Millions of people around the world live with permanent ringing or buzzing that still has no cure
In Spain alone, there are hundreds of thousands of people who never hear the silence. At night, when everyone sleeps, or on a mountain, no matter how isolated it is, they are still accompanied by a continuous beeping or a non-stop buzzing. Tinnitus or tinnitus is a relatively common problem that usually goes unnoticed by those who do not suffer from it because it does not present any external symptoms, although the "coming out" of celebrities with this ailment, such as the presenter Carme Chaparro or the musician of the Black Eyed Peas Will.i.am., have made the problem more visible.
Despite the number of pseudo-remedies that a desperate patient can find on the internet, for most of those who suffer from this disorder, the real treatments do not go beyond alleviating the stress of hearing a continuous beep. In the last two years, the drug AM-101 has been seen to not respond to expectations in two phase three trials, the last one that the drugs must pass before reaching the public. Other molecules that have sparked interest among patients, such as OTO-313, which would cure the disease with a single injection, are still in phase II, with enough hurdles and testing time ahead to moderate expectations.
In the experimental field, work is being done in search of new solutions, such as the one recently published in the magazine PLOS Biology. A team from the University of Arizona concluded in a study with mice that inflammation of a region of the brain responsible for processing sound can cause tinnitus and reducing that inflammation could offer treatment options. But there is a huge gap between what has been achieved in mice and a cure for humans.
The causes of noise that does not stop can be several. Damage from excessive noise at work or at night, a plug in the middle ear or a brain problem can be the cause of a non-existent tinnitus that is actually a symptom. Somehow, the brain tries to compensate for damage to the ear and creates tinnitus. "It's very similar to phantom limb syndrome, where someone loses a limb, but it still hurts because the brain tries to compensate for a lack of peripheral information," he says. Peter Cobo, a CSIC researcher who designs sound therapies for people with this problem.
“There are patients who have hearing damage, but they don't necessarily have tinnitus. However, of those with tinnitus, 98% have hearing loss." Antonio Lopez-Escamez, Scientific Director of the Biosanitary Research Institute of Granada. Despite this common trait, one of the research fronts on tinnitus is the search for an objective diagnosis. For now, surveys that rely heavily on the patient's own perception are used to assess the severity of the problem.
López-Escámez explains that tinnitus is a sign of "many other diseases, and for this reason, the first thing to do is go to the ENT doctor to identify the origin." In some cases, for example, when there is significant hearing loss, a cochlear implant can eliminate the problem. To better understand the origin of the disease, López-Escámez and his team have carried out experiments with identical twins to see if it has a genetic origin. "We have seen that patients who have tinnitus in both ears have a high genetic component, and those who have it in only one do not," he points out. In addition, they observed that in young women there is a higher degree of heritability than in men, a difference between the sexes that is rare in diseases.
Research improves knowledge of the disease, but for now there are only treatments that focus on helping the patient to live with their lack of silence. Although it is not the feeling that someone who searches the internet for "cure for tinnitus" may have. “On the internet you can find many pseudo-therapies, but what comes out are mainly miracle cures. It is important that people understand that they do not work”, he points out. Isabel Varela-Nieto, of the "Alberto Sols" Biomedical Research Institute (CSIC-UAM).
Trials that respect scientific protocols have failed in advanced phases "because the ear is a very inaccessible organ and local treatment is necessary," says Varela-Nieto, who is also group leader at CIBERER, dedicated to rare diseases. . Although these treatments have worked in animal models, the human ear is more elusive. “Furthermore, it is full of liquid that is replaced every so often and that makes the drug disappear quickly and it would have to be re-administered, something that is difficult to do in an inaccessible organ. These problems must be solved”, he adds.
While they resolve, what works are therapies that help to keep noise less present. Treatments for depression or stress can reduce the intensity with which tinnitus is perceived, and cognitive behavioral therapy, which is also used for these psychological problems, has been shown to be effective in helping patients reduce the impact it has on their lives.
Another treatment to improve the experience of tinnitus is sound therapy. Pedro Cobo, a physicist expert in acoustics, explains how he measures the audiometry of each patient's ear to create a curve of their hearing loss. Then, using that curve as a reference, he creates an hour-long sound file with different shapes and tones, or designs something similar to white noise that incorporates the inverse curve of their hearing loss. "We try to stimulate the auditory pathway to reverse or alleviate the damage," continues Cobo.
With this technique, he has already treated 46 patients, of whom 22 have completed the four-month treatment that he applies. In 20 people they have managed to reduce the levels of disability caused by tinnitus. Now, they want to expand the number of patients to be able to carry out trials that provide greater scientific validity to the treatment.
Exposure to intense noise at work or through devices such as headphones are some of the factors that are increasing the number of people affected by these non-existent beeps. To all this is added aging, which is the great risk factor for hearing impairment. For now, the only thing that works is prevention, avoiding excessive volumes, but researchers like Varela-Nieto trust that the problem, which is receiving more and more attention from scientists, will eventually be solved.