• Posted May 1, 2025

Do You Have Tinnitus? The Answer Might Be Written In Your Face

THURSDAY, May 1, 2025 (HealthDay News) — Subtle facial gestures linked to the body’s fight-or-flight response could be used to help diagnose people with tinnitus, a new study says.

Video recordings showed that people with tinnitus experienced facial twitches and pupil dilation in response to certain sounds, researchers reported April 30 in the journal Science Translational Medicine.

This is the first time researchers have found a marker that could be used to identify tinnitus in people suffering from the hearing problem, researchers said.

“Imagine if cancer severity were determined by giving patients a questionnaire – this is the state of affairs for some common neurological disorders like tinnitus,” senior investigator Daniel Polley, director of Mass Eye and Ear’s Lauer Tinnitus Research Center in Boston, said in a news release.

“For the first time, we directly observed a signature of tinnitus severity,” Polley said. “When we began this study, we didn’t know if sounds would elicit facial movements; so, to discover that these movements not only occur, but can provide the most informative measure to date of tinnitus distress, is quite surprising.”

Tinnitus is the medical term for ringing in the ears, but it also can present as other persistent phantom sounds like buzzing or clicking, researchers said in background notes. 

Tinnitus affects about 12% of people, including 25% of seniors 65 and older. Most learn to live with the nuisance, but about 15% of people have tinnitus so severe that it disrupts their sleep, mental health and everyday function, researchers said.

For this study, researchers hypothesized that people with debilitating tinnitus might exist in constant fight-or-flight mode, reacting to everyday sounds as though they were threats.

The team recruited 47 folks with varying levels of tinnitus and compared them to 50 healthy people who served as a control group.

The people were videotaped as they listened to pleasant, neutral or distressing sounds. The unpleasant sounds included coughing fits, yelling or a baby crying.

Using artificial intelligence (AI) software, they looked for rapid and subtle involuntary facial movements, like twitches in the cheeks, eyebrows or nostrils.

Researchers found that these twitches correlated with the levels of distress that participants had reported from tinnitus in questionnaires.

Further, the pupils of people with severe tinnitus dilated extra wide at all sounds, be they pleasant or unpleasant, researchers report. The pupils of people without tinnitus or with less bothersome tinnitus only responded to the most unpleasant sounds.

Combining the facial twitches with pupil dilation, researchers found they could accurately identify people most tormented by tinnitus.

“What’s really exciting is this vantage point into tinnitus severity didn’t require highly specialized brain scanners; instead, the approach was relatively low-tech,” Polley said. “If we can adapt this approach to consumer-grade electronics, they could be put to use in hearing health clinics, as objective measures in clinical trials and by the public at large.”

Researchers are now using this test to develop ways to eliminate or significantly reduce the loudness of the phantom sounds from tinnitus.

“These biomarkers get to the root of the distress,” said Polley. “While imaging might show hyperactive brain regions in tinnitus patients, these biomarkers reveal body-wide threat evaluation systems that are operating outside of their normal range, leading to the distressful symptoms they experience.”

More information

The Cleveland Clinic has more about tinnitus.

SOURCE: Mass Eye and Ear, news release, April 30, 2025