Noise exposure therapies may be doing more harm than good, suggested a review article recently published in JAMA Otolaryngology. While sound therapies like white noise provide short-term relief for people with various conditions, including tinnitus, they may undermine the overall functional and structural integrity of the brain, and even accelerate its aging.
Tinnitus affects over 50 million people in the United States. While there is no cure for this disabling condition, sound therapy is one of the most common approaches to manage tinnitus. In fact, there is some evidence that point to the benefits of noise-based sound therapy in providing relief from disturbing tinnitus percepts via auditory masking. However, neuroscientists from University of California San Francisco and with Posit Science argue that the potential adverse effects of auditory masking via noise therapy might actually outweigh its benefits.
"Increasing evidence shows that the brain rewires for the worse when it is fed random information, such as white noise. Neural inhibition is reduced, temporal integration times increase, and cortical representations lose precision," lead author Mouna Attarha, PhD, told The Hearing Journal. "These maladaptive changes in the brain have consequences that, with time, exacerbate the tinnitus, degrade functioning of the auditory system, and compromise other important cognitive processes, such as language comprehension. A therapeutic strategy so often recommended needs to be more fully understood, including its unintended and often overlooked consequences."
Evaluating therapies in the context of brain health and cognition is vital, noted the authors. "We became interested in writing this editorial after noting widespread use of white noise generators by health professionals across a number of settings – hospitals, treatment centers, therapy offices, ICUs," Attarha shared.
Noting the need for alternative therapies, the authors suggest exploring the potential of structure sounds and other strategies that don't have a negative impact on the brain.
"Health professionals should have a sense of how repeated exposure to randomly-generated information, even at low volume levels, remodels the brain and should offer structured sounds as the alternative," Attarha suggested. "Structured sounds – such as music and speech – can successfully mask or "cover" phantom sounds heard in the head without compromising the structural and functional integrity of the brain. Given how distressing tinnitus can be to some, a treatment program could also include emerging interventions to the extent that those interventions show initial efficacy and demonstrate low-risk."
These treatment programs include validated computerized brain training and stimulus timing dependent plasticity. "Ultimately, the resolution of tinnitus will require programs that can remodel and restore the organization of the brain," Attarha noted.
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