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Caldwell J, Gopal K, Ortu D, Miller S. Electrophysiological auditory measures to identify potential cortical markers of tinnitus. Brain Res 2024; 1842:149100. [PMID: 38942351 DOI: 10.1016/j.brainres.2024.149100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024]
Abstract
Tinnitus, or the perception of a sound in the absence of an external acoustic stimulus, is a common condition that cannot yet be objectively diagnosed. Current diagnostic tests of tinnitus consist of case history and behavioral measures that rely on subjective responses. This study examined electrophysiological measures, specifically the auditory late response (ALR), mismatch negativity (MMN), and P300 as potential neural biomarkers of tinnitus in both a tinnitus and non-tinnitus control group while utilizing the pitch-matched tinnitus frequencies as the test stimuli. Results of this study found differences in MMN amplitudes and area under the curve, and in P300 topographic maps between tinnitus and control subjects. The differences in MMN responses across groups suggest that dysfunctional processing of acoustic stimuli located near the tinnitus frequency in individuals with tinnitus manifests as soon as 200 ms after initial onset of the stimulus. In addition, results from a global field power analysis and differences in spatial distributions on topographical maps indicate that deficits persist through higher levels of cortical processing. A secondary goal of this study was to determine if electrophysiological measures correlated with reported tinnitus severity on questionnaires. This analysis indicated that P2 latency was a significant predictor of Tinnitus Reaction Questionnaire, Tinnitus Handicap Inventory, and percent of the time participant's tinnitus was considered bothersome, suggesting that this measure could potentially be used to assess the efficacy of treatment programs for tinnitus.
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Affiliation(s)
- Joshua Caldwell
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States.
| | - Kamakshi Gopal
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States
| | - Daniele Ortu
- Department of Behavior Analysis, The University of North Texas, Denton, TX, United States
| | - Sharon Miller
- Department of Audiology and Speech-Language Pathology, The University of North Texas, Denton, TX, United States
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Chen F, Fahimi Hnazaee M, Vanneste S, Yasoda-Mohan A. Effective Connectivity Network of Aberrant Prediction Error Processing in Auditory Phantom Perception. Brain Connect 2024. [PMID: 39135479 DOI: 10.1089/brain.2024.0013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2024] Open
Abstract
Introduction: Prediction error (PE) is key to perception in the predictive coding framework. However, previous studies indicated the varied neural activities evoked by PE in tinnitus patients. Here, we aimed to reconcile the conflict by (1) a more nuanced view of PE, which could be driven by changing stimulus (stimulus-driven PE [sPE]) and violation of current context (context-driven PE [cPE]) and (2) investigating the aberrant connectivity networks that are engaged in the processing of the two types of PEs in tinnitus patients. Methods: Ten tinnitus patients with normal hearing and healthy controls were recruited, and a local-global auditory oddball paradigm was applied to measure the electroencephalographic difference between the two groups during sPE and cPE conditions. Results: Overall, the sPE condition engaged bottom-up and top-down connections, whereas the cPE condition engaged mostly top-down connections. The tinnitus group showed decreased sensitivity to the sPE and increased sensitivity to the cPE condition. Particularly, the auditory cortex and posterior cingulate cortex were the hubs for processing cPE in the control and tinnitus groups, respectively, showing the orientation to an internal state in tinnitus. Furthermore, tinnitus patients showed stronger connectivity to the parahippocampus and pregenual anterior cingulate cortex for the establishment of the prediction during the cPE condition. Conclusion: These results begin to dissect the role of changes in stimulus characteristics versus changes in the context of processing the same stimulus in mechanisms of tinnitus generation.
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Affiliation(s)
- Feifan Chen
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland
| | - Mansoureh Fahimi Hnazaee
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
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Fabrizio-Stover EM, Oliver DL, Burghard AL. Tinnitus mechanisms and the need for an objective electrophysiological tinnitus test. Hear Res 2024; 449:109046. [PMID: 38810373 DOI: 10.1016/j.heares.2024.109046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/16/2024] [Accepted: 05/22/2024] [Indexed: 05/31/2024]
Abstract
Tinnitus, the perception of sound with no external auditory stimulus, is a complex, multifaceted, and potentially devastating disorder. Despite recent advances in our understanding of tinnitus, there are limited options for effective treatment. Tinnitus treatments are made more complicated by the lack of a test for tinnitus based on objectively measured physiological characteristics. Such an objective test would enable a greater understanding of tinnitus mechanisms and may lead to faster treatment development in both animal and human research. This review makes the argument that an objective tinnitus test, such as a non-invasive electrophysiological measure, is desperately needed. We review the current tinnitus assessment methods, the underlying neural correlates of tinnitus, the multiple tinnitus generation theories, and the previously investigated electrophysiological measurements of tinnitus. Finally, we propose an alternate objective test for tinnitus that may be valid in both animal and human subjects.
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Affiliation(s)
- Emily M Fabrizio-Stover
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA; Department of Otolaryngology-Head and Neck Surgery, Medical University South Carolina, Charleston, SC, USA
| | - Douglas L Oliver
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alice L Burghard
- Department of Neuroscience, University of Connecticut School of Medicine, Farmington, CT, USA.
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Naghdabadi Z, Jahed M. Heterogeneous correlate and potential diagnostic biomarker of tinnitus based on nonlinear dynamics of resting-state EEG recordings. PLoS One 2024; 19:e0290563. [PMID: 38166014 PMCID: PMC10760901 DOI: 10.1371/journal.pone.0290563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 08/09/2023] [Indexed: 01/04/2024] Open
Abstract
Tinnitus is a heterogeneous condition of hearing a rattling sound when there is no auditory stimulus. This rattling sound is associated with abnormal synchronous oscillations in auditory and non-auditory cortical areas. Since tinnitus is a highly heterogeneous condition with no objective detection criteria, it is necessary to search for indicators that can be compared between and within participants for diagnostic purposes. This study introduces heterogeneous though comparable indicators of tinnitus through investigation of spontaneous fluctuations in resting-state brain dynamics. The proposed approach uses nonlinear measures of chaos theory, to detect tinnitus and cross correlation patterns to reflect many of the previously reported neural correlates of tinnitus. These indicators may serve as effective measures of tinnitus risk even at early ages before any symptom is reported. The approach quantifies differences in oscillatory brain dynamics of tinnitus and normal subjects. It demonstrates that the left temporal areas of subjects with tinnitus exhibit larger lyapunov exponent indicating irregularity of brain dynamics in these regions. More complex dynamics is further recognized in tinnitus cases through entropy. We use this evidence to distinguish tinnitus patients from normal participants. Besides, we illustrate that certain anticorrelation patterns appear in these nonlinear measures across temporal and frontal areas in the brain perhaps corresponding to increased/decreased connectivity in certain brain networks and a shift in the balance of excitation and inhibition in tinnitus. Additionally, the main correlations are lost in tinnitus participants compared to control group suggesting involvement of distinct neural mechanisms in generation and persistence of tinnitus.
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Affiliation(s)
- Zahra Naghdabadi
- Department of Electrical Engineering, Sharif University of Technology, Tehran, Iran
| | - Mehran Jahed
- Department of Electrical Engineering, Sharif University of Technology, Tehran, Iran
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Objective Detection of Tinnitus Based on Electrophysiology. Brain Sci 2022; 12:brainsci12081086. [PMID: 36009149 PMCID: PMC9406100 DOI: 10.3390/brainsci12081086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/29/2022] [Accepted: 08/12/2022] [Indexed: 11/24/2022] Open
Abstract
Tinnitus, a common disease in the clinic, is associated with persistent pain and high costs to society. Several aspects of tinnitus, such as the pathophysiology mechanism, effective treatment, objective detection, etc., have not been elucidated. Any change in the auditory pathway can lead to tinnitus. At present, there is no clear and unified mechanism to explain tinnitus, and the hypotheses regarding its mechanism include auditory plasticity theory, cortical reorganization theory, dorsal cochlear nucleus hypothesis, etc. Current theories on the mechanism of tinnitus mainly focus on the abnormal activity of the central nervous system. Unfortunately, there is currently a lack of objective diagnostic methods for tinnitus. Developing a method that can detect tinnitus objectively is crucial, only in this way can we identify whether the patient really suffers from tinnitus in the case of cognitive impairment or medical disputes and the therapeutic effect of tinnitus. Electrophysiological investigations have prompted the development of an objective detection of tinnitus by potentials recorded in the auditory pathway. However, there is no objective indicator with sufficient sensitivity and specificity to diagnose tinnitus at present. Based on recent findings of studies with various methods, possible electrophysiological approaches to detect the presence of tinnitus have been summarized. We analyze the change of neural activity throughout the auditory pathway in tinnitus subjects and in patients with tinnitus of varying severity to find available parameters in these methods, which is helpful to further explore the feasibility of using electrophysiological methods for the objective detection of tinnitus.
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Vasudevan H, Palaniswamy HP, Balakrishnan R, Rajashekhar B. Cortical Reorganization Following Psychoeducational Counselling and Residual Inhibition Therapy (RIT) in Individuals with Tinnitus. Int Arch Otorhinolaryngol 2022; 26:e701-e711. [DOI: 10.1055/s-0042-1743287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 08/22/2021] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction Psychoeducational counselling and residual inhibition therapy (RIT) are traditional approaches used in many clinics to manage tinnitus. However, neurophysiological studies to evaluate posttreatment perceptual and functional cortical changes in humans are scarce.
Objectives The present study aims to explore whether cortical auditory-evoked potentials (CAEPs; N1 and P3) reflect the effect of modified RIT and psychoeducational counselling, and whether there is a correlation between the behavioral and electrophysiological measures.
Methods Ten participants with continuous and bothersome tinnitus underwent a session of psychoeducational counselling and modified RIT. Perceptual measures and CAEPs were recorded pre- and posttreatment. Further, the posttreatment measures were compared with age and gender-matched historical control groups.
Results Subjectively, 80% of the participants reported a reduction in the loudness of their tinnitus. Objectively, there was a significant reduction in the posttreatment amplitude of N1 and P3, with no alterations in latency. There was no correlation between the perceived difference in tinnitus loudness and the difference in P3 amplitude (at Pz).
Conclusion The perceptual and functional (as evidenced by sensory, N1, and cognitive, P3 reduction) changes after a single session of RIT and psychoeducational counselling are suggestive of plastic changes at the cortical level. The current study serves as preliminary evidence that event-related potentials (ERPs) can be used to quantify the physiological changes that occur after the intervention for tinnitus.
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Affiliation(s)
- Harini Vasudevan
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal, Karnataka, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal, Karnataka, India
| | | | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal, Karnataka, India
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Vasudevan H, Ganapathy K, Palaniswamy HP, Searchfield G, Rajashekhar B. Systematic review and meta-analysis on the effect of continuous subjective tinnitus on attention and habituation. PeerJ 2021; 9:e12340. [PMID: 34900408 PMCID: PMC8628620 DOI: 10.7717/peerj.12340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 09/28/2021] [Indexed: 01/10/2023] Open
Abstract
Background Attention and habituation are two domains known to play key roles in the perception and maintenance of tinnitus. The heterogeneous nature of tinnitus and the methodologies adopted by various studies make it difficult to generalize findings. The current review aims at assessing and synthesizing evidence on the possible roles of attention and habituation in continuous subjective tinnitus. Methodology The literature search included five databases (PubMed, Scopus, Web of Sciences, CINAHL and ProQuest) that resulted in 1,293 articles, published by July 2019. Studies on attention and/or habituation in individuals with tinnitus using either behavioural or electrophysiological tests were included in the review after a quality assessment. Results Seventeen studies on attention in tinnitus were included in the narrative synthesis. Two meta-analyses were performed to assess the role of attention in tinnitus using a behavioural methodology (z = 4.06; p < 0.0001) and P300 amplitude (z = 2.70; p = 0.007) with 531 participants. With respect to habituation, the review indicates the lack of quality articles for habituation inclusion in the narrative synthesis. Conclusions The review highlights that selective domains of attention were consistently impaired in individuals with tinnitus. Habituation, on the other hand, needs further exploration.
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Affiliation(s)
- Harini Vasudevan
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Kanaka Ganapathy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
| | - Grant Searchfield
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Bellur Rajashekhar
- Department of Speech and Hearing, Manipal College of Health Professions (MCHP), Manipal Academy of Higher Education (MAHE), Manipal, karnataka, India
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Cardon E, Joossen I, Vermeersch H, Jacquemin L, Mertens G, Vanderveken OM, Topsakal V, Van de Heyning P, Van Rompaey V, Gilles A. Systematic review and meta-analysis of late auditory evoked potentials as a candidate biomarker in the assessment of tinnitus. PLoS One 2020; 15:e0243785. [PMID: 33332414 PMCID: PMC7746183 DOI: 10.1371/journal.pone.0243785] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022] Open
Abstract
Subjective tinnitus, the perception of sound in the absence of any sound source, is routinely assessed using questionnaires. The subjective nature of these tools hampers objective evaluation of tinnitus presence, severity and treatment effects. Late auditory evoked potentials (LAEPs) might be considered as a potential biomarker for assessing tinnitus complaints. Using a multivariate meta-analytic model including data from twenty-one studies, we determined the LAEP components differing systematically between tinnitus patients and controls. Results from this model indicate that amplitude of the P300 component is lower in tinnitus patients (standardized mean difference (SMD) = -0.83, p < 0.01), while latency of this component is abnormally prolonged in this population (SMD = 0.97, p < 0.01). No other investigated LAEP components were found to differ between tinnitus and non-tinnitus subjects. Additional sensitivity analyses regarding differences in experimental conditions confirmed the robustness of these results. Differences in age and hearing levels between the two experimental groups might have a considerable impact on LAEP outcomes and should be carefully considered in future studies. Although we established consistent differences in the P300 component between tinnitus patients and controls, we could not identify any evidence that this component might covary with tinnitus severity. We conclude that out of several commonly assessed LAEP components, only the P300 can be considered as a potential biomarker for subjective tinnitus, although more research is needed to determine its relationship with subjective tinnitus measures. Future trials investigating experimental tinnitus therapies should consider including P300 measurements in the evaluation of treatment effect.
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Affiliation(s)
- Emilie Cardon
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- * E-mail:
| | - Iris Joossen
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Hanne Vermeersch
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Olivier M. Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vedat Topsakal
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
- Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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Vasudevan H, Palaniswamy HP, Balakrishnan R. Sensory and Cognitive Components of Auditory Processing in Individuals With Tinnitus. Am J Audiol 2019; 28:834-842. [PMID: 31825641 DOI: 10.1044/2019_aja-19-0011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Purpose The main purpose of the study is to explore the auditory selective attention abilities (using event-related potentials) and the neuronal oscillatory activity in the default mode network sites (using electroencephalogram [EEG]) in individuals with tinnitus. Method Auditory selective attention was measured using P300, and the resting state EEG was assessed using the default mode function analysis. Ten individuals with continuous and bothersome tinnitus along with 10 age- and gender-matched control participants underwent event-related potential testing and 5 min of EEG recording (at wakeful rest). Results Individuals with tinnitus were observed to have larger N1 and P3 amplitudes along with prolonged P3 latency. The default mode function analysis revealed no significant oscillatory differences between the groups. Conclusion The current study shows changes in both the early sensory and late cognitive components of auditory processing. The change in the P3 component is suggestive of selective auditory attention deficit, and the sensory component (N1) suggests an altered bottom-up processing in individuals with tinnitus.
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Affiliation(s)
- Harini Vasudevan
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
| | - Hari Prakash Palaniswamy
- Department of Speech and Hearing, Manipal College of Health Professions, Manipal Academy of Higher Education, India
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Exposing Pathological Sensory Predictions in Tinnitus Using Auditory Intensity Deviant Evoked Responses. J Neurosci 2019; 39:10096-10103. [PMID: 31699888 PMCID: PMC6978936 DOI: 10.1523/jneurosci.1308-19.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/08/2019] [Accepted: 10/04/2019] [Indexed: 12/19/2022] Open
Abstract
We tested the popular, unproven theory that tinnitus is caused by resetting of auditory predictions toward a persistent low-intensity sound. Electroencephalographic mismatch negativity responses, which quantify the violation of sensory predictions, to unattended tinnitus-like sounds were greater in response to upward than downward intensity deviants in 26 unselected chronic tinnitus subjects with normal to severely impaired hearing, and in 15 acute tinnitus subjects, but not in 26 hearing and age-matched controls (p < 0.001, receiver operator characteristic, area under the curve, 0.77), or in 20 healthy and hearing-impaired controls presented with simulated tinnitus. The findings support a prediction resetting model of tinnitus generation, and may form the basis of a convenient tinnitus biomarker, which we name Intensity Mismatch Asymmetry, which is usable across species, is quick and tolerable, and requires no training.SIGNIFICANCE STATEMENT In current models, perception is based around the generation of internal predictions of the environment, which are tested and updated using evidence from the senses. Here, we test the theory that auditory phantom perception (tinnitus) occurs when a default auditory prediction is formed to explain spontaneous activity in the subcortical pathway, rather than ignoring it as noise. We find that chronic tinnitus patients show an abnormal pattern of evoked responses to unexpectedly loud and quiet sounds that both supports this hypothesis and provides fairly accurate classification of tinnitus status at the individual subject level. This approach to objectively demonstrating the predictions underlying pathological perceptual states may also have a much wider utility, for instance, in chronic pain.
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Sedley W. Tinnitus: Does Gain Explain? Neuroscience 2019; 407:213-228. [DOI: 10.1016/j.neuroscience.2019.01.027] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 02/01/2023]
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