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Will NIH’s new Tinnitus treatment device be able to hush the murmurs?

For years, the sound of silence has crept unnoticed and without a cure. Is there hope in the horizon for the ones who are suffering or is this going to be just another false dawn like many before?

National Institute of Health are asking for volunteers for clinical trials to test a new and improved device for people suffering from the non-life threatening but serious life-destroying disease tinnitus. Tinnitus is a medical condition of perception of noise in ear(s) or head without any external acoustic producing agent. The noise is clear, constant and with varying frequency depending on the time of day and the activity undertaken. It is an extremely common condition faced by people in all parts of the world. In US alone there are more than 30 Million people suffering from tinnitus however the exact number is still unknown. The sound of tinnitus varies from individual to individual. Most commonly it is experienced as a ringing noise. Its other forms include hissing, buzzing, roaring, humming, beeping, cricket chirping, cicada noise or a pure steady tune like in a hearing test. Its frequency can be intermittent or continuous.

There is no single cause of tinnitus. The subjective tinnitus has many different reasons and pinpointing one exact factor or reason is almost impossible within the current medical science technology framework. Research on causes of tinnitus is an on-going area of study and there are many questions that require further understanding and comprehensive research. A general understanding and belief is that tinnitus is actually the sound of neurological activity in the cochlea (the hearing organ inside the inner ear), which can be heard in absolute silence by everyone.

In normal circumstances it is not heard because

  • The sounds in the environment around us dampen the effects of this activity and the brain is unable to process it
  • There are complex masking systems inside the human brain which work in different patterns and perform filtration and mute unnecessary sounds. The brain trains itself to prioritize sounds based on importance to human functions and filters low priority sounds coming from inside human body making them inaudible. This is the reason why a baby crying or an alarm clock ringing is more obvious and sudden sound than traffic noise in the background while driving.

Tinnitus can be caused by damage to ears. These include ear damage from high music, acoustic shock, ear infections, earwax impaction, age assisted hear loss and mercury or lead poisoning. Other possible reasons for tinnitus include the neurological disorders including head injury, whip lash and multiple sclerosis. Metabolic problems like thyroid disease, psychiatric issues like depression and anxiety, side effect of medicines like Aspirin, and other conditions like Lyme disease, migraine and nasal congestions can all also result in tinnitus. The exact cause of tinnitus can vary for each individual making it difficult to speculate and assume a general cause.

The new clinical trial and research are aimed to create new avenues about understanding and curing for tinnitus. The small clinical trial will be conducted at four different facilities over a period of one year and results will be monitored and relayed back to the researchers continuously. Researchers believe that they have found new clues and are very close to finding a good treatment for tinnitus that can help people suffering from tinnitus at different levels. The major cause for chronic tinnitus, loss of hearing due to inner ear damage from various reasons results in neural behavior changes. The damage to sensory cells can lead to the auditory cortex malfunctioning hence the researchers have tried to see what will happen if they manage to correct the source which is the brain in this case.

Scientists believe that the auditory pathway is organized like a map, a tonotopic map, which is a fundamental arrangement like a motorway having different lanes. Each frequency is carried on a distinct and specific lane without mixing with other frequencies. The loss of hearing can create the tonotopic map to be distorted, creating a false signal for the neurons in the auditory cortex making the neurons to work extra hard to receive those signals. The case of tinnitus being an extra effort by the brain to listen to the frequencies those are no longer available. The activity is carried out with more fervor in the absence of an external sound as more energy can be spent on due to free neurons.

The new device is going to use a technique known as Vagus Nerve Stimulation which will take advantage of the ability of the brain to reconstruct and rewire itself (neuroplasty). The therapy will allow the patients to use headphones where a series of single frequency tones paired with stimulation to the vagus nerve will be played for consecutive hours. This will help the brain to re-wire itself hence reducing the sound of tinnitus. The study will be carried out with control group to see the relative impact and have clearer findings. Researchers believe that regardless of the outcome, the clinical trial has opened new dimensions to tinnitus research and a possibility of a complete cure is much more realistic than before.

No matter what happens in the clinical trials, the researchers believe that the new avenues opened will ultimately help one day to cure tinnitus. Good news for an increasingly large community of people that have lived in fear and hopelessness for too long.

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