Unintended Consequences of White Noise Therapy for Tinnitus—Otolaryngology's Cobra Effect: A Review

  title={Unintended Consequences of White Noise Therapy for Tinnitus—Otolaryngology's Cobra Effect: A Review},
  author={Mouna Attarha and James Bigelow and Michael Merzenich},
  journal={JAMA Otolaryngology–Head \& Neck Surgery},
Importance Critical to the success of many medical therapeutics is a consideration of the brain’s miraculous ability to dynamically rewire itself anatomically and neurochemically on the basis of incoming information. We argue that white noise exposure, a commonly recommended therapy for patients with tinnitus, engages these plastic processes in a way that induces maladaptive changes in the brain that degrade neurological health and compromise cognition. Observations The pathophysiologic… 
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Clinical verification of sound therapy programs should be used to ensure the output is appropriate for individual patient's hearing and consistent with the clinician’s desired approach to tinnitus management.
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This Review highlights the links between animal and human studies, and discusses several therapeutic approaches that have been developed to target the neuroplastic changes underlying tinnitus.
The auditory cortex and tinnitus – a review of animal and human studies
  • J. Eggermont
  • Medicine
    The European journal of neuroscience
  • 2015
Comparisons indicate that neural correlates of tinnitus can be studied successfully both at the level of animal models and in humans, as neither hearing loss nor hyperacusis appear to be necessary conditions for tinnitis to occur in humans.
Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model
It is reported that in human subjects with tinnitus and a normal audiogram, auditory brainstem responses show a significantly reduced amplitude of the wave I potential but normal amplitudes of the more centrally generated wave V.
A review of tinnitus symptoms beyond ‘ringing in the ears’: a call to action
  • B. Langguth
  • Medicine
    Current medical research and opinion
  • 2011
Clinicians need to recognize and diagnose tinnitus that occurs with other wide-ranging symptoms that include emotional components such as sleep disturbance, anxiety, depression, irritation, and concentration difficulties to ensure that these symptoms are identified and patients receive effective treatment.
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Evidence is reported that reversing the brain changes responsible can eliminate the perceptual impairment in an animal model of noise-induced tinnitus and this method for restoring neural activity to normal may be applicable to a variety of neurological disorders.