Pittsburgh Hearing Research Center and Department of Otolaryngology, University of Pittsburgh, Pittsburgh, Pennsylvania.
Center for Neuroscience, University of Pittsburgh, Pittsburgh, Pennsylvania.
Physiol Rev. 2021 Oct 1;101(4):1609-1632. doi: 10.1152/physrev.00029.2020. Epub 2021 Mar 26.
Tinnitus is a pervasive public health issue that affects ∼15% of the United States population. Similar estimates have also been shown on a global scale, with similar prevalence found in Europe, Asia, and Africa. The severity of tinnitus is heterogeneous, ranging from mildly bothersome to extremely disruptive. In the United States, ∼10-20% of individuals who experience tinnitus report symptoms that severely reduce their quality of life. Due to the huge personal and societal burden, in the last 20 yr a concerted effort on basic and clinical research has significantly advanced our understanding and treatment of this disorder. Yet, neither full understanding, nor cure exists. We know that tinnitus is the persistent involuntary phantom percept of internally generated nonverbal indistinct noises and tones, which in most cases is initiated by acquired hearing loss and maintained only when this loss is coupled with distinct neuronal changes in auditory and extra-auditory brain networks. Yet, the exact mechanisms and patterns of neural activity that are necessary and sufficient for the perceptual generation and maintenance of tinnitus remain incompletely understood. Combinations of animal model and human research will be essential in filling these gaps. Nevertheless, the existing progress in investigating the neurophysiological mechanisms has improved current treatment and highlighted novel targets for drug development and clinical trials. The aim of this review is to thoroughly discuss the current state of human and animal tinnitus research, outline current challenges, and highlight new and exciting research opportunities.
耳鸣是一个普遍存在的公共卫生问题,影响了美国约 15%的人口。在全球范围内也有类似的估计,在欧洲、亚洲和非洲也发现了类似的患病率。耳鸣的严重程度不同,从轻度不适到极度干扰。在美国,约 10-20%经历耳鸣的人报告说,耳鸣症状严重降低了他们的生活质量。由于个人和社会负担巨大,在过去的 20 年里,对基础和临床研究的协同努力极大地提高了我们对这种疾病的理解和治疗水平。然而,既没有完全理解,也没有治愈方法。我们知道,耳鸣是一种持续的、不由自主的、内部产生的、非言语的、不清晰的噪音和音调的幻觉感知,在大多数情况下,耳鸣是由获得性听力损失引起的,只有当这种损失与听觉和听觉外脑网络中的特定神经元变化相结合时,耳鸣才会持续存在。然而,对于耳鸣的感知产生和维持所必需的和充分的神经活动的确切机制和模式仍不完全了解。动物模型和人类研究的结合将是填补这些空白的关键。尽管如此,在研究神经生理机制方面的现有进展已经改善了当前的治疗方法,并突出了药物开发和临床试验的新靶点。本综述的目的是全面讨论人类和动物耳鸣研究的现状,概述当前的挑战,并强调新的和令人兴奋的研究机会。
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