Binaural sound therapy for tinnitus treatment: A psychometric and neurophysiological evaluation

Investigating the effectiveness of music therapy combined with binaural beats on chronic tinnitus: A randomized controlled trial

BACKGROUND

Binaural beat stimulation (BBS) involve presenting two sinusoidal waves with specific frequency differences to induce neural changes in the brain, often used for mental state induction and symptom reduction. However, there are limited studies on its effectiveness for tinnitus. This study aimed to assess the effectiveness of combining binaural beats with music containing nature sounds for chronic tinnitus.

METHODS

A total of 30 men, aged 45.87 on average (SD = 8.09), who had chronic tinnitus and symmetrical mild to moderate hearing loss, were included in this study. The participants were randomly assigned to two groups: MT group (Music therapy; n = 15), which received relaxing music containing the sound of sea waves, and MT + BBS group (Music therapy plus binaural beats; n = 15), which received the same music combined with alpha frequency (8 Hz) binaural beats. The therapy sessions were conducted twice a day for 15 min, over a period of 4 weeks. Outcome measures, including the Tinnitus Handicap Inventory (THI), Tinnitus Functional Index (TFI), Hospital Anxiety and Depression Scale (HADS), Visual Analog Scale (VAS) and the pitch and loudness of tinnitus were administered before, immediately after, and during the three-month follow-up period.

RESULTS

The findings revealed improvements in loudness and annoyance VAS, as well as THI total and all subscale scores in both groups (p < 0.001). Additionally, TFI total score showed improvement in both groups (MT: p = 0.001; MT + BBS: p < 0.001) except for the sense of control subscale in both groups and the cognitive subscale in the MT group after the treatment and during the three-month follow-up period. Furthermore, both groups exhibited a decrease in scores for both subscales of HADS. However, there were no significant differences between the two groups in any of the measurement outcomes (p > 0.05), except for the emotional subscale scores of TFI (p = 0.049) and the functional subscale scores of THI (p = 0.034). In other words, during the follow-up period, the MT + BBS group exhibited lower scores in these two subscales compared to the MT group.

CONCLUSION

Although our study failed to demonstrate the superiority of combining binaural beats with music, both groups experienced significant improvements. This suggest that there are potential benefits to be gained from these types of stimuli. Given the sustained effect of both methods and the even greater improvements in follow-up observed in the binaural beats group for some scales, it seems that the changes in neural response and brain waves caused by our stimulations are persistent. This necessitates further research involving brain mapping, especially with longer follow-up durations.

Graph-Based Electroencephalography Analysis in Tinnitus Therapy

Tinnitus is the perception of sounds like ringing or buzzing in the ears without any external source, varying in intensity and potentially becoming chronic. This study aims to enhance the understanding and treatment of tinnitus by analyzing a dataset related to tinnitus therapy, focusing on electroencephalography (EEG) signals from patients undergoing treatment. The objectives of the study include applying various preprocessing techniques to ensure data quality, such as noise elimination and standardization of sampling rates, and extracting essential features from EEG signals, including power spectral density and statistical measures. The novelty of this research lies in its innovative approach to representing different channels of EEG signals as new graph network representations without losing any information. This transformation allows for the use of Graph Neural Networks (GNNs), specifically Graph Convolutional Networks (GCNs) combined with Long Short-Term Memory (LSTM) networks, to model intricate relationships and temporal dependencies within the EEG data. This method enables a comprehensive analysis of the complex interactions between EEG channels. The study reports an impressive accuracy rate of 99.41%, demonstrating the potential of this novel approach. By integrating graph representation and deep learning, this research introduces a new methodology for analyzing tinnitus therapy data, aiming to contribute to more effective treatment strategies for tinnitus sufferers.

Comparative analysis of acoustic therapies for tinnitus treatment based on auditory event-related potentials

Introduction

So far, Auditory Event-Related Potential (AERP) features have been used to characterize neural activity of patients with tinnitus. However, these EEG patterns could be used to evaluate tinnitus evolution as well. The aim of the present study is to propose a methodology based on AERPs to evaluate the effectiveness of four acoustic therapies for tinnitus treatment.

Methods

The acoustic therapies were: (1) Tinnitus Retraining Therapy (TRT), (2) Auditory Discrimination Therapy (ADT), (3) Therapy for Enriched Acoustic Environment (TEAE), and (4) Binaural Beats Therapy (BBT). In addition, relaxing music was included as a placebo for both: tinnitus sufferers and healthy individuals. To meet this aim, 103 participants were recruited, 53% were females and 47% were males. All the participants were treated for 8 weeks with one of these five sounds, which were moreover tuned in accordance with the acoustic features of their tinnitus (if applied) and hearing loss. They were electroencephalographically monitored before and after their acoustic therapy, and wherefrom AERPs were estimated. The sound effect of acoustic therapies was evaluated by examining the area under the curve of those AERPs. Two parameters were obtained: (1) amplitude and (2) topographical distribution.

Results

The findings of the investigation showed that after an 8-week treatment, TRT and ADT, respectively achieved significant neurophysiological changes over somatosensory and occipital regions. On one hand, TRT increased the tinnitus perception. On the other hand, ADT redirected the tinnitus attention, what in turn diminished the tinnitus perception. Tinnitus handicapped inventory outcomes verified these neurophysiological findings, revealing that 31% of patients in each group reported that TRT increased tinnitus perception, but ADT diminished it.

Discussion

Tinnitus has been identified as a multifactorial condition highly associated with hearing loss, age, sex, marital status, education, and even, employment. However, no conclusive evidence has been found yet. In this study, a significant (but low) correlation was found between tinnitus intensity and right ear hearing loss, left ear hearing loss, heart rate, area under the curve of AERPs, and acoustic therapy. This study raises the possibility to assign acoustic therapies by neurophysiological response of patient.

Effect of real-time binaural music on sedation with dexmedetomidine during spinal anesthesia: A triple-arm, assessor-blind, randomized controlled trial

STUDY OBJECTIVE

Binaural audio induces sedation and reduces pain and anxiety in surgical patients. This study tested the hypothesis that dexmedetomidine requirement for adequate sedation during spinal anesthesia would be lower in patients listening to music with binaural sound than that in patients listening to plain or no music.

DESIGN

A triple-arm, assessor-blind, randomized controlled study.

SETTING

Operating room.

PATIENTS

One hundred and eighty-nine patients undergoing orthopedic surgery under spinal anesthesia.

INTERVENTIONS

Patients were randomly assigned to music with binaural sound, plain music, or no music groups. Dexmedetomidine was infused for sedation during surgery. The loading infusion rate was 6 μg/kg predicted body weight (PBW)/h, followed by continuous infusion at 0.6 μg/kg PBW/hr. Loading was stopped after achieving adequate sedation, defined as the Observer's Assessment of Alertness/Sedation (OAA/S) scale score of 3. Infusion rate was adjusted every 30 min per the OAA/S scale.

MEASUREMENTS

Primary outcomes were the difference in the dexmedetomidine loading dose adjusted for the patient's PBW between (1) the binaural and plain music groups and (2) the binaural and control groups. Secondary outcomes were the total dose and total loading time of dexmedetomidine; Patient State Index; relative powers of the alpha, theta, and delta bands; recovery from sedation; and patient satisfaction score.

MAIN RESULTS

The final analyses included 184 patients. The PBW-adjusted dexmedetomidine loading dose was significantly lower in patients listening to music with binaural sound (1.15 ± 0.30 μg/kg PBW) than that in patients without music (1.33 ± 0.33 μg/kg PBW; mean difference, 0.18 μg/kg PBW; 95% confidence interval [CI], 0.06 to 0.29; P = 0.002). However, the difference was not statistically significant when compared with the plain music group (1.26 ± 0.36 μg/kg PBW; mean difference, 0.11 μg/kg PBW; 95% CI, -0.01 to 0.23; P = 0.070). Dexmedetomidine total dose, recovery from sedation, and patient satisfaction score showed no difference among the three groups.

CONCLUSIONS

Compared with no music, music with binaural sound reduced the dexmedetomidine loading dose; however, this sedative-sparing effect of binaural sound was not found when compared to plain music.

An Electroencephalography-based Database for studying the Effects of Acoustic Therapies for Tinnitus Treatment

The present database provides demographic (age and sex), clinical (hearing loss and acoustic properties of tinnitus), psychometric (based on Tinnitus Handicapped Inventory and Hospital Anxiety and Depression Scale) and electroencephalographic information of 89 tinnitus sufferers who were semi-randomly treated for eight weeks with one of five acoustic therapies. These were (1) placebo (relaxing music), (2) tinnitus retraining therapy, (3) auditory discrimination therapy, (4) enriched acoustic environment, and (5) binaural beats therapy. Fourteen healthy volunteers who were exposed to relaxing music and followed the same experimental procedure as tinnitus sufferers were additionally included in the study (control group). The database is available at https://doi.org/10.17632/kj443jc4yc.1 . Acoustic therapies were monitored one week after, three weeks after, five weeks after, and eight weeks after the acoustic therapy. This study was previously approved by the local Ethical Committee (CONBIOETICA19CEI00820130520), it was registered as a clinical trial (ISRCTN14553550) in BioMed Central (Springer Nature), the protocol was published in 2016, it attracted L'Oréal-UNESCO Organization as a sponsor, and six journal publications have resulted from the analysis of this database.

Effect of Auditory Discrimination Therapy on Attentional Processes of Tinnitus Patients

Tinnitus is an auditory condition that causes humans to hear a sound anytime, anywhere. Chronic and refractory tinnitus is caused by an over synchronization of neurons. Sound has been applied as an alternative treatment to resynchronize neuronal activity. To date, various acoustic therapies have been proposed to treat tinnitus. However, the effect is not yet well understood. Therefore, the objective of this study is to establish an objective methodology using electroencephalography (EEG) signals to measure changes in attentional processes in patients with tinnitus treated with auditory discrimination therapy (ADT). To this aim, first, event-related (de-) synchronization (ERD/ERS) responses were mapped to extract the levels of synchronization related to the auditory recognition event. Second, the deep representations of the scalograms were extracted using a previously trained Convolutional Neural Network (CNN) architecture (MobileNet v2). Third, the deep spectrum features corresponding to the study datasets were analyzed to investigate performance in terms of attention and memory changes. The results proved strong evidence of the feasibility of ADT to treat tinnitus, which is possibly due to attentional redirection.