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Tinnitus–the Noise in Your Head that Won’t Go Away
Almost everyone has experienced tinnitus—what’s commonly called ringing in the ears—at least once. Usually it goes away. But for some people it doesn’t, and the noise can range from a soft whooshing to a piercing shriek that makes it impossible to think or concentrate, let alone fall asleep at night.
The problem with tinnitus, as Dr. Richard Tyler told an audience of more than 40 scientific researchers gathered for an NIDCD-sponsored workshop on the NIH campus in Bethesda, Md., is that because there is still no cure, people are told they just have to live with it. “Most of them do,” says Tyler, a tinnitus researcher at the University of Iowa. “But that doesn’t mean they like it.” (See a list of the participants and the agenda for the meeting.)
Tyler arrived at this conclusion when his university sent out an alumni newsletter with a tiny paragraph tucked into its pages about one of his NIDCD grants. Within three months, he had received more than 300 Emails from people across the country. “They were all pretty much the same,” he said. “Something like, ‘I’ve had tinnitus for about ten years and it doesn’t bother me. But if you could fix it, I’d fly out to Iowa City tomorrow.’”
Because there are so many reasons for tinnitus, ranging from hearing loss to medications, diagnosing the cause or causes is a challenge. Figuring out how to help a patient is even more daunting, which is why NIDCD scientific program directors Roger Miller, Ph.D., and Gordon Hughes, M.D., decided to bring together researchers from the tinnitus and neural prosthesis communities for two days of brainstorming on the possibilities for developing devices to treat tinnitus. Fifteen presentations covered topics in basic science, FDA guidelines for device development, experimental clinical trials, and the growing numbers of veterans returning from Iraq and Afghanistan with tinnitus from bomb blast injuries.
Although tinnitus may begin in the ear, chronic tinnitus continues in the brain. How that happens is still being debated among researchers. There are many places along the path a hearing signal travels between the inner ear and the brain where things can go wrong to cause tinnitus. If we can understand how and where that happens, and why it causes tinnitus, it might be possible to find places on that path where some kind of therapeutic intervention could stop tinnitus in its tracks.
One of the more promising directions involves the use of electrical or magnetic stimulation on areas of the brain involved in hearing. Implantable “pacemaker” devices already exist to reduce the trembling of Parkinson’s disease and the compulsions of obsessive-compulsive disorder (OCD). Similar devices could be used to normalize the neural circuits involved in tinnitus.
To encourage this kind of research, NIDCD is offering two different funding opportunities: for the development of new interventions (PAR-09-056), and for new or enhanced diagnostic, intervention, and treatment paradigms (PAR-09-057). “There’s no question that there’s plenty of room for new thinking and new ideas to help people with disabling tinnitus,” said Roger Miller at the beginning of the meeting. By the end, researchers were clustered in the hallways, plotting how.