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Bart

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 #1 
Hello dear Dr. Nagler ,

What are your tought on the new Neuromod device that will be on the market in 2019 ?

The results sound promising . There is at least one confirmed case who has her tinnitus completely resolved after 12 weeks of using the device in clinical trials .

[Ed note: Link removed. smn]

Thanks .
Dr. Nagler

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 #2 
Hello Bart -

I confess that I do not have much of an opinion one way or another on the Neuromod device. I am of course aware that there is a quite a bit of enthusiasm about it on one of the other boards.

To be honest, the Neuromod concept confuses me, at least on its surface. The theory - the idea of using the tongue to indirectly access the auditory system - seems to me more like fantasy than real science, but I readily admit that I might be wrong about that. Anyway, to the best of my knowledge all of the data collected thus far are either anecdotal (e.g., the "one confirmed case") or internally generated or both. What I am looking for are reliable and independently verifiable properly controlled and blinded studies published in peer-reviewed scientific journals.

Would I like the company to be successful in its efforts to provide meaningful lasting relief. Absolutely. I would be thrilled!

But since 1994 (when I myself developed tinnitus) every single one of the "latest and greatest" devices to come down the pike has ultimately proved to be little more than smoke and mirrors. Will this one be different? I just do not know.

So, to answer your question, my thoughts on the Neuromod device can be summed up in three words: Wait And See.

Why do you ask?

Stephen M. Nagler, M.D.

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The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
Bart

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 #3 
Thanks for the reply ,

I ask because I need the opinion of proffesionals who can indeed as you say, have an objective look at it , my audiologist pretty much said the same , that the results look promising but that there is very little known about methodolgy and/or how they measured the results, the peer reviewed papers are yet to be released . I certainly want to believe in it but I try and keep my enthousiasm pretty low. 

Luckily we have come a long way in research and understanding tinnitus since 1994 , this is suppose to be based on years of research , it seems a shotgun approach and indeed, let's wait and see .

You are sorely missed from my point of view on that particular board , I Always enjoyed your clear and objective look on things .


Dr. Nagler

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 #4 
Quote:
Thanks for the reply ,

You are welcome.

Quote:
I ask because I need the opinion of proffesionals who can indeed as you say, have an objective look at it ,

It really doesn't take a professional to have an objective look. I mean, I would like to see a cure for tinnitus every bit as much as the next person. I recall well how much I suffered back in the mid-1990s, and I don't wish that on anybody. A cure would be fantastic. I just refuse to let my heart stand in the way of my objectivity!

Quote:
Luckily we have come a long way in research and understanding tinnitus since 1994 , this is suppose to be based on years of research , it seems a shotgun approach and indeed, let's wait and see .

It doesn't seem like a shotgun approach to me. It sounds like a logical approach based upon a theory. My concern has to do with the theory, which I do not understand. But I remain open-minded until reliable and independently verifiable properly controlled and blinded studies are in - or until enough time has gone by without such studies. Right now it is just too early to tell.

I might add that the way the folks who run Tinnitus Talk have included their members in putting together a set of questions for Steve Harrison to pose to Ross O'Neill of Neuromod in the form of a video is really admirable. 

Quote:
You are sorely missed from my point of view on that particular board , I Always enjoyed your clear and objective look on things .

Thank you for the kind words. I very much enjoyed participating on Tinnitus Talk. Between April 2014 and June 2015 I answered some 450 questions on their Doctors' Corner. But at some point the owners banned me. To be honest I do not recall the exact circumstances, but in retrospect undoubtedly the fault was mine. I tended to be rather abrupt in some of my postings there - and the admins likely figured I was more trouble than I was worth. Perhaps they were right! Anyway, my archived Doctors' Corner responses can be found HERE.

I can also tell you that I was quite bitter about the whole banning business for a long time. I took it very personally and made some comments here on this board that I truly regret posting. I removed it all a while back, but some things you just can't undo. I consider it a lesson learned, even at the ripe old age of 70!

Anyway, I'm pretty sure that the folks who run Tinnitus Talk know that I would return if they were interested. But apparently they are not, and I have to respect that. They continue to put a tremendous amount of time and effort into their site - and they deserve to have it exactly the way they want it. I wish them well.

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
ruud1boy

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 #5 
As I understand it, Neuromod have conducted a controlled, double-blinded study re this device, which is currently being prepared / submitted for peer review. Does that lend it any more credence to you as a professional?
Dr. Nagler

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 #6 
Quote:
Originally Posted by ruud1boy
As I understand it, Neuromod have conducted a controlled, double-blinded study re this device, which is currently being prepared / submitted for peer review. Does that lend it any more credence to you as a professional?

As a professional my answer would be no. As a professional I would want to be assured that the study is both reliable (which means that the methodology is sound) and verifiable (which means that the findings have been replicated by investigators who do not have a vested interest in the outcome). The standard of reliability and verifiability is what any professional would look for.

Now as a person who has had first-hand experience suffering from severe intrusive tinnitus, I am of course very pleased to hear that a controlled double-blind study is being prepared for submission to a peer reviewed journal. But you asked my opinion as a professional, and I responded as a professional.

All the best -

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
ruud1boy

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 #7 
A slightly provocative question then. What's your professional opinion of Rich Tyler? Do you think he would put his name to something like this if he felt it was just a shot in the dark? (Thanks for humouring me BTW, it's greatly appreciated).
Dr. Nagler

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 #8 
My professional opinion of Rich Tyler? Rich Tyler is a very dedicated tinnitus clinician and researcher. I have known Rich for almost two decades now and consider him to be a friend. He offers an annual tinnitus course at the University of Iowa for hearing healthcare professionals, and I have given guest presentations at five of them.

But I haven't the faintest idea why he would put his name to any given project. If he is like most clinical researchers, his name is associated with some projects that ultimately succeed, and his name is associated with some projects that ultimately fail.

If I may ask, why is my opinion about these things of such great interest to you? I mean, what I might think about Neuromod (or Rich Tyler, for that matter) carries with it absolutely no predictive value whatsoever.

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
ruud1boy

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 #9 
There aren't many portals available where one can pick the brains of tinnitus professionals in an open forum. I know what I think (& hope) about Neuromod, but it's always good to get the opinions of others, particularly where those others might know more than me about tinnitus.

The calibre of people involved with this Neuromod project (your friend Rich, Deb Hall, Hubert Lim etc) gives me some confidence that it's not just a fishing exercise and does have some prospects for efficiency. You've noted that if it works it would be in every VA / ENT office, but that can't happen until the treatment can be proven. Fingers crossed it will be in a few years time.
ruud1boy

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 #10 
There aren't a great many portals where one can pick the brains of tinnitus clinicians. I know what I think (and hope) about Neuromod, but it's always good to get the opinions of others, especially if those others might know more about than subject than I do.

The calibre of people involved in this Neuromod project (your friend Rich, Deb Hall, Hubert Lim etc) gives me some hope that this may have some prospect of success. You've mentioned that if it worked, it would be in every VA / ENT office, but that can't happen until it's been proven to work. Fingers crossed that day is getting closer.
Dr. Nagler

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 #11 
Ruud1boy, you are new here. I just want to let you know that you only have to submit posts one time. Posts do not actually appear on this board until I have had a chance to read them and give some thought to my responses. That can often take a day or two. Occasionally even longer!

Quote:
There aren't a great many portals where one can pick the brains of tinnitus clinicians. I know what I think (and hope) about Neuromod, but it's always good to get the opinions of others, especially if those others might know more about than subject than I do.

Well, you have my opinion on Neuromod, which is basically that I have no opinion on Neuromod! 

Quote:
The calibre of people involved in this Neuromod project (your friend Rich, Deb Hall, Hubert Lim etc) gives me some hope that this may have some prospect of success. You've mentioned that if it worked, it would be in every VA / ENT office, but that can't happen until it's been proven to work. Fingers crossed that day is getting closer.

I can absolutely understand how you find it reassuring that some reputable people are involved with Neuromod.

Strictly from a practical standpoint, however, I myself have come to view hope as somewhat overrated. Why? Because hoping that this treatment or that will eliminate tinnitus or lastingly reduce its intensity is not going to affect the likelihood of that actually happening one iota. However, if you wake up each morning hoping that maybe today will be the day, then there is a very good chance that you will start each day being disappointed that nobody has yet come up with the holy grail, a treatment that will either eliminate tinnitus or lastingly reduce its intensity. On the other hand, if you assume that your tinnitus is here to stay forever, and then all of a sudden you find out that somebody has indeed discovered the grail - then you can be totally thrilled to have been wrong in your original assumption. To my way of thinking the latter approach makes much more sense. After all, why start out even one day being disappointed if you don't absolutely have to??!!

I know that some might find the above philosophy to be cold. But it is born out of years and years and years of disappointment after disappointment after disappointment. Folks sometimes forget that my ears ring too!

All the best -

Stephen M. Nagler, M.D.

__________________

The best way to find yourself is to lose yourself in the service of others.
- Mahatma Gandhi

No bird ever soared in a calm. Adversity is what lifts us.
-
David McCullough quoting Wilbur Wright
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Dr. Nagler's Tinnitus Corner is provided for education and information only. It is not intended for the purpose of providing medical care and should in no way substitute for appropriate in-person consultations with qualified healthcare professionals. By using this site, participants agree to hold Dr. Nagler and Atlanta Tinnitus Consultants, LLC harmless with respect to any loss, injury, claim, liability, or damage arising from following the postings herein.