It is estimated that ~10% of the adult population in developed countries is affected by subjective tinnitus. Physiopathology
of subjective tinnitus remains incompletely explained. Nevertheless, subjective tinnitus is thought to result from hyperactivity
and neuroplastic reorganization of cortical and subcortical networks following acoustic deafferentation induced by cochlear
or auditory nerve damage. Involvement of both auditory and non-auditory central nervous pathways explains the conscious perception
of tinnitus and also the potentially incapacitating discomfort experienced by some patients (sound hypersensitivity, sleep
disorders, attention deficit, anxiety or depression). These clinical patterns are similar to those observed in chronic pain
following amputation where conditioning techniques using virtual reality have been shown both to be theoretically interesting
and effectively useful. This analogy led us to develop an innovative setup with dedicated auditory and visual 3D virtual reality
environments in which unilateral subjective tinnitus sufferers are given the possibility to voluntarily manipulate an auditory
and visual image of their tinnitus (tinnitus avatar). By doing so, the patients will be able to transfer their subjective
auditory perception to the tinnitus avatar and to gain agency on this multimodal virtual percept they hear, see and spatially
control. Repeated sessions of such virtual reality immersions are then supposed to contribute to tinnitus treatment by promoting
cerebral plasticity. This paper describes the theoretical framework and setup adjustments required by this very first attempt
to adapt virtual reality techniques to subjective tinnitus treatment. Therapeutic usefulness will be validated by a further
controlled clinical trial.
Keywords Tinnitus - Virtual reality - Neuroplasticity