The AudioNotch Tinnitus Treatment Blog

Can an old drug (D-cycloserine) reduce the cognitive side effects of tinnitus?

Written by AudioNotch Team on November 12, 2014

Extremely interesting new research indicates that some tinnitus patients found a subjective improvement in their cognition when they took D-cycloserine:

People with tinnitus perceive ringing in their ears and this phantom noise can cause difficulty concentrating.

A new noise doesn’t make the perceived noise go away—but it does seem to help patients cope with it in their daily lives.

A pilot study shows that patients participating in computer-based cognitive training and taking a drug called d-cycloserine report greater improvements in the ability to go about their daily lives than patients who did the same cognitive training but took a placebo.

Why was this particular agent chosen?

“There is a lot of evidence that d-cycloserine can help people train their brains,” Piccirillo says. “It facilitates neuroplasticity and is known to be effective in fear extinction, obsessive-compulsive disorder, and anxiety disorders. And now we have evidence that it has some benefit in tinnitus.

The results should be qualified, however. The improvement measured was subjective, not objective:

However, the drug was also associated with improvements in self-reported cognitive deficits on the Cognitive Failures Questionnaire (CFQ; change in score, –4.5 vs –2.0), which remained significant after adjustment for other factors.

In attempting to explain why DCS was associated with a statistically significant improvement in self-reported cognitive difficulties yet did not affect objectively assessed cognitive performance or more strongly reduce tinnitus bother, the authors suggest that as the study was so small an effect may have been observed only in the most strongly affected outcome.

Noting that DCS most clearly augments learning related to reduced fear, they also suggest that in this study the drug may have helped reduce concerns about cognitive performance, rather than learning reflected in scores on objective neurocognitive testing.