“Polytherapeutic” tinnitus treatment app yields impressive results


The ringing and rushing noise of tinnitus is a complex condition. It is caused by a range of factors, so there is no known single treatment. But researchers are reporting great results with a combined treatment in a smartphone app.

About 5% of people suffer from tinnitus at some point in their lives – I’m one of them. It can develop after repeated exposure to loud noise; that’s probably where I picked it up, thanks to a long association with drums, live music and loud motorcycles. But it can also occur due to wax buildup, the effect of medications, inflammation due to disease, tumor growth, or even problems with the circulatory system.

Sometimes it’s barely noticeable, other times it can be impossible to ignore. This phantom noise can go away and come back, it can go from a high-pitched ring in your left ear, like the sound when an old TV is turned on with no sound, to a high-pitched hiss in your right, like someone left something behind. hand a powerful guitar amplifier over your shoulder. It can make it difficult to sleep, encroaching on the silence of the night, or it can flare up and make it hard to listen to conversations. Indeed, whatever the initial cause of tinnitus, the symptom itself is generated by the brain. It can cause stress and anxiety, and it can escalate in response to them in a vicious circle.

Many treatments have been proposed, and some have shown promise for certain types of tinnitus patients, but a team of researchers from the University of Auckland found they were seeing good results with a smartphone app that takes a kitchen sink approach, combining a number of different treatments into one.

“Digital Polytherapy” combined “goal-based counseling with passive and active game-based personalized sound therapy.” It was personalized for each subject after an assessment by an audiologist, who adapted the app’s digital tools to the user’s own experience with tinnitus. The Auckland team tested their app against a popular white noise passive sound therapy app called White Noise Lite.

Top: screenshots of the polytherapeutic application. Bottom: Screenshots of the White Noise Lite app

University of Auckland

The main measure of effectiveness was the Tinnitus Functional Index, a standard scale used to quantify a person’s experience of tinnitus, in which a change of 13 points is considered a clinically significant difference.

Thirty-one people with moderate to severe chronic tinnitus used the polytherapeutic app for 12 weeks and 30 used the white noise app. The group using the polytherapeutic reported an average improvement of 16.36 points after six weeks and 17.83 points after 12 weeks, with around 55% of participants experiencing clinically significant improvement after six weeks and 65% at 12 weeks.

These results were significantly better than the white noise app, although it made a difference for some users as well. The average improvement for white noise users was 10.77 points at six weeks, 10.12 at 12 weeks, with 33% of this group experiencing clinically meaningful improvements at six weeks and 43% at 12 weeks.

The white noise-only app provided clinically meaningful improvements for some users, but the polytherapy was more effective and reliable across the group as a whole
The white noise-only app provided clinically meaningful improvements for some users, but the polytherapy was more effective and reliable across the group as a whole

University of Auckland

“This is more important than some of our previous work and is likely to have a direct impact on the future treatment of tinnitus,” says Associate Professor of Audiology Grant Searchfield, lead author of a paper published in Frontiers in Neurology. “Previous trials have shown that white noise, goal-oriented counseling, goal-oriented games, and other technology-based therapies are effective for some people once in a while. It’s faster and more effective, taking 12 weeks instead of 12 months for more individuals to gain some control.What this therapy does is basically rewire the brain in a way that reduces the sound of tinnitus to background noise that has no meaning or relevance to the listener.

We reached out to Dr Caitlin Barr, CEO of Soundfair Australia, a hearing equality organization that also runs Tinnitus Australia, a nonprofit focused solely on tinnitus, for an independent opinion on this study and the potential for combination therapy to bring about real change for the average. suffering from tinnitus.

“Tinnitus is a symptom,” says Dr. Barr. “It’s like a sore elbow, it can be caused by many different things. So the same treatment won’t work for all of these causes. There are people whose tinnitus is psychological, they can experience it as a way for their body to signal stress, or they’ve attributed a traumatic response to the presence of that sound. Treatment is therefore more effective if it is more psychological and based on cognitive behavioral therapy, leading a person to take a step back from what they are experiencing and encourage their brain to not attribute any feelings to the experience instead of negative feelings. This is relatively new, but there is plenty of evidence that CBT is successfully applied in the tinnitus space.

“But if it’s more of a physiological cause,” she continues, “a sudden hearing loss, for example, where the brain is trying to recalibrate how it interprets sound, then sound therapies are likely to help. ‘be a more effective treatment modality. But we may not always clearly understand the causes, there are so many gaps in our knowledge of tinnitus, making it very difficult for researchers and sufferers to find a panacea That’s what’s exciting about this research: a combined approach means you’re more likely to help more people.

“This is a very small study,” says Dr. Barr, “so obviously they still have a lot of work to do. But it’s a promising first finding. The other digital options I’ve seen take stronger psychological impact or sound therapy – this is the first one I’ve seen that combines them quite well Professor Grant Searchfield is highly regarded around the world in the field of tinnitus, he is an expert international, so there should be some confidence alongside that.

Tinnitus can have various causes, but the symptoms of ringing or ringing in the ears are generated in the brain
Tinnitus can have various causes, but the symptoms of ringing or ringing in the ears are generated in the brain

But, adds Dr Barr, no matter how effective app-based therapies seem to be, it is essential that tinnitus sufferers present their symptoms to a specialist with specific knowledge in this area before embarking on any type of therapy.

“The idea of ​​self-help, I think, is problematic for tinnitus,” she says. “There are medical causes, like a tumoral growth, for example, on the auditory nerves. You need someone who can sort those things out and tell you if you need medical attention. Go see an audiologist, that would be my first suggestion – but going to someone with a specific interest or expertise in tinnitus is even better.There are tinnitus organizations in many countries, and that’s where a group like Tinnitus Australia or the American Tinnitus Association can help, we maintain a registry of specialists who know more about tinnitus than your average audiologist.”

The Auckland team are working to secure regulatory approval for the polytherapeutic application and hope to have it available in the clinic within about six months. They are looking to market it under the trade name True Silence Therapeutics.

“The key message for people with tinnitus,” says Dr. Barr, “is that there is hope. You don’t have to spend a lot of money, there are inexpensive and accessible options. who can do something for you. They might not fix it entirely, but they could. As you say, some people in the control group saw improvements.

The study is open access in the journal Frontiers in Neurology.

Source: University of Auckland

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