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Thursday, 21 March, 2002, 12:17 GMT
Training the brain could cure tinnitus
Exposure to loud music can lead to tinnitus
Exposure to loud music can lead to tinnitus
Retraining how the brain processes sounds could help cure the annoying and debilitating condition tinnitus, researchers say.

A small-scale study has shown that sufferers can be relieved just by learning to tell the difference between computer generated tones.

It has been estimated that tinnitus - a persistent ringing or buzzing in the ears which cannot be blocked out - is so bad for around 1% of the population that it has debilitating effect on their daily lives.

Researchers from the University of Heidelberg's Central Institute of Mental Health found that in the brains of tinnitus sufferers, a part called the auditory cortex becomes "reorganised".


Dr Flor and her group have done some interesting work ... but this present report is very preliminary

British Tinnitus Association spokeswoman
Normally, areas of the auditory cortex that respond to different sound frequencies are of similar size. But in people with tinnitus, those sections which correspond to the frequencies of the rogue buzzing and ringing sounds are disproportionately large.

The German team looked to see if the distortion followed the patter of how the brains of patients with phantom limb pain following amputation work.

In those patients, the area of the brain that represents the amputated body part seems to become smaller as areas around it, representing other body parts, take over the space.

Phantom pain link

The team, led by Herta Flor's, successfully treated amputees by asking them to recognise the position and frequency of non-painful electric shocks applied to their stumps, thereby stimulating the corresponding brain areas and persuaded them to expand again.

Phantom pain was reduced in these patients by almost 70%. The team decided to use the same principal to treat tinnitus sufferers, but in reverse.

Nine people with chronic tinnitus were asked to discriminate between different pairs of tones pitched at frequencies near to the phantom noises they heard as a symptom of their condition.

They were exposed to the tones for two hours a day for four weeks.

At the end of the study, they reported a 35% reduction in their tinnitus.

A second group which had had no treatment showed no improvement over that time.

Caution

Why the treatment worked in this small group of patients is not yet known, and larger trials are planned.

The treatment may cause the regions in the brain causing tinnitus to shrink, or the training may cause permanent changes in the brain.

The researchers also say four weeks may not be long enough to make a permanent difference, but longer periods of treatment may increase the benefits to patients.

The connection with phantom limb pain relief gives researchers hope it may be possible to prevent tinnitus in the first place.

Phantom limb pain can be reduced by giving patients drugs immediately before or after amputation, blocking the receptors in the brain that are involved in the brain reorganisation which takes place during learning.

The German team suggest that people exposed to a trigger for tinnitus such as a loud noise or injury could be protected by taking the same drugs straight afterwards.

But tinnitus experts are sceptical about the treatment.

Gerhard Andersson of the University of Uppsala, Sweden, warned most tinnitus patients hear complex sounds rather than a pure tone.

A spokesman for the British Tinnitus Association's professional advisory committee told BBC News Online the analogy between tinnitus and phantom limb pain was first made in the 1950s, and was widely accepted.

She added: "The concept that cortical reorganisation is an important mechanism in tinnitus is also widely accepted.

"Dr Flor and her group have done some interesting work considering the potential role of cortical reorganisation in tinnitus, but this present report is very preliminary.

"Any intervention for tinnitus should be investigated with the same rigour as any other medical intervention, specifically a randomised controlled trial by an independent group.

"Whilst it is heartening to see that a wider trial is planned , one should wait until that study is reported in a peer review journal before raising patient hopes."

Details of the work are published in New Scientist.

See also:

27 Feb 01 | Health
Mind unlocks tinnitus secret
14 Jan 01 | Health
Ginkgo 'ineffective' for tinnitus
10 May 00 | Health
Secrets of hearing uncovered
03 Aug 99 | Health
Loud music threat to the young
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