PDF(Pubmed)
Abstract：
In advancing our understanding of tinnitus, some of the more impactful contributions in the past two decades have come from human brain imaging studies, specifically the idea of both auditory and extra-auditory neural networks that mediate tinnitus. These networks subserve both the perception of tinnitus and the psychological reaction to chronic, continuous tinnitus. In this article, we review particular studies that report on the nodes and links of such neural networks and their inter-network connections. Innovative neuroimaging tools have contributed significantly to the increased understanding of anatomical and functional connections of attention, emotion-processing, and default mode networks in adults with tinnitus. We differentiate between the neural correlates of tinnitus and those of comorbid hearing loss; surprisingly, tinnitus and hearing loss when they co-occur are not necessarily additive in their impact and, in rare cases, additional tinnitus may act to mitigate the consequences of hearing loss alone on the brain. The scale of tinnitus severity also appears to have an impact on brain networks, with some of the alterations typically attributed to tinnitus reaching significance only in the case of bothersome tinnitus. As we learn more about comorbid conditions of tinnitus, such as depression, anxiety, hyperacusis, or even aging, their contributions to the network-level changes observed in tinnitus will need to be parsed out in a manner similar to what is currently being done for hearing loss or severity. Together, such studies advance our understanding of the heterogeneity of tinnitus and will lead to individualized treatment plans.
摘要：
在推进我们对耳鸣的理解时，在过去的二十年中，一些更有影响力的贡献来自人脑成像研究，特别是调节耳鸣的听觉和听觉外神经网络的想法。这些网络既保护耳鸣的感知，又保护对慢性耳鸣的心理反应，持续耳鸣.在这篇文章中,我们回顾了有关此类神经网络的节点和链接及其网络间连接的特定研究。创新的神经成像工具为增加对注意力的解剖和功能联系的理解做出了重大贡献。情绪处理，和默认模式网络在成人耳鸣。我们区分耳鸣和共病听力损失的神经相关性；令人惊讶的是，同时发生的耳鸣和听力损失不一定会加重其影响，在极少数情况下，额外的耳鸣可能会减轻听力损失对大脑的影响。耳鸣的严重程度似乎也对大脑网络有影响，一些通常归因于耳鸣的改变仅在令人烦恼的耳鸣的情况下才具有意义。随着我们更多地了解耳鸣的合并症，比如抑郁症，焦虑,高音,甚至衰老，他们对耳鸣中观察到的网络水平变化的贡献需要以类似于目前对听力损失或严重程度所做的方式进行解析.一起,这些研究促进了我们对耳鸣异质性的理解，并将导致个性化治疗计划。
