I Have SEEN This Little B*st*rd!

Long story short, i am a long term patient of the brai2n clinic in Antwerp. Dirk De Ridder was my physician. I had done a TMS test which was negative so i was prescribed a neuronavigated TMS test. It is the same principle but the coil is placed by a robotic arm guided by your neuroimaging data. Thus, in order to know very precisely where my tinnitus activity is they made a fMRI so i have pretty images of my tinnitus.



Of course it is mostly the auditory cortex which is lighted up. They were able to tell me my main tinnitus frequency was 8300 hz. Audiological tests gave no reliable result.

In addition: some EEG images of my poor brain:


This one shows the connections between activated brain zones:


By the way, i have some news from the clinic: De Ridder Left for New Zealand. He keeps in touch with the clinic weekly via skype. One of his research colleagues, Sven Vanneste who has copublished many recent papers with him went to Dallas to work with Kilgard on VNS ! So all that is left is an ENT, Paul Van Den Heyning as director of the clinic. He was codirector with De Ridder. They are looking for other physicians to complete the staff.

They aren't satisfied with their pilot study on VNS. Initially, 7 of the 10 patients had good results but most reverted back to their previous states. Long terms wise, only two of them have a light amelioration. Shown by both the EEGs and the questionnaires. I was told that the tinnitus of the lab rats was recent and some of the human test patients had tinnitus as old as 8 years. Also the implantation wasn't complete: they had just an electrode on their vagus nerve but used an external stimulator which was used only in hospital for short sessions. Maybe with an implanted stimulator sending impulses all day long the results will be better.

I was also told about the electrode implantations. They are still perfecting this. Since overctive cortical zones stimulate each other, taming one zone with one electrode is efficient with a minority of cases. that's why they experiment with mutli electrode implants. Sometimes 3 or 4 electrodes on different cortical sites ! The problem is often the tinnitus is tamed at first but comes back after a while and they have to find new stimulation parameters. They told me they still need several years to perfect this. Some lucky patients have had a total suppression of their tinnitus with that but they are a tiny few.

Anyway an implantation of one electrode costs around 20 000 € ! i don't want to guess how much it would cost for mutli electrode implants.

 

Thats amazing Daedalus. Weird to see your own brain. I was wondering if they can tell us the T frequency from a scan (as its hard to pitch match yourself I find) so now I know they can.

Bad news about DeRidder leaving, is he carrying on working on T in New Zealand?

Also bad news about VNS not working fully. Although like you say, surely if they stimulated for longer then the remission would be longer?

Thanks for such an interesting post.

 

Daedelus,

Thanks for sharing your fMRI pics. Of particular interest is the interconnectedness of the T zones. I always thought that was an issue and why resolutions are so difficult. I'm curious about your main tinnitus frequency. How did they determine that? What did your audiogram say? Cancelling out tinnitus through a similar frequency has some merit, but I'm not sure if we can accurately determine that frequency. (Plus, you've introduced the idea of one's primary frequency; that's also hard to tell if you have several.) The sound is so hard to match and I'm not sure about the relationship between the audiogram and your T freqency. Is is near where you hearing dips? My hearing is great and only dips slightly in the 5K zone.

Any info would be appreciated.

 

Yes, the interconnections between many cortical zones is the problem. This is why De Ridder wants to identify the hubs of the tinnitus network to disrupt them. For my main tinnitus frequency, they played sounds during my fMRI and saw the corresponding brain activity spots on their screens. I was told the frequency but i haven't received any written confirmation of this. I have a tone plus some narrow band noise. They tried to test me by classical audiological means but didn't succeed. My audiograms doesn't show any particular dips connected to my tinnitus.

Many people with a hearing trauma linked tinnitus have a hearing loss at the frequency of their tinnitus. Sometimes undetectable by classical audiograms. It is just not my case, my tinnitus came after a burn out without anything special auditory wise. I have very good hearing.

 

Thanks so much for the information. A few months ago, I read a research article about tinnitus in people with normal audiograms. The authors argued hearing cannot just be measured by an audiogram--that is, there was also a hidden part the needed discovery. I looked for that article today and couldn't find it. If I do, I will post on the board.

Thanks again!! DeRidder's work is truly a paradigm shift in tinnitus treatment. Tackling this problem with electrodes--since the brain is a chemical-electrical organ--makes perfect sense!

 

You may be interested in the audioscan from essilor then. Instead of setting a frequency and playing it by increments of 10 db they play a sound with a fixed intensity but they sweep the frequencies. The end result has a much better frequency resolution.

http://www.ncbi.nlm.nih.gov/pubmed/10736925

This is in French: http://auriol.free.fr/psychosonique/audioscan/manuel.htm

 

Yes, the audioscan does look interesting. I wonder how many clinics utilize it where I live? Anyway, I did a cursory google of some message boards. The responses I saw suggest the audioscan improves audiologists' ability to set their patients' hearing aids.

Both of my audiograms are identical, including the slight 5K dip. My hearing is actually fine, and the 5K dip is bilateral. One audiologist told me I might have always had the dip. While my hearing loss is bilateral, however, my tinnitus is unilateral. It resulted from a barotrauma to my left ear.

On hidden hearing loss, I found two references to it. Both seem to refer to the same study. The research postulates that the nerves on the cochlea can become damaged, but still function. Specifically, the authors use the analogy of unplugging half the wires between a microphone and a sound recorder. Sounds are still recorded, but are compromised. In other words, the hair cells can still perceive sound, but are damaged. It's interesting, and I believe explains my tinnitus. Here are the links:

http://www.tinnitusresearch.org/en/...usResearchArticleSeries_forTRI_4_Schaette.pdf

http://www.ncbi.nlm.nih.gov/pubmed/21940438

BTW, did you ever have an auditory brainstem test? So much of my sound emanates from the base of my skull that I know there's a somatic component.

 

Thanks for showing us your brain Daedalus! lol never thought I say that to someone!

Jazz thank you also for those links on hidden hearing loss.

 

I have got an essilor audioscan audiometer