Enhancing Inhibition-Induced Plasticity in Tinnitus – Spectral Energy Contrasts in Tailor-Made Notched Music Matter

Stein, Alwina; Engell, Alva; Lau, Pia; Wunderlich, Robert; Junghöfer, Markus; Wollbrink, Andreas; Bruchmann, Maximilian; Rudack, Claudia; Pantev, Christo

doi:10.1371/journal.pone.0126494

Cited by 19 publications

(26 citation statements)

References 66 publications

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“…However, effects of TMNMT have already been demonstrated after 3 days of training using a notch width of half an octave [ 19 – 21 ]. A further methodological modification of TMNMT was suggested by Stein et al [ 20 , 22 ], who investigated the role of the notch edges. By increasing spectral energy contrasts of the notch edges relative to the frequency region outside of the notch, the authors succeeded in further boosting the effect of lateral inhibition.…”

Section: Introductionmentioning

confidence: 99%

Clinical trial on tonal tinnitus with tailor-made notched music training

et al. 2016

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BackgroundTinnitus is a result of hyper-activity/hyper-synchrony of auditory neurons coding the tinnitus frequency, which has developed due to synchronous mass activity owing to the lack of inhibition. We assume that removal of exactly these frequencies from a complex auditory stimulus will cause the brain to reorganize around tonotopic regions coding the tinnitus frequency through inhibition-induced plasticity. Based on this assumption, a novel treatment for tonal tinnitus - tailor-made notched music training (TMNMT) - has been introduced and was tested in this clinical trial.MethodsA randomized controlled trial in parallel group design was performed in a double-blinded manner. We included 100 participants with chronic, tonal tinnitus who listened to tailor-made notched music for two hours a day for three consecutive months. Our primary outcome measures were the Tinnitus Handicap Questionnaire and Visual Analog Scales measuring perceived tinnitus loudness, awareness, distress and handicap. Participants rated their tinnitus before and after the training as well as one month after cessation of the training.ResultsWhile no effect was found for the primary outcome measures, tinnitus distress, as measured by the Tinnitus Questionnaire, a secondary outcome measure, developed differently in the two groups. The treatment group showed higher distress scores while the placebo group revealed lower distress scores after the training. However, this effect did not reach significance in post-hoc analysis and disappeared at follow-up measurements. At follow-up, tinnitus loudness in the treatment group was significantly reduced as compared to the control group. Post hoc analysis, accounting for low reliability scores in the Visual Analog Scales, showed a significant reduction of the overall Visual Analog Scale mean score in the treatment group even at the post measurement.ConclusionThis is the first study on TMNMT that was planned and conducted following the CONSORT statement standards for clinical trials. The current work is one more step towards a final evaluation of TMNMT. Already after three months the effect of training with tailor-made notched music is observable in the most direct rating of tinnitus perception – the tinnitus loudness, while more global measures of tinnitus distress do not show relevant changes.Trial registrationCurrent Controlled Trials ISRCTN04840953; Trial registration date: 17.07.2013

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Section: Introductionmentioning

confidence: 99%

Clinical trial on tonal tinnitus with tailor-made notched music training

et al. 2016

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“…However, in a study focusing on inhibition-induced plasticity due to the induction of LI in the auditory cortex of tinnitus patients, where a distributed source model was applied, an inhibition-induced plasticity was found in a post N1m time interval comparable to the study at hand (150 to 250 ms cf. [ 28 ]). Hence, it could be hypothesized, that the distributed source model might be better suited to investigate the effect of LI in both N1m and later time windows when significant activity variance occurs simultaneously at other cortical regions.…”

Section: Discussionmentioning

confidence: 99%

“…Considering the mechanism of LI, a gain increase together with a sharper tuning of auditory neurons could in fact enhance the amount of inhibition which is spread to the neurons coding the center frequency of the notch, leading to a larger reduction of neural activity due to LI under focused attention. First hints towards such a mechanism have recently been shown by Pape and coworkers [ 27 ], who examined the prolonged influences of LI due to notch-filtered music, namely “inhibition-induced plasticity” [ 28 ]. They demonstrated that in tinnitus patients inhibition-induced plasticity only emerged under focused attention on the music and it was not observable in a condition were subjects actively produced the notch-filtered music.…”

Section: Introductionmentioning

confidence: 99%

Modulatory Effects of Attention on Lateral Inhibition in the Human Auditory Cortex

et al. 2016

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Reduced neural processing of a tone is observed when it is presented after a sound whose spectral range closely frames the frequency of the tone. This observation might be explained by the mechanism of lateral inhibition (LI) due to inhibitory interneurons in the auditory system. So far, several characteristics of bottom up influences on LI have been identified, while the influence of top-down processes such as directed attention on LI has not been investigated. Hence, the study at hand aims at investigating the modulatory effects of focused attention on LI in the human auditory cortex. In the magnetoencephalograph, we present two types of masking sounds (white noise vs. withe noise passing through a notch filter centered at a specific frequency), followed by a test tone with a frequency corresponding to the center-frequency of the notch filter. Simultaneously, subjects were presented with visual input on a screen. To modulate the focus of attention, subjects were instructed to concentrate either on the auditory input or the visual stimuli. More specific, on one half of the trials, subjects were instructed to detect small deviations in loudness in the masking sounds while on the other half of the trials subjects were asked to detect target stimuli on the screen. The results revealed a reduction in neural activation due to LI, which was larger during auditory compared to visual focused attention. Attentional modulations of LI were observed in two post-N1m time intervals. These findings underline the robustness of reduced neural activation due to LI in the auditory cortex and point towards the important role of attention on the modulation of this mechanism in more evaluative processing stages.

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“…Bei beiden Gruppen nahm die Tinnituslautheit ab. In der Magnetenzephalografie erschien die entsprechende neuronale Aktivität bei beiden Gruppen reduziert, bei der ISECGruppeseiendieinhibitorischenEffektenochausgeprägter gewesen [158]. Bereits Ende der 80er Jahre versuchte die sog.…”

Section: Tailor-made-notched-music (Tmnm)unclassified

Evidenz- und Evidenzlücken der Tinnitustherapie

Hesse¹

2016

Laryngo-Rhino-Otol

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A broad variety of therapeutic regimen is proposed, introduced and sold against tinnitus, but most of these approaches lack scientific validation and evidence. Up to date a causal, tinnitus eliminating therapy is not available. Most probably this will not be possible at all, as the mechanism of tinnitus generation are multiple and include peripheral as well as central or cortical reactions. Like in fashion and design however, therapeutic medical interventions against tinnitus come in waves again and again over the last decades, without being able to prove lasting and scientifically evident effects.This review presents, discusses and assesses almost all available therapies regarding their evidence. Evidence should include besides external evidence through publications and available data also internal evidence, e.g. including experience of the therapist and needs of the patients.Almost all interventions that try to influence the inner ear or the auditory cortex either pharmaceutically or by direct stimulation or modulation do not reach evidence. However, there are procedures that have proven to be effective and show at least certain degrees of evidence with proven strength of effect. These are habituation therapies and psychotherapeutic interventions like cognitive behavioural therapy, especially when they are combined with concrete measures to improve auditory perception like hearing-aids, cochlear implants or hearing-therapy.

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Enhancing Inhibition-Induced Plasticity in Tinnitus – Spectral Energy Contrasts in Tailor-Made Notched Music Matter

Cited by 19 publications

References 66 publications

Clinical trial on tonal tinnitus with tailor-made notched music training

Clinical trial on tonal tinnitus with tailor-made notched music training

Modulatory Effects of Attention on Lateral Inhibition in the Human Auditory Cortex

Evidenz- und Evidenzlücken der Tinnitustherapie

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