Auditory Discrimination Training for the Treatment of Tinnitus

Abstract

This paper presents a series of 12 cases of chronic tinnitus patients who participated in 4 weeks of auditory discrimination training either close to or far removed from the tinnitus frequency. The training was based on the assumption that tinnitus is related to a shift of the representation of the tinnitus frequency in auditory cortex outside of the normal tonotopic map and that training close to but not removed from the tinnitus frequency should result in a reduction in the severity of the tinnitus. Tinnitus severity was measured 4 times per day during the entire treatment and other tinnitus-related variables were assessed 1 week before and 1 month posttreatment. The comparison of the training close to as compared to remote from the tinnitus frequency did not yield a statistically significant difference. However, a post hoc analysis revealed that patients who engaged in regular training as compared to those who practiced irregularly were significantly more successful in reducing tinnitus severity independent of the trained frequencies. Treatment success was best predicted by days of training and general activity levels. The data suggest that auditory discrimination training shows a dose response effect irrespective of training location and that treatment success is also related to psychological variables. For more substantial changes in multiple variables an extended training period with additional consideration of emotional variables would be necessary. In addition, controls for nonspecific training effects need to be implemented.

Neurofeedback for treating tinnitus

“…Expectancy of treatment produced a reduction from 34.5 to 29.5 points on the Tinnitus Questionnaire before the actual start of the training (pre 1 to pre 2), but no further reduction in distress then occurred due to the training. The finding that the FDT had little success in alleviating distress in tinnitus is in agreement with the results of other studies (Flor et al, 2004).…”

“…Treatments of this condition have included cognitive-behavioral therapy (Andersson, 2002), psychotherapy (Goebel, 2001), ''tinnitus retraining therapy'' (Jastreboff and Jastreboff, 2006), biofeedback (Landis and Landis, 1992), physical therapy (Rief et al, 2005), transcranial magnetic stimulation (Langguth et al, 2006), auditory frequency training (Flor et al, 2004), prolonged rest and relaxation (Weber et al, 2002), and the administration of such agents as lidocaine (Kalcioglu et al, 2005). Despite isolated reports of success, no treatment has been found to be effective in general (Dobie, 1999).…”

“…Clinical studies have used frequency discrimination trainings (FDTs) targeted at the region around the tinnitus frequency (Flor et al, 2004), or within the deafferented frequency region (see Fig. 4, p. 494), but without noticeable benefit regarding tinnitus.…”

Auditory frequency discrimination learning is affected by stimulus variability

“…The study of perceptual learning (see Gibson, 1953, 1963, and Goldstone, 1998, for definitions and reviews) may have great applicability; various forms of auditory discrimination training contribute to improving children's language abilities Tallal et al, 1996) and reading skills (Kujala et al, 2001) and to reducing the severity of tinnitus (Flor, Hoffmann, Struve, & Diesch, 2004). However, although the list of training benefits is rapidly expanding, the variables and mechanisms affecting auditory learning are still poorly understood.…”

Revisiting the Cochlear and Central Mechanisms of Tinnitus and Therapeutic Approaches

“…Approaches aimed at reducing the putative overrepresentation of tinnitus frequency (the hypothesised cause of tinnitus) have been developed [Flor et al, 2004;Herraiz et al, 2007;Engineer et al, 2011;De Ridder et al, 2014]. However, as the tinnitus frequency is usually outside and above the frequency range of the hearing loss [Noreña et al, 2002;Sereda et al, 2014], it seems very unlikely that it is overrepresented in the auditory cortex ( fig.…”