title: Phantom percepts: tinnitus and pain as persisting aversive memory networks.
abstract: Phantom perception refers to the conscious awareness of a percept in the absence of an external stimulus. On the basis of basic neuroscience on perception and clinical research in phantom pain and phantom sound, we propose a working model for their origin. Sensory deafferentation results in high-frequency, gamma band, synchronized neuronal activity in the sensory cortex. This activity becomes a conscious percept only if it is connected to larger coactivated "(self-)awareness" and "salience" brain networks. Through the involvement of learning mechanisms, the phantom percept becomes associated to distress, which in turn is reflected by a simultaneously coactivated nonspecific distress network consisting of the anterior cingulate cortex, anterior insula, and amygdala. Memory mechanisms play a role in the persistence of the awareness of the phantom percept, as well as in the reinforcement of the associated distress. Thus, different dynamic overlapping brain networks should be considered as targets for the treatment of this disorder.
authors.affiliation: Tinnitus Research Initiative, Brain Research Center Antwerp for Innovative and Interdisciplinary Neuromodulation, and Department of Neurosurgery, University Hospital Antwerp, 2650 Edegem, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.forename: Ana Belen
authors.initials: AB
authors.lastname: Elgoyhen
authors.forename: Ranulfo
authors.initials: R
authors.lastname: Romo
authors.forename: Berthold
authors.initials: B
authors.lastname: Langguth
mesh_terms: D001364:Awareness; D003243:Consciousness; D006801:Humans; D008568:Memory; D008959:Models, Neurological; D009415:Nerve Net / Q000503:physiopathology*; D010146:Pain / Q000209:etiology / Q000503:physiopathology; D010468:Perceptual Disorders / Q000209:etiology / Q000503:physiopathology*; D014012:Tinnitus / Q000209:etiology / Q000503:physiopathology*