Decreased Sound Tolerance and Tinnitus Retraining Therapy (TRT)

Jastreboff, Margaret M.; Jastreboff, Pawel J.

doi:10.1375/audi.24.2.74.31105

Cited by 163 publications

(211 citation statements)

References 18 publications

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“…Indeed, TRT is very effective in treating decreased sound tolerance as well. Specifi c protocols for the treatment and basis for patients categorization can be found elsewhere [7,[20][21][22][23][24][25][26] .…”

Section: Introductionmentioning

confidence: 99%

Tinnitus Retraining Therapy: A Different View on Tinnitus

Jastreboff

2006

ORL

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139

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Tinnitus retraining therapy (TRT) is a method for treating tinnitus and decreased sound tolerance, based on the neurophysiological model of tinnitus. This model postulates involvement of the limbic and autonomic nervous systems in all cases of clinically significant tinnitus and points out the importance of both conscious and subconscious connections, which are governed by principles of conditioned reflexes. The treatments for tinnitus and misophonia are based on the concept of extinction of these reflexes, labeled as habituation. TRT aims at inducing changes in the mechanisms responsible for transferring signal (i.e., tinnitus, or external sound in the case of misophonia) from the auditory system to the limbic and autonomic nervous systems, and through this, remove signal-induced reactions without attempting to directly attenuate the tinnitus source or tinnitus/misophonia-evoked reactions. As such, TRT is effective for any type of tinnitus regardless of its etiology. TRT consists of: (1) counseling based on the neurophysiological model of tinnitus, and (2) sound therapy (with or without instrumentation). The main role of counseling is to reclassify tinnitus into the category of neutral stimuli. The role of sound therapy is to decrease the strength of the tinnitus signal. It is crucial to assess and treat tinnitus, decreased sound tolerance, and hearing loss simultaneously. Results from various groups have shown that TRT can be an effective method of treatment.

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Section: Introductionmentioning

confidence: 99%

Tinnitus Retraining Therapy: A Different View on Tinnitus

Jastreboff

2006

ORL

Self Cite

139

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“…The TRT initial interview is a structured set of questions that are designed specifically to determine proper placement of patients into TRT treatment categories (described in TRT Patient Categories section). In addition to questions about tinnitus, the TRT interview includes questions about decreased sound tolerance (hyperacusis) and about subjective hearing difficulties [6,15]. Hyperacusis is a condition that is observed to occur to some degree for approximately 30 to 40 percent of patients who are evaluated for TRT [4,16,17].…”

Section: Use Of Trt Interview Formsmentioning

confidence: 99%

“…In addition to questions about tinnitus, the TRT interview includes questions about decreased sound tolerance (hyperacusis) and about subjective hearing difficulties [6,15]. Hyperacusis is a condition that is observed to occur to some degree for approximately 30 to 40 percent of patients who are evaluated for TRT [4,16,17]. For some patients, hyperacusis is the primary problem and must be treated accordingly.…”

Section: Use Of Trt Interview Formsmentioning

confidence: 99%

“…For some patients, hyperacusis is the primary problem and must be treated accordingly. Misophonia reflects dislike of sound [6,18] and is present in the majority of patients [17]. Subjective hearing difficulty is a problem that patients often assume to be the result of their tinnitus [6,19].…”

Section: Use Of Trt Interview Formsmentioning

confidence: 99%

“…Hyperacusis is a physiological response to certain sounds; thus, some level of physical discomfort is involved. Misophonia refers to "dislike of sound" that does not include physical discomfort [6,15,38]. If the person dislikes sound but also fears sound, phonophobia is indicated.…”

Section: Question 20mentioning

confidence: 99%

See 2 more Smart Citations

Guide to conducting tinnitus retraining therapy initial and follow-up interviews

Henry¹,

Jastreboff²,

Jastreboff³

et al. 2003

JRRD

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Abstract-Tinnitus Retraining Therapy (TRT) is a structured method of tinnitus treatment that has been performed since 1990. The TRT Initial Interview form was developed to guide clinicians in obtaining essential information from patients that would specify treatment needs. The TRT Follow-up Interview form is similar to the initial interview form and is designed to evaluate outcomes of treatment. The clinician administers these forms verbally. The forms have been used in a highly abbreviated format with the potential for inconsistent interview administration between examiners. This project was to expand the forms to provide specific wording for each question. The expanded forms are presented in this article, and the intent of each question is explained. Standardized administration of these interview forms will facilitate greater uniformity in the initial evaluation and outcomes analyses of patients treated with TRT.

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How everyday sounds can trigger strong emotions: ASMR, misophonia and the feeling of wellbeing

McGeoch

Rouw

2020

BioEssays

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We propose that synesthetic cross-activation between the primary auditory cortex and the anatomically adjacent insula may help explain two puzzling conditionsautonomous sensory meridian response (ASMR) and misophonia-in which quotidian sounds involuntarily trigger strong emotional responses. In ASMR the sounds engender relaxation, while in misophonia they trigger an aversive response. The insula both plays an important role in autonomic nervous system control and integrates multiple interoceptive maps representing the physiological state of the body to substantiate a dynamic representation of emotional wellbeing. We propose that in ASMR crossactivation of the map for affective (sensual) touch leads to an increase in subjective wellbeing and parasympathetic activity. Conversely, in misophonia the effect of the cross-activation is to decrease emotional wellbeing and increase sympathetic activity. Our hypothesis also illuminates the connection between hearing and wellbeing more broadly and helps explain why so many people experience decreased wellbeing from modern urban soundscapes.

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Decreased Sound Tolerance and Tinnitus Retraining Therapy (TRT)

Cited by 163 publications

References 18 publications

Tinnitus Retraining Therapy: A Different View on Tinnitus

Tinnitus Retraining Therapy: A Different View on Tinnitus

Guide to conducting tinnitus retraining therapy initial and follow-up interviews

How everyday sounds can trigger strong emotions: ASMR, misophonia and the feeling of wellbeing

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