Effects of Mindfulness Based Stress Reduction Therapy on Subjective Bother and Neural Connectivity in Chronic Tinnitus
Open accessAbstract
Objective: To evaluate the impact of a Mindfulness Based Stress Reduction (MBSR) program in patients with chronic bothersome tinnitus on the (1) severity of symptoms of tinnitus and (2) functional connectivity in neural attention networks. Study Design: Open‐label interventional pilot study. Setting: Outpatient academic medical center. Subjects: A total of 13 adult participants with a median age of 55 years, suffering from bothersome tinnitus. Methods: An 8‐week MBSR program was conducted by a trained MBSR instructor. The primary outcome measure was the difference in patient‐reported tinnitus symptoms using the Tinnitus Handicap Index (THI) and Tinnitus Functional Index (TFI) between pre‐intervention, post‐MBSR, and 4‐week post‐MBSR assessments. Secondary outcomes included change in measurements of depression, anxiety, mindfulness, and cognitive abilities. Functional connectivity magnetic resonance imaging (MRI) was performed at pre‐ and post‐MBSR intervention time points to serve as a neuroimaging biomarker of critical cortical networks. Results: Scores on the THI and TFI showed statistically significant and clinically meaningful improvement over the course of the study with a median ΔTHI of −16 and median ΔTFI of −14.8 between baseline and 4‐week follow‐up scores. Except for depression, there was no significant change in any of the secondary outcome measures. Analysis of the resting state functional connectivity MRI (rs‐fcMRI) data showed increased connectivity in the post‐MBSR group in attention networks but not the default network. Conclusion: Participation in an MBSR program is associated with decreased severity in tinnitus symptoms and depression and connectivity changes in neural attention networks. MBSR is a promising treatment option for chronic bothersome tinnitus that is both noninvasive and inexpensive.
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All three pre-post studies of mindfulness-based interventions that included a follow-up assessment reported that 58% (7/12), 52.8% (96/182) and 62% (8/13) of participants showed reliable improvements at follow-ups.
“All three pre-post studies of MBIs that included a follow-up assessment reported that 58% (7/12), 52.8% (96/182) and 62% (8/13) of participants showed reliable improvements at follow-ups (Husain et al., 2019;McKenna et al., 2018;Roland et al, 2015).”
From A Systematic Review and Meta-Analysis Exploring Effects of Third-Wave Psychological Therapies on Hearing-Related Distress, Depression, Anxiety, and Quality of Life in People With Audiological Problems. (2022) · cites this paper as Roland et al, 2015
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“Recent work has used rs-fcMRI to measure connectivity differences between nonbothered tinnitus patients, bothered tinnitus patients, and healthy controls.(7,8) Patients with bothersome tinnitus display altered patterns of neural connectivity, including key cortical attention networks, as compared to healthy controls.”
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“Nonbothered patients revealed connectivity networks consistent with healthy controls, suggesting that altered network connectivity may play a role in tinnitus bother.(10) Mindfulness Based Stress Reduction (MBSR) is a meditation and yoga program(11) with a focus on mindfulness, a method for facing, exploring, and alle…”
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“MBSR treatment reduces stress levels, improves immune function, and lowers depression and anxiety in numerous clinical settings.12 A recent study by Gans et al13 provided preliminary behavioral evidence that MBSR may be an effective intervention for patients with tinnitus.”
BackgroundResult
Flagged first, then by citations
2 of the 38 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
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“The PFC also shows increased functional connectivity with the salience network (Menon, 2015), the superior temporal gyrus, the visual cortex, the amygdala, the hippocampus and the posterior cingulate cortex (Kilpatrick et al., 2011; Roland et al., 2015; Wells et al., 2013).”
BackgroundResultInfluentialKing, A. P., Block, S. R., Sripada, R. K., Rauch, S., Giardino, N., Favorite, T., Angstadt, M., Kessler, D., Welsh, R., & Liberzon, I. (2016) · Depression and Anxiety · doi:10.1002/da.22481 · Cited by 225 · see citing works
“We did not perform global-signal regression because it has been suggested that it may result in spurious anticorrelations.[47] However, since rsFC measures low-frequency”
BackgroundNeural networks of tinnitus in humans: Elucidating severity and habituation
Husain, F. T. (2015) · Hearing Research · doi:10.1016/j.heares.2015.09.010 · Cited by 125 · see citing works
“291 In a recent intervention study using mindfulness based therapy (Roland et al., 2015), 292 comparison of pre- and post-therapy resting state fMRI data revealed increased connectivity 293 within the dorsal attention network but not in the default mode network after the intervention.”
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“Participants were also assessed for comorbid disorders using the Mini-International Neuropsychiatric Interview (MINI) (39).”
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“…used in clinical and scientific practice to measure tinnitus distress and to test potential reduction of the THI score as a consequence of applied therapy (see, e.g., Landgrebe et al., 2010; Shekhawat et al., 2013; Roland et al., 2015; Wilson et al., 2015; Wise et al., 2015; Zobay et al., 2015).”
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“…2002), Progressive Tinnitus Management (Henry et al, 2010), Tinnitus Activities Treatment (Tyler et al, 2007), or mindfulness-based therapies (Roland et al, 2015), they are most confident in, regarding effectiveness of the therapy and their application of it, and to start implementing it in…”
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“Additionally, other previous studies have not reported on the functional connectivity of the thalamus due to the heterogeneity of applied fMRI analytic methods (Krick et al. 2017a; Krick et al. 2017b; Roland et al. 2015; Roland et al. 2016).”
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“in an identical fashion to our prior study.(26) The variance between successive EPI volumes was computed, and scans were aligned”
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“Although the research on these treatments are still in their early days, mindfulnessbased therapies have shown initial promise in modulating the severity of tinnitus (Kreuzer et al., 2012; Philippot et al., 2012; Gans et al., 2014; Roland et al., 2015; McKenna et al., 2017).”
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“Mindfulness-Based Stress Reduction Therapy (MBSRT, see e.g., Roland et al., 2015) and Acceptance and Commitment Therapy (ACT, see e.g., Westin et al., 2011) have both led to improvement in tinnitus tolerance.”
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“Roland et al. (2015) Chronic tinnitus Resting state Increased functional connectivity between the left IFG and the left superior temporal gyrus, posterior cingulate, and visual cortex, as well as between the right IFG and the posterior cingulate gyrus.”
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“observed the effects of mindfulness based stress reduction on changes in attention pathways (56).”
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“Such interventions have also been used to treat psychological symptoms associated with tinnitus (Gans, O’Sullivan, and Bircheff 2014; Kreuzer et al. 2012; McKenna et al. 2017; Philippot et al. 2012; Roland et al. 2015).”
BackgroundMethodResultInfluentialPersonality and Sleep Evaluation of Patients with Tinnitus in Japan
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Cognitive Training for Adults With Bothersome Tinnitus
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“Tinnitus retraining therapy (TRT) [35], psychotherapy [36], relaxation and meditation [37,38], hypnosis [39], biofeedback [40], education-information [41], and stress management-problem solving [42], among others, can be helpful and reduce tinnitus [24,25].”
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Electrophysiological correlates of focused attention on low- and high-distressed tinnitus
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Sound therapy can modulate the functional connectivity of the auditory network
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Perception of, and Reaction to, Tinnitus
Husain, F. T. (2020) · Otolaryngologic Clinics of North America · doi:10.1016/j.otc.2020.03.005 · Cited by 12 · see citing works
Effect of Nitrous Oxide as a Treatment for Subjective, Idiopathic, Nonpulsatile Bothersome Tinnitus
Hong, H. Y., Karadaghy, O. A., Kallogjeri, D., Brown, F. T., Yee, B. E., Piccirillo, J. F., & Nägele, P. (2018) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2018.1278 · Cited by 10 · see citing works
“TFI, median (range) 41 (6-92) 42 (6-82) 40 (21-92)”
Self-citationWang, B., Gould, R. L., Kumar, P., Pikett, L., Thompson, B., Gonzalez, S. C., & Bamiou, D.-E. (2022) · American Journal of Audiology · doi:10.1044/2022_aja-21-00162 · Cited by 10 · see citing works
Lv, H., Liu, J., Chen, Q., Zhang, Z., Wang, Z., Gong, S., Ji, J., & Wang, Z. (2023) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2023.3241941 · Cited by 8 · see citing works
Feasibility of Intensive Ecological Sampling of Tinnitus in Intervention Research
Gerull, K. M., Kallogjeri, D., Piccirillo, M. L., Rodebaugh, T. L., Lenze, E. J., & Piccirillo, J. F. (2019) · Otolaryngology · doi:10.1177/0194599819844968 · Cited by 10 · see citing works
“Sex Male 6 (24) Female 19 (76) Age, y 54 (31-70) Education Associate degree or some college 3 (12) Bachelor degree 9 (36) Masters degree or equivalent 8 (32) Doctorate degree or higher 5 (20) Current employment status Full-time 14 (56) Part-time 3 (12) Unemployed 1 (4) Retired 7 (28) 488 Otolaryngology–Head and Neck S…”
Self-citationTransdermal lidocaine as treatment for chronic subjective tinnitus: A pilot study
O’Brien, D. C., Robinson, A. D., Wang, N., & Diaz, R. C. (2019) · American Journal of Otolaryngology · doi:10.1016/j.amjoto.2019.03.009 · Cited by 10 · see citing works
Validation of the Japanese version of the tinnitus functional index (TFI)
Suzuki, N., Oishi, N., & Ogawa, K. (2019) · International Journal of Audiology · doi:10.1080/14992027.2018.1534279 · Cited by 10 · see citing works
“There are many possible options for treatment, such as the use of hearing aids, sound generators, counselling sessions, relaxation techniques, medications such as antidepressants and sedatives, and psychotherapy (Cima et al. 2014; Dobie et al. 1993; Roland et al. 2015; Vernon and Meikle 2003).”
BackgroundSensory neurologic disorders: Tinnitus
Chemali, Z. N., Nehme, R., & Fricchione, G. L. (2019) · Handbook of clinical neurology · doi:10.1016/b978-0-444-64012-3.00022-8 · Cited by 8 · see citing works
Gans, J. J., Holst, J., Holmes, C. E., & Hudock, D. (2023) · American Journal of Audiology · doi:10.1044/2022_aja-22-00063 · Cited by 8 · see citing works
Chatterjee, N., Chattopadhyay, D., & Chatterjee, I. (2021) · International Tinnitus Journal · doi:10.5935/0946-5448.2021007 · Cited by 7 · see citing works
Noguchi, M., Suzuki, N., Oishi, N., & Ogawa, K. (2021) · The journal of international advanced otology · doi:10.5152/iao.2020.9161 · Cited by 7
“[6-8] Sound therapy for tinnitus started to be widely recognized with the advent of tinnitus retraining therapy developed by Jastreboff and Hazell [9] in 1993.”
BackgroundPredictors of Response to Cognitive Behavioral Therapy in Patients With Tinnitus
Mueller, L. E., Kallogjeri, D., Frumkin, M. R., Dizdar, K., Shin, J., Rodebaugh, T. L., & Piccirillo, J. F. (2024) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2024.2264 · Cited by 6 · see citing works
Self-citationMaxwell, K. S., Robinson, J. M., Hoffmann, I., Hou, H. J., Searchfield, G. D., Baguley, D. M., McMurry, G., Piu, F., & Anderson, J. J. (2021) · Otology & Neurotology · doi:10.1097/mao.0000000000003369 · Cited by 8 · see citing works
Rademaker, M. M., Stegeman, I., Lieftink, A. F., Somers, M., Stokroos, R. J., & Smit, A. L. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-033210 · Cited by 9 · see citing works
Fulwiler, C., Siegel, J. A., Allison, J. J., Rosal, M. C., Brewer, J. A., & King, J. A. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-012573 · Cited by 7 · see citing works
“36 37 Mindfulness has also been shown to alter resting-state FC of the amygdala, a region involved in physiological stress response.”
BackgroundHusain, F. T., Schmidt, S. A., Tai, Y., Granato, E. C., Ramos, P., Sherman, P. M., & Esquivel, C. R. (2019) · American Journal of Audiology · doi:10.1044/2019_aja-ttr17-18-0039 · Cited by 6 · see citing works
A Scoping Review of the Role of Attention in Tinnitus Management
Searchfield, G. D., Sanders, P. J., & Barde, A. (2024) · Seminars in Hearing · doi:10.1055/s-0045-1804903 · Cited by 3 · see citing works
“Thirteen studies included behavioral assessments that were purported to measure change in attention in response to electrical/magnetic stimulation, 6,37,39 sound, 40,53–55 perceptual training, 64,66,68 music therapy, 61 and psychological interventions 43,44,48 (Fig.”
InfluentialThe Effectiveness of Mindfulness-Based Cognitive Therapy in the Management of Tinnitus.
Jariengprasert, C., Watanapornmongkol, K., Kiatthanabumrung, S., & Wisupagan, T. (2022) · International Tinnitus Journal · doi:10.5935/0946-5448.20220001 · Cited by 3 · see citing works
“They concluded that, as it is both noninvasive and inexpensive, MBCT is a promising treatment option for chronic tinnitus 26 .”
BackgroundAcceptability of Cognitive Behavioral Therapy for Tinnitus: A Study With Veterans and Nonveterans
Rodriguez, C. R., Piccirillo, J. F., & Rodebaugh, T. L. (2023) · American Journal of Audiology · doi:10.1044/2023_aja-23-00020 · Cited by 3 · see citing works
Self-citationEimontas, J., Gegieckaitė, G., Asačiova, I., Stičinskaitė, N., Arcimavičiūtė, L., Savickaitė, D., Vaitiekūnaitė-Zubriakovienė, D., Polianskis, M., Gans, J. J., Beukes, E. W., et al. (2023) · Trials · doi:10.1186/s13063-023-07299-9 · Cited by 3 · see citing works
“’s [34] study participants attended a general MBSR course, Gans et al.”
BackgroundMethodInfluentialHusain, F. T., Khan, R. A., Tai, Y., & Shahsavarani, S. (2022) · American Journal of Audiology · doi:10.1044/2022_aja-21-00170 · Cited by 3 · see citing works
Complementary and Alternative Medicine Use among Patients with Chronic Tinnitus
Vayisoglu, S. K., & Gur, H. (2020) · International Archives of Nursing and Health Care · doi:10.23937/2469-5823/1510146 · Cited by 2 · see citing works
“Although it is a common condition, patients may turn to complementary and alternative medicine (CAM) when medical treatment cannot be relieved due to the lack of effective pharmacological treatment [3,4].”
BackgroundHusain, F. T. (2021) · The Psychology of learning and motivation/The psychology of learning and motivation · doi:10.1016/bs.plm.2021.02.002 · Cited by 4 · see citing works
The Tinnitus Acceptance Questionnaire (TAQ): A Study of Validity and Reliability in Turkish
Aydoğan, Z., Kutlu, S., Ocak, E., & Yilmaz, S. T. (2025) · Hacettepe University Faculty of Health Sciences Journal · doi:10.21020/husbfd.1522382 · Cited by 1 · see citing works
Aproximaciones psicoterapéuticas para el manejo del tinnitus crónico no pulsátil
Marcelo Arancibia, M., & Cristian Papuzinski, A. (2022) · Revista de otorrinolaringología y cirugía de cabeza y cuello · doi:10.4067/s0718-48162022000300398 · Cited by 1 · see citing works
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Londero, A., & Bouccara, D. (2019) · EMC - Otorrinolaringología · doi:10.1016/s1632-3475(19)42482-x · Cited by 1 · see citing works
Use of mindfulness in the treatment of tinnitus: consensus based on the opinion of Brazilian experts
Honorato, M. C. M., Martins, M. L., Ferreira, L. M. D. B. M., Mantello, E. B., & da Rosa, M. R. D. (2026) · International Symposium on Cooperative Database Systems for Advanced Applications · doi:10.1590/2317-1782/e20250182en
“The primary outcome measure was the difference in patient-reported tinnitus symptoms using the THI and the Tinnitus Functional Index (TFI) between pre-intervention, post-MBSR, and 4 weeks post-MBSR assessments (13) .”
InfluentialThe Role of Mindfulness, Yoga, and Hypnosis in Tinnitus Management: A Comprehensive Narrative Review
Heidari, P., Tavanai, E., Rasouli, A., Khalili, M. E., & Fatahi, F. (2026) · Journal of Modern Rehabilitation · doi:10.18502/jmr.v20i2.21708
“Neuroimaging studies indicate that MBCT increases grey matter volume in the superior frontal gyrus, a region associated with cognitive control, and enhances connectivity in attention networks [35, 36].”
InfluentialFrancois, T. L., Hilberdink, C. E., Guillery‐Girard, B., Leroux, E., Delamillieure, P., Tréhout, M., Chételat, G., Razafimandimby, A., & Bui, É. (2026) · Reviews in the Neurosciences · doi:10.1515/revneuro-2026-0019
“…depressive disorder, posttraumatic stress disorder, schizophrenia) (Fam et al. 2020; Kaiser et al. 2015; Liu et al. 2017; Nekovarova et al. 2014; Roland et al. 2015; Supekar et al. 2019; Wells et al. 2013; Weng et al. 2019; Zheng et al. 2015; Zimmerman et al. 2019), these speci fi c psychiatric…”
Mindfulness-based therapy for chronic tinnitus: a narrative review
Zhang, Z.-C., Xu, Q., Wang, J., Luo, Y., Shao, Q., Li, Y., Lu, H., & Lu, J. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1738053
“Roland et al. (2015) used resting-state functional connectivity MRI to examine changes in attention-related brain networks following mindfulness-based intervention, while Husain et al. (2019) used functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) to investigate possible…”
Das, M., Pundeer, M., Acharya, K., Mishra, A., Nayak, P., & Patra, S. K. (2026) · Archives of Gerontology and Geriatrics Plus · doi:10.1016/j.aggp.2026.100276
Londero, A., Trandafir, C. M., & Simeus, E. J. (2026) · EMC - Otorinolaringoiatria · doi:10.1016/s1639-870x(26)51465-x
Londero, A., Trandafir, C. M., & Simeus, E. J. (2026) · EMC - Otorrinolaringología · doi:10.1016/s1632-3475(25)51323-1
Londero, A., Trandafir, C. M., & Simeus, E. J. (2025) · Encyclopédie médico-chirurgicale. Oto-rhino-laryngologie · doi:10.1016/s0246-0351(25)48890-4
Validation of the Sinhala Version of Tinnitus Handicap Inventory
Rodrigo, A., & Abayabandara-Herath, T. (2023) · Journal of Audiology & Otology · doi:10.7874/jao.2022.00521
Evaluation and Management of Severe Tinnitus: An Evidence-Based Case Report
Zitelli, L. (2021) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2020_persp-20-00205
Zumbido, Estresse e Níveis de Zinco no Contexto Universitário: Revisão Integrativa
Scandiuzzi, L. A. A., Caran, V. C. S., & Robazzi, M. L. D. C. C. (2020) · Archivos de Medicina · doi:10.30554/archmed.20.2.3620
Londero, A., & Bouccara, D. (2019) · EMC - Otorinolaringoiatria · doi:10.1016/s1639-870x(19)42526-9
Londero, A., & Bouccara, D. (2019) · EMC - Oto-rhino-laryngologie · doi:10.1016/s0246-0351(18)79552-4
Emotional Processing and Non-Auditory Based Interventions in Tinnitus
Husain, F. T., Tai, Y., & Finnegan, M. K. (2016) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/persp1.sig7.13
Mindfulness-Based Therapy in the Management of Tinnitus
Prabhu, P. (2022) · Advances in psychology, mental health, and behavioral studies (APMHBS) book series · doi:10.4018/978-1-7998-8682-2.ch011
Research Status of Mindfulness-Based Stress Reduction (MBSR) Therapy for Chronic Subjective Tinnitus
郭, 岚. (2022) · Advances in Psychology · doi:10.12677/ap.2022.125192 · Cited by 1 · see citing works
Les thérapeutiques pour la maladie de Menière
Uziel, A. S., Bordure, P., Dubernard, X., Chays, A., Bazin, A., Kleiber, J.-C., Parietti‐Winkler, C., Lassalle, B., Ribeyre, L., Mom, T., et al. (2016) · Elsevier eBooks · doi:10.1016/b978-2-294-75213-1.00006-7
- Authors
- Roland, L. T., Lenze, E. J., Hardin, F. M., Kallogjeri, D., Nicklaus, J., Wineland, A. M., Fendell, G., Peelle, J. E., & Piccirillo, J. F.
- Affiliations
- Washington University in St. Louis (US)
- Corresponding author
- Roland, Lauren T.
- ORCID
- Venue
- Otolaryngology–Head and Neck Surgery
- Publisher
- Wiley
- Published
- 2015-02-24
- Volume
- 152
- Issue
- 5
- Pages
- 919-926
- ISSN
- 0161-6439 (ISSN-L)
- 0194-5998
- 1097-6817
- PMC
- PMC4650869
- OpenAlex
- W2141355846
- Cited by
- 77
- References
- 38
- Citations by year
- 2026: 7 · 2025: 2 · 2024: 3 · 2023: 6 · 2022: 8 · 2021: 9 · 2020: 10 · 2019: 11 · 2018: 4 · 2017: 7 · 2016: 8 · 2015: 2
- FWCI
- 4.56
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Otolaryngology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Center for Advancing Translational Sciences
- National Center for Complementary and Alternative Medicine
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › Speech and Hearing › Noise Effects and Management
- Keywords
- mindfulness-based stress reduction, chronic tinnitus, tinnitus severity, Tinnitus Functional Index, resting-state functional connectivity, attentional networks, default mode network, depression, anxiety, mindfulness, cognitive ability
- MeSH terms
- Adult, Aged, Chronic Disease, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pilot Projects, Stress, Psychological, Temporal Lobe, Tinnitus, Mindfulness
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