Reversing Cochlear Nucleus Maladaptive Plasticity via Customized Extracochlear Stimulation

[IYIiKe]

Reversing Cochlear Nucleus Maladaptive Plasticity via Customized Extracochlear Stimulation

Tinnitus, a widespread condition affecting numerous individuals worldwide, remains a significant challenge due to limited effective therapeutic interventions. Intriguingly, patients using cochlear implants (CIs) have reported significant relief from tinnitus symptoms, although the underlying mechanisms remain unclear and intracochlear implantation risks cochlear damage and hearing loss. This study demonstrates that targeted intracochlear electrical stimulation (ES) in guinea pigs with noise-induced hearing loss reversed tinnitus-related maladaptive plasticity in the cochlear nucleus (CN), characterized by reduced auditory innervation, increased somatosensory innervation, and diminished inhibitory neural networks. Additionally, a customized extracochlear ES delivered by a newly designed extracochlear electrode array to guinea pigs with salicylate-induced tinnitus also reversed the aforementioned maladaptive plasticity and alleviated tinnitus without causing additional cochlear damage or hearing loss. These findings suggest that CI-delivered ES may alleviate tinnitus by reversing maladaptive CN plasticity. Additionally, the extracochlear ES strategy offers a promising tinnitus treatment with minimal risk to hearing.

This now puts multiple entities trialing electrical stimulation devices:

• Dr. Carlson at Mayo Clinic (2022)
• Dr. Assouly w/ Cochlear Ltd (2024, with this likely being the research backing the likely success of the trial)
• Dr. Hamid Djalilian (trial TBD)

 

[Nick47]

This also explains why tinnitus in cochlear implant patients is often reduced, even when they are placed in a soundproof booth with the device turned on. It's not just masking the tinnitus with external sound.

 

[IYIiKe]

This also explains why tinnitus in cochlear implant patients is often reduced, even when they are placed in a soundproof booth with the device turned on. It's not just masking the tinnitus with external sound.

I genuinely think this route has a less complicated and better/less invasive approach, likely with greater efficacy than the current SSD (though I do believe if the SSD is refined in the future, it may yield even better results.)

I believe the "why it works" could be researched more, but perhaps it represents the home run/ray of hope we all need.