Medical Advances

[sticky]

Hi everyone,

I have been following some of the T research that has been going on recently (as probably a lot of us have) in particular Autifony 63.

I am afraid of getting my hopes up because I fear that the disappointment would be overwhelming.

I am generally a healthy person and so have never bothered to really follow the medical goings on in the world.

Is medical research REALLY advancing? I am a bit ignorant in this area!

Could someone please enlighten me as to what medical breakthroughs , cures or treatments in ANY field in medicine have occurred in the last 20 or so years that have really had a positive effect on people's lives.

I ask this because I feel like the AM101 trial wasn't particularly successful.....please correct me if I am wrong and that we know so little about the human brain because it is such a delicate machine.

I do feel like Autifony may be on the right track (my T feels like it is in my brain) , but again being afraid of disappointment is not helping me.

I have lived over half my life with this racket in my head and I hope I don't have to live another 60 years with there being more chance of it getting worse than better. I am 30 now and I am aware of hearing loss with age around the 65 years mark.....not looking forward to it

Any ideas would be much appreciated.

Should I be excited at the research that is going on?

Peace and quiet to all.

PS Sorry if this is in the wrong forum

Sticky

 

[lapidus]

Well, I'm no expert but from my understanding we're living in a time where medical companies are trying to actually make drugs and medications exclusively for T. This is something that has never been done before. There have been scientific studys before with different drugs, but those drugs main purpose have never been to treat T, Like Campral for example which was made for alcoholics. Instead they have just wanted to see if any already existing drugs may have effect.

There are now clinical trials for the following stuff;

Auris Medical's AM-101 for acute T and later they will develop AM-102 for chronic T.

Otonomy is supposedly starting phase 2 trials for something that is similar to AM-101.

Autifony is starting phase 2 for their drug AUT-00063 which is supposedly for chronic T and hearing loss.

A small study is about to start (or it have already started) to treat chronic T with DBS (Deep Brain Stimulation).

VNS (Vagus Nerve Stimulation) are also supposed to do their second trial in the US after a small (somewhat successful) first trial in Belgium last year to treat chronic T.

All of these things are novel treatments (except DBS which has been around some time but not for T). Nothing like this has ever happened in the world of T research before. At least not to my knowledge. Then there is also the stem cell and hair cell regeneration research but I don't know much about that. And then there is HIFU which I also know next to nothing about.

Maybe @jazz @benryu @attheedgeofscience @rtwombly @CathodeRaySound and other more scientific people will be able to give you a better answer.

 

[Asian]

Not to forget that we already have partially working treatments like TRT and neuromonics having high success rates. Besides there are many people benefiting somewhat from anti depressants, anti anxiety meds, alternative treatments, vitamins and suppliments, yoga and meditation, acupuncture and so on. So its not that much hopeless condition to live with in my opinion specially when we have so many future treatments to look forward to !

 

[jazz]

I have lived over half my life with this racket in my head and I hope I don't have to live another 60 years with there being more chance of it getting worse than better. I am 30 now and I am aware of hearing loss with age around the 65 years mark.....not looking forward to it

I'm also optimistic. But we need to see these drugs and devices tested on chronic sufferers. Everyone knows that chronicity strengthens the tinnitus precept; but I still believe chronicity may be overcome through the newer technologies or drugs (e.g., Autifony or tRNS) or different approaches to existing technologies (e.g., rTMS or tDCS).

Another possibility for chronic sufferers will be to combine different treatment strategies to enhance their effectiveness. Using sound therapy, for example, while taking a drug might achieve better results than either one alone. I do know researchers have suggested this multimodality approach for chronic sufferers. And I'm sure various protocols--including combining therapies-will be implemented as drugs and medical devices come to market. It would probably even be useful to try some of the psychological approaches--like CBT--while you're taking drug therapy.

That said, I do believe relief will be possible for everyone within five years to ten years.

 

[Lisa88]

I'm also optimistic. But we need to see these drugs and devices tested on chronic sufferers. Everyone knows that chronicity strengthens the tinnitus precept; but I still believe chronicity may be overcome through the newer technologies or drugs (e.g., Autifony or tRNS) or different approaches to existing technologies (e.g., rTMS or tDCS).

Another possibility for chronic sufferers will be to combine different treatment strategies to enhance their effectiveness. Using sound therapy, for example, while taking a drug might achieve better results than either one alone. I do know researchers have suggested this multimodality approach for chronic sufferers. And I'm sure various protocols--including combining therapies-will be implemented as drugs and medical devices come to market. It would probably even be useful to try some of the psychological approaches--like CBT--while you're taking drug therapy.

That said, I do believe relief will be possible for everyone within five years to ten years.

Jazz, if you know of any studies of chronicity strengthening the t percept, would you post them? One of the most puzzling things about t is the time limits placed. Why would 1 year be chronic? Do patients stick with their ENTs long enough for there to be statistics? Or maybe statistics exist with audiologists? Is there brain imaging that can show evidence of this? Or is it simply that most cases reported of resolution mostly exist within the first 3 months? Yet, some cases resolve years after. Maybe there are studies of plasticity/coding in other brain conditions? Hmmm, puzzling.

 

[Davo]

It would be easy to become cynical about advances in treatment if YOUR tinnitus is not improving but there is abundant focussed attention upon effective treatment. To sound even more cynical - this is potentially a multibillion dollar industry because of the amount of sufferers worldwide so why wouldn't there be focus upon treatment/cures?

 

[jazz]

Below is the study cited most often regarding chronicity and a strengthening of the tinnitus precept. Please note by strengthening the researchers do not mean an increase in loudness but rather a decrease in response to treatment. It's like if you break a bone. If you set it immediately, the bone will probably heal easily. If you wait until it's started to heal the wrong way, you'll have complications when trying to fix it. This doesn't mean it can't be fixed; but it will be more complicated.

One of the most puzzling things about t is the time limits placed. Why would 1 year be chronic? Do patients stick with their ENTs long enough for there to be statistics? Or maybe statistics exist with audiologists? Is there brain imaging that can show evidence of this? Or is it simply that most cases reported of resolution mostly exist within the first 3 months? Yet, some cases resolve years after. Maybe there are studies of plasticity/coding in other brain conditions?

You need to ask a tinnitus researcher or neurotologist such questions. They are all interesting. Perhaps, Dr. Nagler has some answers. You should ask him.

Otol Neurotol. 2005 Jul;26(4):616-9.

Transcranial magnetic stimulation for tinnitus: influence of tinnitus duration on stimulation parameter choice and maximal tinnitus suppression.

De Ridder D1, Verstraeten E, Van der Kelen K, De Mulder G, Sunaert S, Verlooy J, Van de Heyning P, Moller A.
Author information
Abstract
OBJECTIVE:
Tinnitus is a distressing symptom for which few treatments exist. It leads to an important decrease in quality of life in 2 to 3% of the population. Tinnitus is considered a phantom sound, the result of cortical reorganization. Transcranial magnetic stimulation (TMS) is a noninvasive method to modulate cortical reorganization and has been shown to be able to influence tinnitus perception.

STUDY DESIGN:
Retrospective analysis.

SETTING:
Tertiary referral center.

PATIENTS:
The effect of TMS of the contralateral auditory cortex in 114 patients with unilateral tinnitus is investigated as one of the selection criteria used for surgical implantation of electrodes on the auditory cortex.

INTERVENTION:
TMS is performed at 90% of motor threshold at 1, 3, 5, 10, and 20 Hz, with each stimulation session consisting of 200 pulses. Results were classified as no effect (0-19% improvement), partial effect (20-79% improvement), and good effect (80-100 suppression).

MAIN OUTCOME MEASURES:
TMS had a good effect in 25% of the patients studied, partial effect in 28% patients, and no effect in 47%.

RESULTS:
TMS at 200 pulses is capable of tinnitus suppression for seconds only. The results were influenced by tinnitus duration: the longer the tinnitus exists, the lower the stimulation frequency that yields maximal tinnitus suppression (p < 0.001). The maximal amount of tinnitus suppression decreases in time (p < 0.01), resulting in a 2% decrease of potential tinnitus suppression per year. [emphasis added]

CONCLUSION:
TMS of the auditory cortex is capable of modifying tinnitus perception for a very short time. The maximal amount of suppression and best stimulation frequency depends on the tinnitus duration.

Reference

http://www.ncbi.nlm.nih.gov/pubmed/16015156​

 

[sticky]

Thanks for your replies.

I am very thankful that people are researching T, and I feel that we are on the right track, but of course I can't really say.

I pray for even a 25% reduction, just back to how life was a few months ago. I had big T, but it was NOT an issue.

praying praying praying...without getting my hope up too much.

sticky

 

[Lisa88]

Thanks, @jazz
@Dr. Nagler - Do you know timeframes when t becomes "coded' in the brain. Are there any studies that prove this also? For example, why do doctors say that fading would only take place in the first year? Are there not many cases of t fading after this time period? (not habituation).
Thanks.

 

[Sjoerd]

I want to give this man a thumbs up!!!

 

[Dr. Nagler]

Thanks, @jazz
@Dr. Nagler - Do you know timeframes when t becomes "coded' in the brain. Are there any studies that prove this also? For example, why do doctors say that fading would only take place in the first year? Are there not many cases of t fading after this time period? (not habituation).
Thanks.

Hi @Lisa88 -

I am unaware of any reliable and verifiable scientific studies that actually prove when tinnitus becomes coded in the brain (or even if it becomes coded in the brain). A number of folks believe that after a year or so you are sort of stuck with what you have, but as far as I know that kind of thing is based on anecdote and hunch rather than hard science.

Now let me ask you a question in return. Let's say that there was indeed good science proving that after a year your tinnitus becomes hard-wired, given that you yourself are coming up on one year, how would that knowledge affect the way you would conduct your life from here on out?

Dr. Stephen Nagler

 

[Lisa88]

@Dr. Nagler
Thank you for your honest and helpful answer, as always.
Honest response to your question - I have to have hope to keep moving forward. Just the way I operate right now. I have experienced a fade overall, but weaning off small dose benzos right now, so have not really established a reliable baseline. So with hope, just still playing it by ear (p.s. used to love that pun!)

 

[Dr. Nagler]

@Dr. Nagler
Thank you for your honest and helpful answer, as always.
Honest response to your question - I have to have hope to keep moving forward. Just the way I operate right now.

There are documented cases where tinnitus just seems to disappear on its own even five years out. Exactly how much "hope" do you need to have? More to the point, if maintaining hope is your focus, why would you choose to hang out on a support board where most of the participants are not doing particularly well ... or they wouldn't be here seeking support in the first place?

Just a thought.

Dr. Stephen Nagler

 

[MattK]

More to the point, if maintaining hope is your focus, why would you choose to hang out on a support board where most of the participants are not doing particularly well ... or they wouldn't be here seeking support in the first place?

You're probably familiar with the saying, "Misery loves company". But, there is a level of comfort in knowing that you're not alone in a given situation. That there are others who can relate. It's been frustrating for me to talk to people, even therapists, who know nothing about tinnitus whatsoever. They can't relate to it, and about the only thing they can say is, "I can see how that would suck" and that's about the extent of it. Luckily, by God's grace, I found a therapist who actually has tinnitus who does CBT and is a Christian... so he hits all the points I need for someone to completely relate to me. He's been a huge comfort for me because he has tinnitus. He knows pretty much how I feel about it, and he knows what it's like when it spikes and gets louder. I find his counseling to be so much more effective for me specifically because he has tinnitus.

 

[Dr. Nagler]

You're probably familiar with the saying, "Misery loves company". But, there is a level of comfort in knowing that you're not alone in a given situation.

Right. Just so long as you do not view boards like this as a primary source of information. Don't get me wrong. There's a lot of very good information here. But there's a lot of terrible MISinformation here as well. And since most all of it "makes sense," how are you supposed to tease out the good information from the misinformation? I, for one, am tired of being eviscerated for trying to do it in the best interests of those who come here looking for some sort of direction. So I don't even bother trying anymore.

Dr. Stephen Nagler