Horizon 2020 backs major push to tackle tinnitus

Martin Luther, who led the Protestant Reformation, used to suffer tinnitus so badly in his ear that he had to hire a strongman or two to stop him from physically hurting someone or himself during the bouts of pain. At the time he thought his bouts of tinnitus were Satanic punches, but now we know them to be a form of altered neuronal activity.

Luther complained: “When I try to work, my head becomes filled with all sorts of whizzing, buzzing, thundering noises.”

This story was relayed by Professor Dr Berthold Langguth, a neurologist at the University Hospital of Regensburg in Germany and chairman of the Tinnitus Research Initiative, in a Facebook message to the Tinnitus Hub, in which he asked, “Would Martin Luther have better options for treatment of his tinnitus nowadays?” The answer is not many and the reason is lack of funding for research.

But this may now change because three Marie Sklodowska-Curie Innovative Training Networks, or ITNs, have been funded to the tune of €10.3 million (US$12 million) from Horizon 2020 to teach some 40 plus PhD candidates in France, the United Kingdom, Germany, Denmark, Italy, Sweden, Spain, the Netherlands, Switzerland, Austria and Poland and help support research into tinnitus.

The condition affects up to 50 million people in Europe with an estimated loss of €140 billion per year in Europe due to loss in productivity.

The projects of the three networks – Tinnitus Assessment Causes and Treatments or TIN-ACT, the European School for Interdisciplinary Tinnitus Research or ESIT, and Liaison in Scientific Training for European Auditory Neuroscience or LISTEN – have set out to closely integrate academic institutions and clinical and industrial partners with patient organisations and public health authorities.

All three have begun work over the past year, with TIN-ACT, the latest, starting last month.

Extensive university cooperation

The TIN-ACT network is coordinated by the academic hospital in Groningen in the Netherlands with cooperating academic partners at the Centre National de la Recherche Scientifique or CNRS, France; the University of Nottingham, UK; the university clinics of Erlangen and Charité-Berlin in Germany and private companies in Denmark and the UK.

The ESIT network is coordinated by the university clinic in Regensburg, Germany, with university partners in Nottingham, UK; Karolinska Institute, Sweden; the University of Ulm, Germany; the University Medical Center Groningen and Maastricht University, the Netherlands; the University of Zurich, Switzerland; the Paris Lodron University of Salzburg, Austria; and the Medical University of Lodz, Poland.

LISTEN is coordinated by the Erasmus University Medical Center in Rotterdam, Netherlands; with the University of Leicester and King’s College London, UK; the universities of Göttingen and Mainz in Germany; and the University of Salamanca, Spain; as partners, together with French research institutions.

Extensive sufferings and societal impact

In spite of the enormous socio-economic relevance and human suffering of tinnitus, international research collaborations on tinnitus have been limited. In fact, during the European research framework programmes since the early 1990s only a few projects with relevance to tinnitus have been funded at the European level.

In a much visited letter published five years ago in Nature Biotechnology, entitled “Hearing Loss and Tinnitus – Are funders and industry listening?”, Christopher Cederroth, Barbara Canlon and Professor Langguth referred to the World Health Organization research indicating a tripling of world-wide hearing impairment, up to 900 million people by 2025.

However, investment in research regarding hearing impairment (a subsection of which includes tinnitus) corresponded to only one fifth of the US contributions to diabetes research, which is projected to be only half as prevalent as hearing loss by 2025. In Europe, this gap was shown to be even greater with hearing disorders funded 20 times less than diabetes.

When picturing the situation in 2017, funders and industry have listened. In addition to these three ITN programmes being funded, a handful of pharma-companies focusing on inner ear disorders have emerged, showing a rising awareness.

Research funding bottlenecks

Dr Cederroth is participating in the ESIT network and has since 2013 been active in the COST Action TINNET involving a large number of academics and other professionals, notably by arranging conferences and newsletters.

He organised a research topic, “Towards an Understanding of Tinnitus Heterogenity”, in 2016, which within the first two years drew more than 1.8 million views on the web – “a major achievement that reveals the importance of our research for the community!” he says.

So why has there been so little investment in tinnitus research?

“Perhaps it is related to the fact that tinnitus is considered by many as a symptom resulting from a large variety of morbidities,” Cederroth told University World News. “There is research, the question is why there isn’t there more funding? There is a niche community performing research, but since there aren’t funding calls specific to tinnitus, there hasn’t been a boost for researchers to start investigating it.”

Tinnitus affects many but in most cases at a level that is “bearable” and this may mask those for whom tinnitus is extremely bothersome. For nearly one in 10 people experiencing tinnitus, it dramatically affects their quality of life and wellbeing.

Cederroth says the European Union funding is excellent news because tinnitus research has been lacking EU support until now.

“These three projects (LISTEN, ESIT and TIN-ACT) all support the education of PhD students with a financial basis for their salary. These grants are great initiatives to complement the national funding agencies, which cannot be expected to support such focused topics beyond individual researchers.

“However, the financial contribution to research material and consumables from these projects remains modest. Without greater funding support, we run a large risk of not being able to solve the tinnitus riddle, with the consequence of witnessing an increasing number of people suffering from this devastating condition.”

Cederroth says this is becoming even more relevant in a population of growing age. “This is where larger EU funding schemes on tinnitus are needed. In parallel, while the EU recognises now the existing expertise and the need for greater knowledge, national funding bodies need a clear mind shift.

“Since tinnitus is an emerging field, the lack of in-depth basic research hampers progress in the field and delays translational innovations. The funding landscape needs to consider more explorative research. The research topic we conducted in the journal series Frontiers is clear evidence of the societal expectations.”