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.

 

[ZFire]

You see it all the time on Tinnitus Talk and elsewhere; everyone will claim their tinnitus is 'severe,' myself included. Then, next thing you know, that same person a couple of months later will say their tinnitus isn't all that bad, and they've habituated…

This is why I want something measurable. I want an objective threshold for what constitutes a severe case of tinnitus. Put a real value on it.

Because tinnitus is also unpredictable, we need something that can also capture the volatile nature of this condition, too.

People with variable tinnitus just add more confusion and difficulty (not their fault) in evaluating treatment outcomes. One moment, their tinnitus is calm and quiet, and then the next, it's extremely loud and overwhelming. You're not going to get very far if you solely rely on self-reporting.

I think that's the cold, hard truth about self-reporting. It just isn't reliable when it comes to determining the severity level of one's tinnitus and whether treatments are actually reducing tinnitus.

 

[Joeseph Stope]

You see it all the time on Tinnitus Talk and elsewhere; everyone will claim their tinnitus is 'severe,' myself included. Then, next thing you know, that same person a couple of months later will say their tinnitus isn't all that bad, and they've habituated…

This is why I want something measurable. I want an objective threshold for what constitutes a severe case of tinnitus. Put a real value on it.

Because tinnitus is also unpredictable, we need something that can also capture the volatile nature of this condition, too.

People with variable tinnitus just add more confusion and difficulty (not their fault) in evaluating treatment outcomes. One moment, their tinnitus is calm and quiet, and then the next, it's extremely loud and overwhelming. You're not going to get very far if you solely rely on self-reporting.

I think that's the cold, hard truth about self-reporting. It just isn't reliable when it comes to determining the severity level of one's tinnitus and whether treatments are actually reducing tinnitus.

Something echoes in my mind about an article Dr. Nagler wrote — I'm talking about way back, ten or even twenty years ago. The volume of a person's tinnitus doesn't seem to be closely related to the level of irritation or intrusion it causes.

My interpretation is this: you can have two people with tinnitus. The first patient has it loud but considers it manageable. The second patient experiences it at a more moderate volume but finds it utterly overwhelming.

How do medical professionals measure this perceived loudness? A common method involves the good old audiogram. First, they try to get a rough idea of what the tinnitus sounds like—usually a combination of the damaged frequencies. If it's pure-tone tinnitus, that process might be simpler.

Next, the audiologist plays a model sound at different volumes until it just barely "drowns out" the patient's tinnitus. Then, they may lower the volume slightly, using their judgment to estimate. This gives them a rough idea of how loud the patient's tinnitus is by comparing it to that adjusted volume.

However, this measurement can vary depending on factors like the patient's mood, their disposition on that particular day, whether they've just woken up, or if they've been exposed to traffic noise recently.

Perhaps the Bionics Institute could develop a more reliable, convenient, and absolute method of measuring tinnitus.

 

[Joergen]

You see it all the time on Tinnitus Talk and elsewhere; everyone will claim their tinnitus is 'severe,' myself included. Then, next thing you know, that same person a couple of months later will say their tinnitus isn't all that bad, and they've habituated…

This is why I want something measurable. I want an objective threshold for what constitutes a severe case of tinnitus. Put a real value on it.

Because tinnitus is also unpredictable, we need something that can also capture the volatile nature of this condition, too.

People with variable tinnitus just add more confusion and difficulty (not their fault) in evaluating treatment outcomes. One moment, their tinnitus is calm and quiet, and then the next, it's extremely loud and overwhelming. You're not going to get very far if you solely rely on self-reporting.

I think that's the cold, hard truth about self-reporting. It just isn't reliable when it comes to determining the severity level of one's tinnitus and whether treatments are actually reducing tinnitus.

I think self-reporting using Minimum Masking Level (MML) is reliable to some extent. I can easily assess the level of my own tinnitus by comparing it to an external signal. I'd describe it as reliable but not entirely accurate.

Habituation, however, is a completely separate issue.

I believe Bionics faces a catch-22 problem. To determine the device's accuracy (or reliability), they need to map its measurements to self-reported data, which we know is either inaccurate or, as you argue, unreliable.

 

[UKBloke]

Something echoes in my mind about an article Dr. Nagler wrote — I'm talking about way back, ten or even twenty years ago. The volume of a person's tinnitus doesn't seem to be closely related to the level of irritation or intrusion it causes.

He made that comment about 5 years ago here.

I like that Dr. Nagler posted on Tinnitus Talk, but I do take issue with that particular comment. If the volume doesn't closely relate to the level of irritation or intrusion, then we're back on that slippery slope to CBT.

I don't discount CBT, particularly in (measurably) mild cases. But the Holy Grail is volume reduction. I hope none of us lose sight of that.

 

[ZFire]

I think self-reporting using Minimum Masking Level (MML) is reliable to some extent. I can easily assess the level of my own tinnitus by comparing it to an external signal. I'd describe it as reliable but not entirely accurate.

Habituation, however, is a completely separate issue.

I believe Bionics faces a catch-22 problem. To determine the device's accuracy (or reliability), they need to map its measurements to self-reported data, which we know is either inaccurate or, as you argue, unreliable.

I have nothing against self-reporting per se. It just hasn't been shown to be all that effective in determining whether potential tinnitus treatments are actually lowering the volume of tinnitus. And like I said, with variable tinnitus, the unpredictable nature of it where tinnitus could change in intensity at any moment, self-reporting won't do much good in those cases. We need to be able to observe those fluctuations in real-time.

I think self-reporting has its uses, though, but only as a complementary piece to objective measures. I think most people here realize its limitations, too. Solely relying on self-reports is not the answer. We need more than that.

But the Holy Grail is volume reduction. I hope none of us lose sight of that.

This is the key.

 

[Nick47]

The good news is the fNRI was able to show changes in tinnitus severity in the same person. The latest published study, last August, in cochlear implant patients, proved that.

 

[Joergen]

Personally, I think the argument that "research will not make real progress and Big Pharma will not invest until we have an objective measurement" is, if not flawed, then at least highly overstated.

The market is already flooded with antidepressants, the efficacy of which relies heavily on self-reporting. In fact, I believe self-reporting for antidepressants is far less accurate than for tinnitus. With antidepressants, you are comparing your current inner state to a previous inner state without any external reference point. Despite this, significant advancements in research have been made without objective measurements, at least if you consider the results from Susan Shore's studies.

That said, what the Bionics Institute is doing is incredible. Their technology will undoubtedly have a huge impact on advancing our understanding of and ability to treat tinnitus in the future.

 

[ccpjc]

I've read through this thread, but I'm still unsure how this benefits the tinnitus community. There's no discussion about disability or benefits as part of this.

It feels like taking an X-ray to confirm you have a broken bone—perhaps the break is more severe for some than for others.

The problem is that while we can see the broken bone, we have no solutions. So, how does this actually help anyone?

 

[UKBloke]

I'm not sure I agree with the argument about self-reporting anti-depressant efficacy and the absence of an external reference point. It's scarce for patients to exist in a bubble; those around a patient taking anti-depressants will notice improvements in their mental state when the medication is working. It is not scientific per se, but it is a valid metric.

Regarding the question of how having an objective tinnitus measurement helps anyone, we only have to look at what happened with Neuromod.

Around the time Neuromod released Lenire, the company started posting online videos where patients described waking up to no tinnitus after completing their treatment. Irrespective of the way Neuromod reported their clinical trial data (many people here voiced valid concerns but were often shot down as "naysayers"), the Lenire User Experiences thread was set up, and people on the sidelines like me waited with bated breath for all of the positive reports to flood in.

There has not been a single case of a person here reporting waking up to no tinnitus post-Lenire treatment. Moreover, those few people who reported more positive outcomes have had to resort to hyperbole to describe the effect. At the very least, the chance of people spending thousands of pounds on what has turned out to be a dud, at least from the perspective of validated users here who tried the device, would have been greatly reduced by objective measurement data published in clinical trials.

I find it bewildering that we're even discussing these points this far along the line. Tinnitus science must commit to becoming empirical science. As a community, we owe it to ourselves to set the bar this high.

 

[Joergen]

I'm not sure I agree with the argument about self-reporting anti-depressant efficacy and the absence of an external reference point. It's scarce for patients to exist in a bubble; those around a patient taking anti-depressants will notice improvements in their mental state when the medication is working. It is not scientific per se, but it is a valid metric.

Regarding the question of how having an objective tinnitus measurement helps anyone, we only have to look at what happened with Neuromod.

Around the time Neuromod released Lenire, the company started posting online videos where patients described waking up to no tinnitus after completing their treatment. Irrespective of the way Neuromod reported their clinical trial data (many people here voiced valid concerns but were often shot down as "naysayers"), the Lenire User Experiences thread was set up, and people on the sidelines like me waited with bated breath for all of the positive reports to flood in.

There has not been a single case of a person here reporting waking up to no tinnitus post-Lenire treatment. Moreover, those few people who reported more positive outcomes have had to resort to hyperbole to describe the effect. At the very least, the chance of people spending thousands of pounds on what has turned out to be a dud, at least from the perspective of validated users here who tried the device, would have been greatly reduced by objective measurement data published in clinical trials.

I find it bewildering that we're even discussing these points this far along the line. Tinnitus science must commit to becoming empirical science. As a community, we owe it to ourselves to set the bar this high.

You can have as many observers as you want, but the evaluation is still not objective. It remains one mind reporting an experience, often assigning numerical values to different questions. While you can observe behavior, that observation is not truly objective. A sound signal, on the other hand, is external and objective—your therapist is not.

Your entire point about Lenire actually highlights the issue of poor, dishonest, and non-independent research. If you accept the premise that research for antidepressants is not fully objective but still consider antidepressants a valid treatment, then Lenire would be similar to an antidepressant producer praising their own product without proper blinding or rigorous study design.

I apologize if I'm repeating points that have already been made. Perhaps I should have read the thread more carefully. On reflection, I think the argument in my original post was overly negative and unrealistic. I guess I felt the need to counterbalance the discussion, but I may have gone too far.

 

[ccpjc]

I'm not sure I agree with the argument about self-reporting anti-depressant efficacy and the absence of an external reference point. It's scarce for patients to exist in a bubble; those around a patient taking anti-depressants will notice improvements in their mental state when the medication is working. It is not scientific per se, but it is a valid metric.

Regarding the question of how having an objective tinnitus measurement helps anyone, we only have to look at what happened with Neuromod.

Around the time Neuromod released Lenire, the company started posting online videos where patients described waking up to no tinnitus after completing their treatment. Irrespective of the way Neuromod reported their clinical trial data (many people here voiced valid concerns but were often shot down as "naysayers"), the Lenire User Experiences thread was set up, and people on the sidelines like me waited with bated breath for all of the positive reports to flood in.

There has not been a single case of a person here reporting waking up to no tinnitus post-Lenire treatment. Moreover, those few people who reported more positive outcomes have had to resort to hyperbole to describe the effect. At the very least, the chance of people spending thousands of pounds on what has turned out to be a dud, at least from the perspective of validated users here who tried the device, would have been greatly reduced by objective measurement data published in clinical trials.

I find it bewildering that we're even discussing these points this far along the line. Tinnitus science must commit to becoming empirical science. As a community, we owe it to ourselves to set the bar this high.

I understand that you feel duped about this whole situation, but what if some of those people actually did wake up with reduced or no tinnitus? Are you saying you would have waited for a clinical diagnosis or test before buying the device? What if a brain scan showed activity, yet the person truly felt they were in a better place?

I think success or challenges with something are subjective and vary from person to person.

For example, let's say someone loses a limb. For one individual, it might feel like the end of the world. For another, it could be a setback, but they adapt and continue living life with this disruption. I feel this is no different in the tinnitus world. Someone could have what's considered mild tinnitus but feel like their world is ending, while someone else with severe tinnitus might manage it and continue their daily life.

For me, I'm not sure where my tinnitus falls on the severity scale, and frankly, I don't care. It is incredibly impactful to me—life-altering to the point where I can't see a future with this affliction. It destroys me to have those thoughts, to the extent that I had to seek counseling today.

Having a way to measure the impact of something doesn't always correlate with how it affects an individual beyond assigning a number. I'm not trying to dismiss the importance of measurement, but ultimately, it comes down to how this condition impacts your quality of life. No measurement scale can truly capture that accurately because it's entirely up to the individual sufferer.

Or maybe I've completely missed the point. That's entirely possible too, as I'm still grappling with this condition as a newly afflicted individual.

Final point—unless there's an effective treatment available, quantifying severity doesn't mean much to me. What I fear is it being used as more ammunition for doctors to say, "Looks like you're in the mild category. Be happy you're not worse." That kind of response does nothing for anyone—just like saying, "Oh well, you have tinnitus, live with it."

 

[ZFire]

It feels like taking an X-ray to confirm you have a broken bone—perhaps the break is more severe for some than for others.

The problem is that while we can see the broken bone, we have no solutions. So, how does this actually help anyone?

Because X-rays are retaken after surgery (the solution) to assess the results of that broken leg and check if the alignment is good. Months later, X-rays are retaken as a follow-up to confirm that everything is positioned correctly and that all has healed. Then, we can make a note that the surgery was successful for that broken leg. So, in other words, the X-ray has told us that the solution has worked.

If anything, you kinda strengthened our point with that analogy.

It's about trying to figure out whether tinnitus treatments are actually helping to reduce tinnitus volume. We need objective ways to confirm that.

 

[IYIiKe]

I've read through this thread, but I'm still unsure how this benefits the tinnitus community. There's no discussion about disability or benefits as part of this.

It feels like taking an X-ray to confirm you have a broken bone—perhaps the break is more severe for some than for others.

The problem is that while we can see the broken bone, we have no solutions. So, how does this actually help anyone?

Go look at PubMed or any research repository. There are thousands of studies on whether "breathing farts," or its equivalent, is better than CBT therapy (talking at you without really doing anything). These studies almost always use the Tinnitus Handicap Inventory (THI) or some variation to measure the severity of tinnitus, typically at the beginning, during, and after treatment. A reliable measure of tinnitus would provide clinical proof that objectively (rather than subjectively), tinnitus fades or lessens during treatment.

Subjective reporting is inherently unreliable. A bad day, week, month, or even year can affect your scoring. Neurological data, on the other hand, cannot be faked. If your brain is creating the noise, it can be observed on an fMRI or other scans. Objective reporting is crucial for serious studies involving actual treatments, such as drugs or invasive or noninvasive implants designed to assist with tinnitus. It allows researchers to objectively measure treatment feasibility and helps reduce risks for investors when pursuing specific treatments. Furthermore, it can verify or discredit whether anything is truly changing with tinnitus in tools like the THI, beyond just subjective symptom relief—or the normal reduction of symptoms over time, now that it can be measured.

For these purposes, objective measurement is invaluable. For diagnosing tinnitus, however, it is a different story. Insurance is unlikely to cover it unless the condition becomes pervasive because, even if the measurement confirms you have tinnitus, it does not change the clinical reality: you still have it. You might pay out of pocket for an official report, but its practical use ends there. The real importance lies in demonstrating an objective reduction of tinnitus. As technology advances, this methodology could be applied in animal studies before transitioning to human trials.

Having an objective measure also enables researchers worldwide to work with a standardized method, rather than relying on subjective tinnitus questionnaires.

Think of it this way: if tinnitus research were a game, developing an objective measurement methodology would be like a 5% speed modifier to help unlock the cure faster.

 

[Joeseph Stope]

Because X-rays are retaken after surgery (the solution) to assess the results of that broken leg and check if the alignment is good. Months later, X-rays are retaken as a follow-up to confirm that everything is positioned correctly and that all has healed. Then, we can make a note that the surgery was successful for that broken leg. So, in other words, the X-ray has told us that the solution has worked.

If anything, you kinda strengthened our point with that analogy.

It's about trying to figure out whether tinnitus treatments are actually helping to reduce tinnitus volume. We need objective ways to confirm that.

In my mind's eye, I can picture a future ENT, someone completely reliant on spreadsheets and printouts, sending a poor patient back to work in a noisy environment that only worsens their hearing.

But hey, that's the system for you. Your best friend in such a situation will be the amount of money you have managed to save. At least it gives you the option to quit your job and look for a quieter one.

Here's to the future! Progress has always been two steps forward, one step back, or at least that is how it seems most of the time.

Now, I am not much of a numbers guy, but I can see how the Bionics Institute's idea, once it is up and running, could open up a new field of research. Many aspects of the brain and nerves are quantifiable. Future researchers could gather data on receptors, fusiform cells, nerve signals, and other things I do not fully understand (no medical background here ). They could then find correlations between these factors and the volume of tinnitus experienced by patients. By comparing these measurements and correlations with those of non-tinnitus patients or a broader sample of both groups, new insights could emerge.

Of course, correlation does not imply causation, as they say, but we would be getting closer to understanding.

Slightly off topic: I will sign off with the lyrics of a Bruce Springsteen song and a question:

"At night I wake up with the sheets soaking wet
And a freight train running through the middle of my head
Only you can cool my desire
Oh, oh, oh, I'm on fire
Oh, oh, oh, I'm on fire
Oh, oh, oh, I'm on fire."

Does Bruce suffer from tinnitus? A lot of musicians do.

 

[ccpjc]

Go look at PubMed or any research repository. There are thousands of studies on whether "breathing farts," or its equivalent, is better than CBT therapy (talking at you without really doing anything). These studies almost always use the Tinnitus Handicap Inventory (THI) or some variation to measure the severity of tinnitus, typically at the beginning, during, and after treatment. A reliable measure of tinnitus would provide clinical proof that objectively (rather than subjectively), tinnitus fades or lessens during treatment.

Subjective reporting is inherently unreliable. A bad day, week, month, or even year can affect your scoring. Neurological data, on the other hand, cannot be faked. If your brain is creating the noise, it can be observed on an fMRI or other scans. Objective reporting is crucial for serious studies involving actual treatments, such as drugs or invasive or noninvasive implants designed to assist with tinnitus. It allows researchers to objectively measure treatment feasibility and helps reduce risks for investors when pursuing specific treatments. Furthermore, it can verify or discredit whether anything is truly changing with tinnitus in tools like the THI, beyond just subjective symptom relief—or the normal reduction of symptoms over time, now that it can be measured.

For these purposes, objective measurement is invaluable. For diagnosing tinnitus, however, it is a different story. Insurance is unlikely to cover it unless the condition becomes pervasive because, even if the measurement confirms you have tinnitus, it does not change the clinical reality: you still have it. You might pay out of pocket for an official report, but its practical use ends there. The real importance lies in demonstrating an objective reduction of tinnitus. As technology advances, this methodology could be applied in animal studies before transitioning to human trials.

Having an objective measure also enables researchers worldwide to work with a standardized method, rather than relying on subjective tinnitus questionnaires.

Think of it this way: if tinnitus research were a game, developing an objective measurement methodology would be like a 5% speed modifier to help unlock the cure faster.

Let me rephrase: if a brain scan shows tinnitus activity, that's one thing, but I don't think it can accurately reflect the impact it has on an individual.

We hear many stories about habituation, where people learn to tune out their tinnitus. Their brains might still "light up" on a scan, but for them, tinnitus is a non-issue. Conversely, someone else's scan might show relatively low activity related to tinnitus, yet they could be suffering from catastrophic tinnitus.

I'm not sure that objectively showing the presence of tinnitus through a scan can reliably correlate to the quality of life or the perceived severity experienced by the individual.

I understand the need for tests and measurable results, but I firmly believe that the impact on quality of life is subjective. Each person is best suited to describe the changes they're experiencing. Maybe I'm wrong, and this test is incredibly accurate, but everyone's experience with tinnitus is unique. Their ability to cope with it varies, and the severity of their tinnitus is different from person to person.

For example, you and I could have the exact same tinnitus—we'd never know—but our perceptions of its impact on our quality of life would differ. Our brains might also respond differently during a scan, simply because no two brains are the same.

On a personal note, my tinnitus feels catastrophic, and I'm in a dark place right now. I spoke with a doctor yesterday who mentioned that he also has tinnitus, but for him, it's a non-issue—something he forgets about entirely. I have no idea if my tinnitus is worse or better than his, but my quality of life is much more impacted.

It's possible his tinnitus is actually worse than mine, but he's less affected by it. At the same time, my perception of my tinnitus has a much greater effect on my daily life. Ultimately, this doesn't change the fact that the quality of life impact is deeply personal and varies for each individual.

This is concerning because, if brain scan results are used as a benchmark for compensation, treatments, or disability assessments, there's a risk of unfair outcomes.

For instance, if someone shows low tinnitus activity in their brain but is suffering greatly, they might be ignored or pushed to the back of the queue. Meanwhile, another person with highly active brain scans but less impact on their quality of life might receive preferred treatment or other benefits.

This disparity highlights the potential danger of relying solely on objective measures without considering the individual's subjective experience.