Clinical Efficacy of Tinnitus Retraining Therapy

[reggie green]

Can someone offer an opinion on this piece of research?

https://www.ncbi.nlm.nih.gov/pubmed/31049251

 

[JohnAdams]

Well first off, the language is ambiguous.

"In total, 58 patients with tinnitus who did not respond to medications were enrolled in the TRT program.

Medications for what? Tinnitus? Depression? Anxiety? What?

"After six months of TRT, most of the patients found remarkable improvement in the symptoms,"

Which symptoms? Tinnitus? Hyperacusis? Depression? Anxiety?


Obviously the medications are anti-depressants and anti-anxiety drugs, and the symptoms are depression and anxiety.

One day we will look back at stuff like this as if it's equivalent to blood-letting and drinking camel urine.

I can see some half assed know it all ENT reading over that and being like, "Medications, hum ho hum ho. Symptoms, ah yes the symptoms. I will recommend this to all my patients complaining from tinnitus." and coming away from it actually thinking that it will make their tinnitus less loud.

 

[Clint Azzopardi]

I have always wondered how relevant are such studies with only 58 patients. I believe Neuromod tested over 500 patients and 'we' are saying that the sample size is small.

 

[Contrast]

Tinnitus represents a symptom of an underlying condition rather than a disease itself. The most common type of tinnitus is subjective tinnitus, which is sensorineural in origin. The pathophysiological cause of tinnitus remains unclear, but a widely accepted theory states that it involves hyperactive hair cells or nerve fibers activated by a chemical imbalance across cell membrane or by the decoupling of stereocilia.

This was a widely accepted theory in the 80's. I thought modern thinking accepts the central gain hypothesis? Jastreboff has stated tinnitus is neurological but the authors didn't? However I'll keep an open mind. Maybe there are peripheral versions of tinnitus.

Also no mention of hyperacusis like John said.