AzTrials
AzTrials

Tinnitus, SubjectivePHONACOUNCT06880367

Neuromodulatory Effects of Audio-proprio-phonatory Reinforcement Training on Subjective Tinnitus, Demonstrated by High-density Electroencephalogram (HD EEG)

A study testing The intervention is an audio-proprio-phonatory training and high-density electroencephalogram (HD-EEG) in people with Tinnitus, Subjective, run by Centre Hospitalier Régional d'Orléans at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Our ecological approach to neuromodulation in the field of "acouphonology" empowers tinnitus patients to act as their own source of sound stimuli through audio-proprio-phonatory reinforcement (APPR). Read more about this study

Who is it for?
Ages 18 to 84 years
Conditions the study is for
Tinnitus, Subjective
What is being tested?
The intervention is an audio-proprio-phonatory training and high-density electroencephalogram (HD-EEG)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
56 participants
Where
1 siteFrance
Study dates
18 Mar 2025to 18 Sep 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 84 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Person who agreed to participate in the study and gave consent
  • Aged ≥ 18 years and < 85 years
  • Suffering from subjective tinnitus for more than 3 months
  • Have a score on the THI questionnaire taken at T0 greater than or equal to 38
  • Be equipped with a smartphone compatible with the Siopi application and a computer connection for videoconference sessions
  • Have answered the questionnaires on the Siopi application: THI, VAS-D and associated questions and insomnia severity index
Show all 9Show fewer
  • Have committed to diligently following the study protocol, including independent training
  • Have agreed not to take other new treatments for tinnitus throughout the duration of the study
  • Able to understand and carry out assessment instructions.

Who cannot join

  • Patient suffering from objective tinnitus
  • Current port of white noise generators
  • Patient having consulted phoniatrics more than twice or having participated in more than two sound-mediated workshop sessions
  • Bilateral hearing loss > 40 dB uncorrected on an audiogram or having declared serious or severe hearing loss on Siopi questionnaire, with or without prosthetic correction
  • New therapy introduced less than 2 months ago
  • Psychatric disorders causing auditory hallucinations
Show all 12Show fewer
  • Protected person (under guardianship or curatorship)
  • Person under judicial protection
  • Person deprived of liberty
  • Person not affiliated to a social security system
  • Pregnant or breastfeeding woman
  • Person participating in a drug study

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • CHU Orleans

    Orléans, 45067

    Isabelle Dr MARIE-BAILLY, PhD, 238744328 ext. +33, isabelle.marie-bailly@chu-orleans.fr

    Recruiting

Other trials in France

About this study

Our ecological approach to neuromodulation in the field of "acouphonology" empowers tinnitus patients to act as their own source of sound stimuli through audio-proprio-phonatory reinforcement (APPR). By engaging in self-phonations, individuals uncoverthe vast potential for sound production, which can effectively mask their tinnitus or induce residual inhibition, all without relying on external sources.

This clinical study aims to illustrate the positive impact of audio-proprio-phonatory reinforcement training on individuals suffering from chronic subjective tinnitus. This will be further supported and quantified through high-definition electroencephalography (HD EEG) as we explore the relationship between changes in connectivity within specific brain regions and the varying degrees of response to the therapeutic protocol.

Read the detailed description

Three visits will be conducted, with intervals of two periods lasting five weeks each.

Inclusion visit (T0): Following the assessment of eligibility, the patient will receive an informative document regarding the study. After a period of contemplation, the patient will provide consent to participate.

This visit will include a medical examination, an APPR test accompagnied by spectrogram feedback, a tinnitus assessment focusing on residual inhibition, high-density electroencephalograms and self-assessment questionnaires.

Phase 1: Other the course of five weeks, Group A, designated for"audio-proprio-phonatory training" will participate in one group videoconference session each week, along with daily exercises to complete. Participants will also be required to self-assess using the Visual Analog Scale of discomfort (VAS-D) on the days of the group workshops and on Fridays (both morning and evening).

Concurrently, Group B, labeled "no training" will conduct self-assessments using the VAS-D on Mondays and Fridays (morning and evening).

T1 visit: This visit will involve a medical examination, high-density electroencephalograms and self-assessment questionnaires will be performed.

Phase 2: The 2 groups will switch roles and follow the same protocol as outlined in phase 1.

End of study visit (T2): A medical examination and self-assessment questionnaires will be conducted.

Being tested
The intervention is an audio-proprio-phonatory training, high-density electroencephalogram (HD-EEG)
Keywords
Subjective tinnitus, neuromodulation, audio-proprio-phonatory reinforcement, high-density electroencephalogram
Medical subject headings
Tinnitus

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • The intervention is an audio-proprio-phonatory trainingBehavioural

    The audio-proprio-phonatory training involves engaging in group workshops and performing exercise sessions independently, following the guidance provided by the specialist, over a duration of five weeks

  • high-density electroencephalogram (HD-EEG)Diagnostic test

    HD-EEG examination with 256 channels distributed throughout the skull that record resting brain connectivity(10 min).

Study groups in NCT06880367
Study groupRoleWhat they receive
Group 1: audio-proprio-phonatory training (phase 1) then no training (phase 2)ExperimentalPatients will undergo audio-proprio-phonatory training and evaluate their discomfort using the VAS-D scale for a duration of five weeks. Following this period, they will be assessed with the THI score and undergo HD EEG examination (T1). Subsequently, there will be no training and patients will again evaluate their discomfort using the VAS-D score over the next five weeks. At the conclusion of the ten weeks of follow-up, patients will be assessed with the THI score.
Receives: Behavioral: The intervention is an audio-proprio-phonatory training; Diagnostic Test: high-density electroencephalogram (HD-EEG)
Group 2: No training (phase 1) then audio-proprio-phonatory training (phase 2)ExperimentalPatients will be no training and evaluate their discomfort using the VAS-D scale for a duration of five weeks. Following this period, they will be assessed with the THI score and undergo HD EEG examination (T1). Subsequently, there will undergo audio-proprio-phonatory training and patients will again evaluate their discomfort using the VAS-D score over the next five weeks. At the conclusion of the ten weeks of follow-up, patients will be assessed with the THI score.
Receives: Behavioral: The intervention is an audio-proprio-phonatory training; Diagnostic Test: high-density electroencephalogram (HD-EEG)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The objective is to assess whether training that incorporates audio-proprio-phonatory reinforcement (APPR) can alleviate the daily life disability associated with tinnitus, in comparison to patients who have not undergo APPR training.

    The international Tinnitus Handicap Inventory (THI) questionnaire will be employed to assess the influence of training on the quality of patients affected by tinnitus.. This assessment will include a comparison of the changes in THI scores from T0 (Day 0) to T1 (Day 42) in the group that underwent APPR training, relative to the changes in THI scores from T0 (Day 0) to T1 (Day 42) in the group that did not receive APPR training.

    Measured: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days) of the study.

Secondary outcomes (13)
  1. Determine whether APPR exercises reduce the discomfort linked to tinnitus in the short term (tinnitus discomfort VAS), compared to patients who have not followed APPR training

    Visual analog scale of discomfort (VAS-D) tinnitus (scale from 0 to 10 with 10 being the worst score), completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), 4 times per week.

    • For the group with APPR training between T0 and T1, they will be completed : morning and evening, on the day of the group workshops (Monday or Tuesday) and on Friday
    • For the group without APPR training between T0 et T1, they will be completed : upon waking up and in the evening, every Monday and Friday.

    This will first involve comparing the average of the daily differences obtained over 5 weeks . Then we will compare the evolution (taking the daily average of the tinnitus VAS-D) over 5 weeks between T0 et T1 for the 2 groups.

    NB : These results can be confirmed bu analyzing the tinnitus VAS-D over the 5 weeks between T1 (Day 42) and T2 (Day 92) for group B (having the APPR training over this period.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  2. Study the stability over time of quality of life (THI score) after APPR training.

    To study stability over time, only data from patients in group A, without APPR training between T1 (Day 42) et T2 (Day 92) will be used :

    • The THI score (scale from 0 to 100 with 10 being the worst score) measured at T1 and T2 This will involve comparing the results at T2 compared to T1.

    Measured: Evaluation at T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  3. Study the stability over time of tinnitus-related discomfort (VAS) after APPR training.

    To study stability over time, only data from patients in group A, without APPR training between T1 (Day 42) et T2 (Day 92) will be used :

    • VAS-D tinnitus scale (scale from 0 to 10 with 10 being the worst score), completed by te patient (on the Siopi application), weekly between T1 and T2, 4 times per week.

    Measured: Evaluation at T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  4. Describe the evolution of quality of life (THI score) during the study

    Evolution over time of the THI score (scale from 0 to 100 with 10 being the worst score) measured at T0 (Day 0), T1 (Day 42) and T2 (Day 92) for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  5. Describe the evolution of other collateral discomfort (noise) to tinnitus of patients who followed APPR training, compared to patients without APPR training

    Visual analog scale VAS-D (scale from 0 to 10 with 10 being the worst score) associated questions about noises, completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), at a rate of 4 times per week, for the 2 groups. We will compare the evolution of each VAS-D taken independantly, taking the daily average of VAS-D concerned, over the 5 weeks between T0 and T1 for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  6. Describe the evolution of other collateral discomfort (cervical pain) to tinnitus of patients who followed APPR training, compared to patients without APPR training

    Visual analog scale VAS-D (scale from 0 to 10 with 10 being the worst score) associated questions with cervical pain completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), at a rate of 4 times per week, for the 2 groups. We will compare the evolution of each VAS-D taken independantly, taking the daily average of VAS-D concerned, over the 5 weeks between T0 and T1 for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  7. Describe the evolution of other collateral discomfort (jaw pain) to tinnitus of patients who followed APPR training, compared to patients without APPR training

    Visual analog scale VAS-D (scale from 0 to 10 with 10 being the worst score) associated questions with jaw pain completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), at a rate of 4 times per week, for the 2 groups. We will compare the evolution of each VAS-D taken independantly, taking the daily average of VAS-D concerned, over the 5 weeks between T0 and T1 for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  8. Describe the evolution of other collateral discomfort (sleep) to tinnitus of patients who followed APPR training, compared to patients without APPR training

    Visual analog scale VAS-D (scale from 0 to 10 with 10 being the worst score) associated questions about sleep completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), at a rate of 4 times per week, for the 2 groups. We will compare the evolution of each VAS-D taken independantly, taking the daily average of VAS-D concerned, over the 5 weeks between T0 and T1 for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  9. Describe the evolution of other collateral discomfort(stress-anxiety) to tinnitus of patients who followed APPR training, compared to patients without APPR training

    Visual analog scales VAS-D (scale from 0 to 10 with 10 being the worst score) associated questions about stress-anxiety completed by the patient (on the Siopi application), weekly between T0 (Day 0) and T1 (Day 42), at a rate of 4 times per week, for the 2 groups. We will compare the evolution of each VAS-D taken independantly, taking the daily average of VAS-D concerned, over the 5 weeks between T0 and T1 for the 2 groups.

    Measured: Evaluation at T0 (Day 0), T1 (Day 42 +/- 7 days) and T2 (Day 92 +/- 7 days)

  10. Evaluate the effect of APPR training on the usual connectivity of HD-EEG, compared to patients who did not follow APPR training

    Exploratory analyzes of the different HD-EEG parameters measured at T0 (Day 0) and T1 (Day 42) in the 2 groups :

    The evolution of HD-EEG connectivity such as : network efficiency, dwill be described in the group with APPR training and compared to the evolution of this same parameter in the group without APPR training between T0 and T1.

    Measured: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days)

  11. Evaluate the effect of APPR training on the usual connectivity (duration of states) of HD-EEG, compared to patients who did not follow APPR training

    Exploratory analyzes of the different HD-EEG parameters measured at T0 (Day 0) and T1 (Day 42) in the 2 groups :

    The evolution of HD-EEG microstate parameters such as : duration of states, will be described in the group with APPR training and compared to the evolution of this same parameter in the group without APPR training between T0 and T1.

    Measured: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days)

  12. Evaluate the effect of APPR training on the usual microstate parameters (distribution of states) of HD-EEG, compared to patients who did not follow APPR training

    Exploratory analyzes of the different HD-EEG parameters measured at T0 (Day 0) and T1 (Day 42) in the 2 groups :

    The evolution of HD-EEG connectivity and microstate parameters such as : distribution of states, will be described in the group with APPR training and compared to the evolution of this same parameter in the group without APPR training between T0 and T1.

    Measured: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days)

  13. Describe the evolution of the quality of life (THI score) of patients before and after APPR training and the usual connectivity and microstate parameters of HD-EEG, over time.

    Exploratory analyzes of the search for correlation between evolution of connectivity parameters of HD-EEG (determine specific parameters like distribution of states) with the evolution of THI score (scale from 0 to 100 with 100 being the worst score) will be explored (between T0 and T1)

    Measured: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Mar 2025
  2. Study start18 Mar 2025
  3. Primary completion18 Sep 2028 (estimated)
  4. Study completion18 Sep 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Crossover
Model description
This study is prospective, randomized into two groups with stratification based on the THI score specifically comparing grade 3 to grades 4 and 5. The neurology staff conducting the HD EEG examination will remain unaware of the treatment allocation, ensuring a single-blinded design.
Masking
Single blind
Who is masked
Care provider
Enrolment
56 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06880367
Sponsor's protocol ID
CHUO-2024-18
Acronym
PHONACOU
Status last verified
Dec 2025
First submitted
6 Mar 2025
Last updated
30 Dec 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Norena AJ. An integrative model of tinnitus based on a central gain controlling neural sensitivity. Neurosci Biobehav Rev. 2011 Apr;35(5):1089-109. doi: 10.1016/j.neubiorev.2010.11.003. Epub 2010 Nov 19.

    PubMed 21094182
  • Tonndorf J. The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus. Hear Res. 1987;28(2-3):271-5. doi: 10.1016/0378-5955(87)90054-2.

    PubMed 2820913
  • De Ridder D, Vanneste S, Weisz N, Londero A, Schlee W, Elgoyhen AB, Langguth B. An integrative model of auditory phantom perception: tinnitus as a unified percept of interacting separable subnetworks. Neurosci Biobehav Rev. 2014 Jul;44:16-32. doi: 10.1016/j.neubiorev.2013.03.021. Epub 2013 Apr 15.

    PubMed 23597755
  • Huang H, Cai Y, Feng X, Li Y. [An electroencephalogram-based study of resting-state spectrogram and attention in tinnitus patients]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2021 Jun 25;38(3):492-497. doi: 10.7507/1001-5515.202012015. Chinese.

    PubMed 34180194
  • Vanneste S, Byczynski G, Verplancke T, Ost J, Song JJ, De Ridder D. Switching tinnitus on or off: An initial investigation into the role of the pregenual and rostral to dorsal anterior cingulate cortices. Neuroimage. 2024 Aug 15;297:120713. doi: 10.1016/j.neuroimage.2024.120713. Epub 2024 Jun 27.

    PubMed 38944171

Questions about this trial

What is this clinical trial studying?

A study testing The intervention is an audio-proprio-phonatory training and high-density electroencephalogram (HD-EEG) in people with Tinnitus, Subjective, run by Centre Hospitalier Régional d'Orléans at 1 site in France.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 30 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Isabelle Dr MARIE-BAILLY, PhD (2 38 74 43 28 ext. +33, isabelle.marie-bailly@chu-orleans.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The objective is to assess whether training that incorporates audio-proprio-phonatory reinforcement (APPR) can alleviate the daily life disability associated with tinnitus, in comparison to patients who have not undergo APPR training. (time frame: Evaluation at T0 (Day 0) and T1 (Day 42 +/- 7 days) of the study.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06880367, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Dec 2025.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in