|Using magnetic resonance imaging, sufferers could observe and directly influence their brain responses|
Special brain training for tinnitus
Ohio (USA) – Specialized neurofeedback training could help tinnitus patients alleviate or even eliminate their condition. This is the hope of researchers from the United States after a small study, they presented at the annual meeting of the “Radiological Society of North America (RSNA)”. Tinnitus does not manifest in the ear, but in the brain – more specifically, primarily in the auditory cortex, the auditory center.
The fMRI-supported training helps to divert the attention from the annoying, subjectively perceived ear noises and so casually reprogram the brain. The patient is thereby visualized his own brain activity, so that he can react directly to them and influence them. In the long run, the researchers want to develop a simple neurofeedback program based on their results, without the complex technique of functional magnetic resonance imaging (fMRI). Ideally, patients can easily do the training at home, for example with an app.
“The common notion is that in people with tinnitus, excessive attention is drawn to the auditory cortex, which makes this brain area more active than in healthy individuals,” explained Matthew S. Sherwood of Wright State University, Fairborn, Ohio. “Our hope is that sufferers can use Neuro-feedback to divert attention away from their tinnitus and possibly get rid of it.”
Sherwood and his colleagues had tested the FMRT neuro-feedback training in 18 healthy volunteers who had no problems with tinnitus or hearing. About earplugs, the outside noise shielded, the subjects heard alternately a noise or nothing. By means of FMRI, brain activity was observed.
Sherwood and his colleagues
In the run-up, Sherwood and his colleagues identified those areas in the subjects’ brains that responded the most to the noise. Noises are processed especially in the auditory cortex. In the course of the training, the subjects themselves saw how strongly their brains responded – in the form of a bar on a screen. They should watch and actively try to reduce its size. In support of this, the researchers conveyed techniques to direct attention, for example, from hearing to other perceptions such as seeing and feeling. “Many focused on their breathing because it gave them a sense of control,” Sherwood said. “And by diverting their attention away from what they heard, the activity in the auditory cortex decreased and the measured signal also decreased.”
The exact neuronal processes associated with the development and manifestation of tinnitus have not yet been fully elucidated. Presumably, they are connected with attention. Using the fMRI training to demonstrate that there is a clear link between the control of the primary auditory cortex and attention mechanisms is, in Sherwood’s eyes, an important step in the development of therapies.
There are many possible causes of tinnitus, the most common being noise that damages hair cells in the inner ear. The result is a sound that is objectively not there. Medication, a benign tumor or hearing loss in old age can also lead to tinnitus. The cause should be confirmed by the doctor. For the first three to six months, doctors talk about acute tinnitus. However, if the ear noise persists, it is considered chronic after one year. That decides in the brain. Especially when attention is constantly being paid to the sound, coupled with fear that it will not stop, there is a risk of getting caught in a vicious circle. Ignoring the annoying sounds is often easier said than done, but music and other acoustic distractions can help.
Incidentally, the volume hardly seems to play a role in the load. How disturbing or distressing the ear noise is subjectively felt, seems rather a matter of personality. Especially because the emotional is often closely related to the hearing, the burden can be enormous. Not infrequently, side effects such as sleep disorders, anxiety or depression occur. Alternative approaches such as relaxation techniques or hypnotherapy can bring relief here.
So tinnitus is just a symptom. Acute tinnitus often disappears by itself, so it is difficult to prove which therapy is helpful. It becomes an independent disease only if the vicious circle is not broken. If this is the case, this is also reflected in plastic changes in the brain – but can also regress. Tinnitus can therefore be understood as a consequence of reorganization processes in the brain. The therapy with guaranteed success does not exist. Nevertheless, both acute and chronic tinnitus are quite treatable. In chronic tinnitus, cognitive behavioral therapy is often used. The patient learns to accept the ear noises and move them into a different light. Finally he forgets to hear the tinnitus.