Hidden Hearing Loss, Tinnitus and Trouble Hearing Conversations in Noise

Just out of curiosity:
Have you seen anything happening in research in 2016 that positively surprised you and perhaps made you adjust your expectations?

Could you give an example? I would like to understand why this could be the case. If it is not too complex for the lay person.

 

"New test can detect hidden hearing loss"
http://neurosciencenews.com/hidden-hearing-loss-test-5802/

 

What about this then ? The authors seems to have successfully repaired the auditory nerve and recovered auditory function :
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4491783/

https://www.sheffield.ac.uk/research/impact/stories/novel-sensory-neuroscience-cells-1.573958

 

I was actually talking to this man,Kevin Barry is his name and he runs a Chi-Kung class up in Dublin.

Extremely nice guy but a lot of inconsistencies in his story when I was talking to him,things like how his T and H disappeared through the art of Chi-Kung and how he lived in isolation for years as a result of his H only for him to go back to concerts without protection now that he's been"cured"

Personally I found that odd,that he would suffer for over ten years with T and H that was noise induced only for him to cure himself and then throw himself straight back into the very same situation that got him there in the first place?

Would you do that?If you got cured of H would you go front row at a concert without hearing protection?Speak about tempting faith!

Also he didn't experience any pain from sound from what he told me.

 

I wonder if I contacted them would they allow me to do that test?Might give us some insight as to what's happening in H patients ears.

 

What about the stuff discussed in this thread?
https://www.tinnitustalk.com/thread...ditory-cortex-implantation-for-tinnitus.8377/

And there is also a thread about DBS for T somewhere on the forum.

 

I'm going to email them Lapidus,my New Years resolution is to move heaven and earth to do what I can that may help in finally discovering where our damage lies and what we can do about it.

Any email address that I could get them on?

 

No clue. I just found the post on Hyperacusis Research facebook feed. The researchers in the article, Bernstein and Trahiotis are at UConn School of Medicine, so it shouldn't be that hard to find them I think.

Google gave me this:
http://facultydirectory.uchc.edu/profile?profileId=3354
http://facultydirectory.uchc.edu/profile?profileId=Trahiotis-Constantine

 

Liberman is also going to enroll patients next summer to test his device which will detect and diagnose synaptopathy.

 

That's perfect Cheers Lapidus.

 

Where did you hear that?

 

No I wouldn't do that, I only went to one gig without earplugs and got completely screwed. Did he ever talk about if he believed Chi-Kung (Qi Gong) literally healed his inner ear? Did he ever talk about the biologic aspects of his condition? Or if his recovery was sudden or gradual? Qi Gong is quite infamous for making extraordinary health claims. It is not uncommon for a western Qi Gong practitioner to say that Qi Gong was the sole or main reason they recovered from some horrible illness, often ones that western science has no/little cure for.

 

https://www.tinnitustalk.com/posts/204399/

Maybe email him again do see where he's at.

 

Guys it might be a very silly question but I'll risk asking it

"The 84 dB level is also well within the federal guidelines for an 8 h/d exposure for a lifetime (http://www.osha.gov). Results show that normal mice exposed for 1 week to such a moderate-level noise with a spectrum targeting the most sensitive portion of the hearing range show no measureable permanent threshold shifts. However, confocal analysis of immunostained cochleas revealed a loss of up to 20% of the afferent synapses on IHCs in some cochlear regions"

Okay. So we know that 84dB for a week strait will do damage. However, does this come to us as a surprise at all?
We knew already that ~85dB is (probably not so) safe for less than 8 hours strait.

Do you think the results would be so "bad" if mice were exposed to a "week of 85dB noise" over some longer period of time (for example a month?). If the ears had time to "rest"? Oh God, this sound so silly. My background is in math/informatics so please forgive my complete ignorance and lack of appropriate terminology.

 

85db is in regards to haircells in a healthy cochlea but this new discovery may throw all of our current guidelines out the window as they will now become redundant.

These levels don't account for synapse damage and tests show that every time your exposed to loud noise like a concert you lose some of these synapses but don't notice anything until the loss becomes so great that symptoms arise like T and H.What was once thought as a temporary threshold shift is no longer the case,hearing thresholds may return to normal but synapses have been lost as a result,that temporary T you get after a nightclub is the synapses being damaged.

 

It was gradual according to him,slowly but surely it began to back off to where he's fully cured now.
It's an amazing claim but it's just a claim without any solid proof to back him up which is the case with Chi-Kung.

He didn't mention it healing his ears but he did say that he didn't take care of his hearing enough and that's why he got T and H which makes him going back to concerts without plugs sound rather odd?
"I didn't look after my ears enough that's why I'm in this mess"

*Gets cured*

*Goes to concerts front row without protection*

Sounds pretty stupid to me.

 

@HomeoHebbian Not sure if you saw this thread but I think it's inline with the more realistic therapies which may be available in the short term which you mentioned above (most likely you already know about this study). Sounds like a multi-area brain stimulation approach...
https://www.tinnitustalk.com/thread...x-implantation-for-tinnitus.8377/#post-222397

 

This study shows that older subjects with normal audiograms (sensitivity to pure tones) can struggle to discriminate more complex sounds. Nothing too new here. The big issue is that it is impossible to determine whether their deficits were age-related decline in central brain processing or instead reflected a type of hidden damage in the ear. My interpretation is that this is probably a solid, descriptive behavioral study that got "trumped up" by the public relations office at the medical school.

 

I hadn't seen that paper. Thanks for sharing. They show some interesting structural changes in the nerve after the graft but they didn't show that these were functional synapses. Their marker of functional recovery is a change in later waves of the ABR (auditory brainstem response). The later waves are generated by downstream structures in auditory processing centers of the brain. They claimed to have regenerated portions of the nerve. It is curious that the earliest component of the ABR, which is generated by the nerve itself, did not recover. Recovery of late waves could most easily be explained by increased central gain. Many studies, including the one mentioned in this press release - has shown that the brain can increase its gain and 'grow back' a response following auditory nerve injury. https://www.sciencedaily.com/releases/2016/01/160128133035.htm. Still, it's an interesting study and hopefully follow up work will vindicate their proposed mechanism. Too be clear, I am not doubting that auditory nerve synapses can be repaired. I've been convinced it can work shortly after injury. I'm just raising the point that moving the nerve terminal back into the vicinity of the inner hair cell does not make a functional synapse. Their functional marker of recovery could be mediated by changes in the brain and not the emergence of new connections at the level of the auditory nerve.

 

The PI for this study is Prof. Stephane Maison at Mass. Eye and Ear / Harvard. He is a long-time associate of Liberman's but Liberman is not running the study directly. I mention this because you will want to check in with Maison, not Liberman, about participating. Also, Maison doesn't use a special device to measure the SP:AP ratio (his estimate of synapse loss). It's just a more careful analysis of a conventional measurement called electrocochleography. Rather than place electrodes only on your scalp, as per conventional auditory brainstem response measurements), electrocochleography places an electrode in your ear canal. This allows them to measure the amplitude of the earliest waves a little more accurately than others have previously done. Maison is not testing an intervention at this point, not that i know of at least, but rather is just widening the scope of his earlier publication to include additional measurements and include people with tinnitus, know that he is involved with the Lauer Tinnitus Research Center - https://www.masseyeandear.org/resea...s/laboratories/lauer-tinnitus-research-center

 

Yes, I've read through this thread. There hasn't been a high-quality study with compelling results that I have seen. Some fairly worthless case studies, a smattering of animal work and a bunch of poorly conceived tDCS studies that aren't very interpretable. Perhaps there is a good study that I haven't seen? I'd be happy to comment on any particular study, if that would be helpful to you.

I think there is real potential with direct brain stimulation, but it is untapped. Conventional deep brain stimulation has its drawbacks (they need to stick an electrode deep into your brain) and the non-invasive approaches also have major limitations in that they can only stimulate superficial brain areas with poor spatial resolution.

There is a revolutionary new technology coming soon that will allow non-invasive stimulation of deep brain areas with high temporal and reasonable spatial precision. The paper isn't published yet, but I have seen the results (sorry, I'm not at liberty to say anything further) and they look pretty awesome. I'm hoping that it could be a game-changer for tinnitus in the next few years. We're going to be pushing hard on this new technology for tinnitus. First in animal models, but into human subjects as soon as is prudent (safe, effective etc.). I know that this is a bit of a tease because I cannot provide you a link to a published paper but I will as soon as it is out.

 

There is an ongoing study on DBS for tinnitus in San Francisco but it won't end until 2019 (guessing they want to study long term effects) and is very small (only 10 patients). Here's the thread if you haven't read it before.
https://www.tinnitustalk.com/threads/deep-brain-stimulation-dbs-for-tinnitus.3625/

 

I don't mind it being a tease as long as it's good news. Sounds pretty exciting - sign me up when it's ready for testing! I can't stress enough how treatments like this can help more people universally. Thanks for the work.

 

Would DBS work for Hyperacusis also?Just read a paper about how the two are connected together through central gain mechanisms in the brain,my question is if they can suppress T will that also suppress H?

 

My own guess would be yes, if anything for some reason I think H would even be easier/more consistently successfully treated than T through DBS once the research was put into it. Just a guess though.

Yeah this "test" seems to only prove the existence of "hidden hearing loss" which is well established at this point. I didn't get the impression that there was any detailed diagnostic tools for it developed, or anything that would lead to any sort of treatment directly. I guess more awareness is good though.

 

But then why would the ABR have only improved in the animals that recieved the cells on the scar ?

There was no improvement in the ABRs after 3 mo in any of the 20 animals in which cells were delivered by intraneural transplantation to ChABC-treated gliotic auditory nerves (Fig. 2 A–C and Fig. S1B). Positive, monophasic potentials (cut end potentials) (17) indicated that sound-induced electrical activity did not pass the transplantation site. However, ABRs improved in 10 of the 17 animals in which cells were delivered by surface transplantation (Fig. 2 D–F and Fig. S1B). In the ABRs, waves I and II represent activity in the auditory nerve and cochlear nucleus, respectively (18) (Fig. S2 A and B), but they were attenuated by the direct mechanical injury and glial scar formation (Fig. S2C).

If it was just the brain we would see improvements in both groups no ?
Maybe even if the new synapses are not working properly it can help the brain to compensate I don't know...

 

Yup, you are absolutely right. I commented too quickly and missed this important control. Yes, that does provide indirect evidence that the graft is functional. Probably a combination of a small number of added channels conveying signals from the ear to the brain and lots of central amplification. The fiddle can't play without the bow, so to speak. Thanks for pointing this out.

 

Thank you very much @HomeoHebbian for the level of insight, finding it very helpful and most importantly encouraging.

 

"Dr Tetsuji is a brilliant surgeon. He can carefully compress the nerve in the ear, which causes hearing loss similar to that in man, inject replacement cells with great precision and then measure recovery.

"The really hard part is then to section the tissue and to label all the cells we put in. This provides proof that the injected cells reconnect the sensory ‘hearing’ cells to the brain.”

“We had stumbled upon the possibility of a new, non-invasive technique to transplant cells into the nervous system. We showed that the glial scar, rather than an obstacle to regeneration, can actually provide critical cues to the integration of donor cells.”

-----

When the article says "non-invasive technique", what do they exactly mean? How do they get to the nerve in the ear and "section the tissue" and "put the cells in" without this intervention being considered "invasive"?

 

Alot of the greatest discoveries happened by accident. So can someone dumb down the article for us mere mortals. Lol.

From my understanding, this is good news, right?