TU Delft & Prof. Dirk De Ridder — Bimodal Stimulation Device for Treating Tinnitus

[Christiaan]

Secondly, Prof. De Ridder was caught cheating in a sailing competition.

Uhm... this is not Prof. De Ridder, but a Dutch sailor with the same name who represented my country at the 2000 Summer Olympics in Sydney and the one who was banned from 2013 America's Cup after being caught cheating during the America's Cup World Series in 2012 (Wiki).

 

[Nick47]

Note: it seems they have already performed pre-clinical tests, but the question remains how they have conducted them. This is one of those questions that I hope to ask at the symposium next month.

Yes, but where is the published pre-clinical work? The article is vague, blasé and lazy. This is what has led to 'speculation' on here as we are trying to fill in the gaps.

 

[Christiaan]

Yes, but where is the published pre-clinical work? The article is vague, blasé and lazy. This is what has led to 'speculation' on here as we are trying to fill in the gaps.

The article is from a Dutch newspaper, not from a scientific magazine or journal where they evidently go through the specifics of a study.

I understand your question about the pre-clinical work. It's possible that this information isn't publicly available yet. I'd suggest reaching out directly to Prof. De Ridder or Prof. Serdijn for the most accurate details regarding their research publication status/research paper.

 

[Pos]

Uhm... this is not Prof. De Ridder, but a Dutch sailor with the same name who represented my country at the 2000 Summer Olympics in Sydney and the one who was banned from 2013 America's Cup after being caught cheating during the America's Cup World Series in 2012 (Wiki).

Haha - thanks.

 

[Fields]

I can't find a babysitter, unfortunately, so I won't be able to attend.

It's pretty interesting to see the amount of interest this device has already generated, though. Over the past couple weeks somewhere between 5 to 10 people have mentioned this research to me.

I don't think anyone ever mentioned anything tinnitus-related to me before over the past 4 years.

 

[Christiaan]

I've just returned from the symposium and, while time is tight and I won't be able to draft a detailed report (but hopefully in the near future), I wanted to share some key points here on Tinnitus Talk for everyone:

Presentation on DBS: Dr. Marc Janssen (University Maastricht)

Dr. Marc Janssen recently delivered an insightful presentation on the innovative use of deep brain stimulation (DBS) as a potential treatment for tinnitus. He highlighted various strategies for implanting DBS electrodes and shared that their team opted for placing electrodes within the medial geniculate body area of the brain. Dr. Janssen announced plans for a forthcoming human trial involving six participants, aimed at evaluating the safety & efficacy of this intervention.

Intriguingly, Dr. Janssen also revealed that a preliminary human pilot study has already been conducted, yielding promising results. The participant experienced a significant reduction in the severity of their condition. For instance, their Visual Analog Scale (VAS) score, a psychometric tool used to measure subjective experiences of distress, dramatically improved from 95 to 35. Other measures, including the Tinnitus Questionnaire (TQ), the Tinnitus Functional Index (TFI), and the Hospital Anxiety and Depression Scale (HADS), also indicated positive outcomes.

However, Dr. Janssen cautioned that the small sample size of the pilot study limits any definitive conclusions about the treatment's overall effectiveness. The anticipation grows for the upcoming clinical trial, which will provide a clearer understanding of how DBS might benefit additional patients suffering from tinnitus.








Presentation on the Tinnitus Delft device: Prof. Wouter Serdijn (TU Delft)

Professor Serdijn offered enlightening updates about the TU Delft device, a novel approach in the treatment of tinnitus, during his recent presentation. He emphasized the diversity of medical devices aimed at mitigating tinnitus, pointing out the unique aspects of the TU Delft device in comparison to others like Lenire and Dr. Shore's variant of the Auricle device. Prof. Serdijn detailed the device's design, which includes a robust casing enabling the adjustment of auditory frequencies and the timing of somatosensory stimuli. It also comprises headphones and electrodes specifically intended for placement on the auricular branch of the vagus nerve, as illustrated in the presentation slides depicting the ear's anatomy.

Towards the end of his talk, Prof. Serdijn outlined the forthcoming phases for the device's journey, including the clinical trial protocol set to be established in New Zealand, the process of obtaining METC approval for testing the device without a CE marking, and the anticipation of results by November 2024. This comprehensive overview not only showcased the innovative engineering behind the TU Delft device but also set the stage for its potential impact on tinnitus treatment pending further clinical investigation.

Yes, but where is the published pre-clinical work? The article is vague, blasé and lazy. This is what has led to 'speculation' on here as we are trying to fill in the gaps.

I asked Prof. Serdijn & Dr. De Ridder this question at the symposium. This is their response:

I read an article in the AD a few weeks ago about the bi-modal device that you've co-developed. In that same article, You mentioned that you have already tested the device for a couple of years now and that you have found the right parameters to conduct human trials in the near future. Could you tell us how you've conduced pre-clinical research to find the right settings for human trials?

So we've learned from previous attempts, and we've interacted based on the works of Dr. De Ridder, and we've applied the learnings for the treatment of our patients. Many years ago, in cooperation with Dr. De Ridder, we treated a group of patients based on their individual tinnitus profile with a device similar to the TU Delft device. Unfortunately, we had to stop the study as it didn't work out the way we hoped it would, and I was heavily disappointed, because, as an engineer, I would like to solve things. Is there something that you'd like to add, Dirk [De Ridder]?

Yes, we've done previous work where we tried bimodal stimulation [pairing of vagus nerve stimulation with sound stimulation of non-tinnitus frequencies] years ago, and that didn't really benefit our patients. Later on, we developed burst stimulation, which is a specific way of electronically giving a signal that is conceived by the nervous system as a signal that it considers very important, so it's impossible for the nervous system not to respond to it. We've used it in clinical settings for patients with tinnitus and it had a more desired effect.

Basically, if you put pieces together, and that's also the difference with Dr. Shore's device, is our philosophy. We want to tell the brain that the tinnitus is not important. We enforce it by using another stimulation design, a second type of language to communicate with the brain, one that is modeled after the brain's own natural patterns of neuron activity. By replicating these firing sequences, burst stimulation can effectively adjust and control nerve function.

Another difference is that the pairing [of vagus nerve and sound stimulation] is trying to teach the brain something, whereas Dr. Shore's device is a combination of trigeminal stimulation and auditory stimulation that influences the firing rate and synchronicity of fusiform cells in the DNC [by inducing long-term depression in fusiform cells]. So If you have hearing loss, her idea is that the somatosensory system plays an important role [in case of tinnitus], but for us, it's not relevant. It does not mean that the model is wrong. It's just another model. So, maybe in the future we have to develop a device that combines sound stimulation with trigeminal stimulation, we don't know. That would depend on the outcome.

 

[BB23]

I would like to know what they think about the potassium channel openers. Is it too late to ask them about it?

Also, DBS is no child's play. Less invasive methods should be researched IMO. Many, many things can go wrong with it, this is not a basic mole removal op, they are going to drill into your skull and place an electrode in your brain, your body can reject it years down the line, the wires can cause infection and inflame the skin mandating another operation for the implant to be removed, etc. many things can go wrong with this, there are many stories online. I have ZERO trust in doctors doing a capable job like this on us anyways. Unless you have catastrophic tinnitus, I think most people shouldn't even consider this.

 

[Nick47]

@Christiaan, thanks, you've done a great job. The DBS is good news, although sample sizes are very small overall.

As for TU Delft, I'm not sold. Not at all. If that was the reply to the pre-clinical work, it's complete bluster. None of them answered the question and waffled on about a load of nonsense. Enough said there.

There was nothing about the trial design:

• Number of participants
• Start date
• Placebo/control group
• Crossover or not
• Blinding
• Primary outcome measures

I noticed they compared it to Auricle, stating that this competitor reduces tinnitus distress. Something Dr. Dirk De Ridder said years ago in his podcast, almost trying to invalidate Dr. Shore's claims on loudness reduction.

 

[Christiaan]

I would like to know what they think about the potassium channel openers. Is it too late to ask them about it?

Also, DBS is no child's play. Less invasive methods should be researched IMO. Many, many things can go wrong with it, this is not a basic mole removal op, they are going to drill into your skull and place an electrode in your brain, your body can reject it years down the line, the wires can cause infection and inflame the skin mandating another operation for the implant to be removed, etc. many things can go wrong with this, there are many stories online. I have ZERO trust in doctors doing a capable job like this on us anyways. Unless you have catastrophic tinnitus, I think most people shouldn't even consider this.

I actually asked Dr. De Ridder about it, and he provided quite an extensive answer. I didn't have time yesterday to transcribe the audio recording of this particular moment, but I will do so sometime this week.

About DBS: Dr. Marc Janssen talked a considerable part of the presentation about the surgery protocol and how they use brain scans for precision work (to avoid blood vessels, etc.) before using the measuring instrument (as seen in the PowerPoint slide) for the implementation of two electrodes. Granted, this measuring instrument does look a bit archaic, especially when compared to the surgical robot that they use at Neuralink.

 

[Christiaan]

@Christiaan, thanks, you've done a great job. The DBS is good news, although sample sizes are very small overall.

As for TU Delft, I'm not sold. Not at all. If that was the reply to the pre-clinical work, it's complete bluster. None of them answered the question and waffled on about a load of nonsense. Enough said there.

There was nothing about the trial design:

• Number of participants
• Start date
• Placebo/control group
• Crossover or not
• Blinding
• Primary outcome measures

I noticed they compared it to Auricle, stating that this competitor reduces tinnitus distress. Something Dr. Dirk De Ridder said years ago in his podcast, almost trying to invalidate Dr. Shore's claims on loudness reduction.

When it comes to pre-clinical work, I tend to agree with you that they haven't worked delicately, as previous versions of this device haven't been tested in animal studies, which is preferably the way to go.

Dr. De Ridder has conducted many experiments with bimodal stimulation (pre-clinical and clinical), but the main difference with previous devices is that they've now decided to use a different location of the vagus nerve (auricular branch of the vagus nerve instead of the left vagus nerve in the neck) for electrical stimulation. They've also chosen burst stimulation (intermittent) instead of tonic stimulation (continuous) and have decided to pair noise stimulation with tinnitus-matched sounds (instead of sound exposure excluding the tinnitus-matched frequency).

If we talk about burst stimulation specifically: this technique has already been experimented with for VNS combined with tones having frequencies other than the tinnitus sound, and it has not demonstrated to be superior to simple VNS.

However, in this case with the TU Delft device, regarding sound stimulation, the sound frequencies match those characteristic of the tinnitus. The rationale for this approach is that pairing a tinnitus-matched tone with relaxing electrical burst vagal nerve stimulation can reduce the associated arousal of the tinnitus by removing the paradoxical salience attached to the tinnitus tone. Thus, neuroplasticity may significantly contribute to altering the neuronal connections and firing rates, thereby inhibiting the activity of neurons that generate the tinnitus frequencies

Concerning the trial design: that's certainly a good point. They did mention it in a radio interview, but it's beyond me why they haven't discussed it at the symposium. I hope to raise this question at a webinar meeting with Dr. De Ridder tomorrow evening.

I also agree that they shouldn't have grouped Lenire, MicroTransponder, and Auricle together as similar machines on that presentation sheet. It's not intellectually honest of those who put this overview together. As for Dr. De Ridder, I haven't heard him being dismissive of Dr. Shore's research on tinnitus at the symposium. It's perhaps relevant to mention that I had a video consult with him about a year ago, and I remember him saying that he does believe that the Auricle device can reduce not just the distress caused by tinnitus but also its loudness.

 

[UHPTS]

I love what TU Delft wrote on the slide: "Safety was a priority in the design". I wonder what options they were choosing between and which were more and which less dangerous. I imagine stopping tinnitus by chopping the head off would be a dangerous way. On the opposite, there are sound and small electric stimulus. Since they are responsible and like people ($$), they went for the second option.

 

[Nick47]

I actually asked Dr. De Ridder about it, and he provided quite an extensive answer. I didn't have time yesterday to transcribe the audio recording of this particular moment, but I will do so sometime this week.

Hi @Christiaan, I'm interested in what he thought about the Kv7.2/3 openers.

 

[Christiaan]

I would like to know what they think about the potassium channel openers. Is it too late to ask them about it?

Hi @Christiaan, I'm interested in what he thought about the Kv7.2/3 openers.

Yes, just finished with the transcription. Here you go:

I understand that, given the settings we're in at TU Delft, we primarily focus on bio-electrical and biomedical devices for the treatment of tinnitus. But I'm just wondering if you think it's a fruitful avenue to go down the pharmaceutical route, for example with potassium channel modulators, as a way to change the phantom sound perception, or maybe as a way to compound the effect of bio-electrical intervention.

Yes, this is very relevant. You could take the route of medication intervention to tackle the tinnitus issue, but then there wouldn't be a single drug to solve the problem. It would have to be a cocktail, except if you had one drug that works on specific channels. It could be calcium, potassium, or sodium channels, but also neurotransmitters.

So up to now, we've predominantly worked with calcium channel blockers and neurotransmitters, where we empirically see that people with tinnitus seem to benefit, but we use a cocktail. For example, in the sound inhibitory pathway, we use noradrenaline, dopamine, serotonin, GABA, and opioids, but what we do is prescribe an extremely low dose, because we just want to modulate, not activate or inactivate them, depending on whether they're excitatory or inhibitory, and that seems to benefit, at least at the clinical level, some of our patients.

Now, you can also use medication to boost plasticity. For example, we know that with psychedelics, your connectivity goes more towards what you could describe as a 'child phase' of extreme plasticity, and this has been shown in a significant paper in Nature, where you seem to return to the critical period when everything is connected to everything else. Then, in a second phase, you use neuromodulation on this brain that is now very sensitive to stimuli to drive it in the right direction.

But the problem is, as I've mentioned, with classical neuromodulation, we disrupt. To drive the system to do what we want is more difficult. That's where you'll have to shift from single-target stimulation to network stimulation. We've just submitted a paper that describes this philosophy, where you want to anti-correlate all these networks that have become correlated in certain pathologies. This is where drugs would be very complementary to neuromodulation. So yes, you could use it in that sense, as you've suggested.

Note about the network stimulation in the last paragraph: I also attended a webinar featuring Dr. De Ridder on February 8th, where he had an interesting thing to say about an upcoming trial that involves a new network stimulation device for tinnitus. If you want, I could also write a transcription of this portion of the webinar.

@Christiaan, thanks, you've done a great job. The DBS is good news, although sample sizes are very small overall.

As for TU Delft, I'm not sold. Not at all. If that was the reply to the pre-clinical work, it's complete bluster. None of them answered the question and waffled on about a load of nonsense. Enough said there.

There was nothing about the trial design:

• Number of participants
• Start date
• Placebo/control group
• Crossover or not
• Blinding
• Primary outcome measures

I noticed they compared it to Auricle, stating that this competitor reduces tinnitus distress. Something Dr. Dirk De Ridder said years ago in his podcast, almost trying to invalidate Dr. Shore's claims on loudness reduction.

I sent a few questions regarding the study design & (pre)clinical research of the TU Delft device to the organization (Stichting Hoormij) responsible for the webinar featuring Dr. De Ridder on February 8th. They replied that they would contact Dr. De Ridder and give an update as soon as possible.

 

[Fields]

Thanks for all your very informative posts, @Christiaan.

Did Dr. De Ridder happen to expand upon what a "Network Stimulation Device" should entail? Given the name, it sounds like it would stimulate various channels/factors, similar to Dr. De Ridder's medical cocktails – but through neuromodulation instead.

 

[Nick47]

Thanks @Christiaan.

For me, Dr. De Ridder is taking us nowhere other than philosophy. His pre-clinical work is almost non-existent and his financial wealth ever increasing. This may sound harsh and indeed may actually be, however after 25 years of research and not a single treatment, it's time he departed the tinnitus community. I expect he has tried, especially earlier in his career, but ultimately lived off his hyperbole and became detached from research and driven by fanciful brain philosophy. His War on Tinnitus resolves around fanciful proposals with little research to back it up. A range of brain zapping techniques followed by a flower supplement. He's charismatic on show, when allowed to present unchallenged, however when probed and questioned I've seen him get defensive and political. He completely avoided and side-stepped away from the Kv7.2/3 channels.

He also appeared on the Tinnitus Relief Summit again and it was just a rehash of his usual crap!

He's not the only one. If I were Alan Sugar; Rauschecker, Vannaste, Tzounopoulos, Schlee and Langguth would all be fired. I accept that Tzounopoulos has perhaps found something significant in Kv7.2/3 channels, but 15 years of failure have followed.

Ultimately these gentlemen have earned good careers and left little imprint in significant findings and no treatments.

I expect the TU DELFT device will offer little to most people.

Did Dr. De Ridder happen to expand upon what a "Network Stimulation Device" should entail? Given the name, it sounds like it would stimulate various channels/factors, similar to Dr. De Ridder's medical cocktails – but through neuromodulation instead.

I would think it's multi-channel HD-tDCS.

 

[Christiaan]

Thanks for all your very informative posts, @Christiaan.

Did Dr. De Ridder happen to expand upon what a "Network Stimulation Device" should entail? Given the name, it sounds like it would stimulate various channels/factors, similar to Dr. De Ridder's medical cocktails – but through neuromodulation instead.

Yes, he did, and you're also right about the stimulation part. Dr. De Ridder gave quite a lengthy presentation concerning this device, which is called Starstim 32. I'll send the transcription next week (maybe on Friday).

The upcoming trial will most likely involve one group with multitarget brain stimulation and another group with the combination of multitarget brain stimulation + psychedelics (MMDA/MDMA).

Interestingly, this is the very same device that he told me about when we had a virtual meeting on April 11th, 2022.

I had my appointment with Dr. De Ridder today and here are some notes that I'd like to share with all of you.

(...)

- Dr. De Ridder mentioned that he is also collaborating with other scientists on a new neuromodulation device that is based on the principles of the Bayesian model. Neuroelectronics (the developer of Starstim devices) is responsible for the technical development of this new device. Dr. De Ridder expects to receive an update from Neuroelectronics in May about the current developments. For a bit more info about the device, see: → Talk to the brain in a language it understands: multifocal network neuromodulation

Here are pictures of three PowerPoint slides that I took during the webinar:

#1

#2

#3

 

[dd314]

I've just returned from the symposium and, while time is tight and I won't be able to draft a detailed report (but hopefully in the near future), I wanted to share some key points here on Tinnitus Talk for everyone:

Presentation on DBS: Dr. Marc Janssen (University Maastricht)

Dr. Marc Janssen recently delivered an insightful presentation on the innovative use of deep brain stimulation (DBS) as a potential treatment for tinnitus. He highlighted various strategies for implanting DBS electrodes and shared that their team opted for placing electrodes within the medial geniculate body area of the brain. Dr. Janssen announced plans for a forthcoming human trial involving six participants, aimed at evaluating the safety & efficacy of this intervention.

Intriguingly, Dr. Janssen also revealed that a preliminary human pilot study has already been conducted, yielding promising results. The participant experienced a significant reduction in the severity of their condition. For instance, their Visual Analog Scale (VAS) score, a psychometric tool used to measure subjective experiences of distress, dramatically improved from 95 to 35. Other measures, including the Tinnitus Questionnaire (TQ), the Tinnitus Functional Index (TFI), and the Hospital Anxiety and Depression Scale (HADS), also indicated positive outcomes.

However, Dr. Janssen cautioned that the small sample size of the pilot study limits any definitive conclusions about the treatment's overall effectiveness. The anticipation grows for the upcoming clinical trial, which will provide a clearer understanding of how DBS might benefit additional patients suffering from tinnitus.

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Presentation on the Tinnitus Delft device: Prof. Wouter Serdijn (TU Delft)

Professor Serdijn offered enlightening updates about the TU Delft device, a novel approach in the treatment of tinnitus, during his recent presentation. He emphasized the diversity of medical devices aimed at mitigating tinnitus, pointing out the unique aspects of the TU Delft device in comparison to others like Lenire and Dr. Shore's variant of the Auricle device. Prof. Serdijn detailed the device's design, which includes a robust casing enabling the adjustment of auditory frequencies and the timing of somatosensory stimuli. It also comprises headphones and electrodes specifically intended for placement on the auricular branch of the vagus nerve, as illustrated in the presentation slides depicting the ear's anatomy.

Towards the end of his talk, Prof. Serdijn outlined the forthcoming phases for the device's journey, including the clinical trial protocol set to be established in New Zealand, the process of obtaining METC approval for testing the device without a CE marking, and the anticipation of results by November 2024. This comprehensive overview not only showcased the innovative engineering behind the TU Delft device but also set the stage for its potential impact on tinnitus treatment pending further clinical investigation.

View attachment 56418

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I asked Prof. Serdijn & Dr. De Ridder this question at the symposium. This is their response:

Don't forget that DBS involves an MRI scan. They're insanely loud and some people have claimed it's spiked them. My scan didn't seem to affect my tinnitus, but I had a quieter machine.

 

[BB23]

. He's charismatic on show, when allowed to present unchallenged, however when probed and questioned I've seen him get defensive and political. He completely avoided and side-stepped away from the Kv7.2/3 channels.

What do you expect him to say? Oh, the Kv7.2/3 modulators work 100% to the point you won't have to use my device at all?

If the Kv7.2/3 openers would be enough, that would invalidate his decades old research into tinnitus, making his new device meaningless and he wouldn't be able to sell us anything.

I also don't understand how they could consider LSD to be a way to treat tinnitus. LSD is the number one reason why people end up with HPPD, along with tinnitus and depersonalization/derealization, meaning you would go insane and have visual disturbances on top of tinnitus. Tiny doses of LSD is enough to cause that.

 

[Nick47]

@Christiaan, I hope I didn't come across as attacking you. I'm just frustrated by the way Dr. De Ridder goes about his development of treatment. It seems he has very little underpinning research for his models and treatment modality.

I think it is fantastic you attended and reported back for us.

 

[momus]

As someone who has had tinnitus for several decades, and spent a lot of that time looking for a fix (in my case, and pretty much everyone else, it boils down to masking, keeping noise and stress down, etc), this has all the markings of yet another Rah Rah event where someone champions something or someone w/ no real scientifically proven clinical studies that happen over time. Until that happens, it's just talk.

This stuff is insidious, as mine has become more noticeable just typing this!

 

[Christiaan]

I also don't understand how they could consider LSD to be a way to treat tinnitus. LSD is the number one reason why people end up with HPPD, along with tinnitus and depersonalization/derealization, meaning you would go insane and have visual disturbances on top of tinnitus. Tiny doses of LSD is enough to cause that.

You're right about LSD, and the same goes for MDMA (though I'm not sure about MMDA). The PowerPoint slide appears to suggest that Dr. De Ridder plans to combine LSD with multi-target brain stimulation; however, this is not the case. He's actually planning to use MDMA and/or MMDA & electronic stimulation.

During that part of the presentation, he discussed psychedelics like LSD in general and how they help to boost neuroplasticity. He expressed hope that this enhancement of neuroplasticity would make the human brain more receptive to electronic stimulation, aimed at changing or reversing maladaptive plasticity.

 

[EDDTEKK]

I totally agree with @Nick47 and thanks @Christiaan for your summary. It seems Dr. De Ridder still has absolutely no clue with regards to tinnitus. Unfortunately, he is not alone...

Almost all of his treatments and trials have failed. He is a good show master and can talk about tinnitus for hours. But at the end of the day, he has no helpful advice at all. I wish he had. All the discussions I have had with him have been nonsense.

At least he hasn't given up. He has attempted to search for new treatments. But he will probably not succeed in his life. There is too little support by the government and too few researchers on this planet.

Let's hope Susan Shore's device will have some effect. Even a 30% reduction would make me happy and feel cured.

 

[Josh59]

Yes, just finished with the transcription. Here you go:

...

Note about the network stimulation in the last paragraph: I also attended a webinar featuring Dr. De Ridder on February 8th, where he had an interesting thing to say about an upcoming trial that involves a new network stimulation device for tinnitus. If you want, I could also write a transcription of this portion of the webinar.

I sent a few questions regarding the study design & (pre)clinical research of the TU Delft device to the organization (Stichting Hoormij) responsible for the webinar featuring Dr. De Ridder on February 8th. They replied that they would contact Dr. De Ridder and give an update as soon as possible.

Hello @Christiaan.

Dr. De Ridder's comments suggest that it will be difficult to find a single cure for tinnitus.

Tinnitus increases or worsens via the auditory inputs, the somatosensory inputs (trigeminal nerve, dorsal nerve, etc.), or even via the emotional pathway (sudden stress, for example).

This is what I notice in my case, where although the main cause is noise, my tinnitus is is also aggravated by connections with the trigeminal nerve, and I sometimes even have tinnitus attacks because of stress or a nervous condition.

Nobody here is a researcher, but reading the numerous scientific publications, can we think that the hyperactive zone is the cochlear nuclei, which would be linked to the somatosensory inputs, as well as various nerves in the head and neck, and possibly areas of our brain managing emotions?

In any case, thank you for your feedback.

 

[Christiaan]

Thanks @Christiaan.

For me, Dr. De Ridder is taking us nowhere other than philosophy. His pre-clinical work is almost non-existent and his financial wealth ever increasing. This may sound harsh and indeed may actually be, however after 25 years of research and not a single treatment, it's time he departed the tinnitus community. I expect he has tried, especially earlier in his career, but ultimately lived off his hyperbole and became detached from research and driven by fanciful brain philosophy. His War on Tinnitus resolves around fanciful proposals with little research to back it up. A range of brain zapping techniques followed by a flower supplement. He's charismatic on show, when allowed to present unchallenged, however when probed and questioned I've seen him get defensive and political. He completely avoided and side-stepped away from the Kv7.2/3 channels.

He also appeared on the Tinnitus Relief Summit again and it was just a rehash of his usual crap!

He's not the only one. If I were Alan Sugar; Rauschecker, Vannaste, Tzounopoulos, Schlee and Langguth would all be fired. I accept that Tzounopoulos has perhaps found something significant in Kv7.2/3 channels, but 15 years of failure have followed.

Ultimately these gentlemen have earned good careers and left little imprint in significant findings and no treatments.

I expect the TU DELFT device will offer little to most people.

I would think it's multi-channel HD-tDCS.

@Christiaan, I hope I didn't come across as attacking you. I'm just frustrated by the way Dr. De Ridder goes about his development of treatment. It seems he has very little underpinning research for his models and treatment modality.

I think it is fantastic you attended and reported back for us.

I don't see your remarks as a personal attack, but anyway, thanks for being so considerate I can also imagine that it might seem like I'm trying to defend Dr. De Ridder or cover for him; that's not the case. I also value intellectual honesty, especially in the field of tinnitus research. And I, too, have my concerns about some of his work and theories. However, if we were to erase even the recent research performed by researchers like Dr. De Ridder, Dr. Rauschecker, or Dr. Tzounopoulos, would we have a better understanding of how tinnitus manifests in the brain?

If there's one thing that's certain, it's that progress in research often results from trial and error, and that's evidently a sluggish iterative process. This can be understandably frustrating for people who suffer daily from tinnitus and hope for something or someone to help speed up the process of finding a cure for this ailment.

From a certain perspective, it might seem as though we haven't made much progress in the last few years. However, a lot has changed when we consider the shift from viewing tinnitus as primarily an auditory cortex issue to a broader perspective that involves multiple components of the human brain. Dr. De Ridder and Dr. Rauschecker, despite some shortcomings—which we all have—have also made significant scientific contributions in that regard.

So I agree with you in some ways that Dr. De Ridder should reconsider some projects by looking at other avenues that may seem more advantageous or effective, but at the same time I think it's important to keep in mind that researchers like him, Dr. Vanneste and others have played an important part in (recent) tinnitus research and may continue to do so.

#1: The neuroscience of tinnitus: a historical perspective

#2: Several pathways involved in the manifestation of tinnitus

#3: Components of the brain that are likely to be involved in the manifestation of tinnitus

 

[Christiaan]

TU Delft has published videos of the symposium on YouTube in Dutch. You can use the automatic translation feature to follow the lectures:

Dr. De Ridder — Tinnitus: what is it and what can you do about it?



Dr. Serdijn — Technology that leaves you speechless: A device against tinnitus



Joop van Gent (MSc.) — Tinnitus House: How can we better understand tinnitus?

 

[Nick47]

So I agree with you in some ways that Dr. De Ridder should reconsider some projects by looking at other avenues that may seem more advantageous or effective

Yes mate, and an example would be extracochlear electrical stimulation that Dr. Carlson and Dr. Hamid Djalilian are doing. If he is working with a technology giant like TU Delft and he's looked at the success of pilot trials, he would see the opportunity. It's like oh, it's the middle ear and I'm the brain, so not interested.

I think he is so entrenched in the whole brain network model he can't look at what else is happening. I thought the answer to the Kv7.2/3 channel question was bollocks. He moved away from it as soon as possible and switched to talking about cocktails.

 

[Christiaan]

Another article has been published today by a Dutch newspaper (NRC) about the TU Delft device. Most of the text is perhaps old news, but there are some things that might be interesting.

Here are the takeaways from the article:

• The upcoming clinical trial will take place at the university of Otago.
• The trial will start in April and the initial outcomes will be expected in October/November.
• The trial consists of three groups of thirty people.
• One group receives paired simulation: sound and pulses simultaneously.
• The second group receives the sound and pulses uncoupled.
• The third group receives the sound and pulses coupled, and additionally, they will also stimulate the brain with electro-pulses at the endpoint of the vagus nerve in the brain.
• Statement Dr. De Ridder concerning the trial design: ''We expect little results from group 2, because the decoupling will not induce any learning," says De Ridder. "We expect results from both group 1 and group 3. If group 1 works sufficiently, then group 3 is unnecessary. But if we see only partial improvement in group 1, then it might work better in group 3''.

Here's a summary of the article 'Getting Rid of the Maddening Tinnitus with a Clip and Headphones' by ChatGPT:

The article ''Met een klemmetje en een koptelefoon van het gekmakende oorsuizen af" (Getting rid of the maddening tinnitus with a clip and headphones) describes a novel approach to treating tinnitus, a condition where individuals hear noises that are not caused by an external source. Tinnitus can be extremely distressing, affecting approximately two million people in the Netherlands alone. The text explains that despite years of research, effective solutions for tinnitus are still elusive, prompting scientists to rethink their strategies.

Dirk de Ridder, a professor of neurosurgery at the University of Otago in New Zealand, and Wouter Serdijn, a professor of bio-electronics at TU Delft, have collaborated to develop a device intended to treat tinnitus through a new method. Their device, humorously referred to as 'De broodtrommel' (The lunchbox) during the interview but officially called the Delft Tinnitus Device, aims to teach the brain that the sound heard by tinnitus patients is not significant, hoping this realization will lead the brain to stop generating the sound.

The causes of tinnitus are varied, including exposure to loud music, ear infections, and aging. For some, tinnitus is merely annoying, but for others, it can severely impact sleep, work, and overall mental health, with some individuals becoming so desperate that they consider ending their lives.

The innovative approach taken by De Ridder and Serdijn focuses on stimulating the autonomic nervous system using electrical pulses applied to the tragus (a part of the outer ear) while simultaneously exposing the patient to tinnitus sound. This bimodal stimulation aims to condition the brain to perceive the tinnitus sound as unimportant, allowing it to be ignored.

Clinical trials for the Delft Tinnitus Device are set to begin in April in New Zealand. The treatment represents a significant shift from traditional methods that primarily focused on the auditory system to a more holistic view involving the brain's networks and the autonomic nervous system's role in stress and the fight-or-flight response. This innovative approach offers hope for a more effective treatment for the various subtypes of tinnitus, potentially improving the lives of millions suffering from this condition.

Patients are not required to continuously use the device and the clip; short daily sessions over several weeks are expected to have a learning effect, akin to physical therapy. The challenge lies in determining the appropriate strength and pattern of pulses for each patient, as this varies individually. The device operates on the principle of bimodal stimulation, aiming to condition the brain to perceive the tinnitus sound as non-significant, thus hoping to ignore it.

The document also mentions that more researchers are exploring bimodal stimulation as a treatment for tinnitus, with similar devices already being tested or available in the market, such as Lenire in the United States, which uses a stream over the tongue while playing the tinnitus sound, and another device from the University of Michigan that combines sound with electrical streams to the cheek or neck.

The Delft Tinnitus Device is about to be tested in a clinical trial with thirty patients divided into three groups to assess its effectiveness. The trial aims to explore whether simultaneous sound and pulse stimulation, or adding brain stimulation, will significantly improve the patients' condition. Initial outcomes from the trial are expected by October or November.

Patients are not required to continuously use the device and the clip; short daily sessions over several weeks are expected to have a learning effect, akin to physical therapy. The challenge lies in determining the appropriate strength and pattern of pulses for each patient, as this varies individually.

→ Source

 

[IYIiKe]

Dunedin is beautiful, in case anyone was planning a visit.

 

[EDDTEKK]

There was a university in the US that did trials on vagus nerve stimulation (implant) combined with sounds. The name was "MicroTransponder" back in 2011 or so.

The results showed not much success, otherwise they would have continued with that approach. I never heard again from any additional trials.

The TU Delft device is not very different except that it is not invasive. They will stimulate the vagus nerve by the outer ear and combine this with sounds. So, after almost more than 10 years, they try a similar method or theory even when the initial trials with MicroTransponder showed not much benefit. I personally doubt that the TU Delft device will be successful.

I wonder what is the crucial difference?

However, I will keep checking the progress here on Tinnitus Talk. Thanks for all your updates.

 

[Fields]

Having digested all of the information shared by @Christiaan, I'm mostly wondering why exactly Dr. De Ridder believes that the TU Delft device will offer a significantly different effect compared to Auricle. Ultimately, it targets the same nerve(s), albeit through different locations and minimally different applications (burst versus constant).

The NRC interview also includes a final paragraph in which Dr. De Ridder shares that he has tested the device himself, and that he is convinced that it targets the right area because he could feel his heart rate calm down. According to Dr. De Ridder this is a good sign because the heart is also closely connected to the vagus nerve.

Serdijn then mentions that he has also tried the device once, but that he can't really comment on it other than that he felt that his stress response to his tinnitus appeared weakened.