Neural substrates predicting improvement of tinnitus after cochlear implantation in patients with single-sided deafness

Notwithstanding successful reduction of tinnitus after cochlear implantation (CI) in patients with single-sided deafness (SSD) in recent studies, neither the exact mechanism of suppression nor the predictors of the amount of improvement are fully understood yet. We collected quantitative electroencephalography (qEEG) data from nine SSD patients who underwent CI for tinnitus management. By correlating the degree of improvement in tinnitus intensity and tinnitus-related distress with preoperative source-localized qEEG findings and comparing qEEG findings of patients with marked improvement after CI with those with relatively slight improvement with regard to source-localized activity complimented by connectivity analysis, we attempted to find preoperative predictors of tinnitus improvement. Our results showed increased activities of the auditory cortex (AC), posterior cingulate cortex (PCC) and increased functional connectivity between the AC and PCC as negative prognostic factors for the reduction of tinnitus intensity after CI in patients with SSD. Also, relatively increased activity of the right dorsolateral prefrontal cortex and decreased connectivity between distress-related areas such as the orbitofrontal cortex/parahippocampus and sensory-perception areas such as the AC/precuneus were found in patients with relatively slight improvement in tinnitus-related distress as compared with those with marked improvement. The current study suggests that preoperative cortical oscillations can be applied to predict post-CI tinnitus reduction in patients with SSD.

► Preoperative EEG findings may predict post-CI tinnitus reduction in single-side deafness.
► Increased auditory/posterior cingulate cortical activities predict less tinnitus reduction.
► Increased dorsolateral prefrontal cortical activity predicts less distress reduction.