Functional MRI evidence for a role of ventral prefrontal cortex in tinnitus

It has long been known that subjective tinnitus, a constant or intermittent phantom sound perceived by 10 to 15% of the adult population, is not a purely auditory phenomenon but is also tied to limbic-related brain regions. Supporting evidence comes from data indicating that stress and emotion can modulate tinnitus, and from brain imaging studies showing functional and anatomical differences in limbic-related brain regions of tinnitus patients and controls. Recent studies from our lab revealed altered blood oxygen level-dependent (BOLD) responses to stimulation at the tinnitus frequency in the ventral striatum (specifically, the nucleus accumbens) and gray-matter reductions (i.e., anatomical changes) in ventromedial prefrontal cortex (vmPFC), of tinnitus patients compared to controls. The present study extended these findings by demonstrating functional differences in vmPFC between 20 tinnitus patients and 20 age-matched controls. Importantly, the observed BOLD response in vmPFC was positively correlated with tinnitus characteristics such as subjective loudness and the percent of time during which the tinnitus was perceived, whereas correlations with tinnitus handicap inventory scores and other variables known to be affected in tinnitus (e.g., depression, anxiety, noise sensitivity, hearing loss) were weaker or absent. This suggests that the observed group differences are indeed related to the strength of the tinnitus percept and not to an affective reaction to tinnitus. The results further corroborate vmPFC as a region of high interest for tinnitus research.This article is part of a Special Issue entitled: Tinnitus Neuroscience.

► fMRI study compares tinnitus patients with age- and sex-matched controls.
► Activity in ventromedial and lateral prefrontal cortex is related to tinnitus percept.
► Effects are not due to depression, anxiety, hearing loss, or noise sensitivity.