University of Illinois at Urbana-Champaign speech and hearing science professor Fatima Husain and her colleagues found that tinnitus, a condition in which a person hears a ringing sound despite the lack of an actual sound, is associated with emotional processing in a different part of the brain than in those without the condition. The paper, “Alterations of the emotional processing system may underlie preserved rapid reaction time in tinnitus,” published online since June 3, 2014 in the journal Brain Research is available online or from the University of Illinois News Bureau.
Patients with persistent ringing in the ears – a condition known as tinnitus – process emotions differently in the brain from those with normal hearing, researchers report in the new study. Tinnitus afflicts 50 million people in the United States, according to the American Tinnitus Association, and causes those with the condition to hear noises that aren’t really there. These phantom sounds are not speech, but rather whooshing noises, train whistles, cricket noises or whines. Their severity often varies day to day.
University of Illinois speech and hearing science professor Fatima Husain, who led the study, said previous studies showed that tinnitus is associated with increased stress, anxiety, irritability and depression, all of which are affiliated with the brain’s emotional processing systems.
“Obviously, when you hear annoying noises constantly that you can’t control, it may affect your emotional processing systems,” Husain said, according to the June 25, 2014 news release, People with tinnitus process emotions differently from their peers, researchers report. “But when I looked at experimental work done on tinnitus and emotional processing, especially brain imaging work, there hadn’t been much research published.”
She decided to use functional magnetic resonance imaging (fMRI) brain scans to better understand how tinnitus affects the brain’s ability to process emotions
These scans show the areas of the brain that are active in response to stimulation, based upon blood flow to those areas. Three groups of participants were used in the study: people with mild-to-moderate hearing loss and mild tinnitus; people with mild-to-moderate hearing loss without tinnitus; and a control group of age-matched people without hearing loss or tinnitus.
Each person was put in an fMRI machine and listened to a standardized set of 30 pleasant, 30 unpleasant and 30 emotionally neutral sounds (for example, a baby laughing, a woman screaming and a water bottle opening). The participants pressed a button to categorize each sound as pleasant, unpleasant or neutral.
The tinnitus group’s reaction times were slower than the reaction times of those with normal hearing
The tinnitus and normal-hearing groups responded more quickly to emotion-inducing sounds than to neutral sounds, while patients with hearing loss had a similar response time to each category of sound. Over all, the tinnitus group’s reaction times were slower than the reaction times of those with normal hearing.
Activity in the amygdala, a brain region associated with emotional processing, was lower in the tinnitus and hearing-loss patients than in people with normal hearing. Tinnitus patients also showed more activity than normal-hearing people in two other brain regions associated with emotion, the parahippocampus and the insula. The findings surprised Husain.
“We thought that because people with tinnitus constantly hear a bothersome, unpleasant stimulus, they would have an even higher amount of activity in the amygdala when hearing these sounds, but it was lesser,” she said, according to the June 25, 2014 news release, People with tinnitus process emotions differently from their peers, researchers report. “Because they’ve had to adjust to the sound, some plasticity in the brain has occurred. They have had to reduce this amygdala activity and reroute it to other parts of the brain because the amygdala cannot be active all the time due to this annoying sound.”
Because of the sheer number of people who suffer from tinnitus in the United States, a group that includes many combat veterans, Husain hopes her group’s future research will be able to increase tinnitus patients’ quality of life
“It’s a communication issue and a quality-of-life issue,” she said, according to the news release. “We want to know how we can get better in the clinical realm. Audiologists and clinicians are aware that tinnitus affects emotional aspects, too, and we want to make them aware that these effects are occurring so they can better help their patients.”
Are natural remedies sometimes suggested for tinnitus?
Natural remedies for ringing in the ears include finding out whether you have deficiencies of specific nutrients. It has been said historically in some folkloric medicine circles, that zinc, Coenzyme Q10, vitamins D and B12 supplements may be of help for tinnitus or ringing in the ears not caused by other problems.
Minerals such as magnesium, found in leafy green vegetablees (or magnesium citrate supplements) may be of help if your health condition permits you to add a magnisium supplement get it from foods, say various news reports on what to do about tinnitus. Also you may wish to check out a 2011 study, “Tinnitus and Sleep.”
Sometimes magnesium helps various hearing loss issues and tinnitus
You can check out the Mayo Clinic’s clinical trial to find out whether magnesium can help people who have ringing in the ears/tinnitus. Another study years ago in Israel found that military personnel with tinnitus were often short on B12, according to pharmacist, Suzy Cohen’s column. See her article on Facebook.com/SuzyCohenRPh. Check out Suzy Cohen’s column on tinnitus, “Tinnitus: What To Do For Ringing In The Ears.”
Research also has been done with some types of acupuncture and a variety of herbals to deal with tinnitus
Suzy Cohen’s column mentions a recent study concluded that two compounds: Bojungikgitang and banhabaekchulchonmatang significantly improve tinnitus. Other studies exist on the herbal gingko biloba, which may help by improving blood flow and scavenging free radical toxins, that’s the cause of your tinnitus.
You can check out studies on black cohosh root and vinpocetine which improve blood flow and oxygen to the brain, goldenseal, and mullein herb which addresses inflammation. But other studies on black cohosh reveal a problem with a change in the heartbeat. See the WebMD article, “Black cohosh: Uses, Side Effects, Interactions and Warnings.” Don’t take it if pregnant see, “Black cohosh – Drug Store News” and “Black Cohosh to Induce Labor.”
You may wish to check out the article in Scientific American magazine by Tori Rodriguez, “When Talk Therapy Treats Tinnitus.” The idea is to find out which physical complaints often co-occur with what psychological conditions. Stress also may play a role in persistent ringing in the ears, that affects 50 million Americans, according to Suzy Cohen’s column. The Scientific American magazine article refers readers to a study published online in January 2013 in Quality of Life Research found that about half of tinnitus sufferers also have mental disorders, confirming the findings of previous research.
You also may wish to see a 2001 study, “Assessing Tinnitus and Prospective Tinnitus Therapeutics Using a Psychophysical Animal Model.” Or take a look at the research, “Vertigo in the Elderly: Quality of Life and Some Ethical Issues.” There’s also a 1999 study, “Assessing audiological, pathophysiological, and psychological variables in chronic tinnitus: A study of reliability and search for prognostic factors.”
Does emotional stress predict tinnitus? Sometimes meditation may help, since the emotional processing part of the brain is located very close to the hearing part. See, “From Music to Emotions and Tinnitus Treatment, Initial Study” and “Tinnitus, anxiety and automatic processing of affective information: an explorative study.” Also check out the study, “A Review of psychological treatment approaches for patients suffering from tinnitus” and “Mindfulness Based Tinnitus Stress Reduction Pilot Study.” You may want to see the study, “Tinnitus and Anxiety.” On a neurobiological level, many different brain regions have been identified to be involved in the generation of arousal and anxiety. Individuals with tinnitus often suffer from anxiety.
Internet-based therapy relieves persistent tinnitus
A German-Swedish study shows that Internet-based self-help training for tinnitus is as successful as group therapy. Those suffering from nagging tinnitus can benefit from internet-based therapy just as much as patients who take part in group therapy sessions, notes the March 7, 2012 news release, “Internet-based therapy relieves persistent tinnitus.”
These are the findings of a German-Swedish study in which patients with moderate to severe tinnitus tried out various forms of therapy over a ten-week period. The outcome of both the internet-based therapy and group therapy sessions was significantly better than that of a control group that only participated in an online discussion forum and thus demonstrated both the former to be effective methods of managing the symptoms of irritating ringing in the ears. The study was conducted by the Clinical Psychology and Psychotherapy division of the Institute of Psychology at Johannes Gutenberg Universitaet Mainz (JGU) and the Department of Behavioral Sciences and Learning at Linköping University in Sweden.
According to the German Tinnitus League (Deutsche Tinnitus-Liga, DTL), two percent of the population suffer from moderate to unbearable tinnitus. But the symptoms of tinnitus can be successfully managed by means of cognitive behavioral therapy. However, not everyone has the opportunity or the desire to take a course of psychotherapy. As shown by the German-Swedish study, those affected by tinnitus can now achieve the same level of outcome with the help of an internet-based therapy program, which encourages them to adopt individual and active strategies to combat their tinnitus. For the purposes of the study, the training program developed in Sweden was adapted so that it could be used for German patients and then be evaluated for its effectiveness.
The study showed that distress measured using the Tinnitus Handicap Inventory was reduced on average from moderate (40 points) to mild (29 points) in participants who completed the internet-based training course. The results for subjects in the cognitive behavioral therapy group were also very good, with distress levels being reduced from 44 to 29 points. In contrast, there was hardly any change in this respect in the control group subjects participating in the online discussion forum.
Their average distress level was 40 points at the beginning of the study and remained at 37 points thereafter. “Our internet-based therapy concept was very effective when it came to the reduction of tinnitus-related distress or, to put it another way, at increasing the tolerance levels of subjects with regard to their tinnitus,” concludes Dr. Maria Kleinstäuber of the Clinical Psychology and Psychotherapy division at JGU, in the news release.
Preferred method of therapy
At the same time, another interesting result was produced with regard to the preferred method of therapy. A significant number of subjects were initially skeptical with regard to the internet-based therapy concept and expressed a preference for the group therapy course. However, they were randomly assigned to the groups. To everyone’s surprise it turned out on the completion of treatment that there was no difference in the effectiveness of the two strategies. “This means that the internet-based therapy concept produced as positive a result as group therapy despite the initial skepticism,” says Kleinstäuber. Initial evaluations indicate that the effects of both therapy forms were still persisting after six months.
The authors of the study propose that internet-based forms of therapy should be increasingly used in the psychotherapeutic treatment of tinnitus patients. Furthermore, they call for additional research on patients’ skepticism of internet-based therapy, particularly in view of the long waiting times and the lack of outpatient forms of therapy. Also see, “Study provides compelling evidence for an effective new treatment for tinnitus” and “More than 80 percent of patients manage to stop discomfort from tinnitus and can lead a normal life.”
Is magnetic therapy effective for tinnitus?
Loyola University Health System (Loyola University Medical Center) is studying whether a new form of non-invasive magnetic therapy can help people who suffer debilitating tinnitus (ringing in the ears), reports a September 18, 2012 news release, “Is magnetic therapy effective for tinnitus?” The therapy, transcranial magnetic stimulation (TMS), sends short pulses of magnetic fields to the brain. TMS has been approved since 2009 for patients who have major depression and have failed at least one antidepressant.
The Loyola study will include patients who suffer from both depression and tinnitus. Recent studies have found that about 12 percent of people with chronic tinnitus also suffer depression and anxiety — a rate three times higher than that of the general population.
Tinnitus is the perception of sound in one or both ears when there is no external source
It can include ringing, hissing, roaring, whistling, chirping or clicking. About 50 million Americans have at least some tinnitus; 16 million seek medical attention and about 2 million are seriously debilitated, according to the American Tinnitus Association. There is no cure.
The perception of phantom sounds can be more pronounced in people who are depressed. Moreover, antidepressant medications can cause tinnitus occasionally, said Dr. Murali Rao, principal investigator of Loyola’s TMS tinnitus study.
Several earlier studies have found that TMS can benefit tinnitus patients
Loyola’s study is the first to examine patients who suffer from both tinnitus and depression. “The combination of these two conditions can be extremely debilitating,” Rao says in the September 18, 2012 news release, “Is magnetic therapy effective for tinnitus?” For another point of view, also see the Apr 22, 2013 Reuters news article, “Magnetic therapy may not relieve ringing in the ears | Reuters.”
In the Apr 22, 2013 Reuters news story, it noted that in Europe, doctors have been using rTMS to create electrical currents in the auditory nerve for people with tinnitus, seeing a “mild to moderate, short-lasting effect,” according to the scientists noted in the article. He and his colleagues previously tested two weeks of rTMS treatments on people with tinnitus and found it had no benefit. See Reuters Health story of March 24, 2011 here.
Magnetic therapy for tinnitus
In the 2012 news release, “Is magnetic therapy effective for tinnitus?” during TMS treatment, the patient reclines in a comfortable padded chair. A magnetic coil, placed next to the left side of the head, sends short pulses of magnetic fields to the surface of the brain. This produces currents that stimulate brain cells. The currents, in turn, affect mood-regulatory circuits deeper in the brain. The resulting changes in the brain appear to be beneficial to patients who suffer depression. Each treatment lasts 35 to 40 minutes.
The study enrolled 10 to 15 patients. Each patient received five treatments a week for four to six weeks, for a total of 20 to 30 treatments. Each patient was evaluated by a physician three times during the treatment course, or more frequently if the doctor deems necessary.
The treatments do not require anesthesia or sedation. Afterward, a patient can immediately resume normal activities, including driving. Studies have found that patients do not experience memory loss or seizures. Side effects include mild headache or tingling in the scalp, which can be treated with Tylenol.
Rao is chair of the Department of Psychiatry and Behavioral Neurosciences of Loyola University Chicago Stritch School of Medicine. His co-investigator in the study is Sam Marzo, MD, medical director of Loyola’s Balance and Hearing Center. Other investigators are Matthew Niedzwiecki, MD, a psychiatry resident; and James Sinacore, PhD, a statistician.