A Heuristic Pathophysiological Model of Tinnitus

  • Dirk De RidderEmail author


  1. 1.

    Tinnitus pathophysiology should explain both tinnitus distress and tinnitus intensity.

  2. 2.

    Distress in tinnitus is most likely generated by an aspecific distress network consisting of the amygdala–anterior cingulate and anterior insula.

  3. 3.

    Tinnitus intensity might be encoded by gamma band activity in the contralateral auditory cortex.

  4. 4.

    This gamma band activity might result from thalamocortical dysrhythmia.

  5. 5.

    Tinnitus distress can be seen as phase-synchronized co-activation of the auditory cortex activity and the aspecific distress network.

  6. 6.

    For tinnitus to be perceived consciously, it requires the auditory cortex activity be embedded in a larger network.

  7. 7.

    This larger network could be the global workspace, the self-perception network.

  8. 8.

    The tinnitus network changes in time, hypothetically via an allostatic mechanism.

  9. 9.

    In chronic tinnitus, the parahippocampus, insula, and dorsolateral prefrontal cortex networks are critical.

  10. 10.

    The parahippocampus is involved via its auditory sensory gating mechanism, suppressing redundant auditory information.



Tinnitus Gamma Theta Thalamocortical dysrhythmia Distress Deafferentation Plasticity Reorganization Networks 



Auditory cortex


Anterior cingulate cortex


Brodman area


Blood oxygen level dependent


Band pass small


Band pass wide


Brain research center antwerp for innovative & interdisciplinary neuromodulation


Complex adaptive systems


Dorsal part of ACC


Dorsolateral prefrontal cortex




Event related potential


Functional magnetic resonance imaging




Inferior colliculus


Independent component analysis


Intraparietal sulcus


Intracranial EEG


Low resolution electro tomography


Long term potentiation


Minimally conscious state






Medial geniculate body


Nucleus basalis


Other frequency


Positron emission tomography


Posterior cingulate cortex


Persistent vegetative state


Repetitive transcranial magnetic stimulation


Supplementary motor area


Superior parietal lobule


Superior temporal gyrus


Superior temporal sulcus


Tinnitus frequency


Tinnitus questionnaire


Temporoparietal junction


Tinnitus research initiative


Ventromedial prefrontal cortex


Ventral tegmental area


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.TRI Tinnitus Clinic Antwerp, BRAI2N & Department of NeurosurgeryUniversity Hospital AntwerpEdegemBelgium

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