Department of Psychology, Neuroscience, and Behaviour, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4K1, Canada.
Neurosci Biobehav Rev. 2013 Sep;37(8):1754-73. doi: 10.1016/j.neubiorev.2013.07.007. Epub 2013 Jul 19.
Neural mechanisms that detect changes in the auditory environment appear to rely on processes that predict sensory state. Here we propose that in tinnitus there is a disparity between what the brain predicts it should be hearing (this prediction based on aberrant neural activity occurring in cortical frequency regions affected by hearing loss and underlying the tinnitus percept) and the acoustic information that is delivered to the brain by the damaged cochlea. The disparity between the predicted and delivered inputs activates a system for auditory attention that facilitates through subcortical neuromodulatory systems neuroplastic changes that contribute to the generation of tinnitus. We review behavioral and functional brain imaging evidence for persisting auditory attention in tinnitus and present a qualitative model for how attention operates in normal hearing and may be triggered in tinnitus accompanied by hearing loss. The viewpoint has implications for the role of cochlear pathology in tinnitus, for neural plasticity and the contribution of forebrain neuromodulatory systems in tinnitus, and for tinnitus management and treatment.
似乎用于检测听觉环境变化的神经机制依赖于预测感觉状态的过程。在这里，我们提出在耳鸣中，大脑预测它应该听到的内容（这种预测基于听觉丧失影响的皮质频率区域中异常的神经活动，并构成耳鸣知觉）与受损耳蜗传递给大脑的声信息之间存在差异。预测和传递输入之间的差异会激活听觉注意系统，通过皮质下神经调质系统促进有助于产生耳鸣的神经可塑性变化。我们回顾了耳鸣中持续听觉注意的行为和功能脑成像证据，并提出了一个关于注意在正常听力中如何运作以及在伴有听力损失的耳鸣中可能被触发的定性模型。这一观点对耳鸣中耳蜗病理学的作用、神经可塑性以及前脑神经调质系统在耳鸣中的贡献，以及耳鸣的管理和治疗都具有重要意义。
