Tinnitus retraining therapy

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Tinnitus retraining therapy (TRT) is a form of habituation therapy designed to help people who suffer from tinnitus. TRT uses counselling to explain to the patient how a combination of tinnitus retraining and sound enrichment can end their negative reaction to the tinnitus sound, and then reduce their perception of it. Numerous other methods have been suggested for the treatment of tinnitus, two key components directly follow from the neurophysiological model of tinnitus. One of these principles includes counselling aimed at reclassification of tinnitus to a category of neutral signals, while the other includes sound therapy which is aimed at weakening tinnitus related neuronal activity.[1]

Frequently, noise generators are used in TRT to provide a background noise level.[2]

Another study that was conducted for tinnitus retraining therapy showed that there are actually a number of different therapies that can be used to help to habituate to tinnitus. These techniques include hearing aids that can provide a partial masking effect for the condition and group therapy sessions that can help ease the anxiety associated with tinnitus.[3]

In terms of the most powerful drugs that induce tinnitus, these include cisplatin, quinine, and salicylate (aspirin). An administration of salicylate in high doses will always induce tinnitus.[4]

A basic understanding of the Jastreboff model, the Heller and Bergman experiment, and how sound is perceived in the auditory cortex via the subconscious auditory neuronal networks are helpful starting points for someone wishing to begin working with TRT.[5] Two components that are essential are (1) counselling and (2) sound therapy. Counselling tries to reclassify tinnitus to a category of neutral signals and sound therapy attempts to weaken the tinnitus related neural activity.[6] The use of a portable music player as a control instrument in TRT has produced successful results in recent analysis, offering patients a more cost-efficient treatment.[7]

The psychological basis for TRT stems from the fact that the brain exhibits a high level of plasticity. In turn, this allows it to adjust to any sensory signals as long as they do not lead to negative effects. Using this knowledge the TRT works by interfering with the neural activity causing the tinnitus at its source, in order to prevent it from spreading to other nervous systems such as the limbic and autonomic nervous systems.[8]

What causes tinnitus?[edit]

It has been proposed that tinnitus is caused by mechanisms that generate abnormal neural activity, specifically one mechanism called discordant damage (dysfunction) of outer and inner hair cell.[9]

Not everyone who experiences tinnitus suffers from it. However, some of the problems caused by tinnitus include annoyance, anxiety, panic, and loss of sleep and/or concentration.[9] Despite the fact that there haven't been any recent studies which concluded in its optimal treatment, tinnitus retraining therapy has been regarded as effective in treating Hyperacusis.[10]

Results from a review of Tinnitus Retraining Therapy trials indicate that it may be a more effective treatment than tinnitus masking, however, this review was based on only a single trial, other trials were excluded because they were using a modified version of TRT.[11]

See also[edit]


  1. ^ Jastreboff, P.J. (2007). "Tinnitus retraining therapy". Progress in Brain Research 166: 415–423. doi:10.1016/s0079-6123(07)66040-3. ISSN 0079-6123. Retrieved 23 March 2013. 
  2. ^ tinnitus masker, how to use it? Clinton
  3. ^ Tyler et Al. Tinnitus Retraining Therapy: Mixingpoint and Masking are Equally Effective. Ear and Hearing, Volume 33, NO 5, 588-594
  4. ^ Jastreboff, PJ. (2007) "Tinnitus retraining therapy". Progress in Brain Research. 166:415-423.
  5. ^ Jastreboff PJ. Tinnitus Habituation Therapy (THT) and Tinnitus Retraining Therapy (TRT). Tinnitus Handbook. San Diego: Singular, 2000;357-76
  6. ^ Jastreboff, P.J. (2007). "Tinnitus Retraining Therapy". Progress in Brain Research 166: 415–423. doi:10.1016/s0079-6123(07)66040-3. 
  7. ^ Fukuda S, Miyashita T, Inamoto R, Mori N. (2011) "Tinnitus retraining therapy using portable music players". Auris Nasus Larynx, Volume 38, Issue 6, 692-696.
  8. ^ Jastreboff PJ. 2007. Tinnitus retraining therapy. Progress in brain research. 166: 415-423.
  9. ^ a b http://simplelink.library.utoronto.ca/url.cfm/347752
  10. ^ Jastreboff, P.J. (2007). "Tinnitus Retraining Therapy". Progress in Brain Research 166: 415–423. doi:10.1016/s0079-6123(07)66040-3. 
  11. ^ Phillips, John S; Don McFerran (2010). "Tinnitus Retraining Therapy (TRT) for tinnitus". Cochrane Database of Systematic Reviews (3). doi:10.1002/14651858.CD007330.pub2. 

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