Improve Tinnitus by Changing the Brain with Mindfulness

Improve Tinnitus by Changing the Brain with Mindfulness

 

By John M. de Castro, Ph.D.

 

The mindfulness approach is radically different from what most tinnitus sufferers have tried before, and it may not be right for everyone. We are confident, however, that the growing research base has demonstrated how it can offer an exciting new treatment to people who may have found that traditional treatment has not been able to help them yet.” – Liz Marks

 

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. Approximately 25 million to 50 million people in the United States experience it to some degree. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives.

 

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. Mindfulness practices have been shown to be effective in treating Tinnitus. The nervous system is a dynamic entity, constantly changing and adapting to the environment. It will change size, activity, and connectivity in response to experience. These changes in the brain are called neuroplasticity. It is unknown how mindfulness practices may change the brain to improve tinnitus.

 

In today’s Research News article “Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/), Zimmerman and colleagues recruited adult participants in an 8-week Mindfulness-Based Cognitive Therapy (MBCT) program consisting of 2-hour weekly sessions and 40-60 minutes daily home practice. The MBCT program consists of mindfulness training and Cognitive Behavioral Therapy (CBT). During therapy the patient is trained to investigate and alter aberrant thought patterns underlying their reactions to tinnitus symptoms. The participants brains were scanned before and after the MBCT program, and at follow-up 8 weeks later with functional Magnetic resonance Imaging (fMRI) and were measured for tinnitus, anxiety, depression, and mindfulness.

 

They found that the MBCT program produced a significant reduction in tinnitus symptoms that were maintained at the 8-week follow-up. With the fMRI scans they found widespread changes in brain functional connectivity following the MBCT program. Significantly, they found a reduced connectivity between the amygdala and parietal cortex that was negatively correlated with the reduction in tinnitus symptoms. In other words, the greater the decrease in functional connectivity, the greater the reductions in tinnitus symptoms. It will require further research to determine how this connectivity change might be related to tinnitus symptoms.

 

The study demonstrated that the Mindfulness-Based Cognitive Therapy (MBCT) program reduces the symptoms of tinnitus in a lasting way. The brain scan results suggest that alterations of the functional connectivity of brain areas may underlie the symptom improvements. It will require considerably more research to determine the exact nature of the changes and their relationship to tinnitus. But the study is a good first start.

 

So, improve tinnitus by changing the brain with mindfulness.

 

“Mindfulness is a special kind of awareness: it . . . frees you to be more present in your immediate experience, so that you can wake up to the wonder of the one life you are given. Others have found that cultivating this practice has helped reduce the negative impact of tinnitus on their lives. The more open you can be to whatever you are experiencing at any moment, the more awake, alive, happy, and balanced you can be.” – Jennifer Gans

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Zimmerman, B., Finnegan, M., Paul, S., Schmidt, S., Tai, Y., Roth, K., … Husain, F. T. (2019). Functional Brain Changes During Mindfulness-Based Cognitive Therapy Associated With Tinnitus Severity. Frontiers in Neuroscience, 13, 747. doi:10.3389/fnins.2019.00747

 

Abstract

Mindfulness-based therapies have been introduced as a treatment option to reduce the psychological severity of tinnitus, a currently incurable chronic condition. This pilot study of twelve subjects with chronic tinnitus investigates the relationship between measures of both task-based and resting state functional magnetic resonance imaging (fMRI) and measures of tinnitus severity, assessed with the Tinnitus Functional Index (TFI). MRI was measured at three time points: before, after, and at follow-up of an 8-week long mindfulness-based cognitive therapy intervention. During the task-based fMRI with affective sounds, no significant changes were observed between sessions, nor was the activation to emotionally salient compared to neutral stimuli significantly predictive of TFI. Significant results were found using resting state fMRI. There were significant decreases in functional connectivity among the default mode network, cingulo-opercular network, and amygdala across the intervention, but no differences were seen in connectivity with seeds in the dorsal attention network (DAN) or fronto-parietal network and the rest of the brain. Further, only resting state connectivity between the brain and the amygdala, DAN, and fronto-parietal network significantly predicted TFI. These results point to a mostly differentiated landscape of functional brain measures related to tinnitus severity on one hand and mindfulness-based therapy on the other. However, overlapping results of decreased amygdala connectivity with parietal areas and the negative correlation between amygdala-parietal connectivity and TFI is suggestive of a brain imaging marker of successful treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667657/

 

Relieve Tinnitus with Yoga

Relieve Tinnitus with Yoga

 

By John M. de Castro, Ph.D.

 

“With this new research we now know that regular yoga practice can reduce these symptoms and tinnitus without medication.” – Barry Keate

 

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. 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. Approximately 16 million people seek medical attention for their tinnitus, and for up to two million patients, debilitating tinnitus interferes with their daily lives. 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. Mindfulness practices have been shown to be effective in treating Tinnitus. Hence there is a need to further explore the various forms of mindfulness practices as alternative treatments for tinnitus.

 

In today’s Research News article “The Effects of Yoga in Patients Suffering from Subjective Tinnitus.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786150/ ), Köksoy and colleagues recruited tinnitus patients and provided them with yoga instruction for an hour once a week for 12 weeks. The practice consisted of postures, breathing exercises, meditation, and relaxation. The participants were instructed to practice as often as possible at home. They were measured before and after yoga practice for tinnitus severity, the everyday and emotional handicap produced by tinnitus, and stress symptoms produced by tinnitus.

 

They found that after the yoga practice there was a large, 58%, and significant reduction in tinnitus severity, a 44% reduction in the handicap produced by tinnitus, and a 21% reduction in the stress produced by tinnitus, including the psychological, physical, and pain facets of tinnitus produced stress. Hence the yoga practice was very effective in improving the symptoms of tinnitus.

 

It should be noted that there wasn’t a comparison (control) condition present in the study. So, the results should be viewed as preliminary and a proof of concept. In addition, 1//3 of the original patient sample dropped out during the study. Nevertheless, the results provide a clear rationale for the performance of a large randomized controlled clinical trial of yoga for tinnitus. Tinnitus is such a widespread problem with few treatment options that a non-invasive and non-drug treatment that is safe and effective, would be a great step forward in relieving the suffering produced by this mysterious disease.

 

So, relieve tinnitus with yoga.

 

Tinnitus sufferers will definitely be able to benefit from this type of yoga because of how relaxing it is and also beneficial in terms of overall health. When people who have tinnitus are more relaxed and less tense, they have a tendency to not perceive the ringing or buzzing sounds which they usually hear as much. Although this may not be a definitive cure for tinnitus, it is a rather good treatment option to explore.” – Ramdev Yoga

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sümbüle Köksoy, Can Mehmet Eti, Meltem Karataş, Yusuf Vayisoglu. The Effects of Yoga in Patients Suffering from Subjective Tinnitus. Int Arch Otorhinolaryngol. 2018 Jan; 22(1): 9–13. Published online 2017 Apr 3. doi: 10.1055/s-0037-1601415

 

Abstract

Introduction  Tinnitus is a perception of sound in the absence of an external source and it is a distressing issue. Yoga is a system of mind-body practices with the goal of uniting the body, mind and soul. It has been shown to reduce anxiety and stress, as well as improving the quality of life.

Objective  The aim of this study is to investigate the effects of yoga in patients suffering from chronic subjective tinnitus.

Methods  Twelve subjects previously diagnosed with chronic subjective tinnitus were selected for the study. The patients were asked to attend to yoga classes once a week and to practice yoga at home using a worksheet for 3 months. Each yoga class consisted of body exercises (asana), breathing (pranayama) and meditation (shavasana and yoga nidra). Tinnitus scores before and after the yoga classes were compared using the Wilcoxon test.

Results  Among the 12 patients, there were 4 men and 8 women and their mean age was 52.5 years. The median duration of tinnitus among the group was 5.4 years. There were statistically significant differences in the stress ( p  = 0.01), handicap ( p  = 0.004) and severity ( p  = 0.007) questionnaires scores.

Conclusion  This study indicated that yoga practices may reduce life stress and symptoms of subjective tinnitus.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786150/

Tone Down the Ringing in the Ears with Mindfulness

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:

https://www.facebook.com/ContemplativeStudiesCenter/photos/a.628903887133541.1073741828.627681673922429/1250875274936396/?type=3&theater

or below or view the full text of the study at:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650869/

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

 

Study Summary

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

 

Abstract

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.

Study Design

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.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4650869/