The Bionics Institute Claim They Have Found a Way of Objectively Measuring Tinnitus

[Nick47]

I wonder if this opens up further avenues to measure "reactive tinnitus"?

@UKBloke, I've considered this many times. If a patient brought in an instrument, like a fan or kettle, that exacerbates their tinnitus, we could record their baseline and aggravated states. Similar to a cochlear implant, the patient would serve as their own control.

However, then I wondered—how can we be sure that changes in brain responses aren't just due to sound processing, rather than truly representing tinnitus activity?

 

[Joeseph Stope]

Here is a simplified write up of the findings.

→ New publication shows Bionics Institute researchers can objectively measure tinnitus changes in individuals

This is what @DebInAustralia alluded to in January of this year.

Thank you, @Nick47, for the optimistic note today. As I've mentioned in earlier posts, this could be the major contribution—our generation's big step forward, or rather, our era's step forward—in cracking the mystery and, hopefully, eventually delivering a cure for tinnitus, hyperacusis, and maybe even deafness.

Getting a bit philosophical here: I noticed back in university that when you can't solve an intractable problem, you tend to change the question a bit. In this case, while we can't stop the ringing, how can we measure it? How can we prove or detect that it's there… subjectively? Or should I say objectively?

Before the Bionics Institute got started, "subjectively" might have been the only way to describe it. But now, with their success, it's becoming more objective.

Ah, my ongoing struggles with the English language!

 

[UKBloke]

However, then I wondered—how can we be sure that changes in brain responses aren't just due to sound processing, rather than truly representing tinnitus activity?

It might depend on how they/we define sound processing. I mean, hearing with or without tinnitus is all sound processing to a degree, just "normal" or "abnormal" processing.

If they're measuring tinnitus "severity," then going off what I personally experience with reactivity, I'd expect to see a spike in the severity metric after exposure to problematic sounds/frequencies. I think, for now at least, I could overlook the "processing" question.

In the longer term, perhaps the answer lies in a longitudinal study, although that would be pretty crap for the patient as the expectation would be for their condition to worsen in order for us to retrieve the data we want. Maybe an independent control subject without tinnitus could be useful?

 

[Joeseph Stope]

It might depend on how they/we define sound processing. I mean, hearing with or without tinnitus is all sound processing to a degree, just "normal" or "abnormal" processing.

If they're measuring tinnitus "severity," then going off what I personally experience with reactivity, I'd expect to see a spike in the severity metric after exposure to problematic sounds/frequencies. I think, for now at least, I could overlook the "processing" question.

In the longer term, perhaps the answer lies in a longitudinal study, although that would be pretty crap for the patient as the expectation would be for their condition to worsen in order for us to retrieve the data we want. Maybe an independent control subject without tinnitus could be useful?

I must confess that I don't see the difficulty here. I see that you (Tinnitus Onset 1991) are one "year" older than me.

The folks in white coats would simply measure the initial tinnitus loudness at onset, and then, as the years go by, take new readings to track its progress.

No need to worry! If the tinnitus is chronic, it won't go away.

 

[UKBloke]

I see that you (Tinnitus Onset 1991) are one "year" older than me.

Yeah, it's been a long haul!

 

[DebInAustralia]

Update from Bionics:

 

[Nick47]

Good work, @DebInAustralia.

Get the questions in then...

 

[@dam]

@UKBloke, I've considered this many times. If a patient brought in an instrument, like a fan or kettle, that exacerbates their tinnitus, we could record their baseline and aggravated states. Similar to a cochlear implant, the patient would serve as their own control.

However, then I wondered—how can we be sure that changes in brain responses aren't just due to sound processing, rather than truly representing tinnitus activity?

That's what happened when I got tested there. You wear earphones, and they play a sound like the ocean, which then goes silent. I was amazed at how much louder my tinnitus was right after the sound stopped. Then, it gradually died down until the next sound played.

 

[Joeseph Stope]

The thought occurred to me the other day:

We know that there seem to be several types of tinnitus. There are different responses among tinnitus sufferers to the same treatment: some improve, some get worse, and some are even cured.

Once the Bionics Institute puts its machinery on the market and it becomes available in audiology departments or ENT clinics, imagine this scenario: Patient A goes in for an examination, and the printout from the machine reads:

• Tinnitus: detected
• Volume: 10 decibels at the 6,000 kHz frequency
• Source of Tinnitus: 5 cm northwest of the dorsal cochlear nucleus

With this data, ENTs and audiologists would be able to build a knowledge base on which therapy or pharmaceutical option might best alleviate that specific type of tinnitus. I didn't say "cure"—that would be too optimistic, but it's not beyond imagination.

For instance, Patient B's brain scan might show significant activity in the area connected to the nerve in the jaw, indicating a potential case of TMJ. The quest for a single, one-size-fits-all pharmaceutical cure for tinnitus (such as Lidocaine) could then become more of an academic pursuit, perhaps reserved for further study and future research.

The introduction of the Bionics Institute device could bring tinnitus relief to the forefront, allowing for customized, personalized treatments for each patient.

A step forward? I suppose I'll believe it when I see it, as the saying goes.

 

[Nick47]

• Source of Tinnitus: 5 cm northwest of the dorsal cochlear nucleus

With this data, ENTs and audiologists would

I don't think it pinpoints the location of the tinnitus; it only indicates whether it's present and if it's mild or severe.

 

[antonio77]

That's what happened when I got tested there. You wear earphones, and they play a sound like the ocean, which then goes silent. I was amazed at how much louder my tinnitus was right after the sound stopped. Then, it gradually died down until the next sound played.

They play a low sound that completely masks the tinnitus. Then, they turn it off, allowing you to hear your tinnitus in full detail. Over time, you get used to it, and it no longer seems like such a big deal.

It's similar to going to the beach and then getting into a car. On the beach, you hear the low, steady sound of the waves, which drowns out your tinnitus. But when you get back into the car, an almost airtight space, that background noise disappears, and you hear your tinnitus at full intensity.

 

[UKBloke]

Sound familiar?

 

[Joeseph Stope]

Sound familiar?

View attachment 57942

Oh dear! If that fell into the wrong hands—like those of governments or even non-government groups...

 

[Joeseph Stope]

Just a Thought:

At the moment, my tinnitus is screaming away and has been for the past month or so. This could be linked to various factors: the COVID and flu vaccines, exposure to loud traffic noise (like motorbikes), or worry and stress—I'm currently on the housing market.

I thought to myself, Hey, this is bad—just like when I first experienced tinnitus back in the 90s. But this time, there's no alarm or panic. I'm still sleeping okay, though I do wake up somewhat early.

As I mulled this over, I realized: Everything is relative. Sure, Einstein, but what's this loud tinnitus all about? It could be further cochlear damage, or maybe, over time, my tinnitus volume had actually decreased, and I simply adjusted to the quieter version. Now, it feels like it's back to the level it was during its onset. There's no way to confirm this in 2024.

However, once the bionic researchers make progress, it's conceivable that we'll be able to map the trajectory of our tinnitus volume over time.

Back in the 90s, I tried all sorts of treatments—infusions, low-powered lasers, hyperbaric oxygen therapy, acupuncture, and so on. The one that gave me the most relief was TRT (Tinnitus Retraining Therapy). That's just my personal experience, though, and I didn't even receive much counseling or psychological support. The ENT was German, after all.

I remain optimistic about research in this field—not necessarily for finding a cure but for better understanding the nature of this beast.

 

[Joeseph Stope]

Oh oh! Is this a warning sign? I am still enthusiastically praising this new method before it is even widely available.

Back in the early days of my tinnitus onset, debates raged over whether patients should or should not drink alcohol or coffee. The argument was settled more or less; they agreed to disagree. Those who noticed their tinnitus increasing after drinking alcohol were advised to avoid it, and the same went for coffee drinkers whose tinnitus worsened after their cup or two.

I belong to the first group. My tinnitus would increase after a drink or two. However, based on the good Dr. Nagler's advice that alcohol does not enter the cochlea or affect the hair cells or synapses, and that he himself enjoys a glass or two of wine, I decided to do the same. I also drink plenty of coffee and tea.

That was during the early onset phase. Now, as an old hand, I find it makes no difference to me anymore.

What interests me now is this. Suppose all the other pharmaceuticals and therapies fall short, whether because they are too expensive, too intrusive, or carry too high a risk of worsening tinnitus. At the very least, the ability to measure the volume of one's tinnitus could be a valuable tool. This brings me to an important question: How should one steer their life over the long term?

• a) Should one live without coffee?
• b) Should one completely avoid alcohol?
• c) Should one move to a quiet, small town to escape the loud noise exposure of a big city?
• d) What are the effects of supplements like magnesium? Do they actually help?

Of course, broad based longitudinal studies would likely be needed to answer these questions. Still, having reliable ways to measure tinnitus could serve as a consolation prize if other treatments do not work out.

As you all know, everything is relative. Mood and outlook can greatly influence how intrusive tinnitus feels. However, if we had a gold standard for measuring it, that might at least shorten some of the endless debates and discussions, if only a little.