How Does the Stress Response Impact Tinnitus?

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Answer

From the neurophysiological model of tinnitus, we well know the elements at work in a patient with severe tinnitus. However, for some patients, their limbic system involvement can be the most detrimental aspect of the tinnitus cycle. 

The limbic system is the area of the brain where we translate and process how things emotionally affect us. In regard to the tinnitus cycle, the extent to which a patient’s limbic system is involved has everything to do with his or her quality of life, and how much the tinnitus affects the individual on a day-to-day basis. While the damage to the auditory system generates the tinnitus signal, it is the limbic system that drives the tinnitus. The limbic system is telling the brain that the tinnitus signal is something harmful and threatening, and to be on the lookout for it. 

This illustrates the fact that when treating patients with tinnitus, it is absolutely critical to consider all factors contributing to the tinnitus. We know what to do if there is an aidable hearing loss, but what about the patient who is experiencing extreme distress as a result of his or her tinnitus? What about those patients with concurrent issues of anxiety and stress as a result of their tinnitus disturbance?

Specifically targeting the limbic system is the key.

In addition to targeting the auditory and attentional aspects of the tinnitus cycle, the customized Neuromonics stimulus is an excellent way to provide patients relief from their tinnitus by directly impacting their limbic system involvement. With Neuromonics, music is the carrier for the treatment. It provides the patient a pleasant stimulus that is relaxing – while providing much-needed relief from the disturbing effects of the tinnitus.

The Neuromonics Tinnitus Treatment protocol dictates that the patient uses the device when tinnitus is most bothersome. In doing so, the patient is directly targeting the limbic system involvement. This conditions the brain to change the way it categorizes the tinnitus, working to eliminate the stress response and allow the brain to drop its guard. Over time, the debilitating effects of the tinnitus subside and habituation begins to occur. Qualitative usage of Neuromonics is one of the most essential aspects of the therapy.

However, there are those patients who have extreme involvement of their limbic system. For them, counseling and medication may be indicated along with the use of Neuromonics’ treatment. The Tinnitus Reaction Questionnaire can be an excellent tool to help identify who may need an outside referral to a psychologist. (A score of 70 or more on the questionnaire usually indicates that the patient would benefit from psychological services.) Cognitive Behavioral Therapy (CBT) has been found to be the most effect modality of therapy for patients with tinnitus, as it gives redirection and tools to make the lifestyle changes that will ultimately positively affect their tinnitus. 

Never underestimate the role of the stress response in patients with tinnitus. It’s important to give them the tools necessary to target and eliminate the limbic system’s involvement for truly effective treatment.

For more information, visit https://neuromonics.com/ or the Neuromonics Expo Page on AudiologyOnline.