Can neuroplasticity-based interventions address tinnitus-related cognitive deficits?

by

Tinnitus_manTin­ni­tus: Turn­ing Down the Vol­ume (Med­Page Today):

“The drug D‑cycloserine was no more effec­tive than place­bo when used with a com­put­er-based cog­ni­tive train­ing pro­gram for reliev­ing per­sis­tent ear ring­ing in patients with tin­ni­tus in a small clin­i­cal study, but patients did report few­er cog­ni­tive difficulties…

More than 40 mil­lion peo­ple in the U.S. are believed to be affect­ed by tin­ni­tus, and while there is no cure for the per­sis­tent “ring­ing in the ears” there are treat­ments that have been shown to be effec­tive in some patients that mask the noise or help patients learn to ignore the sound, Pic­cir­il­lo told Med­Page Today. Cog­ni­tive issues such as dif­fi­cul­ties with work­ing mem­o­ry, learn­ing, and atten­tion con­trol are among the most com­mon­ly report­ed symp­toms of tin­ni­tus. In one sur­vey, more than 70% of patients with tin­ni­tus report­ed dif­fi­cul­ty concentrating.”

Study: A Nov­el Treat­ment for Tin­ni­tus and Tin­ni­tus-Relat­ed Cog­ni­tive Dif­fi­cul­ties Using Com­put­er-Based Cog­ni­tive Train­ing and D‑Cycloserine (JAMA Oto­laryn­gol­o­gy-Head & Neck Surgery). From the abstract:

  • Impor­tance: Tin­ni­tus affects more than 40 mil­lion peo­ple in the Unites States, and cog­ni­tive dif­fi­cul­ties are among the most com­mon­ly asso­ci­at­ed symptoms.
  • Objec­tive: To test the fea­si­bil­i­ty and pre­lim­i­nar­i­ly the effec­tive­ness of using a puta­tive neu­ro­plas­tic­i­ty-enhanc­ing drug, D‑cycloserine, to facil­i­tate a com­put­er-assist­ed CT pro­gram for improv­ing tin­ni­tus both­er and relat­ed cog­ni­tive difficulties.
  • Con­clu­sions and Rel­e­vance: Use of a com­put­er-based CT pro­gram with a puta­tive neu­ro­plas­tic­i­ty-sen­si­tiz­ing drug, D‑cycloserine, was fea­si­ble and well tol­er­at­ed. With the lim­it­ed sam­ple size, the adju­vant use of D‑cycloserine was no more effec­tive than place­bo at improv­ing tin­ni­tus both­er. The find­ing that D‑cycloserine use was more effec­tive than place­bo at improv­ing self-report­ed cog­ni­tive dif­fi­cul­ties could be impor­tant giv­en the high rate of con­cern for cog­ni­tive deficits in patients with tin­ni­tus. D‑cycloserine and oth­er puta­tive neu­ro­plas­tic­i­ty-facil­i­tat­ing agents could be inves­ti­gat­ed in the future as a strat­e­gy to enhance neuroplasticity–based tin­ni­tus treatments.