UltraQuiet Therapy

[Tha_b_man]

http://www.dailymail.co.uk/health/article-139867/A-sound-hope-tinnitus-victims.html

 

[erik]

Sounds interesting.....thanks for posting

 

[Markku]

Long-Term Inhibition of Tinnitus by UltraQuiet Therapy: Preliminary Report

Results
All eight subjects who completed the study reported abatement of their tinnitus symptoms during the course of treatment. (One subject dropped out for reasons unrelated to the tinnitus study.) The duration of the improvement varied. For two patients, the improvement lasted for 2 or more weeks. For the others, it lasted for 1-2 hours for up to 3 days (Figure 3). A long-term follow-up questionnaire was administered 2-8 months after the end of the treatment; results are as follows. On the question, "How do you feel that your overall tinnitus symptoms have changed since before you began the tinnitus treatment?" one person answered "moderately improved," five people answered "slightly improved," and two people answered "about the same." One person reported benefit lasting 4 weeks after the last treatment, one person reported benefit for 1 week, four people reported benefit for 3-5 days, and two people reported no lasting benefit. No one reported any adverse effects or worsening of symptoms (Figure 4). The mean change between the pretreatment and post-treatment audiograms was less than 5 dB (Figure 5), which was not statistically significant. No individual audiogram showed any notable change.

Subjects occasionally reported an "afterimage" of the stimulus after the sessions, but this was not perceived as aversive and, in some cases, seemed to enhance the suppression of tinnitus. Some subjects also reported a subjective improvement in hearing, but this was not supported by the post-treatment audiometric results. However, discrimination was not assessed.

Discussion
The response of the patients suggests that the UltraQuiet therapy is able to induce RI of tinnitus for a duration substantially longer than that of conventional masking noise. Potentially, the improvement reported by the patients is truly a plastic change at the central level that may, over time, reflect the establishment of a "new" interneuronal network for auditory perception and the elimination of the aberrant auditory phenomenon (i.e., tinnitus). Central nervous system involvement in tinnitus has been found at both subcortical and cortical levels. Both levels could playa role in long-term inhibition.

 

[Karl]

This is amazing news! So simple: Ultra quiet. We've been told the exact opposite, to avoid silence.

Is this "The Cure" we've been looking for? Amazing. Makes sense.

 

[Karl]

Whoops, I misunderstood this! I was reading only the headline, "Ultraquiet" - thinking that's all this treatment was: Quiet.

"Ultraquiet" is the name of a device that uses very high frequencies. Still very interesting with impressive results.

What is this magazine? "The National Enquier Science Edition"? (While I was reading about "Ultraquiet", I saw a lot of interesting gossip posted on the side about Lindsey Lohan and Wayne Gretskys daughter.)

It is very interesting reading about a new theory: When the auditory system loses its ability to hear high frequency, those auditory circuits begin "listening" to lower frequencies. I found this interesting because my right ear - the one where my tinnitus started, picks up low frequencies which I don't hear in my left ear. Once I start hearing low frequencies in my right, somehow it causes my left to hear high pitched buzzing.

 

[Dhaval]

Hi guys

I've been meaning to try and use some sort of masking to get my life back on track. My tinnitus is fairly recent... I can pin it down to 4 months since I first noticed it... although it may have been before that. I had got a viral infection then I think that's where all of it started... in May I developed something like a nuritis or labyrinthis... No docs have been able to say what... Since I should not have tinnitus with nuritis although a few docs have said that tinnitus is possible with nuritis... I am still reeling... hence I am just trying anything to get my life back to some normalcy.

I have multiple tones in both ears (or so I can make out both low moderate and high pitch)... initially my audiograms detected some hearing loss (this is when tinnitus was terrible around May)... but the most recent audiogram suggests that my hearing has returned to normal (with all frequencies upt o 8K showing 20 dB min response...even 10 and 5 dB in some lower ones)... although I still get some ear fullness and pain (mostly bearable)....but am concerned that the tinnitus is not dropping any further.

I have been considering ACR or Ultraquiet therapy... from the posts on ACRN I can understand that it's not been very successful. I would like to know has any one experienced any benefit with ultraquiet although they claim 96% benefit!

Also just off topic here at the time of developing tinnitus did any of you notice a small teee...tinnitus sound about 3 secs with sort of hearing change like your ear's closed and then opened again (I don't mean like what you get with collapsed eustachian tubes. This has happened during the course of sickness several times in both ears... any one has any input on this too...?

Markku... would appreciate your input... I have found this resource quite informative...

Thanks... much appreciate your help.

 

[erik]

A new treatment for tinnitus using vibrations created by synthesised music, improved symptoms in almost all patients during its first trial.

The sonic brain reprogramming treatment, based on sound vibrations that pass through a bone behind the ear, helped eight out of ten of the patients who had twice-weekly sessions of the therapy.


Read more: http://www.dailymail.co.uk/health/article-139867/A-sound-hope-tinnitus-victims.html

 

[jes]

A nice sunday with 2 new cures,but i think the demon is still in my head.

 

[Frederick86]

Any recent news about this? It sounds good, I'm interested in trying Dichonics or something like this till there is a better treatment in the future...

 

[Sound Wave]

This is interesting. Pinging @Steve. We could probably try this with a DIY / hacker approach by getting suitable audio stimuli in the 10-20KHz range (Steve?) and playing that through a "piezoelectric bone conduction transducer" the study mentions. Instructables has for example a DIY instructions to make one of those: http://www.instructables.com/id/Bone-Conducting-Earphones Bone conducting headphones are also sold commercially and I have already asked for advice from one person I know who knows about them.

 

[Sound Wave]

This is the bone conducting headphone model my friend suggested: http://www.amazon.co.uk/Aftershokz-Bluez-Conduction-Headphones-AS500/dp/B00JO9Y176/ref=sr_1_1?ie=UTF8&qid=1401443553&sr=8-1&keywords=bluez 2

 

[Frederick86]

I'm all for it! As I understand from the paper, this is another form of lasting RI that works through neuronal plasticity. They say it clearly in the discussion paragraph, that it may over time lead to a "new" neuronal network. Any treatment that can sustain cortical inhibition for long times would have the potential of letting the neuronal pathways "regrow" correctly, then.

When it says that a patterned sound is used and that music (not continuos tones) works better, I thought of the system used by SoundCure, the S-tones, as the rhythm of the stimulus seems important for neuronal syncrony. Would it be a good approach to experiment with something like that but with bone conduction?

Also I searched for the UltraQuiet company, and in Daily Strenght I saw someone mentioning they are broke and out of business, what could make difficult to replicate their treatment...

Anybody knows if this is true? And if people here were to try to DIY this, would it be a good idea to do some kind of crowfunding? Are professional tools or software needed? I'd be willing to donate and/or offer myself for testing, as the paper stated no one got worse so it seems safe.

 

[Sound Wave]

The Tinnitus Network could facilitate this kind of community effort DIY projects with or without crowdfunding. 'Pro-amateur' non-clinical trials if you will. How about this idea @Markku, @Steve?

 

[Steve]

The Tinnitus Network could facilitate this kind of community effort DIY projects with or without crowdfunding. 'Pro-amateur' non-clinical trials if you will. How about this idea @Markku, @Steve?

Interesting.

Do we know any more about the audio signals? I was going to buy some bone conduction headphones a while back but never got round to it, the Aftrshockz seemed to be pretty much the only choice.

It's easy to make some high frequency sounds, I can work an octave below and transpose it up to the regions where most of us can't hear any more. I can monitor the volume of the high frequency noises and put audio in at a lower frequency as a guide to volume level when listening, so it should be perfectly safe to try.

I'll definitely give it a go if we can get some guidance as to how it worked. Maybe we can track down the company and ask? I imagine they wouldn't have a viable product as it is so easy to copy, so maybe they went out of business due to a lack of funding.

 

[Markku]

Maybe we can track down the company and ask? I imagine they wouldn't have a viable product as it is so easy to copy, so maybe they went out of business due to a lack of funding.

http://www.tinnitusjournal.com/detalhe_artigo.asp?id=207

ULTRAQUIET THERAPY

UltraQuiet therapy provides patterned auditory stimulation in the high audio and ultrasonic ranges (10-20 kHz) using a bone conduction transducer (Figure 1). It is based on the work of Lenhardt et al. [10], demonstrating ultrasonic perception by humans through bone conduction up to 100 kHz. UltraQuiet therapy differs from the conventional masker in that none of the sound overlaps the range of reported tinnitus. Nevertheless, ultrasound was even more effective than was speechrange masking noise for tinnitus masking and producing RI in a study by Meikle et al. [9]. In UltraQuiet therapy, the auditory stimulation, rather than the band of noise commonly used for masking, is music that has been processed and shifted in pitch. Davis and Wilde [15] demonstrated music to be a more effective tinnitus masker than noise. They attributed the greater effectiveness of music in part to the involvement of more central and cognitive processes. In UltraQuiet therapy, the processed music is presented through a bone conduction transducer at a low level-approximately 6 dB above threshold-for periods of 30 minutes to 1 hour twice weekly. The goal is to effect changes in the central nervous system mechanisms of tinnitus, resulting in long-term inhibition.

Stimulus

The tinnitus treatment stimulus was produced using Kyma Version 5 software with a Capybara 320 Sound Computation Engine (Symbolic Sound Corporation, Champaign, IL) and was recorded on a compact disk. The stimulus consisted of music digitally processed and used to modulate a signal in the 10-to 20-kHz range. The compact disk was played through a custom-made amplifier into a piezoelectric bone conduction transducer. The transducer was held in place on the mastoid bone of the subject by a headband. Although the stimulus is presented on only one side of the head, it is heard binaurally through bone conduction.

Procedure

The subjects listened to the tinnitus treatment stimulus for eight sessions (twice weekly for 4 weeks), beginning with 30-minute sessions and increasing to 60-minute sessions. The stimulus was presented at 6 dB above the threshold of each individual.


Sound Technique Systems, LLC:
http://www.accessdata.fda.gov/cdrh_docs/pdf2/k021202.pdf

http://www.people.vcu.edu/~lenhardt/Pages/UltraQuiet.html
http://www.tinnitus.vcu.edu/Pages/Main.html

http://www.tinnitus.vcu.edu/Pages/ASA01lay.PDF

 

[Steve]

Thanks @Markku

I've mailed Dr Martin Lenhardt to ask if they are no longer producing the device and if so can we help to further it through the forum (using MP3 player and bone conduction headphones).

I'll update if / when I get a response.

 

[Markku]

Thanks @Markku

I've mailed Dr Martin Lenhardt to ask if they are no longer producing the device and if so can we help to further it through the forum (using MP3 player and bone conduction headphones).

I'll update if / when I get a response.

https://web.archive.org/web/20060613060425/http://hearultraquiet.com/

This might be interesting as well:

https://web.archive.org/web/20050207100648/http://www.hearultraquiet.com/Pages/Professional.html

And the protocol:

https://web.archive.org/web/20050212022130/http://www.hearultraquiet.com/Pages/Professional2.html

Here's a PDF poster by Dr. Lenhardt:

https://web.archive.org/web/20041015112642/http://hearultraquiet.com/Pages/ARO Poster.pdf

 

[Frederick86]

Any new answer? As I read is still possible (or was at some point) to get a CD from them, but I wonder if it's possible to replicate the treatment with what we already know, in case there are no CD's left? What would it take?

 

[jazz]

@Markku Thank you gathering all that information on Ultra Quiet!

@Steve Thank you for emailing the doctor. If the device is no longer being produced, perhaps the doctor will share the sounds with us free of charge!

 

[earflappin]

Wow. I live about 6 blocks from the VCU campus in Richmond, VA. I had no idea this work was going on so close to me.

 

[Steve]

They are still making the device, so we won't get any freebies unfortunately.

It's being updated.

 

[earflappin]

They are still making the device, so we won't get any freebies unfortunately.

It's being updated.

So is there a web site where you can purchase the device and associated audio?

 

[Steve]

So is there a web site where you can purchase the device and associated audio?

Not at the moment, Martin said

I am in the process of developing a different and hopefully improved product. The economy has slowed the progress.

 

[Frederick86]

@Steve Then would you say is still worthy to try to DIY this treatment? I'm quite interested in trying cheap stuff first. If you or other tech-wise people here is not interested, what would you think I'd need to know to do this? Would it be enough with some audio editting basic skills or is this a task for more experienced people?

 

[Steve]

@Steve Then would you say is still worthy to try to DIY this treatment? I'm quite interested in trying cheap stuff first. If you or other tech-wise people here is not interested, what would you think I'd need to know to do this? Would it be enough with some audio editting basic skills or is this a task for more experienced people?

We can absolutely DIY this. It just needs each person to get some bone conduction headphones and have an audio player that will play uncompressed files (WAV / AIFF / FLAC). Probably wired headphones as Bluetooth will have some form of inherent audio loss.

It seems that the music or sound just needs to have high frequency activity. I can make something that I'm sure will work, best thing is probably a random pattern like you would get from some wind chimes - so it can be listened to without being too distracting.

 

[Frederick86]

@Steve Great! I think it could be important to check the need for customized stimulus in the case of those with very high frequency tones, as the paper seems to state this as important:

Muhlnickel et al. [23] explored the reorganization of the auditory cortex in tinnitus, using magnetoencephalography. These authors found a marked shift of the cortical representation of the tinnitus frequency into an area adjacent to the expected tonotopic location. They also found a strong positive correlation between the strength of the tinnitus and the amount of cortical reorganization. They pointed out the similarities between tinnitus and phantom limb pain: Both cases exhibit a loss of input from peripheral nerves accompanied by a similar reorganization of the cortex. Muhlnickel et al. [23] suggested a possible therapeutic approach in which patients attend to and discriminate some features of acoustic stimuli that are close to the tinnitus frequency, to drive cortical reorganization of the nontinnitus frequencies into the tinnitus representation, thereby reducing it. Note that this is considerably different from conventional masking, wherein the acoustic stimuli encompass the tinnitus frequency; it is also different from the TRT paradigm, in which the point is to learn not to attend to the sounds. It does, however, resemble the UltraQuiet system, which uses patterned stimuli well removed from the tinnitus frequency.


Also, do you think the rythm of the pattern will need to be a very precise secuence, or probably it will suffice being dynamic and randomised, kind of ACRN like?

 

[Steve]

Also, do you think the rythm of the pattern will need to be a very precise secuence, or probably it will suffice being dynamic and randomised, kind of ACRN like?

@Frederick86 After much experimentation with that particular protocol the best results I found were using 90Bpm as a timing. The pauses seem to be needed too, we can experiment with the sounds but I think that a pure tone (sine wave) will still be the way to go.

I'm going to have a look at the headphones, the aftershokz seem to be the most widely available and not too expensive.

 

[Frederick86]

When you say pure tones, it means you tried several frequencies with 90bpm? How many hours of RI did you achieved?

 

[earflappin]

The aftershokz reviews are pretty much what I would have expected...they work, but you don't get excellent full spectrum audio performance. Fortunately for our application, this is not a deal breaker IMO. Frankly, given the commercial availability of these units at such reasonable price points, I wonder why UltraQuiet would even attempt to bring to market a Gen2 model unless they: (1) feel the currently available units are not effective and/or (2) they believe they have to package their treatment with their own unit in order to drive the revenue they need to recover their R&D costs and create an on-going business.

 

[Salt]

To chime in with my 2 cents i believe that most apple and android devices will play uncompressed .aiff files (i'm almost certain an iPhone does). So with the right headphones and the proper audio file it sounds doable to recreate this treatment DIY style. I would recommend using the highest possible quality... at least 24bit / 96khz, if not 192khz. Its my understanding that the higher kHz the higher the capacity for higher frequencies.