Nature Communications volume 15, Article number: 6806 (2024 ) Cite this articl

Combining sound with tongue stimulation for the treatment of tinnitus: a multi-site single-arm controlled pivotal trial

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2024-09-23 13:30:07

Nature Communications volume 15, Article number: 6806 (2024 ) Cite this article

Bimodal neuromodulation is emerging as a nonsurgical treatment for tinnitus. Bimodal treatment combining sound therapy with electrical tongue stimulation using the Lenire device is evaluated in a controlled pivotal trial (TENT-A3, NCT05227365) consisting of 6-weeks of sound-only stimulation (Stage 1) followed by 6-weeks of bimodal treatment (Stage 2) with 112 participants serving as their own control. The primary endpoint compares the responder rate observed in Stage 2 versus Stage 1, where a responder exceeds 7 points in the Tinnitus Handicap Inventory. In participants with moderate or more severe tinnitus, there is a clinically superior performance of bimodal treatment (58.6%; 95% CI: 43.5%, 73.6%; p = 0.022) compared to sound therapy alone (43.2%; 95% CI: 29.7%, 57.8%), which is not observed in the full cohort across all severity groups. Consistent results are observed for the secondary endpoint based on the Tinnitus Functional Index (bimodal treatment: 45.5%; 95% CI: 31.7%, 59.9%; sound-only stimulation: 29.6%; 95% CI: 18.2%, 44.2%; p = 0.010), where a responder exceeds 13 points. There are no device related serious adverse events. These positive outcomes led to FDA De Novo approval of the Lenire device for tinnitus treatment.

Tinnitus is a phantom auditory sensation that is coded within the brain that affects 10–15% of the population1,2,3,4,5,6, where approximately 6-11% of the tinnitus population experience bothersome tinnitus and 2–8% experience a severe form of tinnitus3,7, with limited treatment options8,9,10. Encouragingly, there is growing evidence across multiple animal and human studies demonstrating that bimodal neuromodulation combining sound with electrical stimulation of peripheral nerves, such as trigeminal and somatosensory nerves, can drive significant neural plasticity relevant for tinnitus treatment and improve tinnitus symptoms11,12,13,14,15,16,17,18,19,20,21,22.