title: Theta-gamma dysrhythmia and auditory phantom perception.
abstract: Tinnitus is considered an auditory phantom percept analogous to phantom pain. Thalamocortical dysrhythmia has been proposed as a possible pathophysiological mechanism for both tinnitus and pain. Thalamocortical dysrhythmia refers to a persistent pathological resting state theta-gamma coupling that is spatially localized at an area where normally alpha oscillations predominate. Auditory cortex stimulation via implanted electrodes has been developed to treat tinnitus, targeting an area of activation on functional MR imaging elicited by tinnitus-matched sound presentation. The authors describe a case in which clinical improvement was correlated with changes in intracranial recordings. Maximal tinnitus suppression was obtained by current delivery exactly at the blood oxygen level-dependent activation hotspot, which colocalizes with increased gamma and theta activity, in contrast to the other electrode poles, which demonstrated a normal alpha peak. These spectral changes normalized when stimulation induced tinnitus suppression, both on electrode and source-localized electroencephalography recordings. These data suggest that thetagamma coupling as proposed by the thalamocortical dysrhythmia model might be causally related to a conscious auditory phantom percept.
authors.affiliation: Brai2n, Tinnitus Research Initiative Clinic, and Department of Neurosurgery, University Hospital Antwerp, Belgium. dirk.de.ridder@uza.be
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.forename: Elsa
authors.initials: E
authors.lastname: van der Loo
authors.forename: Sven
authors.initials: S
authors.lastname: Vanneste
authors.forename: Steffen
authors.initials: S
authors.lastname: Gais
authors.forename: Mark
authors.initials: M
authors.lastname: Plazier
authors.forename: Silvia
authors.initials: S
authors.lastname: Kovacs
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.forename: Tomas
authors.initials: T
authors.lastname: Menovsky
authors.forename: Paul
authors.initials: P
authors.lastname: van de Heyning
mesh_terms: D000328:Adult; D001298:Audiology; D001301:Audiometry, Pure-Tone; D001307:Auditory Perception; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D004569:Electroencephalography; D006320:Hearing Tests; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D015225:Magnetoencephalography; D008297:Male; D019635:Neurosurgical Procedures; D010100:Oxygen / Q000097:blood; D013826:Theta Rhythm; D014012:Tinnitus / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome
chemical_list: D010100:Oxygen