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Re: AUDITORY Digest - 13 Sep 2011 to 14 Sep 2011 (#2011-208)



Hi Margaret,

You might take a look at this attempt at using video games to treat tinnitus:

www.ear-machine.com/Tinnitus.html

We don't have any real data yet, but are on the brink of starting a real investigation. 

Best,
Andy Sabin


On Wed, Sep 14, 2011 at 11:41 PM, AUDITORY automatic digest system <LISTSERV@xxxxxxxxxxxxxxx> wrote:
There is 1 message totalling 276 lines in this issue.

Topics of the day:

 1. Treating subjective tinnitus with cortical remapping?

----------------------------------------------------------------------

Date:    Tue, 13 Sep 2011 21:15:09 -0700
From:    Margaret Mortz <mmortz@xxxxxxxxx>
Subject: Treating subjective tinnitus with cortical remapping?

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Recent research indicates some types of subjective tinniutus can be treated
with methods to enhance cortical remapping to compensate for missing inputs
from cochlear damage. The premise is that neurons in the auditory cortex
lose their inhibition when they lose sensory inputs.  A  possible remedy is
to reorganize the neurons to become sensitive to other inputs.   Is anyone
familiar with methods to retrain the brain to compensate for missing inputs=
,
such as auditory discrimination training?  How much of it can be done via
interactions with computer programs?

I was wondering if some type of app for a smartphone would be effective
for cortical remapping training to reduce tinnitus,  under the supervision
of some type of expert? I don't know what kind of expert that would be sinc=
e
it is the interface of hearing and psychology, with computer-aided-therapy.
(However, I doubt other types of tinnitus would be affected by cortical
remapping; e.g., tinnitus caused by cerebrovascular disease. )

Here is some background material to the question about retraining the brain
to reduce tinnitus.

1.
S. Yang, B. D. Weiner, L. S. Zhang, S.-J. Cho, S. Bao. *Homeostatic
plasticity drives tinnitus perception in an animal model*. *Proceedings of
the National Academy of Sciences*, 2011; 108 (36): 14974 DOI:
10.1073/pnas.1107998108 <http://dx.doi.org/10.1073/pnas.1107998108>

As reported in http://www.sciencedaily.com/releases/2011/09/110912144247.ht=
m

"Bao's experiments in rats with induced hearing loss explain why the neuron=
s
in the auditory cortex generate these phantom perceptions. They showed that
neurons that have lost sensory input from the ear become more excitable and
fire spontaneously, primarily because these nerves have "homeostatic"
mechanisms to keep their overall firing rate constant no matter what.

"With the loss of hearing, you have phantom sounds," said Bao, who himself
has tinnitus. In this respect, tinnitus resembles phantom limb pain
experienced by many amputees,

One treatment strategy, then, is to retrain patients so that these brain
cells get new input, which should reduce spontaneous firing. This can be
done by enhancing the response to frequencies near the lost frequencies.
Experiments over the past 30 years, including important research by
Merzenich, have shown that the brain is plastic enough to reorganize in thi=
s
way when it loses sensory input. When a finger is amputated, for example,
the region of the brain receiving input from that finger may start handling
input from neighboring fingers

"

The above research is consistent with:

2.
J. W. Middleton, T. Kiritani, C. Pedersen, J. G. Turner, G. M. G. Shepherd,
T. Tzounopoulos. *Mice with behavioral evidence of tinnitus exhibit dorsal
cochlear nucleus hyperactivity because of decreased GABAergic
inhibition*. *Proceedings
of the National Academy of Sciences*, 2011; DOI:
10.1073/pnas.1100223108<http://dx.doi.org/10.1073/pnas.1100223108>
"

Also,
3.

Carlos Herraiz <http://www.springerlink.com/content/?Author=3DCarlos+Herrai=
z>,
I. Diges <http://www.springerlink.com/content/?Author=3DI.+Diges>, P.
Cobo<http://www.springerlink.com/content/?Author=3DP.+Cobo>,
J. M. Aparicio <http://www.springerlink.com/content/?Author=3DJ.+M.+Aparici=
o>and
A.
Toledano <http://www.springerlink.com/content/?Author=3DA.+Toledano>.
*Auditory discrimination training for tinnitus treatment: the effect of
different paradigms *
European Archives of
Oto-Rhino-Laryngology<http://www.springerlink.com/content/0937-4477/>
Volume 267, Number 7 <http://www.springerlink.com/content/0937-4477/267/7/>=
,
1067-1074, DOI:10.1007/s00405-009-1182-6


4. The physical analog to this type of tinnitus is phantom limb pain, which
can be treated cognitively to a certain extent.

Scholar.google.com  143 citations of
Herta Flor Prof
PhDa<http://www.sciencedirect.com/science/article/pii/S014067360004890X#aff=
1>,
[image: Corresponding Author Contact
Information]<http://www.sciencedirect.com/science/article/pii/S014067360004=
890X#cor1
>,
[image: E-mail The Corresponding Author] <flor@xxxxxxxxxxxxxxxxxxxx>,
Claudia Denke PhDb, Michael Schaefer Dipl-psycha, Sabine Gr=FCsser
PhDb<http://www.sciencedirect.com/science/article/pii/S014067360004890X#aff=
2>

Lancet, Volume 357, Issue
9270<http://www.sciencedirect.com/science?_ob=3DPublicationURL&_hubEid=3D1-=
s2.0-S0140673600X02437&_cid=3D271074&_pubType=3DJL&view=3Dc&_auth=3Dy&_acct=
=3DC000228598&_version=3D1&_urlVersion=3D0&_userid=3D10&md5=3D52dc5bb821f66=
2bd343781058bab229b
>,
2 June 2001, Pages 1763-1764

*"Effect of sensory discrimination training on cortical reorganisation and
phantom limb pain."*


5. Even a mirror technique can help with phantom limb pain.
*http://www.nejm.org/doi/full/10.1056/NEJMc071927*

 6. Review of tinnitus
J Clin Neurol. 2009 March; 5(1): 11=9619.
Published online 2009 March 31. doi:
10.3988/jcn.2009.5.1.11<http://dx.crossref.org/10.3988%2Fjcn.2009.5.1.11>
Copyright <http://www.ncbi.nlm.nih.gov/pmc/about/copyright.html>=A9 2009
Korean Neurological Association
*Tinnitus: Characteristics, Causes, Mechanisms, and Treatments*
Byung In Han, MD,[image: corresponding author]a Ho Won Lee, MD,b Tae You
Kim, MD,c Jun Seong Lim, MD,d and Kyoung Sik Shin, MDe

Margaret Mortz

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<div>Recent research indicates some types of subjective=A0tinniutus can be =
treated with methods to enhance cortical remapping to compensate for missin=
g inputs from cochlear damage.=A0The premise is that neurons in the auditor=
y cortex lose their inhibition when they lose sensory inputs.=A0=A0A =A0pos=
sible remedy is to reorganize the neurons to become sensitive to other inpu=
ts.=A0 =A0Is anyone familiar with methods to retrain the brain to compensat=
e for missing inputs, such as auditory=A0discrimination training?=A0 How mu=
ch of it can be done via interactions with computer programs?</div>
<div><div class=3D"articleTitle svTitle">=A0</div><div class=3D"articleTitl=
e svTitle">I was wondering if some type of app for a smartphone would be ef=
fective for="" remapping training=A0to reduce tinnitus, =A0under th=
e supervision of some type of expert?  I don&#39;t know what kind of expert=
 that would be since it is the interface of hearing and psychology, with co=
mputer-aided-therapy. <div class=3D"articleTitle svTitle">
 </div><div class=3D"articleTitle svTitle">(However, I doubt other types of=
 tinnitus would be affected by cortical remapping; e.g., tinnitus caused by=
 cerebrovascular disease. )</div></div><div class=3D"articleTitle svTitle">
=A0</div><div class=3D"articleTitle svTitle">Here is some background materi=
al to the question about retraining the brain to reduce tinnitus.</div></di=
v><div>=A0</div><div><div>1. </div><div>S. Yang, B. D. Weiner, L. S. Zhang,=
 S.-J. Cho, S. Bao. <strong>Homeostatic plasticity drives tinnitus percepti=
on in an animal model</strong>. <em>Proceedings of the National Academy of =
Sciences</em>, 2011; 108 (36): 14974 DOI: <a href="" href="http://dx.doi.org/10.1= 073/pnas.1107998108" target="_blank">http://dx.doi.org/10.1=
073/pnas.1107998108" rel=3D"nofollow" target=3D"_blank">10.1073/pnas.110799=
8108</a></div>
<div>=A0</div><div>As reported in <a href="" href="http://www.sciencedaily.com/re= leases/2011/09/110912144247.htm" target="_blank">http://www.sciencedaily.com/re=
leases/2011/09/110912144247.htm">http://www.sciencedaily.com/releases/2011/=
09/110912144247.htm
</a></div></div><div><p>&quot;Bao&#39;s experiments in r=
ats with induced hearing loss explain why the neurons in the auditory corte=
x generate these phantom perceptions. They showed that neurons that have lo=
st sensory input from the ear become more excitable and fire spontaneously,=
 primarily because these nerves have &quot;homeostatic&quot; mechanisms to =
keep their overall firing rate constant no matter what.</p>
<p>&quot;With the loss of hearing, you have phantom sounds,&quot; said Bao,=
 who himself has tinnitus. In this respect, tinnitus resembles phantom limb=
 pain experienced by many amputees,</p><p>One treatment strategy, then, is =
to retrain patients so that these brain cells get new input, which should r=
educe spontaneous firing. This can be done by enhancing the response to fre=
quencies near the lost frequencies. Experiments over the past 30 years, inc=
luding important research by Merzenich, have shown that the brain is plasti=
c enough to reorganize in this way when it loses sensory input. When a fing=
er is amputated, for example, the region of the brain receiving input from =
that finger may start handling input from neighboring fingers</p>
</div><div>=A0</div><div>&quot;</div><div>=A0</div><div>The above research =
is consistent with:</div><div>=A0</div><div>2.</div><div>J. W. Middleton, T=
. Kiritani, C. Pedersen, J. G. Turner, G. M. G. Shepherd, T. Tzounopoulos. =
<strong>Mice with behavioral evidence of tinnitus exhibit dorsal cochlear n=
ucleus hyperactivity because of decreased GABAergic inhibition</strong>. <e=
m>Proceedings of the National Academy of Sciences</em>, 2011; DOI: <a href=""> =3D"http://dx.doi.org/10.1073/pnas.1100223108" rel=3D"nofollow" target=3D"_=
blank">10.1073/pnas.1100223108</a>=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0=A0 &=
quot;</div>
<div>=A0</div><div>Also, </div><div>3.</div><p class=3D"authors"><a title=
=3D"View content where Author is Carlos Herraiz" href="" href="http://www.springe" target="_blank">http://www.springe=
rlink.com/content/?Author=3DCarlos+Herraiz">Carlos Herraiz</a>, <a title=3D=
"View content where Author is I. Diges" href="" href="http://www.springerlink.com" target="_blank">http://www.springerlink.com=
/content/?Author=3DI.+Diges">I. Diges</a>, <a title=3D"View content where A=
uthor is P. Cobo" href="" href="http://www.springerlink.com/content/?Author=3DP.+=" target="_blank">http://www.springerlink.com/content/?Author=3DP.+=
Cobo">P.  Cobo</a>, <a title=3D"View content where Author is J. M. Aparicio=
" href="" href="http://www.springerlink.com/content/?Author=3DJ.+M.+Aparicio" target="_blank">http://www.springerlink.com/content/?Author=3DJ.+M.+Aparicio">J. =
M. Aparicio</a> and <a title=3D"View content where Author is A. Toledano" h=
ref=3D"http://www.springerlink.com/content/?Author=3DA.+Toledano">A. Toleda=
no</a>.</p>
<div><strong>Auditory discrimination training for tinnitus treatment: the e=
ffect of different  paradigms </strong></div><div><div class=3D"primary"><a=
 lang=3D"en" title=3D"Link to the Journal of this Article" href="" href="http://w" target="_blank">http://w=
ww.springerlink.com/content/0937-4477/">European Archives of Oto-Rhino-Lary=
ngology</a> </div>
<div class=3D"secondary"><a lang=3D"en" title=3D"Link to the Issue of this =
Article" href="" href="http://www.springerlink.com/content/0937-4477/267/7/" target="_blank">http://www.springerlink.com/content/0937-4477/267/7/">Volu=
me 267, Number 7</a>, <span class=3D"pagination">1067-1074</span><span clas=
s=3D"doi">, <span class=3D"label">DOI:</span><span class=3D"value">10.1007/=
s00405-009-1182-6</span></span></div>
</div><div>=A0</div><div>=A0</div><div>4. The physical analog to this type =
of tinnitus is phantom limb pain, which can be treated cognitively to a cer=
tain extent.</div><div>=A0</div><div><a href="" href="http://Scholar.google.com" target="_blank">http://Scholar.google.com">=
Scholar.google.com</a> =A0143 citations of </div>
<div>Herta Flor Prof PhD<a href="" href="http://www.sciencedirect.com/science/art= icle/pii/S014067360004890X#aff1" target="_blank">http://www.sciencedirect.com/science/art=
icle/pii/S014067360004890X#aff1" name=3D"baff1"><sup><font size=3D"2">a</fo=
nt></sup></a><sup><font size=3D"2">, </font></sup><a href="" href="http://www.sci" target="_blank">http://www.sci=
encedirect.com/science/article/pii/S014067360004890X#cor1" name=3D"bcor1"><=
a style=3D"font-size: smaller; vertical-align: super;" href="" href="http://www.s" target="_blank">http://www.s=
ciencedirect.com/science/article/pii/S014067360004890X#cor1"><font size=3D"=
2"><img style=3D"vertical-align: top;" title=3D"Corresponding Author Contac=
t Information" border=3D"0" alt=3D"Corresponding Author Contact Information=
" src="" href="http://www.sciencedirect.com/scidirimg/entities/REcor.gif" target="_blank">http://www.sciencedirect.com/scidirimg/entities/REcor.gif"></font>=
</a><sup><font size=3D"2">, </font></sup><a href="" href="mailto:flor@xxxxxxxxxxx">flor@xxxxxxxxxxx=
nnheim.de"><sup><font size=3D"2"><img title=3D"E-mail The Corresponding Aut=
hor" border=3D"0" alt=3D"E-mail The Corresponding Author" src="" href="http://www" target="_blank">http://www=
.sciencedirect.com/scidirimg/entities/REemail.gif"></font></sup></a><a name=
=3D"b"></a>, Claudia Denke PhD<a><sup><font size=3D"2">b</font></sup></a>, =
Michael Schaefer Dipl-psych<a><sup><font size=3D"2">a</font></sup></a>, Sab=
ine Gr=FCsser PhD<a href="" href="http://www.sciencedirect.com/science/article/pi= i/S014067360004890X#aff2" target="_blank">http://www.sciencedirect.com/science/article/pi=
i/S014067360004890X#aff2" name=3D"baff2"><sup><font size=3D"2">b</font></su=
p></a></a></div>
<div>=A0</div><div>Lancet, <a href="" href="http://www.sciencedirect.com/science?= _ob=3DPublicationURL&amp;_hubEid=3D1-s2.0-S0140673600X02437&amp;_cid=3D2710= 74&amp;_pubType=3DJL&amp;view=3Dc&amp;_auth=3Dy&amp;_acct=3DC000228598&amp;= _version=3D1&amp;_urlVersion=3D0&amp;_userid=3D10&amp;md5=3D52dc5bb821f662b= d343781058bab229b" target="_blank">http://www.sciencedirect.com/science?=
_ob=3DPublicationURL&amp;_hubEid=3D1-s2.0-S0140673600X02437&amp;_cid=3D2710=
74&amp;_pubType=3DJL&amp;view=3Dc&amp;_auth=3Dy&amp;_acct=3DC000228598&amp;=
_version=3D1&amp;_urlVersion=3D0&amp;_userid=3D10&amp;md5=3D52dc5bb821f662b=
d343781058bab229b">Volume 357, Issue 9270</a>, 2 June 2001, Pages 1763-1764=
=A0 </div>
<div>=A0</div><div><div class=3D"articleTitle svTitle"><strong>&quot;Effect=
 of sensory discrimination training on cortical reorganisation and phantom =
limb pain.&quot;</strong></div><div class=3D"articleTitle svTitle">=A0</div=
><div class=3D"articleTitle svTitle">
=A0</div><div class=3D"articleTitle svTitle">5. Even a mirror technique can=
 help with phantom limb pain.=A0 </div><div class=3D"articleTitle svTitle">=
<strong><a href="" href="http://www.nejm.org/doi/full/10.1056/NEJMc071927" target="_blank">http://www.nejm.org/doi/full/10.1056/NEJMc071927">http:/=
/www.nejm.org/doi/full/10.1056/NEJMc071927</a></strong></div>
<div class=3D"articleTitle svTitle">=A0</div><div class=3D"articleTitle svT=
itle">=A06. Review of tinnitus</div><div class=3D"articleTitle svTitle"><di=
v><div><span class=3D"citation-version"></span><span class=3D"citation-abbr=
eviation">J Clin Neurol. </span><span class=3D"citation-publication-date">2=
009 March; </span><span class=3D"citation-volume">5</span><span class=3D"ci=
tation-issue">(1)</span><span class=3D"citation-flpages">: 11=9619. </span>=
</div>
<div><span class=3D"fm-vol-iss-date">Published online 2009 March 31. </span=
><span class=3D"fm-vol-iss-date"> </span><span class=3D"fm-vol-iss-date">do=
i:  <a class=3D"ref-extlink" href="" href="http://dx.crossref.org/10.3988%2Fjcn.2=" target="_blank">http://dx.crossref.org/10.3988%2Fjcn.2=
009.5.1.11" target=3D"pmc_ext">10.3988/jcn.2009.5.1.11</a></span></div>
<div><span class=3D"fm-vol-iss-date"><div class=3D"fm-copyright"><a class=
=3D"int-reflink" href="" href="http://www.ncbi.nlm.nih.gov/pmc/about/copyright.ht=" target="_blank">http://www.ncbi.nlm.nih.gov/pmc/about/copyright.ht=
ml">Copyright</a>=A9 2009 Korean Neurological Association</div><div class=
=3D"fm-title">
<strong>Tinnitus: Characteristics, Causes, Mechanisms, and Treatments</stro=
ng></div><div class=3D"contrib-group fm-author">Byung In Han, MD,<sup><img =
alt=3D"corresponding author" src="" href="http://www.ncbi.nlm.nih.gov/corehtml/pm= c/pmcgifs/corrauth.gif" target="_blank">http://www.ncbi.nlm.nih.gov/corehtml/pm=
c/pmcgifs/corrauth.gif"></sup><font size=3D"2"><sup>a</sup> Ho Won Lee, MD,=
<sup>b</sup> Tae You Kim, MD,<sup>c</sup> Jun Seong Lim, MD,<sup>d</sup> an=
d  Kyoung Sik Shin, MD<sup>e</sup></font></div>
</span></div><div><span class=3D"fm-vol-iss-date"></span>=A0</div></div></d=
iv><div class=3D"articleTitle svTitle">Margaret Mortz</div></div>

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End of AUDITORY Digest - 13 Sep 2011 to 14 Sep 2011 (#2011-208)
***************************************************************