TINNITUS HACKATHON 2025 – FULL SUMMARY
Purpose of the Event
A first-of-its-kind 3-day hackathon in Wiesbaden (Oct 15–17, 2025) where scientists, clinicians, funders, and patient advocates gathered to
stop rehashing old ideas and instead
define a real path toward treatments that can silence tinnitus.
The field is fragmented, outdated, and lacks biomarkers — so the event focused on building a shared research agenda.
KEY THEMES
1. The Field Is Stuck Without a Mechanistic Model
Participants agreed:
We still don't actually know
how tinnitus works — not precisely enough to target it.
Knowns are extremely high-level (e.g., "tinnitus is a phantom percept"), while unknowns cover all meaningful details.
2. Tinnitus Is Not One Disease
Everyone emphasized massive heterogeneity.
Different mechanisms → different subtypes → different treatments.
Current divisions (tonal vs hissing, with vs without hearing loss) are useless.
3. We Need an Objective Biomarker
The single biggest barrier to:
- running serious clinical trials
- attracting pharma
- validating treatments
- creating personalized medicine
The TIDE consortium is building a multi-country biomarker pipeline, but the field still can't even agree what a biomarker
should measure (loudness? presence? neural activity? distress? treatment response?).
4. Animal Models Mostly Don't Represent Human Tinnitus
Polley hammered this:
Animal models = oversimplified + non-translatable.
Without a valid model, pharma won't invest.
THE THREE KEYNOTE PERSPECTIVES
Dan Polley (Harvard) – Precision or Bust
- Most tinnitus models are primitive.
- Need circuit-level and mechanism-based interventions.
- Push the field to be as rigorous as oncology.
- Placebo-controlled, biomarker-driven studies.
Dirk de Ridder – Tinnitus Is a Network Disorder
- Not just auditory cortex → entire brain networks: limbic, salience, DMN, attention.
- Treat tinnitus like chronic pain: multi-target, multi-modal.
- Future: "digital twin brain" to simulate an individual's tinnitus and predict treatment.
Amy Rommel (Rainwater Foundation) – Follow the Tauopathy Playbook
- Success in other fields came from:
- open data
- standardized biomarkers
- unified diagnostic frameworks
- global collaboration
- Push tinnitus funders to coordinate instead of working in silos.
WORKSHOPS & BREAKOUTS
The "Knowns" (Very Few)
- Tinnitus commonly starts from cochlear injury → brain fills in missing signals.
- It's a network problem (auditory + emotional + attention systems).
- Hearing restoration can help some people.
- There is massive heterogeneity.
The "Unknowns" (Almost Everything That Matters)
- Exact neural generators
- Whether a final common pathway exists
- Subtypes based on biology, not symptoms
- Why some recover and some get chronic
- What a true biomarker should measure
- Why tinnitus worsens in some
- How to target specific neural circuits
- The role of genetics and predisposition
If You Had Only Big Data
- Use national-scale longitudinal datasets
- Mandate open data
- Develop a canonical analysis model
- AI to fill missing patient data
Borrowing From Other Fields
- Pain, epilepsy, Parkinson's, depression all show thalamocortical dysrhythmia, similar to tinnitus.
- Need to map shared pathways explicitly.
Repurposing Drugs/Devices
Promising drug categories:
- Inner hair cell ribbon-synapse restoration (e.g., AC102)
- Restoring inhibition (anticonvulsants, KCC2 modulators)
- Potassium channel modulators (e.g., KCNQ4)
- Anti-inflammatory TNF-alpha blockers for acute trauma
- Case-report monitoring for "accidental cures"
Promising devices:
- Cochlear implants
- Auditory nerve electrical stimulation
- TMS/tDCS (mixed results but deserves better subtyping)
- Hearing aids for subset relief
AI Approaches
- Gene pattern recognition
- Imputing missing biological data
- AI clustering for subtypes
- Wearable-based monitoring
Unlimited Funding Scenario
- Global infra + shared data
- Fast pipelines (fail fast)
- Combine basic → clinical → translation
- Use PR to create urgency
- Let researchers specialize deeply instead of wasting time on admin
THE 10 RESEARCH PRIORITIES (THE REAL OUTCOME)
- Define the precise neural mechanisms of tinnitus.
- Determine if a final common pathway exists or multiple separate ones.
- Create biological, clinically meaningful subtypes.
- Understand the mechanisms of chronification (why some recover and others get stuck).
- Define and validate a tinnitus biomarker.
- Build valid animal or computational models (possibly digital twins).
- Identify repair/plasticity mechanisms that can be targeted.
- Map tinnitus' shared mechanisms with pain, epilepsy, anxiety, depression.
- Consolidate global datasets to reveal patterns (sleep, stress, fluctuations, triggers).
- Test combination therapies and determine which work for which subtypes.
These 10 priorities will guide funding and collaborations for the next phase.
CONCLUSION
This report is basically a call for a
total overhaul of tinnitus science.
The field needs:
- Real mechanistic understanding
- Real subtypes
- A real biomarker
- Real models
- Real international collaboration
- Real targeted therapies (not masking, not CBT)
Tinnitus Quest and partners (Rainwater, Cochlear, etc.) will now convert these into funded research programs and global structures for data and clinical trials.
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