Episode 1: In Search of a Tinnitus Cure — Dr. Josef Rauschecker

[Tinnitus Talk]

Dear members,

We are extremely proud to be launching our new podcast series, under the same name as this forum: Tinnitus Talk.

Please take a look here at our dedicated podcast page.

General Introduction

The podcast aims to inform, raise awareness, connect and entertain on all matters related to tinnitus. Our main focus will be interviews with both tinnitus experts and patients. We also aim to keep you updated on important news and developments in the field.

Our podcast host is @Jack Straw. He took the initiative to launch this series and has put immense time and effort into it. @Hazel and @Markku will be frequent contributors to the podcast.

First Episode

It starts with an intro from Jack about the podcast in general, followed by an interview with Dr. Rauschecker by Hazel. The segments are time stamped for your convenience.

Dr. Rauschecker has been researching tinnitus for many years. He is focussed on understanding the brain mechanisms of tinnitus, which should bring us closer to a cure. He is currently raising funds for a new study into animal models for tinnitus. We talked with Dr. Rauschecker about how his own tinnitus has informed his research, theories on tinnitus brain mechanisms, the dire lack of funding for cure focused research, and much more.

​

Listen on:

• Tinnitus Talk Podcast (incl. timestamps and transcript)
• SoundCloud
• iTunes
• Spotify

Your Questions

We addressed many questions suggested by you guys for Dr. Rauschecker, but of course there wasn't time to cover everything, and we can imagine that the interview raises some new questions for you as well. So please feel free to pose any follow-up questions below. Dr. Rauschecker has graciously offered to make time to answer any questions. We will collect your questions and forward them to him.

Plans for the Future

Future episodes that we have in the pipeline are:
- Already recorded: David Stockdale (BTA) on tinnitus associations, public awareness, funding
- Already recorded: Dr. Will Sedley (researcher) on tinnitus from a neurological perspective
- Tentatively confirmed for late 2019: Dr. Susan Shore (researcher) on her clinical trials

Become Involved

If you can think of anyone else we should invite as a guest, please let us know. This is not limited to researchers or experts, we are also interested in tinnitus patients with interesting stories.

If you are interested in contributing a segment for, or becoming a guest on, a future episode, please PM @Markku, @Jack Straw and @Hazel.


Sharing Is Caring
Share the podcast on your social media and with your tinnitus friends!

 

[OnceUponaTime]

So grateful for all your hard work. I thank God for each and everyone of you. Love you tons!

Once

 

[Jiri]

Great work! Very professional and engaging voices of the presenters. Thank you for this

 

[Agrajag364]

Fantastic idea. Well done to all involved and thank you so much for your hard work.

 

[Hazel]

Great to get the first responses in, and so positive

Well, I can't lie, it is really nice to get acknowledgement for all our hard work! In that vein, and hopefully without sounding too pompous, I'd like to point out that:

• We've been deliberating and making preparations for months, deciding on stuff like scope, topics, branding, guests, recording set-up, distribution, website design, and many other things.
• The preparation time for any episode alone runs into the dozens of hours: reading up on the topic, coordinating with the guest, preparing a structure & questions.
• It took us quite some time to get the technical set-up for recording right, and many test takes were done!
• Audio editing was done by Jack; probably took 10h or so to remove audio disturbances and other glitches.
• Markku spent about 30h designing logos and building the dedicated podcast page. As per Markku's usual web wizard style, it looks really sleek and professional.

All in all, I'd estimate about 150h of work so far.

Also, @Ed209 and @TuxedoCat have been our focus group / test audience. Thanks guys!

One way you could acknowledge our efforts and help out would be to share the podcast on social media, and within any other tinnitus groups you may be a member of. Please link directly to the podcast episode here. It would be much appreciated!

 

[TimmyC]

Amazing podcast. I am so thankful for all of the hard work you put in. This was incredibly insightful.

 

[razo]

Very excited to see this new podcast.

I think the biggest message in this interview from the doctor - to us - is a Call for Action. As he says, our disorder is an invisible one that «we don`t die from» viewed from the outside, i.e. our disorder is not recognized enough, although perhaps 5-10% of the world's population is affected. Explain what it is to have tinnitus and what it means for quality of life.

I also think it is easier to support this tinnitus research now that I have heard him explaining his research in a broadcast like this. I will be a supporter for Dr. Rauschecker for sure after this. Very inspiring to hear him be so positive that he imagines a cure and and explains how he plans to get there.

It's fun to speculate on the causes of tinnitus on the research page of the forum (I have done this myself), but I agree with the doctor that where we can put our energy to best use is to make ourselves heard to the people that can provide support and funding for the tinnitus research field. I also hear the doctor say there is a high potential in the community. And I agree with this. Very few out there are there to help us, so we must do the job ourselves. Very important to have that clear in mind.
Nowadays with internet everyone has the potential to make a big difference - it is only up to our own creativity.
Direct the energy outwards, create a revolt as the doctor says (but responsibly). Everyone can make a difference. Do it as the best (and in reality the only) way to contribute to speed up finding a cure.

Now the real work should start for us.
It's the doctor's message.

 

[JohnAdams]

Definitely better than the TED Talk.

 

[Eric N]

Thanks for the amazing work. It's sad to see the that it might take another 10 years to find a cure and that is being optimistic. 10+ years for me is considered someday in the far future.

 

[Bill Bauer]

Many of the questions were not answered. Perhaps the person you interviewed could look over the questions we prepared and post the answers to the questions that were not covered in the podcast and that he knows the answer to in that thread?

 

[Bill Bauer]

Direct the energy outwards, create a revolt as the doctor says (but responsibly).

How do I create a responsible revolt that you speak of?

 

[Julien87]

This is a great idea! Thank you so much for your hard work, I will listen to this right away

 

[glynis]

Brilliant podcast and hope first of many!

Well done. xxx

 

[jay777]

Thank you everyone.

 

[Jazzer]

A great job from my perspective.

I am a complete layman, as far as things technical and medical are concerned, so I can only speak 'off the top of my head' as it were.

My only sphere of comparative excellence lay in my erstwhile ability to control a manually operated pitch adjuster, (trombone.), now redundant of course, courtesy of
tinni-fucking-tus. ('scuse my French.)

Dr. Rauschecker comes across to me as an ethical, authentic medical, neurological research doctor, highly intelligent, perceptive and thorough.
I would trust him with my ears.

Hazel did a great job, handling the interview very well, with good clear diction, and a hint of a Dutch accent which I am accustomed to at home.

Just a couple of observations.

The good doctor complained at one point that there was very little cross referencing between research agencies; and then when Hazel brought up 'Bi-modal stimulation,' he admitted that he didn't know what it was.

Rather strange I thought.

When Hazel gave a brief description he seemed somewhat dismissive.
Perhaps he would doubt the degree of research and subsequent science that lay behind it.

I must admit to being skeptical of the gizmo gadget approach myself.
Apart from the question of its curative possibilities, I worry that physically tampering with nerve structures might have a potential to cause more damage.

I am pleased that the direction of Dr. Rauschecker's research is pharmaceutically based rather than gadget.

I fully agree that it is the responsibility of all of us in this community to raise as much awareness as we can, and I try not to miss any opportunity myself.
(Sometimes to the point of becoming a pain in the proverbial - - - - .)

Dave x
Jazzer

 

[Hazel]

Many of the questions were not answered. Perhaps the person you interviewed could look over the questions we prepared and post the answers to the questions that were not covered in the podcast and that he knows the answer to in that thread?

To answer all the questions that came from the forum (I think there were around 70 or so) I would have needed to conduct a 10h interview with Dr. Rauschecker! He already agreed to answering any remaining questions, as Markku already noted in the OP. We'll figure out the best way to do this.

Dr. Rauschecker comes across to me as an ethical, authentic medical, neurological research doctor, highly intelligent, perceptive and thorough.
I would trust him with my ears.

Yep, that how he seemed to me. Genuinely nice and highly committed to the cause.

Hazel did a great job, handling the interview very well, with good clear diction, and a hint of a Dutch accent which I am accustomed to at home.

Thanks, Dave!

 

[Paulmanlike]

A great job from my perspective.

I am a complete layman, as far as things technical and medical are concerned, so I can only speak 'off the top of my head' as it were.

My only sphere of comparative excellence lay in my erstwhile ability to control a manually operated pitch adjuster, (trombone.), now redundant of course, courtesy of
tinni-fucking-tus. ('scuse my French.)

Dr. Rauschecker comes across to me as an ethical, authentic medical, neurological research doctor, highly intelligent, perceptive and thorough.
I would trust him with my ears.

Hazel did a great job, handling the interview very well, with good clear diction, and a hint of a Dutch accent which I am accustomed to at home.

Just a couple of observations.

The good doctor complained at one point that there was very little cross referencing between research agencies; and then when Hazel brought up 'Bi-modal stimulation,' he admitted that he didn't know what it was.

Rather strange I thought.

When Hazel gave a brief description he seemed somewhat dismissive.
Perhaps he would doubt the degree of research and subsequent science that lay behind it.

I must admit to being skeptical of the gizmo gadget approach myself.
Apart from the question of its curative possibilities, I worry that physically tampering with nerve structures might have a potential to cause more damage.

I am pleased that the direction of Dr. Rauschecker's research is pharmaceutically based rather than gadget.

I fully agree that it is the responsibility of all of us in this community to raise as much awareness as we can, and I try not to miss any opportunity myself.
(Sometimes to the point of becoming a pain in the proverbial - - - - .)

Dave x
Jazzer

I thought exactly the same, a tinnitus researcher with no knowledge of bi-modal neuromodulation despite making headlines last year and much hype in the tinnitus community.

 

[TuxedoCat]

when Hazel brought up 'Bi-modal stimulation,' he admitted that he didn't know what it was.

Rather strange I thought.

When Hazel gave a brief description he seemed somewhat dismissive.
Perhaps he would doubt the degree of research and subsequent science that lay behind it.

I thought exactly the same, a tinnitus researcher with no knowledge of bi-modal neuromodulation despite making headlines last year and much hype in the tinnitus community.

Read between the lines. Dr. Rauschecker is a gentleman and was being diplomatic, perhaps at his own expense.

Dr. Rauschecker and Susan Shore both did research as part of the Tinnitus Research Consortium between 1998 - 2012. From what I can tell, that was a fairly tight knit group that existed in the US and was funded by a philanthropist who donated over 8 million dollars over a 15 year period. So, I would venture that both are aware of each other's work, and if either leads to a benefit to patients, they will not discount that.

However, bimodal stimulation centers around stimulating the Dorsal Cochlear Nucleus in the brainstem. Dr. Rauschecker acknowledged that there is some evidence that this area of the brain may play a part, but his theory is that tinnitus is more complex. Rather, he says that in addition to hearing loss, areas of the brain within the limbic system are also damaged in some way. His model is that both damage to the "ear" and damage to the limbic system must both exist for tinnitus to occur. If these limbic regions were not damaged, the tinnitus signal would not reach the auditory cortex and we would not "hear it". Therefore, the undamaged limbic structures act as a gating mechanism which nicely explains why not everyone with hearing loss experiences tinnitus. His research centers on understanding the mechanisms at work in the limbic system and this understanding will lead to better treatments and eventually a cure. Here is a very hasty and rough schematic.

As far as Neuromod is concerned, I have not heard one thing about it here in the US. The AARP (American Association of Retired Persons) is advertising the Levo System. Nowhere have I seen anything about Neuromod except an ad in the ATA magazine which only talked about their clinical program, which I found strange.

Speaking of AARP, like the Veteran's associations, they are another fairly powerful group in the US when it comes to lobbying. We should keep that in mind.

TC

 

[Paulmanlike]

Read between the lines. Dr. Rauschecker is a gentleman and was being diplomatic, perhaps at his own expense.

Dr. Rauschecker and Susan Shore both did research as part of the Tinnitus Research Consortium between 1998 - 2012. From what I can tell, that was a fairly tight knit group that existed in the US and was funded by a philanthropist who donated over 8 million dollars over a 15 year period. So, I would venture that both are aware of each other's work, and if either leads to a benefit to patients, they will not discount that.

However, bimodal stimulation centers around stimulating the Dorsal Cochlear Nucleus in the brainstem. Dr. Rauschecker acknowledged that there is some evidence that this area of the brain may play a part, but his theory is that tinnitus is more complex. Rather, he says that in addition to hearing loss, areas of the brain within the limbic system are also damaged in some way. His model is that both damage to the "ear" and damage to the limbic system must both exist for tinnitus to occur. If these limbic regions were not damaged, the tinnitus signal would not reach the auditory cortex and we would not "hear it". Therefore, the undamaged limbic structures act as a gating mechanism which nicely explains why not everyone with hearing loss experiences tinnitus. His research centers on understanding the mechanisms at work in the limbic system and this understanding will lead to better treatments and eventually a cure. Here is a very hasty and rough schematic.

View attachment 26127

As far as Neuromod is concerned, I have not heard one thing about it here in the US. The AARP (American Association of Retired Persons) is advertising the Levo System. Nowhere have I seen anything about Neuromod except an ad in the ATA magazine which only talked about their clinical program, which I found strange.

Speaking of AARP, like the Veteran's associations, they are another fairly powerful group in the US when it comes to lobbying. We should keep that in mind.

TC

TuxedoCat do you believe Neuromod will reduce/alleviate tinnitus?

 

[Jazzer]

Read between the lines. Dr. Rauschecker is a gentleman and was being diplomatic, perhaps at his own expense.

Dr. Rauschecker and Susan Shore both did research as part of the Tinnitus Research Consortium between 1998 - 2012. From what I can tell, that was a fairly tight knit group that existed in the US and was funded by a philanthropist who donated over 8 million dollars over a 15 year period. So, I would venture that both are aware of each other's work, and if either leads to a benefit to patients, they will not discount that.

However, bimodal stimulation centers around stimulating the Dorsal Cochlear Nucleus in the brainstem. Dr. Rauschecker acknowledged that there is some evidence that this area of the brain may play a part, but his theory is that tinnitus is more complex. Rather, he says that in addition to hearing loss, areas of the brain within the limbic system are also damaged in some way. His model is that both damage to the "ear" and damage to the limbic system must both exist for tinnitus to occur. If these limbic regions were not damaged, the tinnitus signal would not reach the auditory cortex and we would not "hear it". Therefore, the undamaged limbic structures act as a gating mechanism which nicely explains why not everyone with hearing loss experiences tinnitus. His research centers on understanding the mechanisms at work in the limbic system and this understanding will lead to better treatments and eventually a cure. Here is a very hasty and rough schematic.

View attachment 26127

As far as Neuromod is concerned, I have not heard one thing about it here in the US. The AARP (American Association of Retired Persons) is advertising the Levo System. Nowhere have I seen anything about Neuromod except an ad in the ATA magazine which only talked about their clinical program, which I found strange.

Speaking of AARP, like the Veteran's associations, they are another fairly powerful group in the US when it comes to lobbying. We should keep that in mind.

TC

I am pretty sure you are right re' the diplomatic stance TC - given his earlier proximity to Susan Shore he would actually have known about these other disciplines, and perhaps declined to address them.

Thanks for the diagram - exactly what I took away from his explanation also.

 

[Paulmanlike]

How on earth do you go about changing/repairing the limbic system then?

I like it when he says a cure in 5 years if enough money was there. We wish.

 

[Jazzer]

Very good point @Paulmanlike.
If the gate was open and allowed noise to wreck the cochlea stereo cilia, then presumably that gate is still open, as we are now under even more stress (and subsequent cortisol) than we were in the first place.

 

[TuxedoCat]

TuxedoCat do you believe Neuromod will reduce/alleviate tinnitus?

@Paulmanlike

Right now, I have my doubts that it will help my tinnitus. I subscribe to the Rauschecker theory as it pertains to what I have experienced. I suspect my hearing loss existed before I developed tinnitus and before tinnitus I was not depressed or anxious.

I believe Susan Shore when she talks about her device benefiting those with somatic tinnitus as defined as those who can modulate their tinnitus by moving their head, neck or jaw. The way I understand it somatic neurons coming into the Dorsal Cochlear Nucleus have an inhibitory effect on neurons coming from the cochlea. What I have read is that this mechanism naturally exists so that when you turn your head, for example, you don't hear the sounds it makes. Have you ever read about people who can hear the noise their eyes make when they look from side to side? So by providing stimulation to somatic nerves like the trigeminal nerve, the device is increasing inhibitory effects in the DCN. I'm not up on it enough to understand about the timing needs and I have a difficult time accepting that somatic tinnitus is as prevalent as Susan Shore reports.

I remain cautiously optimistic and am looking forward to hearing her review of the science if she does a podcast with Tinnitus Talk.

TC

 

[TuxedoCat]

How on earth do you go about changing/repairing the limbic system then?

I like it when he says a cure in 5 years if enough money was there. We wish.

Well, that is a key question. Dr. Rauschecker addresses it when he mentions there is an ongoing study of deep brain stimulation and this may be a treatment for those most affected.

Then he hints at drug therapy as being possible if the neuromodulators and their receptors in the limbic system can be understood. So the neuromodulators will be those chemical transmitters that fine tune the signals in the limbic system. Dopamine and serotonin are the ones Dr. Rauschecker mentions.

I suspect that an understanding the cell receptors will be important because a drug that is specific for those receptors will be needed. This is similar to Dr. Tzounopoulos approach when he says that Dr. Wipf and he have redesigned Trobalt. I think the receptor Dr. Tzounopoulos is working with may be in a different location than the limbic system, but I will have to check on that.

But the other thing that Dr. Rauschecker stresses is that input from other disciplines will be needed. I have heard this also from the group at the Lauer Center at Mass Eye and Ear Infirmary. They did a seminar which you can access from their website. Dr. Dan Polley mentions in his presentation that tinnitus lies at the intersection of neuroscience, otolaryngology and psychiatry and that none of these disciplines are talking to one another.

TC

 

[Allan1967]

Thank you for all your hard work.

 

[Deamon22]

Fantastic podcast guys. Great job as always @Hazel, @Markku and everyone involved. @Jack Straw you make an awesome host buddy, it is a pleasure listening to you .

I think this is a great opportunity for people who can, and maybe have not yet donated to Tinnitus Talk, to show that they appreciate the work and want to support this.

 

[Ed209]

I think this is a great opportunity for people who can, and maybe have not yet donated to Tinnitus Talk, to show that they appreciate the work and want to support this.

I concur, one million per cent!!

The work here is beyond awesome and is infinitely deserving of a few beers (in donation money).

 

[Bill Bauer]

@Jack Straw you make an awesome host buddy, it is a pleasure listening to you

I like how Jack pronounces the word "tinnitus". This is how I choose to pronounce it. Is it the case that the majority of people pronounce it the way Hazel pronounces it? Or is it an American vs. British English thing?!

 

[Deamon22]

I like how Jack pronounces the word "tinnitus". This is how I choose to pronounce it. Is it the case that the majority of people pronounce it the way Hazel pronounces it? Or is it an American vs. British English thing?!

I think so, although I pronounce it like Dr. Rauschecker, since it is the same as in German.

 

[Stakovic]

Thank you guys for your efforts but sorry, to be honest, I do not see any news, we turn on the same point.