Auditory and visual 3D virtual reality therapy for chronic subjective tinnitus: theoretical framework

Abstract

It is estimated that *10% of the adult population in developed countries is affected by subjective tinnitus. Physiopathology of subjective tinnitus remains incompletely explained. Nevertheless, subjective tinnitus is thought to result from hyperactivity and neuroplastic reorganization of cortical and subcortical networks following acoustic deafferentation induced by cochlear or auditory nerve damage. Involvement of both auditory and non-auditory central nervous pathways explains the conscious perception of tinnitus and also the potentially incapacitating discomfort experienced by some patients (sound hypersensitivity, sleep disorders, attention deficit, anxiety or depression). These clinical patterns are similar to those observed in chronic pain following amputation where conditioning techniques using virtual reality have been shown both to be theoretically interesting and effectively useful. This analogy led us to develop an innovative setup with dedicated auditory and visual 3D virtual reality environments in which unilateral subjective tinnitus sufferers are given the possibility to voluntarily manipulate an auditory and visual image of their tinnitus (tinnitus avatar).By doing so, the patients will be able to transfer their subjective auditory perception to the tinnitus avatar and to gain agency on this multimodal virtual percept they hear, see and spatially control. Repeated sessions of such virtual reality immersions are then supposed to contribute to tinnitus treatment by promoting cerebral plasticity. This paper describes the theoretical framework and setup adjustments required by this very first attempt to adapt virtual reality techniques to subjective tinnitus treatment. Therapeutic usefulness will be validated by a further controlled clinical trial.

Feasibility of Virtual Reality Audiological Testing: Prospective Study

“…To be more specific, there is an imaginary place, VS, and through interaction and immersion, individuals feel more present, or connected, to the VS. VR's biggest strength is that auditory and visual information are provided simultaneously to generate realistic environments. There are studies showing the efficacy of VR in certain areas, such as pain management, stroke rehabilitation, and chronic subjective tinnitus [30][31][32][33][34]. For audiology, VR has been researched for sound localization, but research into the effect of VS on speech performance has been sparse [35][36][37].…”

The user experience of personalized content

“…Further, considering their conclusion on presence as a multidimensional construct, the dimensions transportation, impression of translocation, and immersion, the degree of submergence into an artificial environment, appear to be one of the most important characteristics for telemedicine mediated patient-physician interaction (Skalski 2011). In the context of healthcare, several studies emphasize the importance of presence for clinical effectiveness and consider presence a main constituting factor for a realistic artificial environment (Garrett et al 2018;Londero et al 2010;Price and Anderson 2007;Riva et al 2002;Viciana-Abad et al 2004). To ensure a multidimensional feeling or sense of presence, the creation of a mediated reality is oriented on an asymptotic convergence of the artificial and the real world (Heeter 1992).…”

33rd Bled eConference – Enabling Technology for a Sustainable Society: June 28 – 29, 2020, Online Conference Proceedings

“…Further, considering their conclusion on presence as a multidimensional construct, the dimensions transportation, impression of translocation, and immersion, the degree of submergence into an artificial environment, appear to be one of the most important characteristics for telemedicine mediated patient-physician interaction (Skalski 2011). In the context of healthcare, several studies emphasize the importance of presence for clinical effectiveness and consider presence a main constituting factor for a realistic artificial environment (Garrett et al 2018;Londero et al 2010;Price and Anderson 2007;Riva et al 2002;Viciana-Abad et al 2004). To ensure a multidimensional feeling or sense of presence, the creation of a mediated reality is oriented on an asymptotic convergence of the artificial and the real world (Heeter 1992).…”