NIHR National Biomedical Research Unit in Hearing, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.
J Assoc Res Otolaryngol. 2012 Aug;13(4):543-59. doi: 10.1007/s10162-012-0323-6. Epub 2012 Apr 4.
That auditory perceptual training may alleviate tinnitus draws on two observations: (1) tinnitus probably arises from altered activity within the central auditory system following hearing loss and (2) sound-based training can change central auditory activity. Training that provides sound enrichment across hearing loss frequencies has therefore been hypothesised to alleviate tinnitus. We tested this prediction with two randomised trials of frequency discrimination training involving a total of 70 participants with chronic subjective tinnitus. Participants trained on either (1) a pure-tone standard at a frequency within their region of normal hearing, (2) a pure-tone standard within the region of hearing loss or (3) a high-pass harmonic complex tone spanning a region of hearing loss. Analysis of the primary outcome measure revealed an overall reduction in self-reported tinnitus handicap after training that was maintained at a 1-month follow-up assessment, but there were no significant differences between groups. Secondary analyses also report the effects of different domains of tinnitus handicap on the psychoacoustical characteristics of the tinnitus percept (sensation level, bandwidth and pitch) and on duration of training. Our overall findings and conclusions cast doubt on the superiority of a purely acoustic mechanism to underpin tinnitus remediation. Rather, the nonspecific patterns of improvement are more suggestive that auditory perceptual training affects impact on a contributory mechanism such as selective attention or emotional state.
听觉感知训练可以缓解耳鸣，这基于两个观察结果：（1）耳鸣可能是由于听力损失后中枢听觉系统活动改变引起的；（2）基于声音的训练可以改变中枢听觉活动。因此，人们假设提供跨越听力损失频率的声音丰富度的训练可以缓解耳鸣。我们通过两项涉及总共 70 名慢性主观性耳鸣患者的频率辨别训练的随机试验来检验这一预测。参与者接受以下三种训练之一：（1）在其正常听力区域内的纯音标准；（2）在听力损失区域内的纯音标准；（3）跨越听力损失区域的高通谐复合音。对主要结果测量的分析显示，在训练后自我报告的耳鸣残疾总体上有所减轻，并且在 1 个月的随访评估中得到维持，但组间没有显著差异。二次分析还报告了不同的耳鸣残疾领域对耳鸣感知的心理声学特征（感觉水平、带宽和音高）以及训练时间的影响。我们的总体发现和结论对以纯粹的声学机制为基础来支持耳鸣修复的优越性提出了质疑。相反，非特异性的改善模式更表明听觉感知训练会影响选择性注意或情绪状态等促成机制的影响。
