CR® technology (CR® = Coordinated Reset) for neuromodulation is a new therapeutic approach for diseases characterised by excessive neuronal synchronicity (e.g. tinnitus or Parkinson's disease). Targeted impulses based on a complex mathematical algorithm interrupt pathological synchronicity, causing the neurons to "unlearn" how to fall back into the synchronous, pathological state in the long term. The transmission of targeted CR® impulses to the appropriate areas of the brain can be invasive (via electrodes) or non–invasive (via acoustic signals).
Firstly, targeted impulses are used to disrupt the highly synchronous neuronal network, whereby the impulses have to be offset both spatially and chronologically. The impulses address different spatial areas and split the synchronous nerve cell assembly into four spatially separated sub-groups. Each sub-group is synchronous within itself – however, their cycles are different due to the chronological offset of the CR® impulses transmitted to the different areas.
Splitting of the synchronous, heavily networked cell assembly into sub-groups
The spatially and chronologically offset impulses are transmitted in multiple short bursts (sequences 1 to 3) to split the synchronous, heavily networked cell assembly fully into its sub-groups.
It is important to note that both the spatial and chronological control of the impulses is critical to the success of the treatment. The spatial application of CR® impulses for tinnitus patients is calculated using the appropriate stimulation frequencies. The chronological cycle is not simply "guesstimated" but rather calculated on the basis of a complex mathematical algorithm (CR® algorithm) in alignment with neuronal activity.
The CR® impulses are followed by a pause – and Nature is given free rein: based on the so-called "principle of self–organisation", the neurons of one sub-group striving pathologically to achieve synchronisation attempt to synchronise with the cells of another sub-group (one that is "ticking" in a different cycle) – and end up in a completely asynchronous state in the short term. "Healthy" asynchronous chaos rules! You can try using the image of singing a canon to imagine what happens: first of all, each group sings their allocated verse. Then they are instructed to sing the same verse – but without a conductor! All of the singers will sing happily along, albeit in a state of disarrangement – until, after a while, they harmonise their singing.
The chronological cycle – the duration of the pause – is once again decisive for the therapeutic effect and is calculated exactly on the basis of the CR® algorithm to reflect neuronal activity.
In the long term the treatment affects the brain's natural synaptic plasticity: disrupting the cycle over and over again weakens the pathologically enhanced connections in the highly synchronous, hyperactive nerve cell assembly. As the connections between the nerve cells grow weaker they are less able to synchronise. This means: pathologically synchronous cells "unlearn" synchronicity – and, as a result, how to produce the tinnitus tone. It is therefore the natural synaptic plasticity of the brain itself that supports the sustainable success of treatment using Acoustic CR® Neuromodulation.
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Our video explains the neurological causes of tonal tinnitus and how audiologists at The Tinnitus Clinic are able to treat it with a pioneering therapy known as Acoustic CR® Neuromodulation.