Research labs around the world are exploring new ways to control — and hopefully cure — tinnitus. Below, ATA has itemized some of the more promising prospective treatments for tinnitus. Please note: these treatments are experimental and are generally not available for patients outside of controlled clinical research trials.
Why are these treatments described as “experimental?” Most of the prospective therapies summarized below have yielded some promising preliminary outcomes data. Some have even made big, splashy headlines in the news, advertising sensational benefits. However all of these treatments are decidedly still in development. Simply put, more data is needed to validate the safety and efficacy of these treatments. This is particularly true of procedures that require invasive surgery, which may carry significant health risks that outweigh any potential benefits.
While ATA supports the ongoing development of these promising treatments, we urge patients to first try existing treatment options for tinnitus rather than wait for these options to reach the healthcare market.
Repetitive Transcranial Magnetic Stimulation (rTMS)
Strong electromagnetic stimulation is known to reduce neural activity. Because tinnitus is believed to be a function of hyperactivity in the brain’s neural cortex, many researchers believe that such stimulation can reduce the perception and severity of tinnitus. Repetitive Transcranial Magnetic Stimulation uses a powerful, noninvasive magnetic coil, carefully positioned adjacent to the the patient’s head, to deliver electromagnetic pulses into the underlying brain tissue.
Preliminary research data on rTMS has yielded mixed results, especially when rTMS patients are compared to patients in a placebo test group. To improve the clinical efficacy of rTMS, researchers need to further optimize treatment protocols, such as ideal coil placement, stimulation frequency, stimulation intensity, and the frequency of patient treatments.
Transcranial Direct Current Stimulation (tDCS)
Transcranial Direct Current Stimulation is another form of non-invasive electromagnetic treatment, which researchers hope will minimize the neural hyperactivity underlying tinnitus. Patients wear a series of electrodes on their scalp, which transmit electromagnetic pulses through the skull into the underlying brain tissue. The amount of electrical stimulation varies, depending on the neural excitability beneath each electrode.
Research on tDCS has been promising. Some studies show up to 40% of patients receive some benefit from the treatment. However, more large randomized clinical trials are needed before the full benefit of this procedure is fully validated.
Deep Brain Stimulation (DBS)
Deep Brain Stimulation is already an accepted clinical procedure for patients with Parkinson’s Disease, tremors, and other chronic medical conditions. It is based on the concept of stimulating the brain with electromagnetic energy. However, unlike rTMS and tDCS, DBS is an invasive procedure, involving surgical implantation of electrodes directly into the brain.
Much of the data on DBS’s efficacy come from subjects who primarily received the treatment for another condition (such as Parkinson’s), but who reported a reduction of tinnitus as a peripheral benefit. Before DBS can be considered an appropriate treatment solely for tinnitus, researchers must better identify optimal target areas in the brain for stimulation.
Brain Surface Implants
Some scientists are experimenting with the use of brain surface implants — electrodes surgically positioned on the exterior of the brain. Like other brain stimulation techniques, there is some promising preliminary evidence on brain surface implants, but further research is needed to identify ideal electrode placement on the brain. Moreover, this approach is complicated by the significant risks associated with neural surgery.
Vagus Nerve Stimulation (VNS)
The vagus nerve runs through the neck, connecting the brain to the heart and digestive system. The use of an implanted electrode to apply electrical stimulation on the vagus nerve has already been shown effective in the management of epilepsy, and depression. Some researchers believe that the same practice may assist patients with tinnitus.
Research on the impact of VNS on tinnitus is mixed, with much of the scientific output coming from private companies attempting to develop commercial VNS products. Like other in-body devices, VNS carries risks associated with surgical implantation.
Folmer, R.L., Theodoroff, S.M., Martin, W.H., Shi, Y. (2014) “Experimental, Controversial and Futuristic Treatments for Chronic Tinnitus.” Journal of the American Academy of Audiology, 25:106-125.