Avatar therapy for bothersome tinnitus using an augmented reality mobile application: a pilot feasibility study

Digital avatar-based interventions have been proposed as a promising approach for managing phantom sensations such as tinnitus by externalizing the perceived source of sensation and enabling users to interact with it. However, the emotional impact of symptom-representing avatars on users has received limited attention; it remains unclear whether emotional closeness with avatars influences impressions of phantom sensations and subjective symptom experiences. This pilot study aimed to explore the feasibility and emotional impact of an augmented reality (AR)-based avatar therapy for subjective bothersome tinnitus. We developed a mobile AR application that represents tinnitus as interactive avatars, allowing users to engage with them in everyday environments. Participants reported transient alleviation of symptoms immediately following application use, as well as a nominal improvement in tinnitus-related impression after the 1-week intervention period. Exploratory analyses suggested a possible association between depressive/anxiety-related stress responses and short-term changes in tinnitus botheration. This pilot evaluation provides preliminary insights into the feasibility and emotional aspects of AR-based avatar therapy for tinnitus. The findings inform the design of future controlled studies and suggest that emotionally oriented interactions with symptom-representing avatars may represent a promising direction for digital health interventions targeting tinnitus and other phantom sensations.