RSNA 2017: fMRI, neurofeedback may help quiet tinnitus

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Tinnitus—the perception of sound, often ringing, without external noise—can be a difficult condition to treat, because, in many cases, an exact cause cannot be identified. Recent work showed promise, though, by using neurofeedback and functional MRI (fMRI) to identify activity in the brain’s auditory cortex.

In a Nov. 27 presentation at RSNA 2017, researchers, led by Matthew Sherwood, PhD, with Wright State University in Fairborn, Ohio, discussed a tinnitus treatment designed to train patients to take focus from the sound.

"We started with alternating periods of sound and no sound 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 team examined 18 healthy individuals with normal hearing function, each undergoing five fMRI-neurofeedback sessions. Participants were introduced to white noise via earplugs, while researchers used single-shot echoplanar imaging to measure blood oxygen levels and brain activity.

Individuals were able to see real-time measurements of auditory cortex activity. Each session alternated 30-second “relax” periods with “lower” periods, when participants were told to try to lower such brain activity. Researchers told participants to divert attention from the sound by focusing on other senses.

The study also included nine participants who were given sham neurofeedback, so researchers could detect the real effects of attempts to control auditory cortex function. The team found participants were able to exert some control—promising findings that could lead to therapeutic research.

"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," Sherwood said.

A video summarizing the researchers’ report, “Self-Regulation of the Primary Auditory Cortex Activity via Directed Attention Mediated By Real-time fMRI Neurofeedback,” can be viewed here.