Gameplay as a Source of Intrinsic Motivation in a Randomized Controlled Trial of Auditory Training for Tinnitus

Abstract

BackgroundPrevious studies of frequency discrimination training (FDT) for tinnitus used repetitive task-based training programmes relying on extrinsic factors to motivate participation. Studies reported limited improvement in tinnitus symptoms.PurposeTo evaluate FDT exploiting intrinsic motivations by integrating training with computer-gameplay.MethodsSixty participants were randomly assigned to train on either a conventional task-based training, or one of two interactive game-based training platforms over six weeks. Outcomes included assessment of motivation, tinnitus handicap, and performance on tests of attention.ResultsParticipants reported greater intrinsic motivation to train on the interactive game-based platforms, yet compliance of all three groups was similar (∼70%) and changes in self-reported tinnitus severity were not significant. There was no difference between groups in terms of change in tinnitus severity or performance on measures of attention.ConclusionFDT can be integrated within an intrinsically motivating game. Whilst this may improve participant experience, in this instance it did not translate to additional compliance or therapeutic benefit.Trial RegistrationClinicalTrials.gov NCT02095262

Subtyping Somatic Tinnitus: A Cross-Sectional UK Cohort Study of Demographic, Clinical and Audiological Characteristics

“…The meta-analysis used anonymised data that had been collected as part of various research studies led by the National Institute for Health Research (NIHR) Nottingham Hearing Biomedical Research Unit (BRU) conducted between 2009 and 2014. Because of the meta-analytic nature of this study it was not subject to a specific ethical approval, but for the individual research studies themselves written informed consent had been given by all participants and the studies had been approved by the following local National Health Service (NHS) Ethics Committees: Derbyshire [ 26 ]; East Midlands—Nottingham 1 [ 27 , 28 ]; East Midlands—Nottingham 2 [ 29 ], and East Midlands—Derby (Mohamad, personal communication). Sponsorship for all research studies was provided by Nottingham University Hospitals (NHS) Trust.…”

“…All participants were assessed prior to any intervention as part of the eligibility screening or the baseline evaluation and so our dataset included data from people who had been excluded from the research study according to its specific eligibility criteria, as well as those who had been enrolled as a subject. The participants were: 82 participants from a randomised controlled study of auditory training using a computerised listening assessment platform [ 26 ]; 294 participants from a randomised controlled trial of a commercial tinnitus device [ 27 ]; 64 participants from a controlled study of auditory training using a computerised gameplay platform [ 29 ]; 60 participants from a prospective evaluation of hearing aid benefit for tinnitus with brain imaging as one of the secondary outcome measures [ 28 ], and 174 participants from an cross-sectional study evaluating the relationship between tinnitus and cognition (ongoing). This gave us a total of 674 participant records.…”

“…Three participant records were removed because the TSCHQ had not been administered. These were two from the study using a computerised gameplay platform [ 29 ] and one from the hearing aid study [ 28 ].…”

A Scientific Cognitive-Behavioral Model of Tinnitus: Novel Conceptualizations of Tinnitus Distress

“…Results from this study did point to an attentional deficit among tinnitus subjects but one that suggested a difficulty in the executive control of attention (i.e., the ability to focus on task relevant information and inhibit processing of irrelevant information) rather than in the selective attention component. Interestingly, a recent study by Hoare et al ( 89 ) also found no correlation between tinnitus handicap and performance on a visual version of a selective attention task as measured by The Test of Everyday Attention ( 80 ). However, as these studies assessed selective attention in the visual domain, they would not have been sensitive to impairments in the auditory modality.…”

“…There was no significant change in tinnitus handicap, but baseline THI scores were relatively low. Hoare et al ( 89 ) administered a number of frequency discrimination training auditory games designed to interrupt tinnitus, possibly by diverting attention away from the tinnitus sound and toward an externalized sound source. However, the training had no impact on performance on an auditory sustained attention task as measured by The Test of Everyday Attention ( 80 ).…”