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Featured ArticleBrief Communications

Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model

Roland Schaette and David McAlpine
Journal of Neuroscience 21 September 2011, 31 (38) 13452-13457; DOI: https://doi.org/10.1523/JNEUROSCI.2156-11.2011
Roland Schaette
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David McAlpine
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Abstract

Ever since Pliny the Elder coined the term tinnitus, the perception of sound in the absence of an external sound source has remained enigmatic. Traditional theories assume that tinnitus is triggered by cochlear damage, but many tinnitus patients present with a normal audiogram, i.e., with no direct signs of cochlear damage. Here, we report that in human subjects with tinnitus and a normal audiogram, auditory brainstem responses show a significantly reduced amplitude of the wave I potential (generated by primary auditory nerve fibers) but normal amplitudes of the more centrally generated wave V. This provides direct physiological evidence of “hidden hearing loss” that manifests as reduced neural output from the cochlea, and consequent renormalization of neuronal response magnitude within the brainstem. Employing an established computational model, we demonstrate how tinnitus could arise from a homeostatic response of neurons in the central auditory system to reduced auditory nerve input in the absence of elevated hearing thresholds.

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The Journal of Neuroscience: 31 (38)
Journal of Neuroscience
Vol. 31, Issue 38
21 Sep 2011
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Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model
Roland Schaette, David McAlpine
Journal of Neuroscience 21 September 2011, 31 (38) 13452-13457; DOI: 10.1523/JNEUROSCI.2156-11.2011

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Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model
Roland Schaette, David McAlpine
Journal of Neuroscience 21 September 2011, 31 (38) 13452-13457; DOI: 10.1523/JNEUROSCI.2156-11.2011
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  • Tinnitus with normal audiogram
    Murray Grossan, M.D.
    Published on: 30 September 2011
  • Published on: (30 September 2011)
    Page navigation anchor for Tinnitus with normal audiogram
    Tinnitus with normal audiogram
    • Murray Grossan, M.D., Otolaryngology

    Tinnitus may be at 200 or 10,000 khz, which we normally do not test for. Also, you don't need 100% of the hair cells working well to get a normal audiogram. Suppose for example, that 60% of the hair cells were functioning, and you could still get a normal audiogram? Then the tinnitus could arise from the damaged 40%

    We see this in ears where the DPOE shows damage at certain tones, but the audiogram is normal, an...

    Show More

    Tinnitus may be at 200 or 10,000 khz, which we normally do not test for. Also, you don't need 100% of the hair cells working well to get a normal audiogram. Suppose for example, that 60% of the hair cells were functioning, and you could still get a normal audiogram? Then the tinnitus could arise from the damaged 40%

    We see this in ears where the DPOE shows damage at certain tones, but the audiogram is normal, and the tinnitus is at that tone.

    We also see patients who insist they have difficulty hearing speech, yet their audiogram is normal. In some patients, we find abnormal or reduced hair cell function on DPOE.

    Conflict of Interest:

    None declared

    Show Less
    Competing Interests: None declared.

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