Posted on 08/14/2002 3:28:07 PM PDT by 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.
You must be my long lost twin brother.
Do you have random semi-darkened areas in your vision that last a few months too? How about "sparkly" visual migraines?
But I digress. I wonder if Blue Cross will cover these devices? I intend to find out pronto!
I was on that for a while but had to stop, I developed non-stop coughing from it. I am on Avapro, Plavix, and Norvasc now, but none of these has affected my tinnitus that I can tell. I attribute mine to too many front-row Grateful Dead concerts in the 60s, and too much pistol shooting without hearing protection in the 70s. (Yes, I was an idiot.)
If Blue Cross won't cover it, I'm going to build one. Piezo discs are available dirt cheap in a variety of sizes, with frequency response ranging up to ultrasonic, and the circuitry to drive them shouldn't cost more than ten bucks or so.
The times when it's most noticable are the times it's the most annoying -- when looking up at the stars on a quiet country night, or sitting in a deer blind trying to listen for a twig snapping or brush moving (or even just trying to enjoy the near-silence of the woods).
How much do you take, and how often do you take it?
Don "I'll try anything to get rid of this!" Joe
The "yellow area" in the fft looks to be centered around 13khz, so not really ultrasonic. Any audio grade transducer should work. Also since it is audio, you can probably use your PC sound card as the audio source and your PC speaker amps as the amplifier. I'm not sure right off what their amplitude measurement means (20dbB/1.00 m/s^2) but I doubt it is extremely loud.
Do you have random semi-darkened areas in your vision that last a few months too? How about "sparkly" visual migraines?
Yes, and yes.
I've had this since Basic Training 35 years ago. Firing range accident, after which everyone was issued earplugs. Ron Reagan had it due as a result of a stage gun.
I've always wondered why we can do all kinds of plastic surgery, but not repair a scarred eardrum.
As I was falling asleep, it occured to me that I might be able to use my TENS unit as a ready to roll driver for it, but then I remembered that its highest freq. was still low enough that I could sense the "vibes", indicating that it's much to low a freq, for this sort of application. The sound card idea is pretty good, it might be a good prototype test bed to find the best freq's, warble-rates, volume levels, etc. Once I home in on what works, I think I can rig up a pocket-sized box with ten bucks (or less) worth of stuff in it to drive the transducers.
Hmm, my doc was acting like I was the only one this ever happened to. Do you know if there is any name for this stuff (the dark areas), or of any resources I can point him at? If you've got an opthamologist who knows anything about this, is there any way you can have him get in touch with my opthamologist? Do you know if this is supposed to be a "stable" condition, or something that is supposed to get worse? When it first started I was in a panic about losing my vision, and frankly, the only thing that keeps me from freaking out about it is the fact that it doesn't seem to be getting worse since it first started happening.
Nothing worked for mine, including enough hydrocodone to knock a horse down, unless I caught them just as they were starting. Once the migraine was going full bore, I was on for the duration. A year or two I started taking Imitrix for them and it is a godsend. The first time I tried it, I used the nasal squirt version. One squirt in my nostril, and five minutes later (literall), the headache was completely gone. (The pill version seems to work a little longer, although it takes a bit longer to work, but if your nose is stuffed up the nasal version won't work.)
I had angioedema about 15 years ago for a few years. Started up for no apparent reason, and would hit me pretty much once every day or so, sometimes more than once a day. Lip, chin, cheek area mostly, but would hit anywhere it wanted, sometimes in my throat, sometimes in my arm. It would scare my kids when part of my face swelled up to several times its normal size. I didn't get that reaction from the Vasotec, though. Not that I'm complaining. :)
My doctor threatened to stop treating me if I didn't continue on the Vasotec. I told him "fine, then stop", because the constant coughing was intolerable. He backed down and prescribed Procardia. I took it once. It was a time-release "pill" I put that in scare quotes because it wasn't really what you'd think of as a pill -- it was a pill-shaped "machine" that had a spring that would squirt a stream of the drug out a hole after your digestive juices hit it. It's ejected into the toilet after it makes its way through your system. Meanwhile, it's pumping its contents into you all the way through the gut.
It gave me the worst, and longest headache I'd ever had. It was just amazing, I didn't know it was possible to hurt that much without passing out. I had an appointment with a cardiologist that day (the lunatic who put me on the Vasotec was a GP), and she asked why I was bent over and moaning. After I explained, she shook her head and gave me a prescription for Avapro.
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