New University of Michigan Tinnitus Discovery — Signal Timing

[kelpiemsp]

I guess I'm too slow. Thanks @Markku

 

[hans799]

Do you think that a person can have two types of tinnitus at once (so part of the noise is somatic, part of it is not)?

I have many sounds (3-8 or so, varies by time of day, level of fatigue, the mood of the gods etc...) and certain sounds I can modulate through jaw movements, but not others.

Though any reduction of the orchestra is very welcome, of course.

 

[brummygirl]

@Markku @kelpiemsp
Brilliant. Thanks very much. This is spot on where my interest lies for my son.

 

[kelpiemsp]

Do you think that a person can have two types of tinnitus at once (so part of the noise is somatic, part of it is not)?

I have many sounds (3-8 or so, varies by time of day, level of fatigue, the mood of the gods etc...) and certain sounds I can modulate through jaw movements, but not others.

Though any reduction of the orchestra is very welcome, of course.

There are many different types and combinations of T depending on the lens you view it from. This model shows two pathways, and many different ways. I.E. 4 different cranial nerves, a neck nerve, the auditory nerve. This is just one model.

 

[Greg Sacramento]

I think that it about vertebral and deep cervical veins and c spine. As discussed by Susan Shore and research from Charter 4 Cervical Spine Trauma. One of the exercises is do nothing. It's about taking pressure off of your cervical veins that thru a network of nerves that goes to the DCN and to take pressure off the c spine. I use a regular non foam pillow. Bunch it up to partly fit under neck. Sleep on one side and place inward hand on temporal. Fold other arm to your side. Bend legs but keep back in straight line to neck. Have your shoulders raised a little. If you change sides, do the same. I have done for two nights and today I woke up with 1/10 T down from 10/10. Now after 12 hours, I'm back up to a 8.

 

[Steven__]

Do you think that a person can have two types of tinnitus at once (so part of the noise is somatic, part of it is not)?

I have many sounds (3-8 or so, varies by time of day, level of fatigue, the mood of the gods etc...) and certain sounds I can modulate through jaw movements, but not others.

Though any reduction of the orchestra is very welcome, of course.

I think I do ,I have at least 4 different sounds and I had the ringing before I had been exposed to loud noise exposure which made the noise a whole lot louder. I kinda thought before my hearing was normal. Then I read up about tinnitus after the noise exposure

 

[Spoon]

I figured I would give an update about what I have heard after speaking with a tinnitus researcher about this project at UM.

"This approach is actually designed for those with noise-induced tinnitus (perhaps it can work for those with TMJ-related tinnitus, e.g.), and that's the magic of it. Because noise or aging damage has presumably changed the firing balance in the cochlear nucleus that arrives via the VIII cranial nerve (audio-vestibular nerve) toward a more excitable state (loosely). VII nerve afferents are a "back door" to this brainstem center that can perhaps be recruited to balance out that overexcitability. I'm not quite sure the nature of the electrical activity or its patterns (we might never know if it is proprietary) but that is the conceptual idea.
For those with normal jaw functioning, for example, it is very common for noise-related tinnitus sufferers to report a modulation of their T percept by clinching their jaw. The current approach takes advantage of this relationship."

So this treatment would is not just aimed at those with TMJ issues, but other tinnitus types as well. I'm assuming that anyone who has the ability to modulate their tinnitus by clenching their jaw might benefit from it (if it actually works). The cool thing about this approach is that it is non invasive, as opposed to the Microtransponder approach of surgically implanting a device to stimulate the vagus nerve (the target is a different nerve, but their theory is that it would possibly calm overexcitability as well).

On top of that, if the device indeed moves to clinical trials, the ride would be a fairly smooth one I'm guessing because of the relatively safe nature of the method overall. It would be more a question of whether it's efficacious or not. That means they could basically jump Phase 1 trials and move directly to Phase 2 trials.

My tinnitus can become high/low by moving my jaws, I don't understand why this happened, when I was teen, I had my jaw injured... I forgot when was it, that time I still don't have tinnitus. Until one day, tinnitus appeared and won't go away, I think my tinnitus is related to this jaw injury which I had at 18 yo... Now I'm 26, I had tinnitus for more than 7 years already I think...

 

[threefirefour]

The diagram can be found here:

https://www.sciencedirect.com/science/article/pii/S0079612307660178

The full article is behind a paywall though.

The diagram is also referenced here:

http://www.dizziness-and-balance.com/disorders/hearing/tinnitus/somatic tinnitus.html

There's an access wall I can't get passed, so this may be helpful for those stuck too:

https://pdfs.semanticscholar.org/e9...7.1400208387.1523897195-1132365215.1523897195

More informative ebook preview:
https://books.google.com/books?id=XydUtbVHtdEC&pg=PA195&lpg=PA195&dq="Evidence+for+a+tinnitus+subgroup+responsive+to+somatosensory+based+treatment+modalities"&source=bl&ots=Qm-JIk1tK2&sig=vnZiUMOGsBOv68PML5xbi-iLIiE&hl=en&sa=X&ved=0ahUKEwjA4Z6doL_aAhWHxVQKHV8QDjgQ6AEIOTAE#v=onepage&q="Evidence%20for%20a%20tinnitus%20subgroup%20responsive%20to%20somatosensory%20based%20treatment%20modalities"&f=false

 

[kelpiemsp]

@threefirefour Are you student? If so, most colleges and universities have a special access program. You would have to go to the library... but if its for an assignment or a paper they can grant you access to use the University's license. However, it would be a rather large violation to post that paper here if you do that.

 

[threefirefour]

@threefirefour Are you student? If so, most colleges and universities have a special access program. You would have to go to the library... but if its for an assignment or a paper they can grant you access to use the University's license. However, it would be a rather large violation to post that paper here if you do that.

You're right. It would be an absolute shame if it were to somehow... get leaked, wouldn't it?

 

[jay777]

@kelpiemsp hi as a researcher at what point would you give up on a drug or device that you know will fail? or would you carry on till funding ran out?

 

[threefirefour]

The reason can be seen in this diagram. T which passes through the Dorsal Cochlear Nucleus can be of somatic or otic origin. However, the reason they are testing this T is because it can be accessed through a somatic pathway regardless. Follow the map. For the 20 percent of T which goes through the ventral cochlear nucleus, researchers are unsure. But this is how you frame up a study. I hope this helps clarify.
View attachment 16672

So does this mean that you can tell if your tinnitus goes through the DCN if you can somatically modulate it?

 

[kelpiemsp]

That's the theory! All this to say there's some real hope for those with somatically modulated T!

 

[kelpiemsp]

@kelpiemsp hi as a researcher at what point would you give up on a drug or device that you know will fail? or would you carry on till funding ran out?

That is a great question! You wouldn't waste your time that's for sure, however you would never get funded again if you couldn't complete your study and provide an explanation or new direction. Unfortunately, we can't really read too much into this treatment other than the study isn't finished. However, I believe if shore didn't think this would work she could cut her losses at the previous trial, and try to tweak the study and redo it. The fact that the protocol is so close should be a good sign. I find encouragement in that DARPA has started funding this type of therapy.

 

[threefirefour]

That is a great question! You wouldn't waste your time that's for sure, however you would never get funded again if you couldn't complete your study and provide an explanation or new direction. Unfortunately, we can't really read too much into this treatment other than the study isn't finished. However, I believe if shore didn't think this would work she could cut her losses at the previous trial, and try to tweak the study and redo it. The fact that the protocol is so close should be a good sign. I find encouragement in that DARPA has started funding this type of therapy.

She actually did do that once when this product failed the first (and hopefully only) time. Hope that this means the fact she's going forward with this design suggests that she has good confidence in it.

 

[Greg Sacramento]

Attachment 16672 is a reference showing cranial nerves and spinal nerve C2. Susan Shore is involved in spasm of the sternocleidomastoideus and trapezius due to possible strain of the sensory fibers of the spinal accessory nerve on exit of the C2-C4 spinal nerves. Also treatment sometimes needs to be given to vertebral arteries and deep cervical veins, occipitocervical ligaments, capsular ligaments and perivertebral ligaments.

Other factors that can contribute is the c spine itself and lordotic curve must be highly considered. I would assume that these areas would be examined by the New University of Michigan team before any treatment.

 

[kelpiemsp]

She actually did do that once when this product failed the first (and hopefully only) time. Hope that this means the fact she's going forward with this design suggests that she has good confidence in it.

She's not the only one either. The lab at the UofM (Minnesota) is looking at a nearly identical treatment, but T is just one area they are looking at. Chronic pain and depression being some others.

 

[threefirefour]

She's not the only one either. The lab at the UofM (Minnesota) is looking at a nearly identical treatment, but T is just one area they are looking at. Chronic pain and depression being some others.

Hope it works. From what I hear, the head researcher on that study admits it's less effective when tried on a larger group. Does that mean it's not a good product?

 

[kelpiemsp]

It could be sooo many things. Maybe the signal timing is off, maybe our neurons fire at different rates and it has to be personalized. The concept of this tech is really in its infancy. I believe that regardless of this Shore's outcome, it's in the right direction and this may get us there faster than pharmaceuticals. Besides we still don't know the long term effects. Maybe if you teach the brain how to partially quiet the T, it will do the rest eventually. Maybe, I hope

 

[parsky]

Hope it works. From what I hear, the head researcher on that study admits it's less effective when tried on a larger group. Does that mean it's not a good product?

Where did you hear this? Source?

 

[threefirefour]

Where did you hear this? Source?

Its in the university of Minnesota thread on research news. I'm not talking about SS.

 

[kelpiemsp]

Here is the info: http://soniclab.umn.edu/research/neural-beamforming-tinnitus to me they admitted the effects were short lived, but that this was "controllable" to prevent the possibility of inducing permanent loud T. Which I get. I'd hate to be that person, but I just might be.... to science!

 

[Tony Phylactou]

Great! Looks like a sound and electrical stimulus device. They said based on 15 years of research. Let's hope it doesn't take that long to be available.

2018 and still waiting. Maybe 3018

 

[hans799]

I consider Susan Shore and her project to be the light at the end of the tunnel. There's an appreciable chance that they'll have something out in 2-3 years or so. I can live with this for 2-3 more years, easy. I have 50 years or so left from my lifespan - if everything goes fine, I'll live more than 90% of those years in silence! That's a great thought, now isn't it?

 

[threefirefour]

I consider Susan Shore and her project to be the light at the end of the tunnel. There's an appreciable chance that they'll have something out in 2-3 years or so. I can live with this for 2-3 more years, easy. I have 50 years or so left from my lifespan - if everything goes fine, I'll live more than 90% of those years in silence! That's a great thought, now isn't it?

I don't know if this is good or bad news, but since the second trial is not much more rigorous than the first, the chances of it passing are very high. IDK if that will translate into success post-market.

 

[hans799]

I don't know if this is good or bad news, but since the second trial is not much more rigorous than the first, the chances of it passing are very high. IDK if that will translate into success post-market.

Well, we'll certainly know more.

My understanding is that the first trial included 10 people for about a month or so, while the second will include 50 and they'll use the device for several months, right? My fervent hope is that the second group will also report a consistent effect, and the effect size will increase with time, which would indicate that 1. the device really is working 2. neuroplasticity is working in our favor and the brain can be "trained off" tinnitus. If this is the case then we'll be on the threshold of salvation.

I refuse to think of the alternative.

 

[threefirefour]

Well, we'll certainly know more.

My understanding is that the first trial included 10 people for about a month or so, while the second will include 50 and they'll use the device for several months, right? My fervent hope is that the second group will also report a consistent effect, and the effect size will increase with time, which would indicate that 1. the device really is working 2. neuroplasticity is working in our favor and the brain can be "trained off" tinnitus. If this is the case then we'll be on the threshold of salvation.

I refuse to think of the alternative.

The first successful trial lasted for a few months with 20 people. People would wear the active/sham device for 30 minutes daily for 4 weeks, and then have a two week washout, then switch devices. The second has 50 but that's not a huge improvement. It more than doubles participants but it's small compared to the more rigorous hundreds medicines go through.

This upcoming Trial in August, according to an email another user here got, will go through to August 2019, but since the next trial will experiment with 6 week intervals, anywhere from February 2019-August 2019 is reasonable.

IMO, the first device more than demonstrated that it's working because of the huge margins of improvement for the 55% who experienced improvement. The real question for me, is what percent of somatic-sufferers will it work on? The device permanently shutting down tinnitus via neuroplasticity is a realistic desire but right now with current data nothing suggests that it will, but that could be because of the small window of usage.

 

[Autumnly]

they'll use the device for several months, right?

The upcoming trial in August, which received funding from the National Institutes of Health's Brain Initiative, will administer the treatment a bit longer, perhaps 6 weeks instead of 4 or a longer duration per day, Shore said.

 

[ee9892]

The first successful trial lasted for a few months with 20 people. People would wear the active/sham device for 30 minutes daily for 4 weeks, and then have a two week washout, then switch devices. The second has 50 but that's not a huge improvement. It more than doubles participants but it's small compared to the more rigorous hundreds medicines go through.

This upcoming Trial in August, according to an email another user here got, will go through to August 2019, but since the next trial will experiment with 6 week intervals, anywhere from February 2019-August 2019 is reasonable.

IMO, the first device more than demonstrated that it's working because of the huge margins of improvement for the 55% who experienced improvement. The real question for me, is what percent of somatic-sufferers will it work on? The device permanently shutting down tinnitus via neuroplasticity is a realistic desire but right now with current data nothing suggests that it will, but that could be because of the small window of usage.

I dont believe the effects would be long lasting if you stopped using the device... but wouldnt it be nice to have a device that makes life more manageable while we wait for a permanent cure?

Thats my outlook on this.

 

[jay777]

@threefirefour where are the details of the first report?