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Tinnitus: Why Won't My Ears Stop Ringing?

For a long time, doctors thought tinnitus was a problem in the ears. They now think it's more of a problem in the brain. (iStockphoto.com)

Ringing in the ears, or tinnitus, can be so annoying that a person with it can't sleep, think or work. It's a common problem for veterans returning from Iraq and Afghanistan. But tinnitus can also start for no apparent reason. That's what happened to Mark Church.

He went to the dentist for a routine visit 11 years ago, and soon after had an annoying buzzing sound in his ears. The doctor said he had tinnitus.

" 'Is there a pill or something you can give me?' " Church asked. "He said, 'No, you don't do anything for it. And I go, 'Well, when is it going to stop?' He says, 'It's not going to stop.' "

* Caution: This story contains a high-pitched sound that simulates what tinnitus sufferers hear.

About 50 million Americans have tinnitus, but Church is among the 2 million with severe symptoms. "I was having panic attacks," says Church, now 50. "I couldn't sleep at night. I lost my appetite. I was losing weight."

The sound was so disruptive that Church had to take a leave of absence from the software company he owns in St. Louis, Mo. "I just could not sit through business meetings," he says. "I couldn't carry out my responsibilities. I couldn't think clearly."

A Problem In The Brain?

For a long time, doctors thought tinnitus was a problem in the ears. But they now think it's more of a problem in the brain. In the past 10 years, brain imaging has given clues that the tinnitus "sounds" may be caused by a brain that is not connecting its various sections clearly.

Jay Piccirillo, a professor of otolaryngology at Washington University in St. Louis, is trying to reset those brain connections by holding an electromagnet to people's heads.

"We think that perhaps that electrical stimulation just clears away that pathological, or that faulty, connection," Piccirillo says, "with the hope that the reconnections are more normal and more healthy."

Mark Church decided to try transcranial magnetic stimulation as part of a clinical trial run by Piccirillo. The two-week trial of daily transcranial magnetic treatments found no improvement in participants, and Church dropped out of a second, four-week trial because he thought it was making his tinnitus worse. Piccirillo is analyzing the results of that second trial to see if any patients benefited. He's also conducting a study of military members deployed to Iraq and Afghanistan, doing MRI scans of their brains before and after deployment.

The Defense Department is giving a big boost to tinnitus research. That's because 20 to 40 percent of soldiers returning from Iraq and Afghanistan have tinnitus due to hearing loss caused by exposure to loud noise from gunfire, aircraft or explosions. It is now the most common service-related disability, with 744,000 vets receiving compensation for tinnitus, according to the American Tinnitus Association, an advocacy group.

The fact that so many veterans have tinnitus after being exposed to loud noises has made it clear that even if tinnitus isn't generated in the ears, hearing loss is often involved.

So some scientists are trying to retrain the brain to quit paying attention.

A Pacemaker For The Ears

Michael Kilgard, a neuroscientist at the University of Texas in Dallas, is experimenting with vagus nerve stimulation, a therapy used to treat epilepsy and severe depression. A pacemaker-like device is used to send tiny jolts of electricity to the brain via the vagus nerve in the chest.

Kilgard says that instead of having too many neurons listening to one tone — the tinnitus frequency — the treatment redistributes the resources evenly. "But trials with humans are just starting, so relief will be years away, if it works at all," he says.

The Web is awash with untested tinnitus "cures," many of them expensive. Church found his own cheap, simple workaround, suggested by his wife: radio static. One evening when he was tormented by tinnitus, she gave him an inexpensive personal radio and told him to put on the headphones.

"So I put it on, and I turned it on, and I put it between stations — immediate relief. Oh, my God, this is amazing. I went from being a basket case to being able to function for the rest of the evening within minutes."

Now, Church says, he's able to largely ignore the tinnitus at work, and turns to the radio static for relief in the evening. It's a lot like living next to an airport. "When you first move in, you hear the planes go over every day. But after you live there for a while, you figure that noise is not important to me. 'Cause the planes are going to continue to come, they're not going to crash into my house. It just happens to be where I live. So before you know it, you don't hear the planes anymore."

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Transcript

STEVE INSKEEP, host:

It's MORNING EDITION from NPR News. I'm Steve Inskeep.

MARY LOUISE KELLY, host:

And I'm Mary Louise Kelly. Good morning.

Today in Your Health, two different approaches to treat ringing in the ears. About 50 million Americans have the problem. It's called tinnitus. In our first story, NPR's Nancy Shute reports on new efforts to understand�where tinnitus comes from.

NANCY SHUTE: When Mark Church went to the dentist for a routine visit 11 years ago, he didn't think�that one visit would change his life. But it did.

Mr. MARK CHURCH:�That evening, I noticed that my ears were ringing.

(Soundbite of buzzing)

SHUTE: That's a sound created by the American Tinnitus Association, and Church says it's pretty close to what he heard.�

(Soundbite of buzzing)

That's enough. Let's turn it down.

But Mark Church couldn't turn the sound down. A week later, he was still hearing it.�So he went to the doctor. The doctor said he had tinnitus.�

Mr. CHURCH: But what do we do for it? You know, is there a pill or something you can give me? He said no, you don't do anything for it. And I go, well, when does it going to stop? He says, well, it's not going to stop.

SHUTE: There are no cures for tinnitus. But a lot of researchers are working on the problem. That's good, because for about two million Americans like Mark Church, tinnitus interferes with life.�

Mr. CHURCH:�I was having panic attacks. I couldn't sleep at night. I lost my appetite. I was losing weight.

SHUTE: He had to stop working at the software company he owns in St. Louis.

(Soundbite of buzzing)

Mr. CHURCH:�I just could not sit through business meetings. I could not just do my - I couldn't carry out my responsibilities. I was just not able to think clearly.

SHUTE: For a long time, doctors thought�tinnitus was a problem in the ears. But they now think it's a problem in the brain.�Jay Piccirillo is an ear, nose and throat doctor at Washington University in St. Louis.�He says it looks like the brain isn't doing a good job of connecting its sections. He's trying to reset those brain connections by holding an electromagnet to people's heads.

Dr. JAY PICCIRILLO (ENT, Washington University): We think that perhaps that electrical stimulation just clears away that pathological or that faulty connection, with the hope that the reconnections are more normal and more healthy.

SHUTE: Mark Church decided to try Piccirillo's electromagnetic treatment, as part of a clinical trail.�

MR. CHURCH: You're in a reclining chair, and they put this big magnet - it's like a six-inch in diameter or something like that - and just press it against your head. It just presses against it. I actually had to pull out. And I had to pull out because, about halfway through, because my tinnitus seemed to be getting worse.

SHUTE: Unfortunately for Church, the magnet didn't get rid of his tinnitus. Piccirillo is now analyzing results to see if any patients were helped.

And he's not the only researcher looking for tinnitus cures. Tinnitus research has gotten a big boost from the Defense Department. It's funding research because 20 to 40 percent of soldiers coming back from the Iraq and Afghanistan wars have tinnitus due to hearing loss caused by gunfire or explosions. Michael Kilgard is a neuroscientist at the University of Texas in Dallas.

Dr. MICHAEL KILGARD (Neuroscientists, University of Texas): Hearing loss is causing changes in the brain, and those changes in the brain sometimes lead to tinnitus perceptions.

SHUTE: It's like the brain is trying to fill in for sounds the ears no longer hear. Kilgard is trying to teach the brain to stop paying so much attention. He's using vagus nerve stimulation, which is also used to treat depression, to give the brain a tiny jolt of electricity.

Dr. KILGARD:�Instead of having too many neurons representing one tone, the tinnitus frequency, you now redistribute the resources evenly.

SHUTE: But these are still just potential treatments, leaving people like Mark Church with few options. He finally found relief though a common workaround.

(Soundbite of static)

Listening to a sound that's similar to the tinnitus frequency, to override that bad signal from the brain. He tried putting on headphones, and listening to radio static.

(Soundbite of static)

Mr. CHURCH: I put it on, and I turned it on, and I turned it between stations.

(Soundbite of static)

Immediate relief. I'm like, oh my god, this is amazing. And I went from being a basket case to, you know, being able to function for the rest of the evening within minutes.�

SHUTE Now, he says, he can pretty much ignore that sound, just like he would if he lived next to an airport.�

Mr. CHURCH: When you first move in, you hear the planes go over every day. But after you live there for a while, you figure out that noise is not important to me. Because the planes are going to continue to come, they're not going to crash into my house. It just happens to be where I live. So before you know it, you don't hear the planes any more.�

SHUTE: And Mark Church says that's exactly where you want to get to with tinnitus - you don't pay attention to it.��

Nancy Shute, NPR News. Transcript provided by NPR, Copyright NPR.

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