Medical Breakthrough: Cured of the Rings (tinnitus)

Discover Magazine ^ | Aug 10, 2002 | Fenella Saunders

[The Raven]

Some 20 million people in the United States have tinnitus, a chronic ringing or whooshing in the ears, and about 4 million of them experience such severe symptoms that "they wonder if they're going insane," says Martin Lenhardt, a biomedical engineer at Virginia Commonwealth University. The cause of the ailment is, in essence, a biological computer error. So Lenhardt has found a way to reprogram the brain and make the maddening sounds go away, temporarily at least.

When people lose the ability to hear very high frequencies— whether due to aging, disease, or exposure to loud noise— the neurons in the brain that used to process those sounds start to respond to a lower frequency instead. At the same time, those neurons may also increase how often they fire without any input, leading to phantom ringing. Lenhardt and his colleagues at the Martha Entenmann Tinnitus Research Center in New York City are reprogramming the neurons to proper functioning by exposing them to high-frequency vibrations.

This audio spectrum shows, in yellow, the frequency range of the vibrations used to treat tinnitus. Courtesy of Martin Lenhardt.

The researchers place a quarter-sized piezoelectric disk behind the patients' ears, which sends the vibrations through the skin and into the temporal bone of the skull. Although these motions bypass the middle ear, they stimulate the neurons, which respond if they were once again being exposed to high-pitch sounds coming from the ear itself. Lenhardt uses music that has been modulated to high frequencies to guide the action of the disk, so that its vibrations have a pattern. "We wanted a rhythmic source, that wasn't too boring," says Lenhardt. Pulsed sound is also a better neural stimulator than steady sound, he says: "We think it has to pulse a little bit to be effective, or you're not paying attention to it." After receiving two months of half-hour-long vibration sessions, conducted twice a week, most of the patients in a small pilot study said their tinnitus had vanished. Symptoms returned within two weeks, however, so Lenhardt expects that repeated sonic treatments will be needed to keep the neurons properly programmed. "But if you can do it in a non-invasive way and only need a little bit of time, this could be a real breakthrough for people who just go crazy with tinnitus," he says. His group has just received FDA approval for the device, called UltraQuiet.

Lenhardt and his colleagues are also working on Tactaid, a complimentary treatment that could relieve tinnitus symptoms immediately but that wouldn't provide long-term relief. Tactaid uses a very low-frequency vibrating disk to stimulate the muscles around the ear. In about a third of tinnitus cases, the symptoms seem to be influenced by a link between the brain's auditory system and the somatosensory system, which is involved in movement and automatic reactions. This connection makes a certain amount of sense: The phantom ringing of tinnitus is much like a type of phantom limb phenomenon, whereby a person can feel that his arm is moving, even when it is not, if the correct part of the brain is stimulated. Hearing is connected to the somatosensory system because some muscular movement occurs when we hear -- something that is more obvious in animals such as cats and dogs that can swivel their ears as they listen.

Tactaid's low-frequency vibrations stimulate the muscles around the ear, creating a signal that travels through the somatosensory pathways. Some of these pathways, in turn, connect to the cochlear nucleus, the part of the brainstem that is first to process sounds. The vibratory signal inhibits the cochlear nucleus, causing a cascade of neural reactions further up in the brain, which ultimately blocks the nerve impulses that people hear as phantom ringing. But as soon as the muscle vibration stops, the tinnitus comes back. Thus Tactaid is a bit like an aspirin for tinnitus, giving spot relief when the ringing is severe but not addressing the cause of the pain. The hope, Lenhardt says, is that Tactaid and UltraQuiet will address both halves of the problem, removing the symptoms right away while reprogramming the neurons in a way that will permanently cancel the ringing.

-------------------------------------------------------------------------------- RELATED WEB SITES: "Cured of the Rings." "Vibrotactile suppression of tinnitus." Martin L. Lenhardt. Journal of the Acoustical Society of America, Vol 111, No 5, Pt 2, May 2002. Presented at the 143rd meeting in Pittsburgh, June 3-7, 2002. See http://asa.aip.org/web2/asa/abstracts/search.apr02/asa177.html.

"High-Frequency Sound Treatment of Tinnitus" by Martin L. Lenhardt, Douglas G. Richards, Alan G. Madsen, Abraham Shulman, Barbara A. Goldstein, and Robert Guinta is at www.acoustics.org/press/142nd/lenhardt.html.

See more at Lenhardt's Web page: www.tinnitus.vcu.edu.

[gargoyle]

...a bump, for later...

[GailA]

Interesting...my ear ringing goes way down after I get my neck realigned by my chiropractor (sp?)

[dougherty]

I go to sleep with something (TV, Radio) in the background, or I can't get to sleep.

Same for me. Most nights I turn a fan on near my bed and that really drowns the ringing out. Without that noise from the fan, I would go crazy.

[Ronin]

Very interesting indeed. Tinnitus has been one of my curses since my Navy days. Anything that offers some relief is well worth knowing about.

[Mr. Jeeves]

It gets so loud at times my wife swears she can hear it when she puts her ear to mine!

It's true - supposedly you can hear someone else's tinnitus. I'm not sure how that works. I have it too, but it isn't too bad. I can usually ignore it. One too many Metallica concerts back in the mid-80's, I think...

[Iowa Granny]

A fan running in the bedroom gives the sensation of a jet engine roaring for me. I use the radio or tv method. I first noticed the "Sea Shell" sensation at about age 4. I'm now older than dirt. I was mentioning this problem to my Mother about 20 years ago,,, she has always had it, too. My 24 y.o. son has the same Sea Shell sound. Does anyone else have any knowledge of the possibility of there being a hereditary problem?

[tubebender]

Does anyone else have any knowledge of the possibility of there being a hereditary problem?"


Are you saying we are related? ( please use sign language)

[tubebender]

Great post...I describe my ringing like a milliom crickets on a hot summer nite. I told my audiologist a couple of years ago that there had to be a remedy for this but he said live with it.

True story...I was so excited getting my hearing aid because I could now hear my barbers great jokes and I wouldn't have to "fake it anymore". So my first visit every thing was working great until I sat down and he said I would have to take my hearing aid out...

[my_pointy_head_is_sharp]

I, too, am a tinnitus sufferer. I've had it since I was a child. I wasn't aware there was any research being done. This is good news that people are working on the problem.

[nopardons]

BUMP

[jlogajan]

I don't hear it unless for some reason I am thinking about it, like now. Then I hear it. Just a very high pitched slowly wavering background noise. I also have high-frequency hearing loss. So it sounds like I'm the type. It doesn't drive me to distraction or anything, since I don't usually notice it. But if it is quiet and I am trying to listen for something, then I hear it, as it is unavoidable.

[RJL]

Thanks for posting this. If it works as presented in this article, this will be a major blessing for millions of people.

[uglybiker]

Yours sounds kind of like mine. Mine sounds like the capacitors in an old color tv firing up. It's never intrusive, it's just....there.

[SierraWasp]

"I was going to make some joke about Gore having this,"

No way! He's got a "LOCK BOX" stuck in his left ear!!!

Our CA Governurd has a cash register ringin in his left ear!!!

Seriously, I'm gonna hafta look into this cause I've got this ring in my left ear and I cain't rememer which ear means yer queer!!!

[Grampa Dave]

I had tinnitus off an on for years as probably due to being under a 5 inch gun in the Navy with a head phone with one ear covered for awhile and then reversing it. I also did a lot of skeet shooting and trap shooting for about 10 years after getting out of the Navy. We used the little gum rubber ear plugs in the head phone protectors used in shooting now.

About 6 years ago it went from moderate ringing in the day time to really bad every evening until I went to sleep. I went to my doctor, and in a few months I had developed high blood pressure. He felt the ringing was due to the high blood pressure.

He put me on Vasotec 5 mg twice a day. I basically don't have any wrong numbers ringing until after dinner and after the evening on the Vasotec. In social situations, I don't notice it. When at home it starts in about 6:30 pm and rings until I go to bed. Then it seems to die down and disappear.

My wife is an RN, and she would check my BP at first in the evening incase I became refractory to the Vasotec in the evening. Actually my BP dropped about 5 points in the evening, so it wasn't high blood pressure.

My hearing has not deteriorated the past 6 plus years since I took early retirement. In fact my hearing and vision have improved since retiring. In the old days when we went out to a restaurant with a group, she knew when I didn't want to listen to someone or her. I sat so they were on my right side. In a medium to high noise restaurant, I could not hear anyone on my right side. It was an inside joke with us.
Now I can hear too well some times.

Hopefully we can buy this machine and use it at home a few times a week to reprogram the old auditory nerves.

My Dad and Grandfather on my mother's side had tinnitus. My mother at age 86 does not have it unless she is getting sick with a cold or a virus infections. She gets the ringing in her ear 12-24 hours before the onset of the cold or virus.

[rightofrush]

A boon for 50+ hard rock fans.

[SierraWasp]

It's sucha spooky affliction that it helps to have people to talk to about it.

You still didn't tell me which ear to have the ring in ta keep frum bein queer!!!

I think, since it really isn't a noise, per se, that I don't notice it when I get busy, which is why I'm cognizant of it more in the evening hours, like you said you are. It doesn't keep me awake, although that's when it's the loudest, just as my head hits the pillow like it's gonna do right now! G'nite!!!

[I still care]

I have it off and on at various intervals in my life, also sometimes vertigo. I have found in my case chromium helps.

[general_re]

marker

[tsomer]

I listened in seashells when I was a kid and what I rember sounded nothing like sufferers of tinnitis describe.

Could it be the shape of your outer ear? That's genetic too; it's not inconceivable that they channel air the same way as a seashell .