Episode 17: Tinnitus, Ingrained in the Brain? — Prof. Dirk De Ridder

It is a problem regarding tinnitus and using hearing aids when related to no hearing loss on an audiogram.

As a rule I cannot see how tinnitus is completely in the brain as some doctors claim that it is when the evidence doesn't conclusively support this at all.

 

@tommyd87 - my point is doctors would not give me hearing aids with no hearing loss, but there are hearing aids w/ maskers for tinnitus and they would not sell me them either. But I found a doctor that would. I think they could help people with tinnitus. I was not using hearing aids for hearing loss, I only want the masker function.

I don't think tinnitus is solely in the ear. I think it is 70/30 with 70% being in the brain. And when they can pinpoint the location, then they can travel to the ear and fix both. My tinnitus is stress related.

 

In layman's terms, because I'm no scientist or medical professional, I think De Ridder is saying that it starts in the ear but certain people lack the ability to turn off the brain's probing for that missing frequency. His research is showing certain areas of the brain lighting up for people with tinnitus vs people without it. There could possibly be many others out there with synapse damage and no tinnitus because their brains are not susceptible to being caught in this infinite loop of constantly filling in those missing frequencies because their brains simply do not care that that information is not missing.

I know I had a definite wow moment when he was describing the type of personality traits of someone susceptible to tinnitus. He described me almost perfectly.

 

I didn’t watch the video but how do we explain the cessation of tinnitus?

I developed tinnitus in 2015 after a loud concert. Two years later it was gone. Three years later I had some mild hearing loss in my left ear and it came back as an seashell like echo. A year later I had additional minor loss in that ear and it changed to an annoying pure tone ring. Most annoying sound from my perspective. Give me back the echo.

The otologist told me I had a damaged left ear, that my hearing would fluctuate and he had no real idea of the cause as had not had any noise trauma. After a 3 week course of steroids my hearing improved on audiogram and my tinnitus resolved. I was tinnitus free in that ear for four months.

Then I noticed this past week that it is creeping back ever so quietly. I suspect I have had another minor shift in my hearing. But all this to say, there are many examples where people have developed tinnitus that has ultimately resolved. Maybe for the long term, maybe not. And not all tinnitus is related to hearing loss. At least not measurable hearing loss. It is obvious that tinnitus is multifactorial. According to my otologist it is very difficult to determine the etiology in absentia of known SNHL b/c over 200 things cause tinnitus.

So maybe it isn’t always ingrained in your brain. I would like to think that the brain has a way of learning to ignore it. Otherwise I feel like we’re all doomed. Particularly since you lose 1/2% of your hair cells every year you age.

 

Dr. De Ridder said something along the lines of, if the brain doesn't care about the missing audio information it won't try and fill it in with what it thinks is missing. So it's possible you stopped worrying about your tinnitus and, therefore, stopped filling in the missing frequencies before it became an ingrained part of your "self."

I hope that wasn't too terrible of an explanation.

 

Not at all. Thanks.

 

If the brain would just lose that frequency and ignore it, none of us would be here, or even better, if the hair cells could just heal like every other animal.

What an absolutely dumb malfunction.

 

All this seems to confirm a theory that some wires are crossed and shorted in the brain and that is the cause of tinnitus. I bet that tinnitus could be cured by neuromodulation in addition to one of those drugs that allows the reshuffling of thoughts in the brain, like psychedelics or Ketamine derivatives. I'm surprised a multi-pronged approach isn't being performed yet. Perhaps that is what prevents people from getting success from the neuromodulation, their brain isn't able to reform, or at least they don't have the right amount of neuroplasticity left.

Who knows! Any research is good research.

 

What do you mean by 'CI'?

 

Excuse me if I misunderstand, but you developed hearing loss after a concert as well as tinnitus, then had it for two years before it completely disappearef for a while? So after two years of tinnitus all of a sudden you heard silence again? That's absolutely insane, I can't imagine.

 

Cochlear Implants.

 

You did not misunderstand. Yes, it went away. For about 3 years.

And then I got it again in my left ear only for a year and that went away too. And at that time I had mild hearing loss, which I did not have following the concert.

 

I’ve heard numerous examples of people who have been fitted with cochlear implants that have greatly reduced or completely eliminated tinnitus while the device is activated. This probably only works for people whose tinnitus is from hearing loss.

This is a clear example that most likely tinnitus is a reaction of the brain to auditory deprivation and once that sound is restored the tinnitus can fade away and there is no reason for the brain to react that way.

So once again if you treat the underlying cause i.e. hearing loss, you can alleviate the symptom.

 

I'm assuming your noise induced tinnitus was high pitched ringing or only static (back then)?

 

It changed a lot. Started out as a pure tone ring. Not particularly high pitched at all. Very easily masked by mid frequency noise as opposed to it being so pitched that you hear it over everything. Then it sort of turned into a light saber noise in my head. Then it was gone.

When I had hearing loss in my left ear in early 2020, it sounded like an echo. Like a seashell. Then 10 months later it turned into a pure tone ring, as I had some additional loss but very mild. It was like a dial tone which was the worst in my experience, but it was mid frequency so I could mask it ok. It went away after about 3 months.

 

Echo and seashell sounds a lot like ETD. I think I've read if that's the case it goes away when you lean forward with your head down by your knees, helping it close up?

 

Nothing changed the sound. I mean it changed on its own after about 10 months or so and then went away three months or so later, but I couldn’t do anything to modulate it. And it never spiked or changed volume. Nothing I did impacted it. It was just a steady sound all the time. I wouldn’t however, be surprised if there was some ETD involved. I have perpetual allergic rhinitis. I’m always stuffed. My ears are always full. I just re-introduced myself to my friend Flonase.

 

What is ETD?

 

I wonder if you have a unique variation somewhere in any of the systems in your body that makes you one of a kind in the way that you can recover from something that almost no one is able to recover from. Maybe you can tell your story to Dirk de Ridder. You can email him. I'm sure he'd be very interested. I sincerely hope you do this. Wish you the best!

 

Who is Dirk de Ridder? I don’t really know anything about him.

I have had both ENT and otologists tell me that it can go away or it doesn’t go away.

I would argue that there are definitely people who used to be on the site that probably no longer experience tinnitus or are so habituated that they never even hear it anymore and therefore they’re not on the site anymore. I was off the site for over three years. Until I had some hearing loss and the tinnitus came back in the left ear - now resolved.

 

I believe that tinnitus is due to ear malfunctions and physical pathways. That parts of the brain are just not happy with this.

 

Eustachian Tube Dysfunction.

 

A lot of people have reactive tinnitus and listening to an hour's podcast is not an option. Do you have a text transcript of this?

I mean... I MUST be mistaken here?

Please share the link to text file (I certainly hope there is one!)?

 

You mean there’s a transcript!!? Who knew!

 

@star-affinity, this is my question especially for those of us whose tinnitus started in our brain or centrally. Are we doomed to only treat with the Dr. Schulman protocol?

I’d seen posts like this in the past about this kind of tinnitus being permanent but not any data.

 

Gotta say after reading the transcript this is pretty depressing. There goes that 5-10 year tagline completely dependent on massive factors that I don’t see realistically coming together like collaboration and massive funding.

Here’s to hoping he’s wrong about Dr. Shore since it seems he overlapped her work with Lenire quite a bit.

 

I don't think any mammals have the ability to regenerate hair cells, but birds and fish do.