Secondary Benefits from Tinnitus Retraining Therapy: Clinically Significant Increases in Loudness Discomfort Level and Expansion of the Auditory Dynamic Range
from Seminars in Hearing
In this report, the authors highlight clinically significant improvements in sound tolerance observed over the past decade among patients who were enrolled in tinnitus retraining therapy (TRT) at the University of Maryland Tinnitus and Hyperacusis Center. Pretreatment and TRT follow-up audiometric threshold, loudness discomfort level (LDL), and dynamic-range (DR) data are documented for (1) a group of 68 tinnitus patients who presented with primary complaints of sound intolerance, and (2) a second group of 70 patients who reported only tinnitus (and no sound tolerance problems). TRT-related increases in sound tolerance are (1) due to increases in LDLs and occur independently of changes in audiometric threshold, which were invariant with treatment; (2) statistically significant in tinnitus patients with and without sound tolerance problems, and with and without hearing loss; (3) observed among 81% of the patients with sound tolerance complaints and 44% of the patients who reported primary tinnitus; (4) independent of audiometric frequency over the range 1000 to 8000 Hz; and (5) seemingly independent of TRT treatment duration, which is consistent with recent experimental evidence of a rapid treatment effect (within the first month of TRT). The TRT treatment effects were clinically meaningful, offering new opportunities for expanding the auditory DR and improving sound tolerance in the general hearing-impaired population. The mechanism responsible for the plasticity underlying these treatment effects is uncertain, but appears consistent with a centrally mediated auditory gain control process. Sound tolerance problems were overpredicted among the authors’ sample of tinnitus-only patients when existing objective audiometric criteria were used. This finding promoted the development of a new predictive model for sound tolerance problems, which is described in a companion report.
No comments yet.
Leave a comment
About the Callier Library
Callier Library is a satellite facility of The University of Texas at Dallas, McDermott Library. It is located at the Dallas, Texas campus of the Callier Center for Communication Disorders. The library supports the graduate-level programs and faculty in communications sciences which are located at the center. It also supports the work of clinicians in hearing and speech disorders who work at both campuses of the Callier Center. One of the missions of Callier Library is to be a useful source of information to the international community of researchers and clinicians in communication disorders. To that end, this web log of citations and news in the field has been built and maintained by Allen Clayton, the Callier Center Librarian.
Note: These news items are gleaned from over 400 sources on the Internet and are provided as a service to our patrons. The University of Texas at Dallas does not guarantee the veracity, reliability or completeness of any information provided on this page, or in any hyperlink appearing on this page
