Research ArticleTINNITUS

Auditory-somatosensory bimodal stimulation desynchronizes brain circuitry to reduce tinnitus in guinea pigs and humans

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Science Translational Medicine  03 Jan 2018:
Vol. 10, Issue 422, eaal3175
DOI: 10.1126/scitranslmed.aal3175

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The sound of silence

Tinnitus reduces quality of life for millions of tinnitus sufferers worldwide. Using a guinea pig model of tinnitus induced by noise trauma, Marks et al. delivered precisely timed bimodal auditory-somatosensory stimulation designed to induce long-term depression (LTD) in the cochlear nucleus of these animals. Twenty minutes per day of bimodal stimulation to induce LTD in the cochlear nucleus reduced physiological and behavioral evidence of tinnitus in the animals. The same bimodal protocol reduced tinnitus loudness in human subjects in a double-blinded, sham-controlled, crossover clinical study. Unimodal stimulation did not reduce tinnitus in the animals or the humans. Bimodal auditory-somatosensory stimulation that induces LTD may hold promise for suppressing chronic tinnitus in patients.

Abstract

The dorsal cochlear nucleus is the first site of multisensory convergence in mammalian auditory pathways. Principal output neurons, the fusiform cells, integrate auditory nerve inputs from the cochlea with somatosensory inputs from the head and neck. In previous work, we developed a guinea pig model of tinnitus induced by noise exposure and showed that the fusiform cells in these animals exhibited increased spontaneous activity and cross-unit synchrony, which are physiological correlates of tinnitus. We delivered repeated bimodal auditory-somatosensory stimulation to the dorsal cochlear nucleus of guinea pigs with tinnitus, choosing a stimulus interval known to induce long-term depression (LTD). Twenty minutes per day of LTD-inducing bimodal (but not unimodal) stimulation reduced physiological and behavioral evidence of tinnitus in the guinea pigs after 25 days. Next, we applied the same bimodal treatment to 20 human subjects with tinnitus using a double-blinded, sham-controlled, crossover study. Twenty-eight days of LTD-inducing bimodal stimulation reduced tinnitus loudness and intrusiveness. Unimodal auditory stimulation did not deliver either benefit. Bimodal auditory-somatosensory stimulation that induces LTD in the dorsal cochlear nucleus may hold promise for suppressing chronic tinnitus, which reduces quality of life for millions of tinnitus sufferers worldwide.

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