Let's hear it for tinnitus research

Today, on World Hearing Day, I’d like to encourage everyone to listen with care and to avoid tinnitus – that insidious, invisible disorder.

Commonly referred to as “ringing in the ears”, tinnitus is any sound heard when no external sound is present. Up to 30 percent of the population experience mild tinnitus at some point in their life with possibly five percent experiencing distressing tinnitus.

In New Zealand, more than 13 percent of our population aged 65 and over will experience constant tinnitus. Severe tinnitus can affect concentration, interfere with hearing, disrupt sleep, and increase anxiety and depression.

Tinnitus often occurs following a slight hearing loss when the brain tries to make sense of changed hearing. The brain responds to changes at the ear by reorganising and increasing activity in different brain regions. These include those responsible for hearing, pattern detection, attention and emotion. The areas and patterns of tinnitus-related brain activity differ from person to person, making treatment difficult. These differences between people are one reason no tinnitus cure yet exists.

The good news is that New Zealand is a world leader in tinnitus research. The University of Auckland, AUT University, Canterbury and Otago Universities are all researching tinnitus. Research at the University of Auckland is focusing on personalising therapies, to take into account the large variability in people's experiences, and individual differences in brain activity. In collaboration with AUT University we are developing novel Artificial Intelligence methods that can predict the best treatment for different people. We can already predict those who will or won’t benefit from a treatment, based on recordings of brain activity (electroencephalogram). We believe in the near future these methods will be able to “tune” therapy – in real time – meaning treatments can continually adapt to the person’s progress and tinnitus.

This new AI technology may help the development of new tinnitus drugs that target different processes and a new class of therapy – digital therapy. These use wearable computers or smartphones to train the user to adapt to tinnitus. The therapy weakens brain activity causing the tinnitus. It can include counselling, “sound therapy” to interrupt tinnitus, and brain-training games.

The tinnitus lab at the University of Auckland is completing one of the first large-scale trials of digital therapies for tinnitus. The first results are very promising and one next step is to make the therapy available in audiology clinics. To enhance these digital therapies further, researchers from the Auckland Bioengineering Institute, audiology, and computer science departments are working to develop Augmented Reality treatments. AR adds images or sound to what people experience. The goal of AR in tinnitus therapy is to force the brain to make sense of the strange sound.

Preliminary work in this innovative project has been sponsored by the Eisdell Moore Centre at the University of Auckland, a hearing and balance research group with membership from across the country. Although tinnitus research in New Zealand is strong, it is, along with other areas of hearing research, underfunded. Support from the Hearing Research Foundation to the EMC enables small-scale research funding, but outside of this seed funding there is just one research fund dedicated to tinnitus in New Zealand. Tinnitus researchers must compete with other medical researchers for funding, or seek commercial or philanthropic support. Despite these challenges, tinnitus researchers are strongly committed to understanding tinnitus and finding treatments.

Hearing loss from exposure to loud sound is the most common cause of tinnitus, so safe listening is the best way to prevent tinnitus. In 2021, the WHO launched the World Report on Hearing, which highlighted the increasing number of people living with, and at risk of, hearing loss.

The WHO estimates that a half of people aged 12-35 are listening to music on their devices at volumes that pose a risk to their hearing and 40 percent of those that visit nightclubs, and other venues with loud music, are at risk of hearing loss.

In New Zealand, one in six have hearing loss and 25 percent of all hearing loss cases are caused by noise-induced hearing loss.

The theme of World Hearing Day is safe listening: “To hear for life, listen with care!” I encourage you to take this advice. Learn which sounds are damaging, move away from them, turn them down or wear hearing protection. If you listen safely you will reduce the risk of hearing injury and tinnitus.