Electrical suppression of tinnitus with high-rate pulse trains.
OBJECTIVE
Application of high-rate pulse trains (e.g., 4800 pps) to the cochlea may represent an effective treatment of tinnitus.


BACKGROUND
Tinnitus is a widespread clinical problem with multiple treatments but no cure. A cure for tinnitus would restore the perception of silence. One plausible hypothesis for the origin of tinnitus associated with sensorineural hearing loss is that it is due to loss or alteration of the normal spontaneous activity in the deafferented regions of the cochlea. Electrical stimulation of the cochlea with 5000-pps pulse trains can produce spontaneous-like patterns of spike activity in the auditory nerve.


METHODS
Eleven volunteer human subjects with bothersome tinnitus and high-frequency sensorineural hearing loss underwent myringotomy and temporary placement of a round window electrode. High-rate pulse train stimuli were presented at various stimulus intensities and tinnitus, and stimulus perception were scaled by the subject. Three cochlear implant recipients with tinnitus in the implanted ear underwent similar stimulation.


RESULTS
Five of 11 (45%) of transtympanic subjects showed substantial or complete tinnitus suppression with either no perception or only a transient perception of the stimulus. Three showed tinnitus suppression only in association with the perception of the stimulus. Three showed no effects on tinnitus. A similar pattern of responses was seen in the cochlear implant subjects.


CONCLUSIONS
Although the study lacked an ideal placebo control, the results are promising and support further research to develop a clinically useful intervention for this troubling disorder.
Rubinstein
Jay T
JT
Department of Otolaryngology, University of Iowa, Iowa City, Iowa 52242, USA. jay-rubinstein@uiowa.edu
Tyler
Richard S
RS
Johnson
Abigail
A
Brown
Carolyn J
CJ
D000328:Adult; D001299:Audiometry / Q000295:instrumentation; D001309:Auditory Threshold / Q000502:physiology; D003051:Cochlea / Q000503:physiopathology / Q000601:surgery; D019929:Cochlear Implantation / Q000295:instrumentation; D003056:Cochlear Nerve / Q000503:physiopathology; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D006198:Hair Cells, Auditory / Q000503:physiopathology; D006319:Hearing Loss, Sensorineural / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D011571:Psychoacoustics; D011795:Surveys and Questionnaires; D013997:Time Factors; D014012:Tinnitus / Q000150:complications / Q000503:physiopathology / Q000628:therapy*