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Neuromonics Review - Treatment for Tinnitus

Neuromonics has a catchy, sciency-sounding name, but what is it and what does it claim to do?

I reviewed the available papers on Pubmed, and sought independent info from the British Tinnitus Association and Dr James Jackson (my tame tinnitus researcher at Leeds Trinity University).

I am of the opinion that current neuromonics research has not proven it has anything to offer above and beyond what is already out there. Neuromonics is a blend of counselling (Cognitive Behavioural Therapy style) and sound stimulus. The difference between this and Tinnitus Retraining Therapy (TRT), as far as I can see, is that the sounds you are asked to listen to have been specifically selected for your hearing loss. TRT uses white noise (like radio static, equal sound energy at all frequencies), neuromonics uses sound with frequencies aligned with areas where your hearing is lacking.

There does not seem to be evidence of an effective control group (or any control group?) so it is impossible for me to say whether this treatment is any better than CBT alone. We already know that tinnitus-targeted CBT is effective at reducing tinnitus distress. So ANY treatment that uses CBT would be expected to produce a positive effect. What neuromonics needs to do, then, is demonstrate that their treatement is MORE effective than CBT alone. This is really the obvious thing they need to do, and they haven't done it (prove me wrong, Neuromonics designers!).

Indeed, one might ask why they haven't done it? Knowing CBT helps tinnitus sufferers, I could design a treatment that has sufferers take CBT and wear a pink hat at the same time. Then I could say it was effective, and start marketing my pink hats with a trademark, and call it successful.

Other factors in the papers suggest a high drop-out rate. Normally, if people are distressed by their tinnitus and are being helped by a trial, they stay in it. The ones who drop out are more skewed towards not getting beneficial effects. If you exclude drop outs then, the remaining people give you a really high success rate. And that's what we've seen.

So far, I still recommend CBT for those who are having trouble with negative thoughts and depression related to their tinnitus. CBT is delivered via the NHS, privately from an accredited psychologist or psychotherapist, or via apps such as Tinnibot, which use elements of CBT in their design. You can also access worksheets online for free, and read up on it yourself.

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