Episode 22: Revisiting a Friend of Tinnitus Talk — Dr. Josef Rauschecker

[Tinnitus Talk]

Let us start off by conveying our deepest regrets that it has been 11 months since we last published a podcast episode. Ugh. Well, we did publish some bonus content for our Patreon supporters, but no full-length podcast episode. Last year was a busy one with conferences like ARO and TRI (where @Hazel presented (!) – see her blog post here). We did record some podcast episodes that we haven't found time yet to edit, so those are still coming. What we're trying to say, in any case, is that we remain equally committed to the Tinnitus Talk Podcast!

I'm sure most of you know about Dr. Josef Rauschecker. He is a neuroscientist, tinnitus sufferer, and the only researcher to have done a Ted Talk on tinnitus. He was also the first ever guest on the Tinnitus Talk Podcast; we revisit with him (in person!) at his office in Georgetown University.

Josef's gating theory poses that while neural 'noise' may arise in the ear and lower brain regions due to hearing loss, this noise is typically cancelled out further up the auditory pathway. For most people at least, but not for those experiencing tinnitus.

We speak to Josef about how his theory has evolved, his views on psychological treatments for tinnitus, why animal studies for tinnitus often fail, and how we can quickly get new tinnitus medications to market.

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Listen on:

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

We welcome any discussion, but please keep the following in mind when commenting:

• Off-topic comments, i.e. not directly responding to the content of the podcast, will be removed. So please do listen before commenting!
• While we welcome constructive criticism on ideas or policies, we do not tolerate direct attacks on individuals.

This episode was produced by @Markku and @Hazel, with the transcript created by @Hazel as well. We also want to thank Josef for welcoming Hazel to his office at Georgetown University! Do you want to take part in creating the podcast? Let us know.

We thank our Patreon supporters for making this podcast possible.

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[ZFire]

I know for a fact @UKBloke will dig this one!

As for my evening plans, I've already picked out what I'll be listening to later tonight. Great work to everyone involved in these podcasts. As always.

 

[UKBloke]

I know for a fact @UKBloke will dig this one!

Roger that Did you listen to it yet?

Thanks @Markku and @Hazel - interesting stuff.

Dunno... it's nice to hear from Dr. Rauschecker but it leaves me slightly crestfallen that although he still stands by the gating model from the 2010 paper, the "dreaming" as he puts it is essentially still the same and the tech/research hasn't really moved on much. It's almost like somebody puts a brilliant idea out there and it just falls to the breeze.

One thing that concerns me is the effort into subtyping of tinnitus. And he really exemplifies that point here. I personally feel that if the gating model is going to hold true (and I believe it will) then it cares very little for the cause or subtype of tinnitus.

In and of itself that statement doesn't mean much, however, when one considers the idea that subtyping (with all the time, money and effort being spent on it) might be off-target, it casts the consequence of that in a different light. Similarly scanners and scanning. I'm not convinced that seeing electrical activity in the brain is really going to lead anywhere useful absent a more conclusive gating model.

I get a sense he's frustrated regarding the, who will and won't fund tinnitus research, question. I think this is good for us, if for no other reason than when the times comes (and again I believe it will) that top guys like him and his circle really embrace "open-source" research there's every possibility we'll see a momentous nudge forward towards a cure.

 

[ZFire]

Roger that Did you listen to it

Yup. I jotted down some notes.

I do have to agree with you that it seems like his research on the gating theory hasn't significantly progressed all that much, despite additional imaging studies and the inclusion of more brain regions they think are important. He also mentioned resting state and functional connectivity studies and how there are distinct patterns in tinnitus patients — higher volume of brain matter in the cortex. I'm curious if this is new information for you?

I did find his points on developing alternative animal models for tinnitus intriguing though. He emphasized the importance of using primates in studies because of their closer resemblance to us (humans) in terms of brain organization. Personally, I'm starting to roll my eyes every time I see mice and other rodents being used in tinnitus research. It hasn't translated well in testing for potential drug treatments for tinnitus. I'm open to the idea of exploring the use of monkeys (ethically of course) to see if we could produce more reliable and consistent results, and hopefully establish a solid benchmark for comparing animal and human studies.

He also talks about tinnitus as an issue associated with aging. He cited an interesting statistic that shows a 45% increase in prevalence among those aged 65+. I'm starting to think the actual numbers of people affected by tinnitus might be higher than commonly acknowledged as well.

His unintentional experience with Lidocaine and how it cured his tinnitus temporarily was another interesting bit. That would explain his strong interest for testing existing drugs.

The summarization of his gating theory is really good in this episode too, especially if you're a newbie to tinnitus research. I was hoping to hear some new developments in his theory though...

One thing that concerns me is the effort into subtyping of tinnitus. And he really exemplifies that point here. I personally feel that if the gating model is going to hold true (and I believe it will) then it cares very little for the cause or subtype of tinnitus.

I really like this take and been warming up to it lately. It implies a more universal approach to understanding and potentially addressing the condition... regardless of its origins or variations. Hopefully the gating model will be proven accurate in the foreseeable future.

 

[UKBloke]

I'm curious if this is new information for you?

I remember reading an article or study last year I think that mentioned the higher volume of grey matter in tinnitus sufferers. I can't remember who authored it though. So yeah, hearing about it again wasn't completely new news but interesting nevertheless.

He also talks about tinnitus as an issue associated with aging. He cited an interesting statistic that shows a 45% increase in prevalence among those aged 65+. I'm starting to think the actual numbers of people affected by tinnitus might be higher than commonly acknowledged as well.

It implies a more universal approach to understanding and potentially addressing the condition...

If the gating model holds up, then one speculative cause for a failure across the gate (something I've been working on and am very close to completion) could be reduced voltages at the input.

It makes total sense to me that voltage reduction into that side of the network could result from cochlear insult, Ménière's, and basically all the other triggers we've come to know and love. Additionally though, I would go out on a limb and say that it wouldn't surprise me if systemic voltage reductions are also just a natural consequence of ageing.

In other words, even if a person has managed to avoid all the insults that get hurled at a genetically flawed (my best guess) gate over their lifetime, eventually old-age gets everyone, and when that person's systemic voltages start to reduce this highlights the flawed gate with the result being tinnitus. That's approximately my speculation as it stands today.

 

[Mathilda]

@Hazel, I would love to read the transcript of this interview; unfortunately, a wrong PDF is linked on the website. Could you maybe fix this? I would very much appreciate it. Thank you!

 

[Hazel]

@Hazel, I would love to read the transcript of this interview; unfortunately, a wrong PDF is linked on the website. Could you maybe fix this? I would very much appreciate it. Thank you!

Hey there! I'm not sure where you are looking, but from what I can see the transcript is there and looks correct?

Just go to the episode page and click on the "CC" button to the right-hand side of the player, and the transcript should show up.

Please let us know if you are still having any issues!

 

[Mathilda]

Hey there! I'm not sure where you are looking, but from what I can see the transcript is there and looks correct?

Just go to the episode page and click on the "CC" button to the right-hand side of the player, and the transcript should show up.

Please let us know if you are still having any issues!

@Hazel
Thank you so much; I found it!

I did not see the "CC button" - I am still finding my way through Tinnitus Talk. I was looking at a different place; Another (wrong) script is attached below linked to "click here for the description".)

Have a great day.