By John M. de Castro, Ph.D.
“Mindful meditation helped me to think (and not think) about tinnitus in ways that had not occurred before, and in doing so made tinnitus much less of a burden to carry. It did not fix my tinnitus but it fixed me in a way that made tinnitus easier to bear. I now feel as if I live in the same universe as everybody else. I wouldn’t be anywhere else.” – Claire Bartlett
Tinnitus is one of the most common symptoms to affect humanity. People with tinnitus live with a phantom noise that can range from a low hiss or ringing to a loud roar or squeal which can be present constantly or intermittently. It can have a significant impact on people’s ability to hear, concentrate, or even participate in everyday activities. Tinnitus is not a disease itself; it is a symptom that something is wrong in the auditory system. The vast majority of people with tinnitus have what is known as subjective tinnitus. This is caused by unknown problems somewhere in the auditory system; the inner, middle, or outer ear, the part of the brain that translates nerve signals as sounds, or the auditory nerves.
Approximately 25 million to 50 million people in the United States experience it to some degree. Tinnitus and hearing loss are the top service-related disabilities among veterans; 60 percent of those who served in Iraq and Afghanistan return home with hearing loss. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives. Tinnitus is sometimes the first sign of hearing loss, occurring in roughly 90 percent of tinnitus cases. There are a number of treatments for tinnitus including, counseling, sound therapy, drugs, and even brain stimulation. Unfortunately, none of these treatments is very effective. Hence there is a need for safe and effective alternative treatments for tinnitus.
In today’s Research News article “Effects of Mindfulness-Based Stress Reduction Therapy On Subjective Bother and Neural Connectivity in Chronic Tinnitus.” See:
or below or view the full text of the study at:
Roland and colleagues investigate Mindfulness Based Stress Reduction (MBSR) training as a treatment for tinnitus. MBSR is an 8-week program that includes meditation, yoga, and body scan techniques. There are once a week 2-hour meetings and daily home practice. They recruited adult tinnitus sufferers, measured symptoms and scanned their brains with Magnetic Resonance Imaging (MRI) for brain structure and functional connectivity. Subsequently they received MBSR training followed by tinnitus measurements and MRI scanning.
They found a clinically significant decrease in both tinnitus symptoms and the degree of handicap produced by tinnitus after MBSR that was maintained at a one month follow up examination. They also found that after MBSR training there was increased functional connectivity with the prefrontal and operculum cortexes which are known to be associated with attention mechanisms, but no change in the default mode network that is associated with mind wandering and self-referential thoughts. These connectivity results make sense as MBSR is targeted at improving attention to the body and the present moment.
These results are very exciting as they suggest that Mindfulness Based Stress Reduction (MBSR) training may be a safe and effective treatment for tinnitus. The symptom improvements were substantial and over 60% of the tinnitus sufferers had clinically significant improvements. They further suggest that MBSR may improve tinnitus symptoms by increasing the effectiveness of brain attentional networks. It is possible that, by improving attention to the present moment, MBSR results in less attention being paid to the tinnitus, reducing its impact.
It should be kept in mind, however, that this was a pilot study without a control group. Hence the conclusions must be tempered with caution until a definitive randomized controlled trial can be conducted. The results are encouraging enough that such a trial is warranted.
Nevertheless, tone down the ringing in the ears with mindfulness.
“participants commented that tinnitus no longer seemed like a dreadful curse; it was just another sensation that could be annoying but was not insurmountable.” – Jennifer Gans
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are available on Google+ https://plus.google.com/106784388191201299496/posts
Roland, L. T., Lenze, E. J., Hardin, F. M., Kallogjeri, D., Nicklaus, J., Wineland, A., … Piccirillo, J. F. (2015). Effects of Mindfulness-Based Stress Reduction Therapy On Subjective Bother And Neural Connectivity In Chronic Tinnitus. Otolaryngology–Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery, 152(5), 919–926. http://doi.org/10.1177/0194599815571556
Objective: To evaluate the impact of an MBSR program in patients with chronic bothersome tinnitus on the 1) severity of symptoms of tinnitus and 2) functional connectivity in neural attention networks.
Open-label interventional pilot study.
Setting: Outpatient academic medical center.
Subjects: A total of 13 adult participants with a median age of 55 years, suffering from bothersome tinnitus.
Methods: An 8-week MBSR program was conducted by a trained MBSR instructor. The primary outcome measure was the difference in patient-reported tinnitus symptoms using the Tinnitus Handicap Index (THI) andTinnitus Functional Index (TFI) between pre-intervention, post-MBSR, and 4-week post-MBSR assessments. Secondary outcomes included change in measurements of depression, anxiety, mindfulness and cognitive abilities. Functional connectivity MRI was performed at pre- and post- MBSR intervention time points to serve as a neuroimaging biomarker of critical cortical networks.
Results: Scores on the THI and TFI showed statistically significant and clinically meaningful improvement over the course of the study with a median ΔTHI of −16 and median ΔTFI of −14.8 between baseline and 4-week follow-up scores. Except for depression, there was no significant change in any of the secondary outcome measures. Analysis of the rs-fcMRI data showed increased connectivity in the post-MBSR group in attention networks but not the default network.
Conclusion: Participation in an MBSR program is associated with decreased severity in tinnitus symptoms and depression, and connectivity changes in neural attention networks. MBSR is a promising treatment option for chronic bothersome tinnitus that is both noninvasive and inexpensive.