The Neurocognitive Mechanisms Underpinning Chronic Tinnitus

Interesting Nature paper on how the brain networking systems are affected in chronic tinnitus.
Main Points:
- Altered function of the salience network, cognitive control network and autobiographical memory network may impair the down-regulation of internal awareness of tinnitus meaning it continues to be intrusive and emotionally invasive.
- This dysfunction has also been linked to depression and anxiety
- This would suggest that although the experience of tinnitus is generated by the auditory system, the awareness is actually maintained in the brain
- A failure of top-down mechanisms such as attention-switching means tinnitus sensation is perpetuated
- Suggests non-auditory regions are part of tinnitus perception, rather than being affected by it.
- This approach to understanding tinnitus suggests therapies helping restore balance within these brain networks may improve tinnitus

This might just seem like something we already knew (tinnitus is being produced in the brain) but at least there is ongoing research into the neurological pathway involved in tinnitus- which is promising!

https://www.nature.com/articles/s41598-017-15574-4

 

Thanks Interesting post, and yes I'm almost sure it has nothing to do with the ears or ear damage, but more linked to depression and anxiety in the first place. Something like a chronic pain in other health disorders. The only thing I don't understand yet is why when exposed to loud sounds you can also get T afterwards, maybe both use the same mechanism ?

 

I don't know if I'd go as far as to say that it has nothing to do with ear damage. A lot of people, like my dad, have T after experiencing some form of hearing loss. But I do agree that mental health appear to be huge triggers as well. It's probable that a lot more than 10% of the population have T, as we all do regularly expose ourselves to loud noise (before we become aware of how bad that is), but that most don't consciously acknowledge it. When people are depressed or anxious, they probably bring their T into their conscious mind. How this happens isn't totally clear, potentially in the case of anxiety, your body is on high alert and so your auditory pathway picks up signals it wasn't before. But that's just a shot in the dark really.

 

@lucluc I agree again with you. I was told by a neuro that specializes in T, that those that have stress or experience different excitement levels can get T from having a single trauma experience or it can be from life long situations.

He feels that most that receive T are people who analyze when problems happen. They often have careers where they have to analyze stuff.

 

I have been giving this a thought, but who doesn't when it comes to work.? I have been quite stressed and over-analytic since several years. That lead to sleep disorders. I had been experiencing frequent bouts of sleep paralysis. This combined with being awake late night due to work overload, gradually lead to chronic sleep interruption. Then i started getting migraines. I suppose there must be a connection of the above with my tinnitus onset, however i have as well, other possible offenders to blame such as noise or medicine that i was prescribed before getting my symptoms. In any case it was an interesting reading.

I would be interested to know any kind of such therapies. Are there any suggestions?

 

Yes, you may be right, still it surprises me why some people don't get it even with ear damage or why it sounds louder at some moments when we're stressed ... at least the stress factor aggravate things for sure, but we don't need to underestimate the power of our brains, even my ENT said that 70% of most illnesses have their start in the brain.

 

I think there’s a genetic component. I got mine from cumulative exposure to loud music, but I know many people who have been exposed to more than I have and they don’t have it (at least not to the extent I do). I saw an audiologist that specializes in T and H a few days ago. She says that some people can go to many rock concerts without earplugs and not get T, whereas others will get it from ONE show WITH earplugs. If we could solve that mystery, we’d be taking a big step forward towards treatments or even a cure.

 

Yes, I also know people who played many more concerts then I do and don't have T, but I'm not 100% sure about the genetic component, you may be right, but I think it's more a mix of stress/anxiety/gut issues + noise exposure at the same time, but that's my personal experience with it, I can be wrong.

 

I speculate people with tinnitus have better memories than those without

I have an excellent memory and so does another person I know who has it.

I wonder if other people with t do? And those who expose themselves who don't get it don't consider themselves to have a good memory.

 

I also have had problems with fluid in my middle ear since I was 10. Since then, they’ve made crackly noises whenever I swallow or stretch my jaw certain ways. I’ve long “habituated” to that. Maybe this has compromised my ears somewhat. I have kind of bad neck posture too.

 

Yes I 100% agree, I have excellent memory too, and it often bothers me, I rarely forget things, wish I could, life would be much easier!

 

But don't we all have some kind of crackles in middle ear ? I mean I also have fluid in ear and my ears crackle a lot, but it fluctuates. Next week I'll have surgery for my sleep apnea issues, my ENT said that maybe my T will come down when I will finally sleep normally without interruptions. My T is really worse when I have lots of sleep apneas during night.

 

Just about the only thing the medical community agrees on in regard to T is that the vast majority of people who get T starts with a hearing loss/damage.

 

I agree, maybe I overstated that comment, but the fact that some people have hearing loss and no T, or others have T without hearing loss says to me it's not just hearing loss ... I feel a lot is ignored by the medical community about T, they always say it's just hearing loss etc, but it's much more complex then that. Also if you read the success stories from time to time, if it's only related to hearing loss, how do some people get rid of their T then if it was only related to hearing loss ? Don't get me wrong, sure hearing loss is part of it probably for some people, but not for everyone.

 

I have such a bad memory (always have had) and I have T.