Acoustic CR® Neuromodulation: a New Treatment for Tinnitus

joe · Jan 22, 2012

Here's something that's been realised here in the UK.

It will only work if your tinnitus is tonal, and no higher than 10 kHz.

http://www.thetinnitusclinic.co.uk/tinnitus-treatment/acoustic-neuromodulation/

Markku · Jan 22, 2012

Huh, it's expensive.

http://www.thetinnitusclinic.co.uk/tinnitus-treatment/prices

The Acoustic CR® Neuromodulation treatment package costs £5815.

Future scientific highlights:

November 2011: Start of a 12-months Real Life Tinnitus Study with 200 patients in approx. 20 German study centres. The study is currently recruiting patients - more information is provided on the German ANM homepage.

Q1 2012: Start of a multicentre, randomized, double-blinded, placebo-controlled clinical long-term tinnitus study enrolling approx. 100 patients in Great Britain.

Markku · Jan 22, 2012

In Germany there's a trial being started (the November 2011 one mentioned above):
http://clinicaltrials.gov/ct2/show/NCT01435317

The link states that they are still recruiting participants. So if you're in Germany, maybe check that out.

I couldn't find a trial based in the UK yet, but then again it said on anm-medical.com that it would start in Q1 2012, so there's still time.

joe · Jan 22, 2012

Put aside the cost what do you think about this theres a trial complete on this one. The second trial with Anm, is on the next model with "real life"

Markku · Jan 22, 2012

Hm, I couldn't find results on that trial? Or have they been published yet?

Can you give me a link and I'll read it over! Thanks.

EDIT:
I found this: http://clinicaltrials.gov/ct2/show/NCT00927121
It's been completed but I couldn't find results.

joe · Jan 23, 2012

Thats the one I think, you're right no results although the study is complete??? How can this be??

Markku · Jan 23, 2012

myself said: ↑

i ve called them this morning but i find the device quiet expensive as they are charging about 6000 p.when the device is costing half from germany so let me think twice about that
Click to expand...

Yep, it's expensive, but there's the possibility of a refund though, except for the consultation fees. Of course they likely expect you to hand out nearly £6000 before they give you the device, so even with the possibility of refund it's a lot of money to give away for a short while...

If the device had a no-refund policy, I'd currently suggest it to nobody, as I haven't been able to find published results from that first trial and the two additional trials are only now starting...

Markku · Jan 23, 2012

Where did you find though that it costs half that in Germany? I wonder if they have a refund policy for this device in Germany.

-
If you someone are reading this, and you've invested in this device (doesn't matter whether in the UK or Germany), I'd love to hear your experience. Is it easy to use, how has your tinnitus changed if it has etc...

exodus · Jan 23, 2012

i ve called the company in germany and they gave me some audiologists contact number and also got the price information here:
http://www.info-acouphenes.com/foru...source=activity&id=4280269:Topic:20835&page=2

The device will cost € 2685, - and is currently a private performance.
Please note arise that, for the further implementation of the therapy costs by the treating ENT specialist.

You can use the stimulator within eight weeks, at cost (with a total service charge of € 390, - Return), if you do not respond to therapy should be.

joe · Jan 23, 2012

Yes, I have family in Germany and well aware it's half the price, it's not just a case of buying the unit and then you use it, it needs adjustment as your tinnitus frequency begins to adjust, this can only be done by a ANM qualified audiologist. Hence going backwards and forth. I think in the long run you would spend what you save in travel??

Don H · Jan 24, 2012

What about Canada or North America? Does anyone know of any centers prescribing/selling it? If I could get the number of the Company that would be great.

joe · Jan 24, 2012

Hi Don, They have plans to launch in USA, I dont know exactly when but you could possibly send them an email

Karen · Feb 1, 2012

Hi, Don and Joe,
info@anm-medical.com
I sent an E-mail to ANM at the above address , and just got a response back regarding plans for the United States. Here it is:

Dear Karen,
since last December we have got the FDA approval 510k and know we are going to talk with potential distribution partner for the US market. This takes some time. Today I cannot say when we if start this year or in 2013.

Kind regards
Stefan Wolter

joe · Feb 1, 2012

Great work Karen

Dave99 · Feb 12, 2012

Hi, I spoke to a doctor at this clinic in Berlin. http://hno-sz.de/index.php?mainmenuid=1

They were very helpful but have only treated 4 or 5 patients to date. The doctor pointed out that to get the best out of the device you really need to near the clinic for the first 4 to 6 weeks as the device needs to be constantly adjusted based on your feedback. The costs were approx €2600 for the device and €1200 for consultation.

My only concern with the tinnitus clinic in London ( apart from the cost) is that there doesn't seem to be any ENT consultants or medical doctors in the clinic.

It would be great to hear from anyone who is using this treatment positive or negative

hope this information is helpful.

joe · Mar 19, 2012

http://www.telegraph.co.uk/health/healthnews/9149059/Tinnitus-silenced-by-retuning-brain.html

Karl · Apr 13, 2012

(An article from "Hearing News")

75% of Tinnitus Patients Benefited in Acoustic CR Neuromodulation Trial

Jülich, Germany— A clinical trial led by Professor Peter Tass at Jülich Research Center in Germany reports that a non-invasive technique known as Acoustic CR® Neuromodulation benefited 75% of patients. The results were published in Restorative Neurology and Neuroscience.
Acoustic Coordinated Reset (CR) Neuromodulation provided the trial’s patients with a “significant and clinically relevant decrease” in tinnitus loudness and annoyance within 12 weeks, compared to patients who received a placebo, according to the authors.

Tass suggests that Acoustic CR® Neuromodulation reduces tinnitus loudness by reducing the overactivity of auditory nerve cells within the hearing portion of the brain.
The treatment involves patients wearing headphones that emit a series of tones designed to match the frequency of their individual tinnitus tones. The treatment's emitted tones are designed to interfere and eventually disrupt the patient's rhythmic tinnitus firing patterns in the nerve cells that are believed to be causing the tinnitus.

In the prospective, randomized, single blind, placebo-controlled trial in 63 patients diagnosed with chronic tonal tinnitus and up to 50 dB hearing loss, the placebo treatment did not lead to any significant changes.

However, the effects gained by patients treated with 12 weeks of Acoustic CR persisted through a preplanned 4-week therapy pause and showed sustained long-term effects after 10 months of therapy, according to the researchers. In fact, 75% of patients had some benefit, as measured by a visual analogue scale, tinnitus questionnaire scores, and spontaneous EEG recordings.
A British Tinnitus Association spokesperson commented, “The results of this exploratory first trial are interesting and encouraging. The findings now need to be replicated by an independent research group. A randomized-controlled trial is required to assess whether this new intervention is a viable and effective treatment for tinnitus patients. We look forward to seeing the results of the planned larger scale Phase 2 Trial.”

joe · Apr 17, 2012

Yes the Trial Starts next week here in the Uk

erik · Jul 10, 2012

JULY 9th UPDATE (Story): Very Expensive but research looks good.

Counteracting tinnitus by Acoustic Coordinated Reset Neuromodulation 2012 Study Link

The £4,500 headphones that eased my terrible tinnitus
On a flight back from Switzerland three years ago, Jane Mellor was painfully aware of a high-pitched ringing sound in her ears.

‘It was a horrible harsh sound that set my teeth on edge,’ says Jane, 54, a biochemistry professor.

‘And there was no escaping it because it seemed to drill through my head.’

Though she had occasionally heard ringing in her ears before, this was far more intense.

And it persisted for weeks, driving through her head so she couldn’t concentrate and struggled to get to sleep.

Like an estimated 10 per cent of Britons, Jane was suffering from tinnitus — a buzzing, ringing or whistling sound in the ears when there is no external source for it.

And 1 per cent of the population suffers from tinnitus that is so severe it seriously affects their quality of life, disturbing sleep and causing anxiety.

While experts don’t fully understand what causes it, exposure to loud music and noise can trigger tinnitus.

It’s also linked to age-related hearing loss, and is more common in older people.

Normally when we hear a sound, nerve cells in the brain fire in response.

Studies of brainwaves in tinnitus patients show that these groups of nerve cells fire even when there is no external sound.

Age-related tinnitus is thought to be the result of our losing the ability to hear higher frequencies.

As a result, the brain starts to compensate, producing phantom sounds that correspond to the pitches we can no longer hear.

‘It’s a little like phantom limb pain,’ says Mark Williams, principal scientific audiologist at the Tinnitus Clinic in London.

This is borne out by Jane’s experience: the tinnitus is worse in her right ear, which has reduced hearing levels.‘Because there’s reduced stimulation to the brain due to hearing loss, the system starts to become hyperactive and produces impulses, which are interpreted as the tinnitus sounds.’

‘I was a typical Seventies teenager who liked loud music, which may be partly to blame,’ she says.

Unfortunately, there is no single effective treatment for tinnitus.

Once diagnosed, Jane was seen by a specialist who recommended relaxation exercises and music.

She tried distraction techniques, too, such as opening a window at work so gentle background sounds would take her mind off the sound.

Jane also bought special speakers to put in her pillow that played white noise to override the screaming noise in her head.

‘But nothing stopped it completely,’ she says.

‘And as I became more sleep deprived, I’d get irritable with my three children and with Fintan, my husband.

'And I worried that the quality of my work was suffering.’

Researchers have previously tried treating tinnitus using electrodes implanted in the brain.

These emit an electrical impulse to stimulate the nerve cells and break up the abnormal firing pattern, but results have been mixed.

Jane did some research of her own, and last summer read about a new treatment, Acoustic Co-ordinated RESET neuromodulation, which had been developed in Germany.

After a hearing test to establish the pitch of the patient’s tinnitus, they then wear a portable neuromodulation device (a bit like an MP3 player) to listen to a series of chimes just above and below their tinnitus frequency for between four and six hours a day.

The theory is that this retrains nerve cells in the brain so they stop firing.

At £4,500 for a six-month treatment, it is by no means cheap — but in the study Jane found, published in the journal Restorative Neurology and Neuroscience, it benefited seven in ten patients, who reported a ‘significant and clinically relevant decrease’ in tinnitus loudness and annoyance within 12 weeks, compared with patients who received a placebo.

‘Yes, it is a lot of money, but I was desperate for some sort of relief,’ says Jane.

‘There is a lot of quackery surrounding a condition such as tinnitus, but this treatment is scientifically validated and it was this that attracted me to it.’

Studies by the maker found an average 50 per cent reduction in their tinnitus, which continues after treatment ends.

First, Jane underwent a 90-minute assessment where she was played a series of sounds until she could identify the exact pitch of her tinnitus.

This information was programmed into the neuromodulation device she was given at the next visit.

The earphones attached to the device are special medical ones that do not completely block the patient’s ears, meaning they can still hear external everyday sounds.

‘When I first put them on, it was wonderful,’ says Jane.

‘It seemed to take the focus off the horrible tinnitus sound.’

She started wearing the special headphones for four to six hours a day at low levels while she worked, made phone calls and watched TV.

‘Even after I took the earphones out, the noise was less annoying,’ she says.

‘I can concentrate and sleep properly again.’

Follow-up tests showed her tinnitus was lowering in pitch — a sign that the device was working.
The Tinnitus Clinic has commissioned a six-month clinical trial to run at the National Biomedical Research Unit in Hearing in Nottingham and University College Hospital, London.

Most sound therapy devices are called maskers because the stimulation they provide covers up tinnitus while they are worn,’ says Dr Derek Hoare, who is overseeing the trial and is vice-chair of the British Tinnitus Association’s professional advisory committee.

‘The neuromodulation device is interesting as the manufacturers explicitly propose it does not just mask, but interrupts tinnitus by resetting or retraining a particular form of brain activity commonly associated with tinnitus.’

Jane says: ‘The tinnitus is still there — but it’s less shrill, and I hope one day it will fade until it no longer bothers me.’

Dr Ralph Holme, head of biochemical research at Action on Hearing Loss, adds: ‘The demand for effective treatments to silence tinnitus is high and this is an interesting approach, but we need to wait for the results of larger studies before passing comment on whether this is an effective treatment or not.’

Karl · Jul 12, 2012

erik -
This article has provided me enough information to try a new test on myself. I need to find that photo of Gene Wilder as Young Frankestein ("schteen") and use that as my avatar again. "It's alive! It's alive".

I few months ago I purchased the NCH Tone Generator. I know that my tinnitus is about 4kHz. I made an MP3 files of 4kHz tone which I listened to for 1-2 hours a day for 6 weeks. I stopped that experiment about 3 weeks ago, and I'm back to using my maskers.

Experiment #2: Using the idea discussed in this article, I've just put two sine waves into the generator: One at 4153 Hz (above my tinnitus) and another at 3918 Hz (below my tinnitus). Have it at low volume. I'll try this an hour today.

In a way this approach seems to make sense - but I will restrain myself from getting too pumped up. I'm up, I'm down...basically running out of options, I'm afraid.

As this article explains very well, most of the experts consider tinnitus to be like phantom limb pain. In the case of tinnitus, instead of having a lost limb, an inner hair cell bundle has been lost. It would seem that the bundles on each side of the damaged bundle should be intact. So, perhaps it makes sense to use frequencies on each side of the target frequency, to "corner the thing".

It's interesting that Jane says "The tinnitus is still there - but it's less shrill...". That isn't necessarily glowing praise, like what I have read about Dichonics, which cost significantly less at $3000. Dichonics claims to actually cancel tinnitus for 75% of the patients that use it. It is my understanding that the canceling effect is not permanent, lasting up to 12 hours. This is the same percentage that Acoustic Neuromodulation claims.

mock turtle · Jul 14, 2012

Karl
erik
thanks for finding and sharing all this information

im a do-it-yourself-er and have tried many "solutions" from diet and supplements to different kinds of acoustic stimulation

almost 20 years ago i played with a phenomenon called "residual inhibition"...we dont hear as much talk about it these days but as im sure you are familiar with it

then of course notched which its day and may even "hold the field" along with vagus nerve stimulation...dont know have to wait and see latest double blind study results...but

i just never could decide if i should douse myself with tinnitus frequencies...avoid them...or mask them.. suround them.... data was all so contradictory

i am sympathetic to the phantom limb syndrome theory...but i like to ad that tinnitus is in some ways like epilepsy and so my present tactic is to listen to broad band sound ...symphonic music, pink noise, water and wind sounds etc and try otc supplements that are gaba agonists that can cross the blood brain barrier

nothing would make me happier than to see a non chemical solution so im silently rooting for these acoustical remediation....but in my heart i wonder if nothing short of replacing the broken stereo cilia and returning hearing sensation will "cure" the problem

and then there is doing everything i can to "ignore" tinnitus...divert my attention...or as some call it, "doing nothing"

if tinnitus were a creature ...or a being...id take it out back and give it a good thrashing...dont-cha just wish you could ring its neck!

thanks again for the great information
best wishes
mock turtle

DezDog · Jul 14, 2012

Karl
Have you tried notching music/white noise at 4KHz? This is where you remove those frequencies instead of listening to them.

I've read a little bit about creating notched music/white noise and would be happy to send you some files. We'd both be experimenting though.

I'd do this myself, but I can't determine my frequencies. I think I'm narrow-band white noise at around 12-13 Khz.

Cheers
DD

Karl · Jul 15, 2012

mt -
I am not afraid of medicines, unless they make me depressed. If there was a chemical/drug that would alleviate this, I would go for it. I like your idea of "gaba supplements", although I don't yet understand what those things are. Last week I took niacin, and I swear I felt a difference.

The most impressive step toward a cure that I've seen are the MEG/MRI scans being done at West Texas A&M. Dichonics, Inc., is an off-spring of that research. Based on that, I've been gerry-rigging my own sound experiments, trying to do something similar to what I've read about Dichonics, Acoustic Neuormodulation and Serenade Soundcure.

DD -
Haven't tried notched music, but I'm aware of it. If I wanted to try it, I know how to create notched music using the NCH Tone Generator and WavePad. There are videos on YouTube showing the steps involved.

Notching avoids the tone, probably making it less significant compared to other spectrum of frequencies. I want to cancel the tinnitus. I'm not into homeopathic medicine, but homeopathy has a saying:"Like cures like".

Shay O'Connor · Aug 21, 2012

I'm just curious on this one that although it has been available on the market in Germany and the UK now for at least a year or so and with over 3000 people treated (3000 in Germany alone according to the rep i spoke to) I have not seen one review that wasn't in a newspaper. I can only conclude that it is ineffective.

Just wondering why no members here appear to have tried it either. Anybody planning on trying? I would consider going to Germany (the rep suggested an ENT in Cologne who has been working with it from the start) as it is far cheaper than the UK. I however would only consider it on hearing some independent verification. Any thoughts? Am I missing something?

Cal · Aug 22, 2012

Hi

Aside from the positive testimonials on the website of the Tinnitus Clinic in London, it is almost impossible to find an independent positive review of the ANM device.

There have, unfortunately, been numerous negative reviews of this treatment in German tinnitus forums. Many of those that have posted on the German sites are very critical of the inventor, Professor Peter Tass, and of the Julich Institute for the unusual way in which they have allowed this treatment to been distributed and marketed. Essentially, it is being tested on desperate tinnitus sufferers (at great expense). As you may know, a trial of the device is being conducted in Nottingham in the UK at the moment. One can only hope that it produces proper data.

Best Wishes

Cal

Shay O'Connor · Aug 23, 2012

Hi Cal

Thanks for that. As I don't speak German I wasn't aware of this and in fact it explains the rather defensive response I got when I questioned its efficacy. So where do they get the '75% of sufferers report significant reduction in tinnitus symptoms'?...Anyways I'll turn my attention elsewhere for now..c'mon my fellow Irishmen and the mutebutton!

Philip Datlen · Sep 19, 2012

Hello All,
In a couple of weeks I will hopefully be starting to participate in a trial on the Acoustic Neuromodulation device. I have passed the preliminary stages of being accepted into the research trial and will be off to London for a physical check over and hopefully be fitted with the device for a 9 month period....fingers crossed it all goes well....

erik · Sep 19, 2012

Great Philip and congratulations! Please keep us regularly updated on your progress. There will be a great many people here would be interested in knowing this information.

Shay O'Connor · Sep 19, 2012

Yes best of luck Philip..i see you have tinnitus for 16 yrs..i really hope it brings you some relief..keep us posted!

Louise · Sep 21, 2012

I didnt realise they were testing this in the UK?

I had an Assessment with the Tinnitus Clinic about 2 months ago (£185). They didnt mention they needed test people.

I was told last week that the results of a bigger study will be published Jan/Feb next year.

I dont think it is cheaper in Germany as I emailed ANM a few weeks ago to ask, the price of the device is about the same but in the UK you pay for 5 or 6 consultations at the same time whereas in Gremany you dont, you pay for the consult as you go. The Tinnitus Clinics 4.5k package is the device and the consultant appointments. Its not feasible to go to Germany I dont think because you have to get it adjusted more often at first - if its working for you that is. You may need to get an adjustment once a week?

I read a huge thread from a German forum (I cant read German either, it went through Google Translate) and there was a lot of negativity. However some people WERE helped by it. One guy had 3 tones to his T and it got rid of 2 of them and reduced the third with this device. One person collated all the info from everyone on that site who had tried it (about 17 people from memory) and I think nearly half of them benefitted. I'll try to find that table and post it here.

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