Schaette Roland
UCL Ear Institute, 332 Gray's Inn Road, London WC1X 8EE, UK.
Hear Res. 2014 May;311:63-71. doi: 10.1016/j.heares.2013.12.004. Epub 2013 Dec 25.
The phantom auditory sensation of tinnitus is now studied in humans, animals, and computer models, and our understanding of how tinnitus is triggered and which neural mechanisms give rise to the phantom sensation in the brain has increased considerably. In most cases, tinnitus is associated with hearing loss, and even tinnitus patients with normal hearing thresholds might have cochlear damage that is not detected through conventional audiometry, as has been recently shown through auditory brainstem response measurements. Animals show behavioural signs of tinnitus after induction of hearing loss, indicating a causal relation. Moreover, surgical reduction of hearing loss in otosclerosis can reduce or even abolish tinnitus. However, hearing loss does not always lead to tinnitus. Psychophysical measurements have indicated that certain types of cochlear damage might be more closely linked to tinnitus than others. Recent animal studies have used behavioural testing to distinguish between animals with and without tinnitus after noise exposure. Comparisons between these groups of animals have helped identify neural correlates of tinnitus as well as factors that could represent a predisposition for tinnitus. Human neuroimaging studies have also begun to separate the neural signature of tinnitus from other consequences of hearing loss. The functional mechanisms that could underlie tinnitus development tinnitus have been analysed in computational modelling studies, which indicate that tinnitus could be a side-effect of the brain's attempt to compensate for hearing loss. Even though causal treatments for tinnitus are currently not available, hearing aids can provide considerable benefit when used in conjunction with counselling, tinnitus retraining therapy or cognitive behavioural therapy. Finally, animal studies demonstrate that the development of chronic noise-induced tinnitus might be prevented through timely interventions after noise exposure. This article is part of a Special Issue entitled <Annual Reviews 2014>.
目前,人们在人类、动物和计算机模型中对耳鸣的幻听感觉进行了研究,我们对耳鸣如何引发以及哪些神经机制在大脑中产生幻听感觉的理解有了显著提高。在大多数情况下,耳鸣与听力损失有关,而且正如最近通过听觉脑干反应测量所显示的那样,即使听力阈值正常的耳鸣患者也可能存在通过传统听力测定法未检测到的耳蜗损伤。动物在听力损失诱发后会表现出耳鸣的行为迹象,这表明存在因果关系。此外,耳硬化症患者听力损失的手术减轻可以减少甚至消除耳鸣。然而,听力损失并不总是导致耳鸣。心理物理学测量表明,某些类型的耳蜗损伤可能比其他损伤与耳鸣的联系更紧密。最近的动物研究使用行为测试来区分噪声暴露后有耳鸣和无耳鸣的动物。这些动物组之间的比较有助于确定耳鸣的神经关联以及可能代表耳鸣易感性的因素。人类神经影像学研究也已开始将耳鸣的神经特征与听力损失的其他后果区分开来。在计算建模研究中分析了可能是耳鸣发展基础的功能机制,这些研究表明耳鸣可能是大脑试图补偿听力损失的副作用。尽管目前尚无针对耳鸣的因果治疗方法,但助听器与咨询、耳鸣再训练疗法或认知行为疗法结合使用时可带来显著益处。最后,动物研究表明,在噪声暴露后及时进行干预可能预防慢性噪声性耳鸣的发生。本文是名为《2014年年评》特刊的一部分。