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The British Tinnitus Association (BTA) is a world leader, with a trained team of friendly and experienced advisers for anyone who experiences tinnitus or those simply seeking guidance or information about the condition. In the past, the major obstacle blocking the way towards a cure was that our understanding of how tinnitus arises had been quite limited. At the UCL Ear Institute, we pursue an integrated approach to tinnitus research that comprises data collection from tinnitus patients, animal experiments to study in detail the mechanisms of tinnitus development, and computer modeling to derive a comprehensive theory of tinnitus development.
Even though the in the UK alone there are more than a million tinnitus sufferers, it is difficult to obtain funding for tinnitus research, and the number of research groups that focus on understanding this condition has therefore remained relatively small. In most cases, tinnitus is associated with hearing loss, and how damage to the inner ear might trigger the development of tinnitus has been studied in great detail.
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Tinnitus has no cure or treatment medications available, but scientists are moving closer to understanding the condition's cognitive roots. Tinnitus is most basically classified as a constant ringing of the ears; however, the condition plays host to a wide range of sounds, all of which may arise for different reasons. Josef Rauschecker, a professor of neuroscience at the Georgetown University Medical Center and tinnitus expert, believes science must move toward understanding why tinnitus doesn’t always lead to hearing loss — only in about 30 percent of patients, he says. In other words, if Rauschecker can conduct a study of SSRI (selective serotonin reuptake inhibitor) antidepressants and successfully show that tinnitus’ volume gets turned down, the link to depression will be nearly cemented. But for others it can become chronic and almost intolerable.There are currently no drugs available to treat or prevent tinnitus.
In the past decade, tinnitus research has made tremendous progress, and we have learned a lot about the mechanisms that are involved in the development of tinnitus.

Moreover, we have learned from animal studies that tinnitus might be linked to increased spontaneous activity of nerve cells in the brain. We believe that all these building blocks are necessary to gain a thorough understanding of tinnitus, as they form a closed loop: the data we collect from humans and animals is used to advance our computer model of tinnitus, and the predictions from the model inspire new experiments. However, a substantial fraction of tinnitus patients has a normal audiogram, and it has been an open question whether tinnitus is caused by the same mechanism in that case, or whether we are dealing with different pathologies that just give rise to the same symptom. Secondly, we want to study the mechanisms of tinnitus development in more detail in animal experiments, and we will specifically tailor the experiments to match the characteristics of our human data. He then returned to Berlin where he did a PhD on Tinnitus and continued working there as a postdoc before starting work at the Ear Institute. Robert De Mong, a tinnitus sufferer for six years, began in the first group but eventually experienced a violent shove into the second. But it wasn’t to a physician, or an ear doctor (called an “otologist”), or even a tinnitus specialist.
But interestingly, the findings don’t automatically paint depression as a result of the tinnitus; the conventional wisdom holds that both are co-dependent on one another. It involves mindfulness and what clinical psychologist Jennifer Gans calls “moving into” one’s tinnitus — embracing it like an icy road that causes you to skid. Without a thorough understanding of these issues, the potential targets for tinnitus treatments were unclear. A recent success of this strategy has been that we could validate a specific prediction of the computer model, when we found physiological evidence for cochlear damage even in tinnitus patients with a normal audiogram.
We could now provide physiological evidence that also tinnitus patients with a normal audiogram have a certain kind of damage to structures of the inner ear, and our computer model predicts that this kind of damage could act as a trigger for tinnitus.

In that way, we can observe directly in the brain how the nerve cell activity changes in a situation that resembles human tinnitus as closely as possible.
This broadened scope has attracted the interest of brain researchers towards tinnitus, and today more research groups than ever before are involved in tinnitus research.
However, a clearer picture of the mechanisms of tinnitus development has been emerging in the last decade, and this could form the basis for new targeted approaches towards tinnitus treatment in the not too distant future. Since the post was established two years ago, we have managed to provide new evidence for a common mechanism for the development of tinnitus with and without apparent hearing loss, providing an important piece to the puzzle of the genesis of tinnitus. Moreover, our data also indicate that plastic changes that might be involved in the generation of tinnitus already take place in the early processing stages of the auditory system.
The picture of the mechanisms that lead to the development of tinnitus has become much clearer.
We have thus come a lot closer to identifying and localising the processes that lead to tinnitus. We hope that this integrated approach, spanning all the levels from basic to clinical research, will significantly speed up the search for a cure for tinnitus.
I thus expect that the puzzle of how tinnitus arises will be solved within the next decade, and that this will lead to true targeted tinnitus treatments. However, several candidate mechanisms have been identified recently, and we have also come closer to understanding where exactly in the auditory system these changes take place.

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