Abstract:
Tinnitus, the auditory phantom percept, is a well-known heterogenous disorder with multiple subtypes. Researchers and clinicians have tried to classify these subtypes according to clinical profiles, aetiologies, and response to treatment with little success. The occurrence of overlapping tinnitus subtypes suggests that the disorder exists along a continuum of severity, with no clear distinct boundaries. In this perspective, we propose a neuro-mechanical framework, viewing tinnitus as a dimensional disorder which is a complex interplay of its behavioural, biological and neurophysiological phenotypes. Moreover, we explore the potential of these dimensions as interacting networks without a common existing cause, giving rise to tinnitus. Considering tinnitus as partially overlapping, dynamically changing, interacting networks, each representing a different aspect of the unified tinnitus percept, suggests that the interaction of these networks determines the phenomenology of the tinnitus, ultimately leading to a dimensional spectrum, rather than a categorical subtyping. A combination of a robust theoretical framework and strong empirical evidence can advance our understanding of the functional mechanisms underlying tinnitus and ultimately, improve treatment strategies.
摘要:
耳鸣,听觉幻影感知,是一种众所周知的具有多种亚型的异质性疾病。研究人员和临床医生试图根据临床资料对这些亚型进行分类,病因学,对治疗的反应收效甚微。重叠的耳鸣亚型的发生表明,这种疾病是沿着严重程度的连续体存在的,没有明确的界限。从这个角度来看,我们提出了一个神经机械框架,将耳鸣视为一种维度障碍,这是其行为的复杂相互作用,生物和神经生理表型。此外,我们探索这些维度作为交互网络的潜力,没有共同的现有原因,引起耳鸣.考虑到耳鸣部分重叠,动态变化,互动网络,每个代表统一耳鸣感知的不同方面,表明这些网络的相互作用决定了耳鸣的现象学,最终导致了一个维度的光谱,而不是分类子类型。一个强大的理论框架和强大的经验证据的结合可以促进我们对耳鸣的功能机制的理解,并最终,改进治疗策略。