which is a blessing and a curse. Thank you for your efforts and concerns for those of us who suffer a slow, agonizing, torturous existence, that in my opinion may not see a cure or treatment for in my life.

  12. Should Big Data and A.I. help in any way making a new prop for a more complete brain mapping?

    Further, is there any Institute in your knowledge using Big Data and A.I. effectively?

    Thank you!


    • Good question, Leonardo. One of our previous podcast episodes on the Bionics Institute covers the AI aspect to some extent. And we are working with some researchers on a big data project, hope to tell more about that soon!

  13. I have severe long term tinnitus and have believed for many years that the cause is in the brain and not just the ears. I am now 80 years old and have had tinnitus in varying degrees since mid twenties.

    I am happy to offer my help as a research subject and am very happy that there seems to be more and more evidence that this problem is brain or synapses based and not just ears.

  14. Very interesting. I have severe tinnitus which began the moment my auditory nerve was crushed due to an acoustic neuroma. Up to that point I had very keen hearing – I was born with perfect pitch and spent years as a vocalist and, for the past 18 years, as a professor. One evening as I was grading papers at my desk, the room began to spin, this incredible noise began in my head (which has not stopped for a moment since then), and when I tried to stand up I realized that I was completely off balance. I could not walk straight and simply standing was difficult without something to hold onto. I went to the doctor, who initially thought I had an inner ear infection. After some steroids, which didn’t help at all, she sent me in for a brain MRI – and there it was: an acoustic neuroma that had crushed my left auditory nerve and left balance nerve. While I have learned to walk straight with physical therapy and, now, my right brain has taken over for my left brain relevant to balance, the deafness of my left ear is complete, according to my audiologist, and the roaring in my head (sounds like a huge swarm of cicadas on a summer evening) hasn’t stopped for a moment. While I grieve the loss of hearing, I grieve most deeply about the loss of silence. My neurologist thought that the noise would “get better,” “get quieter,” or completely go away. But that has not been the case. My radiologist has wondered if the noise related to the sudden loss of hearing (when the auditory nerve was crushed by the tumor) is still so prominent and disabling because I had such keen hearing to begin with. I would be very happy to volunteer for any studies that might come up in the future.

  15. This was the best interview I’ve ever heard on the subject. As one who suffers with both tinnitus and bruits (which is NOT tinnitus), I was especially struck at Dr De Ridder’s comment that a misshapen artery might be touching a nerve causing bruits. How might one get in touch with Dr De Ridder? I tried searching for him but it also sounded like he might be changing geographic location. Thank you!

  16. Hi. I have had tinnitus since I was 45. I am now 67. I’m pretty sure that I inherited it from all the stress that my employer caused! Sometimes I hear about three or four sounds at the same time and it is so loud I cannot ignore them. I always thought that a doctor could pinpoint the area that is triggering the tinnitus and zap it to kill the source?

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