B. Langguth, G. Hajak, T. Kleinjung, A. Cacace & A.R. Møller (Eds.) Progress in Brain Research, Vol. 166 ISSN 0079-6123 Copyright r 2007 Elsevier B.V. All rights reserved CHAPTER 43 Object identification and attention training for treating tinnitus Grant D. Searchfield à , Jeanie Morrison-Low and Kim Wise Section of Audiology, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand Abstract: We hypothesize that abnormal attention and auditory scene analysis contribute to the severity of tinnitus and that the incongruence between tinnitus and normal auditory perception is responsible for its resistance to traditional sound-based habituation therapies. New methods of treatment using auditory and visual attention training are proposed as a means to augment counseling and sound therapies for tinnitus management. Attention training has been demonstrated to improve an individuals’ ability to attend to relevant sounds while ignoring distracters. The main aim of the current study was to determine the effec- tiveness of structured Auditory Object Identification and Localization (AOIL) tasks to train persons to ignore their tinnitus. The study looked at the effects of a 15-day (30 min/day) take-home auditory training program on individuals with severe tinnitus. Pitch-matched tinnitus loudness levels (TLLs), tinnitus min- imum masking levels (MMLs) and measures of attention were compared before and after the auditory training. The results of this study suggest that short-duration auditory training which actively engages attention, object identification and which requires a response from participants, reduces tinnitus. There was a greater effect on pitch-matched tinnitus MMLs than on actual TLLs. The reason(s) for this are unclear, although a correlation found between changes in MMLs and improvements in the ability to shift attention may be one underlying reason. Although this study followed a small number of participants over a limited time-span, it is believed that the training and accompanying model are a promising approach to investigate and treat some forms of tinnitus. Keywords: auditory scene analysis; attention; training; treatment; tinnitus Introduction The last two decades have seen major advances in understanding the neurophysiology of tinnitus (Eggermont and Roberts, 2004) (see Chapter 2) and its similarities to chronic pain (Møller, 2000). An area which has developed slower is our under- standing of the cognitive aspects of tinnitus perception (Zenner and Zalaman, 2004). Simple perceptual constructs of tinnitus such as pitch and loudness may be insufficient as means of charac- terizing tinnitus. We need to extend our view of tinnitus as a phantom perception of a simple sound to incorporate concepts with greater eco- logical validity such as auditory object perception and figure ground differentiation (Winkler et al., 2006). The authors of this chapter consider that tinnitus is complex auditory activity that disobeys rules that normally apply to auditory object à Corresponding author. Tel.: +64 09 373-7599; Fax: +64 09 373-7496; E-mail: g.searchfield@auckland.ac.nz DOI: 10.1016/S0079-6123(07)66043-9 441