3 'Hidden in Plain Sight' Body Signs Show Your Tinnitus Is Worse Than You Think
Scientists at Mass General Brigham identified pupil dilation and facial twitches as new biomarkers for tinnitus severity.
Let’s be honest. When you are trying to explain to a partner or a doctor why a quiet room suddenly feels like a war zone it is incredibly frustrating. You are describing a noise that only you can hear. You are describing ringing or buzzing or clicking. You are hoping they believe you. Researchers at Mass General Brigham have been thinking about this exact problem and they have just dropped some fascinating news. Imagine if cancer severity were determined by giving patients a questionnaire. That is the state of affairs for some common neurological disorders like tinnitus according to Daniel Polley. He is the vice chair for basic science research and director of the Eaton-Peabody Laboratories at Mass Eye and Ear. He is also a member of the Mass General Brigham healthcare system. He recently stated in a new study published in Science Translational Medicine that for the first time they directly observed a signature of tinnitus severity. It is not just about the noise in your head. It is about the physical way your body reacts to the world around you.
This study is a real game changer for how we understand the condition. We have known for a while that tinnitus affects about 12 percent of the general population and 25 percent of individuals ages 65 and older. For an estimated 15 percent of sufferers the condition is so disabling that it disrupts sleep mental health and daily functioning. Until now there has been no objective way to differentiate between the annoyance of a nuisance and the severe distress of a disability. This new research suggests that the answer might be hiding in plain sight in your own eyes and face. The researchers focused on the sympathetic nervous system. This is the body’s fight flight or freeze mechanism. They looked for outward involuntary signs of distress that might indicate that a person with tinnitus is chronically in vigilance mode. They hypothesized that people with debilitating tinnitus are reacting to everyday sounds as if they are threats.
To test this hypothesis they did something pretty clever. They recruited 97 participants with normal hearing. This group included 47 people with varying levels of tinnitus and sound sensitivity and 50 healthy volunteers serving as controls. Video recordings were made while participants listened to pleasant neutral or distressing and unpleasant sounds. The researchers did not just play random noise. They played specific triggers like coughing fits yelling or a baby crying. Using artificial intelligence powered software they were able to detect rapid and subtle involuntary facial movements. These twitches in the cheeks eyebrows or nostrils were then correlated with the reported tinnitus distress levels. When you combine this data with pupil dilation data the predictive power for measuring severity increased even more.
The results were striking and offer a glimpse into the difference between mild and severe cases. In people with severe tinnitus the pupils dilated extra wide at all sounds including pleasant neutral or unpleasant ones. Their facial movements were also blunted when exposed to the same sounds. People without tinnitus or with less bothersome tinnitus by contrast showed exaggerated pupil dilation and facial movements but only to the most unpleasant sounds. This suggests a difference in how the nervous system processes threat. The study authors are calling these biomarkers essential for understanding the condition. "What's really exciting is this vantage point into tinnitus severity didn't require highly specialized brain scanners. Instead the approach was relatively low-tech. If we can adapt this approach to consumer-grade electronics they could be put to use in hearing health clinics as objective measures in clinical trials and by the public at large." This quote comes from Polley who is also the director of Mass Eye and Ear's Lauer Tinnitus Research Center.
Of course the science is never perfect and this study has its limitations. To demonstrate the potential uses of their video-based approach researchers had to exclude many individuals with co-occurring issues like hearing loss advanced age or mental health challenges. These are the very populations who are commonly associated with complex and severe tinnitus. Future research will aim to include these more at-risk populations. The work is far from over. Polley and his lab are now using these biomarkers to develop new therapies. These therapies combine neural stimulation with immersive software environments designed to eliminate or significantly reduce the loudness of the tinnitus phantom sound. "These biomarkers get to the root of the distress," said Polley. While imaging might show hyperactive brain regions in tinnitus patients these biomarkers reveal body-wide threat evaluation systems that are operating outside of their normal range. This leads to the distressful symptoms they experience.
For those of us trying to connect in a noisy world this is incredibly important information. It reminds us that when someone says they are stressed by the sound of a dripping faucet they might be telling the truth about their internal state. We are finally getting the tools to see what these silent battles look like from the outside.
First reported by ScienceDaily: Relationships.
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