[Date Prev][Date Next][Thread Prev][Thread Next][Date Index][Thread Index]

Treating subjective tinnitus with cortical remapping?

Recent research indicates some types of subjective tinniutus can be treated with methods to enhance cortical remapping to compensate for missing inputs from cochlear damage. The premise is that neurons in the auditory cortex lose their inhibition when they lose sensory inputs.  A  possible remedy is to reorganize the neurons to become sensitive to other inputs.   Is anyone familiar with methods to retrain the brain to compensate for missing inputs, such as auditory discrimination training?  How much of it can be done via interactions with computer programs?
I was wondering if some type of app for a smartphone would be effective for cortical remapping training to reduce tinnitus,  under the supervision of some type of expert? I don't know what kind of expert that would be since it is the interface of hearing and psychology, with computer-aided-therapy.
(However, I doubt other types of tinnitus would be affected by cortical remapping; e.g., tinnitus caused by cerebrovascular disease. )
Here is some background material to the question about retraining the brain to reduce tinnitus.
S. Yang, B. D. Weiner, L. S. Zhang, S.-J. Cho, S. Bao. Homeostatic plasticity drives tinnitus perception in an animal model. Proceedings of the National Academy of Sciences, 2011; 108 (36): 14974 DOI: 10.1073/pnas.1107998108
As reported in http://www.sciencedaily.com/releases/2011/09/110912144247.htm

"Bao's experiments in rats with induced hearing loss explain why the neurons in the auditory cortex generate these phantom perceptions. They showed that neurons that have lost sensory input from the ear become more excitable and fire spontaneously, primarily because these nerves have "homeostatic" mechanisms to keep their overall firing rate constant no matter what.

"With the loss of hearing, you have phantom sounds," said Bao, who himself has tinnitus. In this respect, tinnitus resembles phantom limb pain experienced by many amputees,

One treatment strategy, then, is to retrain patients so that these brain cells get new input, which should reduce spontaneous firing. This can be done by enhancing the response to frequencies near the lost frequencies. Experiments over the past 30 years, including important research by Merzenich, have shown that the brain is plastic enough to reorganize in this way when it loses sensory input. When a finger is amputated, for example, the region of the brain receiving input from that finger may start handling input from neighboring fingers

The above research is consistent with:
J. W. Middleton, T. Kiritani, C. Pedersen, J. G. Turner, G. M. G. Shepherd, T. Tzounopoulos. Mice with behavioral evidence of tinnitus exhibit dorsal cochlear nucleus hyperactivity because of decreased GABAergic inhibition. Proceedings of the National Academy of Sciences, 2011; DOI: 10.1073/pnas.1100223108              "

Carlos Herraiz, I. Diges, P. Cobo, J. M. Aparicio and A. Toledano.

Auditory discrimination training for tinnitus treatment: the effect of different paradigms
European Archives of Oto-Rhino-Laryngology
Volume 267, Number 7, 1067-1074, DOI:10.1007/s00405-009-1182-6
4. The physical analog to this type of tinnitus is phantom limb pain, which can be treated cognitively to a certain extent.
Scholar.google.com  143 citations of
Herta Flor Prof PhDa, Corresponding Author Contact Information, E-mail The Corresponding Author, Claudia Denke PhDb, Michael Schaefer Dipl-psycha, Sabine Grüsser PhDb
Lancet, Volume 357, Issue 9270, 2 June 2001, Pages 1763-1764 
"Effect of sensory discrimination training on cortical reorganisation and phantom limb pain."
5. Even a mirror technique can help with phantom limb pain. 
 6. Review of tinnitus
J Clin Neurol. 2009 March; 5(1): 11–19.
Published online 2009 March 31. doi: 10.3988/jcn.2009.5.1.11
Tinnitus: Characteristics, Causes, Mechanisms, and Treatments
Byung In Han, MD,corresponding authora Ho Won Lee, MD,b Tae You Kim, MD,c Jun Seong Lim, MD,d and Kyoung Sik Shin, MDe
Margaret Mortz