Patient Care Research

Mindfulness-based stress reduction a promising treatment for tinnitus

Headshot of Dr. Piccirillo with WashU shield

As many as 20% of people may experience tinnitus, the perception of noise or ringing in the ears. While it’s usually not a sign of something serious, the phantom noise created by tinnitus can interfere with the ability to concentrate, hear external sound, sleep, and sometimes even enjoy life.

Common causes for tinnitus include age-related hearing loss, exposure to loud noise, earwax blockage and ear bone changes. Less common causes include an inner ear disorder called Meniere’s Disease, dysfunction of the tube in the ear, TMJ or temporomandibular joint disorders, head or neck injuries or a noncancerous (benign) tumor called an acoustic neuroma. Some medications can cause or worsen tinnitus.

Because tinnitus can significantly impact quality of life and cannot necessarily be cured, Jay Piccirillo, MD, and director of the Clinical Outcomes Research Office, conducted a study of patients with severe, bothersome tinnitus to see if mindfulness-based stress reduction therapy (MBSR) could help.

A mind-body intervention whereby individuals focus on their self-awareness through meditative techniques, MBSR has been shown to improve anxiety, depression, insomnia, and other conditions.

In Dr. Piccirillo’s study, subjects with severe, bothersome tinnitus participated in an eight-week MBSR program delivered by a trained MBSR instructor. To track critical brain networks before and after MBSR, magnetic resonance images (MRI) were taken of each subject’s brain while “at rest” in the MRI scanner to see how different areas of the brain are connected.

Participants described meaningful improvement in tinnitus bother, and analysis of the imaging showed increased connectivity in attention networks. The study supported the hypothesis that MBSR can increase connectivity in attention networks, by improving alignment and more closely organizing the network of brain neurons responsible for paying attention, concentrating and re-directing our attention. This results in better cognition and thinking and less disruption from tinnitus.

Dr. Piccirillo believes there are two reasons why MBSR addresses the problems associated with tinnitus: 1) MBSR enhances the attentional processes and other healthy brain changes; and 2) MBSR reduces perceived stress and improves psychological health. For people experiencing bothersome tinnitus Dr. Piccirillo recommends an online MBSR program created by Jennifer Gans, PhD.