Møller A R
School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX 75083-0688, USA.
Prog Brain Res. 2007;166:47-53. doi: 10.1016/S0079-6123(07)66004-X.
Tinnitus has many similarities with the symptoms of neurological disorders such as paresthesia and central neuropathic pain. There is considerable evidence that the symptoms and signs of some forms of tinnitus and central neuropathic pain are caused by functional changes in specific parts of the central nervous system and that these changes are caused by expression of neural plasticity. The changes in the auditory nervous system that cause tinnitus and the changes in the somatosensory systems that cause central neuropathic pain may have been initiated from the periphery, i.e. the ear or the auditory nerve for tinnitus and receptors and peripheral nerves in the body for pain. In the chronic condition of tinnitus and pain, abnormalities in the periphery may no longer play a role in the pathology, but the tinnitus is still referred to the ear and central neuropathic pain is still referred to the location on the body of the original pathology. In this chapter we will discuss specific similarities between tinnitus and pain, and compare tinnitus with other phantom disorders. Since much more is known about pain than about tinnitus, it is valuable to take advantage of the knowledge about pain in efforts to understand the pathophysiology of tinnitus and find treatments for tinnitus.
耳鸣与诸如感觉异常和中枢神经性疼痛等神经障碍的症状有许多相似之处。有大量证据表明,某些形式的耳鸣和中枢神经性疼痛的症状和体征是由中枢神经系统特定部位的功能变化引起的,并且这些变化是由神经可塑性的表达所致。导致耳鸣的听觉神经系统变化以及导致中枢神经性疼痛的体感系统变化可能始于外周,即耳鸣源于耳朵或听神经,而疼痛源于身体中的感受器和外周神经。在耳鸣和疼痛的慢性状态下,外周异常可能不再在病理过程中起作用,但耳鸣仍被认为与耳朵有关,中枢神经性疼痛仍被认为与身体上原始病理部位有关。在本章中,我们将讨论耳鸣与疼痛之间的具体相似之处,并将耳鸣与其他幻肢障碍进行比较。由于对疼痛的了解比对耳鸣的了解多得多,利用有关疼痛的知识来努力理解耳鸣的病理生理学并找到耳鸣的治疗方法是很有价值的。