Low frequency repetitive Transcranial Magnetic Stimulation (rTMS) of the temporal cortex has been proposed as a new treatment for patients with chronic tinnitus. However, functional abnormalities in tinnitus patients also involve brain structures used for attention and emotional processing, such as the prefrontal cortex. Therefore, researchers at the University of Texas at Dallas have developed a new rTMS treatment strategy for tinnitus patients that consists of a combination of high-frequency prefrontal and low-frequency temporal rTMS. Directly after therapy there was an improvement in the Tinnitus Questionnaire score for both groups but no difference between groups. An evaluation after 3 months revealed a remarkable benefit from the use of combined prefrontal and temporal rTMS treatment. These results support recent data that suggest that auditory and non-auditory brain areas are involved in tinnitus pathophysiology.

Barry Keate

Baby boomers are experiencing in greater numbers the effects of loud rock music listened to over the years. I know this fact first hand. Having played in numerous “garage bands” in my youth and standing face to face with a wall of tie-dyed speakers at “Dead” concerts, I have  bouts of hearing loss and tinnitus that seem  to increase with age.

But the hearing damage being done to the generations of MP3 (think IPod) enthusiasts may prove much worse.

IPod users and the like are pumping music at dangerous decibel levels into the heart of the inner ear canal which over time can do long-term harm and desensitize their ears to further damage.

In Spring of 2007, Apple marked the 100 millionth IPod sold worldwide, making it the fastest-selling music player in history. As of June of 2006  as many as one in five Americans over the age of 12 now own portable MP3 Players and one in 20 own more than one, according to the global  research firm Ipsos. Over half of American teens now own some form of an MP3 player and one third of 18 to 34 year-olds own one.

The dark side to this impressive business growth is the explosion of hearing-related maladies in the younger generation including hearing loss and tinnitus. Many people are listening to their ear buds at volumes high enough to create permanent hearing loss. While snug fitting ear buds provide great sound definition, they increase decibel penetration into the inner ear.

According to a study published last year in the Journal Ear and Hearing reported that on average, the smaller the ear bud, the deeper they fit in your ear canal, the higher their output levels are at any given volume control setting. For example, the white headphones sold with the iPod, will increase sound levels by up to 9 decibels. Although 9 decibels don’t sound like much, that is about the difference between an alarm clock and a lawn mower.

Brent Curtis - Editor

Tryptophan is a natural amino acid that safely increases seratonin levels in the brain. Selective seratonin re-uptake inhibitor medications (SSRI anti-depressants) are prescription drugs that concentrate existing levels of seratonin in the brain so they stay in the synapse between nerve endings. Tryptophan is the only compound that actually increases seratonin levels, however it has been banned by the FDA since 1989 due to an adulterated product from an unscrupulous Japanese manufacturer.

Despite intense lobbying efforts by the pharmaceutical industry, the FDA could no longer justify the ban on tryptophan.  Pharmaceutical-grade tryptophan can now be imported for use in dietary supplements. This means that many people using drugs such as Prozac, Paxil, Lexapro and Celexa will be able to discard these medications and once again treat their seratonin deficiency syndrome with natural tryptophan.

Barry Keate

We were interested to note that British researcher, Dr Lindsay St Claire and the Center for Hearing and Balance Studies at Bristol University have received a research grant for £55,000 or $110,000 to finally determine if caffeine does indeed affect tinnitus.

While we applaud further research into all aspects of tinnitus, we won’t hold our breath as to the outcome. For almost a decade we have written about the three major offenders of tinnitus: caffeine, salt, and alcohol. In fact certain "food" substances such as MSG and the sweetener Aspartame (think Equal and diet sodas) can be deleterious to tinnitus as well.

According to tinnitus authority and inner ear specialist, Michael Seidman, MD FACS, diet plays a major role in in affecting tinnitus levels. The old adage, "Your are what you eat" applies double to those living with tinnitus.

Brent Curtis - Editor

A recent news report discusses the possibility of Viagra and other erectile dysfunction (ED) medications causing sudden hearing loss in a small number of users. The FDA found 29 reports of sudden hearing loss, of which one third was temporary and the remainder was permanent. Most hearing loss involved one ear only.

This is an extremely small number considering the millions of prescriptions issued each year for Viagra, Cialis and Levitra. Nevertheless, the FDA has changed the labels of these drugs to include this new precaution and has issued an updated adverse reactions section.

Anyone using these medications should be aware of the potential for hearing loss. If this occurs, immediately discontinue the medication and contact an Ear, Nose and Throat physician. Many cases of hearing loss can be corrected if treated within a few days.

Barry Keate

Hi Barry,
I am suffering from tinnitus for the last 18 months. Doctors have diagnosed the cause to be small perforations in my left and right eardrums .According to my ENT specialist, most of the eardrum perforations close automatically after 6 months to 12 months. My perforations, however, are not closed.

Do you think tinnitus can really be caused by eardrum perforations ? Also, do you believe that Arches Tinnitus Formulas can help in reducing tinnitus due to eardrum perforations? What would you recommend for tinnitus caused due to eardrum perforations?

Thanks,
Harry
Bedford, TX

Read tinnitus expert Barry Keate’s answer to this and other tinnitus questions >>

A recent article by the Associated Press discussed the huge influx of hearing-related injuries connected to the wars in Iraq and Afghanistan by US military personnel. The most prevalent of these disabling injuries centered on acute hearing loss and tinnitus.

Hearing loss has always been a hazard associated with military service but the these injuries have seen an exponential increase since the war on terror. According to the Department on Veteran Affairs, hearing loss is now the number one disability of US servicemen. 70,000 military personnel are now collecting disability for tinnitus just from these current conflicts.

The marked increase of improvised explosive devices (IED) such as roadside bombs and the frequency of firefights and ambushes are blamed for the increase of hearing injuries. According to military officials these blasts can cause extreme changes in air pressure rupturing ear drums.

While the military provides hearing protection for its war fighters they often go unused, Many soldiers feel that wearing hearing protection on patrol limits their ability hear subtle changes is sound that may indicate an ambush.

Michael Hoffer, MD, an otolaryngologist (ENT) and Navy commander discussed aspects of hearing loss and tinnitus in the military at both the 24th International Tinnitus Forum in Toronto in 2006 and again in Washington, DC at the 25th International Tinnitus Forum.

Dr. Hoffer served in Iraq treating war fighters for a variety of hearing disorders. He concluded that he saw four types of tinnitus due to warfare: noise induced;blast induced (pressure); tinnitus without hearing loss; and post traumatic Meniere’s disease.

The Naval Medical Center San Diego has conducted studies on antioxidants such as such as N-Acetyl Cysteine and Acetyl-L-Carnitine, and their ability to prevent hearing loss and found they can be effective if taken within eight hours of hearing loss damage.

Ben Balough, MD is the Chief of Neurotology at the Naval Medical Center San Diego stated in a talk at the 23rd International Tinnitus Forum that Ginkgo biloba extract showed good indications that it could be a benefit to tinnitus patients but more studies are needed with standardized testing and large numbers of participants.

Brent Curtis - Editor

Oregon Health & Science University (OSHU), Oregon state’s only health and research university has received funding to conduct a study on a medication previously used for the treatment of alcoholism to see if it may be effective in reducing symptoms of tinnitus.

There has been previous evidence that suggests the drug, Acamprosate, used to treat alcoholism may indeed be viable for tinnitus. A small clinical trial in Brazil conducted on 25 tinnitus patients in Brazil showed that 87% had some degree of relief and nearly 48% had a reduction of more than 50%. 1

The study had the shortcoming of having a small number of participants and researchers speculated that those on the active medication were aware of it due to the marked drowsiness associated with the drug. They also say the drowsiness itself may have contributed to improvement as many tinnitus patients have trouble sleeping. The OSHU study plans on having over 150 participants.

Billy Martin, Ph.D., professor of otolaryngology/head and neck surgery, and director of the OHSU Tinnitus Clinic believes that since Acamprosate can restore balance between two competing neurotransmitters in the brain, it may also serve the same role in tinnitus suffers.

Neurotransmitters in the brain conduct information between brain cells. An imbalance of neurotransmitters occurs in alcoholics and scientists speculate that those suffering with ringing in the ears may have the same type of imbalance

Researchers hope to identify, by the close of the study, the common characteristics of people who respond to the medication, for example tinnitus pitch, degree of sleep problems and level of hearing loss.

We spoke with OSHU project coordinator Linda Howarth, who told us the study is now open for participants to apply. Each individual must first answer a series of questions to see if they qualify for participation. 150+ qualified individuals will be accepted to participate. Inquiries should be directed to Linda Howarth at (503) 494-0670.

1. Rev Bras Otorrinolaringol (Engl Ed). 2005 Sep-Oct; 71(5):618-23. Epub 2006 Mar 31. Tinnitus treatment with acamprosate: double-blind study. Azevedo AA, Figueiredo RR.

Brent Curtis - Editor