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Updated: May 22, 2026
A Protocol for the Administration of Real-Time fMRI Neurofeedback Training
Published on: August 24, 2017
Tinnitus retraining therapy: mixing point and total masking are equally effective
Richard S Tyler1, William Noble, Claudia Barros Coelho
1Departments of Otolaryngology-Head and Neck Surgery, The University of Iowa, Iowa City, Iowa 52242, USA. rich-tyler@uiowa.edu
Objectives:
Habituation to tinnitus cannot occur with total masking, an argument made by proponents of "tinnitus retraining therapy." We also compared the effectiveness of retraining therapy with mixing-point masking, total masking, and with counseling alone.
Design:
Forty-eight tinnitus patients were randomly assigned to one of three groups: counseling, counseling plus bilateral noise generators set to completely mask the tinnitus, or counseling plus bilateral noise generators with a focus on the mixing point (partial masking just below total masking). A picture-based counseling protocol was used to assist in providing similar counseling among all three groups. The Tinnitus Handicap Questionnaire was administered before and after about 12 months of treatment.
Results:
After 12 months, in the counseling group, three of 18 patients benefited significantly, in the mixing-point group, six of 19 patients benefited, and in the total masking group, four of 11 patients benefited from the treatment. The average decrease in the questionnaire was 16.7% for the counseling group, 31.6% for the retraining group, and 36.4% for the total masking group. No significant average differences among groups were observed.
Conclusions:
One premise of retraining therapy is incorrect; a focus on mixing-point masking is not required for habituation.
