Somatic Modulation Appears To Be A Fundamental Attribute Of Tinnitus

It is well known that an occasional patient can change her/his tinnitus with a head or neck maneuver. However, it is unknown how widespread this attribute of tinnitus is. This study was undertaken to answer this question. We physically examined 70 consecutive patients seen in our tinnitus clinic for their ability to modify their tinnitus with 16 brief but forceful extremity or head and neck isometric contractions. Regardless of etiology or audiometry, more than two-thirds of all subjects could modulate the loudness of their tinnitus with one or more of these maneuvers. As compared to extremity manipulations, head and neck manipulations were about twice as likely to modulate tinnitus, never were weaker in their effect, and always produced the same type of changes (i.e. louder or softer). These maneuvers sometimes resulted in prolonged effects and could alter pitch as well as laterality of the tinnitus percept. Decreased tinnitus loudness was far more likely to occur for subjects with monaural tinnitus than binaural tinnitus. These results suggest that somatic modulation may be a fundamental attribute of tinnitus on a par with the auditory and affective attributes of tinnitus.