Published April 7, 2014
Western New Yorkers suffering from tinnitus, or ringing in the ears, may have the opportunity to try a new device that is showing promise as a new treatment for the condition.
One of just four institutions chosen for the study nationwide, UB is recruiting 10 volunteers for a small clinical trial to test an implantable device that helps retrain the part of the brain involved in hearing.
While the trial is small, it is the first step toward a potential, new treatment for tinnitus, which affects approximately 10 million Americans and which is now the major disability of veterans returning from Afghanistan and Iraq.
The study, funded by the National Institutes of Health, is being done through a cooperative agreement with MicroTransponder Inc. a Dallas-based medical device company.
The UB part of the trial is being conducted through the Speech-Language and Hearing Clinic in the Department of Communicative Disorders and Sciences, College of Arts and Sciences. Christina Stocking, clinical assistant professor, is principal investigator; Ernesto Diaz-Ordaz, clinical assistant professor, is the surgeon-investigator.
Interested individuals must have had tinnitus for at least one year and must meet other criteria.
Those selected for the study will undergo an outpatient surgical procedure in which an electrode will be placed on the vagus nerve in the neck with a lead to a processor — about the size of a cardiac pacemaker — implanted in the upper chest. The device uses vagus-nerve stimulation and sound in a way that retrains the auditory brain. Vagus-nerve stimulation is a safe form of neural stimulation that has been used to treat other disorders, such as epilepsy and depression.
The treatment takes advantage of the brain’s ability to reconfigure itself through neuroplasticity, the process by which changes in brain pathways occur as a result of environmental, behavioral or neuronal changes. Once the device is implanted, patients will attend two training sessions at the UB lab, where they will wear headphones and listen to single frequency tones while the vagus nerve is being stimulated. For the next three months, they will use the treatment for 2 1/2 hours each day at home. Vagus nerve stimulation results in the release of brain chemicals that foster neuroplasticity.
“The idea,” says Stocking, “is to repair the aberrant changes that have caused the tinnitus perception.”
The origins of tinnitus — which causes someone to hear noise when there isn’t any — are still unknown. This therapy addresses one possible source of the problem: an attempt by the brain to compensate for being unable to hear certain frequencies by turning up the signals of neurons in other frequencies, even in the absence of noise. These changing brain patterns may produce the noise sensations that tinnitus sufferers hear.
Until now, audiologists have offered patients ways to cope better with their symptoms and to attempt brain retraining through other methods. While these methods do benefit some patients, others continue to suffer, she says.
“This is the first treatment that uses direct neural stimulation along with sound in an attempt to change what’s causing the tinnitus in the first place,” says Stocking.
UB’s Center for Hearing and Deafness and Speech-Language and Hearing Clinic have been leaders in conducting research on tinnitus. Studies conducted in the 1990s by Richard Salvi, SUNY Distinguished Professor in the Department of Communicative Disorders and Sciences, and his colleagues were among the first to suggest that the condition originated not in the inner ear but in the brain.
Those interested in information about eligibility for participating in the study should send an email to firstname.lastname@example.org.
A welcome study, from which a follow-up might be generated for patients' benefit.
In earlier work supervised by Professor Salvi, it was shown by MS student Mark Szymanski (now a medical engineer at Greatbatch) that the electrodes could be quickly treated to more intimately bond with nerve tissue. The study was improved -- with RPCI help -- by PhD student Laurie O'Connor to show better stimulation results by electrical impedance spectroscopy (Dr. O'Connor is now at Praxair).
Perhaps the sponsor would like to differentially treat some electrodes to obtain this effect?
I am interested in this study. I have had tinnitus for more than two years. I do live in Syracuse but can commute. I came to your clinic for help and started a support group in Syracuse/Central New York to help other sufferers.
I do believe either the brain is trying to compensate for the loss of these sounds or is somehow reacting to the sounds it cannot hear and find this interesting.
The tinnitus trial in this story has now begun enrollment. You can visit www.tinnitustrial.com to find out more information about the trial and register for the trial at the University at Buffalo.