Patients with tinnitus may soon have a definitive therapy

By Dr. Ananya Mandal, MDMar 21 2012

Clinical trials of the new therapy, called Acoustic Coordinated Reset (ACR), have shown that it reduces the loudness and annoyance caused by tinnitus in seven out of 10 patients.

Up to 10 per cent of adults are thought to have tinnitus - the perception of ringing, buzzing or hissing in the ears - to some extent, according to the British Tinnitus Association, although most only mildly. It is more common in the elderly. Tinnitus can lead to loss of sleep, depression and anxiety, and have a severe impact on domestic and working life. To date the only treatments available have been those which mask symptoms, such as CDs of ocean waves, or psychological techniques to help people cope better.

Researchers say a new trial comparing ACR against a sham treatment in 63 people with long-term tinnitus, provides hard evidence it works. Acoustic CR Neuromodulation was developed from therapies for neurological diseases such as Parkinson’s that involve stimulating neurons with probes sunk deep into the brain. But unlike invasive deep brain stimulation, all it requires is for patients to wear special headphones for a few hours a day. The headphones emit a series of tones tuned according to the characteristic frequency of the patient’s tinnitus. This is said to disrupt the rhythmic firing patterns of tinnitus-creating auditory nerve cells.

Volunteers were first asked to match their tinnitus tone to one of a range played to them. Scientists have now found that playing sufferers the same tone which they “hear” in their mind stops auditory brain cells from creating the perceived noise. This tone was then played to volunteers through in-ear headphones four to six hours a day, for 12 weeks. They were then taken off it for four weeks, before being put on it again for regular intervals for another 22 weeks. At the end of the 40 week RESET trial, led by Professor Peter Tass at Jülich Research Centre in Germany, about seven in 10 who received active treatment said their tinnitus had got quieter and less annoying. On average, it halved the intensity of their symptoms.

The British Tinnitus Association said the results were “encouraging” but said a larger, independent trial was needed.

Known as Acoustic Co-ordinated Reset (CR) Neuromodulation, it is slated to cost £4,500 treatment and is currently only available to private patients, but the trial results could pave the way to it being offered freely on the NHS. Acoustic CR Neuromodulation has been available in Germany since 2010, where it has been used to treat more than 2,000 patients.

Results from the trial will be presented at a British Medical Association conference tomorrow and also appear in the journal Restorative Neurology and Neuroscience.

Mark Williams, an audiologist at the Tinnitus Clinic in London, which uses the treatment, said: “As the first treatment for tinnitus to remove rather than mask symptoms, clinical evidence will hopefully open this treatment to a wider range of patients.”