Evaluating the Efficacy of a Smartphone App for Tinnitus Relief Using Behavioral and Brain Imaging Measures

Purpose: In this exploratory, open-label study, we used behavioral and brain imaging measures to assess the effectiveness of a smartphone application (ReSound Relief app), which aims to help reduce tinnitus-related distress. Method: Fourteen participants with a wide range of tinnitus-related symptoms and who were not currently undergoing any external treatment participated. They completed the 6-month study and reported different levels of engagement with the app. Results: Across a range of tinnitus questionnaires, most participants showed either no change or decrease in tinnitus handicap. Resting-state and task-based functional magnetic resonance imaging (fMRI) data were collected at baseline and the end of the study. Resting-state fMRI of 12 participants revealed alterations in interregional connectivity of default mode, salience, emotion, auditory, and visual processing networks at the end of the intervention period compared to baseline. Ratings of affective sounds (as pleasant, neutral, or unpleasant) were assessed using fMRI, and comparison after 6 months of app usage revealed reduced activity in the left superior temporal gyrus (secondary auditory cortex), right superior occipital gyrus, and left posterior cingulate cortex. Our findings were not significant at a false discovery rate level of p < .05. Conclusions: The reported changes were not significant, possibly due to the small sample size, heterogeneity of the tinnitus handicap among subjects at the start of the project, and the length of the intervention period. Nevertheless, this study underscores the ease of usage of the app and the potential use of brain imaging to assess changes due to a passive, self-administered intervention for individuals with varying levels of tinnitus severity.