Translational Research IBimodal Neuromodulation for Tinnitus Treatment About 10-15% of the population suffers from bothersome or debilitating tinnitus, a phantom sound condition coded within the brain. The only clinically recommended treatment for tinnitus based on current clinical guidelines is cognitive behavioral therapy, with increasing evidence for similar types of psychotherapy approaches that can lead to long term benefit of symptoms. Sound therapy approaches can provide benefit to some tinnitus sufferers. The main advantage of sound devices is that they are easy to implement and accessible, unlike psychotherapy approaches that can take many months to be effective; however, sound methods typically have transient therapeutic effects and are still not sufficiently effective for many individuals. An emerging approach that can provide long-term benefit of tinnitus symptoms in an accessible way is bimodal neuromodulation, which combines sound therapy with electrical stimulation of the body (e.g., tongue, ear, neck or face regions). One proposed mechanism of action of how bimodal neuromodulation treats tinnitus is based on Pavlovian conditioning or the concept of paired plasticity. Sound therapy can mask or interfere with the tinnitus percept or enable temporary habituation to the tinnitus symptoms. Electrical body stimulation can amplify or enhance the benefits of sound therapy by reinforcing their therapeutic effects through paired plasticity that can drive potentially long-term changes in the brain. There have been five separate groups across three countries that have consistently demonstrated the ability to reduce tinnitus symptoms with bimodal neuromodulation that can have lasting benefit from several weeks to one year after treatment has stopped; these benefits have shown to be greater and longer lasting compared to what has been observed for sound only approaches in animal and human studies. There are several large-scale randomized clinical trials that have been or are currently being performed to validate bimodal neuromodulation for the treatment of tinnitus that are paving the way towards building acceptance and confidence for this emerging approach, as well as recent real-world data supporting successful integration of bimodal neuromodulation into a clinical setting.
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Hubert Lim is a Professor in the Biomedical Engineering and Otolaryngology Departments at the University of Minnesota and was hired as an Institute for Translational Neuroscience Scholar. He is also the Endowed Lions Professor in Otolaryngology and Co-Director for the Center for Neural Engineering. He completed a B.S.E. in Bioengineering at UC-San Diego, followed by a dual Master’s in Biomedical Engineering and Electrical Engineering & Computer Science and then a Ph.D. in Biomedical Engineering at the University of Michigan. At the University of Minnesota, his lab’s research focuses on neural engineering, neuromodulation technologies, sensory neuroscience, neural plasticity, and neuro-immune physiology with the aim of developing new stimulation treatments for hearing disorders, pain, and inflammatory conditions in collaboration with multiple clinicians and companies (Medtronic, Cochlear, Blackrock Neurotech, MED-EL, GE Research, Starkey, Neuromod Devices, SecondWave Systems). Dr. Lim has been awarded the Peter and Patricia Gruber International Research Award in Neuroscience from the Society for Neuroscience, the Institute for Engineering in Medicine Faculty Career Development Award, and the Institute for Engineering in Medicine Outstanding Service Award. Outside his academic activities, he is currently involved with two start-up companies, serving as the Chief Scientific Officer of Neuromod Devices (developing a tinnitus treatment device) and as the Chief Scientific Officer of SecondWave Systems (developing a wearable phased-array ultrasound device for various health conditions). Additional information can be found at