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You might call it “ringing in the ears.”
If you have it you might also call it “a pain in the butt.”
Doctors call it tinnitus, or tinnitus, and right after that
they usually add “and I’m afraid there’s not much I can do about it.”
You’re basically hearing a sound that isn’t there,
which doesn’t lend itself to any obvious treatment strategies.
Unless we could trick your brain into not hearing a fake sound?
No, really, that actually seems to work,
and it could mean relief for millions of people. Here’s how.
[♪ INTRO]
Tinnitus is the seemingly phantom perception of various sounds, including ringing,
roaring, or buzzing, when there is nothing outside of the body
creating sound waves that travel to the ear.
It’s more a set of symptoms than a disease per se,
and what causes it in a particular patient may not always be clear.
Tinnitus symptoms are thought to affect at least 10% of the world’s population,
and for some, those symptoms can seriously affect quality of life.
It often accompanies hearing loss, and may be part of the
progression of hearing loss, though that varies from person to person.
Contributing factors range from occupational exposure to
noise to head or neck injuries to too much earwax.
Certain folks may also have a genetic predisposition
contributing to their symptoms.
But while we’re coming to a better understanding of the causes,
actual treatments have been tough to come by.
Doctors have sometimes dismissed patients with these symptoms,
sometimes implying that it’s all in the person’s head.
Which, technically correct, but that still makes you a jerk.
Even providers who do take tinnitus seriously have had limited options to offer.
These include a combination of psychotherapy and sound therapies.
The psychotherapy was for the distress that some people with tinnitus symptoms
experience, not for reducing the actual noises.
And the sound therapies that some doctors have recommended so far
are approved for other conditions, not tinnitus itself.
Meaning there’s very little that’s been available to
address the root cause of the symptoms.
So people with tinnitus have kind of been on their own to deal with the
sometimes debilitating toll on concentration, memory, and sleep,
which can trigger or worsen anxiety or depression.
Though it has been described as a particularly elusive set of symptoms to unravel,
our understanding of tinnitus has improved.
And it appears the key to treatment may be in using senses
in addition to hearing to hack people’s brains.
In the past decade or so, doctors and researchers have increasingly noticed that
some patients can modulate their tinnitus by moving or applying pressure to
their head, neck, face, or other parts that don’t have to do directly with hearing.
These people have what’s referred to as somatosensory or somatic tinnitus.
They’re not quite sure how it all works, but basically,
it’s like people can listen to another sense.
That sounds kind of unreal because, typically,
we think of each of our senses as separate.
Sight and touch, for instance, have their own processes to
convey information through their different sensory organs to the brain.
But our sensory systems are more integrated than that.
It’s more like an interconnected web that brings all the different
kinds of information we can perceive together and sends it to our brains.
Knowing that patients could sometimes improve their symptoms by
crossing their own sensory wires, researchers started
chasing the idea as a lead to better understanding of tinnitus.
Several studies in the 2010s looked at animals, including guinea pigs,
who were exposed to excess noise to induce tinnitus.
Their results suggested that whatever causes tinnitus also causes
changes to the strength and connection between the cells in the brain stem.
Eventually, scientists figured out that a lot of this is going on
in the dorsal cochlear nucleus, or DCN, a layered structure in the brain stem.
In mammals, this area is the first site where inputs of sound that hit the ear come
together with inputs of touch and other bodily sensations in the head and neck.
Scientists still have a lot to learn about this structure,
but they know that the DCN doesn’t only receive and convey these inputs.
It also plays a key role in processing them.
Those animal studies showed that something was specifically happening
in a part of the DCN called the fusiform cell circuit.
This group of neurons is one of the final sites in the DCN that
processes inputs before sending them on their way to be perceived.
In animals with tinnitus, the fusiform cells
had dialed up neural connections and increased activity.
Which seems like the source of the phantom noise.
Researchers at the University of Michigan pulled all this together in a double-blind,
randomized clinical trial involving 99 participants with somatic tinnitus.
They published their results in the journal JAMA Network Open in June of 2023.
They hypothesized that a well-timed combination of sound and touch
could dial back that extra activity in the fusiform cell circuit.
This would go further than previous therapies and actually
turn down the volume of the sounds experienced by people with tinnitus.
Trial participants wore a type of headset dealio that delivered a combination
of both sounds and vibrations using electrodes
placed on the neck or head for 30 minutes at a time.
Participants in the control group received only sounds, but everybody in the study
got to trade places and be in the treatment group part of the time
Over half of the participants receiving both vibrations and sounds
showed a significant reduction in the distress caused by symptoms,
as well as the volume of the sounds.
Basically, this treatment intentionally throws a wrench
at the part of the brain that coordinates sensory signals.
While that doesn’t sound like something you’d normally want to do,
it was for a good reason and it worked for more than half the participants!
What’s even better is that the treatment effect persisted
even after participants were no longer using the headset thingy every day.
The team at the University of Michigan says that their results are promising
and represent hope for people with tinnitus.
Since this trial has concluded, the researchers are keen to move quickly
through the approval process to get their device to market.
So yeah, it goes to show that just because something is all in someone's head,
or somewhere between their ears and brains in particular,
that doesn't mean that it's not real.
Here's hoping that soon, instead of patients having to just deal with tinnitus,
doctors will be able to turn down these frustrating sounds
with some literal good vibes.
If you’re looking for other ways to hack your brain, you can try tricking yourself into
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