Lenire — Bimodal Stimulation Treatment by Neuromod

I'm curious how Lenire can work off signal timing based on the very precise millisecond timing between sounds and tongue zap...

...but then uses Bluetooth headphones? Which has a very high latency in hundreds of milliseconds and it's not a constant latency too. It fluctuates and very difficult (if not impossible) to compensate for on the tongue zapper end.

Why didn't they just use a wired headphone with no latency?

Not saying it doesn't work, but as an electrical engineer I'm a bit skeptical on this detail.
Good question, I've also wondered about this.

They are very strict about the headphone: there is one specific model that they used in both the trials and in the finished devices. This comes up in the Q&A, too. Maybe this specific headphone has been selected for low jitter (so stable latency).

Also, because the device is tethered to you by the tonguetip electrode, and you are stationary during treatment, the headphone is very close to the device and the distance is constant.
 
When you say they latency fluctuates, do you also mean between two similar units or even within a unit at any given moment? (Same model and brand). Otherwise it's possible they can account for the latency in their system as long as they don't change any components.

I suppose it can still be risky as companies are known to change component suppliers over the lifespan of a certain model of headphones. You wouldn't necessarily know if they changed anything inside the headphones like an electronical circuit.
The latency can vary in the same unit due to the varying distance of the headphone, the signal strength of the receiver, the buffering time and codec used to compress the audio.

A Bluetooth codec such as AAC has an average of 350ms latency. That is high enough that if you are watching a fast moving video or playing a game, the audio and video will noticeably be off sync.

I really hope this bit isn't something they just overlooked. Because if the other poster is correct in that Lenire is supposed to work off ~5 millisecond timing (1 cycle), then the audio cue would literally be 70 cycles late.

I just want to raise some awareness (maybe Neuromod can look into this), not bring anyone's hopes down, since I really want Lenire to work.
 
This would be an incredible oversight and so far Neuromod has struck me as a competent, careful bunch. Maybe someone could ask them about this, or I will do so on November 5 when I'm headed out for device fitting.
 
I really hope this bit isn't something they just overlooked.
I e-mailed them today to ask how they handled this problem. In the Phase 2 papers they speak about the synchronised fashion in which both stimuli are applied. There were 3 study arms and in each one they worked with different timings. Synchronised, Temporally aligned w varying short delays and temporally aligned w long delays. So yes, that makes me think they didn't overlook this.

Then again, they got results so does it really matter if we fully comprehend what went into it? Do we even know the timing is as important as we believe. There has been a lot of comparing between Shore's device and Lenire, but they aren't exactly the same. We know pitch and loudness of the tones are not crucial. As in, customized to your tinnitus profile. Just the white noise is matched to your audiogram. And @Allan1967 said they could omit the white noise for him.

I'm not enough scientifically inclined to understand how it works, but man, do I hope it works!
 
I don't mean to be impolite GlennS, but jeez, you've changed your tune since July when you were coming down like a ton of bricks on anyone on the thread who expressed slight cynicism around Neuromod.
That's because I took Neuromod's data for granted. Now I'm keying on data from the field. If and when the field data starts to align with Neuromod's I'll go back to being more optimistic.
 
Good question, I've also wondered about this.

They are very strict about the headphone: there is one specific model that they used in both the trials and in the finished devices. This comes up in the Q&A, too. Maybe this specific headphone has been selected for low jitter (so stable latency).

Also, because the device is tethered to you by the tonguetip electrode, and you are stationary during treatment, the headphone is very close to the device and the distance is constant.
Maybe so, but introducing any Bluetooth device into a scheme, where success or failure can literally be measured in milliseconds is just asking for trouble, no matter how sophisticated the Bluetooth may be.

Also there could be some kind of a minor outside interference with the Bluetooth signal, which could be just enough to skew the results.
 
Ok, I dug up a bit more:

Lenire uses AKG K845BT headphones according to an image on their site.

This model is aptX-enabled, which is a Bluetooth codec specifically designed for low and consistent latency.

Maybe that helps.

https://www.aptx.com/products/akg-k-845bt-headphones
A little more googling puts a number on the latency.

https://www.head-fi.org/threads/logitech-ue-9000-vs-akg-k845bt.714554/page-4
aptX® Low Latency for Bluetooth® offers a total end-to-end latency of just 32 milliseconds (ms) – far less than the standard Bluetooth latency of more than 150 ms (+/-50ms), and well under the 40 ms recommended latency for audio/video applications.
Low latency is still latency but as long as it's predictable and constant then Lenire will just have to add artificial delay to get the simulation and audio into sync.
 
Good question, I've also wondered about this.

They are very strict about the headphone: there is one specific model that they used in both the trials and in the finished devices. This comes up in the Q&A, too. Maybe this specific headphone has been selected for low jitter (so stable latency).

Also, because the device is tethered to you by the tonguetip electrode, and you are stationary during treatment, the headphone is very close to the device and the distance is constant.
I'm curious how Lenire can work off signal timing based on the very precise millisecond timing between sounds and tongue zap...

...but then uses Bluetooth headphones? Which has a very high latency in hundreds of milliseconds and it's not a constant latency too. It fluctuates and very difficult (if not impossible) to compensate for on the tongue zapper end.

Why didn't they just use a wired headphone with no latency?

Not saying it doesn't work, but as an electrical engineer I'm a bit skeptical on this detail.
I am sure none of their PhDs thought about this when coming up with the device. You should probably email them to let them know.
 
Low latency is still latency but as long as it's predictable and constant then Lenire will just have to add artificial delay to get the simulation and audio into sync.
That's the thing though. Googling shows me aptX latency is around 32-40 ms and it varies... so it's not all the time constant.
 
I am sure none of their PhDs thought about this when coming up with the device. You should probably email them to let them know.
Just to be clear: I emailed them to ask how they worked around this, assuming they thought about this. Nothing cocky, just out of curiosity. When I'm about to drop 2500 euro, I like to believe I'm allowed to ask the odd question.
 
I am sure none of their PhDs thought about this when coming up with the device. You should probably email them to let them know.
History is full of failed projects, which were literally crawling with engineers and PhDs.

Simple human error like:
"I thought Ross had that part worked out"... "I thought Hubert solved that one with the boys at the lab", is always possible, no matter how many credentials or PhDs are involved.
 
Just to be clear: I emailed them to ask how they worked around this, assuming they thought about this. Nothing cocky, just out of curiosity. When I'm about to drop 2500 euro, I like to believe I'm allowed to ask the odd question.
I wouldn't hold my breath.

You will most likely receive some vaguely worded answer, containing words such as "proprietary technology".
 
I am sure none of their PhDs thought about this when coming up with the device. You should probably email them to let them know.
You'd be surprised how little PhDs know outside of their very specific field. I work with senior electrical engineers that don't know how to check their car tire pressure. I had to help one of them check it!
 
History is full of failed projects, which were literally crawling with engineers and PhDs.
Simple human error like:
"I thought Ross had that part worked out"... "I thought Hubert solved that one with the boys at the lab", is always possible, no matter how many credentials or PhDs are involved.
Here's an infamous example. It's shocking how often this sort of stuff happens.
 
You'd be surprised how little PhDs know outside of their very specific field. I work with senior electrical engineers that don't know how to check their car tire pressure. I had to help one of them check it!
Very true, as I can attest to similar experiences involving highly schooled individuals, some of whom are unable to hang up a simple shelf, without getting injured (or finding out that putting screws directly into the drywall without any anchors is not the best idea).
 
Simple human error like:
"I thought Ross had that part worked out"... "I thought Hubert solved that one with the boys at the lab", is always possible, no matter how many credentials or PhDs are involved.
Since they had positive results in the trial, they must've done something right.
If someone made a mistake as in the spaceship example, the outcome (a destroyed spacecraft) is quite obvious...
 
Wow some people are being so negative! No wonder you guys made @Redknight leave! Shame on you. No appreciation for their endeavors whatsoever. The time is still way too early. Our sample size is still tiny, and none of the treatments are even completed.

Just sit and wait for the users instead of going Lord of the Flies. Get a sound machine or something in the meantime. But don't set up discouragement for those who are planning to try the device in the near future. That's messed up. Show your support, then observe the results.
 
Maybe so, but introducing any Bluetooth device into a scheme, where success or failure can literally be measured in milliseconds is just asking for trouble, no matter how sophisticated the Bluetooth may be.

Also there could be some kind of a minor outside interference with the Bluetooth signal, which could be just enough to skew the results.
Yes. The wireless headphones introduce risks and cost more. Very dumb in my opinion.
 
Since they had positive results in the trial, they must've done something right.
If someone made a mistake as in the spaceship example, the outcome (a destroyed spacecraft) is quite obvious...
In this case it may not be quite so obvious, due to the elusive, hard to pin down nature of tinnitus.

Look... I do want Lenire to be a success just like everyone else here and there is still time for them to pull it off. But as the real life user testing is nearing its conclusion, I have a feeling, that this might fall into the "great idea, not so great execution" category.

As I stated before, I'm a bit puzzled about their decision to use Bluetooth, knowing that perfect, precise timing is literally everything, but there are other little things, that leave me rather cold to this product.

I'm not quite sure if it is their hesitation about the release of the peer review, their vaguely worded testimonials with scripted feel to them, the fact that one has to travel to Dublin 4x, or the year+ waiting list.

But they definitely do deserve credit for being the first ones to relase something, that is based on technology, which I believe will deliver us from this waking nightmare eventually.

The others are no doubt watching and learning from any mistakes they have made.

This is why I feel, that either the Susan Shore device, or the Minessota device will be most likely more effective, once released.
 
Hi, I've been following Neuromod for a while. Based on my audiogram I should be eligible, but I wonder: does one need to be able to hear at the tinnitus frequencies?

My tinnitus is a hiss in the 12 kHz range and in the ear where my tinnitus is loudest that's where my hearing rolls off quickly. I can hear 13 kHz but only when I crank it up. With the other ear I hear up to 14 kHz.

I'm asking because Dr. Shore's device needs you to have less than 55 dB hearing loss around your tinnitus.
So you can't have hearing loss greater than 55 dB? Where did you read this :( ?
 
A long time sufferer just posted an update worth taking a look at to the Lenire User Experience thread.
Dear Tinnitus Talk forum members,

I am currently halfway through my treatment with the Lenire. I must say I had a very stressful and busy month with moving, travel, and work on a new television series, but my time with the Neuromod device has helped a lot. It's hard to quantify— sometimes I feel as if it's just given me that 20 percent boost that makes it seem possible to overcome it and find some joy in life.

I'm certainly working and functioning at a high rate.

Three days ago, I went grocery shopping and beforehand sat down in a restaurant to grab a burger and watch the ND football game. The place wasn't noisy, but I couldn't hear the tinnitus, for an hour, the first time since it started that June years ago.

Please forgive me for not checking in more. I want to give time proper time. Bless you and @Markku and everyone.
 
So you can't have hearing loss greater than 55 dB? Where did you read this :( ?
https://clinicaltrials.gov/ct2/show/NCT02974543

I read it in this thread and just took it for truth. Actually I looked it up and it says "hearing thresholds of 50dB or less at tinnitus frequency"

That means you can still have hearing loss greater than 50dB, just not around your tinnitus, although I don't know if that applies to anyone as I believe your greatest loss would be right at the frequencies where your tinnitus is at. This is based on what I read. Can't back this up.

I wouldn't worry too much just yet. It's the design of the study, as every study needs well-defined criteria for its test subjects. It doesn't mean that this will still hold true for the commercialized treatment.

Shore's device and Lenire are compared a lot on here, and with Lenire tinnitus frequency is not a factor at all (heck, we don't even know if Lenire's signal timing is as important as many of us on the forum believe) so I don't think we should be comparing them too much even though they're both examples of bimodal stimulation treatment.
 

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