Tomographic neurofeedback interventions in older patients with chronic tinnitus


  • Prof. Dr. M. Meyer, Institute of Neuropsychology, University of Zurich
  • ESIT (European School for Interdisciplinary Tinnitus Research); a project funded by the EU as part of the "Horizon 2020" research and development program to train young scientists in tinnitus research.

The chronic ear noise (tinnitus) is a hearing sensation that is not caused by an external acoustic signal but is generated by the self-activation of the hearing system and is perceived by those affected as a real, often extremely stressful, noise.

To this day there is unfortunately no satisfactory and effective therapy available to cure tinnitus to complete remission. Recently, however, new approaches to neuromodulation have increasingly become the focus of research. The aim of our project is to develop innovative neurofeedback protocols (NFB) and to systematically test their effectiveness.

In order to better understand the neural circuits that maintain chronic ear noise, the investigation of spontaneous brain wave activity using the temporally high-resolution method of electroencephalography (EEG) has recently moved to the forefront.  In particular, the evaluation of the distribution of the distinct frequency bands in spontaneous EEG has proven to be informative in this context. It has been shown that patients with tinnitus symptoms have an abnormal distribution of the dominant frequency in the α-, β-, θ, and γ- bands.

The neurofeedback procedure follows the simple idea of changing certain aspects of neuronal activity (such as the extent to which γ-oscillations occur) by means of operant conditioning. The subject receives a (mostly visual) feedback of the EEG activity measured in real time, with the goal of either intensifing or inhibiting the subject's behavior. In doing so, the brain learns to act automatically and of its own accord to produce the desired EEG patterns and suppress the unwanted oscillations. Ideally, the pattern of spontaneous EEG activity changes in the desired direction over the course of several training sessions.

Applying the innovative method of tomographic neurofeedback (i.e. the combination of neurofeedback with the EEG source estimation methods developed in recent years) allows for the precise targeting of distinct cortical regions and the specific modulation of their activity.

Treatment approach for chronic tinnitus: Development of neurofeedback training in the case of abnormal brain activity

The first study on the application of tomographic neurofeedback in patients with chronic tinnitus started in 2015 in collaboration with the Psychological Institute of the University of Zurich (Prof. Dr. M. Meyer) and was completed in 2017. Fifty patients were treated as part of the study. Currently, the extensive data evaluation is in progress. This evaluation will further provide the foundation for a follow-up project, which is focused on the development of a personalized neurofeedback therapy program for chronic tinnitus patients based on individual EEG data.

Although many forms of tinnitus treatment have been both  developed and proposed to date, there is still no reliable cure. Based on the findings of abnormal brain activity in tinnitus patients, we work with a therapeutic approach based on the operant conditioning of these specific EEG patterns. 
With the help of neurofeedback, an EEG-based biofeedback, patients can learn to remodulate their neuronal circuits. At the same time, this training should also reduce the tinnitus-related burden.