Objective Measurement of Tinnitus — ABR (Auditory Brainstem Response)

[Johan_L]

Study shows that chronic tinnitus can be measured with ABR (Audiometric Brainstem Response).

Also Decibel Therapeutics are mentioned in the article so they are somehow involved.

Short article:
Constant Tinnitus Is Linked to Altered Brain Activity

Long version:
Alterations in auditory brainstem response distinguish occasional and constant tinnitus

SUMMARY:

BACKGROUND. The heterogeneity of tinnitus is thought to underlie the lack of objective diagnostic measures.

METHODS. Longitudinal data from 20,349 participants of the Swedish Longitudinal Occupational Survey of Health (SLOSH) cohort from 2008 to 2018 was used to understand the dynamics of transition between occasional and constant tinnitus. The second part of the study included electrophysiological data from 405 participants of the Swedish Tinnitus Outreach Project (STOP) cohort.

RESULTS. We determined that with increasing frequency of the occasional perception of self-reported tinnitus, the odds of reporting constant tinnitus after 2 years increases from 5 for previous tinnitus (sometimes) to 30 for previous tinnitus (often). When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603, suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater. Auditory brainstem responses (ABRs) from subjects reporting non-tinnitus (controls), occasional tinnitus, and constant tinnitus show that wave V latency increased in constant tinnitus when compared to occasional tinnitus or non-tinnitus. The ABR from occasional tinnitus was indistinguishable from that of the non-tinnitus controls.

CONCLUSIONS. Our results support the hypothesis that the transition from occasional to constant tinnitus is accompanied by neuronal changes in the midbrain leading to a persisting tinnitus, which is then less likely to remit.

 

[Stacken77]

Just came across this. Very interesting stuff! Go Christopher Cederroth!

 

[Champ]

So much better than Audiograms. Finally we're getting real tests and real solutions. If we don't have robust testing, even if we have solutions it will be difficult to figure out which solution to use. Great news.

 

[OptimusPrimed]

If we don't have robust testing, even if we have solutions it will be difficult to figure out which solution to use. Great news.

Still have no way to fix it unfortunately.

 

[GoatSheep]

ABR tests are normally very loud. When I had mine they wanted to go to 100dB. Does it say what volume they have to test at? I had hyperacusis and couldn't go beyond 80 dB so the results for the ABR were deemed inconclusive. And I probably was only able to go that high because I was on Clonazepam daily at the time. That's not a good thing being that I could have unknowingly got setback thinking my tolerance was higher than it actually was.

Granted they weren't testing for "tinnitus", but they were supposed to be looking for indications of hyperacusis. I never understood how such a loud test could be considered for detecting hyperacusis. It very well may have worsened me if I hadn't refused to keep upping the volume of the clicks.

 

[Champ]

ABR tests are normally very loud. When I had mine they wanted to go to 100dB. Does it say what volume they have to test at? I had hyperacusis and couldn't go beyond 80 dB so the results for the ABR were deemed inconclusive. And I probably was only able to go that high because I was on Clonazepam daily at the time. That's not a good thing being that I could have unknowingly got setback thinking my tolerance was higher than it actually was.

Granted they weren't testing for "tinnitus", but they were supposed to be looking for indications of hyperacusis. I never understood how such a loud test could be considered for detecting hyperacusis. It very well may have worsened me if I hadn't refused to keep upping the volume of the clicks.

That's infuriating. They blow your hearing out more and then sell you hearing aids. So awful to hear.

 

[DimLeb]

When previous tinnitus was reported to be constant, the odds of reporting it as constant after 2 years rose to 603, suggesting that once transitioned to constant tinnitus, the likelihood of tinnitus to persist was much greater.

No shit, Sherlock.

 

[Joeseph Stope]

Hey! It's nice to have a proof for something (i.e. the causation of chronic tinnitus is located in the brain) that we have long assumed.

But!

For those such as me who also suffer from hyperacusis... it's the loud noise that's killing us... and makes our tinnitus spike.

So the peripheral auditory system plays a role in this. How else would the noise manifest itself within the brain.

Just sayin' like.

 

[Gabriel5050]

ABR tests are normally very loud. When I had mine they wanted to go to 100dB. Does it say what volume they have to test at? I had hyperacusis and couldn't go beyond 80 dB so the results for the ABR were deemed inconclusive. And I probably was only able to go that high because I was on Clonazepam daily at the time. That's not a good thing being that I could have unknowingly got setback thinking my tolerance was higher than it actually was.

Granted they weren't testing for "tinnitus", but they were supposed to be looking for indications of hyperacusis. I never understood how such a loud test could be considered for detecting hyperacusis. It very well may have worsened me if I hadn't refused to keep upping the volume of the clicks.

I looked a bit through the paper and it says:

Two setups for the ABR recordings were used in this study, the Madsen EP200 Chartr and the Interacoustics Eclipse. The settings for both systems were identical, with high and low pass filters of .1 and 3 kHz, respectively, with 100 µs click stimuli of alternating polarity presented at 9.1 clicks/s at 90 dBnHL through insert earphones, with contralateral masking of −40 dB relative to the stimulus ear.

Yeah. I don't know if I would willingly subject myself to 90 dB to be told I have tinnitus. But at least this time it would be an objective measurement. Better than doing an often useless tympanometry, which is also a loud test. I am happy for the progress, but now researchers have to make use of it.

 

[bob johnson25]

Isn't this news kind of terrible? Not like we had any treatments before, but brainstem sounds so much worse and harder to fix than inner ear :/

 

[Stacken77]

Isn't this news kind of terrible? Not like we had any treatments before, but brainstem sounds so much worse and harder to fix than inner ear :/

One of the leading theories for tinnitus is that it's mainly a brain problem, but with a peripheral cause, e.g. hearing loss. Either we fix the hearing loss (and the brain may follow), or we fix the brain which is, in my opinion, likely to happen sooner than fixing the ears, e.g. with medications targeting the hyper-active areas of the brain.

This is a different topic in and of itself, and there's numerous discussions about it on this forum.

Wish you well,
Stacken

 

[DimLeb]

@bob johnson25, I may be all wrong, but I believe the inner ear is much harder to approach for treatments because if you try to penetrate it (surgically, with injections etc) it just falls apart and can't regenerate. However, with brain there already are procedures that "fix" it.

A bit unrelated I know, but one can only speculate. Let's hope though that all these upcoming inner ear regeneration drugs can help us.

 

[rewgs]

Perhaps this test is simply essentially showing the brain activity of tinnitus... happening? Seeing as it's a sound that we hear, the act of hearing it and listening to it will of course by definition show brain activity. I of course am not a doctor but my rudimentary understanding makes me think that, much in the same way that something can be mistaken for causation when in fact there's only correlation, brain activity might be mistaken her for a mechanism/proof that tinnitus somehow is generated or perpetuated by the brain, when in reality the signal they're picking up might just be the result of the subject hearing the sound.

Or am I totally off base here?