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Extinction training for tinnitus
1Department of Clinical and Cognitive Neuroscience, University of Heidelberg, Central Institute of Mental Health, Mannheim, Germany.
Abstract:
Recent accounts of tinnitus development and maintenance assign an important role to central mechanisms. Residual inhibition is a frequent phenomenon in individuals with tinnitus, and refers to the fact that tinnitus can temporarily be reduced by presenting sounds or noises that inhibit tinnitus for a limited time even after termination of the sound. This kind of stimulation-induced inhibition of tinnitus could potentially be used for treatment by combining it with additional interventions to enhance the extinction of tinnitus. Here we propose a training program aimed at the amplification and the extension in time of residual inhibition as well as the extinction of negative emotional responses to the tinnitus. The program is tested alone or in combination with a pharmacological intervention that is aimed at decreasing central hyperactivity. Treatment effects are assessed by tinnitus questionnaires, electroencephalographic measures (reduction in the amplitude of the N(100) component of the event-related potential as an indicator of habituation) as well as skin conductance responses to 1000 Hz tones or tinnitus-like tones. This training is an example of the use of centrally acting and mechanism-oriented tinnitus treatments.
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