Development of a personalized sound therapy system and its therapeutic effect on subjective tinnitus patients
Abstract
Background/Aim. Tinnitus is a prevalent auditory condition that significantly affects the quality of life. Despite the variety of treatments available, their effectiveness is inconsistent. The aim of this study was to evaluate the impact of a newly developed sound therapy system on tinnitus patients, specifically in terms of changes in audiology, tinnitus-related tests, and tinnitus psychoacoustic characteristics. Methods. A total of 100 patients with tinnitus were included in the study. They were divided into two groups: the control group (CG) (n = 48) and the treatment group (TG) (n = 52). Various demographic characteristics of the patients were recorded. All patients had a thorough audiological assessment, which included pure tone audiometry and acoustic immittance testing, as well as tinnitus-specific evaluations, such as tinnitus frequency matching, tinnitus loudness matching, minimum masked level (MML), and residual inhibition (RI) examinations. In addition, psychoacoustic characteristics of tinnitus were assessed, including Tinnitus Handicap Inventory (THI), Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Visual Analog Scale (VAS) scores. Results. There were no significant differences in various demographic characteristics between CG and TG before acoustic therapy. Additionally, there were no significant differences between the groups in audiometric assessments, tinnitus-related tests, psychological acoustic characteristics before treatment, or in the distribution of tinnitus frequencies. The hearing threshold level in TG was notably lower than in CG (p = 0.0238). Tinnitus loudness was significantly reduced in TG (p = 0.0256). MML in TG tended to improve (p = 0.0532), although this difference did not reach statistical significance and showed a positive trend. Among the subscales of THI, TG demonstrated significant improvements. PSQI scores also indicated they were significantly lower in TG than in CG (p = 0.0238). The total score on HADS (16.58 ± 2.89 vs. 16.67 ± 2.76; p = 0.8730) and the total score on VAS (4.19 ± 1.48 vs. 4.22 ± 1.37; p = 0.9160) did not show a significant difference. Conclusion. Acoustic therapy significantly improves patients’ hearing, reduces tinnitus loudness, and improves sleep quality. Our acoustic therapy system is an effective strategy for alleviating chronic subjective tinnitus.
References
Yuan LL, Li DK, Tian YH, Sun Y. Greenness, Genetic Predis-position, and Tinnitus. Adv Sci (Weinh) 2024; 11(17): e2306706.
Clifford RE, Maihofer AX, Chatzinakos C, Coleman JRI, Daska-lakis NP, Gasperi M, et al. Genetic architecture distinguishes tinnitus from hearing loss. Nat Commun 2024; 15(1): 614.
Marrie RA, Reider N, Cohen J, Stuve O, Trojano M, Cutter G, et al. A systematic review of the incidence and prevalence of cardiac, cerebrovascular, and peripheral vascular disease in multiple sclerosis. Mult Scler 2015; 21(3): 318–31.
McCormack A, Edmondson-Jones M, Somerset S, Hall D. A sys-tematic review of the reporting of tinnitus prevalence and se-verity. Hear Res 2016; 337: 70–9.
Jafari Z, Kolb BE, Mohajerani MH. Age-related hearing loss and tinnitus, dementia risk, and auditory amplification outcomes. Ageing Res Rev 2019; 56: 100963.
Burkart M, Brueggemann P, Szczepek AJ, Frank D, Mazurek B. Intermittent tinnitus-an empirical description. HNO 2019; 67(Suppl 2): 51–8.
Weise C, Hesser H, Andersson G, Nyenhuis N, Zastrutzki S, Kröner-Herwig B, et al. The role of catastrophizing in recent on-set tinnitus: its nature and association with tinnitus distress and medical utilization. Int J Audiol 2013; 52(3): 177–88.
Milinski L, Nodal FR, Vyazovskiy VV, Bajo VM. Tinnitus: at a crossroad between phantom perception and sleep. Brain Commun 2022; 4(3): fcac089.
Zenner HP, Vonthein R, Zenner B, Leuchtweis R, Plontke SK, Tor-ka W, et al. Standardized tinnitus-specific individual cogni-tive-behavioral therapy: a controlled outcome study with 286 tinnitus patients. Hear Res 2013; 298: 117–25.
Denton AJ, Finberg A, Ashman PE, Bencie NB, Scaglione T, Kuzbyt B, et al. Implications of Transcranial Magnetic Stimula-tion as a Treatment Modality for Tinnitus. J Clin Med 2021; 10(22): 5422.
Jahn KN. Clinical and investigational tools for monitoring noise-induced hyperacusis. J Acoust Soc Am 2022; 152(1): 553.
Fuller T, Cima R, Langguth B, Mazurek B, Vlaeyen JW, Hoare DJ. Cognitive behavioural therapy for tinnitus. Cochrane Da-tabase Syst Rev 2020; 1(1): CD012614.
Tinnitus Retraining Therapy Trial Research Group; Scherer RW, Formby C. Effect of Tinnitus Retraining Therapy vs Standard of Care on Tinnitus-Related Quality of Life: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2019; 145(7): 597–608.
Suh MW, Park MK, Kim Y, Kim YH. The Treatment Outcome of Smart Device-Based Tinnitus Retraining Therapy: Prospec-tive Cohort Study. JMIR Mhealth Uhealth 2023; 11: e38986.
Wang Y, Xiao L, Li P, Cui J. Research on masking effect of multiple natural sounds for monotone-like tinnitus. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2017; 34(3): 325–8. (Chi-nese)
Aydin N, Searchfield GD. Changes in tinnitus and physiological biomarkers of stress in response to short-term broadband noise and sounds of nature. Complement Ther Med 2019; 46: 62–8.
Tavanai E, Rahimi V, Bandad M, Khalili ME, Fallahnezhad T. Efficacy of tailor-made notched music training (TMNMT) in the treatment of tinnitus: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol 2024; 281(10): 5033–49.
Hemanth N, Vipin Ghosh PG. Effect of Frequency Discrimina-tion Training on Tinnitus in Individuals with Flat Sensorineu-ral Hearing loss. Indian J Otolaryngol Head Neck Surg 2022; 74(1): 70–7.
Phillips JS, McFerran D. Tinnitus Retraining Therapy (TRT) for tinnitus. Cochrane Database Syst Rev 2010; 2010(3): CD007330.
Scherer RW, Formby C, Gold S, Erdman S, Rodhe C, Carlson M, et al. The Tinnitus Retraining Therapy Trial (TRTT): study protocol for a randomized controlled trial. Trials 2014; 15(1): 396.
Portnuff CDF, Kleindienst S, Bogle JM. Safe Use of Acoustic Vestibular-Evoked Myogenic Potential Stimuli: Protocol and Patient-Specific Considerations. J Am Acad Audiol 2017; 28(8): 708–17.
Argence M, Saez I, Sassu R, Vassias I, Vidal PP, de Waele C. Modulation of inhibitory and excitatory synaptic transmission in rat inferior colliculus after unilateral cochleectomy: an in situ and immunofluorescence study. Neuroscience 2006; 141(3): 1193–207.
Trevis KJ, McLachlan NM, Wilson SJ. Psychological mediators of chronic tinnitus: The critical role of depression. J Affect Disord 2016; 204: 234–40.
Shore SE, Roberts LE, Langguth B. Maladaptive plasticity in tinnitus-triggers, mechanisms and treatment. Nat Rev Neurol 2016; 12(3): 150–60.
Feng X, Li GY, Yun SH. Ultra-wideband optical coherence elastography from acoustic to ultrasonic frequencies. Nat Commun 2023; 14(1): 4949.
Wurzer H, Hauptmann C. Adapted Acoustic CR Neuromodula-tion in Patients with Chronic Tonal Tinnitus and Hearing Loss. Front Med (Lausanne) 2018; 5: 288.
Zhang Y, Karadas M, Liu J, Gu X, Vöröslakos M, Li Y, et al. In-teraction of acetylcholine and oxytocin neuromodulation in the hippocampus. Neuron 2024; 112(11): 1862–75.e5.
Lan L, Liu Y, Wu Y, Xu ZG, Xu JJ, Song JJ, et al. Specific brain network predictors of interventions with different mechanisms for tinnitus patients. EBioMedicine 2022; 76: 103862.
Aljuaid SM, Mirza AA, Habib LA, AlHarthi LA, Alansari BM, AlQahtani BG, et al. Does Caffeine Intake Increase the Inci-dence of Tinnitus? A Systematic Review. Int Arch Otorhino-laryngol 2020; 25(4): e628–32.
Michiels S, van der Wal AC, Nieste E, Van de Heyning P, Braem M, Visscher C, et al. Conservative therapy for the treatment of patients with somatic tinnitus attributed to temporomandibu-lar dysfunction: study protocol of a randomised controlled tri-al. Trials 2018; 19(1): 554.
Therdphaothai J, Atipas S, Suvansit K, Prakairungthong S, Thongyai K, Limviriyakul S. A Randomized, Controlled Trial of Notched Music Therapy for Tinnitus Patients. J Int Adv Otol 2021; 17(3): 221–7.
Zhu M, Gong Q. EEG spectral and microstate analysis originat-ing residual inhibition of tinnitus induced by tailor-made notched music training. Front Neurosci 2023; 17: 1254423. Erratum in: Front Neurosci 2024; 17: 1355150. Erratum in: Front Neurosci 2024; 18: 1369080.
Connell JT, Bassiouni A, Harrison E, Laden S, O'Brien S, Sahota R, et al. Customised acoustic therapy delivered through a web-based platform – An innovative approach to tinnitus treatment. Clin Otolaryngol 2023; 48(2): 226–34.
Kim HG, Kim DS, Choi YS, Lee ES, Yoo HJ, Kim DY. High-Intensity Focused Ultrasound Therapy Versus Coblation for the Treatment of Inferior Turbinate Hypertrophy: A Clinical Trial. Clin Exp Otorhinolaryngol 2023; 16(2): 141–7.
Reetz S, Bohlender JE, Brockmann-Bauser M. Do Standard In-strumental Acoustic, Perceptual, and Subjective Voice Out-comes Indicate Therapy Success in Patients With Functional Dysphonia? J Voice 2019; 33(3): 317–24.
Dode A, Mehdi M, Pryss R, Schlee W, Probst T, Reichert M, et al. Using a visual analog scale (VAS) to measure tinnitus-related distress and loudness: Investigating correlations using the Mini-TQ results of participants from the TrackYourTinnitus platform. Prog Brain Res 2021; 263: 171–90.
Rodrigo A, Abayabandara-Herath T. Validation of the Sinhala Version of Tinnitus Handicap Inventory. J Audiol Otol 2023; 27(3): 128–32.
Xia L, He G, Feng Y, Yu X, Zhao X, Yin S, et al. COVID-19 associated anxiety enhances tinnitus. PLoS One 2021; 16(2): e0246328.
Sun W, Xia L, Ji C, Wei Q, Zhang J, He S, et al. Relationship between covid-pandemic anxiety and sleep disorder with men-strual disorders among female medical workers. BMC Womens Health 2023; 23(1): 210.
Holmes S, Padgham ND. Review paper: more than ringing in the ears: a review of tinnitus and its psychosocial impact. J Clin Nurs 2009; 18(21): 2927–37.