A multisensory approach to training for tinnitus

Abstract

Tinnitus is the perception of sound with no external source; it can be distressing and disabling for some individuals. This proof-of-principle study investigated the effectiveness of multisensory training as a treatment for tinnitus. It was hypothesised that participants with unilateral tinnitus would show an improvement in tinnitus or tinnitus related distress, and improved attentional skills following training. It was also an aim of the study to ascertain if either a sensory-integration approach, using a novel training paradigm presenting multisensory stimuli congruent to the tinnitus side, or if an attention-diversion approach, using multisensory stimuli presented incongruent to the tinnitus side, would reveal superior improvements. Eighteen participants were provided with laptop computers and trained on a home-based computerised programme over 20 consecutive days for 20-30 minutes per day. Participants were allocated to either the congruent group, with auditory, visual and tactile stimuli presented the same side as tinnitus, or to the incongruent group, with auditory, visual and tactile stimuli presented to the non-tinnitus side. A comprehensive battery of measures assessed the effectiveness of treatment by using questionnaires, attention measures and psychophysical measures of tinnitus. Significant improvements were achieved after multisensory training, with reductions in tinnitus perception and the negative impact of tinnitus captured by tinnitus questionnaires and psychophysical measures of tinnitus. Enhancements in the attentional skills of participants were recorded, with improvements beyond the effects of procedural learning. Although both groups revealed significant improvements, overall the sensory-integration approach to training was more effective than the attention-diversion approach. Training with a sensory-integration approach gained greater benefits with reduced perception of tinnitus and tinnitus related effects, along with attentional changes that may reflect plastic changes due to multisensory training. Significant improvements occurred after only 20 days of training compared to many months for current common treatments.