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Acoustic CR neuromodulation for tinnitus, explained

Updated October 7, 2026 · 6 minute read

Acoustic coordinated reset, or CR, is a sound pattern built from four short tones around your tinnitus pitch. It was developed as a way to disrupt the synchronized nerve activity some researchers link to tinnitus. Here's exactly how the pattern works, how people use it, and what the trials found.

The four tones

CR starts from your tinnitus frequency and plays four tones: two just below it and two just above. The ratios used in the published research are:

Tone	Ratio to your pitch	If your tinnitus is 4,000 Hz
1	0.766 ×	3,064 Hz
2	0.9 ×	3,600 Hz
3	1.1 ×	4,400 Hz
4	1.4 ×	5,600 Hz

The tinnitus frequency itself is not played.

The timing pattern

Short tones in shuffled order. Each tone lasts about 150 milliseconds with soft edges. All four play in each cycle, in a new random order every time.
About 1.5 cycles per second. That works out to roughly six tones a second.
On and off. The research protocol plays three cycles, then rests for two, and repeats. Some online tools instead add a short pause after each sequence.
Quiet. The tones are set to about the loudness of your tinnitus, not louder.

The shuffled, staggered timing is the "coordinated reset" part. The idea is to stimulate neighboring groups of nerve cells at slightly different moments so they fall out of step with each other.

What the research found

Study	Design	What they found
Tass and colleagues, 2012 (RESET)	63 people; single-blind (participants didn't know, researchers did); placebo comparison	Tinnitus loudness and symptoms dropped in the CR groups but not with placebo. About 75% met the study's threshold for improvement.
Hall and colleagues, 2022 (Brain Sciences)	100 adults at two UK centers; double-blind (neither participants nor researchers knew) with placebo; plus a 24-week open-label extension	No group-level improvement in tinnitus severity compared with placebo, or over the extension period. The authors noted some individuals may still benefit.

The honest summary: the first study was encouraging, but it was small and single-blind, and outside experts said it needed independent confirmation. The larger, double-blind trial that followed didn't find a benefit on average. CR is best seen as an experimental, low-risk option some people like to try, not an established treatment.

For comparison, the US clinical practice guideline for tinnitus (AAO-HNS, 2014) gives its firmest recommendation to cognitive behavioral therapy (CBT), lists sound therapy as an option, and recommends a hearing aid evaluation for people with hearing loss. It's worth discussing those with your doctor or audiologist alongside anything you try at home.

How to try CR tones

Get an accurate pitch match first, with the octave check. CR is built entirely around that number. See how to find your tinnitus frequency.
Set the volume to about the loudness of your tinnitus, and no louder.
Use headphones in the ear or ears where you hear the tinnitus.
Plan for time. The 2012 study used about 4 to 6 hours a day, spread out. Use a timer so sessions end on their own.
Keep notes on loudness and how much it bothers you, weekly. Stop if it makes your tinnitus worse.

The Tinnitus Sounds CR tones tool uses the published ratios and the three-on, two-off pattern by default, with options for a pause between sequences or continuous play. The four tones light up as they play, so you can see the pattern.

Build CR tones around your pitch

Find your pitch free, then try CR tones with the full version's free trial.

Find your pitch →

Common questions

Is CR the same as a hearing aid or masker?

No. Maskers and background sounds aim to make tinnitus less noticeable while they play. CR is a specific tone pattern built from your tinnitus pitch, intended to change how the hearing system behaves over time.

Do I need a special device?

The research used dedicated devices, but the tone pattern itself can be played through ordinary headphones. What matters most is an accurate pitch match and a sensible volume.

How long until I'd notice anything?

Studies ran for 12 weeks or more. If you try it, give it several weeks of regular use before judging, and stop if your tinnitus gets worse.

Sources

Tass PA, Adamchic I, Freund HJ, von Stackelberg T, Hauptmann C. Counteracting tinnitus by acoustic coordinated reset neuromodulation. Restorative Neurology and Neuroscience. 2012. PubMed 22414611.
Hall DA, et al. Systematic evaluation of the T30 neurostimulator treatment for tinnitus: a double-blind randomised placebo-controlled trial with open-label extension. Brain Sciences. 2022. PMC8946033.
Tunkel DE, et al. Clinical practice guideline: tinnitus. Otolaryngology–Head and Neck Surgery. 2014. doi:10.1177/0194599814545325.

This guide is general information written by the Tinnitus Sounds team. It isn't medical advice. Talk to a doctor or audiologist about your tinnitus.