Frontostriatal network dysfunction as a domain-general mechanism underlying phantom perception.

In the present study, we use resting state fMRI to investigate whether nucleus accumbens (NAc) and extended frontostriatal networks are involved in the pathology of auditory phantom perception, i.e., tinnitus, through a study of functional connectivity. We hypothesize that resting state functional connectivity involving NAc will be increased relative to what is observed in healthy subjects and that this connectivity will correlate with clinical measures of tinnitus such as percept loudness, duration of symptoms, etc. We show that a large sample of patients with chronic tinnitus (n = 90) features extensive functional connectivity involving NAc that is largely absent in healthy subjects (n = 94). We further show that connectivity involving NAc correlates significantly with tinnitus percept loudness and the duration of tinnitus symptoms, even after controlling for the effects of age and hearing loss. The loudness correlation, which involves NAc and parahippocampal cortex, is consistent with existing literature identifying the parahippocampus as a tinnitus generator. Our results further suggest that frontostriatal connectivity may predict the transition from acute to chronic tinnitus, analogous to what is seen in the pain literature. We discuss these ideas and suggest fruitful avenues for future research.

Functional connectivity analysis of fMRI data collected from human subjects with chronic tinnitus and varying levels of tinnitus-related distress.

The data presented here are functional connectivity analyses based on fMRI scans from a clinical sample of the chronic tinnitus population (n = 75). All data were obtained during an experiment in which subjects listened to auditory stimuli via headphones while undergoing fMRI scanning. The stimuli consisted of tones and bandpass noise presented at different frequencies. Stimulus frequency was the experimental factor, which was set (1) at each subject's tinnitus percept frequency (TF) and (2) at an unrelated control frequency (CF) at least one octave away from the TF stimuli. All subjects were presented with stimuli at these two frequencies. We refer the reader to our original research article "Functional brain changes in auditory phantom perception evoked by different stimulus frequencies" (Hullfish et al., 2018) for further discussion. Here, we present data specifically from group-level analyses where the subjects were divided according to their level of tinnitus-related distress. The high-distress (HD) group comprised 43 subjects with Tinnitus Questionnaire (TQ) scores greater than or equal to 47, out of a possible 82 points. The low-distress (LD) group comprised the remaining 32 subjects with TQ score less than 47. The data presented include contrasts of functional connectivity elicited by TF and CF stimuli in each group as well as contrasts between the two groups.

Functional brain changes in auditory phantom perception evoked by different stimulus frequencies.

Bayesian models of brain function such as active inference and predictive coding offer a general theoretical framework with which to explain several aspects of normal and disordered brain function. Of particular interest to the present study is the potential for such models to explain the pathology of auditory phantom perception, i.e. tinnitus. To test this framework empirically, we perform an fMRI experiment on a large clinical sample (n = 75) of the human chronic tinnitus population. The experiment features a within-subject design based on two experimental conditions: subjects were presented with sound stimuli matched to their tinnitus frequency (TF) as well as similar stimuli presented at a control frequency (CF). The responses elicited by these stimuli, as measured using both activity and functional connectivity, were then analyzed both within and between conditions. Given the Bayesian-brain framework, we hypothesize that TF stimuli will elicit greater activity and/or functional connectivity in areas related to the cognitive and emotional aspects of tinnitus, i.e. tinnitus-related distress. We conversely hypothesize that CF stimuli will elicit greater activity/connectivity in areas related to auditory perception and attention. We discuss our results in the context of this framework and suggest future directions for empirical testing.