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A Predictive Coding Model-based Sound Therapy for Patients With Subjective Tinnitus: A Pilot Study.

Kuan-Chieh Chen1, Ting-Hsu Lee2, Chun-Chia Yang3

  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung.

Otology & Neurotology : Official Publication of the American Otological Society, American Neurotology Society [And] European Academy of Otology and Neurotology
|February 25, 2026
PubMed
Summary
This summary is machine-generated.

Shepard tone sound therapy showed potential for reducing tinnitus symptoms, especially in severe cases. Further research is needed to confirm these findings for chronic subjective tinnitus patients.

Keywords:
Chronic tinnitusPredictive codingShepard toneSound therapySubjective tinnitus

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Area of Science:

  • Auditory Neuroscience
  • Clinical Psychology
  • Medical Acoustics

Background:

  • Chronic subjective tinnitus significantly impacts quality of life.
  • Current treatments offer limited efficacy for many patients.
  • Predictive coding models offer a novel framework for understanding auditory perception and tinnitus.

Purpose of the Study:

  • To evaluate the therapeutic efficacy of a predictive coding model-based sound therapy using Shepard tones for chronic subjective tinnitus.
  • To investigate the impact of Shepard tone therapy on tinnitus symptom severity, frequency, and intensity.
  • To explore the relationship between baseline tinnitus characteristics and treatment response.

Main Methods:

  • A single-centre, randomized, single-blind, 3-arm trial involving 71 adults with chronic subjective tinnitus.
  • Participants were assigned to Shepard tone therapy, down-shifted Shepard tone therapy (control A), or matched-noise therapy (control B).
  • Outcomes included Tinnitus Handicap Inventory (THI) scores and changes in tinnitus frequency and intensity after 2 weeks of daily therapy.

Main Results:

  • The Shepard tone therapy group exhibited trends towards reduced THI scores, tinnitus frequency, and intensity, though not statistically significant.
  • Control group B (matched-noise therapy) demonstrated a significant reduction in THI scores (P = 0.032).
  • A negative correlation was observed between baseline tinnitus severity and post-therapy changes in the experimental group, suggesting greater benefit for individuals with more severe tinnitus.

Conclusions:

  • Customized Shepard tone therapy may provide therapeutic benefits for chronic subjective tinnitus, particularly for individuals with severe symptoms.
  • The findings suggest that targeting prediction errors in auditory processing could be a viable therapeutic strategy.
  • Larger-scale, long-term clinical trials are warranted to validate these preliminary results and optimize treatment protocols.