Talking about tinnitus

Only people who have suffered from this disorder can describe what it really “sounds” like. Descriptions range from soft hissing, to an annoying buzzing, to a downright loud roar of pneumatic drill. The worst thing is that your doctor doesn’t hear what you hear and you start questioning your sanity. Are you simply imagining things?

No, you are not. It is called tinnitus. According to the US National Institute on Deafness and other Communication Disorders (NIDCD)

Tinnitus is a symptom associated with many forms of hearing loss. It can also be a symptom of other health problems… Some cases are so severe that it interferes with a person’s daily activities. People with severe cases of tinnitus may find it difficult to hear, work, or even sleep.

Tinnitus approximately affects 25 million people in the US alone.  It can occur in one (unilateral) or both ears (bilateral).

What causes tinnitus?

• Hearing loss. Research studies have found a strong association between different kinds of hearing loss and tinnitus.
• Loud noise. Long-term exposure to loud noise can cause noise-induced hearing loss and tinnitus. This has been observed in young people who routinely listen to loud music.
• Medications. Tinnitus is a common side effect of certain medications. The NIDCD estimates that more than 200 medicines can cause tinnitus.
• Other health problems. Allergies, brain tumours, cardiovascular problems as well as problems of the jaws, and neck can cause tinnitus.

A recent research by researchers at the Henry Ford Hospital reports the development of a non-invasive imaging technique can actually diagnose tinnitus.

The perceived sounds originate from certain areas of the brain and there used to be no way of pinpointing the specific location of tinnitus in the brain. However, the new imaging technique called magnetoencephalography (MEG), can more or less pinpoint the site of perception of tinnitus in the brain. Once the area is identified, doctors can target the area with electrical or chemical therapies to lessen symptoms.

According to study co-author Dr. Susan M. Bowyer, bioscientific senior researcher, Department of Neurology at Henry Ford Hospital.

“Since MEG can detect brain activity occurring at each instant in time, we are able to detect brain activity involved in the network or flow of information across the brain over a 10-minute time interval. Using MEG, we can actually see the areas in the brain that are generating the patient’s tinnitus, which allows us to target it and treat it.”

Other imaging techniques such as PET and fMRI have been used to try to unravel the puzzle of tinnitus. However, they only provided a general location of the tinnitus but wasn’t specific enough for targeted therapies.

MEG, by comparison, measures the very small magnetic fields generated by intracellular electrical currents in the neurons of the brain. It is used in presurgical mapping of the brain before epilepsy treatment or surgery to remove brain tumours. Only about 20 hospitals and clinics n the U.S. are equipped with a MEG scanner

According to Dr. Michael Seidman, director of the Otolaryngology Research Laboratory and co-director of the Tinnitus Center at Henry Ford

“With PET and fMRI, most of the auditory cortex of the brain lights up with activity during imaging. MEG, however, is a much more sophisticated machine and it can identify a specific tone or topic point, so only a small area in the brain lights up. It’s like having the lights on in only the city of Detroit, compared to having the lights on in the entire state of Michigan.”

For the study, Dr. Seidman and his colleagues collected MEG results from 17 patients with tinnitus and 10 patients without tinnitus. MEG data were collected for 10 minutes, and then digitally filtered. Study participants wore ear plugs to eliminate outside sounds, and kept their eyes open and fixated on one point on the ceiling in the room during testing.

Using a MEG scan, the researchers detected multiple small active areas in the brain of patients without tinnitus. However, none of these areas were found to be really coherent during the 10-minute MEG scan.

In contrast, patients with unilateral tinnitus showed the greatest amount of brain activity in the auditory cortex on the opposite site of the brain from their perceived tinnitus. For those with bilateral tinnitus, MEG imaging showed activity in both hemispheres of the brain, with greater activity appearing in the opposite side of the brain where the perception of tinnitus is strongest. The imaging technique has the great potential for more specific targeting that will help in alleviating the symptoms.

Current treatments for tinnitus are

• Hearing aids. Many people with tinnitus also have a hearing loss. Wearing a hearing aid makes it easier for some people to hear the sounds they need to hear by making them louder. The better you hear other people talking or the music you like, the less you notice your tinnitus.
• Maskers. Maskers are small electronic devices that use sound to make tinnitus less noticeable. Maskers do not make tinnitus go away, but they make the ringing or roaring seem softer. For some people, maskers hide their tinnitus so well that they can barely hear it. Some people sleep better when they use maskers. Listening to static at a low volume on the radio or using bedside maskers can help. These are devices you can put by your bed instead of behind your ear. They can help you ignore your tinnitus and fall asleep.
• Medicine or drug therapy. Some medicines may ease tinnitus. If your doctor prescribes medicine to treat your tinnitus, he or she can tell you whether the medicine has any side effects.
• Tinnitus retraining therapy. This treatment uses a combination of counseling and maskers. Otolaryngologists and audiologists help you learn how to deal with your tinnitus better. You may also use maskers to make your tinnitus less noticeable. After a while, some people learn how to avoid thinking about their tinnitus. It takes time for this treatment to work, but it can be very helpful.
• Counseling. People with tinnitus may become depressed. Talking with a counselor or people in tinnitus support groups may be helpful.
• Relaxing. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse. By relaxing, you have a chance to rest and better deal with the sound.