Tinnitus disorder and musical auditory training: a double-blind randomized controlled clinical trial.

Only 20 people took part, 10 per group, in one university clinic. The sample size calculation aimed at 75% power, below the 80% usually expected, and the authors say a larger sample would be needed to see effects on the other evoked potential components. The intervention lasted four weeks and there was no long-term follow-up, so nothing here shows whether any benefit lasts. The authors say a longer programme might give better results. The control group also improved substantially on both questionnaires. The authors attribute this to the welcoming contact with researchers and to expectation of benefit, so the extra improvement in the training group cannot be separated from the non-specific effects of taking part in either programme. The paper contradicts itself about the control group's evoked potentials: the results section reports a significant change in P3 duration in the control group, while the conclusion states that passive intervention changed the amplitude of P3 only. Exclusions were frequent: of 70 volunteers, 10 were excluded for high anxiety and depression scores, nine for hearing loss greater than mild, seven for psychiatric or neurological disease, seven for middle ear problems, five for somatosensory or vascular modulation, four for low discomfort scores and eight for age. These results therefore apply to a narrow group of adults.

The authors declare no financial support and nothing to declare. The musical training protocol used here was developed by a different research group and is published online; the authors state that access to the full protocol and to the session response data was authorised by the responsible author.

Do not read the questionnaire improvements as proof that the musical training was the active ingredient. The control group, who listened to music while watching silent films with a researcher present, also improved substantially, and the authors themselves say this may reflect the welcoming contact and the expectation of benefit rather than the training. Do not present the P3 changes as established evidence of neuroplasticity either: this was 20 people in one clinic.