European Radiology

, Volume 20, Issue 3, pp 696–703 | Cite as

Real-time fMRI feedback training may improve chronic tinnitus

  • Sven HallerEmail author
  • Niels Birbaumer
  • Ralf Veit



Tinnitus consists of a more or less constant aversive tone or noise and is associated with excess auditory activation. Transient distortion of this activation (repetitive transcranial magnetic stimulation, rTMS) may improve tinnitus. Recently proposed operant training in real-time functional magnetic resonance imaging (rtfMRI) neurofeedback allows voluntary modification of specific circumscribed neuronal activations. Combining these observations, we investigated whether patients suffering from tinnitus can (1) learn to voluntarily reduce activation of the auditory system by rtfMRI neurofeedback and whether (2) successful learning improves tinnitus symptoms.


Six participants with chronic tinnitus were included. First, location of the individual auditory cortex was determined in a standard fMRI auditory block-design localizer. Then, participants were trained to voluntarily reduce the auditory activation (rtfMRI) with visual biofeedback of the current auditory activation.


Auditory activation significantly decreased after rtfMRI neurofeedback. This reduced the subjective tinnitus in two of six participants.


These preliminary results suggest that tinnitus patients learn to voluntarily reduce spatially specific auditory activations by rtfMRI neurofeedback and that this may reduce tinnitus symptoms. Optimized training protocols (frequency, duration, etc.) may further improve the results.


fMRI BOLD Biofeedback Tinnitus Neurofeedback 



blood oxygenation level dependent


dorso-lateral prefrontal cortex




echoplanar imaging


functional magnetic resonance imaging


real-time functional magnetic resonance imaging


repetitive transcranial magnetic stimulation


ventro-lateral prefrontal cortex



We thank all subjects for participation in the study.

Conflict of interest

No conflicts of interest.


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Copyright information

© European Society of Radiology 2009

Authors and Affiliations

  1. 1.Institute of Radiology, Department of NeuroradiologyUniversity Hospital BaselBaselSwitzerland
  2. 2.Institute of NeuroradiologyDepartment of Imaging and Medical Informatics, Geneva University HospitalGenevaSwitzerland
  3. 3.Institute of Medical Psychology and Behavioral NeurobiologyUniversity of TübingenTübingenGermany
  4. 4.Ospedale San CamilloInstituto di Ricovero e Cura a Carattere ScientificoVeneziaItaly

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