Tinnitus Clinical Trial
Official title:
Treatment of Chronic Bothersome Tinnitus Using Cognitive Training and D-cycloserine
The purpose of this research study is to determine if a medication along with a computer program designed to improve memory and other mental processes can help people like yourself with tinnitus. The medication that will be investigated, d-cycloserine, was developed as an antibiotic. However, more recently, research in other studies has shown that this medication may enhance learning and memory. The investigators would like to determine if computer programs designed to improve memory and attention are enhanced by this medication. In addition, the investigators hope to learn if the use of these programs can help participants with their tinnitus as well as their ability to remember and focus. All research participants will receive therapy with a computer-based program designed to improve memory and attention. Half of participants will also receive d-cycloserine while the other half of participants will receive placebo. The placebo is a sugar pill without active medication.
Tinnitus is the perception of a "ringing or hissing" sound in the absence of an acoustic
stimulus affecting more than 40 million people in the United States. While the exact
etiology of chronic bothersome tinnitus is unknown, current evidence based on numerous
studies and neuroimaging results suggests chronic bothersome tinnitus involves the central
nervous system with abnormalities in neural networks including attention and emotional
networks. These neuroplastic changes in multiple neural networks may offer targets in the
treatment of chronic bothersome tinnitus.
The Brain Fitness Program® (Posit Science Corporation, San Francisco, California) is a
cognitive rehabilitation program that has been used in the treatment of schizophrenia and
geriatric populations, and has been shown to have favorable results by reorganizing aberrant
neural networks. Preliminary results from our team have shown improvements in tinnitus
severity and cognitive functioning for participants with chronic bothersome tinnitus using
this cognitive rehabilitation program.
Recent studies in numerous disorders have shown d-cycloserine (DCS) augments learning
therapy programs by enhancing neuroplasticity. In addition, the adjuvant use of DCS with
learning therapies has been found to accelerate symptom reduction decreasing the time-burden
needed for learning therapies. Based on the belief that chronic bothersome tinnitus involves
changes in malleable neural networks that can be targets of therapy and that DCS enhances
neuroplasticity, the investigators hypothesize that adjuvant DCS with cognitive
rehabilitation treatment may improve tinnitus severity and the cognitive deficits associated
with chronic bothersome tinnitus.
This randomized-controlled trial will use an abbreviated cognitive rehabilitation program
given for 5 weeks with DCS or placebo to evaluate the impact of a
neuroplasticity-sensitizing drug on tinnitus symptom severity and cognitive performance
among patients with chronic bothersome tinnitus. A positive result on this study will have
numerous implications, including offering a new treatment option for chronic bothersome
tinnitus with few known side effects and limited time commitment or cost.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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