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Temporary Suppression of Tinnitus by Modulated Sounds

Journal of the Association for Research in Otolaryngology volume 13, pages 561–571 (2012)Cite this article

Abstract

Despite high prevalence of tinnitus and its impact on quality life, there is no cure for tinnitus at present. Here, we report an effective means to temporarily suppress tinnitus by amplitude- and frequency-modulated tones. We systematically explored the interaction between subjective tinnitus and 17 external sounds in 20 chronic tinnitus sufferers. The external sounds included traditionally used unmodulated stimuli such as pure tones and white noise and dynamically modulated stimuli known to produce sustained neural synchrony in the central auditory pathway. All external sounds were presented in a random order to all subjects and at a loudness level that was just below tinnitus loudness. We found some tinnitus suppression in terms of reduced loudness by at least one of the 17 stimuli in 90% of the subjects, with the greatest suppression by amplitude-modulated tones with carrier frequencies near the tinnitus pitch for tinnitus sufferers with relatively normal loudness growth. Our results suggest that, in addition to a traditional masking approach using unmodulated pure tones and white noise, modulated sounds should be used for tinnitus suppression because they may be more effective in reducing hyperactive neural activities associated with tinnitus. The long-term effects of the modulated sounds on tinnitus and the underlying mechanisms remain to be investigated.

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References

  • ASA (1960) Acoustical terminology SI, 1–1960. In: New York: American Standards Association.

  • Bauer CA, Turner JG, Caspary DM, Myers KS, Brozoski TJ (2008) Tinnitus and inferior colliculus activity in chinchillas related to three distinct patterns of cochlear trauma. J Neurosci Res 86:2564–2578

    Article  PubMed  CAS  Google Scholar 

  • Beck AT, Steer RA (1984) Internal consistencies of the original and revised Beck Depression Inventory. J Clin Psychol 40:1365–1367

    Article  PubMed  CAS  Google Scholar 

  • Beck AT, Epstein N, Brown G, Steer RA (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56:893–897

    Article  PubMed  CAS  Google Scholar 

  • Bulbul SF, Muluk NB, Cakir EP, Tufan E (2009) Subjective tinnitus and hearing problems in adolescents. Int J Pediatr Otorhinolaryngol 73:1124–1131

    Article  PubMed  Google Scholar 

  • Cacace AT (2003) Expanding the biological basis of tinnitus: crossmodal origins and the role of neuroplasticity. Hear Res 175:112–132

    Article  PubMed  Google Scholar 

  • Davis PB, Wilde RA, Steed LG, Hanley PJ (2008) Treatment of tinnitus with a customized acoustic neural stimulus: a controlled clinical study. Ear Nose Throat J 87:330–339

    PubMed  Google Scholar 

  • De Ridder D, Elgoyhen AB, Romo R, Langguth B (2011) Phantom percepts: tinnitus and pain as persisting aversive memory networks. Proc Natl Acad Sci U S A 108:8075–8080

    Article  PubMed  Google Scholar 

  • Duan N, Manning WG, Morris CN, Newhouse JP (1983) A comparison of alternative models for the demand for medical care. J Bus Econ Stat 1:115–126

    Article  Google Scholar 

  • Eggermont JJ (2007) Pathophysiology of tinnitus. Prog Brain Res 166:19–35

    Article  PubMed  CAS  Google Scholar 

  • Eggermont JJ, Komiya H (2000) Moderate noise trauma in juvenile cats results in profound cortical topographic map changes in adulthood. Hear Res 142:89–101

    Article  PubMed  CAS  Google Scholar 

  • Engineer ND, Riley JR, Seale JD, Vrana WA, Shetake JA, Sudanagunta SP, Borland MS, Kilgard MP (2011) Reversing pathological neural activity using targeted plasticity. Nature 470:101–104

    Article  PubMed  Google Scholar 

  • Fausti SA, Wilmington DJ, Gallun FJ, Myers PJ, Henry JA (2009) Auditory and vestibular dysfunction associated with blast-related traumatic brain injury. J Rehabil Res Dev 46:797–810

    Article  PubMed  Google Scholar 

  • Feldmann H (1971) Homolateral and contralateral masking of tinnitus by noise-bands and by pure tones. Audiology 10:138–144

    Article  PubMed  CAS  Google Scholar 

  • Folmer RL, Martin WH, Shi Y (2004) Tinnitus: questions to reveal the cause, answers to provide relief. J Fam Pract 53:532–540

    PubMed  Google Scholar 

  • Frisina RD (2001) Subcortical neural coding mechanisms for auditory temporal processing. Hear Res 158:1–27

    Article  PubMed  CAS  Google Scholar 

  • Gerken GM (1996) Central tinnitus and lateral inhibition: an auditory brainstem model. Hear Res 97:75–83

    PubMed  CAS  Google Scholar 

  • Goldstein B, Shulman A (1996) Tinnitus–hyperacusis and the loudness discomfort level test—a preliminary report. Int Tinnitus J 2:83–89

    PubMed  Google Scholar 

  • Gu JW, Halpin CF, Nam EC, Levine RA, Melcher JR (2010) Tinnitus, diminished sound-level tolerance, and elevated auditory activity in humans with clinically normal hearing sensitivity. J Neurophysiol 104:3361-3370

    Google Scholar 

  • Hanley JA, Negassa A, Edwardes MD, Forrester JE (2003) Statistical analysis of correlated data using generalized estimating equations: an orientation. Am J Epidemiol 157:364–375

    Article  PubMed  Google Scholar 

  • Hazell JW, Wood S (1981) Tinnitus masking—a significant contribution to tinnitus management. Br J Audiol 15:223–230

    Article  PubMed  CAS  Google Scholar 

  • Hazell JW, Wood SM, Cooper HR, Stephens SD, Corcoran AL, Coles RR, Baskill JL, Sheldrake JB (1985) A clinical study of tinnitus maskers. Br J Audiol 19:65–146

    Article  PubMed  CAS  Google Scholar 

  • Henry JA, Rheinsburg B, Zaugg T (2004) Comparison of custom sounds for achieving tinnitus relief. J Am Acad Audiol 15:585–598

    Article  PubMed  Google Scholar 

  • Hoare DJ, Kowalkowski VL, Kang S, Hall DA (2011) Systematic review and meta-analyses of randomized controlled trials examining tinnitus management. Laryngoscope 121:1555–1564

    Article  PubMed  Google Scholar 

  • Jastreboff PJ (1990) Phantom auditory perception (tinnitus): mechanisms of generation and perception. Neurosci Res 8:221–254

    Article  PubMed  CAS  Google Scholar 

  • Jastreboff PJ, Hazell JW (1993) A neurophysiological approach to tinnitus: clinical implications. Br J Audiol 27:7–17

    Article  PubMed  CAS  Google Scholar 

  • Jastreboff PJ, Gray WC, Gold SL (1996) Neurophysiological approach to tinnitus patients. Am J Otol 17:236–240

    PubMed  CAS  Google Scholar 

  • Jesteadt W (1980) An adaptive procedure for subjective judgments. Percept Psychophys 28:85–88

    Article  PubMed  CAS  Google Scholar 

  • Jesteadt W, Bacon SP, Lehman JR (1982) Forward masking as a function of frequency, masker level, and signal delay. J Acoust Soc Am 71:950–962

    Article  PubMed  CAS  Google Scholar 

  • Kaltenbach JA, Rachel JD, Mathog TA, Zhang J, Falzarano PR, Lewandowski M (2002) Cisplatin-induced hyperactivity in the dorsal cochlear nucleus and its relation to outer hair cell loss: relevance to tinnitus. J Neurophysiol 88:699–714

    PubMed  CAS  Google Scholar 

  • Kujawa SG, Liberman MC (2006) Acceleration of age-related hearing loss by early noise exposure: evidence of a misspent youth. J Neurosci 26:2115–2123

    Article  PubMed  CAS  Google Scholar 

  • Landgrebe M, Frick U, Hauser S, Hajak G, Langguth B (2009) Association of tinnitus and electromagnetic hypersensitivity: hints for a shared pathophysiology? PLoS One 4:e5026

    Article  PubMed  Google Scholar 

  • Lanting CP, de Kleine E, van Dijk P (2009) Neural activity underlying tinnitus generation: results from PET and fMRI. Hear Res 255:1–13

    Article  PubMed  CAS  Google Scholar 

  • Liang L, Lu T, Wang X (2002) Neural representations of sinusoidal amplitude and frequency modulations in the primary auditory cortex of awake primates. J Neurophysiol 87:2237–2261

    PubMed  Google Scholar 

  • Llinas RR, Ribary U, Jeanmonod D, Kronberg E, Mitra PP (1999) Thalamocortical dysrhythmia: a neurological and neuropsychiatric syndrome characterized by magnetoencephalography. Proc Natl Acad Sci U S A 96:15222–15227

    Article  PubMed  CAS  Google Scholar 

  • Lockwood AH, Salvi RJ, Burkard RF (2002) Tinnitus. N Engl J Med 347:904–910

    Article  PubMed  Google Scholar 

  • Lu T, Liang L, Wang X (2001) Temporal and rate representations of time-varying signals in the auditory cortex of awake primates. Nat Neurosci 4:1131–1138

    Article  PubMed  CAS  Google Scholar 

  • Malone BJ, Scott BH, Semple MN (2010) Temporal codes for amplitude contrast in auditory cortex. J Neurosci 30:767–784

    Article  PubMed  CAS  Google Scholar 

  • Muhlnickel W, Elbert T, Taub E, Flor H (1998) Reorganization of auditory cortex in tinnitus. Proc Natl Acad Sci U S A 95:10340–10343

    Article  PubMed  CAS  Google Scholar 

  • Nelson JJ, Chen K (2004) The relationship of tinnitus, hyperacusis, and hearing loss. Ear Nose Throat J 83:472–476

    PubMed  Google Scholar 

  • Newman CW, Jacobson GP, Spitzer JB (1996) Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg 122:143–148

    Article  PubMed  CAS  Google Scholar 

  • Norena AJ (2010) An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci Biobehav Rev 35:1089–1109

    Article  PubMed  Google Scholar 

  • Norena AJ, Eggermont JJ (2006) Enriched acoustic environment after noise trauma abolishes neural signs of tinnitus. Neuroreport 17:559–563

    Article  PubMed  Google Scholar 

  • Norena A, Micheyl C, Chery-Croze S, Collet L (2002) Psychoacoustic characterization of the tinnitus spectrum: implications for the underlying mechanisms of tinnitus. Audiol Neurootol 7:358–369

    Article  PubMed  Google Scholar 

  • Okamoto H, Stracke H, Stoll W, Pantev C (2010) Listening to tailor-made notched music reduces tinnitus loudness and tinnitus-related auditory cortex activity. Proc Natl Acad Sci U S A 107:1207–1210

    Article  PubMed  CAS  Google Scholar 

  • Pan T, Tyler RS, Ji H, Coelho C, Gehringer AK, Gogel SA (2009a) The relationship between tinnitus pitch and the audiogram. Int J Audiol 48:277–294

    Article  PubMed  Google Scholar 

  • Pan T, Tyler RS, Ji H, Coelho C, Gehringer AK, Gogel SA (2009b) Changes in the tinnitus handicap questionnaire after cochlear implantation. Am J Audiol 18:144–151

    Article  PubMed  Google Scholar 

  • Picton TW, John MS, Dimitrijevic A, Purcell D (2003) Human auditory steady-state responses. Int J Audiol 42:177–219

    Article  PubMed  Google Scholar 

  • Rajan R, Irvine DR (1998) Neuronal responses across cortical field A1 in plasticity induced by peripheral auditory organ damage. Audiol Neurootol 3:123–144

    Article  PubMed  CAS  Google Scholar 

  • Reed GF (1960) An audiometric study of two hundred cases of subjective tinnitus. AMA Arch Otolaryngol 71:84–94

    Article  PubMed  CAS  Google Scholar 

  • Roberts LE, Moffat G, Baumann M, Ward LM, Bosnyak DJ (2008) Residual inhibition functions overlap tinnitus spectra and the region of auditory threshold shift. J Assoc Res Otolaryngol 9:417–435

    Article  PubMed  Google Scholar 

  • Roberts LE, Eggermont JJ, Caspary DM, Shore SE, Melcher JR, Kaltenbach JA (2010) Ringing ears: the neuroscience of tinnitus. J Neurosci 30:14972–14979

    Article  PubMed  CAS  Google Scholar 

  • Ross B, Draganova R, Picton TW, Pantev C (2003) Frequency specificity of 40-Hz auditory steady-state responses. Hear Res 186:57–68

    Article  PubMed  Google Scholar 

  • Salvi RJ, Wang J, Ding D (2000) Auditory plasticity and hyperactivity following cochlear damage. Hear Res 147:261–274

    Article  PubMed  CAS  Google Scholar 

  • SAS I (1999) SAS/STAT® User’s guide, version 8. In: Ch. 29, pp 1414–1416. Cary, NC: SAS Institute Inc.

  • Sasaki CT, Kauer JS, Babitz L (1980) Differential [14C]2-deoxyglucose uptake after deafferentation of the mammalian auditory pathway—a model for examining tinnitus. Brain Res 194:511–516

    Article  PubMed  CAS  Google Scholar 

  • Schaette R, Kempter R (2006) Development of tinnitus-related neuronal hyperactivity through homeostatic plasticity after hearing loss: a computational model. Eur J Neurosci 23:3124–3138

    Article  PubMed  Google Scholar 

  • Seki S, Eggermont JJ (2003) Changes in spontaneous firing rate and neural synchrony in cat primary auditory cortex after localized tone-induced hearing loss. Hear Res 180:28–38

    Article  PubMed  Google Scholar 

  • Sweetow RW, Sabes JH (2010) Effects of acoustical stimuli delivered through hearing aids on tinnitus. J Am Acad Audiol 21:461–473

    Article  PubMed  Google Scholar 

  • Tang Q, Liu S, Zeng FG (2006) Loudness adaptation in acoustic and electric hearing. J Assoc Res Otolaryngol 7:59–70

    Article  PubMed  Google Scholar 

  • Terry AM, Jones DM, Davis BR, Slater R (1983) Parametric studies of tinnitus masking and residual inhibition. Br J Audiol 17:245–256

    Article  PubMed  CAS  Google Scholar 

  • Trotter MI, Donaldson I (2008) Hearing aids and tinnitus therapy: a 25-year experience. J Laryngol Otol 122:1052–1056

    Article  PubMed  CAS  Google Scholar 

  • Vernon J (1977) Attempts to relieve tinnitus. J Am Audiol Soc 2:124–131

    PubMed  CAS  Google Scholar 

  • Vernon J (1981) The history of masking as applied to tinnitus. J Laryngol Otol Suppl:76–79

    Google Scholar 

  • Wang J, Salvi RJ, Powers N (1996) Plasticity of response properties of inferior colliculus neurons following acute cochlear damage. J Neurophysiol 75:171–183

    PubMed  CAS  Google Scholar 

  • Weisz N, Muller S, Schlee W, Dohrmann K, Hartmann T, Elbert T (2007) The neural code of auditory phantom perception. J Neurosci 27:1479–1484

    Article  PubMed  CAS  Google Scholar 

  • Widen SE, Erlandsson SI (2004) Self-reported tinnitus and noise sensitivity among adolescents in Sweden. Noise Health 7:29–40

    PubMed  Google Scholar 

  • Zeng FG, Turner CW (1991) Binaural loudness matches in unilaterally impaired listeners. Q J Exp Psychol A 43:565–583

    PubMed  CAS  Google Scholar 

  • Zeng FG, Tang Q, Dimitrijevicb A, Starr A, Larky J, Blevins NH (2011) Tinnitus suppression by low-rate electric stimulation and its electrophysiological mechanisms. Hear Res 277:61-66

    Google Scholar 

  • Zoger S, Svedlund J, Holgers KM (2001) Psychiatric disorders in tinnitus patients without severe hearing impairment: 24 month follow-up of patients at an audiological clinic. Audiology 40:133–140

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank the participation and persistence of the 20 tinnitus sufferers who had to endure many boring and frustrating hours of testing. The authors also thank Tom Lu, Jerry Northern, Paul Manis, Jennifer Melcher, and four anonymous reviewers for comments on the manuscript, and Edward Wu and Essie Fine for assistance with subject recruitment and data collection. This work was supported by American Tinnitus Association and NIH Grant P30 DC008369.

Conflict of interest

Q.T. and F.G.Z. have an equity interest in, while J.A.C. is currently an employee of, SoundCure, Inc., Boston, MA, an AlliedMinds company that may potentially benefit from the research results. In addition, F.G.Z. also serves on the company's Scientific Advisory Board. The terms of this arrangement have been reviewed and approved by the University of California, Irvine, in accordance with its conflict of interest policies.

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Authors and Affiliations

  1. Center for Hearing Research Department of Otolaryngology–Head and Neck Surgery, University of California, Irvine, 110 Medical Science E, Irvine, CA, 92697-5320, USA

    Kelly M. Reavis, Vanessa S. Rothholtz, Qing Tang, Jeff A. Carroll, Hamid Djalilian & Fan-Gang Zeng

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  1. Kelly M. Reavis
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  2. Vanessa S. Rothholtz
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Correspondence to Fan-Gang Zeng.

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Reavis, K.M., Rothholtz, V.S., Tang, Q. et al. Temporary Suppression of Tinnitus by Modulated Sounds. JARO 13, 561–571 (2012). https://doi.org/10.1007/s10162-012-0331-6

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  • DOI: https://doi.org/10.1007/s10162-012-0331-6

Keywords

  • subjective tinnitus
  • hyperacusis
  • sound therapy
  • loudness
  • loudness recruitment
  • amplitude modulation
  • frequency modulation
  • pure tones
  • white noise