Acute vs. Sub Acute vs. Chronic Tinnitus (+ Plasticity Game)

[Hudson]

I'm curious about some stuff here, and it seems that there is no solid information regarding this.

I've read that at the Tinnitus Research Initiative (I'm seriously thinking of donating to these folks... the quality of research I've read out of them since their inception is leaps and bounds better than what the ATA has provided in the 40 or so years it's existed) are in the process of creating a database to record tinnitus information about patient cases (this is huge!).

Acute Tinnitus is <90 days.

It seems sub-acute tinnitus is 90<x<180 days.

And chronic tinnitus is >365 days.

Why this distinction in the medical community thus far? Are there lots of documented cases of tinnitus changing at intervals or peoples' tinnitus lessening at those intervals? Or is that a timeline that revolves more around the likelihood of the sufferer habituating to it? I'm about 32 days into an onset of a slight worsening of my tinnitus and I'm just wondering about the ability of things to clear up. I've been doing this plasticity game in the hopes that it will help "re-train" my brain for about 20 minutes a day. It's worth a shot I suppose.

Not sure if this belongs in research, admin can move it if he or she feels a better place for it.

edit* link to the plasticity game. Kind of fun actually. Plus it helps if you think you're being "proactive" about your condition.

http://blog.szynalski.com/2012/08/19/plasticity/

 

[Markku]

Well yes I suppose. Many tinnitus cases completely resolve on their own within days/weeks. Although I think the chances of complete recovery decrease dramatically after a couple of weeks or so... "disco tinnitus" or such usually don't last for weeks. Then again, there have been plenty of cases where someone has got tinnitus due to a medication, such as an antidepressant or benzo, and after stopping the drug it has taken several months for the tinnitus to disappear.

But treatments like HBO are best had as soon as possible after onset, as is taking prednisone, etc... all that is backed by studies.

I don't have any studies or hard data available, but generally speaking, I think it's not that often chronic tinnitus (>12 months) resolves anymore. Habituation, yes, but most people will still be able to hear the tinnitus. For tinnitus sufferers I think habituation doesn't usually mean not being able to hear tinnitus at all. Rather it's more or less a non-issue and can be coped with very well, doesn't cause anxiety etc... If one cannot hear their tinnitus however much they pay attention to it, then I personally categorize that as resolved, healed, cured tinnitus, not habituation... but that's my point of view.

So yes, it would make sense to me that within the first 3 months the chances of recovery (and effectiveness for many treatments) are the best, then the chances decrease somewhat during the sub-acute state and further decrease after a year or so.


I tested the plasticity game. It's very interesting. I played it for ten minutes and will try tomorrow again. Quite addicting, somehow... Had never before heard about the app before, so thanks for bringing it up!

 

[oatsey]

I've noticed that after using plasticity(for only a little bit), I've been less preoccupied by my tinnitus.

 

[oatsey]

Mar 24 73,250 Lvl 7
Mar 25 120,250 Lvl 8
Mar 26 118,250 Lvl 7
Mar 27 179,250 Lvl 8

It looks like my auditory cortex is being rewired

 

[Hudson]

It can't hurt... it's like giving your ears a workout. And your auditory cortex. I keep the volume way low, so that it stresses my hearing to try and discern between the pitches. Like I said, I think it can only really help. I doubt there's any chance of worsening our condition in any way. Plus, it gives you the feeling that you're being proactive and that you may have some inkling of influence over your condition, other than watching your salt intake and consuming a mountain of supplements.

 

[click]

Well yes I suppose. Many tinnitus cases completely resolve on their own within days/weeks. Although I think the chances of complete recovery decrease dramatically after a couple of weeks or so... "disco tinnitus" or such usually don't last for weeks. Then again, there have been plenty of cases where someone has got tinnitus due to a medication, such as an antidepressant or benzo, and after stopping the drug it has taken several months for the tinnitus to disappear. But treatments like HBO are best had as soon as possible after onset, as is taking prednisone, etc... all that is backed by studies. I don't have any studies or hard data available, but generally speaking, I think it's not that often chronic tinnitus (>12 months) resolves anymore. Habituation, yes, but most people will still be able to hear the tinnitus. For tinnitus sufferers I think habituation doesn't usually mean not being able to hear tinnitus at all. Rather it's more or less a non-issue and can be coped with very well, doesn't cause anxiety etc... If one cannot hear their tinnitus however much they pay attention to it, then I personally categorize that as resolved, healed, cured tinnitus, not habituation... but that's my point of view. So yes, it would make sense to me that within the first 3 months the chances of recovery (and effectiveness for many treatments) are the best, then the chances decrease somewhat during the sub-acute state and further decrease after a year or so. I tested the plasticity game. It's very interesting. I played it for ten minutes and will try tomorrow again. Quite addicting, somehow... Had never before heard about the app before, so thanks for bringing it up!

The meaning of habituation... this has been touched on by many in here and it is often interpreted differently.

I'm going with Jastreboff's explanation below which explains that, although the process of habituation involves a period when we can hear it but we don't care about it too much, the end result of habituation is that we do not hear it anymore - even if listened for:

Habituation of reaction and perception...
The presence of any continuous stimulus usually results in a process called habituation, whereby the individual responds less and less to the stimulus as long as it does not have any special negative meaning. The final stage in this process is when the signal is no longer detected, and cortical neurones are unresponsive. With tinnitus this means that it is no longer heard, even if it is listened for.

I'm currently going through the process of habituation but I still expect to reach the end result.... tinnitus free.

This is why I try not to mask (although at times I have to)... if my brain can hear it and I don't treat it as a negative... then eventually I will no longer hear it.


[optimistic click]

 

[erik]

I don't know if I can believe in the final stage of Jastreboff's explanation. I know at least 10 people who have had T long term, some that I work with. These people have had T at least 10 years or longer. Most 25-30 year range. I have talked to each of them about T over the past year, most several times and I have always asked them if they can hear their T and they all do. My dad has had T for over 30 years and he says he hears it now just like he did 30 years ago, just now he doesn't care about it.

To me, habituation is not whether you still hear the T or not, it's how you respond to it. If you don't care, then does hearing it really make that much difference in the end?

 

[click]

Very true Erik... when we don't care about it anymore then obviously it won't matter to us and it will be excellent.

But Jastreboff's theories are the ones that have made the most sense to me ever since this horrid thing began so I'm still hoping that the theory above is correct. I don't like to say it... because tomorrow my T may be screaming again... and yesterday it was screechy... but I am getting more and more hours when I can't hear it even if I listen for it... so the theory fits with my experience so far. We can only apply all these things to our own experience I suppose.

I'm still believing the 'completely gone at end of habituation' theory but, as you say, it doesn't make a lot of difference in the end if you no longer care about having it.

 

[Chicken]

I spoke to Jastreboff personally and he indicated my T would go away didn't say how long it would take but after telling him when and how mine started he seemed pretty optimistic - well it's been a year and a half and it's still here - better but still here - the TMJ is so much better though - read somewhere it could take up to two years to get better with TMJ problems - I'm wondering if I didn't do some permanent damage

 

[click]

My ENT Consultant said the same thing to me - that it would go but it would take a long time. He seemed to indicate that it does depend on what caused it in the first place .... but didn't expand on that!

I'm giving mine 2 years Chicken. Based on the progress so far. I know I may be wrong but I still believe And if it hasn't gone then it should at least be better than it is...

 

[erik]

I think it would depend on if your T is caused by hearing loss or some other condition. If it is some other condition, there is a much greater chance it can be resolved and go away. If due to hearing loss which is permanent, most likely not.

 

[Chicken]

you guys give me so much hope and to all of us out there whose T didn't start with hearing loss - keep your chin up - for those whose T comes from hearing loss - keep your chin up too

 

[Markku]

Yep, I know too many folks who have habituated to the noise, have had it for years and years and still can hear their tinnitus if they want. They just don't give a s*it. Most days, that is. That's what I personally call habituation, because the anecdotes I've read doesn't support the hypothesis that tinnitus goes completely inaudible once a person is habituated.


I'm not dismissing Jastreboff. His theory makes very much sense, but I would like to know how many tinnitus patients he has seen/know of that have had chronic tinnitus and they've habituated to the point of not being able to hear it even if specifically listening to it. Dear Pavel, if you are reading this, why not come forward and tell us more!

People get habituated to the noise of fridge. To the noises of nearby airplanes. To the noises of trains.

However, if they listen for it....

This by erik sums it up IMHO: "To me, habituation is not whether you still hear the T or not, it's how you respond to it. If you don't care, then does hearing it really make that much difference in the end?"

Either way, you can't lose. Whether the final phase of habituation is the complete inability to hear tinnitus or not caring about it and it having minimal if any effect on one's quality of life, the end result is good.

To me, the latter definition of habituation isn't a cure but it's a very effective way of being able to continue one's life, and I will remember to come and tell if I reach a place where I really can't hear it anymore. Promise!

 

[click]

As soon as I permanently cannot hear it anymore.. even when listening for it.. I'll come back and tell you all too

 

[oatsey]

nearly doubled my score on plasticity. at least if it doesn't relieve my tinnitus, I'll be a world-class tone perceiver.

 

[jazz]

nearly doubled my score on plasticity. at least if it doesn't relieve my tinnitus, I'll be a world-class tone perceiver.

That's actually very useful for matching T. I'm always guessing, like between 4 and 8 hz. That's not useful. But at least I have audiograms, which also evidence where your T zone exists.