Auditory and visual 3D virtual reality therapy as a new treatment for chronic subjective tinnitus: Results of a randomized controlled trial

• Published in: Hearing research 2016-03, Vol.333, p.127-135
• Main Authors: Malinvaud, D., Londero, A., Niarra, R., Peignard, Ph, Warusfel, O., Viaud-Delmon, I., Chatellier, G., Bonfils, P.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Auditory Perception; Chronic Disease; Cognitive behaviour therapy; Cognitive Therapy; Computer Graphics; Computer Science; Disability Evaluation; Female; Graphics; Human health and pathology; Humans; Imaging, Three-Dimensional; Life Sciences; Male; Middle Aged; Neurons and Cognition; Paris; Sensory Organs; Severity of Illness Index; Subjective tinnitus; Surveys and Questionnaires; Time Factors; Tinnitus - diagnosis; Tinnitus - psychology; Tinnitus - therapy; Treatment Outcome; Virtual reality; Virtual Reality Exposure Therapy; Visual Perception
• ISSN: 0378-5955; 1878-5891
• DOI: 10.1016/j.heares.2015.12.023

Subjective tinnitus (ST) is a frequent audiologic condition that still requires effective treatment. This study aimed at evaluating two therapeutic approaches: Virtual Reality (VR) immersion in auditory and visual 3D environments and Cognitive Behaviour Therapy (CBT). This open, randomized and therapeutic equivalence trial used bilateral testing of VR versus CBT. Adult patients displaying unilateral or predominantly unilateral ST, and fulfilling inclusion criteria were included after giving their written informed consent. We measured the different therapeutic effect by comparing the mean scores of validated questionnaires and visual analog scales, pre and post protocol. Equivalence was established if both strategies did not differ for more than a predetermined limit. We used univariate and multivariate analysis adjusted on baseline values to assess treatment efficacy. In addition of this trial, purely exploratory comparison to a waiting list group (WL) was provided. Between August, 2009 and November, 2011, 148 of 162 screened patients were enrolled (VR n = 61, CBT n = 58, WL n = 29). These groups did not differ at baseline for demographic data. Three month after the end of the treatment, we didn't find any difference between VR and CBT groups either for tinnitus severity (p = 0.99) or tinnitus handicap (p = 0.36). VR appears to be at least as effective as CBT in unilateral ST patients. •We propose a new therapeutic tool for subjective tinnitus: Virtual Reality (VR).•VR immersion allows patients to voluntarily manipulate an avatar of their tinnitus.•This new and original approach is compared to cognitive-behavioural therapy (CBT).•Results are evaluated on tinnitus severity and handicap validated questionnaires.•VR appears to be at least as effective as CBT in subjective tinnitus patients.