Modern life is loud. The
jolting buzz of an alarm clock awakens the ears to a daily
din of trucks idling, sirens blaring, televisions droning,
computers pinging and phones ringing — not to mention
refrigerators humming and air-conditioners thrumming.
But for the 12 million Americans who suffer from severe
tinnitus, the phantom tones inside their head are louder
than anything else.
IOften caused by prolonged or sudden exposure to loud
noises, tinnitus (pronounced tin-NIGHT-us or TIN-nit-us)
is becoming an increasingly common complaint, particularly
among soldiers returning from combat, users of portable
music players, and aging baby boomers reared on rock ’n’
roll. (Other causes include stress, some kinds of chemotherapy,
head and neck trauma, sinus infections, and multiple sclerosis.)
Although there is no cure, researchers say they have never
had a better understanding of the cascade of physiological
and psychological mechanisms responsible for tinnitus.
As a result, new treatments under investigation —
some of them already on the market — show promise
in helping patients manage the ringing, pinging and hissing
that otherwise drives them to distraction.
The most promising therapies, experts say, are based on
discoveries made in the last five years about the brain
activity of people with tinnitus. With brain-scanning
equipment like functional magnetic resonance imaging,
researchers in the United States and Europe have independently
discovered that the brain areas responsible for interpreting
sound and producing fearful emotions are exceptionally
active in people who complain of tinnitus.
“We’ve discovered that tinnitus is not so
much ringing in the ears as ringing in the brain,”
said Thomas J. Brozoski, a tinnitus researcher at Southern
Illinois University School of Medicine in Springfield.
Indeed, tinnitus can be intense in people with hearing
loss and even those whose auditory nerves have been completely
severed. In the absence of normal auditory stimulation,
the brain is like a driver trying to tune in to a radio
station that is out of range. It turns up the volume trying
but gets only annoying static. Richard Salvi, director
of the Center for Hearing and Deafness at the State University
of New York at Buffalo, said the static could be “neural
noise” — the sound of nerves firing. Or, he
said, it could be a leftover sound memory.
Adam Edwards, a 34-year-old co-owner of a wheel repair
shop in Dallas, said he developed tinnitus four years
ago after target shooting with a pistol. “I had
all the risk factors,” he said. “I grew up
hunting, I played drums in a band, I went to loud concerts,
I have a loud work environment — everything but
living next to a missile launch site.” His tinnitus,
which he described as a “computer beeping”
sound, was so intense and persistent that he needed sedatives
to sleep at night.
Mr. Edwards says he has gotten relief from a device developed
by an Australian audiologist, which became widely available
in the United States last year. Manufactured by Neuromonics
Inc. of Bethlehem, Pa., it looks like an MP3 player and
delivers sound spanning the full auditory spectrum, digitally
embedded in soothing music.
Similar to white noise, the broadband sound, tailored
to each patient’s hearing ability, masks the tinnitus.
(The music is intended to ease the anxiety that often
accompanies the disorder.) Patients wear the $5,000 device,
which is usually not covered by health insurance, for
a minimum of two hours a day for six months. Since completing
the treatment regimen last year, Mr. Edwards said his
tinnitus had “become sort of like Muzak at a department
store — you hear it if you think about it, but otherwise
you don’t really notice.”
A small, company-financed study in the journal Ear &
Hearing in April 2007 indicated that the Neuromonics method
was 90 percent successful at reducing tinnitus. A larger
study is under way to determine its long-term effectiveness.
Anne Howell, an audiologist at the Callier Center for
Communication Disorders at the University of Texas at
Dallas, said the Neuromonics device was a big improvement
over older sound therapies that required wearing something
that looked like a hearing aid all the time and took 18
to 24 months.
“The length of time was discouraging for many patients,”
she said. “And a lot of them told me that wearing
something that looks like a hearing aid would cause a
problem in their professional life.”
Other treatments showing promise include surgically implanted
electrodes and noninvasive magnetic stimulation, both
intended to disrupt and possibly reset the faulty brain
signals responsible for tinnitus. Using functional M.R.I.
to guide them, neurosurgeons in Belgium have performed
the implant procedure on several patients in the last
year and say it has suppressed tinnitus entirely.
But the treatment is controversial. “It’s
a radical option and not proven yet,” said Jennifer
R. Melcher, an assistant professor of otology and laryngology
at Harvard Medical School.
The magnetic therapy, similar to treatments used for depression
and chronic pain, involves holding a magnet in the shape
of a figure eight over the skull. Clinicians use functional
M.R.I. to aim the magnetic pulses so they reach regions
of the brain responsible for interpreting sound. Patients
receive a pulse every second for about 20 minutes. “It
works for some people but not for others,” said
Anthony Cacace, professor of communication science and
nerve disorders at Wayne State University in Detroit.
Since tinnitus has so many causes, Dr. Cacace said, the
challenge now is to find out which “subsets of patients
benefit from this treatment.”
Researchers in Brazil have published a study indicating
that a treatment called cranial-sacral trigger point therapy
can relieve tinnitus in some head and neck trauma cases
by releasing muscles that constrict hearing and neural
pathways.
And drugs intended to treat alcoholism, epilepsy, Alzheimer’s
and depression that alter levels of various neurotransmitters
in the brain like serotonin, dopamine and gamma-aminobutyric
acid have quieted tinnitus in some published animal and
human studies.
“We’ve never been so hopeful,” said
Dr. Salvi, of SUNY Buffalo, “of finding treatments
for a disorder that haunts people and follows them everywhere
they go.”
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INFORMATION
This article first appeared
in The Racket, a student-produced weekly newspaper distributed
for the University of Wisconsin-La Crosse. The editorial
staff assumes full responsibility for content and policies..
Their website can be found at http://media.www.theracquet.net
Music without words means leaving behind the mind. And leaving behind the mind is meditation.
Meditation returns you to the source. And the source of all is sound. — Kabir
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