TINNITUS MODULATION BY MUSCLES PRESSURE OR CONTRACTION CAN BE REDUCED USING THE SAME MOVEMENTS THAT EVOKE IT

Tanit Ganz Sanchez, Márcia Kii, Márcio Pio, Patricya Figueiredo
University of São Paulo Medical School

Introduction: Different stimuli on non auditory nature – especially muscle contractions, gaze or tactile - can interfere with the auditory pathways, evoking tinnitus modulation while such stimuli are present.

This modulation pattern – usually tinnitus worsening - seems to be a result of neural plasticity, especially involving the activity of dorsal cochlear nucleus.

Objective: Observe whether a personalized training with daily repetition of the muscle movements that evoke tinnitus modulation can reduce this modulation in a two-month period.

Methods: Seven patients (mean age: 53, ranging from 22 to 72 years-old) who spontaneously complained about the onset of a new tinnitus or changes in loudness or pitch of their preexistent tinnitus by pressure or contraction of head and neck muscles were enrolled. One subject also presented tinnitus modulation by upper and lower limbs movements. All patients were asked to perform a personalized training involving repetitive pressures or contractions of the own muscles that evoked their modulation. Training was suggested to start with 10 repetitions of
each movement, two or three times a day. The medical follow-up was scheduled every fortnight for two months.

Results: Four subjects (57.1%) showed reduction of tinnitus modulation pattern after 30 days of training, including one patient who also improved his preexistent tinnitus after 4 months. On the other side, two patients (28.5%) showed no change and one impaired his modulation pattern after 30 days. Additional head and neck muscles modulating tinnitus were identified after repetitive contractions in two patients.

Conclusions: It is possible to change the tinnitus modulation caused by muscular contractions using the repetition of the same movements that evoke the modulation. Such changes start to occur about 30 days of training. Future controlled studies with prolonged periods of repetitive modulation movements should be performed to check improvement of the preexistent tinnitus.