Tinnitus: Causes and Clinical Management (The Lancet Neurology)

daedalus

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Author
Jul 17, 2011
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Brussels
Tinnitus Since
04/2007
Apparently it is rare enough to be considered a cause of celebration by the Tinnitus Research Initiative. Of course it is owned by the evil Elsevier. Two things worth to mention: neuromodulation is evoked and De Ridder hasn't dropped tinnitus research after his move to New Zealand. There was a misunderstanding with my last post so i post this again. Enjoy. The important part is it is posted in a well known journal. The "it's not otological but neurological" and "direct brain stimulation can help" are IMHO important message to spread so other neuroscientists hop in the bandwagon. Right now tinnitus research is very confidential and seems to be overshadowed by the "oh it's psychological there nothing to do medically" type of discourse.

Tinnitus: causes and clinical management.

Langguth B, Kreuzer PM, Kleinjung T, De Ridder D.
Source

Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany; Interdisciplinary Tinnitus Center, University of Regensburg, Regensburg, Germany. Electronic address: berthold.langguth@medbo.de.
Abstract

Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus. With prevalence ranging from 10% to 15%, tinnitus is a common disorder. Many people habituate to the phantom sound, but tinnitus severely impairs quality of life of about 1-2% of all people. Tinnitus has traditionally been regarded as an otological disorder, but advances in neuroimaging methods and development of animal models have increasingly shifted the perspective towards its neuronal correlates. Increased neuronal firing rate, enhanced neuronal synchrony, and changes in the tonotopic organisation are recorded in central auditory pathways in reaction to deprived auditory input and represent-together with changes in non-auditory brain areas-the neuronal correlate of tinnitus. Assessment of patients includes a detailed case history, measurement of hearing function, quantification of tinnitus severity, and identification of causal factors, associated symptoms, and comorbidities. Most widely used treatments for tinnitus involve counselling, and best evidence is available for cognitive behavioural therapy. New pathophysiological insights have prompted the development of innovative brain-based treatment approaches to directly target the neuronal correlates of tinnitus.

There is another paper in the lancet by Baguley et al but it mentions only psychology and sound therapy.
 
I'd like to see what they mention about new insights that are prompting new treatments.
 
I second that Hudson. I think that we with T, all know it was more of a brain thing than an ear thing, so not sure why this is such a revelation except for De Ridder and Langguth who have always claimed this.

Maybe, it's the that fact they all finally agree on the neuro aspect, disorder and cause of T. Nonetheless, it is great news. Now that they all agree, they can collaborate and work to finding more effective treatments to go along with neuro stimulation. This news does also correlate with Microtransponder report from TRI and the recent announcing of 3 Microtransponder brain stimulation studies.

Thanks daedalus!
 
@erik

Do you have any overview how much work there has been done in combining nerve and sound stimulation? In how many ways has this been tried?

They have been doing it for quite a lot of time on lab mice, they did a phase1 clinical study in belgium for which they had not perfect but quite good results. I think microtransponder is the only company seriously into that technology today.
 
Yes, they have been doing this for a while, at least the past 5-6 years. But the treatment is very invasive as they have to implant a device into your head behind the ear to do the stimulation and this is only in very limited use so the data is not really there. Perhaps now that there is something of a consensus, there will be more studies.
 
Yes, they have been doing this for a while, at least the past 5-6 years. But the treatment is very invasive as they have to implant a device into your head behind the ear to do the stimulation and this is only in very limited use so the data is not really there. Perhaps now that there is something of a consensus, there will be more studies.


the device is implanted in the chest not the ear, it targets the vagus nerve. I guess preliminary models are invasive but if their device works as expected, they'll probably have some less invasive technology to build
 
Yes, I did get that a little confused with TMS. I was thinking more about the Dirk DeRidder's TMS stimulation where they do implant a device from behind the ear into the head/brain and then electrically stimulate it. It was discussed in the BBC documentary "Longing For Silence" here: https://www.tinnitustalk.com/threads/recommended-listen-bbc-longing-for-silence.705/. Even though it is a few years old, it is a good listen.
 
Wow! There are just so many approaches being tried. Yet they are to categorize which treatment would work for what. I think vns stimulation would suit more for ppl with non cochlear tinnitus. Although then they don't describe the patients history any where.
 

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