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A screenshot of the MindEar app showing the on screen functions

Train your brain to overcome tinnitus

An app can change the lives of those affected by tinnitus

  • Millions of people have been told to there is nothing they can do about their tinnitus.
  • That’s bad advice and for many it leads to more stress anxiety and depression. 
  • With specialist psychological support you can train your brain to ignore tinnitus. But that’s expensive and not widely available. 
  • Now, a research team led by the University of Auckland have developed an app that, in a trial published today in Frontiers in Audiology and Otology, reduced the impact of tinnitus in two-thirds of users in weeks. 

Contents

An international research team has shown that the debilitating impact of tinnitus can be effectively reduced in just weeks by a training course and sound therapy delivered via a smartphone app.

A screenshot of the MindEar app showing the on screen functions
The MindEar app guides users through a journey to help manage their tinnitus symptoms

The research team from Australia, New Zealand, France and Belgium report these findings today in Frontiers in Audiology and Otology. 

It offers some hope for millions affected by tinnitus who:

  • have been told that there is nothing they can do about it
  • face long queues waiting for treatment, or
  • can’t afford the costs of specialist support.

The initial trial worked with 30 sufferers, of whom almost two thirds experienced a ‘clinically significant improvement’. The team are now planning larger trials in the UK in collaboration with the University College London Hospital. 

The app, MindEar, is available for individuals to trial for themselves on a smartphone in North America, Australia, New Zealand, the UK, Ireland and select other countries (more coming soon).

Tinnitus is common, affecting up to one in four people. It is mostly experienced by older adults but can appear for children. For some, it goes away without intervention. For others, it can be debilitatingly lifechanging: affecting hearing, mood, concentration, sleep and in severe cases, causing anxiety or depression. 

“About 1.5 million people in Australia, 4 million in the UK and 20 million in the USA have severe tinnitus,” says Dr Fabrice Bardy, an audiologist at Waipapa Taumata Rau, University of Auckland and lead author of the paper. Dr Bardy is also co-founder of MindEar, a company set up to commercialise the MindEar technology.

Dr Fabrice Bardy, lead author and co-founder of MindEar

“One of the most common misconceptions about tinnitus is that there is nothing you can do about it; that you just have to live with it. This is simply not true. Professional help from those with expertise in tinnitus support can reduce the fear and anxiety attached to the sound patients experience,” he says. 

“Cognitive behavioural therapy is known to help people with tinnitus, but it requires a trained psychologist. That’s expensive, and often difficult to access,” says Professor Suzanne Purdy, Professor of Psychology at Waipapa Taumata Rau, University of Auckland. 

“MindEar uses a combination of cognitive behavioural therapy, mindfulness and relaxation exercises as well as sound therapy to help you train your brain’s reaction so that we can tune out tinnitus. The sound you perceive fades in the background and is much less bothersome,” she says. 

“In our trial, two thirds of users of our chatbot saw improvement after 16 weeks. This was shortened to only 8 weeks when patients additionally had access to an online psychologist,” says Dr Bardy. 

Why does it work?

Even before we are born, our brains learn to filter out sounds that we determine to be irrelevant, such as the surprisingly loud sound of blood rushing past our ears. As we grow, our brains further learn to filter out environmental noises such as a busy road, an air conditioner or sleeping partners.

Most alarms, such as those in smoke detectors, bypass this filter and trigger a sense of alert for people, even if they are asleep. This primes the fight-or-flight response, and is especially strong for sounds we associate with bad prior experiences. 

Unlike an alarm, tinnitus occurs when a person hears a sound in the head or ears, when there is no external sound source or risk presented in the environment, and yet the mind responds with a similar alert response.

The sound is perceived as an unpleasant, irritating, or intrusive noise that can’t be switched off. The brain focuses on it insistently, further training our mind to pay even more attention even though there is no risk. This offers the pathway for patients. By training and actively giving the tinnitus less attention, the easier it becomes to tunes out.

MindEar aims to help people to practice focus through a training program, equipping the mind and body to suppress stress hormones and responses and thus reducing the brain’s focus on tinnitus.

Tinnitus is not a disease in itself but is usually a symptom of another underlying health condition, such as damage to the auditory system or tensions occurring in the head and neck.

Although there is no known cure for tinnitus, there are management strategies and techniques that help many sufferers find relief. With the evidence of this trial, the MindEar team are optimistic that there is a more accessible, rapidly available and effective tool available for the many of those affected by tinnitus still awaiting support.

MindEar is based on the research work of an international multi-disciplinary team composed of audiologists (Dr Laure Jacquemin, Dr Michael Maslin), psychologists (Prof Suzanne Purdy and Dr Cara Wong) and ENTs (Prof Hung Thai Van) led by Dr Fabrice Bardy based at the University of Auckland.

Find out more at https://www.mindear.com/
Full paper will be available after embargo at https://www.frontiersin.org/articles/10.3389/fauot.2023.1302215/abstract
(Author proof available under embargo below)

For more information and to coordinate interview with study authors

Interviews with spokespeople, patient case studies, and a media pack are available on request.

  • Journalists in the USA & Canada, please contact Erin Kim: e@erinheejoon.com | +1 347 261 2364
  • Journalists in Australia, New Zealand, UK and elsewhere, please contact Tom Carruthers: tom@scienceinpublic.com.au | +61 404 404 026 

Read on for:

  • Research article abstract, authors and affiliations
  • Additional comments & quotes
  • Background on the development of MindEar
  • Further background resources on tinnitus

Download:

Research paper

Delivery of internet-based cognitive behavioral therapy combined with human-delivered telepsychology in tinnitus sufferers through a chatbot-based mobile app

Frontiers in Audiology and Otology
DOI: https://doi.org/10.3389/fauot.2023.1302215

Paper authors and affiliations 

Fabrice Bardy1,2*, Laure Jacquemin3,4, Cara L. Wong, Michael R. D. Maslin1,2,5, Suzanne C. Purdy1,2 and Hung Thai-Van6,7,8

1School of Psychology, Speech Science, The University of Auckland, Auckland, New Zealand
2Eisdell Moore Centre for Hearing and Balance Research, Auckland, New Zealand
3Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
4University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
5School of Psychology, Speech and Hearing, The University of Canterbury, Canterbury, New Zealand
6Service d’Audiologie & d’Explorations Otoneurologiques, Hospices Civils de Lyon, Lyon, France
7Université Claude Bernard Lyon 1, Villeurbanne, France
8Institut de l’Audition, Institut Pasteur, Inserm, Paris, France

N.B.: Fabrice and Laure are members of the MindEar team. 

Paper abstract

Background: While there is no cure for tinnitus, research has shown that cognitive behavioral therapy (CBT) is effective in managing clinical sequelae. Although traditional CBT is labor-intensive and costly, new online consultations may improve accessibility. Moreover, there is promise in an engaging conversational agent, or a “chatbot,” delivering CBT in a conversation-like manner and allowing users to work through complex situations with the guidance of a virtual coach. Currently, there is little research examining a possible hybrid model using iCBT and tele consultation with a psychologist.

Methods: A randomized, 2 parallel-group trial was conducted to compare the clinical effectiveness of (1) iCBT delivered through a chatbot mobile app (i.e., Tinnibot only group) (2) Tinnibot combined with telepsychology (i.e., hybrid- intervention group). A total of 30 eligible adults with tinnitus were included. After an 8-week intervention period, participants were followed up for 2 months. The primary outcome measure, the Tinnitus Functional Index (TFI), and the secondary outcome measures, Hyperacusis Questionnaire (HQ), Generalized Anxiety Disorder 7-item (GAD-7), and Patient Health Questionnaire (PHQ-9), were assessed before treatment, post-treatment, and at follow-up.

Results: The TFI decreased significantly over time in both groups, with a trend for a larger improvement in the group that received telepsychology. At post-treatment, a clinically significant improvement was observed in 42% of the Tinnibot-only group and 64% of the hybrid-intervention group. At follow-up, this was 64% for both groups. The secondary outcome measures, PHQ-9 and GAD-7 improved significantly over time, but the HQ did not.

Discussion: Internet-based delivery of CBT is effective in decreasing tinnitus distress, and levels of anxiety and depression, which is more relevant today than ever in the context of a global pandemic that has challenged the delivery of face-to-face intervention. The addition of telepsychology might be beneficial, but not essential for the effectiveness of treatment. There is a need for further research to determine whether there is any relationship between the characteristics of tinnitus patients and the success of the different modes of delivery of therapy.

Additional quotes

Dr Emma Laird Project & Program Lead, Tinnitus Australia, Soundfair

“My work at Soundfair includes supporting people like me, who live with constant tinnitus. So many are desperate for help and have tried endless supposed “quick fixes” with no success. The people I talk to often report anxiety, depression, and even suicidal thoughts. Developing evidence-based management options is essential so that we can offer more help to those suffering with tinnitus.”

Dr Pau Medrano Director – Investment, UniServices, University of Auckland – More info

“The University of Auckland Inventors’ Fund was one of the first investors in MindEar back in 2020. At that time, we were impressed with the founding team’s ability to absorb feedback, pivot and build a science-led digital product. Their perseverance and progress to date has achieved several milestones, including securing strategic investors and thousands of users.”

Sara K. Downs, interim executive director of the American Tinnitus Association

“Access to effective and meaningful tinnitus care is one of the greatest challenges an individual encounters when seeking help. Hence, an app that combines use of cognitive behavioral therapy for tinnitus, which is the leading evidence-based intervention for people bothered by the condition, with telehealth consultations with a licensed psychologist is a tremendous step forward in helping individuals with mild-to-moderate tinnitus severity. To date, one of our greatest concerns has been lack of research on outcomes for people using apps to reduce the distress that often accompanies tinnitus. Hence, this study, which draws on the experiences of 28 participants, is encouraging. We look forward to future research that includes more participants, which might indicate who is most likely to benefit from this treatment model.”

Professor Peter Thorne Department of Physiology and director of the Eisdell Moore Centre, University of Auckland

“Tinnitus can be a distressing and debilitating condition. This is a very encouraging outcome from this research into a more personalised and comprehensive cognitive behavioural therapy approach that could provide relief to many patients.”

Patient case studies available for interview are available on request

Background on MindEar

MindEar (originally named Tinnibot) aims to change the global provision of tinnitus care to enable access to rehabilitation for everyone sooner, cheaper and more efficiently.

Foundation

MindEar was established by co-founders, Dr Fabrice Bardy and Dr Matthieu Recugnat, both of whom have close family members profoundly affected by tinnitus.

Fabrice’s father developed severe tinnitus in 2006, following a fall from a tree that resulted in a head injury. While not associated with hearing loss, his tinnitus significantly impacted his daily quality of life. As an audiologist, Fabrice wanted to help his father but found it challenging. His normal approach addressed tinnitus via addressing hearing loss with a hearing aid, something his father didn’t need. Finding a psychologist with a special focus on tinnitus also proved difficult.

It was this experience that led Fabrice to envision a tool that would not only be accessible to patients, but that could also be recommended by audiologists to provide effective tinnitus management via treatments like cognitive behavioural therapy.

Matthieu’s grandmother also suffered severely from tinnitus. Fabrice and Matthieu’s shared experience became a point of connection while they were both completing their respective PhDs at the Australian Hearing Hub.

MindEar isn’t the first time the pair collaborated. Initially, Fabrice and Matthieu developed a chatbot for ordering coffee at their local cafe in the Australian Hearing Hub. Their system used QR codes placed on tables, allowing customers to order conveniently or even skip the queue. Though innovative, being prior to the COVID-19 pandemic, it was perhaps a bit ahead of the time for widespread adoption of such technology.

Initial investment

The University of Auckland UniServices Inventors’ Fund was one of the first investors in MindEar back in 2020. UniServices was impressed with the founding team’s ability to absorb feedback, pivot and build a science-led digital product. Their perseverance and progress to date has achieved several milestones, including securing strategic investors and thousands of users.

Further background information on tinnitus

The MindEar app is available on for iOS and Android via their respective app stores in the UK, USA, Canada, Australia, New Zealand, Ireland, and other select countries (more coming soon).