A Proposed Method of Action for Tinnitus

Dear friends,

I have written a layman's paper regarding the above. I was originally going to upload it as a post but once it started to run at over 3000 words with diagrams, posting a PDF became a better alternative.

Initially I had intended to invite some of you to do a kind of review process, or at the very least seek advice on editing. But in the end time restraints have made it more appropriate to just put the work out there in its naked form "and let the chips fall where they may".

There are a number of people, researchers and not whom, for reasons that should be clear to any of you that read the paper, I would hope can be encouraged to take a look. In no particular order:

• Prof. Josef P. Rauschecker
• Prof. Wouter A. Serdijn
  
• Dr. Dirk De Ridder
• Dr. Hamid Djalillian
• Brian Fargo

 

Very interesting.

One thing that occurred to me (that others may or may not have thought of) is that a tinnitus filtering mechanism might have explanatory power as to the causes of tinnitus.

I have seen many people say that drug x is ototoxic and caused my tinnitus. Whilst I have absolutely no doubt that these drugs have caused people's tinnitus, I think that very few of these drugs are genuinely ototoxic (meaning they damage the inner ear). Rather, my theory is that these drugs (e.g., SSRIs) break the tinnitus filtering mechanism (which had been filtering out unnoticed hearing loss).

My father is half deaf and has no tinnitus - I find this ridiculous (and annoying!).

 

Yes, it infuriates me. They throw this nonsense around without understanding what otoxicity is. The ATA has made this worse.

 

FYI @HomeoHebbian.

 

With his background in electronics, Prof. Serdijn is probably one of the best tinnitus researchers out there to ask to give a perspective on the above paper. I emailed him two months ago but didn't receive a reply. He may not have received the email of course.

@Christiaan, being that I think you are in contact with him, are you able to assist?

 

I can't say I'm in contact with Prof. Serdijn. He also seems to overlook my e-mails, but I can imagine that he has a busy schedule and only selectively answers some e-mails concerning his field of expertise.

Have you also considered reaching out to researchers who work closely with Prof. Serdijn? They might offer you assistance on how to get in touch with the professor. There's this website where you can see who worked closely with Prof. Serdijn in the last few years (W.A. Serdijn – Network — TU Delft Research Portal). Perhaps V. Giagka (Assistant Professor) or F. Varkevisser (MSc) may be worth contacting.

 

Thanks for that, I'll give it a go.

 

I've now completed a round of emails to researchers specializing in bio-electronics with interest in the field of tinnitus and those in their associated networks. I requested recipients take a look at the above paper and comment, if possible, on whether or not the (electrical) theory can be correct.

The responses I have received fall broadly into two categories:

• No response at all.
• "Thank you for your email but tinnitus isn't my speciality."

 

However, you were proactive and temporarily brought it to their attention. It was not a waste. Well done!

 

Thanks mate. We press on.

 

In a completely unrelated endeavor, I was researching how to diagnose a battery leak in a car. The technician eventually located a wire within the door housing in one video I watched. A tiny section of the insulation on the wire had a nick in it, and current was arcing against the metal, thus draining the battery over time. The image reminded me of myelin sheath:

What does the myelin sheath do?
The myelin sheath has three functions:

• Its fatty-protein coating provides protective insulation for your nerve cell, like the plastic insulation covering that encases the wires of an electrical cord.
• It allows the electrical impulses to travel quickly and efficiently between one nerve cell and the next.
• It maintains the strength of the impulse message as it travels down the axon.

I'm aware there has been research into how compromised myelin sheath might be implicated in tinnitus. Still, I'm unsure how far along the line any of it has gotten to provide more definitive answers to the problem. Damaged myelin resulting in auditory system leaks would fit this thread's flawed gate model.

Could tinnitus sufferers have some congenital defect that means our myelin has a different thickness, is susceptible to tearing, or has different electrical properties? Is there a way to test for this, a biomarker, or specific current measurements?

 

Oh my goodness, @UKBloke, I am so happy I discovered your 14-page paper today.

I've been having a very bad hyperacusis and tinnitus setback that started in late May after I was caught off guard outdoors in the presence of loud construction equipment. I couldn't put on hearing protection fast enough or run away from the noise fast enough to prevent a spike in symptoms. Last night, as I was crying myself to sleep, I wondered whether to contact my audiologist, primary care physician, or ENT doctor for help. I was afraid that none of them could help me because, as intelligent as they were, they were not applying the correct paradigm to the problem.

My primary care doctor is well-rounded and competent, but she has no specialized knowledge concerning maladies of the ears or brain.

My ENT is like a plumber with a strictly mechanical worldview. He understands the ear, nose, and throat as pipes and valves that handle earwax, snot, saliva, or other bodily fluids. Invisible things are beyond his ken.

My audiologist deals with invisible sound waves, but his training and education don't overlap enough with all the things that an electrician or sound engineer would know.

Your paper proposes a paradigm that is worth a second look by an expert in medicine or academia. Even if it's all hypothetical and metaphorical, there may be something to it. Neurology might be the specialty most simpatico to this sort of paradigm, as it is founded largely on biochemistry and electricity.

What makes the "AND gate" dysfunctional in some people but not others? Who knows whether it's a genetic anomaly, wear and tear, or even a psychological disposition toward leaving that gate stuck in one position when it ought to open and close in accordance with the situation? It's a tricky question to answer and verges on the metaphysical.

I sometimes feel that the air around me is full of knives. Still, I never voice that thought out loud because it would sound too melodramatic and paranoid to anybody who hasn't suffered firsthand from the effects of tinnitus and hyperacusis. If only we could all control our own gates, how wonderful it would be. No more knives, no more pain, no more metallic screeches.

As a layperson like yourself, I can't do anything concrete about anyone's proposed theory of the etiology of tinnitus or hyperacusis. Still, I do like the idea of meditating upon my "AND" gates and trying to open and close them with the power of my imagination. At the risk of sounding too "woo" or "New Age," I sometimes feel like my aura is ragged, torn, and vulnerable to sound waves and other outside influences. I really want to know how to heal and seal the compromised areas to prevent future damage and pain.

Thank you for sharing your paper with us. It's excellent food for thought, and I wouldn't be surprised if a researcher in the future were to prove that some or all of what you say is true. It simply takes time for science to catch up with certain ideas of a speculative nature and turn them into verifiable facts.

 

Sorry to hear about your setback. My hyperacusis has been misbehaving as well for a couple of months now, and it makes this condition much more difficult to deal with. I hope you manage to get some better sleep because that really does seem to help mitigate things to a degree.

I hear what you say about the various medical practitioners and absolutely concur. There's a lot of excellence out there in the individual fields, but tinnitus seems to fall between the cracks, unfortunately. Personally, I think this is because tinnitus is not primarily an audiological problem or even (for the most part) something ENT in nature. I believe the central fault underpinning tinnitus is neurological in nature, which is why I also agree that the current treatment paradigms seem off-key and need to shift. I guess there's room to come at this problem from all angles until there's a breakthrough.

There's nothing 'woo' or melodramatic in what you've said. I sometimes feel like the air around me is full of knives, too. I've often remarked that sound "feels" like it's grating against my eardrums. These symptoms we experience are real; they're not something we make up in our imagination!

 

I wonder if you'd be interested in crowdsourcing this (like a Google doc, etc.)

You make a lot of statements that indicate what you're saying is backed by research, but there is no research cited, for example. There is no discussion of research indicating other possible mechanisms.

I understand it might not be your intent that anything comes of it, but if you/Tinnitus Talk ever wanted to co-create a more academic paper, I think we have the capacity to do it together.

 

Yes, I'd be interested in this as an end goal if someone can bring some expertise to help make that happen. The only caveat on my side is that I wouldn't be able to go super-quick right now — more like slow and steady.

The lack of formal citation is my fault, and it partly came about because I am not an academic author. Everything in the paper that is technical in nature and not my own direct speculation on the model structure can be cited, including the work of Szent-Györgyi and Rauschecker, as well as other stuff, like semiconductor manufacturing processes, Boolean gating, etc.

Could you clarify what you mean by this?

 

The easiest way is to create a Google doc with a throwaway Google account, or something similar. I'm sure there's something not Google out there, too.

The academic citation/author thing is the part I think folks here would be happy to help within your spare time, so long as you can sort of fill in the gaps / leave links to the papers and page number/paragraph you're referencing. It's important because without citations of what you're talking about, it's impossible to understand to an outside reader, and the references you're making and validate what you're saying is accurate, i.e., a paper from 2010, what paper, what is the link, what paragraph refers to what you're talking about?

Think of science as the art of being wrong thousands of times before someone is right. Say your theory is only 5% right based on future advances, but that 5% is super helpful to someone furthering the field of tinnitus in the future. Tracing back the ideas to established papers gives your credibility/theory paper and allows you to build on what you're talking about. Without being able to trace back to the references, it pokes holes in the theory you're creating as it has no basis to track back to, and ultimately, those doing research will discount it out of hand, rightly/wrongly.

Think of a part of writing a paper as consolidating all of the different somewhat relevant theories around the aspect of tinnitus you're describing outside of just stating a hypothesis (I believe tinnitus is caused by X). In a more robust paper to support your hypothesis, you would be expected that instead of simply stating what you believe tinnitus is and/or what's causing it and how to fix it, you'd have gathered several different leading theories that are supported by current literature and be able to say why your paper is not necessarily different but where it fills in a missing gap in tinnitus research. This helps you build up why your paper is different as you can cite how those theories/papers go down routes yours does not and expand upon the existing literature.

 

First of all, thank you for your input; it's much appreciated.

As I mentioned previously, I'm not an academic or a paper writer per se, so this is new ground for me. That said, I can start working on links to the Rauschecker paper (and the other bits) over the next few days.

Absent the academic protocol, I think it's important to briefly outline the process I went through to get to where we are. I hope that will address some of the points you've raised.

I don't know if you've read the 2010 Rauschecker paper or not, but when I first read it, a couple of things immediately stood out. The main one is that he talks in terms of quite simple filtering systems, gating, and actual "switches," in fact. Yet when it comes to representing these (in the tangible sense), the discussion returns to what is, I suppose, more complex and classical neurological terminology.

As someone with a reasonably (although lapsed) high level of academic training in electronics and electrical engineering, I felt the Rauschecker paper missed a trick in presenting those systems more simply, utilizing their real-world solid-state counterparts in electronics to illustrate his theory. Hence, my "paper."

I've no idea if I was correct to approach it this way or whether or not, by doing so, we can expand on the formal tinnitus literature. Furthermore, I've no idea how to challenge or validate other aspects of the Rauschecker paper because it's deeply complex and academic, and I'm simply not qualified to do that job.

I suppose my paper interprets Rauschecker's (and others') work in a way that makes sense to me. It also (rightly or wrongly) explains a question (that even Rauschecker pondered in his paper) about why some people experience tinnitus while others don't. I think the TL;DR is probably that my paper is quite a basic layman's speculative extension of the Rauschecker paper with the work of Hamid Djalilian (and incidentally now Heidi Olze) supplementing the theory.

I can reference the neurological material, but again, I do so as a layman. That will be the hardest part, but I'm up for the challenge. The big question is, how do I get that process started? What do I physically need to do? Pointers wanted!