Millions of Americans suffer from tinnitus. However, there is no widely accepted treatment that has been shown to be effective in controlled investigations. The purpose of this study is to evaluate the effectiveness of Tinnitus Retraining Therapy (TRT) using two controls. TRT, while actively promoted, has not been tested in a controlled investigation. It is based theoretically on a neurophysiological habituation model, where the brain learns to ignore continuous stimuli that are insignificant. TRT involves two main parts: counseling and the use of noise generators set slightly below the perceived loudness of the tinnitus, the """"""""mixing point"""""""". In order for habituation to occur, the tinnitus must be perceived above the noise. This study will investigate the contributions of counseling, the use of devices, and the importance of setting the noise to the mixing point. The proposed study would include six different groups with 30 subjects per group. Subjects with hearing aids will be randomized to Counseling, Masking and Retraining groups. Subjects without hearing aids will be randomized to three different Counseling, Masking and Retraining groups. All groups will receive the same Counseling. In pilot studies we have developed a picture-based counseling protocol. The Retraining group will use binaural noise generators set to the mixing point. The Masking group will use the binaural noise generators set to mask the tinnitus. Each patient will be tested on three standardized tinnitus handicap scales before the treatment and 18 months after the commencement of treatment. The results of this study will determine if TRT is more effective than masking or counseling. This research will have direct and immediate clinical relevance for professionals and patients. Both are eager to seek out new treatments that promise success. If TRT is more effective than masking or counseling alone, then more professionals will want to use this procedure, and more patients will seek it. If TRT is shown to be no more effective than masking or counseling, professionals should focus on more efficient therapeutic techniques. This experiment will test the neurophysiological model of tinnitus. ? ?

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Research Project (R01)
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Integrative, Functional and Cognitive Neuroscience 8 (IFCN)
Program Officer
Hughes, Gordon B
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University of Iowa
Schools of Medicine
Iowa City
United States
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Pan, Tao; Tyler, Richard S; Ji, Haihong et al. (2015) Differences Among Patients That Make Their Tinnitus Worse or Better. Am J Audiol 24:469-76
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Tyler, Richard S; Noble, William; Coelho, Claudia Barros et al. (2012) Tinnitus retraining therapy: mixing point and total masking are equally effective. Ear Hear 33:588-94
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Tyler, Richard; Coelho, Claudia; Tao, Pan et al. (2008) Identifying tinnitus subgroups with cluster analysis. Am J Audiol 17:S176-84
Coelho, Claudia Barros; Tyler, Richard; Hansen, Marlan (2007) Zinc as a possible treatment for tinnitus. Prog Brain Res 166:279-85
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Tyler, Richard S; Oleson, Jacob; Noble, William et al. (2007) Clinical trials for tinnitus: study populations, designs, measurement variables, and data analysis. Prog Brain Res 166:499-509
Tyler, Richard S; Coelho, Claudia; Noble, William (2006) Tinnitus: standard of care, personality differences, genetic factors. ORL J Otorhinolaryngol Relat Spec 68:14-19; discussion 20-2

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