tinnitusThe 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.

Sixteen study participants with tinnitus were treated with D-cycloserine – the dextrorotary form of the antibiotic cycloserine, which has been widely studied in conjunction with cognitive behavioral therapy for the treatment of anxiety and stress-related psychiatric disorders. Another 14 patients were treated with placebo and all 30 study participants took part in cognitive training sessions, conducted twice weekly for five weeks.

At the end of the study period, the D-cycloserine plus cognitive training group showed a significant improvement in median Tinnitus Functional Index (TFI) score (−5.8; 95% CI, −9.4 to −1.1) and self-reported cognitive deficits (−4.5; 95% CI, −11.5 to −1.0), but the placebo group did not (−1.0; 95% CI, −11.7 to 4.9 and −2.0; 95% CI, −5.1 to 2.0, respectively).

After controlling for age and duration of tinnitus, no significant difference in TFI score change was seen between the two groups (P=0.41). But, the D-cycloserine group did show a significantly greater improvement in self-reported cognitive deficits (P=0.03), researcher Jay Piccirillo, MD, of Washington University School of Medicine, St. Louis, Missouri, and colleagues wrote in the journal JAMA Otolaryngology-Head & Neck Surgery, published online Oct. 30.

Many Current Tinnitus Treatments Mask Noise

More than 40 million people in the United States 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.

The exact etiology of the condition is not known, but there is growing evidence that tinnitus is primarily a disorder of the central nervous system. In neuroimaging studies, patients with tinnitus have been shown to have abnormalities in the central auditory pathways and non-auditory areas of the brain involved in the allocation of attention, perception, and emotional processes.

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.

In an earlier, small pilot study conducted by Piccirillo and colleagues, 10 of 13 (77%) people with tinnitus who underwent computer-based cognitive training for six weeks reported improvements in attention and/or memory and 6 of 13 (46%) reported “changes for the better” in their tinnitus.

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