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耳鸣与神经可塑性(2014年于柏林举行的第十一届国际耳鸣研讨会上的通多夫讲座)

Tinnitus and neural plasticity (Tonndorf lecture at XIth International Tinnitus Seminar, Berlin, 2014).

作者信息

Eggermont Jos J

机构信息

Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada.

出版信息

Hear Res. 2015 Jan;319:1-11. doi: 10.1016/j.heares.2014.10.002. Epub 2014 Oct 12.

Abstract

Ten years ago, animal models of noise-induced hearing loss predicted three cortical neural correlates of tinnitus resulting from noise-induced hearing loss: increased spontaneous firing rates, increased neural synchrony, and reorganization of tonotopic maps. Salicylate also induces tinnitus, however, the cortical correlates were reduced spontaneous firing rates, unchanged neural synchrony but some change to the tonotopic map. In both conditions increased central gain, potentially a correlate of hyperacusis, was found. Behavioral animal models suggested that tinnitus occurred, albeit not in all cases. The study of the neural substrates of tinnitus in humans is currently strongly based on network connectivity using either spontaneous EEG or MEG. Brain imaging combined with powerful analyses is now able to provide in excellent detail the lay out of tonotopic maps, and has shown that in people with tinnitus (and clinical normal hearing up to 8 kHz) no changes in tonotopic maps need to occur, dispensing therefore of one of the postulated neural correlates. Patients with hyperacusis and tinnitus showed increased gain, as measured using fMRI, from brainstem to cortex, whereas patients with tinnitus without hyperacusis only showed this in auditory cortex. This suggested that top down mechanisms are also needed. The open problems can be formulated by the following questions. 1) Are the neural substrates of tinnitus etiology dependent? 2) Can animal results based on single unit and local field potentials be validated in humans? 3) Can sufficient vs. necessary neural substrates for tinnitus be established. 4) What is the role of attention and stress in engraining tinnitus in memory?

摘要

十年前,噪声性听力损失的动物模型预测了噪声性听力损失导致耳鸣的三种皮质神经关联:自发放电率增加、神经同步性增加以及声调图谱重组。水杨酸盐也会诱发耳鸣,然而,其皮质关联是自发放电率降低、神经同步性不变,但声调图谱有一些变化。在这两种情况下,均发现中枢增益增加,这可能是听觉过敏的一个关联因素。行为动物模型表明耳鸣会出现,尽管并非在所有情况下都会出现。目前,人类耳鸣神经基质的研究主要基于使用自发脑电图或脑磁图的网络连接性。脑成像结合强大的分析方法现在能够非常详细地呈现声调图谱的布局,并且已经表明,耳鸣患者(以及高达8千赫兹临床听力正常者)的声调图谱无需发生变化,因此摒弃了一种假定的神经关联因素。使用功能磁共振成像测量发现,听觉过敏和耳鸣患者从脑干到皮质的增益增加,而无听觉过敏的耳鸣患者仅在听觉皮质出现这种情况。这表明自上而下的机制也是必需的。这些尚未解决的问题可以通过以下问题来阐述。1)耳鸣病因的神经基质是否相互依赖?2)基于单细胞和局部场电位的动物实验结果能否在人类身上得到验证?3)能否确定耳鸣的充分和必要神经基质?4)注意力和压力在使耳鸣铭记于记忆中起什么作用?

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