Hearing things: New tinnitus therapy tested at UZ Antwerp

Summary

One-third of patients suffering from ringing in the ears improved after undergoing electrical stimulation therapy, which targets specific areas of the brain

An ounce of prevention

When Dr Laure Jacquemin was still an audiology student, her brother got tinnitus. Due to a noise trauma, he began to hear sound without an external source present.

He was not alone. Some 15% of the world population has such a condition, known as tinnitus.

Jacquemin was unable to help him. “I realised that I didn’t know enough about it,” she says. “Soon after, I also started to perceive tinnitus. It was probably a stress reaction to my brother‘s condition. I was focusing too much on tinnitus, afraid of having it too.”

A doctor reassured her that her hearing was normal, after which Jacquemin’s tinnitus started to disappear instead of going from an acute phase to a chronic one. The timely response interrupted the potential cycle where tinnitus-related preoccupation and fear lead to continued, and even worsening, tinnitus.

She was saved. But curiosity remained a welcome side effect of the experience. “From that moment on, I started to focus more on the topic in my audiology classes,” says Jacquemin.

Power to the brain

She landed an internship at the Pento Audiology Centre in Hengelo, the Netherlands, which focuses on diagnosis and treatment of tinnitus. “I got my first clinical experience in the tinnitus field. And after completing my masters, I applied for a research position at Antwerp University Hospital to focus on the treatment and the electrophysiology of tinnitus.”

Four years later, she is a doctor of audiology and working on an electrical stimulation therapy that can help patients cope with the condition. Although the problem affects millions of people worldwide – including celebrities such as Belgium’s musical siblings Angèle and Roméo Elvis – there is still no cure for it.

Complicating the matter is that causes of tinnitus vary. From acoustic trauma and ear infections to brain abnormalities and emotional stress, there are many things that can make your ears ring – constantly, to the point of sleep deprivation, having trouble concentrating or depression.

“A cure remains our end-goal,” says Jacquemin. “But we have to help the patients now.”

There are multiple areas in the brain involved in the perception of sound

- Dr Laure Jacquemin

To do that, the audiologist has conducted a test using electric currents. The impressively named High-Definition transcranial Direct Current Stimulation (HD-tDCS) is a promising technique, developed only recently.

It aims to modify brain activity with a low direct current (2 mA), which is applied for 30 minutes through small electrodes connected to the head. Patients undergo six sessions.

“Previous research has shown that there are changes in brain activity associated with tinnitus,” explains Jacquemin. “More specifically, there are multiple areas in the brain involved in the perception of sound, like those associated with concentration, auditory stimulation and the regulation of emotions. We wanted to explore targeting specific areas of the brain as a treatment option for tinnitus.”

Nearly 120 people took part in the study, all of them previous patients at Antwerp University Hospital. The results are extremely promising. “One-third of the patients reported improvement, such as less intense tinnitus, less stress from it or better coping skills,” says Jacquemin.

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Dr Jacquemin and her colleagues would like to expand the reach of HD-tDCS and so are setting up a clinical trial to investigate the effects of targeting multiple brain areas at the same time.

“Another promising route we are following is the measurement of tinnitus through brain activity,” she says. Currently, there is no evidence-based way to properly assess a patient’s tinnitus – neither before nor after therapy – because doctors rely on self-evaluation. Being able to measure related brain activity could give tinnitus its own alternative to blood tests or X-rays.

While the future for tinnitus sufferers looks bright, Jacquemin emphasises that there is no one-size-fits-all solution. And so it is still much easier to prevent tinnitus than to treat it.

Corona tinnitus?

People often exposed to loud sounds for long periods of time – musicians, for instance,  airline staff or certain factory and industrial workers, as well as concert-goers – should wear ear protection, preferably tailor-made. “Filters on ear protection can ensure good sound and speech quality, while hair cells in your inner ears are protected from intense sound waves.”

The prevalence and severity of tinnitus is also related to levels of stress and anxiety. “That’s the reason for tinnitus being more common in the Western Europe compared to, say, New Zealand,” explains Jacquemin.

And it occurs more during particularly stressful periods – such as a pandemic. “In this case, the importance of a balanced lifestyle cannot be overstated.”

If you enjoyed the video above, check out the Science Figured Out website, which gathers short, easy-to-understand videos detailing research in Flemish institutions. Some of them are in English.

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