Recent reports suggest that scientists are making progress in their efforts to better understand and treat tinnitus, the ringing in the ears that is a common cause of distress among people of all ages:
SPECIALIZED APPROACH WORKS BETTER THAN STANDARD TINNITUS TREATMENT
MAASTRICHT, NETHERLANDS—A team of researchers based at Maastricht University has found a multi-faceted approach to tinnitus to be more effective than the standard treatment in relieving the distress caused by tinnitus. Tinnitus affects, to varying degrees, about a fifth of all adults at some point in their lives.
An article published in the May 26 issue of The Lancet reported the results of a four-year study in which nearly 500 tinnitus patients took part in a head-to-head comparison of a standard treatment with a specialized treatment based on cognitive behavior therapy.
The standard treatment used involved a hearing test, an ear examination, an explanation of the cause of the tinnitus, and a hearing aid, if deemed necessary.
The specialized treatment included counseling to help people overcome the distress their tinnitus causes, the use of soothing background noises like rain or ocean waves to mask the sound, and physical relaxation exercises.
In determining the effectiveness of the two treatment protocols, the researchers used measurements of health-related quality of life, tinnitus severity, and tinnitus impairment.
Findings are promising
Compared with the 247 patients who received the usual care, the 245 patients assigned to specialized care showed greater improvement in health-related quality of life during a period of 12 months. They also had a larger decrease in both the severity of their tinnitus and the impairment it caused. The effectiveness of the specialized treatment did not seem to be affected by the severity of the patients’ tinnitus at the start of the trial.
The authors concluded that “specialized treatment of tinnitus based on cognitive behavior therapy could be suitable for widespread implementation for patients with tinnitus of varying severity.”
David Baguley, the head of audiology at Cambridge [UK] University Hospitals and a leading expert on tinnitus, was involved in the design of the study and the interpretation of the results.
In an interview with The Telegraph, a British newspaper, Baguley said, “The high quality of the research design and implementation means that we now have robust evidence that taking care to address not only the hearing needs of people with tinnitus, but also their dismay and distress, results in better outcomes.”
He added, “This will be important in underpinning decisions about commissioning future services for this important group of patients.”
STUDY PROBES PHYSIOLOGY OF TINNITUS
LEICESTER, UK–While the University of Maastricht group focused its research on treatments that can be used today to mitigate the symptoms of tinnitus, scientists in the University of Leicester’s Department of Cell Physiology and Pharmacology recently published findings about how tinnitus develops. It is hoped that their research could lead to the discovery of pharmaceutical treatments that will prevent tinnitus.
Writing in the journal Hearing Research, Martine Hamann and her co-authors reported having identified a cellular mechanism that could underlie the development of tinnitus following exposure to loud noises.
In an interview with Science Daily, Hamann said: “We need to know the implications of acoustic overexposure, not only in terms of hearing loss but also what’s happening in the brain and central nervous system. It’s believed that tinnitus results from changes in excitability in cells in the brain, in this case more reactive to an unknown sound.”
The University of Leicester scientists examined neurons in the dorsal cochlear nucleus that carry signals from nerve cells in the ear to the parts of the brain that decode and make sense of sounds. They found that after exposure to loud noises, some of the neurons in the dorsal cochlear nucleus begin firing erratically, which eventually leads to tinnitus.
The team also identified the specific cellular mechanism that leads to the neurons’ over-activity. Malfunctions in the potassium channels that help regulate the nerve cells’ electrical activity prevent the neurons from returning to a resting state. When that happens, the cells continuously fire in random bursts, creating the sensation of constant noise when none exists, i.e., tinnitus.
The group is looking for drugs that could potentially regulate the damaged cells and prevent their erratic firing that causes tinnitus. If suitable drug compounds are discovered, they could be used to treat patients who have been exposed to loud noises to protect them from the onset of tinnitus.
These investigations are still at a preliminary stage, and are not expected to result in a drug treatment for years.