Diagram by S Blatrix, from "Journey into the World of Hearing*", www.cochlea.eu/en by R
Pujol et al., NeurOreille, Montpellier
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
BEHAVIOUR
Schema analysis – categorisation
Higher cortices
Cross-modal analysis
Multi -modal Cortex
Abstraction
Auditory cortex
Feature Analysis
Ascending pathways to PAC
Encoding
Cochlea
SOUND
Diagram by S Blatrix, from
"Journey into the World of
Hearing*",
www.cochlea.eu/en by R Pujol
et al., NeurOreille, Montpellier
Modified from: Griffiths TD and W. JD. (2004).
"What is an auditory object?" Nat Rev
Neurosci. 5(11): 887-92.
BEHAVIOUR
Schema analysis – categorisation
Higher cortices
Cross-modal analysis
Multi -modal Cortex
Abstraction
Auditory cortex
Feature Analysis
Ascending pathways to PAC
Encoding
Cochlea
SOUND
Diagram by S Blatrix, from
"Journey into the World of
Hearing*",
www.cochlea.eu/en by R Pujol
et al., NeurOreille, Montpellier
Modified from: Griffiths TD and W. JD. (2004).
"What is an auditory object?" Nat Rev
Neurosci. 5(11): 887-92.
Implications for treatment
• Can we change these brain patterns and how
the brain interprets tinnitus?
Auditory Scene Analysis
Tinnitus Scene Analysis
The individual
A
• Personality
• Memories
• Thoughts
• Emotions
FOCUS
Tinnitus
Sound
The individual
A
• Personality
• Memories
• Thoughts
• Emotions
FOCUS
Tinnitus
Sound
The individual
B
• Personality
• Memories
• Thoughts
• Emotions
Tinnitus
FOCUS
Sound
Disrupting patterns reducing
annoyance
10
9
8
7
6
5
4
3
2
1
0
Intensity
Before
Annoyance
After 3 months
Life effects
After 6 months
Rating scale
Del Bo L, Berto V, Carrabba L, Costantini M, Forti S, Kaur M , Kobayashi, K, Paglialonga A,
Searchfield GD, Wise K, Dyrlund, O
30 participants
“I hear tinnitus in my head”
Where?
Spatial masking
Identify the localisation of the tinnitus and deliver the
masking noise to cover the Tinnitus at the same virtual
location.
1.Localise Tinnitus
2.Mask tinnitus @ Tinnitus location
Y
Z
C
T
X
14%
3D
No preference
57%
29%
Change handicap
p = 0.006
Change MML
P = 0.08
Center
Train the brain
• Attention
• Multi-sensory integration
“Terrain” (PC Game)
Tetris
Terrain
Terrain (blue, auditory) and Tetris (red, visual)
35
TFI
30
25
20
15
10
5
0
3 weeks pre
Pre-training
Post-training
3 weeks post
7
7
6
6
5
TSNS
Annoying
4
5
TSNS
Ignore
4
Terrain
Terrain
3
Tetris
3
2
2
1
1
Tetris
0
0
3 weeks pre
Pre-training
Post-training
3 weeks pre
3 weeks post
7
7
6
6
5
Pre-training
Post-training
3 weeks post
5
TSNS
Uncomfortable4
4
TSNS
Unpleasant
Terrain
3
Tetris
Terrain
3
2
2
1
1
0
Tetris
0
3 weeks pre
Pre-training
Post-training
3 weeks post
3 weeks pre
Pre-training
Post-training
3 weeks post
Attention
Shift Discrim
AVMT - Visual
AVMT - Aud
AVMT - Mixed
0.4
0.2
Change in reaction time (sec)
0
-0.2
Terrian
-0.4
-0.6
-0.8
-1
-1.2
Tetris
Multisensory treatment for tinnitus
• Integration approach – stimuli are paired
with tinnitus
Tinnitus
Audio
Tactile
Visual
Multisensory treatment for tinnitus
• Attention diversion approach – stimuli are
un-paired with tinnitus
Tinnitus
Audio
Tactile
Visual
tDCS
0.6
Sham tDCS
tDCS
Loudness change
Change in loudness
0.4
0.2
0
-0.2
-0.4
-0.6
1
4.2
2
3
Session
4
5
3
Session
4
5
Mean CGI
Mean CGI
4
3.8
3.6
3.4
3.2
3
1
2
Syed Salman Shahid et al 2014 J.
Neural Eng. 11 036002
doi:10.1088/17412560/11/3/036002
© IOP Publishing. Reproduced by
permission of IOP Publishing. All
rights reserved
Treatment approaches
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
CBT
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
CBT
Hearing aids/sound
therapies
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
CBT
Perceptual training
Hearing aids/sound
therapies
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
CBT
Perceptual training
Noninvasive
brain
stimulation
Hearing aids/sound
therapies
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
CBT
Drugs
Perceptual training
Noninvasive
brain
stimulation
Hearing aids/sound
therapies
Diagram by S Blatrix, from "Journey into the World of Hearing*",
www.cochlea.eu/en by R Pujol et al., NeurOreille, Montpellier
Why no cure yet?
•
•
•
•
Complexity
“Moving target”
Researcher interest
Funding
Figure Christopher R
Cederroth, Barbara Canlon &
Berthold Langguth
Nature Biotechnology 31, 972–
974 (2013) doi:10.1038/nbt.2736
Acknowledgements
J M Cathie Trust/AMRF, TRI, DRF
NZ, Neurological Foundation
Research Partcipants
Tinnitus Research Group
Students at The University of
Auckland