Boston researchers hope computer game will help many plagued by hearing disorder
Relentless ringing. Or hissing. Or a chirping sound that is often magnified at night when everything else quiets down.
This cacophony of invasive noises, a hearing impairment known as tinnitus, is the unwelcome soundtrack of everyday life for millions of Americans with ear injuries, notably many of the more than 260 people wounded in last year’s Marathon bombings.
Yet there is no cure for tinnitus, the result of sound-processing nerve cells being thrown out of whack and fostering the illusion of sound when none exists.
Now, Boston researchers have developed a novel computer game they hope might help tinnitus sufferers rewire their brains by taming misbehaving nerve cells and helping turn down the volume on the incessant noises.
With financial support from One Fund Boston, which has collected more than $80 million to help Marathon survivors, the researchers hope to start enrolling survivors this month in a first-of-its-kind study to test the effectiveness of their audio game.
Much is riding on the study.
As many as 12 million Americans grapple with chronic tinnitus, according to the American Tinnitus Association, and while the exact cause is not known, ear damage from loud noises is believed to be a culprit.
"The game is designed with few visuals, to force players to rely on their hearing. Otherwise, ‘people will use video cheats,’ "said Jonathon Whitton, an MIT graduate student who is one of the researchers on the project.
But for many, getting an appointment with a tinnitus specialist can be daunting — some Boston specialists have a two-year waiting list — so researchers hope their audio game can one day help fill the treatment void.
The concept of the audio game is similar to an approach that uses video games to treat “lazy eye” in children and adults.
“Tinnitus is far more common than [lazy eye] yet nobody really seems to be taking advantage of this wealth of information that exists about neuroscience-inspired sensory training games,” said Daniel Polley, a Harvard Medical School assistant professor and researcher at Massachusetts Eye and Ear, who is leading the audio game study. Among the legions who have grappled with tinnitus are actor William Shatner, comedian Jerry Stiller, and Coldplay singer Chris Martin.
The game, played on a touch screen tablet, challenges patients to assemble a digital jigsaw puzzle even though they cannot at first see the pieces. Rather, players must follow audio cues to find each piece.
As players move a finger along the screen, they listen for a sound that alerts them that they have reached the outline of the unseen puzzle piece. They then keep moving their finger, hunting for the sound that tells them they are on the right path, until they have etched the full shape of that piece. It is repeated over and over.
No two patients will hear the same sounds as they play the game. Instead, researchers will tailor sounds to the characteristics of each patient’s tinnitus. The objective is to bring the activity patterns of the out-of-control nerve cells back into balance.
The game, which grows more challenging as patients progress, is designed with few visuals, to force players to rely on their hearing.
Otherwise, “people will use all the visual cheats they can,” said Jonathon Whitton, an audiologist and Massachusetts Institute of Technology graduate student who helped design the game and is one of the researchers on the project.
The study will include about 80 participants, split into two groups. Half will play the audio game for about eight weeks, while the others engage in another tinnitus treatment that has shown potential.
In that segment, participants listen to music that is tailored to each individual’s tinnitus, also with the aim of quieting the misfiring nerve cells.
Then the two groups switch activities, while scientists track progress and compare outcomes.
Among those keen on signing up for the study is Eric Whalley, a 66-year-old retired biotech researcher who lost sight in his right eye and nearly lost his right leg in the April 2013 blasts.
“I was stunned to learn that there is not one FDA-approved drug on the market” for tinnitus, said Whalley, a former professor who spent years teaching students about the uses and effects of medications.
Both Whalley and his wife, Ann, who was also severely injured, suffer from tinnitus. Whalley is plagued by a constant high-pitched buzz that he likens to the drone of an aircraft engine. So far, no treatment he has tried, including surgery and music therapy, has worked.
Dr. Daniel Lee, an ear specialist at Mass Eye and Ear who is treating Marathon survivors, said tinnitus in these patients varies greatly. While scientists have determined that sound is detected by the ear and processed by the brain, they are still stymied in pinpointing where and how in the process nerve cells misfire in tinnitus patients.
“For some, it’s mild and intermittent,” Lee said, “while for others it’s quite debilitating just getting through the day.”
Lee is a medical adviser for the newly formed One Fund Center, housed at Massachusetts General Hospital, and created with $1.5 million from the One Fund to help survivors battling what has been called the bombings’ invisible injuries — tinnitus, other hearing problems, traumatic brain injuries, and post-traumatic stress and other mental health issues.
“There is so much stigma about seeking psychological care,” said Dr. Rebecca Brendel, a Mass. General psychiatrist and medical director of the One Fund Center.
“There is this perception that [these invisible wounds] are not real.”
Source: The Boston Globe