Tinnitus Mapped Inside Human Brain

Yes and then you have the issue of residual inhibition. I feel that in the papers they equal residual inhibition to a "cured state" or a normal non T. state, like a person who never has had T. In fact this might be false. The only way we could know for sure is if we ran the test on a person prior to them developing T. and then redo it after the onset of T.

So now we just need that voluntary candidate

 

The question was raised by @amandine. When amandine is where you are, she can "do tinnitus" to her heart's content. But right now I suggest that she not devote a single moment she doesn't absolutely have to to tinnitus research, etc. It goes to the concept behind Overcoming Obstacles to Habituation. Not a problem for you, but a huge problem for her at this point in time.

 

My personal opinion - and I say this with the greatest respect for all who devote their efforts to this board for all the right reasons - is that in general people who are truly suffering from tinnitus tend to spend too much time here. It is certainly true that misery loves company and that being around those who suffer as you suffer can be helpful and reassuring. But - again just my personal opinion - there is so much bull spit on this board that goes totally unchecked that at some point in time it becomes counterproductive to log in. Look, I consider myself to be a fairly bright guy - but if I were to go on an electricians' message board, and somebody was spewing a bunch of utter nonsense, then as long as it made sense to me I'd probably think it was valid. Because I don't know squat about being an electrician. Same thing happens here. Most everything people write makes sense. But if misleading information is dispensed in a somewhat authoritative tone, many folks who are in bad shape with their tinnitus are bound to take it seriously - often to their own detriment. And in my personal opinion, there is no shortage of misleading information here. That's my take on it, anyway.

 

Eh, what did they correct?

Anyhow, they should rather conduct the fMRI on fresh T patients vs non-T patients.

 

Thanks @Sharpfire for posting the full article link.

This study is phenomenal. Though researchers have known about auditory and non-auditory brain areas being implicated in tinnitus--and have done MRI studies of functional connectivity--this article actually breaks down the tinnitus network into three sub-networks. (Well, this is their hypothesis, subject to further testing.)

1. The "tinnitus driving network" that results from "aberrant thalamic input."
2. The "tinnitus memory network."
3. The "tinnitus perception network."

Why is this important? As researchers study this further, they will learn the neural correlates of tinnitus and thus be able to develop more effective technologies to stop the precept. We know, for example, that most brain implants have met with little success. Why? Perhaps, it is because more than one area is needed to break up the interconnectivity of these multiple sub-networks. Likewise, current neurodmodulation technologies--like rTMS or tDCS--might be capable of treating tinnitus, but no one knows the correct areas to treat. Without the right targets, you cannot stop the noise.

I understand no one likes reading about tinnitus being "all over our brains." (I dislike it too.) But, it is what it is. We can't change it. We can be optimistic, however, that researchers are figuring out the complexity of tinnitus and this will lead to more effective treatments.

Here is another popular version of the article. I don't believe it was posted earlier:

http://www.newscientist.com/article...iple-regions-cause-tinnitus.html#.VTs1161Viko​

 

I would think that t originates in the auditory cortex, then memory and continued perception of the sound is activated in other parts of the brain. This seems like an obvious scenario.
But I believe that memory and perception can be diminished.
Habituation may be proof of this.
And other cases of fading t over the years also.
Just my two cents.

 

A breakthrough study in Current Biology (4 May 2015) reveals a stunning new discovery about the behavior of neural pathways in the brain for those who experience Tinnitus. As reported by WBUR on May 5, 2015, Tinnitus does not only occur in the auditory cortex (where it encompasses most of the region, which in and of itself is surprising, as it was theorized that Tinnitus was hyper-localized), but:

Contrary to expectation, these delta changes extended far beyond circumscribed auditory cortical regions to encompass almost all of auditory cortex, plus large parts of temporal, parietal, sensorimotor, and limbic cortex. In discrete auditory, parahippocampal, and inferior parietal “hub” regions, these delta oscillations interacted with middle-frequency (alpha) and high-frequency (beta and gamma) activity, resulting in a coherent system of tightly coupled oscillations associated with high-level functions including memory and perception.
​

Extensive intracranial recordings revealed rich cross-frequency interactions, clearly indicating that Tinnitus requires neural behavior that extends far beyond the auditory cortex but also involves memory, perception, and emotions.

The breakthrough, WBUR reports, means several things to scientists studying the phenomenon:

1. The amount of brain activity has no impact on the perception (i.e., how "loud" the phantom sound is) of Tinnitus.
   
   
2. Tinnitus brain-waves may be fixable using sound to retrain the brain. (Similar to notched music therapy or acoustic coordinated remodulation neurotherapy.)
   
   
3. Neural plasticity offers the best hope for silencing Tinnitus given how complex and multivariate the corresponding brain activity is, suggesting that other therapies that address suspected underlying causes may ultimately be ineffective because brainwaves that misfire often become proactive and anticipatory ("hyperactive") behaviors, rather than responsive or reactive behaviors to a particular stimulus or condition. This is similar to the "centralization" effect that many people who have Tinnitus report.

The paper's author, the University of Iowa's Dr. Phillip Gander, argues that most science on Tinnitus is fundamentally "wrong," and that a targeted solution may be ultimately fruitless since there appear to be innumerable points of hyperactivity disconnected from any single point of origin.

 

More music therapy then...

 

It seems like that's going to be the most promising, yes. So if I were to take this breakthrough to the next logical conclusion, there needs to be a lot more work on music therapy so that it's easier for people to hone in and target the misfiring regions of their brains and suppress the Tinnitus, and retrain the brain to automatically suppress it. Great section from the WBUR article gives me hope:

To identify the neuronal signature of tinnitus, they needed to turn it off — or at least turn down the volume of the phantom sound. They did that by playing a loud sound. Researchers have long known this can temporarily suppress tinnitus.

By monitoring the patient’s brain waves while his tinnitus was active or silenced, they could identify the brain waves associated with his tinnitus.

“That’s why our paper is a big deal for scientists,” Gander says. “We’re able to say what is specific to the tinnitus itself, as opposed to the distress or lapses of attention they might have because of their tinnitus.”

Interestingly, even though multiple areas of the Iowa man’s brain are involved, he has only mild tinnitus. So the severity of tinnitus doesn’t necessarily reflect the extent of brain involvement.

The new evidence is only from a single patient, so Gander says it needs to be interpreted cautiously. He’s currently studying a second epilepsy patient with tinnitus, and is trying to find more. Meanwhile, he hopes researchers can validate the findings in animals with an experimental form of tinnitus.

But the discovery that tinnitus can involve many areas of the brain is not especially good news.

“Maybe the reason tinnitus is so treatment-resistant,” Gander says, “is because it’s involved with so many parts of the brain. So any sort of treatment might not be able to knock out one area of that system. You might have to target all of them, which might be very difficult.”

Remolding The Brain

But Daniel Polley thinks it’s possible. He’s a neuroscientist at the Massachusetts Eye and Ear Infirmary who specializes in “neural plasticity” — the ability of brain activity to be remolded.

He thinks the abnormal tinnitus-associated brain waves found in the Iowa patient are fixable by using sound to retrain the brain.​

 

Thanks for sharing this, @Kaelon! I have read this study previously (and there is another post dedicated to it here: https://www.tinnitustalk.com/threads/tinnitus-mapped-inside-human-brain.9294/page-2#post-109878) but the article you posted is an interesting interpretation of it.

I just read this article that doesn't look like it is associated with the same study exactly but comes to similar conclusions: that a) tinnitus is "all over the brain" and b) this knowledge can help researchers create a "testable model" to identify the parts of the brain and possibly be able to deactivate specific segments.

http://www.eurekalert.org/pub_releases/2015-05/uab-bit051215.php

Interestingly, this section seems to "confirm" why tinnitus sufferers deal with so much stress and anxiety related to it:

As it happens, I will be likely participating in a study starting around June that works somewhat with these tenants: https://www.tinnitustalk.com/thread...cal-stimulation-for-modulating-tinnitus.7624/

I also am planning on working with the lead researcher on this study who is interested in doing a Q&A here.

New research like this will be a great thing to discuss with him!

 

I hate to introduce any four letter words to this wonderful thread, but TRT does come to mind. It's scary (in a good sense) that a quarter of a century after the fact there is an increasing body of work supporting what Dr. Jastreboff has been saying since 1990. And there has yet to appear a single study in the juried scientific literature refuting it. That does not prove he is right, of course. But even the most skeptical of minds would have to admit that it is a distinct possibility.

 

That's very fascinating. It's definitely clear to me that if tinnitus is a perfect storm in and throughout the brain, then, therapies that are designed to accelerate habituation can be very effective in addressing the emotional and memory centers fueling the perception. But, an alternative perspective here might be, if neuropsychological therapies don't actually suppress tinnitus in its entirety, is there a model that can be devised where stimulating a critical mass of neural pathways leads to a cognitive "reset" that halts tinnitus altogether? That seems to be the model that Gander is pursuing and, if he gets it right through sound therapies, could prove superior in the relief potential to neuropsychological approaches like TRT.

 

All I am saying is that Polley talking about using sound therapy to retrain the brain by taking advantage of the phenomenon of neuroplasticity, which is what Dr. Jastreboff has been talking about since 1990 using the exact same terminology.

 

I don't think anyone has disputed that sound therapy + neuroplasticity is a valid way of treating tinnitus.

The problem is that it takes a hell of a long time and for some has very minimal effects. Unfortunately, companies we work for aren't going to give us substantial leave so we focus on rehabilitating our brains from tinnitus. Not gonna happen.

Also, we do not know what an "ideal" treatment plan for a particular sufferer would be, since tinnitus is complex enough that a one-size-fits-all solution doesn't work for everyone. I have read papers from TRT to notched therapy, and while they have their plans, those plans seem rooted in both facts and assumptions. We don't really know the best ways to utilize sound therapy yet.

This is why people are more excited about hair cell regeneration & drug treatments. The drug treatments seem to act quickly, which is desireable. The hair cell regeneration would in theory restore the ear back to a working state, with the hopes of eliminating hair loss symptoms such as tinnitus along with it. That seems even better.

Vagus nerve stimulation is the best hope to make sound therapy a more usable technique, as it speeds up the plasticity process in the brain tremendously. Let's just hope it makes strides in the trials.

 

Actually, some do. But their numbers are dwindling ... because there's this thing called reality.

Substantial leave? Focus on rehabilitating our brains? First of all, TRT requires no "leave" from work at all. And second, focusing on rehabilitation is just about the worst thing in the world you can do, at least from a TRT standpoint.

This is a research forum. I entered this thread to raise a point about current research, but things are going a bit astray. So I think I'll leave it there.

 

I wasn't talking about TRT.

I was talking about notched sound therapy, a technique that has shown serious promise in reducing tinnitus levels in the brain.

Personally, I think they all have it wrong, and the time you should be spending retraining your brain should be WAY more than any of the current techniques recommend.

More research is needed.

 

Why are they shocked? The cerebellum also processes sensory input from the inner ear for equilibrium.

 

Just out of curiosity, what percentage of the dollars allocated toward research for the cure would you suggest diverting to notched sound therapy and the like?

 

That's fascinating. Aside from Dr. Jaktreboff's own publications, what research do you recommend as a good primer to the scholarship behind TRT? I would love to be more educated on its neuropsychological underpinnings, especially when compared with the broader CBT framework.

I'm less concerned about Polley and more focused on Gander's research and his approach towards a cure vector, because I think it moves the conversation forward in a startling new direction. The way I read it is that Gander's implication here -- obviously disclaimed by the fact that much more research about how this Tinnitus Brain Mapping plays out and responds -- is anchored in sound therapy having a much more promising vector than other cure tracks to-date, especially given this breakthrough. What do you generally think about that?

 

None, really. When it comes to TRT, Jastreboff is "da Man!" You might take a look at Jim Henry's book, which is quite good, but it is more clinically-oriented.

Can I let you in on a secret, Kaelon? Promise to keep it just between the two of us and not tell a soul? OK. Here goes. Shhhhhh. You want to know what I generally think about that? What I generally think about that is that I do not know enough about the research to tell you what I generally think about that. My focus - my sole focus - lies in what I can personally do to help tinnitus sufferers today. As to what somebody else might be able to do ten years from now? It is just not on my radar. And that's the honest truth. I support tinnitus research with my dollars, and I encourage others to do the same. But that is the full extent of my involvement.

 

Re: Jastreboff, thanks, I will definitely check out Jim Henry's book. Neural plasticity is very fascinating to me, and if there are practices we can foster and perfect now to start the journey towards mental healing, I'd be very interested in understanding the different theories and mechanisms of how they all work.

Re: Tinnitus Research, I guess my issue is understanding where exactly to put my dollars. As an ATA member, I feel like my donation there is pretty safe - but it's generalized for the programs (and grants) that the ATA executes, as you know far better than I. I'm interested in something a bit more targeted and a lot less experimental: many entrepreneurial startups tend to vacillate between dead-end cure-therapies (including very well-publicized new clinical trials, whose results as of late seem to confirm that they are looking at truly minor and almost irrelevant gains in silence for those who have tinnitus), and frankly crack-pot snake-oil scams. Neuropsychiatric therapies, like ACRN and Notched Music therapies, strike me as very innovative but I don't feel like I have much knowledge or insight on the scientific underpinnings of their work to determine whether I should be supporting one or the other. I also understand I'm only one person, but part of my own coping mechanism is to feel less-than-powerless and actively try and do something to help both myself and others with a pathway to positivity amidst the cacophony of our condition.

 

ATA does not fund projects for which it does not receive grant applications. Once a grant application is received, the first step is to make sure that the proposed project falls along ATA's Roadmap to a Cure. No more funding music studies, etc. Then the remaining grant proposals are carefully reviewed by an international panel of independent experts in the field, after which they are ranked. Since funds are limited, only the highest ranked of the deserving projects actually get funded.

 

Great; like I said, I am very happy being a contributing member of ATA. It's great having a nonprofit organization advocating on our behalf. I think it's a safe bet, and I also like that the Current ATA Research is focused on breakthroughs grounded in better understanding the mechanisms and behavior of Tinnitus. One of the problems I have with a lot of the entrepreneurship by the pharmaceutical industry is that "research" in this sense tends to be restricted to reformulations of previously patented drugs or prior discoveries. For instance, the clinical trials today seem to be trending principally towards trans-tympanic injectable medications -- which is so narrow in its scope, it should be hardly surprising that most of the results we've seen to-date have been really lack-luster. Alternatively, enthusiasm by patients and even some clinicians to prescribe medications for off-label use (such as anti-epileptics in the widely-discussed off-label use threads here on TinnitusTalk) as a way to treat Tinnitus discourages me, if only because it just amplifies how terribly ignorant the entire medical community is about this symptomatic condition and how little is actually being done to harness innovation and creativity to actually solve it.

This is all to say that this brain mapping study is exciting to me because:

• It advances one of the 'unusual suspects' in treating tinnitus -- potentially, sound therapy.
  
  
• It's innovative in uncovering some of the neural mechanisms of how tinnitus works, which has generally been a topic of disinterest to even passionate otolaryngologists working in this field.
  
  
• It's ground-breaking because it tells us that a lot of the assumptions about what tinnitus is or how it works, positions held by medical practitioners for the past five decades, are essentially fundamentally wrong.

I wonder what we can do, as people who talk about research and help fund it, to encourage researchers to be innovative like this - challenging assumptions, creative with applications, and solution-oriented towards curing this condition.

 

The cards are stacked against you.

Let's look at politics, first. The brightest and the best rarely go into politics. Not because they aren't interested in making a difference through public service, but rather because they can make so much more money in other fields that public service is simply not worth it. And even when a true superstar does decide to go into politics (as rare as that might be), it is only with the knowledge that when the "politics" chapter of his or her life is over, there is literally a pot of gold at the end of the rainbow in speakers fees, book releases, corporate deals, and the like. Politics is, in that sense, a stepping stone to riches.

But in tinnitus research? Really? First of all the lowest paying job in politics pays more than the highest paying job in tinnitus research. And secondly, there ain't no pot of gold at the end of that rainbow. It is incredibly rare that researchers can structure their university contracts to be able to meaningfully share in the monies that that research might generate. Indeed, the researchers' greatest challenge lies in being able to generate grants for their universities in order to justify their paltry salaries in the first place.

So, sad to say, it is a real catch-22.

 

Holy crap. 50k of funding for 2 projects. This doesn't even cover the salary of 1 researcher for 1 year.

 

Right, but put another way - it's particularly sad that ATA is the leading grant nonprofit organization of Tinnitus research in the United States. Dr. Nagler alludes to the problem being anchored in the lack of money to fund a cure. I think it's deeper than that -- Tinnitus, because it's only a "nuisance," doesn't pose the same sort of challenges that, say, cancers do. Even so, understanding the brain and how it works could benefit so much more than just curing tinnitus.

 

Then instead of focusing our efforts on the "We need more tinnitus research!" mantra, perhaps our efforts would be more productively focused on the "What can we do to insure that our tinnitus researchers are actually paid what they are worth?" mantra.

 

Here's a thought (more like mental masturbation, but a thought nonetheless). Ten years ago the US Veterans Administration doled out a staggering $418 million in compensation for tinnitus-related disability. If they had at that point in time come up with a $200 million tax-free award for the researcher or research team that developed a safe way to predictably eliminate tinnitus or lastingly mitigate the strength of the tinnitus signal, it would have been a no-lose for the US government. Either we'd have that cure by now at a cost to the government of less than 50% of one year's tinnitus-disability expenditure ... or we'd be no worse off than we are right now.

 

As a "Team Awareness" member your message above caught my eye. Doesn't research happen when researchers are paid? So, in raising awareness of tinnitus, followed by raising millions of dollars, which then are disbursed to researchers (either via the ATA's grant process, or some similar process somewhere else), don't we get the same result?

I'm an optimist + a realist, which means that I'm optimistic that a great Awareness campaign can get potential donors to see why donating to tinnitus research is a valid cause, and I'm realistic to see that without major structural changes, the best way to apply those dollars right now is within the existing framework of research.

I guess that means that your approach above redirecting "our efforts" to a different "mantra" is one I don't really agree with--because we are essentially powerless to get researchers to get paid what they earn in our capitalist society (but I won't go there because this isn't a political forum) but we certainly have the power to do good in the realm of research right now.

I guess I understand this approach because we certainly need to help the sufferers of today get to a "habituated" state. But for someone like you who has essentially devoted the last 20+ years of your life to tinnitus, I'd hope that you have a more active role in facilitating research.

 

That would be ideal! Of course the US government is not exactly known as a bastion of efficiency, but I digress...