Tinnitus dyssynchrony-synchrony theory: a translational concept for diagnosis and treatment.
The tinnitus dyssynchrony-synchrony theory (TDST) is a hypothesis that considers tinnitus to be an abnormal, conscious, auditory percept. It is believed to originate as an initial dyssynchrony in pre- or postsynaptic neuronal transmission within the peripheral or central nervous system (cortical or subcortical). It interferes in the excitatory and inhibitory process or processes involved in maintaining homeostasis for brain neurofunction, in multiple neural substrates, and acts as an aberrant auditory stimulus to express this dysfunction via the auditory system. The conscious auditory percept for tinnitus is hypothesized to reflect clinically a summation of synchronous activities of neuronal activity recordable from multiple neural substrates at the brain cortex. The transformation from the dyssynchrony of the aberrant auditory stimulus to one of synchrony and individual brain function of affect, somatosensory response, and consciousness is clinically considered to be a final common pathway for tinnitus. The clinical application of the TDST has increased the accuracy of tinnitus diagnosis and improved the efficacy of treatment modalities attempting tinnitus relief.
Shulman
Abraham
A
Martha Entenmann Tinnitus Research Center, Forest Hills, New York, USA. metrc@inch.com
Goldstein
Barbara
B
D002540:Cerebral Cortex / Q000503:physiopathology; D049673:History, 20th Century; D006801:Humans; D008954:Models, Biological; D010036:Otolaryngology / Q000266:history; D011930:Reaction Time; D009435:Synaptic Transmission; D014012:Tinnitus / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy