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# ANT - Advancing neurotherapy of tinnitus ## Summary Tinnitus is the perception of noise or ringing in the ears when no corresponding external sound is present. It affects about 15 to 20% of the western population and in 20% of these cases leads to severe impairment of quality of life. No effective treatment options have been discovered yet, leaving this population without an urgently needed cure. Neurofeedback (NFB) is currently evaluated as a treatment option to counteract the maladapted neural substrates of chronic tinnitus and other chronic diseases. NFB is a non-invasive technique used to alter neural activity by displaying an auditory or visual feedback of its own activity. NFB setups are composed of closed-loop systems integrating elements such as neural signal processing, feedback presentation, and training paradigms. Despite the increasing attention these methods attract in the fields of neuroscience and clinical practice, a demonstrable knowledge gap in NFB research exists. No systematic research has been performed yet on the impact of NFB-stimuli and -settings on trained neural activity, specific versus unspecific effects, cognitive load, participant motivation and cognition, specificity of neural targets, or the long-term effects of NFB training. In most current research approaches, simple feedback parameter visualisations or sonifications are implemented, which mostly follow poorly specified frameworks of operant conditioning. Moreover, the critical link between behavioural effects and training of neural correlates remains to be demonstrated. Our overall goal is to provide a treatment option for individuals suffering from tinnitus by the use of NFB training. To do so, it is necessary to improve neurofeedback (NFB) through (i) a systematic development of advanced feedback stimuli and (ii) development of a NFB protocol with tinnitus-specific neural targets, and (iii) evaluate the potential of NFB tinnitus treatment at home. All project partners will collaborate in a tightly synchronised project implementation. The step-wise evolution of the work will aim towards and pivot around therapy of tinnitus as an exemplary clinical use case. First, the design and validation of a set of visual and auditory NFB stimuli will be addressed, based on a systematic assessment of stimulus-specific neural reactions as well as cognitive, affective and motivational consequences of stimulus exposure. Second, based on these stimuli, the validation, localisation, parameterisation, feature extraction, and NFB protocol design will be carried out in parallel. In addition, feasibility studies evaluate needs and requirements for tinnitus home-treatment. Main outcomes of the research project will be best practice methods, data-sets, visual and auditory stimulus designs, and software tools, which will be made openly available for the scientific community, treatment practitioners and the broad public. In addition, all outcomes will be disseminated through high-impact publications in neuroscience and behavioural science, as well as the fields of cognitive ergonomics, sound-, visual- and interaction-design. Uniting three research groups from the domains of clinical neuroscience (University of Zurich, UZH, University Hospital Zurich, USZ), cognitive psychology and user experience evaluation (Bern University of Applied Sciences and the University of Fribourg, BFH-UFR), and visual and interaction design (EPFL+ECAL Lab, Lausanne), the proposed research consortium will be the first of its kind to address these issues from a multidisciplinary perspective and expertise. ## Team ### University (Hospital) of Zurich Tobias Kleinjung, Patrick Neff, Payam Sadeghi Shabestari ### EPFL+ECAL LAB Nicolas Henchoz, Delphine Ribes, Danpeng Cai, Lara Défayes ### Institute for New Work, Department Wirtschaft, Berner Fachhochschule Andreas Sonderegger, Adrian Naas ## Project partners Dimitri Van de Ville, Département de Radiologie Hôpitaux universitaires de Genève Nathan Weisz, Salzburg Brain Dynamics Lab Universität, Salzburg Centre for Cognitive Neuroscience ## Disciplines and keywords Clinical neuroscience, Otorhinolaryngology, (Applied) psychology, Information technology, Neurophysiology, Sound design, User experience, Tinnitus, Visual design, Design aesthethics, Neurofeedback training, Clinical sciences
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