A number of attempts are underway to use neural stimulation to modulate tinnitus perception, including sound stimulation paired with somatosensory stimulation. The effectiveness of these treatments has been variable. It is well described in the literature that cochlear implants can often provide some level of tinnitus suppression, when the implant is being utilized. However, the invasiveness of the procedure and risk for further damage to the cochlea, make its application for tinnitus management alone currently implausible.

A recent review in JAMA Otolaryngology-Head & Neck Surgery discusses potential negative unintended consequences of broadband noise (BBN) for tinnitus therapy. Attarha et al (2018) present an argument suggesting that data demonstrating influence of BBN on maladaptive plasticity in the auditory pathway may further impair central function and result in a net increase in neural activity (or loss of inhibition) related to tinnitus perception.

Precisely timed sound stimulation coupled with weak electrical pulses delivered to the neck or cheeks could bring relief from tinnitus. This is the potentially ground-breaking news from researchers at the University of Michigan. Let’s start at the beginning, shall we?

Anxiety/stress are common comorbid factors to chronic tinnitus. Thus, it common to see patients with tinnitus on selective serotonin reuptake inhibitors (SSRIs). SSRIs are believed to increase the extracellular level of the neurotransmitter serotonin by limiting its reuptake into the presynaptic cell, thereby increasing the level of serotonin available to bind to the post-sympatic receptor. SSRIs are commonly used to treat depression, anxiety, panic disorders, obsessive-compulsive disorder, chronic pain, etc.