Stopping Tinnitus in its Tracks--In-Depth Doctor's Interview
Dr. Sven Vanneste, Associate Professor at UTD, talks about a new surgery that is stopping tinnitus in its tracks.
So, how does vagus nerve stimulus work?
Dr. Vanneste: Well, based on animal research, when you stimulate the vagal nerve you can actually induce changes in the brain and we know in tinnitus patients that there is a hyperactivity and hypersynchrony in a specific brain area, which is called the primary auditory cortex. Basically what you do is tell the brain all the sounds that you’re hearing are important, but because you do not present the tinnitus tone you tell the brain all the sounds are important except the tinnitus tone. That’s the basic idea behind it.
But how do you do that with simple electricity?
Dr. Vanneste: Well, what we know is when you stimulate the vagal nerve, you actually activate some neurotransmitters that are really important. And because you do vagal nerve stimulation, paired with sound therapy, you really can have an effect where you want it to be. So in this case, it is in the primary auditory cortex. Maybe, there are also other regions that might be involved and that we change, but that’s something that we still have to do research on.
Can you explain exactly how you do it, where you implant it, and how it works?
Dr. Vanneste: The surgeon is making an incision around the neck close to the throat and there is the vagal nerve and it’s an electrode that surrounds what you can actually see it over here, that surrounds the vagal nerve. The lead connects to what we call an IPG, an implantable pulse generator, it’s basically a battery. And, we can communicate with that specific device via computer. So, each time that we present a tone, we can also send a trigger to the IPG that the vagal nerve needs to be stimulated, so that’s basically how we do it.
Do you leave the stimulator in and for how long?
Dr. Vanneste: For the clinical trial, we will leave the IPG in there for at least 12 weeks and after 12 weeks, the patient can decide.
How many times during the day would a patient get a treatment?
Dr. Vanneste: So, the treatment is 2-1/2 hours a day for 5 days a week and they receive about 300 stimuli each session. They can also decide when to do it; they can do it in the morning, afternoon, night, it doesn’t matter.
Do you have to be in the clinic to get?
Dr. Vanneste: No, so when we did the first trial in Belgium, they had to come to the clinic because we didn’t have the internal pulse generator yet. So it was a big device. But now, a company made specific IPG that is implantable. So the patient can do the treatment at home.
Does it hook to their computer or what?
Dr. Vanneste: Well, it’s wireless so and they just have to turn on the device to see if it connects with computer and just run the program.
So in Belgium, what have your studies shown there?
Dr. Vanneste: So in Belgium, we had promising results. It was just a pilot study. We implanted it in 10 patients and 5 patients had a response. Five patients didn’t have a response, but interesting thing was that those patients took certain medication that probably blocked the effect, but because it was a pilot study, our idea was we were going to include all types of tinnitus patients just to get more knowledge.
Of the five that it helped, was it a 10% help? Was it a 90% help?
Dr. Vanneste: No, four of them had a very good response, they had a 44% suppression rate which is really a very good response compared to other treatments that we already tried. That’s just for the mood component. So, in tinnitus, you have two components, you have just the sound as it is, but also some people are really stressed by their tones, so for the mood component, we had a 44% suppression rate and then for the loudness, well, we noticed that it was 26 DB, decibels improvement.
So, what you’re doing here could really give some people a chance at a normal life, correct?
Dr. Vanneste: That is our hope. So I have to say a lot of patients with tinnitus can live with it. They say, “I hear the tinnitus, but it’s doable.” But some patients are really desperate because of their tinnitus. It really affects their daily life, so for those patients this could be really helpful, absolutely.
END OF INTERVIEW
This information is intended for additional research purposes only. It is not to be used as a prescription or advice from Ivanhoe Broadcast News, Inc. or any medical professional interviewed. Ivanhoe Broadcast News, Inc. assumes no responsibility for the depth or accuracy of physician statements. Procedures or medicines apply to different people and medical factors; always consult your physician on medical matters.
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Lab for Auditory & Integrative Neuroscience
University of Texas at Dallas
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