Randomized Controlled Trial of a Perceptual Training Game for Tinnitus Therapy

Abnormal executive top-down control of attention may result in, or be a consequence of, tinnitus. On the basis of a study indicating the feasibility of a game designed to treat tinnitus, a Phase II controlled trial of an auditory attention training game was undertaken.

Measures of tinnitus, as well as behavioral and electrophysiological measures of attention, were compared before and after 20 consecutive days of 30-minute training sessions using a game developed with LabVIEW™ software (National Instruments Corp., Austin, TX). Fifteen participants played an experimental attention training game ("Terrain"), and 16 participants played a control game ("Tetris") on their home computers.

Clinically significant reductions in the primary measure, the Tinnitus Functional Index (TFI), were obtained for "Terrain." The secondary measures of Tinnitus Handicap Inventory and rating scales (ability to ignore and tinnitus annoyance) were significantly improved. The reductions in the TFI were correlated with improvements in a mixed auditory-visual task (Comprehensive Attention Battery(®); NeuropsychWorks, Inc., Greensboro, NC) and reduction in N1 auditory-evoked potential latency to stimuli remote from tinnitus pitch.

The results suggest that the attention training game may have reduced focus on the tinnitus, potentially through improved selective attention. "Terrain" was superior to "Tetris" in the population tested and therefore shows promise as a management option for tinnitus. Further testing in a larger, more general, population would be enabled through improving the game's accessibility.