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Katie Couric Interview

"Today" Show - 1/23/98

KATIE COURIC, co-host:
This morning on "Today's Health" – breakthrough findings on TINN-it-us or tin-NITE-us, including new hope for the estimated 50 million Americans who have this condition, also known as "ringing in the ears." Dr. Stephen Nagler is director of a tinnitus clinic in Atlanta. Dr. Nagler, good morning. Nice to see you.

Dr. STEPHEN NAGLER: Good morning, Ms. Couric.

COURIC: Why don't you explain what tinnitus is exactly.

NAGLER: Tinnitus is the experience of sound that comes from a source that is not external to the body. It's definitely a physical phenomenon rather than a psychological phenomenon. About 50 million Americans, as you mentioned, experience it. Maybe 10 million Americans truly suffer from it and are significantly affected.

COURIC: Is this ringing in the ears or ear – is it a sporadic event or is it a constant ringing?

NAGLER: It can be sporadic, but more commonly it is constant. Sometimes you may not be aware of it, but usually it's a constant phenomenon. People are really plagued by it.

COURIC: It's brought on by certain things, isn't it, Doctor?

NAGLER: Certain things can aggravate it. The cause in most cases is felt to be – the original source is often felt to be a problem in the inner ear, but there can be several causes. Noise exposure is the predominant initial insult.

COURIC: Tell us about this new research that is so exciting.

NAGLER: It is exciting, and this is research by Drs. Lockwood and Salvi from Buffalo. The research has implications not only for a potential future cure, but implications for present treatment. They found a group of tinnitus sufferers, who by various facial and oral movements were able to alter the intensity of their tinnitus. They could turn their tinnitus "on" and "off."

COURIC: They could do it by adjusting their jaw, right?

NAGLER: Yes, in some ways, but that's not relevant. What is relevant is that they were able to control their tinnitus, so they could be studied using a special kind of scanner to see the various brain activity when they had their tinnitus and when they didn't. And what they found is that there was activity in the auditory cortex, which is over here in the temporal lobe of the brain (points to model of brain) where you would expect to see it, and that's what they expected to find when the tinnitus was present. And there was no activity in this area of conscious awareness when the tinnitus was absent. What they didn't expect to find was that when tinnitus was present there was also activity in a subconscious part of the brain called the limbic system (points to limbic system in model of brain). The implications for future potential cure is that if pharmacological, or biochemical, or even possibly surgical approaches can be directed at the tinnitus areas within the limbic system, there is potential cure. And for present treatment – for present tinnitus sufferers – among the several effective treatments present is one treatment developed by Dr. Pawel Jastreboff at the University of Maryland, which is directed at physiologically altering the bond between the limbic system and tinnitus. The implication is that this treatment – "Tinnitus Retraining Therapy" – was originally based upon Jastreboff's theory. This is the first hard evidence that the theory may, indeed, be valid. And it's very very hopeful for now and for the future.

COURIC: Very exciting. You think you're optimistic that this research will aid scientists and physicians in terms of finding an actual cure.

NAGLER: I really believe that, and in fact Lockwood and Salvi were just awarded a $1.5 million grant to move ahead with their studies. And the present treatment is available at several places within the United States, and for the future hopefully we will have a cure.

COURIC: Yea, hopefully we'll help those 50 million.

NAGLER: It would be terrific if we could.

COURIC: All right, Dr. Nagler, thanks so much for joining us.

NAGLER: It was my pleasure.