Round Two: Vote on Your Favourite Research Paper!

[Hazel]

What is this about?

Many of you are not satisfied with tinnitus research, or the lack thereof. Many of you also feel that current research efforts do not meet your needs – and rightly so. We want to change that.

Tinnitus Hub, the non-profit behind Tinnitus Talk, has been spending many hundreds of hours over the past years (all volunteer time) to foster close relations with tinnitus researchers and inspire them to involve people with tinnitus directly in their research.

We who suffer from tinnitus want our voices to be heard and steer research in a meaningful direction.

What can YOU do?

This is your chance to make a difference. In the poll above, cast your vote for whatever YOU think is the most valuable academic paper on tinnitus published in October 2020.

This is a democratic vote to determine what were the most interesting, inspiring, and useful research papers published in a one-month period. You can select only one paper. Attached is a PDF with more details on the papers and links to their abstracts.

What will happen with the voting results?

The outcomes will be shared with and heard by the research community. This will send off a clear signal about what kind of research we – as the tinnitus community – value.

How were the papers selected?

We deliberately included all kinds of papers, so this list does not in any way represent what we value; it's just a list of papers about tinnitus.* It's up to you guys to put a value on them.

We know 20 papers is a long list to digest. Any advice on how to make the voting process easier in future is much appreciated.

[FYI, we had to shorten some titles in the poll because of the character limit; the attached PDF contains full titles and links.]


* NB: To make the list somewhat manageable, we did have to exclude some types of papers, e.g.:

• Studies where tinnitus is not the main topic;
• Studies that were previously published, i.e. we only included truly new ones;
• Pulsatile and objective tinnitus (only interesting for a very narrow audience);
• Case studies, unless they have major implications;
• Trial protocols, unless very high profile;
• Descriptive studies (e.g. describing clinical tools or state of health services);
• Studies that merely reproduce existing data, unless it's a large-scale systematic review.

 

[Jcb]

There is a lot to look through. I'm not entirely sure which one yet to choose. I'll vote once I've looked at them. Maybe 3, 11 or 17 (I know there is only one choice).

3 or 17 more so because that's relevant to me.

Thanks guys

 

[weab00]

I would be most interested to hear about the structural changes brain matter undergoes after developing tinnitus.

 

[Jack Straw]

I didn't even know about "Tinnitus and equilibrium disorders in COVID-19 patients."

Does someone have a good link to more information about this?

 

[SallyM]

I didn't even know about "Tinnitus and equilibrium disorders in COVID-19 patients."

Does someone have a good link to more information about this?

Links are in the PDF.

Tinnitus and equilibrium disorders in COVID-19 patients: preliminary results

Results: Thirty-four patients (18.4%) reported equilibrium disorders after COVID-19 diagnosis. Of these, 32 patients reported dizziness (94.1%) and 2 (5.9%) reported acute vertigo attacks. Forty-three patients (23.2%) reported tinnitus; 14 (7.6%) reported both tinnitus and equilibrium disorders.

Conclusion: This study suggests that the presence of subjective otoneurological symptoms such as tinnitus and balance disorders can affect COVID-19 patients; further studies are necessary to investigate the prevalence and pathophysiological mechanisms underlying these subjective symptoms in COVID-19 patients.

 

[Contrast]

My vote, however I 100% agree the pathway from short term to chronic tinnitus is extremely important. I hope one day it is scientifically understood.

 

[Sevv]

Instead of having all these "nice to know"-studies (we already knew 20 years ago that tinnitus affects quality of life and psychotherapy helps to cope), it would be great if more were focused on the pathophysiology and on finding a solution.

Meh, better than nothing I guess.

 

[Hazel]

Instead of having all these "nice to know"-studies (we already knew 20 years ago that tinnitus affects quality of life and psychotherapy helps to cope), it would be great if more were focused on the pathophysiology and on finding a solution.

There are a few pathophysiology focussed papers in there, did you vote for one of those? Or did you not find anything worth voting for?

 

[david c]

Instead of having all these "nice to know"-studies (we already knew 20 years ago that tinnitus affects quality of life and psychotherapy helps to cope), it would be great if more were focused on the pathophysiology and on finding a solution.

Meh, better than nothing I guess.

I agree - far too many of these sociological studies duplicating pre-existing research in many cases. The reason there are so many of these studies is that they are relatively easy to organise and they often get funding from organisations such as the ATA and BTA.

There are several interesting looking studies in the list (from what one can tell from the abstracts) though disappointingly none apparently on stem cell research and tinnitus and only one I think on medications and tinnitus, showing the extent to which we are lacking research in these key areas.

 

[MBH]

I'm all about more brain research.

 

[jimH]

View attachment 41528
Many of you are not satisfied with tinnitus research, or the lack thereof. Many of you also feel that current research efforts do not meet your needs – and rightly so. We want to change that.

Isn't the most important thing needed and desired by people suffering from severe/debilitating Tinnitus something that will at least will provide some degree of relief by ramping down the volume/severity level? I know that's what I desired most when my Tinnitus was at that level if a cure was not likely or possible.

The problem I have in selecting one of these is that I'm not certain as to which is most likely to help us to progress in that direction and I don't think that I'm the only one here that feels this way.

I think we should make supporting research that will most likely lead to helping people that are living lives of desperation and despair because of extremely severe Tinnitus our priority.

 

[Sevv]

There are a few pathophysiology focussed papers in there, did you vote for one of those? Or did you not find anything worth voting for?

Ah sorry, I wasn't precise with my wording. Of course there are a few studies that did focus on pathophysiology. I voted for one of the bimodal stimulation ones (the Dr. Shore one).

 

[Contrast]

It's a really good thing that Academia knows we are watching them. Without us monitoring them, they'd be doing the dumbest things; like researching TRT, CBT and ACT ad nauseum. That's pretty much what took place for thirty whole years, until activist groups like Tinnitus Hub came into the picture. We want the spotlight on neurological pathologies of tinnitus, and regenerative medicines in the inner ear. No one here cares about sociological studies. We want focus on the deep biomedical sciences!

 

[tommyd87]

It's a really good thing that Academia knows we are watching them. Without us monitoring them, they'd be doing the dumbest things; like researching TRT, CBT and ACT ad nauseum. That's pretty much what took place for thirty whole years, until activist groups like Tinnitus Hub came into the picture. We want the spotlight on neurological pathologies of tinnitus, and regenerative medicines in the inner ear. No one here cares about sociological studies. We want focus on the deep biomedical sciences!

I think that this is also what companies like Frequency Therapeutics and Hough Ear Institute have been showing. They have worked out how to regrow the cochlea, and also worked out obviously what might have an effect on tinnitus too.

 

[Frédéric]

Below are my comments if you are interested:

I chose:

• N°18 [Brain structural and white matter reorganization in idiopathic tinnitus patients]
  Because it involves both a strategy to decrease tinnitus (even if it is only a sound therapy) and a neuroimaging tool to screen its effects (3T DTI).

I could have also selected (if it was possible to select more than one):

• N°11 [Alterations of brain activity & functional connectivity in acute to chronic tinnitus]
  This has the merit to investigate the pathophysiology of tinnitus with EEG.
  
  
• N°13 [Bimodal auditory electrical stimulation for the treatment of tinnitus]
  Just to support Susan Shore's work.

Other comments:

• N°1 [Presence of tinnitus and tinnitus-related hearing loss in temporomandibular disorders]
  This is informative but it is just an observation (no intervention to cure TMJ disorders).
  
  
• N°2 [Tinnitus and stress in adults: a scoping review]
  This is nowadays useless. Please M. Hoare, now focus on the pathophysiology of tinnitus!
  
  
• N°3 [The impact of tinnitus on working memory capacity]
  This is contradictory: "Tinnitus was not related to WM scores. Tinnitus handicap was related to some WM scores in tinnitus sufferers."
  
  
• N°4 [How can sound generating devices support coping with tinnitus?]
  This is just the testimonials of only 10 tinnitus sufferers. How many of us have tried sound generators (sounds of any kind) and found no relief?
  
  
• N°5 [Telehealth tinnitus therapy during the COVID-19 outbreak in the UK]
  OK, now focus on the pathophysiology of tinnitus!
  
  
• N°6 [Phenotyping chronic tinnitus patients using self-report questionnaire data]
  Please Mrs. Mazurek, now focus on the pathophysiology of tinnitus!
  
  
• N°7 [Bimodal neuromodulation combining sound and tongue stimulation reduces tinnitus]
  I guess (if I am not wrong) it is related to the TENT-A1 clinical trial of Neuromod's Lenire.
  
  
• N°8 [Adapting personal therapies using a mobile application for tinnitus rehabilitation]
  Now focus on the pathophysiology of tinnitus!
  
  
• N°9 [The role of Manganese, Cadmium, Chromium and Selenium on subjective tinnitus]
  Blood tests of tinnitus sufferers vs controls are worth investigating.
  
  
• N°10 [Tinnitus questionnaires for research and clinical use]
  "For example, a questionnaire designed to screen for the presence or absence of tinnitus should not be used as an outcome measure to answer questions about treatment effectiveness." ???
  
  
• N°12 [Sound therapy for cochlear implant users with tinnitus]
  Well, may be interesting for CI users.
  
  
• N°14 [Tinnitus and its association with mental health and health-related quality of life]
  Now focus on the pathophysiology of tinnitus!
  
  
• N°15 [Tinnitus and equilibrium disorders in COVID-19 patients]
  Now we can add COVID-19 to the long list of tinnitus causes.
  
  
• N°16 [The effect of tinnitus on hearing-related quality of life in adult cochlear implant recipients]
  Well, may be interesting for CI users.
  
  
• N°17 [The prevalence of different types of headache in patients with subjective tinnitus]
  No tool (MRI...) to assess neither tinnitus nor headaches. Now focus on the pathophysiology of tinnitus!
  
  
• N°19 [Factors influencing engagement with a digital intervention for tinnitus self-management]
  Is it possible to also vote for the worst publication? Please M. Hoare, now focus on the pathophysiology of tinnitus! (Oops! I already said that!)
  
  
• N°20 [Dietary factors and tinnitus among adolescents]
  Just one question, did the authors ask adolescents whether they had acoustic trauma or had overuse of headphones?

 

[jimH]

We know 20 papers is a long list to digest. Any advice on how to make the voting process easier in future is much appreciated.

Yes it is a long list... Being that you're open to suggestions, limiting future lists to ONLY studies/research that will contribute or have the potential for contributing towards the developments of future treatments and solutions for tinnitus. You and Markku could perform a final review to determine what studies meet that criteria before posting the lists. It should result in shorter lists.

As an example, to make the point, of the type NOT to post in the future, #2. "Tinnitus and stress in adults: a scoping review."

This would be the first one that I would have eliminated. How useful is a "scoping review" of this subject? Will it contribute towards future treatments or solutions?

 

[Hazel]

Yes it is a long list... Being that you're open to suggestions, limiting future lists to ONLY studies/research that will contribute or have the potential for contributing towards the developments of future treatments and solutions for tinnitus. You and Markku could perform a final review to determine what studies meet that criteria before posting the lists. It should result in shorter lists.

As an example, to make the point, of the type NOT to post in the future, #2. "Tinnitus and stress in adults: a scoping review."

This would be the first one that I would have eliminated. How useful is a "scoping review" of this subject? Will it contribute towards future treatments or solutions?

Hi Jim!

We're definitely open to suggestions, but I'm afraid you may have misunderstood the point of the exercise. The point is to find out what kind of studies are most valued by the tinnitus community, and ensure we have hard data to substantiate this. This can only be done if we include and list ALL tinnitus research from the set period of time (excluding only some specific cases that can't really be considered proper studies, as listed at the bottom of my post), and then have the community members vote for what THEY feel is the most relevant/interesting research.

If we were to make a pre-selection, as you suggest, the whole voting process would be biased, and the research community might therefore not take the results seriously, because the outcomes would reflect our biased pre-selection rather than the will of the broader community. We believe presenting all studies as voting options is the only way to gather reliable data about what the community wants, without us interfering in the process.

So, it really is up to you to send the message you want to send, through the channel that we are providing here. Rest assured that if the outcome is that studies on pathophysiology are most valued (which is what this vote seems to indicate) then THAT is precisely the message we will communicate to the research community, in no uncertain terms. And we will have the voting data to prove it! If we make a pre-selection, the voting data would prove very little, unfortunately; and the exercise might prove meaningless, which would be a lost opportunity

I hope this makes the point of the exercise clearer?

 

[jimH]

If we were to make a pre-selection, as you suggest, the whole voting process would be biased, and the research community might therefore not take the results seriously, because the outcomes would reflect our biased pre-selection rather than the will of the broader community. We believe presenting all studies as voting options is the only way to gather reliable data about what the community wants, without us interfering in the process.

Your point is well made. Sorry about the misunderstanding. Thanks for clearing that up.

 

[Hazel]

Your point is well made. Sorry about the misunderstanding. Thanks for clearing that up.

Oh boy, now I feel like I lectured you; hope I didn't come across too pedantic! But glad to hear you understand

 

[Croaker]

The sociology studies are important for pharmaceutical companies to point to as hard evidence that this is a profitable condition to treat. So while it seems ridiculous to us that somebody has spent money and research hours to say "hey turns out tinnitus sucks and a lot of people have it" it's not totally pointless. However I don't think we need more of them at this point.

 

[Nobody19]

Alterations of brain activity & functional connectivity in acute to chronic tinnitus.

Brain structural and white matter reorganization in idiopathic tinnitus patients was a close second.

 

[T_Almost_Gone]

Instead of having all these "nice to know"-studies (we already knew 20 years ago that tinnitus affects quality of life and psychotherapy helps to cope), it would be great if more were focused on the pathophysiology and on finding a solution.

I agree. I couldn't bring myself to vote on anything in that list.

Like someone else here said:

More research is needed on the neurological pathologies of tinnitus, regenerative medicines in the inner ear, and on medication-induced tinnitus.

 

[ajc]

I agree. I couldn't bring myself to vote on anything in that list.

What's wrong with the following that are part of the voting list?

Alterations of brain activity & functional connectivity in acute to chronic tinnitus.

Brain structural and white matter reorganization in idiopathic tinnitus patients.

 

[Frédéric]

Well, here attached is a previous article from the same team (n°18). Although the sound therapy is not a breakthrough since it consists of listening to your own tinnitus (1 kHz narrow band i.e. tinnitus frequency +- 0.5 kHz).

I don't know if it is worth it creating a new thread about this.

 

[T_Almost_Gone]

What's wrong with the following that are part of the voting list?

Alterations of brain activity & functional connectivity in acute to chronic tinnitus.

Brain structural and white matter reorganization in idiopathic tinnitus patients.

That's fair. Thanks!

 

[Halsy]

I picked Dr. Shore's work because I believe it holds the most promise as a single effective solution for tinnitus. However I still hold, and will always maintain, that the cure for tinnitus for most will probably be multifaceted treatments involving chemicals and electrical equipment. I sure hope someone proves me wrong however. We all want the magic bullet don't we?

I'm still a big fan of neuromodulation though as it has applications far reaching beyond tinnitus in helping people with all manner of neurological conditions. Particularly in a preventative role as society moves forward. A great many neurological conditions are tied in directly with a loss of neuroplasticity.

Tinnitus is increasing in society because we live in an increasingly noisy world. Whenever I go to the big city - with all them that city slickers - my tinnitus is always raging and for several hours after I leave. Well as those numbers keep increasing that means more people demanding real, effective treatment and a cure. And the suits in Big Pharma see there's plenty of moolah to be made with all of this. I don't really care what their motivation is so long as it delivers results. I think we'll be rounding some major corners on this in short order.

As far as the rest of the stuff in regards to QOL, etc. We already know that stuff first hand. We don't require a paper on it. That's just trafficking in the obvious. Some of it can be interesting I'll admit, but I've certainly got much better ways to waste my time.

Thank you for the effort and hard work though, Hazel. It really is appreciated.

 

[weab00]

I'm still a big fan of neuromodulation though as it has applications far reaching beyond tinnitus in helping people with all manner of neurological conditions. Particularly in a preventative role as society moves forward. A great many neurological conditions are tied in directly with a loss of neuroplasticity.

You're right, neuromodulation is also being used in the treatment of Parkinson's and essential tremor, like deep brain stimulation (DBS). It goes to show the power of brain plasticity and I feel like it bodes well for Shore's device, in spite of Lenire's failure and the countless delays.

I still think regenerative medicine will be the best solution for noise-induced tinnitus, especially for those of us with hyperacusis, because it will actually resolve the underlying cochlear damage; you would still remain susceptible to setbacks after Shore's treatment. However, it will be a godsend (if it works) for other causes like TMJ dysfunction, ototoxic drugs, benzo withdrawal, etc. And then of course there will still be those that need both. I'm excited for what the future has in store overall.

 

[Tanni]

Great idea to vote on these papers as feedback for the research community - thanks for putting it together. The four most voted on are very telling already!

I didn't feel smart enough to vote on any of them originally because I couldn't really figure out what they were .
I used @Frédéric's summary to help make my vote (thanks @Frédéric!) Maybe a small summary below each option would help people with these going forward, but it might just be me that's the problem - I'm not very scientifically minded.

 

[Hazel]

I didn't feel smart enough to vote on any of them originally because I couldn't really figure out what they were .
I used @Frédéric's summary to help make my vote (thanks @Frédéric!) Maybe a small summary below each option would help people with these going forward, but it might just be me that's the problem - I'm not very scientifically minded.

That's a great idea, and had already crossed our minds. But... we would need a group of volunteers for that, because it's a lot of work to read all those papers in detail and write good summaries.

Volunteers welcome!