National Center of Scientific Research, Université de Provence, Integrative and Adaptive Neurobiology Laboratory, Université de Provence, Centre Saint-Charles Case B, 3, place Victor Hugo, 13333 Marseille Cedex, France.
Neurosci Biobehav Rev. 2011 Apr;35(5):1089-109. doi: 10.1016/j.neubiorev.2010.11.003. Epub 2010 Nov 19.
The purpose of the current review is to propose a model highlighting the putative connections between hearing loss and the phantom perception of tinnitus (tinnitus being accompanied by hearing loss in the majority, if not all, subjects). Sensory deprivation is followed by dramatic functional and structural changes in the auditory system. Notably, while cochlear injuries are accompanied by a reduced activity in the cochlear nerve, neural activity is increased at virtually all levels in the central auditory system. We suggest that this central hyperactivity could result from a central gain increase; the general purpose of this gain modulation being to adapt neural sensitivity to the reduced sensory inputs, preserving a stable mean firing and neural coding efficiency. However, maintaining neural homeostasis at all costs, in the event of an auditory system sensory deprivation, could be done at the price of amplifying "neural noise" due to the overall increase of gain (or sensitivity), ultimately resulting in the generation of tinnitus. The clinical implications of this model are also presented.
本次综述旨在提出一个模型，强调听力损失与耳鸣的幻听（多数，如果不是全部，耳鸣伴随着听力损失）之间的假定联系。感觉剥夺后，听觉系统会发生显著的功能和结构变化。值得注意的是，虽然耳蜗损伤伴随着耳蜗神经活动减少，但在中枢听觉系统的几乎所有水平，神经活动都增加了。我们认为这种中枢过度活跃可能是由于中枢增益增加所致；这种增益调制的一般目的是调节神经敏感性，以适应减少的感觉输入，保持稳定的平均放电和神经编码效率。然而，在听觉系统感觉剥夺的情况下，不惜一切代价维持神经内稳态，可能会因增益（或敏感性）的全面增加而放大“神经噪声”，最终导致耳鸣的产生。该模型的临床意义也在本文中提出。
