NeuroVR Device: Neurofeedback to Treat Tinnitus

[Christiaan]

So there is an interesting development in the Netherlands. Dutch researchers are currently working on a device with the aim to diminish or even eliminate tinnitus. For now, the device is called Antinnitus, but there are plans to rebrand it as NeuroVR.

Not much is known about NeuroVR. The Antinnitus website mentions that the combination of virtual reality and neurofeedback gives the user the opportunity to create an environment that can train the brain to let go of the tinnitus signal. In other words, the treatment is based on the principles of neurofeedback and gamification to reverse maladaptive neuroplasticity.

Another thing worth mentioning is that a major investor has disclosed on his LinkedIn page that he is excited by the encouraging results from many patients who have taken part in a NeuroVR clinical trial. According to the investor, some patients mentioned a lessening or even disappearance of their tinnitus during the trial. For privacy reasons, I'll not disclose his or her name on Tinnitus Talk, but I think this is perhaps a positive thing to mention for you folks.

NeuroVR is planning to start a new trial. They haven't disclosed when it might take place, but feel free to subscribe to their newsletter for the next trial update: https://antinnitus.org/

 

[DimLeb]

Nice! I love how promising breakthrough (maybe) research news keep coming up from where you least expect it. I hope it's more than a habituation device.

It would be great if anyone could keep this thread updated in English, for us who don't speak Dutch!

 

[Padraigh Griffin]

Sounds cool. Totally different approach. Nice to see.

 

[Uklawyer]

Good one @Christiaan. Can you ask them when they plan to do trials (and put my name down )?

 

[Nobody19]

I can't find any information about the science behind their treatment. A red flag?

 

[reggie green]

This sounds like Lenire again.

 

[koffee_monster]

I can't find any information about the science behind their treatment. A red flag?

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

 

[DimLeb]

@koffee_monster, lol that was fast, shooting down this "treatment". So, it is most likely another habituation crap. Disappointing, but thank you for sharing the knowledge.

 

[koffee_monster]

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (Grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

Hmm, I am unable to find the actual paper I read - looks like I didn't save it.

Here is a ClinicalTrials.gov page about a similar idea:

Virtual Reality and Subjective Tinnitus (ReVA2)

 

[OptimusPrimed]

@koffee_monster, lol that was fast, shooting down this "treatment". So, it is most likely another habituation crap. Disappointing, but thank you for sharing the knowledge.

VSS has been cured or reduced with VR in some cases.

 

[AfroSnowman]

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

For as long as I have had this condition, there is a moment (used to happen all the time, now less frequently) where I am at the edge between wake and sleep but still fully conscious where the screeching part of the tinnitus, the part that matters, the part that can't be unheard, just fades to zero. I try to hold that space there but only can for a second or two and then my brain slips back into the tinnitus pattern and there is nothing I can do to get back to it. If there were a VR system that would help train my mind to hold that space, I'd certainly give it a whirl.

 

[Kam75]

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

I read an article in French that explains exactly that.

The article also adds that virtual reality sessions are as effective as CBT sessions.

There is a tinnitus specialist in Paris who proposes to treat tinnitus with virtual reality (he is a well-known specialist who has already been quoted on Tinnitus Talk and has participated in many conferences).

When I asked him if virtual reality really cures tinnitus, he said yes.

But before trying this therapy he told me that I absolutely had to treat my depression by taking antidepressants.

So I have been on Mirtazapine since November 2021. It helped me to sleep better at first, but for about 2 months now it hasn't worked much.

I hope to start this therapy soon. I will keep you posted.

 

[koffee_monster]

For as long as I have had this condition, there is a moment (used to happen all the time, now less frequently) where I am at the edge between wake and sleep but still fully conscious where the screeching part of the tinnitus, the part that matters, the part that can't be unheard, just fades to zero. I try to hold that space there but only can for a second or two and then my brain slips back into the tinnitus pattern and there is nothing I can do to get back to it. If there were a VR system that would help train my mind to hold that space, I'd certainly give it a whirl.

In the morning I wake up in almost silence. As I start to be "actively awake" I can feel my tinnitus ramp up from 0.5 to 2.5 in about 3 minutes.

I agree with you. There is, very frustratingly, no proper cure, but the short moments of peace give proper hope.

Even if habituation/ignoring training is not a cure, many people will benefit from it to a level that may even allow them to live a normal life.

 

[koffee_monster]

I read an article in French that explains exactly that.

The article also adds that virtual reality sessions are as effective as CBT sessions.

There is a tinnitus specialist in Paris who proposes to treat tinnitus with virtual reality (he is a well-known specialist who has already been quoted on Tinnitus Talk and has participated in many conferences).

When I asked him if virtual reality really cures tinnitus, he said yes.

But before trying this therapy he told me that I absolutely had to treat my depression by taking antidepressants.

So I have been on Mirtazapine since November 2021. It helped me to sleep better at first, but for about 2 months now it hasn't worked much.

I hope to start this therapy soon. I will keep you posted.

I believe the paper I read was also written in French. If you happen to find it, feel free to link it. I have the habit of saving everything I read about tinnitus on my laptop for reference but it looks like I forgot to do so for this paper.

I really do hope this treatment helps you get relief. Do keep us posted as there is almost no information about the efficacy of VR in treating tinnitus at all currently, but it is an interesting approach.

I wonder if the software they create for this treatment would be "simple" enough to recreate for/install on home entertainment VR headsets.

P.S.: If anyone has questions for the company, I am willing to send mails in Dutch or translate (parts of) papers if there's no English translation available.

 

[Harder Calm]

In the morning I wake up in almost silence. As I start to be "actively awake" I can feel my tinnitus ramp up from 0.5 to 2.5 in about 3 minutes.

I agree with you. There is, very frustratingly, no proper cure, but the short moments of peace give proper hope.

Even if habituation/ignoring training is not a cure, many people will benefit from it to a level that may even allow them to live a normal life.

I can confirm this, too @koffee_monster and @AfroSnowman. Sometimes I wake up in silence, but only for a short moment, my brain immediately starts to wonder where the tinnitus is and suddenly there it is...

So thanks for posting this @Christiaan, please keep us up to date!

 

[Frédéric]

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

This news gives me an amusing thought: the possibility, in turn, of virtually torturing my tinnitus avatar, just to get revenge, as a kind of stress relief. But the worst is that it would be able, given the principle of this virtual reality, to shout in the headphones in return and to hurt my ears even more.

 

[DimLeb]

This news gives me an amusing thought: the possibility, in turn, of virtually torturing my tinnitus avatar, just to get revenge, as a kind of stress relief. But the worst is that it would be able, given the principle of this virtual reality, to shout in the headphones in return and to hurt my ears even more.

You can do that already in every simulation video game or something... Same idea.

 

[Kam75]

I believe the paper I read was also written in French. If you happen to find it, feel free to link it. I have the habit of saving everything I read about tinnitus on my laptop for reference but it looks like I forgot to do so for this paper.

I really do hope this treatment helps you get relief. Do keep us posted as there is almost no information about the efficacy of VR in treating tinnitus at all currently, but it is an interesting approach.

I wonder if the software they create for this treatment would be "simple" enough to recreate for/install on home entertainment VR headsets.

P.S.: If anyone has questions for the company, I am willing to send mails in Dutch or translate (parts of) papers if there's no English translation available.

This is the website where I found the information on VR. In this article they tell about the hospital and the ENT I spoke to who treats tinnitus with VR.

 

[DimLeb]

@Kam75, they should stop calling it a "treatment" already.

"The results suggest that VR coaching is as effective as CBT, which is the gold standard treatment for tinnitus." Made me sick in my stomach.

 

[Christiaan]

@Kam75, they should stop calling it a "treatment" already.

"The results suggest that VR coaching is as effective as CBT, which is the gold standard treatment for tinnitus." Made me sick in my stomach.

I agree that we need to take things with a grain of salt when some company claims to have an effective treatment for tinnitus that's perhaps too good to be true. However, the use of neurofeedback + tone pairing + game elements with VR has not been extensively researched for tinnitus.

It's the same with VNS intervention for this ailment. Researchers primarily thought that electrical stimulation of the vagus nerve was not enough to induce neuroplastic changes for tinnitus. However, just a few years later, some researcher found out that pairing VNS stimulation with specific tones + change in amplitude of current have a stronger potential for changes in cortical plasticity & tinnitus percept. So, in a way, it's also a matter of finding the right stimulation parameters by means of clinical trial & error.

So, basically, though I agree that we need to be sceptical for hopeful claims, it's a bit too early to assume that this is just a glorified habituation device. Since we do not entirely comprehend the manifestation of tinnitus, aside from that this ailment involves many parts of the brain (Bayesian brain model), we need to use a wide array of interventions to see how the ''tinnitus' brain responds for research purposes. It's perhaps best to wait for official results from clinical trials of this device before drawing any conclusion.

 

[Christiaan]

I read an article in French that explains exactly that.

The article also adds that virtual reality sessions are as effective as CBT sessions.

There is a tinnitus specialist in Paris who proposes to treat tinnitus with virtual reality (he is a well-known specialist who has already been quoted on Tinnitus Talk and has participated in many conferences).

When I asked him if virtual reality really cures tinnitus, he said yes.

But before trying this therapy he told me that I absolutely had to treat my depression by taking antidepressants.

So I have been on Mirtazapine since November 2021. It helped me to sleep better at first, but for about 2 months now it hasn't worked much.

I hope to start this therapy soon. I will keep you posted.

Hi @Kam75, thanks for sharing your insights. Did your doctor explain why he thinks that virtual reality may help in treating tinnitus and why depression is an obstacle for this treatment?

 

[Christiaan]

Good one @Christiaan. Can you ask them when they plan to do trials (and put my name down )?

I've asked them two months ago about the date of the next trial. They've answered that they're analysing the results (which they've received in November) and that they'll notify people for the next trial if you subscribe to the newsletter.

 

[Christiaan]

I can confirm this, too @koffee_monster and @AfroSnowman. Sometimes I wake up in silence, but only for a short moment, my brain immediately starts to wonder where the tinnitus is and suddenly there it is...

So thanks for posting this @Christiaan, please keep us up to date!

That's really interesting. I only experience this particular situation when I'm just home from a walk. I do not hear my tinnitus outside and would rate it 0,5 at best. But when I'm home, it incrementally ramps up to a 4 (sometimes 5 when stressed).

 

[Christiaan]

I read about it (or something similar to it). I'll need to look for the paper, I am on a mobile device right now and do not have access to my Zotero library. I'm not 100% sure this company is using the same approach as the paper but I imagine it will be similar.

The paper I read a few days ago proposes a treatment where a tinnitus sufferer is able to create a digital, visual avatar for their tinnitus, alongside a sound matched specifically to their tinnitus. This avatar may be an orb, a shape or an object.

During the treatment sessions a subject is put in a digital (VR/AR) world with their tinnitus avatar. They are also given a pair of headphones. They can, in this digital world, manipulate the avatar (grab it, shake it, hide it, enlarge it) and the headphones will attempt to mask or amplify your tinnitus "clone" sound based on what you are doing to the tinnitus avatar.

This is supposed to make the subject feel like they have mental control over the sound and should have the same result as cognitive behavioural therapy: one should be able to make the brain ignore the sound or make the brain discard it as unimportant or non-threatening.

In the long run, subjects are supposed to have mental control over their reaction to the sound. Not a cure, more like coping/habituation training as far as I understand.

I will link the paper once I have access to my Zotero library later today.

Thanks for this good explanation @koffee_monster. I do wonder where NeuroVR differs in their approach vs. the protocol in the research paper that you've read. Of course, there's a big difference in the claim that somethings helps with habituation as opposed to alleviation. Perhaps if someone can get a hold on the research paper of NeuroVR, it might shed some light in why this company makes such an ambitious claim.

 

[DimLeb]

I agree that we need to take things with a grain of salt when some company claims to have an effective treatment for tinnitus that's perhaps too good to be true. However, the use of neurofeedback + tone pairing + game elements with VR has not been extensively researched for tinnitus.

It's the same with VNS intervention for this ailment. Researchers primarily thought that electrical stimulation of the vagus nerve was not enough to induce neuroplastic changes for tinnitus. However, just a few years later, some researcher found out that pairing VNS stimulation with specific tones + change in amplitude of current have a stronger potential for changes in cortical plasticity & tinnitus percept. So, in a way, it's also a matter of finding the right stimulation parameters by means of clinical trial & error.

So, basically, though I agree that we need to be sceptical for hopeful claims, it's a bit too early to assume that this is just a glorified habituation device. Since we do not entirely comprehend the manifestation of tinnitus, aside from that this ailment involves many parts of the brain (Bayesian brain model), we need to use a wide array of interventions to see how the ''tinnitus' brain responds for research purposes. It's perhaps best to wait for official results from clinical trials of this device before drawing any conclusion.

Yeah well, in my opinion, I just can't call "treatments" those coping mechanisms like mindfulness, CBT, masking etc. Yes, they help the patient in some way, but they don't address the root of the problem to bring relief. A Paracetamol pill, for example, is a treatment for pain because it addresses the underlying mechanism causing the pain.

We are just so unlucky that tinnitus, while being such a complex disorder, is thought to be "just a sound" that the patient doesn't need anything more other than basic "stop the negative thinking" crap.

Anyway, if the above device is more than VR imagery and sound, and it includes some neuromodulation of some sort, then cool. If it's just that, then it's nothing more than what you can do with a simple PC, playing a video game, using sound masking etc.

That's really interesting. I only experience this particular situation when I'm just home from a walk. I do not hear my tinnitus outside and would rate it 0,5 at best. But when I'm home, it incrementally ramps up to a 4 (sometimes 5 when stressed).

I also have that and I think it's some kind of residual inhibition most likely. I got generally mild (mid-range) multi-tone tinnitus that is masked easily. But when, for example, I'm in silence and it's blaring, if I make some sssshhhh sound with my mouth for some seconds, a big part of the tinnitus goes away for a bit.

 

[Toby1972]

Stop with such a nonsense device.

There won't be a placebo group in the study, so a study is pretty much worthless.

It will never, ever help people with classic severe tinnitus.

If it would only help me minimally, I would eat a broom in the presence of the company founder.

 

[koffee_monster]

Thanks for this good explanation @koffee_monster. I do wonder where NeuroVR differs in their approach vs. the protocol in the research paper that you've read. Of course, there's a big difference in the claim that somethings helps with habituation as opposed to alleviation. Perhaps if someone can get a hold on the research paper of NeuroVR, it might shed some light in why this company makes such an ambitious claim.

I completely agree with you. The difference between coping and complete relief is enormous. I can't help but feel like these claims are more a publicity stunt or an attention-grabbing attempt than the truth.

I hope I'm wrong, it's a new and innovative approach - perhaps I completely misjudge this approach and it is actually very effective.

 

[Christiaan]

Yeah well, in my opinion, I just can't call "treatments" those coping mechanisms like mindfulness, CBT, masking etc. Yes, they help the patient in some way, but they don't address the root of the problem to bring relief. A Paracetamol pill, for example, is a treatment for pain because it addresses the underlying mechanism causing the pain.

We are just so unlucky that tinnitus, while being such a complex disorder, is thought to be "just a sound" that the patient doesn't need anything more other than basic "stop the negative thinking" crap.

Anyway, if the above device is more than VR imagery and sound, and it includes some neuromodulation of some sort, then cool. If it's just that, then it's nothing more than what you can do with a simple PC, playing a video game, using sound masking etc.

I also have that and I think it's some kind of residual inhibition most likely. I got generally mild (mid-range) multi-tone tinnitus that is masked easily. But when, for example, I'm in silence and it's blaring, if I make some sssshhhh sound with my mouth for some seconds, a big part of the tinnitus goes away for a bit.

I understand what you mean. I also have my fair share of ENTs who practice the Jastreboffian gospel of mental fortitude and my experience with CBT and TRT is not, and I say it with a tone of understatement, particularly successful. Luckily, more and more researchers in this field gain a better understanding that those therapies have their limits for severe tinnitus sufferers.

Perhaps you're right about residual inhibition. That would explain why some people experience lower tinnitus in certain environments. My case is a bit weird when it comes to residual inhibition. I have 3 tinnitus tones. One is a low frequency hum (80 Hz) that always disappears when I'm exposed to sound. But then again, one of my other tones is a high frequency hiss sound and it's basically constant in the presence of sound, but disappears when I'm outside. So it's hard to wrap my head around that one.

 

[Kam75]

Hi @Kam75, thanks for sharing your insights. Did your doctor explain why he thinks that virtual reality may help in treating tinnitus and why depression is an obstacle for this treatment?

Hi @Christiaan, to be honest, I'm not sure exactly why I need to cure my depression before I can do the VR sessions.

My guess about depression is that a depressed psychological state does not lead to a "cure" (even more so when it comes to such a complex disease).

That's why doctors say that you have to work on emotional management when you have tinnitus.

In any case, the ENT specialist in question made it clear to me that curing my depression is a prerequisite.

I emailed him a few days ago to ask him if this is the right time for me to start VR sessions (as I have been on antidepressants for 4 months).

He answered that he has to talk to my psychiatrist first (they work together) because he thinks the psychological state of the person is important to follow this protocol. He also added that there are general inclusion criteria that need to be checked beforehand.

On the one hand, it reassures me that this protocol is so supervised, because it means that he takes his patients seriously.

On the other hand, I can't wait to try it, as my sleep has been severely disturbed by tinnitus for three years.

 

[transient18]

That's really interesting. I only experience this particular situation when I'm just home from a walk. I do not hear my tinnitus outside and would rate it 0,5 at best. But when I'm home, it incrementally ramps up to a 4 (sometimes 5 when stressed).

Very similar experience... but I don't know if it is a 4 or 5. It does become a constant awareness for sure.