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New Therapies Fight Phantom Noises of Tinnitus
01 / 04 / 2008
Modern life is loud. The jolting buzz of an alarm clock awakens the ears to a daily din of trucks idling, sirens blaring, televisions droning, computers pinging and phones ringing - not to mention refrigerators humming and air-conditioners thrumming. But for the 12 million Americans who suffer from severe tinnitus, the phantom tones inside their head are louder than anything else.
Often caused by prolonged or sudden exposure to loud noises, tinnitus (pronounced tin-NIGHT-us or TIN-nit-us) is becoming an increasingly common complaint, particularly among soldiers returning from combat, users of portable music players, and aging baby boomers reared on rock ''n'' roll. (Other causes include stress, some kinds of chemotherapy, head and neck trauma, sinus infections, and multiple sclerosis.)
Although there is no cure, researchers say they have never had a better understanding of the cascade of physiological and psychological mechanisms responsible for tinnitus. As a result, new treatments under investigation - some of them already on the market - show promise in helping patients manage the ringing, pinging and hissing that otherwise drives them to distraction.
The most promising therapies, experts say, are based on discoveries made in the last five years about the brain activity of people with tinnitus. With brain-scanning equipment like functional magnetic resonance imaging, researchers in the United States and Europe have independently discovered that the brain areas responsible for interpreting sound and producing fearful emotions are exceptionally active in people who complain of tinnitus.
"We''ve discovered that tinnitus is not so much ringing in the ears as ringing in the brain," said Thomas J. Brozoski, a tinnitus researcher at Southern Illinois University School of Medicine in Springfield.
Indeed, tinnitus can be intense in people with hearing loss and even those whose auditory nerves have been completely severed. In the absence of normal auditory stimulation, the brain is like a driver trying to tune in to a radio station that is out of range. It turns up the volume trying but gets only annoying static. Richard Salvi, director of the Center for Hearing and Deafness at the State University of New York at Buffalo, said the static could be "neural noise" - the sound of nerves firing. Or, he said, it could be a leftover sound memory.
Adam Edwards, a 34-year-old co-owner of a wheel repair shop in Dallas, said he developed tinnitus four years ago after target shooting with a pistol. "I had all the risk factors," he said. "I grew up hunting, I played drums in a band, I went to loud concerts, I have a loud work environment - everything but living next to a missile launch site." His tinnitus, which he described as a "computer beeping" sound, was so intense and persistent that he needed sedatives to sleep at night.
Mr. Edwards says he has gotten relief from a device developed by an Australian audiologist, which became widely available in the United States last year. Manufactured by Neuromonics Inc. of Bethlehem, Pa., it looks like an MP3 player and delivers sound spanning the full auditory spectrum, digitally embedded in soothing music.
Similar to white noise, the broadband sound, tailored to each patient''s hearing ability, masks the tinnitus. (The music is intended to ease the anxiety that often accompanies the disorder.) Patients wear the $5,000 device, which is usually not covered by health insurance, for a minimum of two hours a day for six months. Since completing the treatment regimen last year, Mr. Edwards said his tinnitus had "become sort of like Muzak at a department store - you hear it if you think about it, but otherwise you don''t really notice."
A small, company-financed study in the journal Ear & Hearing in April 2007 indicated that the Neuromonics method was 90 percent successful at reducing tinnitus. A larger study is under way to determine its long-term effectiveness.
Anne Howell, an audiologist at the Callier Center for Communication Disorders at the University of Texas at Dallas
Often caused by prolonged or sudden exposure to loud noises, tinnitus (pronounced tin-NIGHT-us or TIN-nit-us) is becoming an increasingly common complaint, particularly among soldiers returning from combat, users of portable music players, and aging baby boomers reared on rock ''n'' roll. (Other causes include stress, some kinds of chemotherapy, head and neck trauma, sinus infections, and multiple sclerosis.)
Although there is no cure, researchers say they have never had a better understanding of the cascade of physiological and psychological mechanisms responsible for tinnitus. As a result, new treatments under investigation - some of them already on the market - show promise in helping patients manage the ringing, pinging and hissing that otherwise drives them to distraction.
The most promising therapies, experts say, are based on discoveries made in the last five years about the brain activity of people with tinnitus. With brain-scanning equipment like functional magnetic resonance imaging, researchers in the United States and Europe have independently discovered that the brain areas responsible for interpreting sound and producing fearful emotions are exceptionally active in people who complain of tinnitus.
"We''ve discovered that tinnitus is not so much ringing in the ears as ringing in the brain," said Thomas J. Brozoski, a tinnitus researcher at Southern Illinois University School of Medicine in Springfield.
Indeed, tinnitus can be intense in people with hearing loss and even those whose auditory nerves have been completely severed. In the absence of normal auditory stimulation, the brain is like a driver trying to tune in to a radio station that is out of range. It turns up the volume trying but gets only annoying static. Richard Salvi, director of the Center for Hearing and Deafness at the State University of New York at Buffalo, said the static could be "neural noise" - the sound of nerves firing. Or, he said, it could be a leftover sound memory.
Adam Edwards, a 34-year-old co-owner of a wheel repair shop in Dallas, said he developed tinnitus four years ago after target shooting with a pistol. "I had all the risk factors," he said. "I grew up hunting, I played drums in a band, I went to loud concerts, I have a loud work environment - everything but living next to a missile launch site." His tinnitus, which he described as a "computer beeping" sound, was so intense and persistent that he needed sedatives to sleep at night.
Mr. Edwards says he has gotten relief from a device developed by an Australian audiologist, which became widely available in the United States last year. Manufactured by Neuromonics Inc. of Bethlehem, Pa., it looks like an MP3 player and delivers sound spanning the full auditory spectrum, digitally embedded in soothing music.
Similar to white noise, the broadband sound, tailored to each patient''s hearing ability, masks the tinnitus. (The music is intended to ease the anxiety that often accompanies the disorder.) Patients wear the $5,000 device, which is usually not covered by health insurance, for a minimum of two hours a day for six months. Since completing the treatment regimen last year, Mr. Edwards said his tinnitus had "become sort of like Muzak at a department store - you hear it if you think about it, but otherwise you don''t really notice."
A small, company-financed study in the journal Ear & Hearing in April 2007 indicated that the Neuromonics method was 90 percent successful at reducing tinnitus. A larger study is under way to determine its long-term effectiveness.
Anne Howell, an audiologist at the Callier Center for Communication Disorders at the University of Texas at Dallas