The EU-funded ESIT project is the most far-reaching pan-European initiative to date to investigate tinnitus which, in all its diverse ringing, hissing and buzzing forms, can range from being a sporadic irritation to a persistent, life-changing condition.
The project is aiming to improve scientific and medical understanding of tinnitus’s many causes and manifestations. It hopes to advance innovative research approaches and train a new generation of specialists in the field, ultimately leading to novel therapies and long-awaited relief – and peace and quiet – for sufferers.
‘The most challenging characteristic of tinnitus, besides its often unknown causes and chronic nature, is its inherent heterogeneity: different patients suffer different kinds of tinnitus, the individual causes and symptoms of which require different therapeutic approaches. Because of these differences, there isn’t any uniform “gold standard” tinnitus therapy or cure as of yet,’ says ESIT project coordinator Winfried Schlee of the University of Regensburg in Germany.
Therefore, the ESIT consortium is exploring multiple approaches to the problem, following a multidisciplinary strategy involving researchers from fields as diverse as medicine, psychology and physiotherapy to data science, informatics and engineering. Their goal is to identify novel medical, psychological or technical interventions to improve the quality of life for all kinds of tinnitus sufferers.
As many cases of tinnitus are associated with hearing loss, promising solutions being investigated by ESIT researchers include advanced hearing aids and cochlear implants. They aim to advance research towards a fully implantable cochlear device that would restore a sense of sound to people with severe hearing disabilities – and reduce or cure tinnitus as a result.
Another subgroup of patients suffer from so-called somatic tinnitus, in which the connection between their musculoskeletal and sensory system seems to cause, worsen or influence the perception of noise. These patients could potentially benefit from novel forms of physiotherapy, and one ESIT researcher is currently conducting the first randomised control trial to test possible physiotherapy-based treatments.
Besides the physical effects, tinnitus often creates a significant psychological burden. Consequently, another team is investigating novel psychotherapeutic methods based on cognitive behavioural therapy adapted for each individual patient. Other researchers are looking at neuro-feedback treatments, a type of bio-feedback that uses real-time displays of brain activity to help people self-regulate brain function, or individualised transcranial magnetic stimulation.
‘Overall, it’s clear that individualised forms of therapy are the way forward for the field,’ Schlee says. However, personalised, evidence-based treatments can only be effectively developed on top of large-scale epidemiological data, which provides a scientific understanding of different patient profiles and symptoms. An example of this is a large pan-European epidemiological study with a dataset of 12 000 patients from 12 European countries.
Tracking tinnitus across Europe
In order to support its research with sufficient and reliable data, the ESIT consortium is expanding the largest pan-European tinnitus database which already includes study data from thousands of patients throughout Europe and beyond. ESIT members have also developed a mobile app called Track Your Tinnitus, which 4 000 patients are using to monitor their symptoms and record how they evolve over time.
Furthermore, project partners are conducting the first-ever large-scale genetic study which is expected to provide data on the presumed inheritability of the condition.
‘Large-scale epidemiological studies will generate new insights into the prevalence of tinnitus across different geographical regions, age groups and genders,’ explains Schlee. ‘In addition, novel approaches to data collection and analysis, such as through the tinnitus app, as well as the development of a unified, international database are expected to greatly impact research on tinnitus and, potentially, many other medical fields dealing with chronic conditions.’
As a Marie Skłodowska-Curie Innovative Training Networks project, ESIT is passing on valuable skills to a future generation of interdisciplinary-educated scientists in tinnitus research and related fields. That process is continuing in UNITI, a follow-up Horizon 2020 Research and Innovation Action that will build upon the results of ESIT to support the ongoing development of personalised treatments for tinnitus, in close collaboration with individual patients and patient groups across Europe and beyond.