Objectives/hypothesisSensorineural hearing loss is one of the most common human disorders, with increasing incidence in elderly patients, severely restricting normal activities, and lowering quality of life. The introduction of sound conditioning has the potential to activate auditory pathway plasticity and improve basal frequency hearing. Our objective was to evaluate the safety and efficacy of threshold sound conditioning (TSC). The null hypothesis in this study was that TSC does not have a significant effect on auditory threshold amelioration.MethodsPure tone audiometry (PTA) was performed and hearing thresholds were measured once at baseline, and a second time following TSC intervention. Data were analyzed using an intention‐to treat design.ResultsThe TSC group (78%) significantly differed from the control group (44%) on auditory threshold amelioration; P = .008091 in DV1, P = .000546 in DV2 by Scheffe's post hoc test. Female subjects (77%) showed a significant difference in DV1 from male subjects (47%); P = .025468 in DV1 by Scheffe's post hoc test. Older subjects (75%) showed no significant difference from younger subjects (53%); P = .139149 in DV1, P = .082920 in DV2 by Scheffe's post hoc test.ConclusionsWe observed a significant improvement in a narrow band frequency threshold in this randomized controlled prospective clinical study in a broad range of subjects. These data have important clinical implications since there is no current long‐term therapy for this widespread and growing disability. Additional physiologic, mechanistic, and molecular studies are necessary to fully elucidate the pathophysiology and mechanism of action of TSC.Level of Evidence1a.

metric thresholds, presence of TOAE and no history of head trauma, neurological disease or ear surgery took part in three random experiments in a soundproof booth. Subjects were instructed: (1) to solve Hanoi Tower problem (cognitive task, silence, no selective auditory attention); (2) to see if they might (or not) detect some sounds (selective auditory attention); (3) to see if they might (or not) detect some change on lightness (visual attention to evaluate the degree of suggestion). All experiments were performed for 5 minutes each. No sound or light changes were presented at all, but after each experiment, participants were asked about their perceptions of sound and light change. RESULTS: Some auditory perception was present in 19,7% of the subjects during Hanoi Tower experiment, in 45,5% under visual attention and in 69,7% under auditory attention (pϽ0.001). Silence without auditory attention was more related to common tinnitus-like perceptions (hissing, buzzing, humming, etc), while silence and auditory attention elicited more uncommon tinnitus-like perceptions, including some similar to auditory hallucinations (music, steps, people talking). CONCLUSION: Silence and auditory attention are important to elicit phantom auditory perceptions, especially when both situations are combined. Descriptions of auditory perceptions were different among experiments and may allow some differentiation between tinnitus and auditory hallucinations. SIGNIFICANCE: This study revisited the concept that tinnitus may be a subclinical symptom, but stated a more realistic rate of occurrence in normal hearing subjects. SUPPORT: Grant from CNPq (Brazil) R087 Auditory Notches in 134 Band Audiograms Sangyeop Kwak, MA (presenter); Eunyee Kwak, PhD

metric thresholds, presence of TOAE and no history of head trauma, neurological disease or ear surgery took part in three random experiments in a soundproof booth. Subjects were instructed: (1) to solve Hanoi Tower problem (cognitive task, silence, no selective auditory attention); (2) to see if they might (or not) detect some sounds (selective auditory attention); (3) to see if they might (or not) detect some change on lightness (visual attention to evaluate the degree of suggestion). All experiments were performed for 5 minutes each. No sound or light changes were presented at all, but after each experiment, participants were asked about their perceptions of sound and light change. RESULTS: Some auditory perception was present in 19,7% of the subjects during Hanoi Tower experiment, in 45,5% under visual attention and in 69,7% under auditory attention (pϽ0.001). Silence without auditory attention was more related to common tinnitus-like perceptions (hissing, buzzing, humming, etc), while silence and auditory attention elicited more uncommon tinnitus-like perceptions, including some similar to auditory hallucinations (music, steps, people talking). CONCLUSION: Silence and auditory attention are important to elicit phantom auditory perceptions, especially when both situations are combined. Descriptions of auditory perceptions were different among experiments and may allow some differentiation between tinnitus and auditory hallucinations. SIGNIFICANCE: This study revisited the concept that tinnitus may be a subclinical symptom, but stated a more realistic rate of occurrence in normal hearing subjects. SUPPORT: Grant from CNPq (Brazil) R087 Auditory Notches in 134 Band Audiograms Sangyeop Kwak, MA (presenter); Eunyee Kwak, PhD

There has been no study on the relationship between chronic tinnitus and harmonic templates. Harmonic templates are harmonically structured receptive fields in the auditory system in which all frequency components are integer multiples of a common fundamental frequency (F0). In this study, data from 19 harmonic templates from each of 196 chronic tinnitus patients were analyzed and mathematical modeling was performed to quantify the loudness of chronic tinnitus. High-resolution hearing threshold data were obtained by algorithmic pure tone audiometry (PTA) conducting automated PTA at 134 frequency bands with 1/24 octave resolution from 250 Hz to 12,000 Hz. The result showed that there is an intriguing relationship between the auditory instability of harmonic templates and simplified tinnitus severity score (STSS). This study provides several mathematical models to estimate tinnitus severity and the precise quantification of the loudness of chronic tinnitus. Our computational models and analysis of the behavioral hearing threshold fine structure suggest that the cause of severe chronic tinnitus could be a severe disparity between different temporal capacities of each neural oscillator in a certain harmonic template.

metric thresholds, presence of TOAE and no history of head trauma, neurological disease or ear surgery took part in three random experiments in a soundproof booth. Subjects were instructed: (1) to solve Hanoi Tower problem (cognitive task, silence, no selective auditory attention); (2) to see if they might (or not) detect some sounds (selective auditory attention); (3) to see if they might (or not) detect some change on lightness (visual attention to evaluate the degree of suggestion). All experiments were performed for 5 minutes each. No sound or light changes were presented at all, but after each experiment, participants were asked about their perceptions of sound and light change. RESULTS: Some auditory perception was present in 19,7% of the subjects during Hanoi Tower experiment, in 45,5% under visual attention and in 69,7% under auditory attention (pϽ0.001). Silence without auditory attention was more related to common tinnitus-like perceptions (hissing, buzzing, humming, etc), while silence and auditory attention elicited more uncommon tinnitus-like perceptions, including some similar to auditory hallucinations (music, steps, people talking). CONCLUSION: Silence and auditory attention are important to elicit phantom auditory perceptions, especially when both situations are combined. Descriptions of auditory perceptions were different among experiments and may allow some differentiation between tinnitus and auditory hallucinations. SIGNIFICANCE: This study revisited the concept that tinnitus may be a subclinical symptom, but stated a more realistic rate of occurrence in normal hearing subjects. SUPPORT: Grant from CNPq (Brazil)