News | Magnetic Resonance Imaging (MRI) | January 11, 2018

Neurofeedback Shows Promise in Treating Tinnitus

Research using fMRI shows that neurofeedback training can reduce the severity of tinnitus

Neurofeedback Shows Promise in Treating Tinnitus

The standard approach to fMRI neurofeedback. Image courtesy of Matthew Sherwood, Ph.D.

January 11, 2018 — Researchers using functional magnetic resonance imaging (fMRI) have found that neurofeedback training has the potential to reduce the severity of tinnitus or even eliminate it, according to a study presented at the annual meeting of the Radiological Society of North America (RSNA), Nov. 26-Dec. 1 in Chicago.

Tinnitus is the perception of noise, often ringing, in the ear. The condition is very common, affecting approximately one in five people. As sufferers start to focus on it more, they become more frustrated and anxious, which in turn makes the noise seem worse. The primary auditory cortex, the part of the brain where auditory input is processed, has been implicated in tinnitus-related distress.

For the study, researchers looked at a novel potential way to treat tinnitus by having people use neurofeedback training to turn their focus away from the sounds in their ears. Neurofeedback is a way of training the brain by allowing an individual to view some type of external indicator of brain activity and attempt to exert control over it.

"The idea is that in people with tinnitus there is an over-attention drawn to the auditory cortex, making it more active than in a healthy person," said Matthew S. Sherwood, Ph.D., research engineer and adjunct faculty in the Department of Biomedical, Industrial and Human Factors Engineering at Wright State University in Fairborn, Ohio. "Our hope is that tinnitus sufferers could use neurofeedback to divert attention away from their tinnitus and possibly make it go away."

To determine the potential efficacy of this approach, the researchers had 18 healthy volunteers with normal hearing undergo five fMRI-neurofeedback training sessions. Study participants were given earplugs through which white noise could be introduced for periods of time. The earplugs also served to block out the scanner noise.

To obtain fMRI results, the researchers used single-shot echoplanar imaging, an MRI technique that is sensitive to blood oxygen levels, providing an indirect measure of brain activity.

"We started with alternating periods of sound and no sound in order to create a map of the brain and find areas that produced the highest activity during the sound phase," Sherwood said. "Then we selected the voxels that were heavily activated when sound was being played."

The participants then participated in the fMRI-neurofeedback training phase while inside the MRI scanner. They received white noise through their earplugs and were able to view the activity in their primary auditory cortex as a bar on a screen. Each fMRI-neurofeedback training run contained eight blocks separated into a 30-second "relax" period followed by a 30-second "lower" period. Participants were instructed to watch the bar during the relax period and actively attempt to lower it by decreasing primary auditory cortex activity during the lower phase.

The researchers gave the participants techniques to help them do this, such as trying to divert attention from sound to other sensations like touch and sight.

"Many focused on breathing because it gave them a feeling of control," Sherwood said. "By diverting their attention away from sound, the participants' auditory cortex activity went down, and the signal we were measuring also went down."

A control group of nine individuals were provided sham neurofeedback — they performed the same tasks as the other group, but the feedback came not from them but from a random participant. By performing the exact same procedures with both groups using either real or sham neurofeedback, the researchers were able to distinguish the effect of real neurofeedback on control of the primary auditory cortex.

The study represents the first time fMRI-neurofeedback training has been applied to demonstrate that there is a significant relationship between control of the primary auditory cortex and attentional processes. This is important to therapeutic development, Sherwood said, as the neural mechanisms of tinnitus are unknown but likely related to attention.

The results represent a promising avenue of research that could lead to improvements in other areas of health like pain management, according to Sherwood.

"Ultimately, we'd like take what we learned from MRI and develop a neurofeedback program that doesn't require MRI to use, such as an app or home-based therapy that could apply to tinnitus and other conditions," he said.

Co-authors are Emily E. Diller, M.S., Subhashini Ganapathy, Ph.D., Jeremy Nelson, Ph.D., and Jason G. Parker, Ph.D. This material is based on research sponsored by the U.S. Air Force under agreement number FA8650-16-2-6702. The views expressed are those of the authors and do not reflect the official views or policy of the Department of Defense and its Components. The U.S. Government is authorized to reproduce and distribute reprints for Governmental purposes notwithstanding any copyright notation thereon. The voluntary, fully informed consent of the subjects used in this research was obtained as required by 32 CFR 219 and DODI 3216.02_AFI 40-402.

For more information: www.rsna.org

Related Content

Key RSNA 2017 Study Presentations, Trends and Video

Related Content

The cartilage in this MRI scan of a knee is colorized to show greater contrast between shades of gray.

The cartilage in this MRI scan of a knee is colorized to show greater contrast between shades of gray. Image courtesy of Kundu et al. (2020) PNAS

News | Artificial Intelligence | September 22, 2020
September 22, 2020 — Researchers at the University of Pitts...
New research from King's College London has found that COVID-19 may be diagnosed on the same emergency scans intended to diagnose stroke.

Canon Medical Systems

News | Cardiac Imaging | September 22, 2020
September 22, 2020 — New research from King's College London has
A new report, Magnetic Resonance Imaging Equipment Market Size, Share & Industry Analysis, conducted by Fortune Business Insights, states that the magnetic resonance imaging (MRI) equipment market reached $7.24 billion in 2019 and is projected to reach $11.36 billion by 2027

Image courtesy of Siemens Healthineers

Feature | Magnetic Resonance Imaging (MRI) | September 21, 2020 | By Melinda Taschetta-Millane
A new report,...
Figure 1. Doppler flows in subpleural consolidation shows smoothly dilated branching arteries

Figure 1. Doppler flows in subpleural consolidation shows smoothly dilated branching arteries 

Feature | Radiology Imaging | September 17, 2020 | By Robert Bard, M.D. PC, DABR, FASLM
COVID-19 is routinely studied using...
Ultrasound-guided carpal tunnel release quickly improves hand function and reduces hand discomfort, making the procedure a safe, effective, and less invasive alternative to traditional open or endoscopic surgery

Patients answered three questionnaires (Quick-Disabilities of the Arm, Shoulder, and Hand [QDASH] and two parts of the Boston Carpal Tunnel Syndrome Questionnaire: symptom severity [BCTSQ-SS] and functional status [BCTSQ-FS] scales) assessing the affected wrist's function and discomfort immediately pre-procedure, 2 weeks post-procedure, and at least one year post-procedure. Infographic courtesy of the American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Ultrasound Imaging | September 17, 2020
September 17, 2020 — According to ARRS' American Journal of Roentgenology (AJR),...
HABLE study prioritizes brain imaging and biomarker research among Mexican Americans.

Getty Images

News | PET Imaging | September 14, 2020
September 14, 2020 — To meet the pressing need to better understand the prevalence, progression, and clinical impact
 A cardiac MRI is effective in identifying inflammation of the heart muscle in athletes and can help determine when those who have recovered from COVID-19 can safely return to play in competitive sports, according to a new study by researchers at The Ohio State University Wexner Medical Center.

Getty Images

News | Cardiac Imaging | September 14, 2020
September 14, 2020 — A...
All intensive care unit equipment, including ventilators, pumps, and monitoring devices, as well as the point-of-care magnetic resonance image operator and bedside nurse, remained in the room. All equipment was operational during scanning.

All intensive care unit equipment, including ventilators, pumps, and monitoring devices, as well as the point-of-care magnetic resonance image operator and bedside nurse, remained in the room. All equipment was operational during scanning. Image courtesy of JAMA Neurology

News | Magnetic Resonance Imaging (MRI) | September 11, 2020
September 11, 2020 — A portable, low-field...
Six months after deployment, the no-show rate of the predictive model was 15.9%, compared with 19.3% in the preceding 12-month preintervention period — corresponding to a 17.2% improvement from the baseline no-show rate (p < 0.0001). The no-show rates of contactable and noncontactable patients in the group at high risk of appointment no-shows as predicted by the model were 17.5% and 40.3%, respectively (p < 0.0001).

Weekly outpatient MRI appointment no-show rates for 1 year before (19.3%) and 6 months after (15.9%) implementation of intervention measures in March 2019, as guided by XGBoost prediction model. Squares denote data points. Courtesy of the  American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Artificial Intelligence | September 10, 2020
September 10, 2020 — According to ARRS’
Vantage Galan with Advanced intelligent Clear-IQ Engine (AiCE) provides high-quality images and fast exam times

Coronal orbit images: Left original and right with AiCE.

News | Magnetic Resonance Imaging (MRI) | September 09, 2020
September 9, 2020