Tiny box in your chest to banish misery of tinnitus

Atiny box implanted in the chest could banish tinnitus — the ringing in the ears that affects five million people in the UK. the device, which is about half the size of a matchbox, stimulates a key nerve called the vagus nerve, which has various functions in the body, including controlling heart rate, breathing and muscles responsible for swallowing and speech.

now, scientists have discovered that by exposing it to low levels of electricity, using a surgically implanted device, they can reduce symptoms of tinnitus.

Many of us suffer temporary tinnitus, often from a cold or after going to a loud concert. But for around one in 100 people, it becomes a long-term affliction.

When the ears are exposed to loud noise or infections, the tiny hair cells that transmit sounds to the brain become stressed and start to emit excess amounts of a chemical called glutamate.

Excess glutamate over-stimulates nerve cells in the inner ear, to the point where they eventually die. these nerve cells have the job of sending sound impulses up to the auditory cortex, the part of the brain that processes noise.

When nerve cells in the inner ear die, nerve cells in the auditory cortex are left in a permanently switched-on state, where they constantly relay sound to the brain, even when there is no incoming signal from the ear.

By then, the tinnitus is no longer caused by damaged ear cells, but is rooted in the brain itself.

TrEAtMEnt for tinnitus includes counselling and relaxation techniques to ease the stress that can make it worse. Another option is sound therapy, where patients listen to background noise, such as gentle music, to distract their attention from the tinnitus.

Vagus nerve stimulation is already used to treat epilepsy, depression, migraine and even inflammatory bowel disease.

treatment involves implanting a small electrical device, similar to a pacemaker, just underneath the skin near the collarbone. A connecting lead under the skin is wrapped around the vagus nerve in the left side of the neck and delivers regular bursts of low-dose electricity.

But, recently, it has also become available as a handset that is held against the neck to stimulate the nerve through the skin.

A team of researchers from the U.S. universities of iowa, Buffalo and texas wanted to see if vagus nerve stimulation could also help tinnitus sufferers. they implanted a vagus nerve stimulator into 30 patients with severe tinnitus. For a couple of hours a day, patients also received ‘paired tones’ — beeping sounds played through headphones — set at frequencies similar to each patient’s tinnitus.

the idea is that stimulating the brain through the vagus nerve at the same time as it tunes into these sounds gradually ‘teaches’ it to shut out tinnitus.

it does this through a process called neuroplasticity — the ability to form new connections between brain cells, as it would through learning or after an injury. Experts liken the process to shutting out the sounds from noisy neighbours.

in the trial, half the patients also received actual vagus nerve stimulation, while the rest received a sham therapy — they were told the implant was on, but it was not.

the results, published in the journal Scientific reports, showed that after a year of daily treatment, 50 per cent of those who got the real stimulation saw a significant improvement in symptoms — nearly double the number who improved with sham treatment.

Dr Will Sedley, a lecturer in neurology at newcastle University, said: ‘nerve stimulation is not a cure for tinnitus, but it seems to reduce symptoms enough that people might see a significant improvement in quality of life.’

MEAnWHiLE, mindfulness — where patients are taught to pay attention to the present moment and their thoughts and feelings — may help treat tinnitus.

in a study by University College London, 75 patients were given weekly mindfulness-based cognitive ‘talking’ therapy or relaxation techniques for two months.

results published in the journal Psychotherapy and Psychosomatics showed mindfulness led to a significantly greater reduction in tinnitus severity than relaxation therapy. it’s thought that it helps reduce stress, which can worsen the condition.